Inferência baseada em magnitude: um olhar para análise individual / Magnitude-based inference: looking at the individual analysis

Os testes de hipótese são amplamente empregados para análise de dados na área de ciência do esporte. Porém, existe um questionamento em relação a utilização desse método e a comunidade científica ainda procura soluções mais adequadas para a análise dos dados. De fato, esse tipo de análise não permite uma interpretação prática das mudanças observadas ao longo do tempo. Por conta disso, o cálculo da "in ferência baseada em magnitude" (IBM) vem sendo cada vez mais utilizado por pesquisadores e analistas de desempenho. Em uma perspectiva aplicada, a IBM permite avaliar a probabilidade de se encontrar diferenças relevantes (i.e., meaningful differences) nas variáveis investigadas. Da mesma forma, a IBM permite examinar com precisão as variações individuais e importantes no desempenho esportivo. O objetivo desse ponto de vista é apresentar e discutir a aplicação da IBM a partir das análises individuais. Para tanto o trabalho aborda os seguintes temas: 1) utilização da análise de dados no "mundo real"; 2) inferência baseada em magnitude: conceitos básicos; 3) aplicando a IBM no contexto do esporte; 4) classificações qualitativas com base nas mudanças observadas; 5) formas de se obter a mínima mudança válida importante e o erro típico; 6) análise e interpretação dos dados. Esperamos que o conteúdo apresentado encoraje pesquisadores e profissionais do esporte a implementar esse novo método de análise em suas rotinas diárias e, ao mesmo tempo, lhes auxilie na interpretação dos dados provenientes das avaliações e testes de desempenho.(AU)

Null hypothesis tests are widely used for data analysis in sport science. However, the scientific community has been questioning this method and is still looking for alternative approaches for data analyses. In fact, this type of analysis does not allow practical interpretation of the changes observed in athletic performance over time. Therefore, the magnitude-based inference (MBI) method has been increasingly used by researchers and performance analysts. From an applied perspective, this method allows examining the probability of finding meaningful differences in assessed variables. In addition, the MBI enables precise assessment of individual changes, which may be releva nt to sport performance. The aim of this article is to present and discuss the application of the individual MBI analysis. Based on this purpose, the manuscript covers the following topics: 1) utilization of data analysis in real world settings; 2) basic concepts of the MBI; 3) applying the MBI approach in sport science; 4) qualitative classifications based on observed changes; 5) different methods to determine the smallest worthwhile change and the typical error; 6) data analysis and interpretation. We hope that this study will encourage practitioners and r esearchers to implement this novel statistical approach in their daily routines, for analysis and interpretation of data collected during physical performance measurements.(AU)

Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach

Objective: To present the essential guidelines for pharmacological management of patients with psychomotor agitation in Brazil. Methods: This is a systematic review of articles retrieved from the MEDLINE (PubMed), Cochrane Database of Systematic Reviews, and SciELO databases published from 1997 to 2017. Other relevant articles in the literature were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association. Recommendations were summarized according to their level of evidence, which was determined using the Oxford Centre for Evidence-based Medicine system and critical appraisal tools. Results: Of 5,362 articles retrieved, 1,731 abstracts were selected for further reading. The final sample included 74 articles that met all inclusion criteria. The evidence shows that pharmacologic treatment is indicated only after non-pharmacologic approaches have failed. The cause of the agitation, side effects of the medications, and contraindications must guide the medication choice. The oral route should be preferred for drug administration; IV administration must be avoided. All subjects must be monitored before and after medication administration. Conclusion: If non-pharmacological strategies fail, medications are needed to control agitation and violent behavior. Once medicated, the patient should be monitored until a tranquil state is possible without excessive sedation. Systematic review registry number: CRD42017054440.

Brazilian guidelines for the management of psychomotor agitation. Part 1. Non-pharmacological approach

Objective: To present the essential guidelines for non-pharmacological management of patients with psychomotor agitation in Brazil. Methods: These guidelines were developed based on a systematic review of articles published from 1997 to 2017, retrieved from MEDLINE (PubMed), Cochrane Database of Systematic Review, and SciELO. Other relevant articles identified by searching the reference lists of included studies were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association. Recommendations were summarized according to their level of evidence, which was determined using the Oxford Centre for Evidence-based Medicine system and critical appraisal tools. Results: We initially selected 1,731 abstracts among 5,362 articles. The final sample included 104 articles that fulfilled all the inclusion criteria. The management of agitated patients should always start with the least coercive approach. The initial non-pharmacological measures include a verbal strategy and referral of the patient to the appropriate setting, preferably a facility designed for the care of psychiatric patients with controlled noise, lighting, and safety aspects. Verbal de-escalation techniques have been shown to decrease agitation and reduce the potential for associated violence in the emergency setting. The possibility of underlying medical etiologies must be considered first and foremost. Particular attention should be paid to the patient's appearance and behavior, physical signs, and mental state. If agitation is severe, rapid tranquilization with medications is recommended. Finally, if verbal measures fail to contain the patient, physical restraint should be performed as the ultimate measure for patient protection, and always be accompanied by rapid tranquilization. Healthcare teams must be thoroughly trained to use these techniques and overcome difficulties if the verbal approach fails. It is important that healthcare professionals be trained in non-pharmacological management of patients with psychomotor agitation as part of the requirements for a degree and graduate degree. Conclusion: The non-pharmacological management of agitated patients should follow the hierarchy of less invasive to more invasive and coercive measures, starting with referral of the patient to an appropriate environment, management by a trained team, use of verbal techniques, performance of physical and mental assessment, use of medications, and, if unavoidable, use of the mechanical restraint. Systematic review registry number: CRD42017054440.