Efeitos do treino resistido na capacidade funcional e na reatividade pressórica em pacientes intradialíticos

Pacientes com doença renal crônica (DRC) submetidos ao treinamento resistido durante a hemodiálise apresentam benefícios substanciais dos sistemas muscular e cardiovascular, da capacidade funcional e da sua qualidade de vida. Entretanto, as melhorias na reatividade pressórica ainda não estão bem esclarecidas. O objetivo foi analisar o efeito do treino resistido na melhora da capacidade funcional e da reatividade pressórica em pacientes hemodialisados, em Natal/RN no ano de 2014. Trata-se de um ensaio clínico controlado e randomizado, com amostra de 64 pacientes, com média de idade de 42,28 (±11,48) anos, distribuídos em grupo experimental (GE) e controle (GC). Para mensurar os ganhos de força de membros inferiores foram utilizados os testes de sentar e levantar e de levantar e caminhar, já para a reatividade pressórica o teste cold pressor, em ambos os grupos antes e após a intervenção. Além disso, apenas o GE participou do treinamento resistido durante a hemodiálise em 16 semanas, composto por 3 sessões semanais, 3 séries de 10 repetições máximas (RM) estimadas (para extensores de joelho e flexores de quadril e joelho), entre 50 a 70% de 10 RM. Para a intensidade do treinamento foi utilizada a escala de Borg entre 11 a 14 durante as seções. Os dados foram analisados utilizando o Teste t para amostras independentes (inter-grupos) bem como para comparar a diferença das médias nos grupos pré e pós-intervenção (intra-grupos) a partir do Teste t para amostras repetidas. Para todas as variáveis foi considerada a significância estatística de 5% executados no software SPSS® 20.0. O estudo foi aprovado pelo comitê de ética do Hospital Universitário Onofre Lopes (HUOL - UFRN) número 37992214.2.0000.5292. Após a intervenção, verificou-se que os pacientes do GE tiveram um desempenho melhor nos testes de força (p<0,001) em comparação ao GC. Resultado também observado na pressão arterial sistólica e diastólica (PAS e PAD) ambas de repouso que apresentaram redução dos níveis pressóricos apenas no GE (p<0,001). Na reatividade pressórica tanto nos períodos pré bem como após 2 minutos também demonstraram reduções estatisticamente significativas do GE (p<0,001 e p=0,012) respectivamente quando comparado ao GC. Conclui-se que o treinamento resistido melhorou desempenho nos testes de força de membros inferiores beneficiando a capacidade funcional dos pacientes em hemodiálise, como também a pressão arterial de repouso e os níveis de reatividade pressórica obtiveram reduções significativas de seus valores após a intervenção. Além disso, este tipo de treinamento também pode ser utilizado como uma estratégia de proteção aos fatores de risco cardiovascular em pacientes renais crônicos.

O slogan empresarial como construção discursiva: uma abordagem cognitivo-funcional

In this paper, we analyze corporate slogans, understanding them as a discursive construction that is, as a pairing of form and function able to unite the notions of textual type and discursive genre. In this way, we developed a qualitative and quantitative analysis, aimed specifically to analyze the formal properties (phonetic, morphological and syntactic) and functional (semantic, pragmatic and discursive) of slogans. Furthermore, we attempted at verifying and quantifying recurring aspects involved in their construction, in order to capture configurational patterns underlying their formation. The data come from slogans collected in products and / or service stores in the metropolitan area of Natal city, Rio Grande do Norte. This research is based on the Cognitive-Functional Linguistics, that conjugates the North American functionalist tradition, represented by researchers as Talmy Givón, Paul Hopper, Joan Bybee, Elizabeth Closs-Traugott, with Cognitive Linguistics, in particular, the chain linked to Construction Grammar, as postulated by Adele Goldberg, William Croft e Jan-Olla Östman, among others. The results ratified the importance of the interface between the formal and functional aspects in the analysis of linguistic uses. These results point to the idea of the slogan as the pairing of form and function on textual / discursive level, in other words, as a discursive construction, constituting as cognitive storage of a scheme / model of textual formation with a specific discursive-pragmatic function.

Modulaçao do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e plasticidade neuronal em saguis (Callithrix jacchus) juvenis: um modelo psiquiátrico e cognitivo

Nos períodos críticos de plasticidade neural ocorre uma maior permissividade do sistema nervoso ao ambiente, por isto, a ação do estresse sobre o individuo e suas repercussões sobre áreas responsáveis pelo controle dos sistemas de resposta ao estresse e por funções cognitivas complexas vem recebendo bastante atenção. A utilização de modelos experimentais translacionais tem sido imprescindível na elucidação destes mecanismos e das patologias associadas. Diante disto, este trabalho investigou os efeitos do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e sobre a neurogênese no córtex pré-frontal (CPF) durante um período crítico de plasticidade cerebral, a fase juvenil, em machos de Callithrix jacchus. Durante cinco meses, 5 animais foram acompanhados em suas famílias (GF) e 5 animais foram isolados socialmente por 4 meses (GI), após um mês em observação em ambiente familiar (fase basal- FB). Ao final do 5º mês foram aplicados 2 testes de memória de trabalho (MT) nos animais GF e GI. Em seguida, 3 animais de cada grupo foram sacrificados para análise do fator de neurogênese BDNF ( Brain Derived Neurotrophic Factor) por imunofluorescência no CPF (sub-regiões orbitofrontal e lateral). Os animais do GF não variaram significativamente o cortisol ao longo do estudo, enquanto o GI elevou o cortisol e comportamentos indicadores de ansiedade (CA) na primeira semana do isolamento. Em seguida, o GI apresentou uma redução no cortisol, nos CA, no peso corporal e um aumento de comportamentos estereotipados e da anedonia, alterações tipicamente depressivas em primatas não-humanos. Ao final, o GI apresentaram níveis de cortisol menores que em FB. Ambos os grupos apresentaram dificuldades em realizar e aprender as tarefas cognitivas e a presença de BDNF no córtex pré-frontal foi independente do grupo (GF ou GI), porém correlacionou-se com os níveis de cortisol presentes na ultima semana do estudo, e os animais com presença de BDNF no CPF lateral e orbitofrontal apresentaram maiores níveis de cortisol. Estes resultados contribuem no processo de validação do sagui como um bom modelo psiquiátrico translacional e aponta para possibilidade de estudos sobre transtornos depressivos na juventude e suas repercussões posteriores. Além disto, os resultados observados para as tarefas cognitivas levou-nos a fazer uma releitura dos protocolos utilizados em estudos de memoria de trabalho com animais adultos desta espécie, com a finalidade de aprimora-los facilitando a aprendizagem em animais juvenis, naives e em situações de estresse. Ademais, evidenciou-se pela primeira vez a relação do estresse, cortisol e níveis de BDNF, em animais juvenis desta espécie, com a fim de contribuir com sua utilização como modelo animal neurocognitivo.

O aprimoramento cognitivo como bem primário em Rawls

The main thesis to be demonstrated in this work is that cognitive enhancement through the use of drugs can be included as a primary good within Rawls' thinking. To develop such notion, the text is structured in two parts. The first part intends to describe the theory of justice as equity in its elements directly related to primary goods. The first information to be verified is the unity of the notion of primary goods in all of Rawls' work. Some elements are modified, for example the distinction of natural and social primary goods. Natural primary goods are intelligence, health, imagination, vigor and chance (luck) and social primary goods are law and liberty, opportunity and power, income and wealth and the social fundaments of self-respect. The perception of some talents such as intelligence has also undergone changes, being altered from "higher intelligence" to "educated intelligence". Such fact highlights education as a primary good that permeates all of Rawls' work in different perspectives. Freedom and self-respect are social-primary goods that will also be deepened. The second part presents the definition of improvement and as to show that the distinction between enhancement and treatment is controversial. The part presents the definition of improvement and as the distinction between enhancement and treatment is controversial. Thus, we have deepened the problems related to practice improvement (enhancement) showing how the concepts of Rawls' primary goods as freedom and self-respect are not in opposition to the practice of improvement, particularly cognitive enhancement. We have shown, instead, that the ban of cognitive improvement could lead to denial of these primary goods. But how could we consider cognitive improvement as a primary social good? What we have done in this thesis is to show how cognitive enhancement is important to ensure that primary products are accessible to citizens, and we rebuilt the process that Rawls uses for choosing his primary goods to test that cognitive enhancement through drugs could perfectly be introduced as such.

O aprimoramento cognitivo como bem primário em Rawls

The main thesis to be demonstrated in this work is that cognitive enhancement through the use of drugs can be included as a primary good within Rawls' thinking. To develop such notion, the text is structured in two parts. The first part intends to describe the theory of justice as equity in its elements directly related to primary goods. The first information to be verified is the unity of the notion of primary goods in all of Rawls' work. Some elements are modified, for example the distinction of natural and social primary goods. Natural primary goods are intelligence, health, imagination, vigor and chance (luck) and social primary goods are law and liberty, opportunity and power, income and wealth and the social fundaments of self-respect. The perception of some talents such as intelligence has also undergone changes, being altered from "higher intelligence" to "educated intelligence". Such fact highlights education as a primary good that permeates all of Rawls' work in different perspectives. Freedom and self-respect are social-primary goods that will also be deepened. The second part presents the definition of improvement and as to show that the distinction between enhancement and treatment is controversial. The part presents the definition of improvement and as the distinction between enhancement and treatment is controversial. Thus, we have deepened the problems related to practice improvement (enhancement) showing how the concepts of Rawls' primary goods as freedom and self-respect are not in opposition to the practice of improvement, particularly cognitive enhancement. We have shown, instead, that the ban of cognitive improvement could lead to denial of these primary goods. But how could we consider cognitive improvement as a primary social good? What we have done in this thesis is to show how cognitive enhancement is important to ensure that primary products are accessible to citizens, and we rebuilt the process that Rawls uses for choosing his primary goods to test that cognitive enhancement through drugs could perfectly be introduced as such.

Efeitos do treino de marcha em esteira com adição de carga ao membro inferior não parético de indivíduos com acidente vascular cerebral: ensaio clínico controlado e randomizado

Introduction: Gait after stroke is characterized by a significant asymmetry between the lower limbs, with predominant use of the non-paretic lower limb (NPLL) over using the paretic lower limb. Accordingly, it has been suggested that adding load/weight to the NPLL as a form of restricting the movement of this limb may favor the use of the paretic limb, reducing interlimb asymmetry. However, few studies have been conducted up to this moment, which only investigated the immediate effects of this practice. Objectives: 1) Investigating whether there is an influence of adding load to the NPLL during treadmill training on cardiovascular parameters and on gait performance of individuals with stroke, compared to treadmill training without load addition; 2) Analyzing the effects of treadmill training with and without load added to the NPLL on kinematic parameters of each lower limb during gait; 3) Analyzing the effects of treadmill training with and without load added to the NPLL on measurements of functional mobility and postural balance of these patients. Materials and Methods: This is a randomized single blinded clinical trial involving 38 subjects, with a mean age of 56.5 years, at the subacute post-stroke phase (with mean time since stroke of 4.5 months). Participants were randomly assigned into an experimental group (EG) or control group (CG). EG (n= 19) was submitted to gait training on a treadmill with the addition of load to the NPLL by ankle weights equivalent to 5% of body weight. CG (n= 19) was only submitted to gait training on a treadmill. Behavioral strategies which included home exercises were also applied to both groups. The interventions occurred daily for two consecutive weeks (Day 1 to Day 9), being of 30 minutes duration each. Outcome measures: postural balance (Berg Functional Balance Scale – BBS), functional mobility (Timed Up and Go – TUG; kinematic variables of 180° turning) and kinematic gait variables were assessed at baseline (Day 0), after four training sessions (Day 4), after nine training sessions (Day 9), and 40 days after completion of training (Follow-up). Cardiovascular parameters (mean arterial pressure and heart rate) were evaluated at four moments within each training session. Analysis of variance (ANOVA) was used to compare outcomes between EG and CG in the course of the study (Day 0, Day 4, Day 9 and Follow-up). Unpaired t-tests allowed for intergroup comparison at each training session. 5% significance was used for all tests. Results: 1) Cardiovascular parameters (systemic arterial pressure, heart rate and derivated variables) did not change after the interventions and there were no differences between groups within each training session. There was an improvement in gait performance, with increased speed and distance covered, with no statistically significant difference between groups. 2) After the interventions, patients had increased paretic and non-paretic step lengths, in addition to exhibiting greater hip and knee joint excursion on both lower limbs. The gains were observed in the EG and CG, with no statistical difference between the groups and (mostly) maintained at follow-up. 3) After the interventions, patients showed better postural balance (higher scores on BBS) and functional mobility (reduced time spent on the TUG test and better performance on the 180° turning). All gains were observed in the EG and CG, with no statistically significant difference between groups and were maintained at follow-up. Conclusions: The addition of load to the NPLL did not affect cardiovascular parameters in patients with subacute stroke, similar to treadmill training without load, thus seemingly a safe training to be applied to these patients. However, the use of the load did not bring any additional benefits to gait training. The gait training program (nine training sessions on a treadmill + strategies and exercises for paretic limb stimulation) was useful for improving gait performance and kinematics, functional mobility and postural balance, and its use is suggested to promote the optimization of these outcomes in the subacute phase after stroke.