Interferência contextual e nível de habilidade na aprendizagem do serviço do voleibol

Este estudo investigou o efeito da interferência contextual (IC) na aquisição do serviço do voleibol em adolescentes com diferentes níveis de habilidade, considerando os testes de transferência imediato e retardado. A amostra foi composta por 56 meninas com idade entre 14 e 16 anos, distribuídas em quatro grupos de prática: aleatório com nível superior de habilidade (GAS), blocos com nível superior de habilidade (GBS), aleatório com nível inferior de habilidade (GAI) e blocos com nível inferior de habilidade (GBI). A tarefa motora consistiu dos serviços por baixo e por cima direcionados a alvos na quadra. Os resultados mostraram que o efeito da IC não foi observado nos grupos GAI e GBI, por outro lado, os grupos GAS e GBS apresentaram melhor desempenho no teste de transferência imediato. A ausência de diferenças significativas no teste de transferência retardado sugere que o efeito da IC pode ser temporário.

Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital

OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5) versus four (3-7) days]; they had lower levels of pH, HCO3 and base excess, and the FiO(2) level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26) days vs. 8 (5-14) days], as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 - 19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II >= 34, an inspiratory positive airway pressure level >= 15 cmH2O and pH<7.40. CONCLUSION: The indications for noninvasive positive-pressure ventilation were quite varied. The failure group had a longer intensive care unit stay and higher mortality. Simplified Acute Physiology Score II >= 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure.