Distribuição em ambiente hospitalar: da distribuição clássica aos novos sistemas de distribuição mecânicos

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas MonizA distribuição de medicamentos nos hospitais é uma das funções dos Serviços Farmacêuticos que possuem uma metodologia e circuitos próprios. A distribuição racional de medicamentos assenta na capacidade de fornecer os fármacos pedidos, quer nas quantidades quer nas especificações requeridas, de forma segura e no prazo estabelecido, recorrendo a sistemas eficazes e de baixos custos. Com a evolução tecnológica surgiram sistemas automatizados na distribuição de medicamentos em ambiente hospitalar. A utilização destes sistemas automatizados associados aos sistemas de distribuição já existentes, contribuiu para um aumento da produtividade, para a segurança dos doentes, para a diminuição da ocorrência de erros, para uma melhor gestão de stocks e para uma racionalização de custos com medicamentos nos hospitais

A ATUAÇÃO DO CICLO ALONGAMENTO-ENCURTAMENTO

O treinamento pliométrico baseia-se no ciclo alongamento e encurtamento (CEF), mecanismo fisiológico cuja função é aumentar a eficiência mecânica dos movimentos que se utilizam ações musculares excêntricas seguidas, imediatamente, por explosivas ações concêntricas. Sua principal contribuição é desenvolver a capacidade de gerar potência máxima em um movimento. O objetivo desta revisão foi ditado pela necessidade de conectar o conhecimento do alicerce fisiológico do CEF à compreensão de sua aplicação no desenvolvimento da potência muscular, entendendo a participação das variáveis intervenientes. O embasamento fisiológico pode ser encontrado em três diferentes mecanismos: a) o acúmulo de energia potencial elástica durante as ações musculares excêntricas utilizadas sob a forma de energia cinética na fase concêntrica; b) o padrão de recrutamento das unidades motoras e; c) o reflexo miotático originado da ativação das estruturas proprioceptivas quando do estiramento. Para a manifestação ótima desses mecanismos, evidenciou-se a importância do entendimento da participação de variáveis componentes do Ciclo como a amplitude do movimento articular, velocidade de pré-extensão, carga de alongamento, altura de queda ou arremesso, tempo de transição, flexibilidade e ação das fibras rápidas e lentas, bem como de que forma os fatores limitantes fadiga e potencial de lesões, influenciariam os resultados desejados. Concluiu-se não haver um consenso quer quanto a ação dos mecanismos fisiológicos, quer no tocante à contribuição das variáveis à aplicação do CEF, recomendando-se mais estudos para a correta definição do papel de cada um dos aspectos abordados. THE PERFORMANCE OF THE STRETCH SHORTENING CYCLE Abstract Plyometric training is based upon the stretch shortening cycle (SSC). The SSC is a physiological mechanism that aims to enhance mechanical efficiency by maximizing the concentric phase of the muscle movement through the storage and utilization of potential elastic energy from the eccentric phase. Its main contribution is to develop the ability to generate the maximal power output. The objective of this study is to understand the application of SSC on power training from the knowledge of its theoretical framework and its interaction with the intervening variables. The theoretical framework can be found in three mechanisms: a) the storage of potential elastic energy during the eccentric phase and its immediate utilization as kinetics energy during the concentric stage; b) the pattern of motor units activation; c) the potential reflex from de proprioceptives structures. This study highlights the importance of variables such as the range of joint movements, velocity of stretching, stretching loads, heights of drop jumping and throwing, transition time, flexibility and action of fast, fibers or slow, fast motor units and slow twitches concerning the proper manifestation of those mechanisms. Fatigue and injury potential are also studied in order to find out their influence on the training is. So far there is no agreement concerning the exact action of the physiological mechanisms and the contribution of variables to SSC. Further studies and research are recommended to define their role

Laboratory of Exercise Physiology -Institute of Science of Physical Education of the Air Force (ISPEAF)

ABSTRACT Resistance exercises can be done uni or bilaterally. Depending on the way by which the movement is conducted, the presence of bilateral deficit (BD) is observed. BD studies have concentrated their effort on the investigation of the phenomenon in exercises done with one single maximum repetition and little is known about their behavior in exercises with many repetitions. The aims of this study were: a) to compare the load in 10 repetition maximum (10RM) in the different sides of the body in exercises done with arms and legs. b) To compare the sum of the unilateral actions with the bilateral results in the same exercises. Twenty trained women between 18 and 30 years old (24 ± 6) were evaluated in uni and bilateral 10RM test in the selected exercises. The statistics analysis was t-test paired, to verify the difference between limbs and the sum of the two limbs separately in relation to bilateral load. Significance level was p < 0.05 for all procedures. No difference was found in the manipulated loads in both members, the same not occurring with the sum of unilateral load compared to bilateral. This demonstrates that the practice of bilateral work in routine situation of training involving 10RM promotes a greater manipulation of load in relation to unilateral work, differently from what is seen in BD in 1RM. In conclusion, at least in the selected exercises, BD was not found. Future studies should be done for better understanding of the BD phenomenon during training routine

Does A Land-Based Compensatory Strength Training Program Really Influence The Rotator-Cuff Balance Of Young Competitive Swimmers?

During the repeated execution of the swimming strokes, the shoulder adductor and internal rotator muscles have a tendency to become proportionally stronger when compared to their antagonist group. This can lead to muscle imbalances. The aim of this study was to examine the effects of a compensatory training programme on the strength and balance of shoulder rotator muscles in young swimmers. A randomized controlled trial design was used. Forty male swimmers took part in the study and were randomly divided into two groups: an experimental group (n = 20) and a training group (n = 20). A control group (n = 16) of young sedentary male students was also evaluated. The experimental group subjects participated in a 16-week shoulder-strength programme with Thera-Band® elastic bands; the training group was restricted to aquatic training. Peak torque of shoulder internal rotator and external rotator (ER) was measured at baseline and after 16 weeks. Concentric action at 1.04 rad s−1 (3 reps) and 3.14 rad s−1 (20 reps) was measured using an isokinetic dynamometer. The strength- training programme led to an improvement of the ER strength and shoulder rotator balance in the experimental group (data from both shoulders at 1.04 rad s−1). Moreover, concentric action at 3.14 rad s−1 presented significant differences only for the dominant shoulder. Findings suggest that the prescribed shoulder-strengthening exercises could be a useful training option for young competitive swimmers. They can produce an increase in absolute strength values and greater muscle balance in shoulder rotators

Effects of Six-week Periodized Versus Non-Periodized Kettlebell Swing Training on Strength, Power and Muscular Endurance

International Journal of Exercise Science 15(4): 526-540, 2022. The purpose of this study was to compare a periodized versus a non- periodized protocol of kettlebell (KTB) swings over six weeks on strength, power, and muscular endurance. Twenty-eight high intensity functional training (HIFT) practitioners were assigned to non- periodized (NPG = 11), periodized (PG = 11), or control groups (CG = 6). NPG used the same load (20 kg) throughout the training period while the PG used a step loading progression (with an added four kilograms every two weeks). Measures of strength and muscular endurance in the deadlift exercise, and power in the countermovement jump were assessed before and after six weeks. A two-way ANOVA was used to verify pre- to post-test differences in strength, power, and muscular endurance. An analysis of the effect size was also incorporated. For strength and power, statistical differences from pre- to post-test were found for both the NPG (p \u3c 0.001; 1-RM improvement = 8.7%; jump height improvement = 8.7%) and PG (p \u3c 0.001; 1-RM improvement = 7.8%; jump height improvement = 10.1%), with no difference between groups. For muscular endurance, only the PG showed significant differences from pre- to post-test (p = 0.013; muscular endurance improvement = 23.8%). In conclusion, when the goal is to increase strength and power performances in HIFT practitioners, periodized and non-periodized KTB models appear to be equally effective, and this can simplify the strength coach\u27s practice in programming KTB swing training periods. For muscular endurance, the addition of KTB swing on a periodized basis seems to be a more effective strategy

An orthodontic-surgical approach to Class II subdivision malocclusion treatment

Despite the different orthodontic approaches to Class II subdivision malocclusions one has also to consider the skeletal components before undertaking any treatment protocol. Significant involvement of the skeletal structures may require a combined surgical orthodontic treatment, which has remained stable for more than four years, as illustrated in this case report

EVOLUÇÃO INTERPRETATIVA DA SUPREMA CORTE DOS ESTADOS UNIDOS DA AMÉRICA ENTRE OS ANOS DE 1803 e 1954

O objetivo principal deste artigo é compreender a evolução interpretativa implementada pela Suprema Corte dos Estados Unidos da América em seus precedentes datados entre 1803 e 1954, evidenciando-se a não homogeneidade desse processo. Dentro desse lapso temporal, diversos precedentes de garantias de liberdades civis serão analisados com o fim de elucidar a hermenêutica adotada pela Corte a partir de 1937, com especial ênfase nos pertinentes a temática de discriminação racial e seus reflexos na sociedade norte-americana.Para tanto, a metodologia aplicada foi a revisão bibliográfica e documental

Mercado e desempenho operacional contábil de longo prazo

Following the value relevance literature, this study verifies whether the marketplace differentiates companies of high, medium, and low long-term operational performance, measured by accounting information on profitability, sales variation and indebtedness. The data comprises the Corporate Financial Statements disclosed during the period from 1996 to 2009 and stock prices of companies listed on the São Paulo Stock Exchange and Commodities and Futures Exchange – BM&FBOVESPA. The final sample is composed of 142 non-financial companies. Five year mobile windows were used, which resulted in ten five-year periods. After checking each company’s indices, the accounting variables were unified in an Index Performance Summary to synthesize the final performance for each five-year period, which allowed segregation in operational performance levels. Multiple regressions were performed using panel data techniques, fixed effects model and dummies variables, and then hypothesis tests were made. Regarding the explanatory power of each individual variable, the results show that not all behaviors are according to the research hypothesis and that the Brazilian stock market differentiates companies of high and low long-term operational performance. This distinction is not fully perceived between companies of high and medium operational performance.Key words: accounting metrics of operational performance, stock returns, long-term sustainability.Seguindo as pesquisas sobre relevância da informação contábil para o valor da empresa (em inglês, categorizadas pela expressão value relevance), este estudo verifica se o mercado diferencia as empresas de alto, médio e baixo desempenho operacional de longo prazo, medido por informações contábeis de rentabilidade, variação de vendas e endividamento. Os dados compreendem as Demonstrações Contábeis Societárias Anuais Individuais divulgadas no período de 1996 a 2009 e o preço das ações das empresas listadas na Bolsa de Valores e de Mercadorias e Futuros de São Paulo – BM&FBOVESPA. A amostra final é composta por 142 empresas não financeiras. Foram utilizadas janelas móveis de cinco anos, que resultaram em dez períodos quinquenais. Após a apuração dos índices de cada empresa, as variáveis contábeis foram unificadas em um Índice Síntese de Desempenho para sintetizar a performance final por empresa a cada quinquênio, o que permitiu a segregação em níveis de desempenho operacional. Foram realizadas regressões múltiplas com técnicas de dados em painel, modelo de efeitos fixos e variáveis dummies, e depois realizados testes de hipóteses. Considerando o poder explicativo individual de cada variável, os resultados demonstraram que nem todos os comportamentos estão de acordo com as hipóteses da pesquisa e que o mercado acionário brasileiro diferencia empresas de alto e baixo desempenho operacional de longo prazo. Essa distinção não é percebida por completo entre as empresas de alto e médio desempenho operacional.Palavras-chave: desempenho operacional contábil, retorno das ações, sustentabilidade de longo prazo

Effects of Different Number of Sets of Resistance Training on Flexibility

International Journal of Exercise Science 10(3): 354-364, 2017. The aim of this study was to investigate the effects of six months of training with three different number of sets of resistance training on flexibility in young men. Forty-seven men (mean ± SD age = 24 ± 1yrs; body mass = 79.39 ± 9.12 kg; height = 174.5 ± 5.6 cm) were randomly divided into three training groups performing either one set (G1S), three sets (G3S), or five sets (G5S) of all exercises in a resistance training session or a control group (CG). All groups were assessed pre- and post-training for Sit-and-Reach test and range of motion of 10 joints using goniometry. The training protocol included three weekly sessions and was composed of nine exercises performed at a moderate intensity (eight to 12RM). The results demonstrated significant differences pre- to post-training for the Sit-and-Reach test for all training groups; however, only the G5S showed significant differences when compared to the CG (31.04 ± 5.94cm vs. 23.56 ± 6.76cm, respectively; p \u3c 0.05). Of the ten joint movements measured, there were range of motion increases only to shoulder flexion (G1S), shoulder extension (G3S), elbow flexion (G3S), and knee flexion (G3S) when comparing pre- to post-training (p \u3c 0.05). In conclusion, different resistance training volumes improved flexibility for some joints of young men. These findings indicate that performing only resistance training can result in increases in flexibility

Physiological Profile of Brazilian Elite Soccer Players: Comparison between U-17, U-20 and professionals

Possible differences in the physical values ​​related to characteristics of the age group and the play positions in soccer. The aims to analyze the isokinetic muscle strength profiles, anthropometric, neuromuscular and cardiovascular characteristics, comparing age, categories and play positions. 105 players divided into U-17, U-20, Professional and six play positions. The isokinetic test, anthropometric measurements, counter-movement jump test with arms and yo-yo intermittent recovery test were performed. Significant differences (p<0.05) were found in the professionals compared to U-20 and U-17 for body mass, height, body fat, VO2max and for U-17 in relation to professionals in the isokinetic test. Significant differences were also found between play positions (p<0.05) for body mass, height, VO2max and isokinetic. Soccer athletes playing in different positions have different profiles of physiological characteristics and U-17 have a lower level of strength compared to professionals, suggesting the importance of training specificity