Since the Children and Families Act 2014, young people and parents appear (on paper) to have a bigger role than ever in negotiating Special Educational Needs provision for themselves/their children. However, recent studies have suggested this is not necessarily the case (Craston et al, 2013a; 2013b; 2013c), particularly for young people with a hidden impairment, such as dyslexia (Ross, 2013b; 2013c). This current study explored the experiences of dyslexic young people, their parents/carers and their teachers in relation to dyslexia-related support interventions. Over 5 months in 2015, fieldwork was undertaken at Hilltop View School (pseudonym), in a ‘Pathfinder’ Local Authority (The Stationary Office, 2011) in the South-West of England. Young people, parents and carers, and teachers participated in focus group sessions and one-to-one interviews. Lessons were also observed. Participants’ understandings of dyslexia, it’s effect on young people’s self-concept and subsequent ability to negotiate social spaces to secure provision of resources were explored within a framework based on Jenkins’ (2008) ‘levels of interaction’, grounded in a Bourdieusien model of the social world. Through the use of this unique theoretical framework, participants were found to have differing capacities to negotiate their own social space at different ‘levels of interaction’ (Jenkins, 2008). Young people and teachers were found to have the best capacity to navigate their social setting at an ‘interactional level’ (person to person interactions), while parents appeared to have more opportunity to engage at the ‘institutional level’ (person/institution to institution interactions). This study provides an understanding of the experiences of stakeholders within a changing policy framework and provides a new theoretical framework within which to undertake investigations into the experiences of stakeholders in SEND provision.

In this thesis I (1) identify some problems in the Popperian scientific method; (2) develop, as an alternative, and to a level of usability, a phenomenological method of knowing; (3) use this method to make a series of inferences about the nature of the human self; (4) compare and contrast my inferences with those of other scholars working on the same themes; and (5) let some of my inferences suggest ways of developing the method further. I show (1:1) how the scientific method is underpinned by a paradigm of ontic dualism; (1:2) how this paradigm has led to a certain conception of the human self; and (1:3) how this conception has led to the normalization of harmful ways of acting in the world, and thus to a planet made up of living beings who cannot find a steady fit with each other's life-ways. I develop an alternative method by building on the work of (2:1) Goethe, (2:2) Holdrege, (2:3) Ellis and (2:4) Heidegger. In essence this method consists of recalling and making inferences from one's experience. (3:1) I undertook a set of six activities (sometimes spoken of as 'Sufism'). (3:2) I try to understand my findings in the light of the ideas of four scholars: the teacher who leads these activities, Murshid Saadi, eleventhcentury polymath ibn Sina, anthropologist Tim Ingold and philosopher David Abram. (3:3) I make fifteen inferences about the human self, falling into seven themes: monism, mood, willing, perceiving, speaking, growing, and substantiveness. (4) Comparing and contrasting my conclusions with those of other scholars suggests that they are valid. (5) I develop the method further by incorporating into it the delineation of classes of phenomena and the delineation of patterns of phenomenal change. I end by discussing some implications for ethical human life-ways.

O combate à epidemia do tabagismo é prioridade estabelecida pela Organização Mundial de Saúde. Objetivou-se estabelecer a prevalência do tabagismo e seu efeito na voz dos servidores e alunos do campus de Bauru da Universidade de São Paulo. Através da aplicação de um questionário autoexplicativo foram avaliadas as características sociodemográficas, saúde geral, voz, e comportamento em relação ao tabagismo. Avaliou-se a prevalência do hábito, o grau de dependência à nicotina (Teste de Fagerstrom) e a motivação para interrupção do hábito (Teste de Richmond). Os resultados foram analisados no programa Statistica for Windows versão 5.1. Foram aplicados os testes qui-quadrado e correlação de Spearman entre grupos, com nível de significância de 5%. O índice de resposta obtido foi de 62,8%, ou seja, 628 respondentes. A maioria dos entrevistados era do sexo feminino (74,5%), com idade entre 18 e 29 anos (46,2%) e com grau de instrução até o ensino médio (57,8%). Com relação ao hábito de fumar 10,5% eram fumantes e 10,5% ex-fumantes. O percentual de alunos fumantes (4,1%) foi significativamente menor comparado aos valores observados para funcionários (p<0,001). A prevalência de fumantes foi significativamente maior entre os entrevistados do sexo masculino (p=0,003), com menor nível de instrução (p<0,001) e na faixa etária com mais de 50 anos (p<0,001). Houve correlação estatisticamente significante entre o grau de dependência à nicotina e o nível de instrução (p< 0,001). No entanto, a motivação para interromper o hábito não mostrou correlação com o nível de instrução (p=0,344). Os fumantes apresentaram sintomas e sensações vocais e laringofaríngeas com frequência significativamente maior do que os não fumantes, incluindo: tosse seca (p<0,001) e com catarro (p<0,001), pigarro (p<0,001), secreção na garganta (p=0,006), garganta seca (p=0,010), rouquidão (p=0,001) e voz grossa (p<0,001). O percentual de satisfação com a própria voz foi 93% em ambos os grupos. Com relação aos cuidados com a voz, 54,3% da amostra havia recebido orientações prévias sobre o assunto. Os dados disponibilizados demonstram a necessidade de estratégias locais adequadas para prevenção e cessação do tabagismo no campus de Bauru. / The fight against the smoking epidemic is a priority established by the World Health Organization. This study analyzed the prevalence of smoking and its effect on the voice of professors, employees and students at the Bauru campus of University of São Paulo. A self-explaining questionnaire was applied to evaluate the sociodemographic characteristics, general health, voice and behavior in relation to smoking. The study evaluated the prevalence of the habit, degree of smoking dependence (Fagerstrom test) and motivation to interrupt the habit (Richmond test). The results were analyzed on the software Statistica for Windows version 5.1. The chi-square and the Spearmen correlation tests were applied between groups, at a significance level of 5%. The response rate was 62.8%, i.e. 628 participants. Most interviewees were females (74.5%), aged 18 to 29 years (46.2%) and with educational level up to high school (57.8%). Concerning the smoking habit, 10.5% were smokers and 10.5% were ex-smokers. The percentage of smoker students (4.1%) was significantly lower compared to the values observed among employees (p<0.001). The prevalence of smokers was significantly higher among male interviewees (p=0.003), with lower educational level (p<0.001) and in the age range older than 50 years (p<0.001). There was statistically significant correlation between smoking dependence and the educational level (p<0.001). However, the motivation to interrupt the habit did not show correlation with educational level (p=0.344). The smokers exhibited vocal symptoms and throat sensations with significantly higher frequency than non-smokers, including dry cough (p<0.001) with catarrh (p<0.001), hem (p<0.001), throat secretion (p=0.006), dry throat (p=0.010), hoarseness (p=0.001) and harsh voice (p<0.001). The percentage of satisfaction with the own voice was 93% for both groups. Concerning the care with the voice, 54.3% of the sample had received previous information on the subject. These data demonstrate the need of adequate local strategies for prevention and interruption of smoking at the Bauru campus.

A busca pela qualidade de vida originou a necessidade de se compreender melhor os aspectos envolvidos no processo de envelhecimento, visando minimizar suas consequências. Embora existam muitos estudos sobre a voz do idoso, a compreensão sobre quais aspectos interferem na qualidade de vida em voz desta população, ainda não é muito explorada. O objetivo do estudo é averiguar o impacto dos aspectos respiratórios e dos aspectos vocais na qualidade de vida em voz de idosos. Participaram 56 idosos acima de 60 anos de idade, sendo 39 mulheres e 17 homens. Foram realizados os procedimentos de avaliação vocal utilizando a Escala Analógica Visual para a análise perceptivo-auditiva da vogal sustentada /a/ e da conversa espontânea e, o programa computadorizado Mult Dimension Voice Program (MDVP), KayPentax, para a análise acústica, dos parâmetros frequência Fundamental (F0), desvio padrão da frequência fundamental (dp F0), shimmer, cociente de perturbação de amplitude (APQ,) jitter, cociente de perturbação de frequência (PPQ) e proporção ruído-harmônico (NHR). Também foi realizada a anamnese quanto aos sintomas e hábitos vocais, avaliação laríngea por meio de exame de nasolaringoscopia para caracterização da amostra; a avaliação da respiração, incluindo medidas de capacidade vital (CV), volume fonatório (VF), fluxo médio fonatório (FMF) e cociente fônico simples (CFS), por meio do espirômetro Pony Fx; a avaliação do tempo máximo de fonação (TMF) durante a emissão de /a/, /s/, /z/ e contagem de números, além da aplicação do Questionário de Qualidade de Vida em Voz (QVV). Foram utilizados o teste t e Mann-Whitney para a comparação dos parâmetros estudados, entre mulheres e homens idosos, e Spearman para correlação entre os dados. Adotou-se nível de significância de 5% para todos os testes.Os idosos do presente estudo apresentaram maior porcentagem de ocorrência de ato de pigarrear, falar alto e ter problemas digestivos e características laríngeas de arqueamento vocal de prega vocal, fenda glótica fusiforme e constrições supraglóticas, sendo mais evidentes no sexo masculino. Os idosos em geral, consideraram suas vozes como sendo boas, além de apresentarem elevado grau de qualidade de vida em voz, com pontuações próximas a 100% para todos os domínios. Quanto à qualidade vocal, os idosos apresentaram características de rugosidade, soprosidade e instabilidade, com diferença estatisticamente significante para o parâmetro rugosidade, sendo maior para os homens. Esta avaliação obteve uma confiabilidade, em sua maioria, excelente, tanto para o julgamento intra como interjuízes. Foi observada correlação positiva do parâmetro rugosidade com o Protocolo QVV no sexo feminino. Quanto às medidas acústicas, também foram observadas diferenças estatisticamente significantes para os parâmetros F0, shimmer e APQ, sendo estes dois últimos maiores para os homens. Foi verificado que estes três parâmetros quando aumentados, interferem negativamente na qualidade de vida em voz das mulheres idosas. As medidas espirométricas evidenciaram diferença significante entre os sexos, tendo valores elevados para os homens. Não foi verificada correlação destas medidas com o Protocolo QVV. Os TMF, assim como a espirometria, evidenciaram diferenças quanto ao sexo, com maiores valores de /a/ e /s/ para os homens. Foi observada correlação do TMF de /a/ e /s/ e da relação s/z com o Protocolo QVV apenas para o sexo masculino. Desta forma, concluiu-se que os aspectos vocais têm impacto negativo na qualidade de vida em voz das mulheres idosas e os aspectos respiratórios são os que mais interferem na qualidade de vida em voz dos homens. / The search for quality of life led to the need to better understand the is aspects involved in the aging process in order to minimize its consequences. Although there are many studies about the aging voice, understanding aspects of which interfere in quality of life in voice this population, still not much explored. The objective of the study is to investigate the impact of respiratory aspects and vocals aspects in quality of life in healthy elderly voice. Participated 56 elderly above 60 years of age, 39 women and 17 men. Was performed the assessment procedures vocal using the Visual Analogue Scale for perceptive analysis - hearing the vowel / a / and spontaneous conversation and, Mult Dimension Voice Program (MDVP) the computerized program, KayPentax, to acoustic analysis, the parameters average fundamental frequency (F0), standard derivation of fundamental frequency (SD F0), shimmer, amplitude perturbation quotient (APQ), jitter, pitch perturbation quotient (PPQ) and harmonic-noise ratio (NHR). Was also performed the interview about symptoms and vocal habits, laryngeal assessment through examination of nasolaryngoscopy for sample characterization, assessment of breathing, including measures of vital capacity (VC), phonation volume (VF), mean flow phonation (FMF ) and phonic simple quotient (CFS) through the spirometer Pony Fx; evaluating the maximum phonation (TMF) for issuing / a /, / s /, / z /, and counting numbers, besides the application of Quality of Life questionnaire in Voice (QLV). Were used the \"t\" test and Mann-Whitney for the compare the parameters studied, among elderly women and men and Spearman used for correlation between the data. Was adopted significance level of 5% for all tests. The elderly of the present study had higher percentage of occurrence of the act of clearing the throat, speak loudly and have problems digestive and laryngeal characteristics of arching vocal fold, glottic fusiform slit and supraglottic constrictions, being more evident in males. The elderly in general considered their voices as being good, besides presenting high level of quality of life in voice, with scores close to 100% for all domains. As the vocal quality presented characteristics of roughness, breathiness and instability, with statistically significant difference for the roughness parameter, being higher for men. This review obtained a trustworthiness, in their majority, excellent, both for the intra judgment as inter judges. Was observed positive correlation the roughness parameter with the Protocol V-RQOL in females. As for acoustic measures have also been observed statistically significant differences to the parameters F0, shimmer and APQ, latter two being larger for men. Was found that these three parameters when increased, negatively affect the quality of life in voice of elderly women. The spirometric measurements showed significant differences between the sexes, having high values for men. No correlation was verified of these measures with the Protocol V-RQOL. The MPT as well as spirometry, showed differences according to the sexes, with higher values of /a/ and /s/ for men. Correlation was observed of MPT /a/ and /s/ and s/z ratio with Protocol V-RQOL only for males. In this way, it was concluded that the vocal aspects have negative impact on quality of life in voice of elderly women and the respiratory aspects are the ones most interfere in the quality of life in men voice.

A maior incidência de disfonia em profissionais que utilizam a voz falada como instrumento de trabalho está entre os professores. O distúrbio da voz relacionado ao trabalho é caracterizado como qualquer alteração vocal diretamente relacionada ao uso da voz durante a atividade profissional que diminua, comprometa ou impeça a atuação e/ou a comunicação do trabalhador. Fatores ambientais e organizacionais podem atuar como atores principais ou coadjuvantes ao desenvolvimento da doença, que freqüentemente ocasiona incapacidade laboral temporária ou permanente; pode ou não haver lesão nas pregas vocais secundária ao uso vocal. Evidências científicas abundantes mostram a contribuição da saúde geral para a qualidade de vida das pessoas ou de populações. Da mesma forma, é sabido que muitos componentes da vida social contribuem para uma vida com qualidade. No caso dos professores, esses componentes envolvem questões muito além do uso excessivo da voz, como problemas de adaptação profissional, condições ruins de trabalho, espaço físico inadequado devido a higiene do ambiente e ao número de alunos ou à má condição acústica da classe, violência, pouco tempo de preparo para as aulas e o estresse gerado pela má remuneração e pelas más condições gerais de trabalho e saúde, entre outros. Muito pode ser evitado se houver atenção à saúde vocal do professor, que deveria ser iniciado durante a formação profissional, visto que muitos professores apresentam episódios de disfonia antes do término da graduação. Com essa mudança, os prejuízos com o absenteísmo dos professores às salas de aulas, que em 2004 ultrapassaram duzentos milhões de reais, poderão ser diminuídos. É preciso ouvir o educador para a elaboração de leis que garantam ao professor o direito de ter o seu distúrbio vocal, quando relacionado ao trabalho, reconhecido como uma doença ocupacional. O objetivo do presente é observar a influência da alteração vocal nos aspectos profissional, pessoal e emocional dos professores da rede pública municipal da cidade de Ribeirão Preto. Participaram da amostra 118 professores, atuantes em salas de aula, da rede municipal de Ribeirão Preto, ambos os sexos, do ensino infantil, fundamental e médio e 96 sujeitos nãoprofessores (controle). Todos foram solicitados a responder o protocolo Vapp – Voice Activity and Participation Profile e o questionário de caracterização da amostra. Os resultados mostraram que a prevalência de 93% de queixa de disfonia entre os professores da rede pública municipal da cidade de Ribeirão Preto/SP e baixos escores de auto-percepção quanto à severidade do problema vocal, como também para a influência dos efeitos da alteração vocal no trabalho, na comunicação diária, na comunicação social e nas emoções. Os valores do PLA revelaram que no momento da entrevista, os professores consideravam-se pouco limitados em suas atividades devido ao problema vocal. Os valores do PRP mostraram que nos últimos seis meses os professores foram pouco restritos em participar de atividades profissionais e de vida diária devido ao problema vocal. Pode ser concluído que os professores da rede municipal de Ribeirão Preto apresentaram baixa influência de problemas vocais nos aspectos profissional, pessoal e emocional no momento da entrevista como também nos últimos seis meses. / The largest dysphonia incidence in professionals that use the voice spoken as work instrument is among the teachers. The disturb of the voice related to the work is characterized directly as any vocal alteration related to the use of the voice during the professional activity that decreases, commit or impede the performance and/or the worker's communication. Environmental and organization factors can act as main or helping actors to the development of the disease, that frequently causes inability temporary or permanent. It cannot or there not to be lesion in the secondary vocal folds to the vocal use. Many scientific evidences show the contribution of the general health forthe quality of the people's life or of populations. In the same way, it is known that many components of the social life contribute to a life with quality. In the teachers' case, those components involve many subjects besides the excessive use of the voice, as problems of professional adaptation, unsatisfactory conditions of work, inadequate physical space due to hygiene of the atmosphere and to the number of students or the bad acoustic condition of the class, violence, little time of prepare for the classes and the stress generated by the bad remuneration and for the bad general conditions. A lot it can be avoided, if there is primary attention to the teacher's vocal health, that should be begun during its professional formation, because many teachers present disfonia episodes before the end of its. With that change, the damages with the absence of the teachers to the rooms of classes, that surpassed two hundred million reals in 2004,. It is necessary to hear the educator for the elaboration of laws that could guarantee to the teacher the right of having the voice disturbance related to the work recognized as a occupational disease. The objective of the present was to observed the influence of the dysphonia in the professional, personal and emotional aspects of the Ribeirão Preto's teachers. They participated in the 118 teachers (10% of the total number of teachers),who worked in class rooms, both sexes, of the infantile, fundamental and medium level and 96 subject no-teachers (control group). Everybody was requested to answer the protocol Vapp - Voice Activity and Participation Profile and the questionnaire of characterization of the sample. The results showed prevalence of 94% dysphonia complaint between the teachers of the municipal public schools of Ribeirão Preto/SP's city and low solemnityperception scores with relationship to the severity of the vocal problem, as well as for the influence of the effects of the vocal alteration in the work, in the daily communication, in the social communication and in the emotions. The values of ALS revealed that in the moment of the interview, the teachers were considered not very limited in its activities due to the vocal problem. The values of PRS revealed that in the last six months the teachers were not very restricted in participating in professional activities and of daily life due to the vocal problem. It can be concluded that the teachers of the municipal public net of the city of Ribeirão Preto presented low influence of vocal problems in the aspects professional, personal and emotional in the moment of the interview as well as in the last six months.

Os indivíduos portadores de desproporções maxilomandibulares apresentaram características miofuncionais orais peculiares ao tipo de desproporção que apresentam. Anormalidades na relação dento-esquelética acarretam prejuízos estéticos e funcionais aos indivíduos, tais como a modificação do espaço anatômico da cavidade oral, que pode vir a desencadear problemas na fala e na voz, assim como prejuízos na respiração. O objetivo do estudo é compreender as características respiratórias e fonoarticulatórias em indivíduos com deformidades dentofaciais submetidos a preparo ortodôntico pré-cirúrgico e verificar se há diferenças entre esses indivíduos comparativamente a indivíduos com equilíbrio dentofacial. Participaram 60 indivíduos de 18 a 40 anos de idade, 30 portadores de deformidades dentofaciais e 30 de um grupo controle. A avaliação da fonoarticulação foi realizada por meio da diadococinesia (DDC) das emissões /pa/, /ta/, /ka/, /pataka/, /a/ e /i/; Tempo Maximo de Fonação (TMF) durante a emissão de /a/, /i/, /u/, /s/, /z/ e contagem de números; avaliação da respiração, incluindo as medidas da capacidade vital e coordenação pneumofonoarticulatória, por meio da espirometria. Foram utilizados os programas computadorizados Sound Forge (Sony), Mult Speech Main Program e Motor Speech Profile Advanced (Kay Elemetrics) e o espirômetro PonyFx. O teste t de Student foi utilizado para comparação dos resultados entre osindivíduos com DDF e os indivíduos com equilíbrio dentofacial, adotando-se o nível de significância de 5%. Os indivíduos com DDF produziram menor número de emissões por segundo comparados ao grupo controle nas seguintes emissões da DDC: sílaba ka para o total de indivíduos (p=0,049), sequência pataka para o subgrupo Padrão III (p=0,012) e para mulheres (p=0,001). Os parâmetros relacionados à irregularidade dos ciclos de algumas emissões da DDC foram produzidas com valores mais elevados pelos indivíduos com DDF do que o grupo controle : maior coeficiente de variação da intensidade da silaba ta para o total de indivíduos (p=0,016) e para o subgrupo Padrão III (p=0,023); maior valor de desvio-padrão do período da sílaba pa para o total de indivíduos (p=0,046) e para o as mulheres (p=0,036); maior valor de desvio-padrão do período da sílaba ta no subgrupo Padrão III (p=0,047) e para o total de indivíduos (p=0,032); maior valor de perturbação do período da silaba pa para o total de indivíduos (p=0,024) e para as mulheres (p=0,031); maior valor de desvio padrão do período da vogal ï para as mulheres (p=0,027). Em relação ao TMF, os indivíduos com DDF apresentaram valores inferiores do que os indivíduos com equilíbrio dentofacial nas emissões: s para o subgrupo Padrão II (p=0,005) e homens (p=0,019); z para o subgrupo Padrão II (p=0,009); contagem de números para os homens (p=0,044). As medidas extraídas pela espirometria foram semelhantes entre os indivíduos com e sem DDF. Concluiu-se que foram encontradas diferenças entre indivíduos com deformidades dentofaciais, comparativamente a indivíduos com equilíbrio dentofacial, quanto à velocidade, e diversos parâmetros de estabilidade da DDC oral e quanto ao desvio-padrão do período da DDC laríngea. O grupo de pacientes com DDF não apresentou características respiratórias diferentes do grupo controle, mas apresentou valores reduzidos de TMF em emissões que contêm fonemas consonantais. / Individuals presented with maxillomandibular disproportions will show oral miofunctional characteristics peculiar to the type of disproportion they exhibit. Abnormalities in the dento-skeletal relation lead to aesthetic and functional losses, such as modification of the anatomical space of the oral cavity, which may trigger problems in ones voice, and in syllable production, as well as breathing damages.This study aims at understanding the respiratory and phonoarticulatory characteristics in individuals presented with dentofacial deformities, submitted to presurgical orthodontic preparation and verify whether there are differences among individuals presented with dentofacial deformities, as compared to individuals with dentofacial balance. Sixty subjects, in the age range 18 - 40 years, 30 presented with dentofacial deformities and 30 of a control group, participated in the study. Phonoarticulation assessment was performed through diadochokinesia (DDC) of emissions /pa/, /ta/, /ka/, /pataka/, /a/ and /i/; Maximum Time of Phonation (MTP) during the emission of /a/, /i/, /u/, /s/, /z/ and number counting; breathing assessment, including measurements of vital capacity and pneumophonoarticulatory coordination, through spirometry. Softwares Sound Forge (Sony), Mult Speech Main Program and Motor Speech Profile Advanced (Kay Elemetrics) and PonyFx spirometer, were utilized. Student´s t test was used for comparison between the results of individuals presented with DFD and those of individuals with dentofacial balance, by adopting the 5% significance level. Subjects presented with DFD produced a smaller number of emissions, per second, as compared to the control group, in the following DDC emissions: syllable ka for the total of individuals (p=0,049), sequence pataka for the Pattern III subgroupI (p=0,012) and for women (p=0,001). Some DDC emissions were produced with more elevated values by individuals presented with DFD, than the control group, regarding the parameters related to the irregularity of the cycles: greater intensity variation coefficient of the syllable ta for the total of individuals (p=0,016) and for the Pattern III subgroup (p=0,023); greater standard variation value of the pa syllable period for the total of subjects (p=0,046) and for the women (p=0,036); greater SD value of the ta syllable period in the Pattern III subgroup (p=0,047) and for the total of individuals (p=0,032); greater disturbance value of the pa syllable period for the total of individuals (p=0,024) and for the women (p=0,031); greater SD value of the vowel ï period for the women (p=0,027). In relation to Maximum phonation time (MPT), the individuals with DFD presented lower values than subjects with dentofacial balance in the emissions: s for the Pattern II subgroup (p=0,005) and men (p=0,019); z for Pattern II subgroup (p=0,009); counting of numbers for men (p=0,044). The measurements extracted through spirometry were similar among individuals with and without DFD. Differences were found between individuals with dentofacial deformities and individuals with dentofacial balance, as to the speed, and several stabiliity parameters of oral DDC and as to the SD of laryngeal DDC. The group of patients with DFD did not present respiratory characteristics different from those of the control group, but presented reduced MPT values in emissions which contain consonant phonemes.

Schools, and in particular physical education (PE), have been increasingly recognised for the role that they play in promoting healthy, active lifestyles amongst children and young people in light of the public health agenda (Armour and Harris, 2013). However, whilst schools have been recognised for the role that they can play in promoting health to children and young people, concerns have been expressed with regard to the status of health in PE and the approaches and practices used to address health-related learning (Cale et al., 2016). A particular concern in this regard is what children and young people know and understand about health , and how they come to conceive this within PE, with a growing body of literature suggesting that pupils conceptions are relatively superficial and simplistic (see Harris et al. (2016) for an overview). Accordingly, the purpose of this research is to explore pupils conceptions of health within PE. The research was comprised of four phases which took place over an 18-month period within the East Midlands region of England. Phase one involved an online survey being distributed to all state secondary schools (n = 293) and with a total of 52 schools responding. Phase two involved semi-structured interviews being conducted with 13 PE teachers at two case study schools and focus groups with 117 pupils (aged 11-12) at the same schools. A participatory approach underpinned the study and relevant methods/techniques were employed within pupil focus groups to generate discussion and elicit pupils conceptions of health . Examples of the methods/techniques employed included: drawings, concept cartoons and statement sheets. Pupils worked interactively with one another to undertake and discuss tasks/activities in line with the youth voice agenda that underpinned the research. This agenda is often allied with participatory methods (Heath et al., 2009) and seeks to privilege the voices of younger participants, recognising that children and young people are competent social agents, capable of both understanding and articulating their own experiences (Christensen and James, 2008). Phase three involved follow-up focus groups with the same pupils who participated during the preceding phase, and a similar participatory approach was employed. Phase four involved semi-structured focus groups being conducted with the same PE teachers at each school. Data generated were analysed using a Foucauldian-inspired discourse analysis. The findings of the study highlight that the vast majority of pupils conceptions of health were reductive, limited and limiting. These conceptions of health were identified as being underpinned by: corporeal notions, aesthetic orientations and healthist influences. In addition, they aligned with normative conceptions of health , that were evidently influenced by public health discourses, which may well have been promulgated by and through PE. Whilst pupils did not necessarily consider that PE influenced their conceptions of health , there were evident links, which PE teachers themselves acknowledged and problematised. Positively, it was highlighted that there were some pupils who were able to disrupt normative conceptions of health and, in doing so, they demonstrated their capacity for criticality. As such, the challenge for PE is now to consider how it might support pupils to develop their capacities to receive, interpret and be critical of health-related information. If it can do so, it may well be that critically-inclined conceptions of health can be fostered within, through and by the subject.

From the author’s work as an educational psychologist in a Scottish local authority and her initial literature review, concerns were raised by her colleagues and local education authority about delaying school entry of children with additional support needs. This study aimed to: explore how the decision making process for delaying school entry operated; develop and trial a methodology to capture the children’s perspective and explore the experiences of the children and their families in nursery and during their first year of school. A qualitative case study approach was used to explore the decision making process for six children and their families and the experiences of five children and their families. Techniques from the mosaic methodology (Clark and Moss, 2001) were adapted to capture the children’s voices. The study revealed that participants held different models of school readiness, in line with other international research, and this influenced their decision to retain. Participants reported a range of positive and negative outcomes of delayed school entry and identified factors that had been supportive in managing the children’s transitions. Children’s perspectives were captured and often offered a unique insight into the children’s views. At the end of the children’s first year in primary school four parents were still happy with their decision to delay school entry but one parent regretted her decision. In conclusion it is suggested that a more interactionist (Meisels, 1998) approach to school readiness should be taken when supporting the transition from nursery to school. A moderated system should be developed to support the decision making process for delaying school entry, with an inbuilt process to follow up longer-term outcomes for the children and families concerned. The methodology developed for gathering children’s views offered a way for children with additional support needs to express their own views and take an active role at this important transition point. There is potential to develop this methodology further to ensure that children’s voices are heard in this first universal educational transition.

Distúrbios neurológicos como o Acidente Vascular Encefálico (AVE) podem causar alterações nos mecanismos responsáveis pela voz e deglutição, levando a quadros de disfonia e disfagia neurogênica, sendo que a maioria dos estudos aborda tais aspectos separadamente. O objetivo do presente trabalho foi estudar as funções de deglutição e voz, bem como a relação entre ambas, em indivíduos com sequelas de AVE. Foram analisados, para este estudo retrospectivo, os prontuários e exames de 30 idosos com média de 72 anos de idade. Foram realizados: aplicação de questionários referentes a queixas de deglutição e voz; avaliação perceptivo-auditiva da voz por meio da escala GRBASI; videoendoscopia da deglutição para classificação do grau da disfagia, da penetração e aspiração, além da taxa de gravidade de secreção; videoendoscopia da fonação, para observação de aspectos morfológicos e funcionais. Para verificar as correlações entre variáveis quantitativas e/ou qualitativas ordinais foi utilizado o Coeficiente de Correlação Spearman. Para verificar associação entre variáveis qualitativas nominais foram utilizados o teste exato de Fischer e o teste de Mann-Whitney. Em todos os testes foi adotado nível de significância de 5%. Para verificar a concordância entre juízes foi utilizada a estatística Kappa. Observou-se que 46% dos indivíduos referiu queixa vocal e voz muito fraca, 43% apresentou sensação de catarro preso na garganta e tosse; 46% dos indivíduos referiu dificuldades para mastigar, 36% engasgo durante as refeições e 32% ingestão de líquidos para ajudar na deglutição e tosse após as refeições. Na escala GRBASI, a maioria dos indivíduos apresentou o grau geral de disfonia e a rugosidade moderados para conversa espontânea e grau geral de disfonia e instabilidade moderados para a vogal /a/ sustentada. Com relação aos aspectos morfológicos, foi possível observar assimetria laríngea (73%), arqueamento bilateral da porção membranosa da prega vocal (77%) e saliência bilateral do processo vocal (77%). Quanto aos aspectos funcionais, observou-se fenda (57%), constrição supraglótica anteroposterior (57%) e constrição mediana (80%). A maioria dos indivíduos (83%) apresentou classificação 6 na escala DOSS, nível 1 para a consistência líquida (57%) e nível 0 para pastosa (57%) e sólida (63%) na escala de Taxa de Gravidade de Secreção. Foram encontradas relações entre sintomas de cansaço depois de falar muito com dificuldade para deglutir os alimentos (p=0,03), engasgo durante as refeições (p=0,00) e tosse após as refeições (p=0,01). Observou-se também relação entre catarro preso na garganta e engasgo durante as refeições (p=0,04), entre pigarro na garganta e ingestão de líquido para ajudar na deglutição (p=0,03), e entre pigarro na garganta e pigarro após as refeições (p=0,00). Ainda, foi observado que houve correlação entre estase em valécula para a consistência sólida e as características vocais de soprosidade (p=0,01) e astenia (p=0,02); relação entre a gravidade dos sinais de alteração da deglutição com a configuração laríngea. Concluiu-se que as características de voz e deglutição apresentadas pela população estudada foram semelhantes às frequentemente encontradas em idosos e que houve relações entre as funções de deglutição e voz. / Neurological disorders such as cerebrovascular accident (AVE) may cause changes in the mechanisms responsible for voice and swallowing, leading to dysphonia and neurogenic dysphagia and most studies addresses these aspects separately. The aim of this retrospective work was to study the functions of swallowing and voice as well as the relationship between them to individuals affected by sequel of stroke. We analyzed the medical charts of 30 patients averaging 72 years of age. Were performed: questionnaires regarding complaints of swallowing and voice; perceptual evaluation of voice through GRBASI scale; videoendoscopy of swallowing to classify the degree of dysphagia, penetration and aspiration, besides the severity rate of secretion; videoendoscopy of phonation, for observation of morphological and functional aspects. To verify the correlation between quantitative variables and / or qualitative ordinal was used Spearman Correlation Coefficient. To assess the association between nominal qualitative variables we used the Fisher exact test and Mann - Whitney. In all tests the level of significance was 5%. To verify the agreement between judges Kappa statistics was used. It was observed that 46% of the individuals reported voice complaints and very weak voice, 43% had feeling of phlegm stuck in throat and cough, 46% of subjects reported difficulty in chewing, 36% choking during meals and 32% drinking to assist in swallowing and coughing after meals. In GRBASI scale, most individuals showed grade and roughness moderate for spontaneous conversation and the grade and instability moderate for the vowel / a / sustained. With respect to morphology, was observed laryngeal asymmetry (73%), bilateral bowing of the membranous portion of the vocal fold (77%) and bilateral protrusion of the vocal process (77%). Regarding to the functional aspects, it was observed slit (57%), supraglottic anteroposterior constriction (57%) and median constriction (80%). Most individuals (83%) had rating 6 in DOSS scale, level 1 for liquid (57%) and level 0 to paste (57%) and solid (63%) in The Secretion Severity Rating scale. Relationships were found between symptoms of fatigue after speaking with much difficulty swallowing foods (p=0.03), choking during meals (p=0.00) and cough after meals (p=0.01). It was also observed relationship between phlegm stuck in my throat and choking during meals (p=0.04) between phlegm in the throat and fluid intake to aid in swallowing (p=0.03), and between phlegm in throat and hoarseness after meals (p=0.00). Still, it was observed that there was a correlation between stasis in the vallecula to solid and the vocal characteristics of breathiness (p=0.01), and asthenia (p=0.02), the relationship between the severity of the signs of swallowing disorders with laryngeal configuration. It was concluded that the characteristics of voice and swallowing presented by this study were similar to those often found in the elderly and that there were relations between the functions of swallowing and voice.

Os professores são profissionais da voz que vêm sendo amplamente estudados por pesquisadores nacionais e internacionais. Pesquisas apontam alta prevalência de alterações vocais dentre os docentes. Um dos critérios para o estabelecimento da prevalência de alteração vocal baseia-se na auto-percepção do professor, denominado de disfonia auto-referida. Conhecer o quanto a alteração vocal pode trazer conseqüências para a vida do professor e para o exercício de sua profissão está de acordo com o proposto pela Organização Mundial da Saúde que sugere avaliar o impacto de uma doença sob o ponto de vista do paciente e não do avaliador. O objetivo desta pesquisa foi comparar medidas de qualidade de vida e voz entre grupo de professores que referiu alteração vocal e grupo de professores que não referiu alteração vocal. Participaram deste estudo 97 professores de 11 escolas da rede municipal de Bauru. Todos os professores responderam a três protocolos psicométricos de qualidade de vida e voz (IDV, QVV, PPAV) além de um questionário para caracterização da amostra. Os resultados demonstraram que 39,8% dos professores reportaram alterações vocais no momento da realização da pesquisa. Quando se compararam medidas de qualidade de vida e voz, entre o grupo com alteração de voz e o grupo sem alteração vocal, diferenças estatisticamente significantes foram observadas: entre a pontuação total do IDV e nas três sub-áreas (orgânica, emocional e funcional); entre a pontuação total do QVV e na pontuação dos dois domínios (funcionalidade física e sócio-emocional) e entre a pontuação total do PPAV e nas cinco sessões (severidade do problema vocal, efeito no trabalho, efeito na comunicação diária, efeito na comunicação social e emoção). Também foi verificado que a dimensão orgânica do protocolo IDV tem mais impacto entre as dimensões deste protocolo, tanto para o grupo com alteração quanto para o grupo sem alteração vocal, indicando desconforto laríngeo e dificuldade ao falar. Com relação ao protocolo QVV, o domínio que apresentou mais alto escore foi o da funcionalidade física, também indicando desconforto laríngeo e impacto vocal na comunicação em professores com e sem alteração. Com relação ao PPAV nenhuma sessão prevaleceu sobre a outra no grupo sem alteração vocal. Para o grupo com alteração vocal, três sessões, comunicação diária, efeito no. trabalho e emoções têm maior impacto que a comunicação social. Os escores de limitação e de restrição foram calculados. Foi observado que a limitação da atividade é maior que a restrição das atividades tanto no grupo com queixa vocal quanto no grupo sem queixa vocal. Concluiu-se que os professores que referiram alteração vocal perceberam o impacto da alteração vocal em diferentes dimensões da qualidade de vida e voz e na realização de suas atividades diárias em maior proporção do que os professores que não referiram alteração vocal. / Teachers are voice professionals who have been widely studied by national and international researchers. Studies show a high prevalence of vocal alterations among teachers. One of the criteria for the establishment of vocal alteration prevalence, is based on teachers´ self-perception, termed as self-reported dysphonia (when the teacher him/herself reports the vocal alteration). To know the degree in which vocal alteration may affect a teacher´s life and his/her career, is consistent with that proposed by the World Health Organization, which suggests assessing the impact of a disease, taking into account the patient´s point of view and not the evaluator´s. This study aimed at comparing voice disordered quality of life (VQOL) measures between a group of teachers who reported vocal alteration and a group of teachers who did not, by verifying the teacher´s perception as for the impact of vocal alteration in the different dimensions of voice quality of life. Ninety-eight teachers, from 11 municipal schools of Bauru and in different grades (infantile and fundamental teaching and education of adolescents and adults), participated in this study. All teachers answered three psychometric protocols of voice quality of life: Voice Handicap Index (VHI), Voice-Related Quality of Life (V-RQOL), and the Voice Activity Participation Profile (VAPP), besides a questionnaire for the characterization of the sample. The result shows that 39.8% of teachers reported vocal alteration. When comparing voice measures between the groups with and without vocal alteration, statistically significant differences were observed: the total score of VHI and its dimensions (physical, emotional and functional); total score of V-RQOL and its dimensions (physical and socio-emotional functioning), and total score of VAAP and its dimensions (severity of vocal problem, effect on work, effect on daily communication, effect on social communication and emotion). It was verified, too, that the physical dimension of VHI has a greater impact among the dimensions of this protocol, both for the group with complaint and the one without complaint, indicating a laryngeal discomfort and difficulty at speaking. As for VRQOL, the most striking dimension was the physical functioning domain, also indicating the laryngeal discomfort and the impact of voice on communication, in teachers with and with no complaint. As for VAAP, no domain prevailed over the others, in the group with no complaint. For teachers with complaint, three domains, i.e., daily communication, work and emotions have a greater impact than social communication. The limitation and restriction scores were calculated as well, and it was observed the limitation of activities is greater than the restriction of activities, both in the group with and the group without complaint. One may conclude that the teachers who reported vocal alterations, better realize the impact of voice in different dimensions of voice quality of life.