A Cardiopulmonary Exercise Testing for Prescribing High-Intensity Interval Training Sessions with Elastic Resistance.

This study aims to analyze the agreement of cardiopulmonary variables between a cardiopulmonary exercise test with elastic resistance (CPxEL) and high-intensity interval exercise with elastic resistance (EL-HIIE). METHODS: Twenty-two physically independent participants were recruited. Visit one consisted of conducting a health survey and anthropometric assessment. On visit two, the participants performed CPxEL. After seven days, on visit three, the participants performed EL-HIIE. The CPxEL was carried out on a rubber mat demarcated by lines representing eight stages. The test consisted of alternating back and forth steps against elastic resistance. The increments were performed at a rate of one stage per minute, following a cadence controlled by a metronome calibrated by beats per minute (bpm). The EL-HIIE was performed at the stage corresponding to an intensity of ~85% VO2max, as determined by CPxEL. The EL-HIIE consisted of 10 × 1 min (work):1 min (passive rest), with a cadence of 200 bpm. Cardiopulmonary parameters, heart rate (HR), and oxygen consumption (VO2) were measured during exercise. Bland-Altman was applied to analyze the agreement between the HR and VO2 found in EL-HIIE and the values prescribed by CPxEL (~85-90% VO2max). RESULTS: The HRpeak and VO2peak in the EL-HIIE showed good agreement with the VO2CPxEL and HRCPxEL values, showing an average difference of (-1.7 mL·kg-1·min-1) and (0.3 bpm). CONCLUSIONS: The results of the present study demonstrate the agreement of cardiopulmonary variables between the CPxEL and the EL-HIIE. Therefore, for a more specific prescription of EL-HIIE intensity, CPxEL can be used.

Acute Cardiopulmonary Response of High-Intensity Interval Training with Elastic Resistance vs. High-Intensity Interval Training on a Treadmill in Healthy Adults.

This study aims to describe and compare cardiopulmonary and subjective responses during high-intensity interval training with elastic resistance (EL-HIIT) and traditional high-intensity interval training (HIIT) sessions. Twenty-two healthy adults (27.6 ± 4.4 years) performed an EL-HIIT and a HIIT protocol consisting of 10 × 1 min at ~85% V·O2max prescribed by cardiopulmonary-specific tests. Pulmonary parameters, heart rate (HR), blood lactate, and rate of perceived exertion (RPE) were measured during exercise. Paired t-test and Cohen's d effect size were used to compare peak and average values. Two-way repeated measures ANOVA and mixed model with Bonferroni's post hoc test were used to compare each bout during the session. The EL-HIIT session showed higher peak and average values of HR, ventilation (V·E), relative and absolute oxygen uptake (V·O2), carbon dioxide production (V·CO2), and RPE than HIIT (p < 0.05). The effect size (ES) comparing HIIT and EL-HIIT was large for HR, V·E, and lactate (≥0.8) in peak values. Comparing each bout between HIIT and EL-HIIT, no difference was found in peak values (p > 0.05) during the session (excluding baseline, warm-up, and recovery). EL-HIIT presented a more pronounced cardiopulmonary and subjective response than HIIT.

Coping na hospitalização: estratégia de enfrentamento familiar de pacientes na unidade semi-intensiva / Coping in hospitalization: a family coping strategy for patients in the semi-intensive care unit / Coping en la hospitalización: estrategia de enfrentamiento familiar de pacientes en unidad semi-intensiva

As circunstâncias envolvidas na hospitalização causam nos cuidadores dificuldades no enfrentamento (coping), exigindo estratégias de adaptação à situação adversa e superação da crise instaurada pelo adoecimento. Este artigo parte de estudo anterior, feito durante a Residência Integrada em Saúde (RIS), sobre o impacto do processo de hospitalização para os acompanhantes do paciente internado na Unidade de Terapia Semi-Intensiva (UTSI), aprofundado nesta pesquisa para abordar as estratégias de enfrentamento. Assim, foi realizado estudo retrospectivo, qualitativo, com 9 familiares cuidadores de pacientes internados na UTSI em hospital de referência em cardiopneumologia. Os dados foram coletados através de entrevistas semiestruturadas e o material submetido à análise de conteúdo. Os resultados encontrados apontam que a prática religiosa é uma estratégia utilizada com frequência pelos familiares, bem como a distração, através de redes sociais, leituras e interação com outras pessoas. Tais ações funcionam como modo de superação a fim de evitar desgastes emocionais encontrados dentro desta unidade internação. (AU)

The circumstances involved in hospitalization cause difficulties in coping for caregivers, requiring them to use strategies for adapting to the adverse situation and overcoming the crisis caused by illness. This article is based on a previous study, carried out during an Integrated Residency in Healthcare, on the impact of the hospitalization process on caregivers in the Semi-Intensive Care Unit (SICU), which has been expanded in this research to also address coping strategies. Therefore, we carried out a retrospective, qualitative study with nine family caregivers of patients hospitalized in the SICU at a reference hospital for cardiopulmonary care. The data was collected through semi--structured interviews, and the material was submitted for content analysis. The results found indicate that religious practice is a frequently used strategy by family caregivers, as well as distractions through social networks, reading and interaction with other people. These actions function as a way of overcoming hardships in order to avoid emotional exhaustion within the care unit. (AU)

Las circunstancias involucradas en la hospitalización causan en los cuidadores dificultades en el enfrentamiento, exigiendo de ellos estrategias de adaptación a la situación adversa y superación de la crisis instaurada. Este artículo se origina en el estudio anterior durante la Residencia Integrada en Salud (RIS), sobre el impacto del proceso de hospitalización para los acompañantes del paciente internado en la Unidad de Terapia Semi-Intensiva (UTSI), profun-dizado en esta investigación para abordar las estrategias de enfrentamiento. De esta manera, fue realizado un estudio retrospectivo, cualitativo, con 9 familiares cuidadores de pacientes internados en UTSI en un hospital que es referencia en cardiopneumología. Los datos fueron recolectados a través de entrevistas semi estructuradas, y el material sometido a análisis de contenido. Los resultados encontrados señalan que la práctica religiosa es una estrategia utilizada con frecuencia por los familiares, así como la distracción, a través de las redes sociales, lectura e interacción con otras personas. Dichas acciones funcionan como superación para evitar desgastes emocionales encontrados dentro de esta unidad. (AU)

Is There Agreement and Precision between Heart Rate Variability, Ventilatory, and Lactate Thresholds in Healthy Adults?

This study aims to analyze the agreement and precision between heart rate variability thresholds (HRVT1/2) with ventilatory and lactate thresholds 1 and 2 (VT1/2 and LT1/2) on a treadmill. Thirty-four male students were recruited. Day 1 consisted of conducting a health survey, anthropometrics, and Cardiopulmonary Exercise Test (CPx). On Day 2, after 48 h, a second incremental test was performed, the Cardiopulmonary Stepwise Exercise Test consisting of 3 min stages (CPxS), to determine VT1/2, LT1/2, and HRVT1/2. One-way repeated-measures ANOVA and effect size (ηp2) were used, followed by Sidak's post hoc. The Coefficient of Variation (CV) and Typical Error (TE) were applied to verify the precision. Bland Altman and the Intraclass Correlation Coefficient (ICC) were applied to confirm the agreement. HRVT1 showed different values compared to LT1 (lactate, RER, and R-R interval) and VT1 (V̇E, RER, V̇CO2, and HR). No differences were found in threshold 2 (T2) between LT2, VT2, and HRVT2. No difference was found in speed and V̇O2 for T1 and T2. The precision was low to T1 (CV > 12% and TE > 10%) and good to T2 (CV < 12% and TE < 10%). The agreement was good to fair in threshold 1 (VT1, LT1, HRVT1) and excellent to good in T2 (VT1, LT1, HRVT1). HRVT1 is not a valid method (low precision) when using this protocol to estimate LT1 and VT1. However, HRVT2 is a valid and noninvasive method that can estimate LT2 and VT2, showing good agreement and precision in healthy adults.

Cardiopulmonary Exercise Testing with Elastic Resistance: A New Reproducible Proposal for Determination of Ventilatory Thresholds and Maximum Oxygen Consumption.

To propose a new Cardiopulmonary Exercise Test with Elastic Resistance (CPxEL) and compare the physiological responses to conventional cardiopulmonary exercise test (CPx) performed on a treadmill. In addition, we tested the reproducibility of the CPxEL. Twenty-four physically active participants completed the CPx (first session) and CPxEL twice (second and third sessions) interspersed by seven days. A treadmill protocol with increments of 1km·h-1 every minute until exhaustion was used in CPx. The CPxEL consisted of performing alternating steps back-and-forth against an elastic resistance attached to a belt and an incremental protocol with 1 stage (S) per minute following a cadence of 200 bpm controlled by a metronome in an 8-stage rubber mat. First analysis: first ventilatory threshold (VT1) occurred at 69.7% and 75.3% of maximal heart rate (HRmax) and 53.5% and 65.7% of maximal oxygen consumption (V̇O2max). Second VT (VT2) occurred at 93.3% and 96.8% of the HRmax and 87.0% and 96.9% of V̇O2max for CPx and CPxEL, respectively. At exhaustion, V̇O2max, perceived exertion (BORG-CR10 and OMNI-RES EB), and test duration presented lower values for CPxEL (P < 0.05). Second analysis: VT1 occurred at warm-up (S0) (P = 0.731), VT2 occurred at S5 (P = 0.912), and the exhaustion occurred at S6 and S7 (P = 0.271) for CPxEL and retest, respectively. The intraclass correlation coefficient (ICC) for V̇O2max was 0.921 and for HRmax was 0.930. The CPxEL has good test-retest reproducibility and represents a possible and interesting add-on to determine maximal oxygen consumption, maximal heart rate, and second ventilatory threshold without using traditional ergometers.

Comment on Teles et al. HIIE Protocols Promote Better Acute Effects on Blood Glucose and Pressure Control in People with Type 2 Diabetes than Continuous Exercise. Int. J. Environ. Res. Public Health 2022, 19, 2601.

After a careful appraisal, we are concerned that the article "HIIE Protocols Promote Better Acute Effects on Blood Glucose and Pressure Control in People with Type 2 Diabetes than Continuous Exercise" [...].

A Global Building Occupant Behavior Database.

This paper introduces a database of 34 field-measured building occupant behavior datasets collected from 15 countries and 39 institutions across 10 climatic zones covering various building types in both commercial and residential sectors. This is a comprehensive global database about building occupant behavior. The database includes occupancy patterns (i.e., presence and people count) and occupant behaviors (i.e., interactions with devices, equipment, and technical systems in buildings). Brick schema models were developed to represent sensor and room metadata information. The database is publicly available, and a website was created for the public to access, query, and download specific datasets or the whole database interactively. The database can help to advance the knowledge and understanding of realistic occupancy patterns and human-building interactions with building systems (e.g., light switching, set-point changes on thermostats, fans on/off, etc.) and envelopes (e.g., window opening/closing). With these more realistic inputs of occupants' schedules and their interactions with buildings and systems, building designers, energy modelers, and consultants can improve the accuracy of building energy simulation and building load forecasting.

Cardiorespiratory fitness level influences the ventilatory threshold identification / Nível de aptidão cardiorrespiratória influencia a identificação do limiar ventilatório

ABSTRACT We aimed to analyze the influence of cardiorespiratory fitness (CRF) on ventilatory threshold identification (VT1) using the Ventilatory Equivalents (VEq) and V-slope methods. Twenty-two male runners (32.9 ± 9.4 years) were divided into two groups: G1 - group with less cardiorespiratory fitness (CRF: VO2max 40 to 51 ml·kg-1·min-1) and G2 - higher CRF (G1; VO2max ?56,4 to 72 ml·kg-1·min-1) divided by the 50th percentile. An incremental cardiopulmonary exercise test was applied to identify VT1 using VEq and V-slope methods to compare heart rate (HR), oxygen consumption (VO2), and speed. Two-way ANOVA was used to compare HR, VO2, and speed (groups vs. methods). The Effect size was calculated using Cohen's d. The intraclass correlation coefficient, variation coefficient, typical error, and Bland Altman were applied to verify reliability and agreement. No significant differences (p < 0.05) were found between methods for G1 (VO2, HR, and speed), and Bland Altman showed good agreement (mean difference: VO2 0.35ml·kg-1·min-1; HR 2.58bpm; speed 0.33km·h-1). However, G2 presented statistical differences between methods (VO2 and speed) and a more significant mean difference (VO2 2.68ml·kg-1·min-1; HR 6.87 bpm; speed 0.88km·h-1). The small effect size was found in G1 between methods (VO2: 0.06; speed: 0.20; HR: 0.14), and small and moderate effects were found in G2 between methods (VO2: 0.39; speed: 0.43; HR: 0.51). In conclusion, runners with lower CRF have a better agreement for the V-slope and VEq methods than those with a higher CRF.

RESUMO O objetivo deste estudo foi analisar a influência do nível de aptidão cardiorrespiratória (ACR) entre os métodos Equivalente Ventilatório (VEq) e V-slope para determinação do Limiar Ventilatório 1 (LV1). 22 homens corredores (32,9 ± 9,4 anos) foram divididos em dois grupos: G1 - grupo com menor aptidão cardiorrespiratória (ACR:VO2máx 40 a 51 ml·kg-1·min-1) e G2 - maior ACR (VO2máx 56,4 a 72 ml·kg-1·min-1), divididos pelo percentil 50. Foi aplicado um teste incremental cardiopulmonar para identificar o LV1 através dos métodos VEq e V-slope, comparando as seguintes variáveis: Frequência Cardíaca (FC), Consumo de Oxigênio (VO2) e velocidade. Para comparações entre FC, VO2 e velocidade (grupos vs. métodos) empregou-se ANOVA de duas vias. O tamanho do efeito foi calculado utilizando d'Cohen. Para verificar a confiabilidade e a concordância, foram aplicados o coeficiente de correlação intraclasse, coeficiente de variação, erro típico e Bland Altman. Não foram encontradas diferenças significativas (p < 0,05) entre métodos para G1 (VO2, FC e velocidade) e Bland Altman revelou boa concordância (diferença média: VO2 0,35ml·kg-1·min-1; FC 2,58bpm; velocidade 0,33km·h-1). Contudo, G2 apresentou diferenças estatísticas entre métodos (VO2 e velocidade) e maior diferença média (VO2 2,68ml·kg-1·min-1; FC 6,87 bpm; velocidade 0,88km·h-1). Tamanho de efeito pequeno foi encontrado no G1 entre os métodos (VO2: 0,06; velocidade: 0,20; FC: 0,14) e efeitos Pequenos e moderados foram encontrados no G2 entre os métodos (VO2: 0,39; velocidade: 0,43; FC: 0,51). Conclui-se que corredores com menor ACR apresentam melhor concordância para os métodos V-slope e VEq em comparação aqueles com maior ACR.

The impact of the hospitalization process on the caregiver of a chronic critical patient hospitalized in a Semi-Intensive Care Unit / El impacto del processo de hospitalización para el acompañante familiar del paciente crítico crónico internado em unidad de cuidado intermédio / O impacto do processo de hospitalização para o acompanhante familiar do paciente crítico crônico internado em Unidade de Terapia Semi-Intensiva

Abstract Objective: To understand the impact of the hospitalization process on the family companion of critical patients admitted to a Semi-Intensive Care Unit (SICU). Method: Exploratory research with a qualitative approach, conducted in the months of April to July of 2016 through a semi-structured interview applied to relatives who were accompanying patients hospitalized in an SICU of a high complexity care hospital in Fortaleza. The interviews were submitted to content analysis. Results: Three themes emerged through the perception of the family members, which reveal the companion's functioning during the hospitalization period: emotional, familiar and behavioural. Conclusion: The companion experiences an intense process of suffering and emotional fragility, causing changes in the family organization. The companion, being a caregiver, is subjected to high levels of stress, having to use coping skills, with; spirituality and social media among the most evident. The companion is an integral care unit for the hospitalized patient and a key piece in the humanization process of health.

Resumen Objetivo: Comprender el impacto del proceso de hospitalización para el acompañante familiar del paciente en Unidad de Terapia Semi-Intensiva (USI). Método: Investigación exploratoria y cualitativa realizada de abril a julio de 2016 por medio de entrevista semiestructurada aplicada en acompañantes familiares de pacientes internados en la USI de un hospital terciario en la ciudad de Fortaleza. Las entrevistas se sometieron al análisis de contenido. Resultados: Ante la percepción de los familiares surgieron tres temáticas, revelando el funcionamiento del acompañante: emocional, familiar y conductual. Conclusión: El familiar vive intensamente el proceso de sufrimiento y fragilidad emocional, habiendo transformaciones en la organización familiar. El acompañante, como cuidador, queda sometido a una elevada carga de estrés, teniendo que utilizar recursos de enfrentamiento, quedando más evidentes la espiritualidad y los medios sociales. El acompañante es una unidad del cuidado integral con el paciente y pieza clave en el proceso de humanización de la salud.

Resumo Objetivo: Compreender o impacto do processo de hospitalização para o acompanhante familiar do paciente internado em Unidade de Terapia Semi-Intensiva (UTSI). Método: Pesquisa exploratória de natureza qualitativa realizada de abril a julho de 2016 por meio de entrevista semiestruturada aplicada acompanhantes familiares de pacientes internados na UTSI de um hospital terciário na cidade de Fortaleza. As entrevistas foram submetidas à análise de conteúdo. Resultados: Diante da percepção dos familiares emergiram três temáticas, as quais revelam o funcionamento do acompanhante no momento da internação: emocional, familiar e comportamental. Conclusão: O familiar vivencia intenso processo de sofrimento e fragilidade emocional, havendo transformações na organização familiar. O acompanhante, enquanto cuidador, fica submetido a elevada carga de estresse, tendo que utilizar-se de recursos de enfrentamento, ficando mais evidentes a espiritualidade e as mídias sociais. O acompanhante é uma unidade do cuidado integral com o paciente internado e peça-chave no processo de humanização da saúde.

Narcisismo: segundo Heinz Kohut e a intersubjetividade / Narcissism: according to Heinz Kohut and intersubjectivity / Narcisismo: según Heinz Kohut y la intersubjetividad

O termo “narcisismo” serviu como adjetivo para a cultura na qual estamos inseridos, nos séculos XX e XXI, como sinônimo de superficialidade emocional, egolatría, arrogância, distanciamento afetivo, hedonismo etc. Estes discursos propiciaram uma abertura para nos questionarmos sobre o impacto das transformações sociais em nossas subjetividades. Porém, o que observamos foi o transbordamento da visão negativa e patológica do conceito aos processos culturais. Isto reforçou a visão moralista e discriminadora do termo. Neste texto, atendendo ao convite que me foi feito, escreverei sobre Heinz Kohut e sua conceituação do narcisismo, e acrescentarei as noções de contexto e de cocriação, adicionadas à psicologia psicanalítica do self pelos teóricos da intersubjetividade e da psicanálise relacional.

The term “narcissism” served as an adjective for the culture in which we operate, in the 20th and 21st centuries, as a synonym for emotional shallowness, egotism, arrogance, emotional detachment, hedonism, etc. These discourses have provided an opening for the questioning about the impact of social changes in our subjectivities. However, what we observed was the spillover of the negative and pathological view of the concept to cultural processes. This reinforced the moralistic and discriminatory view of the term. In this paper, complying to the invitation I was given, I will write about Heinz Kohut and his conceptualization of narcissism, adding the notions of context and of co-creation that were added to psychoanalytic self psychology by theorists of intersubjectivity and relational psychoanalysis.

El término “narcisismo” sirvió como un adjetivo para la cultura en la cual estamos insertados, en los siglos XX y XXI, como sinónimo de superficialidad emocional, egoísmo, egolatría, desapego emocional, hedonismo, etc. Estos discursos han ofrecido una oportunidad para interrogarnos sobre el impacto de los cambios sociales en nuestras subjetividades. Sin embargo, lo que observamos fue la propagación de los puntos de vista negativos y patológicos del concepto hacia los procesos culturales. Esto reforzó la visión moralista y discriminatoria del término. En este trabajo, teniendo en cuenta la invitación que me fue hecha, escribiré sobre Heinz Kohut y su conceptualización del narcisismo, y añadiré las nociones de contexto y de co-creación que se agregaron a la psicología psicoanalítica del self por los teóricos de la intersubjetividad y del psicoanálisis relacional.

Uma ficção sobre as possibilidades do ser: Cidade dos sonhos

Este artigo tem como base e inspiração o filme Cidade dos Sonhos, (Mulholland Drive) dirigido por David Lynch. A autora dividiu-o em duas partes: a primeira parte é composta pela descrição do filme tal como foi visto pela autora e, a seguir, o filme é tratado como um caso clínico tendo como embasamento teórico textos freudianos e o conceito de “sonhos de estados do self” de Heinz Kohut(AU)