Carga vocal de los profesores universitarios: resultados preliminares
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Carga vocal de los profesores universitarios: resultados preliminares
.

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Objetivo. Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos. Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados. Todos los participantes informaron hablar en voz alta en clase, la mayoría informó c... Ver más

Guardado en:

Revista de Investigación e Innovación en Ciencias de la Salud

2665-2056

Oliveira, Cristiane Lemos Carvalho de

Viola, Denise Nunes

Miranda, Tarciane Machado

Souza, Marcelo Santos de

Masson, Maria Lúcia Vaz

FUNDACION UNIVERSITARIA MARIA CANO

10.46634/riics.241

6

2024-01-29

73

97

Colombia

calidad de la voz

acústica

disfonía

trastornos de la voz

dosimetría

ruido

docentes

salud laboral

Revista de Investigación e Innovación en Ciencias de la Salud - 2024

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country_str Colombia
collection Revista de Investigación e Innovación en Ciencias de la Salud
title Carga vocal de los profesores universitarios: resultados preliminares
spellingShingle Carga vocal de los profesores universitarios: resultados preliminares
Oliveira, Cristiane Lemos Carvalho de
Viola, Denise Nunes
Miranda, Tarciane Machado
Souza, Marcelo Santos de
Masson, Maria Lúcia Vaz
Voice
voice quality
acoustics
dysphonia
voice disorders
dosimetry
noise
faculty
occupational health
calidad de la voz
acústica
disfonía
trastornos de la voz
dosimetría
ruido
docentes
salud laboral
title_short Carga vocal de los profesores universitarios: resultados preliminares
title_full Carga vocal de los profesores universitarios: resultados preliminares
title_fullStr Carga vocal de los profesores universitarios: resultados preliminares
title_full_unstemmed Carga vocal de los profesores universitarios: resultados preliminares
title_sort carga vocal de los profesores universitarios: resultados preliminares
description Objetivo. Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos. Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados. Todos los participantes informaron hablar en voz alta en clase, la mayoría informó cambios vocales en los últimos seis meses y solo uno informó cambios vocales actuales. La sala presentó mediciones y estimaciones acústicas fuera de las normas establecidas. Los profesores utilizaron intensidades vocales altas durante las clases. Hubo un aumento en los valores absolutos de los datos agrupados para CAPE-V, jitter y frecuencia fundamental, variando dentro de los límites normales, después de las clases. La intensidad después de las clases y el IFV, en la comparación entre las dos semanas, mostraron un aumento. Conclusiones. La dosis vocal y el IFV posiblemente se vieron afectados por la acústica del aula. El aumento del IFV medio entre semanas pudo deberse a la sensación de cansancio acumulada. Se sugieren nuevas investigaciones con un mayor número de participantes y que se realicen en la sala acondicionada acústicamente para evaluar propuestas de intervención colectiva, con el objetivo de reducir la carga vocal de los docentes.
description_eng Purpose. To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods. Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results. All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions. Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.
author Oliveira, Cristiane Lemos Carvalho de
Viola, Denise Nunes
Miranda, Tarciane Machado
Souza, Marcelo Santos de
Masson, Maria Lúcia Vaz
author_facet Oliveira, Cristiane Lemos Carvalho de
Viola, Denise Nunes
Miranda, Tarciane Machado
Souza, Marcelo Santos de
Masson, Maria Lúcia Vaz
topic Voice
voice quality
acoustics
dysphonia
voice disorders
dosimetry
noise
faculty
occupational health
calidad de la voz
acústica
disfonía
trastornos de la voz
dosimetría
ruido
docentes
salud laboral
topic_facet Voice
voice quality
acoustics
dysphonia
voice disorders
dosimetry
noise
faculty
occupational health
calidad de la voz
acústica
disfonía
trastornos de la voz
dosimetría
ruido
docentes
salud laboral
topicspa_str_mv calidad de la voz
acústica
disfonía
trastornos de la voz
dosimetría
ruido
docentes
salud laboral
citationvolume 6
citationissue 1
publisher Fundación Universitaria María Cano
ispartofjournal Revista de Investigación e Innovación en Ciencias de la Salud
source https://riics.info/index.php/RCMC/article/view/241
language eng
format Article
rights https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
Revista de Investigación e Innovación en Ciencias de la Salud - 2024
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
info:eu-repo/semantics/openAccess
http://purl.org/coar/access_right/c_abf2
references_eng Roy N, Merril RM, Thibeault S, Parsa RA, Gray SD, Smith EM. Prevalence of voice disorders in teachers and the general population. J. Speech Lang. Hear. Res. 2004;47(2). doi: https://doi.org/10.1044/1092-4388(2004/023) 2. Behlau M, Zambon F, Guerrieri AC, Roy N. Epidemiology of voice disorders in teachers and nonteachers in Brazil: prevalence and adverse effects. J Voice. 2012;26(5):665.e9-18. doi: https://doi.org/10.1016/j.jvoice.2011.09.010 3. Brasil. Secretaria de Vigilância em Saúde, Departamento de Vigilância em Saúde Ambiental e Saúde do Trabalhador. Distúrbio de Voz Relacionado ao Trabalho – DVRT. Brasília, DF: Ministério da Saúde; 2018. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/disturbio_voz_relacionado_trabalho_dvrt.pdf 4. Masson MLV, Ferrite S, Pereira LMA, Ferreira LP, Araujo TM. Seeking the recognition of voice disorder as work-related disease: historical-political movement. Cien Saude Colet. (online). 2019;24(3):805-16. doi: https://doi.org/10.1590/1413-81232018243.00502017 5. Cantor Cutiva LC, Vogel I, Burdof A. Voice disorders in teachers and their associations with work-related factors: a systematic review. J. Commun. Disord., Amsterdam. 2013;46(2):143-55. doi: https://doi.org/10.1016/j.jcomdis.2013.01.001 6. Cantor Cutiva LC, Burdof A. Effects of noise and acoustics in schools on vocal health in teachers. Noise Health. 2015;17(74):17–22. Available from: https://journals.lww.com/nohe/fulltext/2015/17740/effects_of_noise_and_acoustics_in_schools_on_vocal.3.aspx 7. Jesus MTA, Ferrite S, Araújo TM, Masson MLV. Work-related voice disorder: an integrative review. Rev. Bras. Saúde Ocup. [online]. 2020;45e26. doi: https://doi.org/10.1590/2317-6369000040218 8. Nudelman CJ, Bottalico P, Cantor-Cutiva LC. The effects of room acoustics on self-reported vocal fatigue: a systematic review. J Voice (impress). 2023. doi: https://doi.org/10.1016/j.jvoice.2022.12.024 9. Hunter EJ, Cantor-Cutiva LC, van Leer E, van Mersbergen M, Nanjundeswaran CD, Bottalico P, Sandage MJ, Whitling S. Toward a consensus description of vocal effort, vocal load, vocal loading, and vocal fatigue. J. Speech Lang. Hear. Res. 2020;63(2):509-32. doi: https://doi.org/10.1044/2019_JSLHR-19-00057 10. Assad JP, Magalhães MC, Santos JN, Gama ACC. Vocal dose: an integrative literature review. Rev. CEFAC. 2017;19(3):429-38. doi: https://doi.org/10.1590/1982-021620171932617 11. Moghtader M, Soltani M, Mehravar M, Yazdi MJ, Dastoorpoor M, Moradi N. The relationship between vocal fatigue index and voice handicap index in university professors with and without voice complaint. J Voice. 2020;34(5):809.e1-809.e5. doi: https://doi.org/10.1016/j.jvoice.2019.01.010 12. Araújo TM, Pinho PS, Masson MLV. Teachers’ work and health in Brazil: thoughts on the history of research, strides, and challenges. Cad Saúde Pública (online). 2019;35(Suppl 1). doi: https://doi.org/10.1590/0102-311X00087318 13. Medeiros YPO, Nascimento CMB, Gomes AOC, Lira ZS, Araújo AN. The use of voice in higher education: what the professors have to say? Rev CEFAC (online). 2020; 22(4):e13519, 2020. doi: https://doi.org/10.1590/1982-0216/202022413519 14. Servilha EAM, Costa ATF. Knowledge about voice and the importance of voice as an education resource in the perspective of university professors. Rev CEFAC [online]. 2015;17(1):13–26. doi: https://doi.org/10.1590/1982-0216201514813 15. Azari S, Aghaz A, Maarefvand M, Ghelichi L, Pashazadeh F, Shavaki YA. The prevalence of voice disorders and the related factors in university professors: a systematic review and meta-analysis. J Voice (impress). 2022. doi: https://doi.org/10.1016/j.jvoice.2022.02.017 16. Korn GP, Pontes AAL, Abranches D, Pontes PAL. Hoarseness and risk factors in university teachers. J Voice. 2015;29(4):518.e21-518.e28. doi: https://doi.org/10.1016/j.jvoice.2014.09.008 17. Gomes NR, Teixeira LC, Medeiros AM. Vocal symptoms in university professors: their association with vocal resources and with work environment. J Voice. 2020;34(3):352-357. doi: https://doi.org/10.1016/j.jvoice.2018.10.010 18. Kyriakou K, Petinou K, Phinikettos I. Risk factors for voice disorders in university professors in Cyprus. J Voice. 2018;32(5):643.e1-643.e9. doi: https://doi.org/10.1016/j.jvoice.2017.07.005 19. Mehta DD, Van Stan JH, Zañartu M, Ghassemi M, Guttag JV, Espinoza VM, et al. Using Ambulatory Voice Monitoring to Investigate Common Voice Disorders: Research Update. Front Bioeng Biotechnol [Internet]. 2015 Oct 16;3:155. doi: https://doi.org/10.3389/fbioe.2015.00155 20. Nudelman CJ, Ortiz AJ, Fox AB, Mehta DD, Hillman RE, Van Stan JH. Daily Phonotrauma Index: objective indicator of large differences in self-reported vocal status in the daily life of females with phonotraumatic vocal hyperfunction. Am J Speech Lang Pathol. 2022;31(3):1412-23. doi: https://doi.org/10.1044/2022_AJSLP-21-00285 21. Hunter EJ, Titze IR. Variations in intensity, fundamental frequency and voicing for teachers in occupational versus non-occupational settings. J Speech, Lang.Hear. Res. 2010;53(4):862-75. doi: https://doi.org/10.1044/1092-4388(2009/09-0040) 22. Behlau M. (Org.). Voz: o livro do especialista. Volume 1. Ed. Revinter, 2001. p. 62-64, 85-245. 23. Ghirardi ACA, Ferreira LP, Giannini SPP, Latorre MRDO. Screening Index for Voice Disorder (SIVD): development and validation. J Voice. 2013;27(2):195-200. doi: https://doi.org/10.1016/j.jvoice.2012.11.004 24. Behlau M, Rocha B, Englert M, Madazio G. Validation of the Brazilian Portuguese CAPE-V Instrument—Br CAPE-V for auditory-perceptual analysis. J Voice. 2022;36(4):586.e15–586.e20. doi: https://doi.org/10.1016/j.jvoice.2020.07.007 25. Yamasaki R, Madazio G, Leão SHS, Padovani M, Azevedo R, Behlau M. Auditory-perceptual evaluation of normal and dysphonic voices using the Voice Deviation Scale. J Voice. 2017;31(1):67-71. doi: https://doi.org/10.1016/j.jvoice.2016.01.004 26. Manly BFJ. Randomization, bootstrap and Monte Carlo methods in biology: texts in statistical science. Flórida: Chapman and Hall/CRC; 2006. 480 p. 27. Orlikoff RF, Kahane JC. Influence of mean sound pressure level on jitter and shimmer measures. J Voice. 1991;5:113-119. doi: https://doi.org/10.1016/S0892-1997(05)80175-4 28. Zambon F, Moreti F, Ribeiro VV, Nanjundeswaran C, Behlau M. Vocal Fatigue Index: validation and cut-off values of the brazilian version. J Voice. 2022;36(3):434.e17-434.e24. doi: https://doi.org/10.1016/j.jvoice.2020.06.018 29. Banks RE, Bottalico P, Hunter EJ. The effect of classroom capacity on vocal fatigue as quantified by the Vocal Fatigue Index. Folia Phoniatr. Logop. 2018;69(3):85-93. doi: https://doi.org/10.1159/000484558 30. Bottalico P, Astolfi A, Hunter EJ. Teachers’ voicing and silence periods during continuous speech in classrooms with different reverberation times. J. Acoust. Soc. Am. 2017;141(1):26–31. doi: https://doi.org/10.1121/1.4973312 31. Berglund, B.; Lindvall, T.; Schwela, D.H.; & World Health Organization. Occupational and environmental Health Team. Guidelines for community noise. Geneva: World Health Organization; 1999. 32. Calosso G, Puglisi GE, Astolfi A, Castellana A, Carullo A, Pellerey F. A one-school year longitudinal study of secondary school teachers' voice parameters and the influence of classroom acoustics. J. Acoust. Soc. Am. 2017;142(2):1055. doi: https://doi.org/10.1121/1.4998707 33. Yiu E. M.; Yip P. P. Effect of noise on vocal loudness and pitch in natural environments: An accelerometer (Ambulatory Phonation Monitor) study. J Voice. 2016;30(4):389–93. doi: https://doi.org/10.1016/j.jvoice.2015.05.016 34. Bottalico P, Passione II, Graetzer S, Hunter EJ. Evaluation of the starting point of the Lombard Effect. Acta Acustica. 2017;103(1):169–72. doi: https://doi.org/10.3813/AAA.919043 35. Bottalico P, Cantor Cutiva LC, Hunter EJ. Vocal fatigue in virtual acoustics scenarios. J. Acoust. Soc. Am. 2017;141(5):3541. doi: https://doi.org/10.1121/1.4987484 36. Titze IR, Hunter EJ. Comparison of vocal vibration-dose measures for potential-damage risk criteria. J Speech Lang. Hear. Res. 2015;58(5):1425–1439. doi: https://doi.org/10.1044/2015_JSLHR-S-13-0128 37. Atará-Piraquive ÁP, Cantor-Cutiva LC. Gender differences in vocal doses among occupational voice users: a systematic review of literature and meta-analysis. Logoped Phoniatr Vocol. 2022;47(1):63-72. doi: https://doi.org/10.1080/14015439.2021.1873415 38. Ahlander VL, Garcia DP, Whitling S, Rydell R, Löfqvist A. Teachers’ voice use in teaching environments: a field study using Ambulatory Phonation Monitor. J Voice. 2014;28(6):841.e5-15. doi: https://doi.org/doi:10.1016/j.jvoice.2014.03.006 39. Titze IR, Svec JG, Popolo PS. Vocal dose measures: quantifying accumulated vibration exposure in vocal fold tissues. J Speech Lang. Hear. Res. 2003;46(4):919–932. doi: https://doi.org/10.1044/1092-4388(2003/072) 40. Nacci, A. et al. The use and role of the Ambulatory Phonation Monitor (APM) in voice assessment. Acta Otorhinolaryngol Ital. 2013;33(1):49-55. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3631805/ 41. Lopes LW, Cavalcante DP, Costa PO. Severity of voice disorders: integration of perceptual and acoustic data in dysphonic patients. CoDAS. 2014;26(5):382-8. doi: https://doi.org/10.1590/2317-1782/20142013033 42. Laukkanen AM, Kankare E. Vocal loading-related changes in male teachers' voices investigated before and after a working day. Folia Phoniatr. Logop. 2006;58(6):229–239. doi: https://doi.org/10.1159/000093180 43. Laukkanen AM, Ilomäki I, Leppänen K, Vilkman E. Acoustic measures and self-reports of vocal fatigue by female teachers. J Voice. 2008;22(3):283-9. doi: https://doi.org/10.1016/j.jvoice.2006.10.001
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spelling Carga vocal de los profesores universitarios: resultados preliminares
Carga vocal de los profesores universitarios: resultados preliminares
Objetivo. Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos. Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados. Todos los participantes informaron hablar en voz alta en clase, la mayoría informó cambios vocales en los últimos seis meses y solo uno informó cambios vocales actuales. La sala presentó mediciones y estimaciones acústicas fuera de las normas establecidas. Los profesores utilizaron intensidades vocales altas durante las clases. Hubo un aumento en los valores absolutos de los datos agrupados para CAPE-V, jitter y frecuencia fundamental, variando dentro de los límites normales, después de las clases. La intensidad después de las clases y el IFV, en la comparación entre las dos semanas, mostraron un aumento. Conclusiones. La dosis vocal y el IFV posiblemente se vieron afectados por la acústica del aula. El aumento del IFV medio entre semanas pudo deberse a la sensación de cansancio acumulada. Se sugieren nuevas investigaciones con un mayor número de participantes y que se realicen en la sala acondicionada acústicamente para evaluar propuestas de intervención colectiva, con el objetivo de reducir la carga vocal de los docentes.
Purpose. To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods. Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results. All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions. Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.
Oliveira, Cristiane Lemos Carvalho de
Viola, Denise Nunes
Miranda, Tarciane Machado
Souza, Marcelo Santos de
Masson, Maria Lúcia Vaz
Voice
voice quality
acoustics
dysphonia
voice disorders
dosimetry
noise
faculty
occupational health
Voz
calidad de la voz
acústica
disfonía
trastornos de la voz
dosimetría
ruido
docentes
salud laboral
6
1
Artículo de revista
Journal article
2024-01-29T17:38:48Z
2024-01-29T17:38:48Z
2024-01-29
text/html
text/xml
application/pdf
Fundación Universitaria María Cano
Revista de Investigación e Innovación en Ciencias de la Salud
2665-2056
https://riics.info/index.php/RCMC/article/view/241
10.46634/riics.241
https://doi.org/10.46634/riics.241
eng
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
Revista de Investigación e Innovación en Ciencias de la Salud - 2024
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
73
97
Roy N, Merril RM, Thibeault S, Parsa RA, Gray SD, Smith EM. Prevalence of voice disorders in teachers and the general population. J. Speech Lang. Hear. Res. 2004;47(2). doi: https://doi.org/10.1044/1092-4388(2004/023) 2. Behlau M, Zambon F, Guerrieri AC, Roy N. Epidemiology of voice disorders in teachers and nonteachers in Brazil: prevalence and adverse effects. J Voice. 2012;26(5):665.e9-18. doi: https://doi.org/10.1016/j.jvoice.2011.09.010 3. Brasil. Secretaria de Vigilância em Saúde, Departamento de Vigilância em Saúde Ambiental e Saúde do Trabalhador. Distúrbio de Voz Relacionado ao Trabalho – DVRT. Brasília, DF: Ministério da Saúde; 2018. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/disturbio_voz_relacionado_trabalho_dvrt.pdf 4. Masson MLV, Ferrite S, Pereira LMA, Ferreira LP, Araujo TM. Seeking the recognition of voice disorder as work-related disease: historical-political movement. Cien Saude Colet. (online). 2019;24(3):805-16. doi: https://doi.org/10.1590/1413-81232018243.00502017 5. Cantor Cutiva LC, Vogel I, Burdof A. Voice disorders in teachers and their associations with work-related factors: a systematic review. J. Commun. Disord., Amsterdam. 2013;46(2):143-55. doi: https://doi.org/10.1016/j.jcomdis.2013.01.001 6. Cantor Cutiva LC, Burdof A. Effects of noise and acoustics in schools on vocal health in teachers. Noise Health. 2015;17(74):17–22. Available from: https://journals.lww.com/nohe/fulltext/2015/17740/effects_of_noise_and_acoustics_in_schools_on_vocal.3.aspx 7. Jesus MTA, Ferrite S, Araújo TM, Masson MLV. Work-related voice disorder: an integrative review. Rev. Bras. Saúde Ocup. [online]. 2020;45e26. doi: https://doi.org/10.1590/2317-6369000040218 8. Nudelman CJ, Bottalico P, Cantor-Cutiva LC. The effects of room acoustics on self-reported vocal fatigue: a systematic review. J Voice (impress). 2023. doi: https://doi.org/10.1016/j.jvoice.2022.12.024 9. Hunter EJ, Cantor-Cutiva LC, van Leer E, van Mersbergen M, Nanjundeswaran CD, Bottalico P, Sandage MJ, Whitling S. Toward a consensus description of vocal effort, vocal load, vocal loading, and vocal fatigue. J. Speech Lang. Hear. Res. 2020;63(2):509-32. doi: https://doi.org/10.1044/2019_JSLHR-19-00057 10. Assad JP, Magalhães MC, Santos JN, Gama ACC. Vocal dose: an integrative literature review. Rev. CEFAC. 2017;19(3):429-38. doi: https://doi.org/10.1590/1982-021620171932617 11. Moghtader M, Soltani M, Mehravar M, Yazdi MJ, Dastoorpoor M, Moradi N. The relationship between vocal fatigue index and voice handicap index in university professors with and without voice complaint. J Voice. 2020;34(5):809.e1-809.e5. doi: https://doi.org/10.1016/j.jvoice.2019.01.010 12. Araújo TM, Pinho PS, Masson MLV. Teachers’ work and health in Brazil: thoughts on the history of research, strides, and challenges. 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