Ações do goleiro de handebol em arremessos de longa e curta distância

Objetivo: identificar as características e ações do goleiro de handebol diante de arremessos de longa (9m) e curta (6m) distâncias, a partir da opinião de treinadores brasileiros da categoria sub-16. Metodologia: foi utilizada uma abordagem qualitativa, a partir de entrevistas semiestruturadas com 19 treinadores de equipes masculinas e/ou femininas da categoria sub-16, que participaram de competições organizadas pelas duas maiores ligas de handebol do Estado de São Paulo. Os depoimentos foram tabulados e analisados com base no método do Discurso do Sujeito Coletivo (DSC). Resultados e Discussão: foram identificados quatro discursos: o DSC1 e o DSC3 apontaram a necessidade de o goleiro ser capaz de identificar as características técnico-táticas dos atacantes no momento do arremesso como forma de subsidiar a sua tomada de decisão; o DSC2 apontou a importância da colaboração entre goleiro e defensores; e o DSC4 apontou possíveis ações do goleiro que visam diminuir as possibilidades de arremesso do atacante. Considerações Finais: O estudo apresentou como considerações finais algumas diretrizes que os treinadores podem utilizar para planejar o treinamento dos goleiros de handebol durante o seu processo de formação esportiva

Influência das instituições normativas do handebol para a aprendizagem dos treinadores: ponto de vista de treinadores do estado de São Paulo

La Confederación Brasileña de Balonmano (CBHb) y la Federación Paulista de Balonmano (FPHb) son instituciones responsables de la gestión del balonman a nivel Nacional y del Estado, respectivamente. Conociendo el papel de éstas, el objetivo de esta investigación fue analizar la relación entre esas instituciones y el aprendizaje profesional de los entrenadores. Se entrevistó a 22 entrenadores de las dos mayores ligas de balonmano del Estado de São Paulo y los testimonios fueron transcritos y analizados con base en el método del Discurso del Sujeto Colectivo. Se notó un distanciamiento entre las instituciones y los entrenadores, la discontinuidad y la descontextualización de diferentes acciones promovidas. Se concluye que las instituciones no ejecutan de forma efectiva el papel de auxiliar en el desarrollo profesional de los entrenadores.The Brazilian Handball Confederation (CBHb) and the Sao Paulo State Handball Federation (FPHb) are Institutions with the responsibility to organize handball in National and State level, respectively. Knowing their roles, the objective of this work was to analyze the relation between these Institutions and the coaches professional learning. Twenty two coaches from two biggest leagues of Sao Paulo State were interviewed. Their speeches were transcribed verbatim and analyzed based on the Collective Subject Discourse method. Coaches reported the distancing between those Institutions and their professional learning, as well the discontinuity and decontextualization of different activities (as courses, clinics workshops). We conclude that those Institutions are not effective to coaches professional learning.A Confederação Brasileira de Handebol (CBHb) e a Federação Paulista de Handebol (FPHb) são instituições responsáveis por gerenciar o handebol em nível Nacional e Estadual, respectivamente. Sabendo do papel destas, o objetivo desta pesquisa foi analisar a relação entre essas instituições e a aprendizagem profissional dos treinadores. Foram entrevistados 22 treinadores das duas maiores ligas de handebol do Estado de São Paulo e os depoimentos foram transcritos e analisados com base no método do Discurso do Sujeito Coletivo. Notou-se um distanciamento entre as instituições e os treinadores, assim como o difícil acesso, a descontinuidade e a descontextualização de diferentes ações promovidas. Conclui-se que as instituições não executam de forma efetiva o papel de auxiliar no desenvolvimento profissional dos treinadores.peerReviewe

Revisão sistemática sobre o processo de ensino e de análise do goleiro de handebol

O objetivo deste trabalho foi identificar o panorama de artigos científicos originais sobre as temáticas de ensino e análise de jogo do goleiro de handebol a partir do ano 2000, por meio de uma revisão sistemática. A busca pelos artigos foi feita em bases de dados indexadoras de revistas científicas a partir de critérios pré-estabelecidos. Ao final da fase de seleção, 29 artigos atenderam aos critérios de inclusão e revelaram o atual panorama das temáticas pesquisadas. Os resultados apontaram para um interesse recente nas temáticas, sobretudo na literatura espanhola, apresentando uma predominância da pesquisa quantitativa e a preferência por estudos que envolvam os goleiros adultos de alto nível de rendimento. Além disso, parece haver maior interesse pelos artigos voltados à análise de jogo quando comparados à temática de ensino. Nos artigos de análise de jogo há grande interesse na eficácia do goleiro em situação de jogo, enquanto nos artigos de ensino identificou-se a preferência por estudos sobre o desenvolvimento do repertório motor e capacidades de percepção e antecipação do goleiro de handebol

Situações de aprendizagem de treinadores de handebol do estado de São Paulo: estudo a partir dos Jogos Abertos do Interior

O objetivo deste estudo foi identificar como as diferentes situações de aprendizagem (mediada, direta e interna) influenciaram a formação dos treinadores de handebol do Estado de São Paulo. A partir de uma abordagem qualitativa, seis treinadores finalistas dos Jogos Abertos do Interior de São Paulo foram entrevistados por um dos pesquisadores (entrevista semiestruturada), cujos discursos foram analisados a partir do método do Discurso do Sujeito Coletivo. Os resultados apontaram que os treinadores utilizam-se de diferentes situações de aprendizagem para sua formação profissional. Os treinadores mencionaram que a graduação, os cursos de pós-graduação (lato sensu) e os escassos cursos de handebol não foram suficientes para que tivessem contato com conhecimentos específicos do handebol, principalmente referentes ao seu contexto de atuação. Em contrapartida, os treinadores parecem valorizar mais as situações de aprendizagem direta (contato com outros treinadores, assistir jogos e treinos, experiências prévias como jogador e busca por materiais didáticos – livros e internet). De maneira muito discreta é apontada a situação de aprendizagem interna, relacionando-se à reflexão sobre os treinos da própria equipe. Os treinadores relataram problemas na graduação (conhecimento dos docentes, ensino do handebol, ensino tecnocrático e descontextualizado) o que os impulsionou à busca por outras situações de aprendizagem. A partir deste cenário, conclui-se que a formação de treinadores de handebol é distante e desconectada com seu contexto prático, justificando a maior valorização dos treinadores por situações que favorecessem a discussão e a resolução dos problemas que enfrentam no cotidiano. Este estudo mostrou lacunas na formação dos treinadores que suscitam a reflexão para a elaboração de estratégias para o processo de aprendizagem profissional.The aim of this study was to identify how the different learning situations (mediated, direct and internal) infl  uenced the professional learning of handball coaches in the State of São Paulo. Six coaches (top-three of the State of Sao Paulo in the “Jogos Abertos do Interior”) were interviewed by one researcher (semi-structured interviews), whose statements were analyzed using the collective subject discourse method. The results showed that coaches use different learning situations for their professional formation. The coaches mentioned that undergraduate, postgraduate courses (lato sensu) and the handball courses were not enough to learn the specifi c knowledge of handball, mainly referring to their context of training. On the other hand, coaches seem to value unmediated learning situations (talk to other coaches, watch games and training sessions, previous experiences as a player and search for teaching materials). In a very discreet way the internal learning situation is pointed out, relating to the refl ection on the training of  the  own  team.  Coaches  also  reported  problems  in  graduation  (technocratic  and  decontextualized  teaching), which led them to search for other learning situations. Therefore, it is concluded that the professional  learning  of  handball  coaches  is  disconnected  with  its  practical  context,  which  justifi es the appreciation for situations that favor the discussion and the troubleshooting of the daily life. This study showed gaps in the professional learning of coaches that lead to refl ection for the elaboration of strategies for the process of professional learning

CONTEXTOS E SITUAÇÕES DE APRENDIZAGEM DE TREINADORES DE HANDEBOL EM ÂMBITO ESCOLAR

This work analyzes school handball coaches’ academic background and identifies their preferred learning contexts and situations. Eleven school coaches from a city in the Brazilian State of São Paulo were interviewed. The semi-structured interview included two main questions: one related to college education (undergraduate and graduate studies) and another one related to different learning contexts. Interviewees reported that undergraduate students play an important role in their training, but were not enough to master the specific knowledge related to their work context. Considering the learning contexts, coaches preferred sources coming from informal contexts – such as their experiences as athletes, conversations with other coaches, and material available online. Coaches also pointed that non-formal contexts were not very relevant to their work. El objetivo de esta investigación fue analizar la formación de entrenadores escolares de balonmano en el ámbito escolar e identificar los contextos y situaciones de aprendizaje preferidos. Para ello fueron entrevistados 11 entrenadores de ámbito escolar de un municipio de la ciudad de São Paulo. El instrumento de entrevista semiestructurada cubrió dos cuestiones principales: la formación académica (grado y postgrado) y los diferentes contextos de aprendizaje. Los entrevistados relataron que la graduación juega un papel importante en la formación, aunque insuficiente para el dominio de los contenidos específicos de su contexto profesional. Teniendo en cuenta los contextos de aprendizaje, los entrenadores manifiestan preferencia por fuentes provenientes del contexto informal (por ejemplo, la experiencia como atleta, conversaciones con otros entrenadores y los materiales disponibles en internet), mientras que señalan el contexto no formal como poco relevante para la actuación profesional. O objetivo desta pesquisa foi analisar a formação de treinadores de handebol de âmbito escolar, bem como identificar os contextos e situações de aprendizagem preferidos por eles. Para isso foram entrevistados 11 treinadores de âmbito escolar de um município do Estado de São Paulo. O instrumento de entrevista semiestruturada abrangeu duas questões principais: uma relacionada à formação acadêmica (graduação e pós-graduação) e outra referente aos diferentes contextos de aprendizagem. Os entrevistados relataram que a graduação cumpre um importante papel na formação, porém insuficiente para o domínio dos conteúdos específicos inerentes ao seu contexto de atuação. Considerando os contextos de aprendizagem os treinadores apontam preferência pelas fontes provenientes do contexto informal (como as experiências como atleta, as conversas com outros treinadores e os materiais disponíveis na internet), ao passo que apontam o contexto não formal como pouco relevante para a atuação.

AVALIAÇÃO TÉCNICA-OPERACIONAL DE PULVERIZADORES DE BARRAS NA REGIÃO DE PATO BRANCO - PR

A inspeção técnica de pulverizadores agrícolas apresenta-se como importante ferramenta para orientar e informar aos usuários quanto a necessidade e importância de se trabalhar com equipamentos em bom estado de conservação e regulagem, evitando desgaste prematuro dos equipamentos, contaminação ambiental, pessoal e danos econômicos. Nesse sentido, o presente trabalho teve como objetivo avaliar a condição de trabalho de pulverizadores quanto ao seu estado de conservação, com vistas a identificar os problemas que interferem na qualidade das pulverizações. Foram avaliados 21 pulverizadores agrícolas de propriedades rurais do município de Pato Branco - PR, realizando avaliações em relação ao tamanho da propriedade, treinamento dos operadores, pressão de trabalho utilizada, critérios utilizados para a escolha das pontas de pulverização, presença e operacionalidade dos manômetros. Os pulverizadores inspecionados podem ser considerados como frota nova, pois a grande maioria possui idade entre 1 e 5 anos. O índice de operadores com treinamento foi de 19%. Dos pulverizadores avaliados, constatou-se que 28% apresentaram pressão de trabalho acima do limite superior recomendado pelo fabricante da ponta de pulverização. A maioria dos produtores entrevistados ainda não possui critérios adequados para a escolha das pontas de pulverização. A assistência técnica é responsável por 42,85% das indicações no momento da troca das pontas. O manômetro estava presente em todos os pulverizadores avaliados, e em 94% das máquinas apresentavam-se operantes

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe