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- Fado and its voices: contribution to the prevention of occupational voice disordersPublication . Malheiro, João Pedro de Melo Pestana Mouga; Freitas, Susana Vaz; Manso, M. ConceiçãoSinging is an activity practiced by many people, both from a professional or recreational standpoint. When a person sings, his/her vocal tract behaves in a way different to speech. Occupational voice disorders in singers are known for their hugely negative impact on their career. Fado is a Portuguese urban folk song having deep roots in the popular culture. An increased risk of voice disorders among these professionals. Some risk examples are to sing without formal training, to perform frequently with no amplification system, to sing in venues with unsuitable characteristics, etc. As an expected outcome, this thesis intends to diminish the gap between professional practices and scientific research in this field. Research on the singing voice was mapped to trace research patterns, to compare the amount of published research and its journals, to analyze trend topics. Descriptive statistics, text mining, and clustering were used. The amount of published papers per annum has been continuously increasing since the first indexed study, in 1949. The major topics highlighted by this study were: voice quality, occupational demands, acoustic analysis, training effects, musical perception and electroglottography. The prevalence of self-reported dysphonia in singers was calculated through a systematic review and a meta-analysis. Eleven studies met the established criteria and grouped according styles and roles. The overall prevalence of self-reported dysphonia was 46.09% (95%CI: 38.16-54.12) – singing teachers showed the highest prevalence (55.15%), followed by non-classical singers (46.96%), classical singers (40.53%) and singing students (21.76%). These results suggest that singers are more prone to report dysphonia comparing to the general population. Fado singers were explored from an epidemiological perspective. First, a population size calculation was done to make this possible. No regulatory institution to handle the professionalization of singers was found in Portugal. A database was created with subjects who met the following criteria: to sing Fado de Lisboa; to be alive; to have recorded, at least, one phonogram. Four hundred and eleven were identified, even though the panel of recruited experts believes that there are much more. A comprehensive self-administered questionnaire was built to find the prevalence and impact of voice disorders in singers, as well as to identify risk or protective factors. It was applied to 111 singers with a convenience and snowball sampling. The overall prevalence of self-reported voice disorders was 39.6%, significantly higher in females. Vocal fold nodules were the most common diagnosis; vocal fatigue and hoarseness were the most common reported symptoms. Nearly half of the singers had to cancel shows due to voice disorders. Significant risk factors were found through univariate and multivariate logistic regression analysis: nose related disorders, decongestants or antihistamines usage (OR=5.5; 95%CI: 1.6-20.8); oral contraceptive or hormone replacement therapy (OR=4.9; 95%CI: 1.2-20.3); previous smoking habits (OR=4.0; 95%CI: 1.5-10.5); and vocal fatigue after performances (OR=2.9; 95%CI: 1.2-7.1). The use of corticosteroids was found to be near the significance, as a protective factor. To sing Fado was found to increase the risk of developing voice disorders – further research is required to compare this population with other singing styles. The last study aimed to conduct the cross-cultural adaptation and validation of the instrument “Evaluation of the Ability to Sing Easily” (EASE) into the European Portuguese version “Avaliação da Capacidade para Cantar com Facilidade” (EASE-PT). One hundred and twenty-two Fado and Choir singers were recruited through convenience and snowball sampling to fill the final version of the instrument. High internal consistency was found to prove its reliability (alpha of Cronbach=0.900 and 0.905 for Fado and Choir singers, respectively).