A prospective cohort study of 412 professional rugby union players registered with the English Premiership clubs was conducted during the 2002-2003 season. Injuries were diagnosed and reported by the club medics and the training practices by the club strength and conditioners. A total of 1,090 club injuries (match: 818; training: 260; unidentifiable onset: 12) and 145 international injuries (match: 97; training: 48) were reported. The incidence and risk of club match injuries was 97 injuries and 1,480 days absence per 1,000 player-hours, and the incidence and risk of international match injuries was 218 injuries and 3,076 days absence per 1,000 player-hours. The highest incidence of match injuries occurred to the thigh, however, injuries to the knee were of highest risk. The incidence of club and international training injuries was 3.1 and 6.1 injuries per 1,000 player-hours, respectively. When intrinsic risk factors were assessed, the youngest players (<21 years old) had the highest incidence and a significantly higher risk of injury. Playing position appeared to be the most influential determinate of injury profile, rather than intrinsic anthropometric risk factors alone. The match injury with the second highest incidence and risk was hamstring muscle injuries and a number of risk factors and protective training factors were identified. Results presented from this study have provided the most comprehensive study of injury incidence, aetiology and risk factors in professional rugby union to date. The data provide objective evidence on which to base both preventative interventions to reduce the probability of sustaining an injury and therapeutic interventions to reduce the severity of an injury and thereby reduce the overall risk associated with injuries.

Orientador: Sérgio Santos Mühlen / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-25T18:16:12Z (GMT). No. of bitstreams: 1 Sousa_MicheleCristinaAlmeida_M.pdf: 12999828 bytes, checksum: 780db7c2e34e93006e841bdc475aef8d (MD5) Previous issue date: 2014 / Resumo: Introdução: O Centro de Material e Esterilização (CME) em unidades de saúde deve garantir a qualidade dos instrumentais médico-hospitalares para um atendimento seguro ao paciente. Para que o processo de esterilização seja realizado de forma adequada, é imprescindível que o artigo a ser esterilizado esteja livre da matéria orgânica e de certas substâncias inorgânicas. Se as atividades de recebimento, limpeza, enxágue e secagem dos instrumentais cirúrgicos, localizadas no Expurgo, forem realizadas de modo inadequado, elas podem comprometer a limpeza total dos instrumentais. Estas falhas podem ter várias origens e determinam fatores importantes a serem identificados para qualificar o processo de trabalho. Objetivo: A fim de avaliar pontos críticos nos processos e identificar pontos de melhoria nas atividades realizadas no setor de expurgo foi aplicada a técnica Healthcare Failure Mode and Effect Analysis (HFMEA) nos procedimentos ali realizados. Métodos: O HFMEA é uma ferramenta que permite avaliar de modo sistemático os pontos críticos nos processo classificando-os de acordo com a severidade dos efeitos potenciais de suas falhas e com a sua probabilidade de ocorrência, permitindo priorizar os riscos a serem controlados. Para a sua aplicação formou-se uma equipe, mapeou-se o processo, fez-se uma análise de risco e depois se avaliaram os modos de falha a eles relacionados. Resultados: Foram encontrados 89 modos de falhas envolvendo os procedimentos de limpeza e secagem dos instrumentais, e associados a esses modos de falha foram encontradas 262 causas potenciais. Desse total, 131 causas potenciais (50%) foram analisadas e selecionadas para propor medidas e ações de melhoria. Por fim, uma proposta de ações e medidas de risco envolvendo técnicas relacionadas aos procedimentos do expurgo, gestão, ambiente de trabalho, equipamento, insumos e equipe operacional foi elaborada, e se for usado, ajudará a equipe de gestores no gerenciamento de risco. Conclusão: A aplicação da ferramenta HFMEA permitiu diagnosticar os pontos críticos do processo e propor soluções de melhoria que foram condensadas numa proposta de ações e medidas que pode contribuir para que a equipe de gestores do CME incorpore rotinas mais seguras na realização de suas atividades / Abstract: Introduction: Material and Sterilization Centers in health care facilities should ensure the quality of medical instruments for safe patient care. For the sterilization process to be carried out properly, it is essential that the article to be sterilized is free from of organic matter and some inorganic substances. If the activities of receiving, cleaning, rinsing and drying of surgical instruments, located in the Cleaning sector, are incomplete or inadequate because of being performed quickly, they can compromise the cleanup. These failures may have diverse origins and they determine important factors to be identified for qualifying the work process. Objective: To assess critical points in processes and identify areas for improvement in the activities undertaken in the cleaning sector, Healthcare Failure Mode and Effect Analysis (HFMEA) technique was applied to the procedures performed in that sector. Methods: The HFMEA is tool that provides a systematic evaluation of the critical points in processes by classifying them according to the severity of the potential effects of their failures and to their probability of occurrence, allowing the prioritization of the risks to be controlled. For its implementation a multidisciplinary team was formed, the process was mapped, the risk analysis was executed and the failure modes related to the process were evaluated. Results: 89 failure modes involving the cleaning and drying of instrumentation were found, and 262 potential causes associated with these failure modes were identified. From this total, 131 potential causes (50%) were selected and analyzed to propose measures and actions for improvement. Finally, a proposal of actions and measures involving risk related to the purge procedures, management, work environment, equipment, supplies and technical operations team was prepared, and if used, will help the management team to manage risk. Conclusion: The application of the HFMEA tool provided a diagnosis of the critical points of the process and resulted in the proposition of improvement solutions that have been condensed into a proposal action and measures that can aid the team managers of CME in incorporating safer routines in the execution of the activities / Mestrado / Engenharia Biomedica / Mestra em Engenharia Elétrica