PERCEPÇÕES DE CRIANÇAS, JOVENS E TREINADORES DO CLUBE GRAMA DEPORTES DE IBAGUÉ SOBRE A EDUCAÇÃO EM VALORES NA GRADE FUTEBOL

Sport is used to foster positive attitudes and behaviors, to transmit groups of camaraderie, respect, values ​​and sportsmanship, but unrewarding and pleasant situations are also observed in the environment of efforts that can affect the child's comprehensive education. Children's football often imitates professional football, a situation that has led many coaches, parents, spectators, managers, children and young people to reproduce attitudes of professional football more than educational and training football. Thus, the main objective of the study was to evaluate the perceptions that underlie children, youth and coaches of the Club Grama Deportes de Ibagué about education in values ​​in grassroots football. For this, an investigation was carried out with a quantitative approach, of a descriptive type. Two surveys were designed and validated, which were applied to 128 children and adolescents between the ages of 7 and 16, from the pre-baby, baby, pre-infant, infant, pre-juvenile and youth categories, and 5 coaches aged between the 26 and 53 years. The results revealed that training in values ​​should be strengthened, taking into account that fair play should be structured on a solid training in these groups. Likewise, from the perception of children, youth and coaches, it can be inferred that there is no policy on values ​​in the Grama Deportes Soccer School. Given the above, it is recommended to design a program to update and qualify your coaches, in such a way that comprehensive training is guaranteed.El deporte es utilizado para fomentar actitudes y conductas positivas, para transmitir valores de compañerismo, respeto, esfuerzo y deportividad, pero también se observan situaciones poco gratificantes y agradables en el entorno de los grupos que pueden repercutir en la formación integral del niño. Frecuentemente, el fútbol infantil imita el profesional, situación que ha llevado a muchos entrenadores, padres, espectadores, directivos, niños y jóvenes a reproducir actitudes del fútbol profesional más que del fútbol educativo y formativo. Así, el objetivo principal del estudio fue valorar las percepciones que subyacen en niños, jóvenes y entrenadores del Club Grama Deportes de Ibagué sobre la educación en valores en el fútbol base. Para ello se realizó una investigación con enfoque cuantitativo, de tipo descriptivo. Se diseñaron y validaron dos encuestas, que fueron aplicadas a 128 niños y adolescentes entre los 7 y los 16 años, de las categorías pre-baby, baby, pre-infantil, infantil, pre-juvenil y juvenil, y 5 entrenadores con edades entre los 26 y 53 años. Los resultados revelaron que se debe fortalecer la formación en valores, teniendo en cuenta que el juego limpio debe estructurarse sobre una sólida formación en estos grupos. Así mismo, de la percepción de los niños, jóvenes y entrenadores, se puede inferir que no existe una política  en valores en la Escuela de Fútbol Grama Deportes. Dado lo anterior, se recomienda el diseño de un programa de actualización y cualificación de sus entrenadores, de tal manera que se garantice  la formación integral.O esporte é usado para promover atitudes e comportamentos positivos, para transmitir valores de camaradagem, respeito, esforço e desportivismo, mas também são observadas situações pouco gratificantes e agradáveis ​​no ambiente de grupo que podem afetar a educação integral da criança. O futebol infantil muitas vezes imita o futebol profissional, situação que tem levado muitos treinadores, pais, espectadores, dirigentes, crianças e jovens a reproduzirem atitudes do futebol profissional em detrimento do futebol educativo e de formação. Assim, o objetivo principal do estudo foi avaliar as percepções que fundamentam crianças, jovens e treinadores do Clube Grama Deportes de Ibagué sobre a educação em valores no futebol de base. Para isso, foi realizada uma investigação com abordagem quantitativa, do tipo descritiva. Foram desenhados e validados dois inquéritos, que foram aplicados a 128 crianças e adolescentes com idades compreendidas entre os 7 e os 16 anos, das categorias pré-bebé, bebé, pré-infantil, infantil, pré-juvenil e juvenis, e 5 treinadores com idades compreendidas entre os 26 e 53 anos. Os resultados revelaram que a formação em valores deve ser reforçada, tendo em conta que o fair play deve ser estruturado numa formação sólida nestes grupos. Da mesma forma, da percepção de crianças, jovens e treinadores, pode-se inferir que não existe uma política de valores na Escolinha de Futebol Grama Deportes. Perante o exposto, recomenda-se a elaboração de um programa de atualização e qualificação dos seus treinadores, de forma a garantir uma formação integral.             &nbsp

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research