Pesquisa-ação: fundamentos do planejamento e do diagnóstico em comunidades rurais.

O presente trabalho nasceu da necessidade de divulgar um aspecto operacional da metodologia da pesquisa-ação chamada de diagnóstico. O estudo tem sido realizado por uma equipe de pesquisadores, extensionistas e agricultores nos Estados da Bahia, Pernambuco e Paraíba através da Embrapa Mandioca e Fruticultura, EMATER-PB, EBDA, EMATER-PE. No Brasil, as comunidades, municípios e regiões apresentam-se de forma diferenciada, com menor ou maior complexidade. Logo, para se intervir em determinada área para promover um processo de mudanças e necessário compreender primeiro sua realidade.bitstream/item/81305/1/Pesquisa-Acao-Jose-Cerqueira-Documentos-93-2000.pd

Confirming the attainment of maximal oxygen uptake within special and clinical groups: a systematic review and meta-analysis of cardiopulmonary exercise test and verification phase protocols

Background and aim A plateau in oxygen uptake (V̇O2) during an incremental cardiopulmonary exercise test (CPET) to volitional exhaustion appears less likely to occur in special and clinical populations. Secondary maximal oxygen uptake (V̇O2max) criteria have been shown to commonly underestimate the actual V̇O2max. The verification phase protocol might determine the occurrence of ‘true’ V̇O2max in these populations. The primary aim of the current study was to systematically review and provide a meta-analysis on the suitability of the verification phase for confirming ‘true’ V̇O2max in special and clinical groups. Secondary aims were to explore the applicability of the verification phase according to specific participant characteristics and investigate which test protocols and procedures minimise the differences between the highest V̇O2 values attained in the CPET and verification phase. Methods Electronic databases (PubMed, Web of Science, SPORTDiscus, Scopus, and EMBASE) were searched using specific search strategies and relevant data were extracted from primary studies. Studies meeting inclusion criteria were systematically reviewed. Meta-analysis techniques were applied to quantify weighted mean differences (standard deviations) in peak V̇O2 from a CPET and a verification phase within study groups using random-effects models. Subgroup analyses investigated the differences in V̇O2max according to individual characteristics and test protocols. The methodological quality of the included primary studies was assessed using a modified Downs and Black checklist to obtain a level of evidence. Participant-level V̇O2 data were analysed according to the threshold criteria reported by the studies or the inherent measurement error of the metabolic analysers and displayed as Bland-Altman plots. 3 Results Forty-three studies were included in the systematic review, whilst 30 presented quantitative information for meta-analysis. Within the 30 studies, the highest mean V̇O2 values attained in the CPET and verification phase protocols were similar (mean difference = -0.00 [95% confidence intervals, CI = -0.03 to 0.03] L·min-1 , p = 0.87; level of evidence, LoE: strong). The specific clinical groups with sufficient primary studies to be meta-analysed showed a similar V̇O2max between the CPET and verification phase (p > 0.05, LoE: limited to strong). Across all 30 studies, V̇O2max was not affected by differences in test protocols (p > 0.05; LoE: moderate to strong). Only 23 (53.5%) of the 43 reviewed studies reported how many participants achieved a lower, equal, or higher V̇O2 value in the verification phase versus the CPET or reported or supplied participant-level V̇O2 data for this information to be obtained. The percentage of participants that achieved a lower, equal, or higher V̇O2 value in the verification phase was highly variable across studies (e.g. the percentage that achieved a higher V̇O2 in the verification phase ranged from 0% to 88.9%). Conclusion Group-level verification phase data appear useful for confirming a specific CPET protocol likely elicited V̇O2max, or a reproducible V̇O2peak, for a given special or clinical group. Participant-level data might be useful for confirming whether specific participants have likely elicited V̇O2max, or a reproducible V̇O2peak, however, more research reporting participant-level data is required before evidence-based guidelines can be given

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients’ perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB

Kinematic Comparison of the Roundhouse Kick Between Taekwondo, Karate, and Muaythai

The roundhouse kick (RHK) is frequently executed in taekwondo, karate, and muaythai because of its high technical effectiveness during combat. The purpose of this study was to compare kinematic characteristics during RHK performance between taekwondo, karate, and muaythai athletes. Forty-seven male athletes (25.5 ± 4.7 years, 1.75 ± 0.1 m, and 75.8 ± 11.5 kg) volunteered to participate (taekwondo: 17; karate: 15; and muaythai: 15). Self-selected distance from target, mean and peak fifth metatarsus linear velocity (LV5mean; LV5peak), mean and peak hip (HAVmean; HAVpeak) and knee (KAVmean; KAVpeak) angular velocities, as well as target linear acceleration (TLA) were analyzed with a 3D video motion analysis system. Comparisons between modalities were performed with 1-way analysis of variances and Bonferroni's post hoc test (α = 0.05). Self-selected distance was lower in muaythai compared with taekwondo and karate (p < 0.001). Also, karate had greater LV5meancompared with muaythai (p = 0.001), and muaythai showed higher HAVmeanthan karate (p = 0.011). In addition, HAVpeakwas greater in muaythai than in taekwondo and karate (p < 0.001). No differences were found for KAVmean, KAVpeak, and TLA. Although it is similarly described between modalities, RHK showed distinct kinematic characteristics between taekwondo, karate, and muaythai. Based on these results, coaches and athletes can improve their RHK technique according to the specificities of each combat sport. Specifically, it is suggested that combat strategies should aim to increase the distance from the opponent during combat for muaythai athletes, whereas taekwondo and karate athletes should focus on decreasing it

Exercise intervention does not reduce the likelihood of VO2max underestimation in older adults with hypertension

The present study aimed to investigate whether training status would influence the capacity of a verification phase (VER) to confirm maximal oxygen uptake (VO2max) of a previous graded exercise test (GXT) in individuals with hypertension. Twelve older adults with hypertension (8 women) were recruited. Using a within-subject design, participants performed a treadmill GXT to exhaustion followed by a multistage VER both before and after a 12-wkcombined exercise training programme. Individual VO2max, respiratory exchange ratio (RER), maximal heart rate (HRmax), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Absolute and relative VO2max values were higher in VER than in GXT at baseline, but only absolute VO2max differed between bouts post-intervention (all p < 0.05). Individual VO2max comparisons revealed that 75% of the participants (9/12) achieved a VO2max value that was ≥3% during VER both before (range: +4.9% to +21%) and after the intervention (range: +3.4% to +18.8%), whereas 91.7% (11/12) of the tests would have been validated as a maximal effort if the classic criteria were employed. A 12-wk combined training intervention could not improve the capacity of older adults with hypertension to achieve VO2max during a GXT, as assessed by VER

Identification of demand characteristics in the production of sires using a conceptual model of quality function deployment: a case study Determinação das características da demanda para produção de touros por meio de um modelo conceitual de desdobramento da função qualidade: um estudo de caso

The objective of this study is to identify demands of customers of a sire-producing company in Rio Grande do Sul, Brazil, by using a methodology adapted from quality function deployment tool. The adaptation consisted on the fact that matrices are treated in an unified manner among product and services due to the high perception of inter-relationship among these business components. The results evidenced that clients priorize traits related to the product, especially genetic value of the bulls. Service items were also highlighted, and they may be presented as an opportunity of differentiation among suppliers. Customer profile influenced priority order inasmuch as farmers with no technical services prioritized performance traits over genetic traits, opposing to those who were assisted and to technical consultants. Concerning to farm size, there were changes only in the tertiary level of the priority order of the demands. The adaptation of the methodology for joint analysis interfered in the results, especially in service prioritization. This study contributed to formatting a model for using quality function deployment in sire production, helping to identify quality demands and its priority levels for the population and researched company, and it may be used in further studies on the product beef sires.<br>Este trabalho foi realizado com o objetivo de identificar as demandas dos clientes de uma empresa produtora de touros de corte no Rio Grande do Sul por meio de uma metodologia adaptada da ferramenta desdobramento da função qualidade. A adaptação consistiu no fato de que as matrizes são tratadas de forma unificada entre o produto e os serviços, devido à percepção do elevado nível de inter-relacionamento entre esses componentes no negócio. Os resultados evidenciaram que os clientes priorizam as características relacionadas ao produto, especialmente o valor genético dos touros. Os itens de serviços também se destacaram, podendo configurar-se como uma oportunidade de diferenciação entre as empresas fornecedoras. O perfil dos clientes influenciou a ordem de priorização, uma vez que os produtores sem assistência técnica priorizaram as características de desempenho às genéticas, ao contrário dos assistidos e dos consultores técnicos. No tamanho da propriedade, só houve alterações na ordem de priorização no nível terciário das demandas. A adaptação da metodologia para a análise conjunta interferiu no resultado, principalmente na priorização dos serviços. O estudo contribuiu com a formatação de um modelo de uso do desdobramento da função qualidade na produção de touros, auxiliando na identificação da qualidade demandada e no seu nível de priorização para a população e empresa pesquisada, podendo ser utilizado em outros estudos para o produto touro

Commentaries on Viewpoint: V̇ o 2peak is an acceptable estimate of cardiorespiratory fitness but not V̇ o 2max

International audienceto the editor: We can define V̇o2max as the highest oxygen delivered and utilized during exercise, and, if we increase the exercise intensity, the oxygen uptake will not increase. This assumption came from an original study of Hill and Lupton (2); they applied on different days higher intensities during a constant-work exercise. The authors observed that, above certain intensity, the O2 uptake does not increase. Because of the nature of the constant-work exercise, they observed a plateau phenomenon. Since then, plateau phenomenon has been the main “true” V̇o2max attainment criterion. If the plateau is not present, we consider it as V̇o2peak. However, the plateau is neither evident for ramp nor step protocol (5). The plateau appearance is dependent on data manipulation (4), subjects’ fitness, motivation, perceived exertion, and so on (3). Therefore, the plateau does not appear to be a natural physiological response in the face of the incremental exercise testing, and a plateau phenomenon is a wrong interpretation of Hill and Lupton study. As the maximum intensity achieved during incremental testing is dependent on, a priori, motivation (3), we must do the V̇o2max confirmation, independently of the plateau appearance, satisfying the main criterion “The O2 uptake does not increase irrespective of intensity increment.” In my view, the V̇o2peak is not a valid physiological index, and the terminology used in the Green and Askew (1) Viewpoint must be withdrawn from the scientific literature. The confirmation test is the best choice for cardiorespiratory assessments