Elderly participation in adventure activities in nature: reflections about environmental aspects

This paper aims to analyze the perceptions of social and environmental aspects related to the practice of adventure activities in nature of 11 elderly participants. It is a descriptive exploratory field search with qualitative approach. After a practical intervention of two adventure activities in nature – stand up paddle and trail – the survey data were obtained by a semi-structured interview, designed specifically for this research. The information collected were organized in NVivo software, version 10.0, and analyzed descriptively by the technique of content analysis. The results show that the participants have the perception of the establishment of positive social relations during the practice intervention, either between the participants or the instructors. About the environmental issues considerations, the participants mentioned several aspects as degradation, conservation, behavior, feelings and actions related to nature; and punctual aspects, such as deforestation, pollution and water shortage

IMPORTÂNCIA DA FISIOTERAPIA NA PREVENÇÃO DE DISTÚRBIOS OSTEOMUSCULARES RELACIONADOS AO TRABALHO

Os objetivos deste estudo foram analisar como os estudos apresentaram a atuação da fisioterapia como prevenção de distúrbios osteomusculares relacionados ao trabalho (DORT) e enfatizar a sua importância. Tratou-se de um estudo de revisão bibliográfica, com artigos publicados no período de janeiro de 1998 a outubro de 2013. Foram analisados 6 artigos, todos utilizaram questionários para avaliação da dor e/ou qualidade de vida do trabalhador, dois estudos utilizaram o check-list e fotos para análise do ambiente de trabalho e um estudo utilizou filmagens para avaliação ergonômica. Foram feitas análises e modificações ergonômicas, orientações posturais e de atividade física e a realização de ginástica laboral em parte dos estudos. Portanto, os estudos apresentaram resultados positivos em relação a medidas preventivas aos DORT, além de relatarem a consequente melhoria da qualidade de vida dos trabalhadores, o que reflete no aumento da produtividade, fato que enfatiza a importância da aplicação da fisioterapia preventiva

PERCEPÇÃO DE COMPETÊNCIAS PROFISSIONAIS DE INSTRUTORES DE ATIVIDADES DE AVENTURA NA NATUREZA ATUANTES EM FLORIANÓPOLIS (SC)

The objective of this study is to analyze the perception of competences of nature adventure activities instructors in the city of Florianópolis, Brazil. It was accomplished descriptive-exploratory and quantitative research. Participated 22 instructors (18 males and four females) with a mean age of 39.5 ± 12.1 years. We used a validated questionnaire for this study, containing 27 questions based on professional competence model of Cheetham and Chivers (1996, 1998) and in the standard 15285 of the Brazilian Association of Technical Standards (2005) on the skills needed to instructors. To analyze the data, we applied the descriptive statistics. Most instructors realize fully master the cognitive, functional, social, ethical and related factors (meta-competencies, personality, reflection, evaluation, entrepreneurship). However, in all for at least one instructor who realizes master them partially and there is one who realizes not dominate two functional skills on the safety of participants. An instructor also believes not master the ability to undertake. Este estudio tiene como objetivo analizar la percepción de competencias de instructores de actividades de aventura en la naturaleza actuantes en Florianópolis (SC). Se realizó una investigación descriptiva-exploratoria y cuantitativa. Participaron 22 instructores (18 del sexo masculino y cuatro del femenino) con edad media de 39,5 ± 12,1 años. Se utilizó un cuestionario validado para este estudio, que contiene 27 preguntas basadas en el modelo de competencia profesional Cheetham y Chivers (1996, 1998) y en la norma 15285 de la Asociación Brasileña de Normas Técnicas (2005) en las competencias necesarias para instructores. Para analizar los datos, se aplicó la estadística descriptiva. La mayoría de los instructores dan cuenta de dominar totalmente las competencias cognitivas, funcionales, sociales, éticas y factores relacionados (meta-competencias, personalidad, reflexión, evaluación, habilidad emprendedora). Sin embargo, en todas hay por lo menos un instructor que se da cuenta de dominarlas parcialmente y hay uno que no se da cuenta de dominar dos competencias funcionales relacionadas a la seguridad de los participantes. Un instructor también cree no dominar la capacidad de emprender.  Este estudo tem como objetivo analisar a percepção de competências de instrutores de atividades de aventura na natureza atuantes em Florianópolis (SC). Realizou-se uma pesquisa descritivo-exploratória e quantitativa. Participaram 22 instrutores (18 do sexo masculino e quatro do feminino), com idade média de 39,5±12,1 anos. Utilizou-se um questionário validado para este estudo, contendo 27 perguntas baseadas no modelo de competência profissional de Cheetham e Chivers (1996, 1998) e na norma 15285 da Associação Brasileira de Normas Técnicas (2005) sobre as competências necessárias aos instrutores. Para analisar os dados, aplicou-se a estatística descritiva. A maioria dos instrutores percebe dominar totalmente as competências cognitivas, funcionais, sociais, éticas e fatores relacionados (metacompetências, personalidade, reflexão, avaliação, empreendedorismo). Contudo, em todas há pelo menos um instrutor que percebe dominá-las parcialmente e há um que percebe não dominar duas competências funcionais relativas à segurança dos participantes. Um instrutor também acredita não dominar a capacidade de empreender.

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved