BIOMECHANICAL APPROACH TO BALLET MOVEMENTS: A STUDY OF THE EFFECTS OF BALLET SHOE AND MUSICAL BEAT ON THE VERTICAL REACTION FORCES

Ballet movements can be the focus of biomechanical studies in order to better understand the characteristic mechanical loads of the locomotor apparatus related to classic dance. "Pointe shoes" have been associated to high incidence of morphological and physiological alterations of ballet dancer's feet, however its contribution to injury mechanisms must still be precisely known. On the other hand, movements like jumps and leaps are frequently repeated in a standard ballet training, where the musical beat also plays a role on the motor behavior and its mechanical aspects. Therefore the purpose of the present study was to describe ground reaction forces during the "saute -1st position" under the influence of footwear (slippers and pointe shoes) and musical beat in order to identify the relative contribution of these factors on the external loads measured. It was observed that the musical beat played a greater role on the ground reaction force magnitudes than the footwear

Stretching and Joint Mobilization Exercises Reduce Call-Center Operators’ Musculoskeletal Discomfort and Fatigue

AIM: We sought to evaluate musculoskeletal discomfort and mental and physical fatigue in the call-center workers of an airline company before and after a supervised exercise program compared with rest breaks during the work shift. INTRODUCTION: This was a longitudinal pilot study conducted in a flight-booking call-center for an airline in São Paulo, Brazil. Occupational health activities are recommended to decrease the negative effects of the call-center working conditions. In practice, exercise programs are commonly recommended for computer workers, but their effects have not been studied in call-center operators. METHODS: Sixty-four call-center operators participated in this study. Thirty-two subjects were placed into the experimental group and attended a 10-min daily exercise session for 2 months. Conversely, 32 participants were placed into the control group and took a 10-min daily rest break during the same period. Each subject was evaluated once a week by means of the Corlett-Bishop body map with a visual analog discomfort scale and the Chalder fatigue questionnaire. RESULTS: Musculoskeletal discomfort decreased in both groups, but the reduction was only statistically significant for the spine and buttocks (p=0.04) and the sum of the segments (p=0.01) in the experimental group. In addition, the experimental group showed significant differences in the level of mental fatigue, especially in questions related to memory Rienzo, #181ff and tiredness (p=0.001). CONCLUSIONS: Our preliminary results demonstrate that appropriately designed and supervised exercise programs may be more efficient than rest breaks in decreasing discomfort and fatigue levels in call-center operators

Caracterização do arco longitudinal plantar de crianças obesas por meio de índices da impressão plantar

OBJETIVO: descrever o desenvolvimento do arco longitudinal medial (ALM) do pé de crianças obesas e verificar a concordância entre 5 índices da impressão plantar que caracterizam este arco. MÉTODOS: 156 crianças obesas, ambos os sexos, idade entre 4 e 10 anos, pertencentes a escolas pública e privada da cidade de São Paulo, Brasil. As crianças classificadas como obesas foram selecionadas entre 1535 crianças estudantes de cinco escolas, com idade entre 4 e 10 anos. Em seguida foram coletadas as impressões plantares de cada criança e calculados índices que caracterizaram o ALM: índice de Cavanagh e Rodgers - CR, índice de Staheli - IS1 e IS2, índice de Chipaux-Smirak ICS e ângulo alfa de Clarke - AA. RESULTADOS: CR, IS e ICS mostraram que a grande alteração na forma do ALM ocorre na transição dos 8 para os 9 anos e o AA mostra dois momentos, passagem dos 6 para os 7 anos e dos 8 para os 9 anos. De uma maneira geral, a classificação IS1 foi a mais discrepante para classificar o ALM nessas crianças e o CR a mais constante. CONCLUSÕES: Observou-se que o ALM se forma mais tardiamente em crianças obesas (8 para 9 anos) em relação às crianças não obesas (5 para 6 anos). Quanto aos índices, houve semelhança na descrição do desenvolvimento do ALM entre CR, ICS e AA, sendo que o IS merece maior cuidado e restrição em seu uso.OBJECTIVES: To describe the development of the medial longitudinal arch (MLA) ofthe foot of obese children and verify the concordance between 5 footprint indexes whichcharacterize such arch. METHODS: 156 obese children, both genders, between 4 and 10 yearsold, belonging to both public and private schools of the city of São Paulo, Brazil. The childrenwere classified as obese according to Cole et al (2000) and selected among 1535 studentsbetween 4 and 10 years old from 5 different schools. Afterwards, the footprints of each obesechild were collected and then the indexes that characterize the MLA were calculated: Cavanaghand Rodgers index - CR, Staheli index - IS1 and IS2, Chipaux-Smirak index - ICS, andfootprint angle - AA. RESULTS: CR, IS and ICS showed that a remarkable change in the MLAshape takes place in the transition from 8 to 9 years of age and the AA showed two transitionranges, from 6 to 7 and from 8 to 9 years of age. Generally speaking, the largest discrepancywas noticed in the IS1 classification when evaluating the MLA for those children and the CRone proved to be the most stable. CONCLUSION: It was observed that the MLA is formed later inobese children (8 to 9 years of age) comparing to non-obese children (5 to 6 years of age).Regarding the indexes, there was a similarity in the description of the MLA developmentbetween CR, ICS and AA. The IS needs more caution and its use should be restricted

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

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

Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait

BACKGROUND: Patellofemoral Pain Syndrome is one of the most common knee disorders among physically active young women. Despite its high incidence, the multifactorial etiology of this disorder is not fully understood. OBJECTIVES: To investigate the influence of Patellofemoral Pain Syndrome on plantar pressure distribution during the foot rollover process (i.e., the initial heel contact, midstance and propulsion phases) of the gait. MATERIALS AND METHODS: Fifty-seven young adults, including 22 subjects with Patellofemoral Pain Syndrome (30 ± 7 years, 165 ± 9 cm, 63 ± 12 kg) and 35 control subjects (29 ± 7 years, 164 ± 8 cm, 60 ± 11 kg), volunteered for the study. The contact area and peak pressure were evaluated using the Pedar-X system (Novel, Germany) synchronized with ankle sagittal kinematics. RESULTS: Subjects with Patellofemoral Pain Syndrome showed a larger contact area over the medial (p = 0.004) and central (p = 0.002) rearfoot at the initial contact phase and a lower peak pressure over the medial forefoot (p = 0.033) during propulsion when compared with control subjects. CONCLUSIONS: Patellofemoral Pain Syndrome is related to a foot rollover pattern that is medially directed at the rearfoot during initial heel contact and laterally directed at the forefoot during propulsion. These detected alterations in the foot rollover process during gait may be used to develop clinical interventions using insoles, taping and therapeutic exercise to rehabilitate this dysfunction

Assessing experience in the deliberate practice of running using a fuzzy decision-support system.

The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches' knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p0.86, p<0.001). From the expert's knowledge and the fuzzy model, running experience is beyond the so-called "10-year rule" and depends not only on practice time, but on the quality of practice (training volume and frequency) and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings

Kappa coefficients of agreement among the five experts in each category classification and the model’s categories, and the general agreement of all classifications of running experience in the real dataset (n = 100).

<p>Kappa coefficients of agreement among the five experts in each category classification and the model’s categories, and the general agreement of all classifications of running experience in the real dataset (n = 100).</p

Rules used in the subsystem 2 –experience level.

<p>Rules used in the subsystem 2 –experience level.</p