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Purpose Masticatory changes in the older adult population may cause nutritional impairment, so epidemiological studies are important to allow specific public health interventions. Thus, this study aims at constructing and validating an instrument for screening for masticatory disorders in older adults (SMDOA). Methods Validation study. First step: validity evidence based on test content. Defining the construct and elaborating the questions by a panel of experts and evaluating the representativeness and relevance of the items in relation to the construct by a committee of 28 experts. Analysis was performed through the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI). Second stage: validity evidence based on response processes. The questionnaire was applied to 40 older adults (≥60 years) using the cognitive interview strategy. Quantitative and qualitative analysis of the responses was carried out. Third stage: validity evidence based on the internal structure. The instrument was applied to 295 older adult patients and a confirmatory factorial analysis was performed to fit the model. Results The first version of SMDOA consisted of 16 issues related to chewing. The CVI and CVI-I were satisfactory, and only one question was excluded. The instrument with 15 questions was well evaluated by the older adults, only requiring minor adjustments to the morphosyntax. After the confirmatory factorial analysis, adjustments were made in its internal structure resulting in the 9-question model in two factors regarding function and masticatory perception. Conclusions The SMDOA presented good evidence of validity in its content, response processes and internal structure.

RESUMO Objetivo identificar quais são os sinais e sintomas de disfagia orofaríngea mais presentes nos idosos residentes em Instituições de Longa Permanência. Estratégia de pesquisa revisão integrativa realizada em quatro bases de dados: Embase, LILACS, MEDLINE/PubMed e Web of Science, com uso de termos na língua inglesa e aplicação de filtros por idioma e idade. Critérios de seleção estudos disponíveis na forma de texto completo em inglês, português ou espanhol, sem restrição de tempo de publicação, relacionados a idosos residentes em Instituições de Longa Permanência que referiram disfagia orofaríngea. Foram excluídos estudos relacionados a idosos da comunidade ou que estavam em hospitais, e com outras condições de saúde não relacionadas aos problemas de deglutição. Resultados de 389 estudos, 16 foram incluídos nesta revisão, publicados entre os anos de 1986 e 2020. Houve predomínio de participantes do sexo feminino, com média mínima de idade de 71 anos e máxima de 87 anos. Os sinais e sintomas mais frequentes de disfagia orofaríngea foram presença de tosse e engasgo, além de outros relevantes, como pressão de língua diminuída, voz molhada, perda de peso e deglutição lenta. Conclusão de acordo com os estudos revisados, os sinais e sintomas mais frequentes relacionados à disfagia orofaríngea nos idosos institucionalizados foram presença de tosse e engasgo, antes, durante ou após a deglutição. Abstract Purpose To identify the most prevalent signs and symptoms of oropharyngeal dysphagia in elderly adults who live in old folks' home. Research strategy Integrative review carried out in four databases: Embase, Lilacs, MEDLINE/Pubmed, and Web of Science using English terms and filters for language and age. Selection criteria Studies available in the full-text form in English, Portuguese or Spanish, with no publication time restrictions, related to elderly people living in care homes who reported oropharyngeal dysphagia. Studies related to elderly people in the community or in hospitals and with other health issuesthat were not related to swallowing disorders were excluded. Results Of 389 studies, 16 were included in this review, published between 1986 and 2020. There was a predominance of female participants whose minimum mean age was 71 and maximum, 87. The most frequent signs and symptoms of oropharyngeal dysphagia were the presence of coughing and choking, in addition to other relevant ones, such as diminished tongue pressure, wet voice, weight loss, and slow swallowing. Conclusion According to the reviewed studies, the most frequent signs and symptoms related to oropharyngeal dysphagia in elderly people living in care homes were (the) presence of coughing and choking, before, during or after swallowing.

Many factors can influence chewing, including age. The ageing process causes morphophysiological changes in the body, including in the performance of the stomatognathic system, which directly affect chewing and swallowing.To determine the prevalence of chewing difficulty in older people in long-term care.We searched six electronic databases and the grey literature. Qualitative and quantitative analyses, including risk of bias, were performed on studies that met the inclusion criteria. The meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored by meta-regression. Risk of bias was determined using the Joanna Briggs Institute's Critical Appraisal Checklist. The certainty of evidence was verified using the GRADE tool.Twelve articles were included in the meta-analysis. The pooled prevalence estimate was 35% (95% confidence interval, 0.19-0.54). As heterogeneity still persisted even after sensitivity analysis, the predictors of mean sample age and sample size were meta-regressed to assess whether these covariates explained the variance between effect sizes. The covariable sample size of the study included in the analysis explained 84.3% of the heterogeneity existing in the analysis (RAbout one in three older people in long-term care have difficulty in chewing.

Made available in DSpace on 2022-04-29T08:37:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: The aim of this study was to determine the accuracy of an epidemiological screening questionnaire for oropharyngeal dysphagia in older people. Background: Determining the cut-off point and the accuracy of the self-reported epidemiological questionnaire for screening oropharyngeal dysphagia in older adults is important for mass screening, which may estimate the prevalence of oropharyngeal dysphagia. Materials and Methods: This was a cross-sectional diagnostic study with a convenience sample of 70 older adults over 60 years of age of both sexes, aged between 60 and 90 years (mean age 69.2; SD, 7.6). It used a screening questionnaire with nine ordered items response options resulted in a score ranging from 0 to 18. The criterion test was the fiberoptic endoscopic evaluation of swallowing, with analysis of the receiver operating characteristic (ROC), with a 5% significance level. Results: Oropharyngeal dysphagia frequency by the criterion test was 73%, with no significant difference between age and sex. The area under the ROC curve was 0.88 (95% confidence interval: 0.79-0.98) above the cut-off point 3. This screening questionnaire showed good parameters of sensitivity (80%), specificity (89%), positive predictive value (95%), negative predictive value (63%), positive likelihood ratio (7.64), negative likelihood ratio (0.22) and accuracy (83%). Conclusions: This questionnaire may be a satisfactory screening tool for estimating the prevalence of oropharyngeal dysphagia in older adults. Department of Speech Language and Hearing Sciences Federal University of Rio Grande of Norte (UFRN) Department of Speech Language and Hearing Sciences Federal University of Paraíba (UFPB) Department of Speech Language and Hearing Sciences São Paulo State University (Unesp) School of Philosophy and Sciences Marília Universtiy of São Paulo Department of Dentistry Postgraduate Public Health Program (PPGSCol-UFRN) Federal University of Rio Grande of Norte (UFRN) Department of Speech Language and Hearing Sciences São Paulo State University (Unesp) School of Philosophy and Sciences Marília Universtiy of São Paulo

OBJECTIVE To determine the prevalence of temporomandibular disorders (TMD) in musicians. MATERIALS AND METHODS Electronic database searches and a manual search were performed. Qualitative and quantitative analysis including risk of bias was performed for studies that met the inclusion criteria. A meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored according to the moderating variable through subgroup analysis and metaregression. The certainty of the evidence was assessed using the GRADE tool. RESULTS A total of 13 articles were included for the meta-analysis. Pooled prevalence estimate was 52.8% (CI 95%; 33.4%-71.7%) for wind instruments, 53.9% (CI 95%; 42.4%-65.2%) for string instruments and 53.9% (CI 95%; 23.5%-82.7%) for string and wind instruments. The average time of use of the musical instrument explained 82.38%, the heterogeneity between the sizes of the effects observed in the analysis (R2 = 82.38%; P

To analyze the impact of photobiomodulation combined with orofacial myofunctional therapy (OMT) on the oral health quality of life (OHQOL) of individuals with temporomandibular disorder, before and after the treatment.Blind, controlled, randomized clinical trial with 34 volunteers randomly distributed into two groups: G1, who received OMT combined with photobiomodulation, and G2, treated with OMT combined with inactive laser. The subjects were first assessed with a visual analog scale (VAS) to classify them according to the degree of orofacial pain and with the Oral Health Impact Profile - Short Form (OHIP-14) regarding the impact on the OHQOL. The resulting data were statistically analyzed. The significance level was set at 0.05 (95%)."Physical pain", "psychological discomfort", "physical disability", and "psychological disability" were the aspects with the greatest impact on the OHQOL. The G1 subjects responded positively to their treatment, as well as G2 to theirs. There was a strong positive correlation between VAS and total OHIP-14 score in both groups after the treatment. However, the functional recovery in the control group individuals (G2) was the most perceived positive change in the OHQOL in comparison with the experimental group (G1).The people who received photobiomodulation combined with OMT perceived an improvement in the OHQOL, as well as those treated with placebo laser. There was a strong positive correlation in both groups in the improvement of the degree of pain and self-perception of the OHQOL.Analisar o impacto na qualidade de vida relacionada à saúde oral de indivíduos com disfunção temporomandibular, antes e após o tratamento de fotobiomodulação associada a terapia miofuncional orofacial.Estudo do tipo ensaio clínico randomizado, controlado e cego, com 34 voluntários distribuídos aleatoriamente em dois grupos: G1, que recebeu a Terapia Miofuncional Orofacial (TMO) associada a fotobiomodulação e o G2, tratado pela TMO associada ao laser inativo. Os indivíduos foram submetidos, primeiramente, à avaliação para serem classificados de acordo com o grau da dor orofacial pela Escala Visual Analógica (EVA) e também quanto ao impacto da qualidade de vida relacionada a saúde oral (QVRSO) pelo questionário Oral Health Impact Profile – Short form (OHIP-14). Os dados obtidos foram analisados estatisticamente. Foi adotado o nível de significância de 0,05 (95%).“Dor física”, “desconforto psicológico”, “limitação física” e “limitação psicológica” foram os aspectos mais impactantes na QVRSO. O G1 apresentou respostas positivas para o respectivo tratamento, assim como o G2. Observou-se correlação positiva e de grau forte para EVA e escore total do OHIP-14 em ambos os grupos após tratamento. Porém, os indivíduos do grupo controle (G2) evidenciaram que a recuperação funcional foi o aspecto que mais se percebeu de mudança positiva na QVRSO em comparação ao grupo experimental (G1).As pessoas que receberam fotobiomodulação associada a TMO-perceberam melhora da QVRSO, assim como as tratadas com o laser placebo. Houve correlação positiva e forte em ambos os grupos na melhora do grau da dor e autopercepção da QVRSO.

Introduction Preterm and low-birth-weight newborns may present immaturity in the functions of sucking, swallowing and breathing, speech therapists inserted in the hospital focus on the development of newborns’ oral sensorimotor system, promoting a safe transition from tube feeding to breastfeeding and contributing to improving the quality of life of the child population. The present study aimed to analyze the development of oral functions, oral feeding transition time and breastfeeding of preterm and low-birth-weight newborns under Speech-Language Pathology care. Methods A prognostic study carried out at a maternity hospital, based on the data collected from 121 filed medical records of newborns attended between September 2015 to July 2017. The Kaplan–Meier method, the Log Rank test and the Pearson correlation test were used for data analysis, considering a significance level of 0.05 (95%). Results It was observed that the lower the gestational age and the birth weight of newborns, the more speech therapy services were required until the establishment of exclusive OF; also, the transition time and the average time of using the orogastric tube were inversely proportional to the gestational age at birth. The non-nutritive sucking technique was the most used for stimulation, and 78.5% of the NBs were discharged from the hospital on exclusive breastfeeding. Conclusion Moderate to late preterm and low-birth-weight newborns are able to more quickly acquire the oral sensorimotor system functional pattern, and there are indications that Speech-Language Pathology care reduces the transition time to oral feeding, thus increasing the success rate of exclusive breastfeeding.

Entre os testes da triagem neonatal mais comuns tem-se: orelhinha, olhinho, pezinho, coracaozinho e linguinha, em que sao avaliadas as condicoes auditiva, visual, sanguinea, de saturacao de oxigenio e de movimentacao da lingua, respectivamente. O contexto deste trabalho refere-se ao teste da linguinha, que verifica se o recem-nascido consegue movimentar corretamente a lingua, pois se houver algo obstruindo essa movimentacao, o bebe apresentara dificuldades nas funcoes que ela exerce (engolir, sugar, falar, mastigar, etc.). Sabe-se que identificar problemas na movimentacao da lingua nao e facil, assim, o auxilio de sistemas computacionais e de processamento inteligente das informacoes contribuiriam muito para acompanhar e dar suporte aos profissionais de saude responsaveis pelo teste. Com isso, este trabalho tem como objetivo desenvolver um sistema de apoio a decisao na realizacao e no acompanhamento do teste da linguinha, utilizando redes neurais artificiais para emissao de alertas e recomendacoes em situacoes anormais. Destaca-se que, na concepcao da rede neural artificial, foi utilizada uma base de dados criada por meio de protocolos reais fornecidos pelos especialistas que acompanharam o trabalho. Os resultados apresentados foram considerados satisfatorios e relevantes por medicos especialistas, principalmente pelas possibilidades de melhoria no atendimento dos recem-nascidos que pode ser propiciado pelo uso do sistema.

Summary Purpose To identify the validity evidence based on the content and response processes of the Rastreamento de Alteracoes Vocais em Idosos (RAVI; "Screening for Voice Disorders in Older Adults"), an epidemiologic screening for voice disorders in older adults. Study Design This is a prospective, nonrandomized, cross-sectional, validation study. Methods Criteria for defining the domains and elaborating the questions were established to confirm the validity evidence based on the content. A multidisciplinary committee of 19 experts evaluated the questions, and the relevance and representation of the domains were analyzed using the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI), respectively. For validity evidence based on the response processes, 40 individuals of both sexes, aged ≥60 years, were stratified by demographic and socioeconomic condition. They responded to the RAVI, made suggestions, and their verbal and nonverbal reactions were observed. Results The first version of the RAVI consisted of 20 questions related to sensations and perceptions associated with the voice. Although the CVI value of 0.80 was satisfactory, the CVI-I and the suggestions of the expert committee indicated that the scale needed to be reformulated. Consultation with older adults indicated a need for further adjustment. The preliminary version of the RAVI consisted of 16 questions. Conclusions The two aspects of validity evidence described in the present study were essential for adapting the questions to better fit the construct of the questionnaire. Other aspects of validity evidence and reliability analysis will be described in part II of this study.

OBJETIVO: verificar as características da mastigação em indivíduos usuários de prótese dentária removível parcial e total, analisando prováveis fatores interferentes associados à função mastigatória. MÉTODOS: participaram 53 indivíduos, ambos os sexos, entre 42 anos e 67 anos, divididos em dois grupos: 32 indivíduos usuários de prótese dentária total e/ou parcial removível estável (G1) e 21 indivíduos com dentição natural (G2). Foram critérios de exclusão: deficiência neurológica ou cognitiva, deformidades dentofaciais, disfunção temporomandibular e qualquer lesão bucal que pudesse interferir na mastigação. A avaliação foi realizada com pão de sal, solicitando-se mastigação habitual. Foram analisados: características das estruturas e da musculatura, tipo de corte, manutenção de vedamento labial, tempo de mastigação, número de ciclos mastigatórios, e tipo de mastigação: se uni ou bilateral, considerando-se predomínio unilateral em mais de 66% dos ciclos mastigatórios em um único lado. RESULTADOS: foram verificadas alterações quanto à característica do músculo masseter e ao tipo de corte para G1 com diferenças estatisticamente significantes, quando comparado à G2. As demais estruturas orofaciais, lábios, língua, bochechas, mentual, e postura de lábios durante a mastigação apresentaram-se normais para ambos os grupos. Não houve diferença significante entre os grupos quanto aos movimentos mandibulares, ao tipo, tempo e número de ciclos mastigatórios e caracterização da deglutição. CONCLUSÃO: a mastigação em usuários de prótese dentária removível caracteriza-se por alterações no corte do alimento, indefinição de tipo mastigatório, vedamento labial satisfatório, média do tempo e de ciclos mastigatórios semelhantes àqueles obtidos para indivíduos com dentição natural. PURPOSE: to check mastication characteristics in individuals using removable dental prosthesis, analyzing probable interference factors associated to functional mastication. METHODS: fifty-three individuals of both genders, between 42 and 67 year old, were divided in two groups: thirty-two individuals, users of total stable prosthesis dentures and/or partially stable removable prosthesis (G1); and twenty-one individuals with natural dentition (G2). the following exclusion criteria were used: neurological or cognitive deficiency, dental facial deformities, temporomandibular disorders and any mouth injuries which could interfere in mastication. Evaluation was done with salt bread, using habitual mastication. The analyses focused on: oral structures and muscle characteristics; type of cutting, maintenance of labial sealing; length of mastication time, number of masticatory cycles, and type of mastication: uni or bilateral, considering unilateral predominance in more than 66% of the cycles on just one particular side. RESULTS: alterations were noted as for the characteristics of the masseter muscle and type of food cutting for G1, with significant statistical differences when compared to G2. All other orofacial structures: lips, tongue, cheeks, mentual, and position of lips during mastication proved to be normal for both groups. There was no significant difference between the groups regarding jaw movements; type, time, and number of masticatory cycles and deglutition characterization. CONCLUSION: mastication in removable prosthesis users is characterized by alterations in the form of cutting food, undefined type of mastication, and satisfactory lips posture. The average time and the number of masticatory cycles are similar to those obtained for individuals with natural dentitions.