De la toma de decisiones, al curso de las decisiones (Prefacio al monográfico "Innovaciones en el estudio de la toma de decisiones en el deporte")

La toma de decisiones en el deporte es un tema apasionante. El timing de los pases de Xavi, el arranque de Cristiano Ronaldo, los desequilibrios provocados por Rafa Nadal, son procesos cuya explicación solo conseguimos realizar a posteriori. De hecho, como dicen Ruiz-Pérez y Arruza- Gabilondo (2005) "Decidir es uno de los ingredientes más presentes de la actividad deportiva; es más, podríamos analizar los deportes en función de su exigencia decisional" (p. 38). A pesar de que la decisión sea uno de los aspectos más impresionantes de un deportista en acción, su estudio en la psicología del deporte ha sido reducido, localizado en pocos grupos de investigación. Por ejemplo, Bar-Eli y Raab (2009) hacen referencia que hasta final del Siglo XX, la investigación se reducía al eje Tenenbaum-Ripoll. Ripoll (1991) describió claramente la investigación que se hacía en este periodo como si estuviera "específicamente preocupada por los procesos que intervienen entre la entrada de información y la respuesta comportamental, es decir, entre el input y el output. Estos procesos se refieren a la lógica fundamental del sistema, que corresponde con el 'software'" (p. 187, traducción propia)

Study protocol - Efficacy of an Educational Action in the Sustained Improvement of Inhalation Technique

Study methodology: This is an institutional, prospective and observational study on COPD out-patients. An inadequate inhaler technique remains a major cause of insufficient disease management. Face-to-face demonstration of inhalation devices are effective methods of teaching the correct inhalation technique. However, if some improvement is sustained over time, is not yet determined. This is the primary aim of this study. Secondary objective is to evaluate the factors that can predict a sustained improvement of inhalation technique. In a previous visit, COPD out-patients diagnosed according to GOLD criteria, were recruited consecutively. Participants were asked to demonstrate the use of their prescribed ID, just as they does it at home. For each inhaler device we defined a checklist of steps for a  correct inhalation technique, and critical errors, which are likely to make therapy useless. After this evaluation, demonstrations and training with placebo inhalers were given to all participants, until a correct use is achieved. Patients will be invited for a second medical visit, 10 to 12 months after the first visit, and they will be asked again to demonstrate the use of their inhalers. It will be used the same check-list of the first visit, and the reevaluation will be done by the same healthcare professional. Impact of the research: To the best of our knowledge this will be the first study carried out in Portuguese population of COPD patients, concerning the sustained improvement of the inhalation technique after a single educational intervention. The characteristics of both the patients and inhalation devices related to a sustained maintenance of a correct inhalation technique can be useful for planning education interventions on COPD patients. This can be the added value of this study

Toma de decisión dinámica en diferentes niveles de expertise en el deporte de vela

Según las mas recientes investigaciónes en otras áreas diferentes de las deportivas (Cannon-Bowers, Salas y Pruitt, 1996; Klein y Woods, 1993), una toma de decisión se define como el proceso cognitivo implicado en el control de una situación dinámica. La tarea dinámica debe tener tres características: la posibilidad de "feedback", sucesiones interdependientes de decisiones, y presión temporal (Brehmer, 1992, Kerstholt, 1994; 1995). Varios autores (Alain y Sarrazin, 1990; Ripoll Kerlirzin, Stein y Reine, 1995; Helson y Pauwels,1988) se refieren a la necesidad de tomar en consideración las características dinámicas en el deporte. Según Starkes y Deakin (1984) y Abernethy (1994) los expertos se distinguen por sus características de "software" y no por sus características de "hardware". Nuestra investigación apoyó esta conclusión en la vela de alta competición (Araújo y Serpa, 1995; 1997). Utilizamos una simulación por ordenador para estudiar la toma de decisión dinámica en una situación específica de Vela (una regata simulada), analizando tres niveles de "expertise", según una clasificación jerárquica basada en los curriculums internacionales de competición de los regatistas. Nuestras hipótesis son: 1) a mayor "expertise" en Vela mejor es la actuación del regatista en una regata simulada; 2) Las intervenciones en el sistema varían según el nivel de "expertise". Los sujetos son 35 regatistas divididos en tres grupos y 23 no regatistas. Medimos el número de acciones (intervenciones en el ordenador) categorizado en dos tipos: 1) técnico y ajustes; 2) el momento de ocurrir de la intervención. Las variables del producto eran la clasificación final, y el tiempo total utilizado. La fidelidad funcional del simulador fué probada y verificada a través de 7 entrenadores especialistas y por todos los regatistas en el estudio. Verificamos la fiabilidad de la medición de la toma de decisión dinámica, usando el método Split-half. Para la primera hipótesis los puntos de la clasificación jerárquica, se pusieron en correlación inversa con el tiempo utilizado (p=0,036) y con la clasificación final (p=0,030). Para la segunda hipótesis y refiriéndose a las variables del producto, los regatistas fueron mejores y tuvieron una diferencia significativamente mejor en su actuación (p=0,000). En general, la diferencia entre regatistas y no-regatistas, se refiere a las variables del proceso y consistió en el hecho de que no-regatistas realizaron significativamente más intervenciones en el sistema (sobre todo los ajustes). El simulador permite una medida específica deportiva de las competencias de decisión. La investigación en la toma de decisión dinámica en deporte revela cómo los sujetos desarrollan los procesos cognitivos a lo largo del proceso en adquirir "expertise", hasta que el regatista se vuelve un experto. Esta conclusión puede tener una consecuencia en la identificación de talentos y en la mejoria de la toma de decisión en Vela, y para el planeamiento de situaciones de entrenamiento por el entrenador.According to the recent research in other areas than sport (Cannon-Bowers, Salas y Pruitt, 1996, Klein y Woods, 1993), a dynamic situation is defined as the cognitive process involved in controlling a dynamic system. The dynamic task must have three characteristics: possibility of feedback, interdependent sequences of decisions, and time pressure (Brehmer, 1992, Kerstholt, 1994, 1995). Several authors (Alain y Sarrazin, 1990; Ripoll y col., 1995, Helson y Pauwels,1988) refer to the need of taking in consideration the dynamic characteristics in sport. According to Starkes y Deakin, 1984, and Abernethy, 1994, the experts are distinguished by their 'software' characteristics and not by their 'hardware' characteristics. Our research supported this conclusion in high level sailing (Araújo y Serpa, 1995, 1997). We used a computer simulation to study the dynamic decision making in a specific situation of sailing (a simulated regatta), analysing three levels of expertise, according to a ranking based on the sailors' international competition curriculum. Our hypothesis are: 1) The higher the expertise in sailing the better is the performance in simulated regatta; 2) The interventions in the system vary according to the expertise level. Subjects were 35 sailor divided into three groups and 23 non-sailors. We measured the number of actions (interventions in the computer) categorised in two types: 1) technical and adjustments; 2) the order of sequence of the intervention occurrence concerning the homogeneous moments all along a regatta. The product variables was the final classification, and the time spend in total. The functional fidelity of the simulator was tested and verified by 7 expert coaches and by all the sailors in the study. We verified the reliability of the dynamic decision making assessment, using the Split-half method. For the first hypothesis the ranking points were inversely correlated with time spent (p=0,036) and with final classification (p=0,030). For the second hypothesis and in referring to the product variables, sailors were better, having a high significant difference in their performance (p=0,000). In general, the difference between sailors and non-sailors, referring to the process variables, consisted in the fact that non-sailors make significantly more interventions in the system (especially adjustments). The simulator allows a sport specific measurement of the decision abilities. Dynamic decision making research in sport can reveal how the subject cognitive processes develop along the process of acquiring expertise, until s/he becomes an expert. This conclusion may have a consequence in talent identification and in the increment of decision making training in sailing, and for the design of training situations by the coach

The (Sport) Performer-Environment System as the Base Unit in Explanations of Expert Performance

In this article we propose that expertise can be best explained as the interaction of the varying constraints/characteristics of the environment and of the individual, framed by the ecological dynamics approach. This rationale of expert performance is contrasted with the typical way that science has approached the study of expertise: i.e., by looking for constraints, located in the individual, either nurture- or nature-based, and related to high performance levels. In ecological dynamics, the base unit of analysis for understanding expertise is the individual-environment system. Illustrating this perspective with Bob Beamon’s 8.90 m long jump, whose 1968 world-record jump was substantially longer than any previous, we argue that expert performers should not be seen as an agglomeration of genes, traits, or mental dispositions and capacities. Rather, expert performance can be captured by the dynamically-varying, functional relationship between the constraints imposed by the environment and the resources of each individual performer

Uma apreciação do método de planejamento de saúde proposto pela Organização Panamericana da Saúde para a América Latina

Foram descritos os principais aspectos da técnica de planejamento de saúde desenvolvida pelo "Centro de Estudios del Desarrollo" (CENDES) na Venezuela e proposta pela Organização Panamericana da Saúde para uso na América Latina. Foi feita análise da técnica de planejamento incluindo comentários tanto sobre os seus aspectos positivos como sobre suas limitações. Foram referidas algumas publicações recentes da OMS/OPAS sobre planejamento de saúde. Conclui-se que a técnica CENDES é considerada como uma metodologia de planejamento de saúde de grande potencial para uso especialmente em regiões em desenvolvimento, dependendo o sucesso na sua aplicação sobretudo da habilidade dos planejadores, em introduzir as modificações necessárias à sua adaptação às condições locais.A brief description of the main features of the health planning technique developed by the "Centro de Estudios del Desarrollo" (CENDES) in Venezuela, and proposed by the Pan-American Health Organization for use in Latin America, is presented. This presentation is followed by an appraisal of the planning method which includes comments both upon its positive aspects and upon its negative points. Comments are also made referring to other recent publications of the WHO/PAHO on health planning. In conclusion, the CENDES technique is considered a health planning method of great potential for use especially in underdeveloped areas, the success of its application depending upon the hability of the health planners to introduce the necessary modifications to adapt to the local circunstamces

Innate Talent in Sport: Beware of an organismic asymmetry – comment on Baker & Wattie

Of fundamental, theoretical and practical, relevance to sport science is the conceptualisation of talent, skill and expertise. Revisiting the question of innate talent is timely, given current pressure on young children selected to specialise in sport at an early age. Here, we re-iterate the conceptualisation of talent, skill and expertise in sport as an increasingly functional relationship between an athlete and a specific performance environment, developed over the macro-timescale of years and decades. This ecological dynamics rationale avoids an organismic asymmetry, the bias towards explanations of human behaviour which over-emphasise the role of inherent properties and qualities, identifiable through early selection. An ecological dynamics rationale, eschewing the organismic asymmetry of innate talent, in favour of exploiting and developing individual functionality in specific performance environments, challenges coaches and sport scientists to collaborate in new models for developing talent, skill and expertise

O direito à assistência médica e suas conseqüências econômicas: um dilema americano

The concepts of "rights" and of "right to health care" including its evolution in modern times are discussed. The consequences of implementing this right are discussed in economic terms, regarding the situation in the United States of America. A discussion is also included on the limitations of the role of Health Insurance as a measure to solve the problem of providing health care for all individuals.São discutidos os conceitos de "direito" e de "direito à saúde" incluindo sua evolução nos tempos modernos. As conseqüências da implementação deste direito são debatidas em termos econômicos particularizando a situação nos Estados Unidos da América. Inclue-se também discussão das limitações do papel do sistema de Seguro de Saúde como uma medida para resolver o problema de prover assistência médica para todos os indivíduos

Conocimiento procesal de la toma de decisión en carrera de orientación : estudio comparativo de jóvenes practicantes con diferentes niveles de pericia utilizando un simulador computerizado

Con el objetivo de estudiar la evolución del conocimiento procesal en la toma de decisión en función del nivel de pericia en Carrera de Orientación, recurrimos a 30 practicantes divididos por tres niveles diferentes. La simulación computerizada fue usada como tarea de evaluación, después de la debida validación. Los atletas ejecutaron un recorrido simulado de Carrera de Orientación grabado en video, verbalizando concomitantemente las informaciones relevantes para su acción. Los resultados demostraron que el desempeño en la carrera simulada está directamente relacionado con los niveles de pericia de los atletas, confirmando en esta situación la adaptabilidad del conocimiento procesal inherente a la toma de decisión. Además de esto, los resultados demuestran que el proceso de toma de decisión varía según el nivel de pericia. La diferencia radica esencialmente en el tipo de referencias usadas en la toma de decisión.Thirty athletes divided into three different levels participated in this study designed to analyse the evolution of procedural knowledge in the decision-making process in different expertise levels in Orienteering. A computer simulation was used as an evaluation task, after due validation. The athletes carried out a simulated, videotaped Orienteering track, concurrently verbalizing information relevant to their actions. The results showed that the performances on simulated tasks is directly related to the athletes' level of expertise, confirming the adaptability of the procedural knowledge inherent in decision-making. Furthermore, the findings demonstrated that the decision-making process varies according to the level of expertise. Essentially, the difference lies in the types of references used in decisionmaking

A PESSOA SUBMETIDA A CIRURGIA: PERTINÊNCIA DA CONSULTA PRÉ-OPERATÓRIA DE ENFERMAGEM

Este trabalho está inserido no âmbito do curso de complemento de licenciatura em enfermagem, tendo como tema “A pessoa submetida a cirurgia: Pertinência da consulta pré-operatória de enfermagem”, que traduz a consciência de uma necessidade clara da equipa de Enfermagem no Bloco Operatório do Hospital Dr. Baptista de Sousa, tentando retratar as vivências, com base nos conhecimentos e experiências de longos anos de profissão. Constitui nossa intenção de propor melhorias do desempenho das equipas de Enfermagem, proporcionando maior satisfação aos utentes/família. Trata-se de um trabalho que se orienta pelos pressupostos de um estudo exploratório a partir da colheita de dados através de levantamento de dados relativos à cirurgia, entrevistas às equipas do bloco operatório, aos utentes/família, e observações no pré-operatório do referido Hospital. O estudo decorreu durante o mês de Novembro de 2012, com o objectivo de demostrar a importância da consulta pré-operatória no preparo psico-socio-espiritual e emocional do utente/família, possibilitando-os a tomada de decisões. A pergunta de partida elaborada foi, “Até que ponto uma consulta pré-operatória de enfermagem contribui para a resolução das necessidades humanas fundamentais dos utentes /família?” e serviu de fio condutor para o desenvolvimento e conclusão do estudo. O trabalho encontra-se estruturado no primeiro momento, num enquadramento teórico resultante da revisão bibliográfica para perceber a influência desta na planificação e intervenção da enfermagem, apoiando a reflexão baseada no modelo de Virgínia Henderson – Necessidades Humanas Fundamentais (NHF´s). No segundo momento, avaliar os dados obtidos, que permitiu identificar e compreender a importância da assistência sistematizada para este procedimento tão relevante que é a cirurgia, possibilitando, através do cuidado integral, a reabilitação do utente