Organizational adaptation and risk management in physical and sports activities in the wild

El riesgo es inherente a cualquier práctica deportiva, especialmente en los deportes de riesgo y aventura. Así, actualmente los técnicos de Turismo Activo se plantean cómo medir el riesgo; qué herramientas deben utilizar o qué actuaciones o protocolos son adecuados y deben poner en marcha. Por ello que se planteó como objetivos de este artículo, adaptar e introducir una herramienta que permita a los profesionales medir el riesgo en las Actividades Físico Deportivas en el Medio Natural. Se realizó la adaptación del modelo Australiano (Standards Australia and Standards New Zealand, 1999) de administración de riesgo, describiendo un proceso formal, para establecer un programa sistemático en la administración de riesgos en los deportes de aventura en el medio natural. Es por ello, que la propuesta consistió en definir y documentar su política de administración de riesgos, adaptando el modelo austriaco, que esta orientado al contexto estratégico en el medio natural.The risk is inherent in any sport, especially extreme sports and adventure. So today Active Tourism technicians consider how to measure risk, what tools should be used or what actions or protocols are appropriate and should be implemented. Why set a goal of this article, adapt and introduce a tool that allows professionals to measure the risk in Sport Physical Activity in the Natural Environment. Adaptation was performed Australian model (Standards Australia and Standards New Zealand, 1999) risk management, describing a formal process to establish a systematic program of risk management in adventure sports in the natural environment. This is why the proposal was to define and document its policy for risk management, adapting the Austrian model, which is oriented to the strategic context in the natural environment

La percepción subjetiva del esfuerzo para el control de la carga de entrenamiento en una temporada en un equipo de balonmano

The aim of this research is to study the applicability of the Rate of Perceived Exertion (RPE) from a double perspective. Firstly, RPE helps coaches monitor training load over a season in team sports. Secondly RPE is used as an ad hoc tool for daily monitoring of planned training by the coaching staff. Heart rate reserve (HRR) was used to regulate the internal load of each session. Thirteen players from a Top Division Handball team participated in the research carried out over a complete season. The results showed RPE is a good indicator of training load in team sports and RPE is also a valid procedure to compare load values planned by coaches (RPEp) with actual values (RPEg) (rxy = .792; p < .01). It can be concluded that RPE and HRR (rxy = .839; p < .01) together are reliable, non-invasive measures for monitoring training load and they also help determine the physical fitness of players throughout the season

Effect of power training in throwing velocity in team handball

El propósito de este estudio fue examinar el efecto de diferentes métodos de fuerza unidos al entrenamiento técnico – táctico sobre la potencia muscular y la velocidad de lanzamiento en ambos brazos. Los participantes fueron 11 jugadores senior de balonmano (25±3 años; 188,7±4,7 cm; 90,6 ±10 Kg). Se tomaron 3 periodos de entrenamiento, cada uno de 8 semanas, con diferentes métodos de entrenamiento de la fuerza. Los resultados muestran como el entrenamiento de fuerza basado en el contraste estato – dinámico unido al entrenamiento técnico – táctico durante el periodo competitivo es más eficaz (p=0,033) que sólo la realización de entrenamiento de fuerza máxima combinada con el pico de potencia para la mejora de la velocidad de lanzamiento.The purpose of this study was to examine the effect of different strength methods combined with technical-tactical training on muscle power and throwing velocity in both arms of team handball players. Eleven senior players participated (25±3 years; 188,7±4,7 cm; 90,6 ±10 Kg) in this study. The season was divided into three training periods, each of eight week, to test different methods of strength training. The results show that strength training based on the contrast static - dynamic combined with technical- tactical training during the competitive season is more effective (p=0.033) that only the realization of maximum strength training combined with peak power for improving throwing velocity

Differences between adjusted vs. non- adjusted loads in velocity-based training: consequences for strength training control and programming

Strength and conditioning specialists commonly deal with the quantification and selection the setting of protocols regarding resistance training intensities. Although the one repetition maximum (1RM) method has been widely used to prescribe exercise intensity, the velocity-based training (VBT) method may enable a more optimal tool for better monitoring and planning of resistance training (RT) programs. The aim of this study was to compare the effects of two RT programs only differing in the training load prescription strategy (adjusting or not daily via VBT) with loads from 50 to 80% 1RM on 1RM, countermovement (CMJ) and sprint. Twenty-four male students with previous experience in RT were randomly assigned to two groups: adjusted loads (AL) (nD13) and non-adjusted loads (NAL) (nD11) and carried out an 8-week (16 sessions) RT program. The performance assessment pre- and post-training program included estimated 1RM and full load-velocity profile in the squat exercise; countermovement jump (CMJ); and 20-m sprint (T20). Relative intensity (RI) and mean propulsive velocity attained during each training session (Vsession) was monitored. Subjects in the NAL group trained at a significantly faster Vsession than those in AL (p < 0.001) (0.88 - 0.91 vs. 0.67- 0.68 m/s, with a 15% RM gap between groups for the last sessions), and did not achieve the maximum programmed intensity (80% RM). Significant differences were detected in sessions 3- 4, showing differences between programmed and performed Vsession and lower RI and velocity loss (VL) for the NAL compared to the AL group (p < 0.05). Although both groups improved 1RM, CMJ and T20, NAL experienced greater and significant changes than AL (28.90 vs.12.70%, 16.10 vs. 7.90% and -1.99 vs. - 0.95%, respectively). Load adjustment based on movement velocity is a useful way to control for highly individualised responses to training and improve the implementation of RT programs

Estimation of the players maximum heart rate in real game situations in team sports: a practical propose

En el presente estudio se propone una ecuación lineal para el cálculo de la frecuencia cardiaca máxima (FC máx) de forma indirecta en jugadores de deportes de equipo en situaciones integradas de juego. La muestra experimental estuvo formada por trece jugadores (24± 3 años) pertenecientes a un equipo de División de Honor B de balonmano. Se midió la FC máx inicialmente por medio de la prueba de Course Navette. Posteriormente, se realizaron veintiuna sesiones de entrenamiento en las que se registró la FC, de forma continua, y la percepción subjetiva del esfuerzo (RPE), en cada tarea. Se realizó un análisis de regresión lineal que permitió encontrar una ecuación de predicción de la FC máx. a partir de las frecuencias cardiacas máximas de las tres sesiones de mayor intensidad. Los datos previstos por esta ecuación correlacionan significativamente con los datos obtenidos en el Course Navette y tienen menor error típico de medida que otros métodos de cálculo. Como conclusión principal se destaca que esta ecuación posibilita una manera útil y cómoda del cálculo de FC máx en situaciones reales de juego, evitándose la realización de test analíticos no específicos y, de este modo, reducir la falta de ecología en la valoración funcional.This research developed a logarithms for calculating the maximum heart rate (max. HR) for players in team sports in game situations. The sample was made of thirteen players (aged 24 ± 3 ) to a Division Two Handball team. HR was initially measured by Course Navette test. Later, twenty one training sessions were conducted in which HR and Rate of Perceived Exertion (RPE), were continuously monitored, in each task. A lineal regression analysis was done to help find a max. HR prediction equation from the max. HR of the three highest intensity sessions. Results from this equation correlate significantly with data obtained in the Course Navette test and with those obtained by other indirect methods. The conclusion of this research is that this equation provides a very useful and easy way to measure the max. HR in real game situations, avoiding non-specific analytical tests and, therefore laboratory testing.peerReviewe

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Análisis de la influencia de la intensidad del entrenamiento sobre variables de control de la carga interna en deportes colectivos

Tesis Univ. Granada. Departamento de Educación Física y Deportiva. Leída el 17 de junio de 201

Medios para cuantificar la carga interna de entrenamiento en deportes de equipo. La frecuencia cardiaca, el consumo de oxígeno, la concentración de lactato en sangre y la percepción subjetiva del esfuerzo: Una revisión

Los deportes de equipo son actividades de cooperación – oposición, donde se realizan esfuerzos intermitentes por parte de los jugadores de los equipos que participan. Para cuantificar estos esfuerzos se debe disponer de instrumentos que permitan una valoración fiable de las diferentes acciones. La literatura científica, remite principalmente a cuatro herramientas para cuantificar la carga interna de entrenamiento para este tipo de actividades; La frecuencia cardiaca (FC), el consumo de oxígeno (VO2), la concentración de lactato en sangre (CLS) y la percepción subjetiva del esfuerzo (PSE). Estas cuatro formas de cuantificar la carga servirá tanto para valoraciones en tests de laboratorio y campo, como para valoraciones in situ del entrenamiento. Así pues el objetivo del presente trabajo fue revisar los diferentes estudios que usan alguno de estos medios para la cuantificación de la carga interna de entrenamiento en deportes de equipo