Centro de excelência e ginástica artística feminina: a perspectiva dos técnicos brasileiros

Durante o período de 2001-2008, a Confederação Brasileira de Ginástica implementou o sistema de seleção permanente concentrada no Centro de Treinamento (CT) de Curitiba. Através de um formato semelhante às escolas-internato esportivas da antiga União Soviética, as ginastas passaram a treinar juntas sob o comando de um renomado técnico estrangeiro. Este artigo visa apresentar e discutir o contexto deste CT e o sistema de seleção permanente da ginástica artística feminina (GAF) brasileira, a partir da opinião dos técnicos que desenvolvem a modalidade no país. Procedemos a um estudo de campo e entrevistamos 34 treinadores de 29 instituições. Dentre os aspectos positivos da seleção permanente, os sujeitos relacionaram principalmente a infraestrutura disponível às ginastas. Sobre os aspectos negativos, foram citados problemas relacionados ao rigor do treinamento, à polarização e a consequente monopolização das atletas, o que revela que, provavelmente, não houve uma adaptação do modelo soviético às características da GAF desenvolvida no Brasil.

Global change synergies and trade-offs between renewable energy and biodiversity

Funded by Kone Foundation ERC-StG. Grant Number: 260393 Academy of Finland Centre of Excellence Programme 2012–2017

Designing and implementing a blended learning approach to executive SCM education:a case study from Ireland

The National Institute for Transport and Logistics (NITL) is Ireland’s centre of excellence for supply chain management (SCM). As part of its mission to promote the development of supply chain expertise in Irish business, it designs and delivers executive modular learning programmes. In 2004, as part of a drive to create more flexible learning opportunities for course participants, NITL designed and implemented an eLearning programme, which involved converting traditionally tutored modules to online modules. This paper describes the rationale behind this initiative and the significance of technology as an enabling tool for executive education, as well as detailing the design and implementation processes for the pilot module. The paper concludes with a critique of the expected and actual benefits realised, as well as future development considerations.

PROGNOSTIC FACTORS PREDICTING FUNCTIONAL OUTCOME AT FOUR MONTHS FOLLOWING ACUTE ANKLE SPRAIN

PROGNOSTIC FACTORS PREDICTING FUNCTIONAL OUTCOME AT FOUR MONTHS FOLLOWING ACUTE ANKLE SPRAINBleakley C.M.1, O'Connor S.R.1, Tully M.A.2, Rocke L.G.3, MacAuley D.C.1, Bradbury I.4, Keegan S.4, McDonough S.M.11University of Ulster, Health & Rehabilitation Sciences Research Institute, Newtownabbey, United Kingdom, 2Queen's University, UKCRC Centre of Excellence for Public Health (NI), Belfast, United Kingdom, 3Royal Victoria Hospital, Department of Emergency Medicine, Belfast, United Kingdom, 4Frontier Science (Scotland), Kincraig, Inverness-shire, United KingdomPurpose: To identify clinically relevant factors assessed following acute ankle sprain that predict functional recovery at four months post-injury.Relevance: Ankle sprains are one of the most common musculoskeletal injuries with an estimated 5000 new cases occurring each day in the United Kingdom. In the acute phase, ankle sprains may be associated with pain and loss of function. In the longer-term there is a risk of residual problems including chronic pain or reinjury. Few studies have sought to examine factors associated with a poor long-term prognosis.Participants: 101 patients (Age: Mean (SD) 25.9 (7.9) years; Body Mass Index (BMI): 25.3 (3.5) kg/m2) with an acute grade 1 or 2 ankle sprain attending an accident and emergency department or sports injury clinic. Exclusion criteria included complete (grade 3) rupture of the ankle ligament complex, bony ankle injury or multiple injuries.Methods: Participants were allocated as part of a randomised controlled trial to an accelerated intervention incorporating intermittent ice and early therapeutic exercise or a standard protection, rest, ice, compression, and elevation intervention for one week. Treatment was then standardised in both groups and consisted of ankle rehabilitation exercises focusing on muscle strengthening, neuromuscular training, and sports specific functional exercises for a period of approximately four to six weeks. On initial assessment age, gender, mechanism of injury, presence of an audible pop or snap and the presence of contact during the injury were recorded. The following factors were also recorded at baseline and at one and four weeks post-injury: weight-bearing dorsi-flexion test, lateral hop test, presence of medial pain on palpation and a positive impingement sign. Functional status was assessed using the Karlsson score at baseline, at week four and at four months. Reinjury rates were recorded throughout the intervention phase and at four months.Analysis: A mixed between-within subjects analysis of variance (ANOVA) was used to determine the effect of each factor on functional status at week four and at four months. Significance was set at a Bonferroni adjusted level of 0.0125 (0.05/4).Results: Eighty-five participants (84%) were available at final follow-up assessment. Pain on weight-bearing dorsi-flexion and lateral hop tests at week four were both associated with a lower functional score at four months post-injury (P = 0.011 and P = 0.001). No other significant interactions were observed at any other timepoint (baseline or week one). There were only two reinjuries within the four month follow-up period with a further two reported at approximately six months post-injury. We were therefore unable to determine whether any factors were associated with an increased risk of reinjury.Conclusions: Potential prognostic factors on initial or early examination after acute ankle sprain did not help predict functional recovery at four months post-injury. However, pain on weight-bearing dorsi-flexion and lateral hop tests observed at four weeks were associated with a slower rate of recovery.Implications: Some clinical tests may help identify patients at risk of poor functional recovery after acute ankle sprain. However, further work is required to examine factors which may be predictive on initial assessment.Key-words: 1. Prognostic factors 2. Recovery 3. Ankle sprainFunding acknowledgements: Physiotherapy Research Foundation, Chartered Society of Physiotherapy, Strategic Priority Fund; Department of Employment and Learning, Northern Ireland.Ethics approval: Office for Research Ethics Committee (UK).

Predators on private land: broad-scale socioeconomic interactions influence large predator management

The proliferation of private land conservation areas (PLCAs) is placing increasing pressure on conservation authorities to effectively regulate their ecological management. Many PLCAs depend on tourism for income, and charismatic large mammal species are considered important for attracting international visitors. Broad-scale socioeconomic factors therefore have the potential to drive fine-scale ecological management, creating a systemic scale mismatch that can reduce long-term sustainability in cases where economic and conservation objectives are not perfectly aligned. We assessed the socioeconomic drivers and outcomes of large predator management on 71 PLCAs in South Africa. Owners of PLCAs that are stocking free-roaming large predators identified revenue generation as influencing most or all of their management decisions, and rated profit generation as a more important objective than did the owners of PLCAs that did not stock large predators. Ecotourism revenue increased with increasing lion (Panthera leo) density, which created a potential economic incentive for stocking lion at high densities. Despite this potential mismatch between economic and ecological objectives, lion densities were sustainable relative to available prey. Regional-scale policy guidelines for free-roaming lion management were ecologically sound. By contrast, policy guidelines underestimated the area required to sustain cheetah (Acinonyx jubatus), which occurred at unsustainable densities relative to available prey. Evidence of predator overstocking included predator diet supplementation and frequent reintroduction of game. We conclude that effective facilitation of conservation on private land requires consideration of the strong and not necessarily beneficial multiscale socioeconomic factors that influence private land management.

Submarine landform assemblages and sedimentary processes related to glacier surging in Kongsfjorden, Svalbard

High-resolution swath-bathymetry data from inner Kongsfjorden, Svalbard, reveal characteristic landform assemblages formed during and after surges of tidewater glaciers, and provide new insights into the dynamics of surging glaciers. Glacier front oscillations and overriding related to surge activity lead to the formation of overridden moraines, glacial lineations of two types, terminal moraines, associated debris lobes and De Geer moraines. In contrast to submarine landform assemblages from other Svalbard fjords, the occurrence of two kinds of glacial lineations and the presence of De Geer moraines suggest variability in the landforms produced by surge-type tidewater glaciers. All the landforms in inner Kongsfjorden were deposited during the last c. 150 years. Lithological and acoustic data from the innermost fjord reveal that suspension settling from meltwater plumes as well as ice rafting are dominant sedimentary processes in the fjord, leading to the deposition of stratified glacimarine muds with variable numbers of clasts. Reworking of sediments by glacier surging results in the deposition of sediment lobes containing massive glacimarine muds. Two sediment cores reveal minimum sediment accumulation rates related to the Kongsvegen surge from 1948; these were 30 cm a-1 approximately 2.5 km beyond the glacier front shortly after surge termination, and rapidly dropped to an average rate of 1.8 cm a-1 in ∼1950, during glacier retreat.

Sistemas de avaliação de tecnologias de saúde: dispositivos médicos

As tecnologias de saúde, nomeadamente medicamentos, dispositivos médicos (DM), procedimentos médicos ou cirúrgicos, entre outros, têm ocupado uma posição de destaque no setor da saúde, e na vida dos seus utilizadores. A inovação e utilização de tecnologias de saúde, e consequente aumento das despesas fizeram emergir a necessidade de avaliação das tecnologias de saúde. Surge assim, a avaliação de tecnologias de saúde (ATS), que tem por objetivo abordar os impactos clínicos, económicos, organizacionais, sociais, legais e éticos de uma tecnologia de saúde, considerando o seu contexto médico específico, bem como as alternativas disponíveis. A ATS pretende que os processos sejam feitos de forma rigorosa, transparente, valorizando e garantindo a sustentabilidade do acesso aos cuidados em saúde. Seguindo a tendência europeia de implementação de políticas e modelos de ATS, Portugal criou o seu próprio sistema de avaliação de tecnologias. O Decreto-Lei nº 97/2015, de 1 de junho veio oficializar a criação do Sistema Nacional de Avaliação de Tecnologias de Saúde (SiNATS). O SiNATS vai permitir uma avaliação não só de medicamentos, mas também de DM e outras tecnologias tendo em consideração a avaliação técnica, terapêutica e económica das tecnologias de saúde com base em fatores sociais, políticos, éticos e a participação de entidades, como, a indústria, as instituições de ensino, as instituições de saúde, os investigadores, os profissionais de saúde, os doentes e as associações dos doentes. O SiNATS vai emitir recomendações e decisões sobre o uso das tecnologias de saúde e possibilitar o ganho em saúde e contribuir para a sustentabilidade do Serviço Nacional de Saúde (SNS). O SiNATS vem permitir a avaliação de DM. O sector dos DM é um sector caracterizado pela inovação, crescimento e também competitividade. A complexidade e especificidade deste sector devem por isso ser tidas em consideração aquando da sua análise. A implementação do SiNATS permitirá avaliar e reavaliar preços, comparticipações, recomendações, contratos ao longo do ciclo de vida de cada DM. No presente momento, ainda é difícil expor os processos através dos quais esta avaliação vai ser processada, uma vez que se aguarda a publicação de despachos e portarias referidos no Decreto-Lei nº 97/2015, de 1 de junho. Tendo em consideração a partilha de informação sobre políticas, métodos, procedimentos de ATS aplicada aos DM na Europa, foram analisados os casos de França e do Reino Unido com o objetivo de alargar o conhecimento acerca do que já é feito a nível Europeu e explorar se os mesmos poderiam ser adaptados à realidade portuguesa. Em França, a ATS está diretamente relacionada com a comparticipação de DM, já no Reino Unido, o National Institute and Centre of Excellence (NICE) tem a responsabilidade de avaliar os DM segundo procedimentos de ATS, mas não está diretamente relacionado com comparticipação. O NICE publica normas de orientação que auxiliam a decisão de aquisição ou não de um DM. Tendo em consideração a informação reunida e descrita, este trabalho também propõe um modelo hipotético sobre o sistema português de avaliação de DM. Este modelo aborda, ainda que não de forma exaustiva, os possíveis processos e procedimentos para a avaliação de DM. Este sistema caracteriza-se pela importância dada ao envolvimento dos stakeholders e partilha de informação com os mesmos, mas também na agilização dos processos, isto é, uma redução e simplificação dos processos de avaliação de DM. A reavaliação de DM durante a sua comercialização também ganha destaque, apontando que cada grupo genérico de dispositivos ou DM inovador dever ser reavaliado a cada cinco anos, ou sempre que informação emergente o justifique. Este modelo representa uma abordagem experimental sobre o futuro do SiNATS aplicado aos DM. A partilha de informação, os fóruns de discussão e o envolvimento da sociedade serão uma mais-valia para que a implementação do SiNATS aos DM seja feita de forma gradual e com a máxima transparência possível.

HIV Disclosure: Parental dilemma in informing HIV infected Children about their HIV Status in Malawi

Background Increasingly many perinatally HIV-infected children are surviving through adolescence and adulthood as a result of improvements in the management of paediatric HIV infection, particularly the increased use of combination therapy. It is usually the parents or guardians of these children who are faced with the task of informing the child living with HIV about his or her positive status. However, many parents—particularly biological parents —find this disclosure process difficult to initiate, and this study explored some of the difficulties that these parents encounter. Objective This study set out to explore potential factors that challenge parents and guardians when informing their perinatally HIV-infected child about the child’s HIV status. Design This was a qualitative narrative study that employed in-depth interviews with parents or guardians of children perinatally infected with HIV. A total of 20 parents and guardians of children who attend the outpatient HIV clinic at the Baylor College of Medicine-Abbott Fund Children’s Clinical Centre of Excellence (COE) in Lilongwe, Malawi were interviewed. Of these, 14 were biological parents and six were guardians. Results Guardians and parents expressed uneasiness and apprehension with the disclosure conversation, whether or not they had already told their child that he or she had HIV. Participants who had not told their children recounted that they had contemplated starting the conversation but could not gather enough courage to follow through with those thoughts. They cited the fear of robbing their child of the happiness of living without the knowledge of being positive, fear of making their own status known to more people, and fear of confrontation or creating enmity with their child as impediments to disclosing their child’s positive HIV status to him or her. Conclusions It is apparent that guardians—more particularly biological parents—of children perinatally infected by HIV find it difficult to inform their children about their children’s HIV status. From this disempowered position, parents dread the disclosure of a positive HIV status to a child as a psychosocial process that has the potential to disturb a family’s previously established equilibrium with threats of stigmatization, marginalization, and parent-child conflict. This calls for strategies that could support parents to make disclosure to the child less challenging.

Centro de Excelência Aeroterrestre

Neste Trabalho de Investigação Científico iremos analisar o impacto que um Centro de Excelência Aeroterrestre traria a Portugal. São analisadas várias variáveis que têm impacto direto, na vantagem que Portugal possui face a outros países para a elaboração de um Centro de Excelência Aeroterrestre. Iremos investigar, também o impacto que este Centro teria tanto nas Forças Armadas como também na utilização destas em apoio às populações civis. Tendo em vista a obtenção de resultados nesta investigação, faremos uma comparação de determinadas características de Portugal face a outros países, passando quer por detalhes técnicos mais específicos da vertente aeroterrestres, também pelos detalhes ambientais. Neste trabalho abordaremos também o papel do Centro de Excelência junto da a Proteção Civil Portuguesa, nomeadamente nas suas capacidades de apoio às populações em caso de catástrofe natural.

At odds with the group: Changes in lateralization and escape performance reveal conformity and conflict in fish schools

Many vertebrates are known to show behavioural lateralization, whereby they differentially use one side of their body or either of their bilateral organs or limbs. Behavioural lateralization often manifests in a turning bias in fishes, with some individuals showing a left bias and others a right bias. Such biases could be the source of considerable conflict in fish schools given that there may be considerable social pressure to conform to the group to maintain effective group evasion. Here, we show that predation pressure is a major determinant of the degree of lateralization, both in a relative and absolute sense, in yellow-and-blueback fusiliers (Caesio teres), a schooling fish common on coral reefs. Wild-caught fish showed a bias for right turning. When predation pressure was experimentally elevated or relaxed, the strength of lateralization changed. Higher predation pressure resulted in an increase in the strength of lateralization. Individuals that exhibited the same turning bias as the majority of individuals in their group had improved escape performance compared with individuals that were at odds with the group. Moreover, individuals that were right-biased had improved escape performance, compared with left-biased ones. Plasticity in lateralization might be an important evolutionary consequence of the way gregarious species respond to predators owing to the probable costs associated with this behaviour.