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That is, soccer coaches and physical trainers face situations with different demands and expected situations with high demands, which change the needs relating to voice care - similar to what happens with journalists during the coverage of events such as Carnival and the World Cup. Such particularities should be investigated and taken into account in the planning of Speech-Language actions aimed at these sports professionals. With regard to the environment, problems related to acoustics and noise and especially aggravated in the contexts of games and championships were confirmed, as they were already identified in studies on physical educators and trainers 1 2 3 As for work, health, and quality of life relations, the Content Analysis showed that the categories experience a paradoxical condition of protection and risk.
With regard to protection, it is known that these professionals earn their living from sport and for the sport and, in a context in which society represents sports as connected to health, the subjects expressed concern about being an example to players, fans and society.
Few mentioned voice in relation to healthy habits C6, C9, T10, and T It is clear that, to maintain the habits cited, subjects are indirectly taking care of their voice However, one must take into account that, as both categories face intense demand for vocal use 1 2 3 and that voice plays a fundamental role in the activities of these professionals 16 , it would be relevant for them to count on guidance and training on professional use of the voice and on the relevant care for the promotion of vocal health, which are not restricted or limited to the habits they already have and mentioned.
Thus, the study highlights the lack of attention, perception, orientation, and preparation of the subjects in both the categories referring to problems directly related to voice and its care. The risk is also expressed in the organization of work, as they are constantly coping with conflicts, problems, demands, and pressures, which require great emotional balance and can cause exhaustion, stress and generate anxieties, and emotional states that negatively impacts general health, vocal health, and quality of life 12 13 Working under high strain and pressure results in the adoption of body hypersolicitation strategies, in addition to the negative impact on mental health and generation of states of physical and mental fatigue 6 8 26 However, apparently, in the assessment of job stress JSS , subjects can find positive compensations in possibilities of high control and social support, which is the dimension with the better situation Table 1.
The Content Analysis also confirmed that social relations, at work and in the family, are remembered as generators of positive and rewarding sensations and feelings. It is noteworthy that social support takes a protective and important role regarding the health-disease-care process As for the assessment of job stress, the pooled analysis of the dimensions Demand, Control, and Support Tables 1 and 2 showed that both categories fall in the Active Work situation, which indicates a good condition as it encourages creativity and can motivate the development of new behaviors.
Therefore, it represents a situation with less risk for adverse reactions to the physical and mental health of the professionals 7 8. The results distinguish the categories in this study from teachers, who showed an association between voice disorder and a highly demanding high strain job and stress in the teaching activity 8 There are certainly many and varied differences between the work of a teacher and the categories under study. Further studies are needed, using other and different methodological instruments, to investigate the characteristics of work conditions in sports and to capture other aspects of the relationship between stress and work from the perspective of soccer coaches and physical trainers.
Furthermore, the mean values of both categories are close to values compatible with healthy voices 19 , slightly lower than expected for subjects with no complaints Yet, it should be noted that the situation of coaches is slightly worse compared with the physical trainers. Because it is, based on the perception of the subjects, that there is the possibility of changes in the results, owing to their capacities being linked to the voice issue and to their realization of the vocal symptoms in relation to the negative aspects of quality of life Previous studies point to the fact that high scores may indicate that subjects may not be sensitive enough to understand and properly identify the voice impact on quality of life, and it is possible that the scores get "worse" after the intervention groups, which suggests that, indeed, there was increased awareness by the subject of their own voices It is worth highlighting the importance of undergoing Speech-Language actions that constitute as social spaces and educational processes on health that foster the subjects' awareness, attention, and perception concerning their own voice and its possible changes and alterations It should also be noted the importance of new studies that enable the comparison of the performance and consistency of the subjects' answers to the V-RQOL, before and after Speech-Language Therapy processes.
Table 3 showed that the issues that proved more problematic values in the questionnaire , considered as moderate to major problems, were as follows: Q1 having difficulty speaking loudly or being heard in a noisy environment ; Q3 not knowing how the voice will sound when you start talking , and Q4 getting anxious or frustrated because of the voice.
The difficulty for speaking loudly or being heard in a noisy environment is consistent with the conditions of the working environment. The noisy environment may hinder communication, causing intense vocal use that can lead to voice complaints, signs, symptoms, and disorders 1 2 3. The performance of the subjects in this question from the V-RQOL points to the need of developing vocal projection from specific techniques, guided by a Speech-Language Pathology.
Statistical tests showed no significant differences for the responses to V-RQOL when comparing the two groups Table 3. Still, it is worth mentioning some distinctions in the ways of perceiving the difficulties regarding "speaking loudly or being heard in a noisy environment" Q1 between both categories.
Perhaps, this difference is explained by the fact that physical trainers do not participate so actively in games and championships when, being in crowded fields and stadiums, ambient noise is much more intense. The difference and inconsistency of results between the questions: Q1 "having difficulty speaking loudly or being heard in a noisy environment" and Q7 "having trouble performing work activities because of the voice" may also seem odd. Because the work activities of both categories require the use of voice with functions and needs related to communicative and interactive efficiency with the sports team and the distant and dispersed players in open and noisy fields 16 and considering that work is one of the dimensions of quality of life, it can be understood that these professionals may not be properly perceiving the impact of voice on quality of life.
But, it is curious that the voice impact on quality of life is more perceived in negative feelings resulting from uncertainty, dissatisfaction, insecurity, and depression questions 3 and 4, Table 3 than at work question 7, Table 3. The questions that show less problematic responses numbers 1 and 2 of the questionnaire, considered as not being a problem or as being a small problem were the following: Q6 referring to difficulties on the phone ; Q8 referring to avoiding social outings ; and Q10 referring to becoming less expansive , suggesting that the voice does not have negative impacts on mediated communication processes or on the interaction and socialization of the subject.
The nature of Fiordland means that planes are not always able to fly. Quality of life is a broad, subjective, and multidimensional concept, encompassing the subject's perceptions on the physical, functional, psychological, social, labor, and environmental aspects and in general health. Data collection was carried out in a quiet room, at a time at the subject's discretion, generally close to the time of games or training sessions 2 games, 1 practice match, and 13 training sessions - sometimes before and sometimes after them. C4 My profession involves a lot of stress, a lot of pressure [ So can you get over the phobia of practising when other people might hear you? However, apparently, in the assessment of job stress JSS , subjects can find positive compensations in possibilities of high control and social support, which is the dimension with the better situation Table 1. In he also wrote an ending for The Mystery of Edwin Drood, unfinished at the death of Dickens, an author who had been a major influence on Garfield's own style.
That is, some subjects perceive negative impacts of voice on the personal dimension but do not perceive them on the socio-interactional dimension. It is understood, then, that Speech-Language actions to encourage awareness, attention, and perception from the subjects, toward a broader perspective of the relationship between voice, work, and quality of life 29 , present themselves as useful and interesting possibilities to help elucidate the real demands and care needs of both categories involved in this study.
In addition, on this issue, it is noteworthy that the category of the coaches possessed double the number of subjects that could be considered "dysphonic" six when compared with Ts three.
Future studies could involve soccer coaches and physical trainers from different teams in different regions and different conditions amateur, professional, and elite teams , considering that Brazil is a country of great proportions and different realities. It would also be interesting to conduct a similar investigation with female professionals in both categories.
There are a limited number of studies focused on the vocal health of soccer coaches and physical trainers, and there is a need for broader studies that include more holistic approaches in the investigation of voice problems, stress, health, work, and quality of life from the perspective of these professionals. However, the perception of the voice impact on quality of life was positive and the mean scores of the V-RQOL questionnaire showed high values for both categories, consistent with healthy voices and subjects without vocal complaints.
The analysis of job stress JSS resulted in the characterization of an active work condition for both categories, which suggests a "good" and supportive work condition. The aspects related to voice, work, stress, health, and quality of life for soccer coaches and physical trainers deserve further investigation. Voice and vocal health in elite sports coaching: considerations for elite football coaching staff. British J Sports Medicin.
Trout T, Mccoll D. Vocal health for physical educators. Occupational vocal health of elite sports coaches: an exploratory pilot study of football coaches. J Voice ;S 14 Quality of life: a brand new concept for research and practice in psychiatry. Tratado das Especialidades em Fonoaudiologia. Educ Sociedade. Texto Contexto Enferm. Connections between voice ergonomic risk factors and voice symptoms, voice handicap, and respiratory tract diseases.
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Swiss Med Wkly. Vocal indices of stress: a review. Rev Soc Bras Fonoaudiol. Braz J Otorhinolaryngol. Voice and work conditions of soccer coaches and physical trainers. Contexto Enferm.
Karasek RA. Job demand, job decision latitude and mental strain: implications for job redesign. Adm Sci Q. Gasparini G, Behlau M. J Voice ;28 4 Performer's attitudes toward seeking health care for voice issues: understanding the barriers. E-mail: rzpenteado unimep. Services on Demand Journal. Original Articles Voice, stress, work and quality of life of soccer coaches and physical trainers. All subjects contacted gave their consent for participation. Data collection took place between January and April and accessibility to the study subjects happened through procedures involving the following steps: 1.
Collection of study data. Demand - refers to pressures of psychological nature questions a through e ; 2. Control - is the worker's ability to use their intellectual skills to carry out their work activities and having sufficient authority to make decisions on how to accomplish them questions f through k ; 3.
C10 Sometimes my throat gets dry [ C11 At the end of the day, I get a little tired from speaking. T7 After a week, my voice gets hoarse. T12 There is a strain owing to the prolonged voice use during a 5- or 6-month championship. C3 You speak very loudly because of the environment. C13 We are outdoors, with a huge crowd cheering and a lot of noise. T3 I do not smoke or drink, and I exercise three times a week. T4 I my line of work, I have to have a good health and a good quality of life.