Doping in sport: a review of medical practitioners' knowledge, attitudes and beliefs.

BACKGROUND: Central to the work of many medical practitioners is the provision of pharmaceutical support for patients. Patients can include athletes who are subject to anti-doping rules and regulations which prohibit the use of certain substances in and out of competition. This paper examines the evidence on medical practitioners' knowledge, attitudes and beliefs towards doping in sport. METHODS: A systematic search strategy was followed. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches limited to English language articles published between 1990 and 2010. Articles were assessed for relevance by two independent assessors and the results of selected studies were abstracted and synthesised. Outcomes of interest were knowledge, attitudes and beliefs in relation to doping in sport. RESULTS: Six studies met the inclusion criteria and were examined in detail. Samples reflected a range of medical practitioners drawn from the UK, France (2), Greece, Italy and Ireland. The investigations varied with respect to outcome focus and quality of evidence presented. CONCLUSION: Whilst the extant empirical research posits a negative attitude towards illegal performance enhancement combined with a positive inclination towards doping prevention, it also exposes a limited knowledge of anti-doping rules and regulations. Insufficient education, leading to a lack of awareness and understanding, could render this professional group at risk of doping offences considering Article 2.8 of the World Anti-Doping Agency Code (WADC). Moreover, in light of the incongruence between professional medical codes and WADC Article 2.8, medical professionals may face doping dilemmas and therefore further discourse is required. At present, the current evidence-base makes it difficult to plan developmentally appropriate education to span the exposure spectrum. Addressing this situation appears warranted

The algorithmics of solitaire-like games

One-person solitaire-like games are explored with a view to using them in teaching algorithmic problem solving. The key to understanding solutions to such games is the identification of invariant properties of polynomial arithmetic. We demonstrate this via three case studies: solitaire itself, tiling problems and a novel class of one-person games. The known classification of states of the game of (peg) solitaire into 16 equivalence classes is used to introduce the relevance of polynomial arithmetic. Then we give a novel algebraic formulation of the solution to a class of tiling problems. Finally, we introduce an infinite class of challenging one-person games, which we call ``replacement-set games'', inspired by earlier work by Chen and Backhouse on the relation between cyclotomic polynomials and generalisations of the seven-trees-in-one type isomorphism. We present an algorithm to solve arbitrary instances of replacement-set games and we show various ways of constructing infinite (solvable) classes of replacement-set games

Library Event Matching event classification algorithm for electron neutrino interactions in the NOvA detectors

We describe the Library Event Matching classification algorithm implemented for use in the NOvA $\nu_\mu \rightarrow \nu_e$ oscillation measurement. Library Event Matching, developed in a different form by the earlier MINOS experiment, is a powerful approach in which input trial events are compared to a large library of simulated events to find those that best match the input event. A key feature of the algorithm is that the comparisons are based on all the information available in the event, as opposed to higher-level derived quantities. The final event classifier is formed by examining the details of the best-matched library events. We discuss the concept, definition, optimization, and broader applications of the algorithm as implemented here. Library Event Matching is well-suited to the monolithic, segmented detectors of NOvA and thus provides a powerful technique for event discrimination.Comment: 10 pages, 7 figures. Minor fixe

DISEQUILIBRIUM MACROECONOMICS: AN EPISODE IN THE TRANSFORMATION OF MODERN MACROECONOMICS

The paper investigates the rise and fall of the disequilibrium approach in macroeconomics between the mid 1960s and the late 1970s. During that period macroeconomists became attracted to the interpretation of unemployment phenomena based on the notion that markets are not in equilibrium. It was believed that such an approach could result in supply and demand functions distinct from those of conventional theory. However, by the late 1980s disequilibrium macroeconomics had largely disappeared from view, while approaches influenced by New Classical Macroeconomics and New Keynesian Economics became dominant. The present paper examines the contributions of the main authors - Patinkin, Clower, Leijonhufvud, Barro, Grossman, Solow, Stiglitz and Malinvaud - in order to offer a new pwerspective on the reasons for its sudden disappearance.

A qualitative analysis of the factors that protect athletes against doping in sport

Design: Ten competitive athletes (M = 5, F = 5) representing five different sports (field hockey, boxing, football, triathlon, rugby) were recruited through convenience sampling to undertake a semi-structured interview to enable a qualitative analysis of athletes' lifelong athletic careers. Method: Verbatim transcripts were analysed using an established three-stage coding process to identify the common themes within the narratives. Results: Personal and situational protective factors were identified in the accounts. Personal factors included: (i) a strong moral stance against cheating; (ii) an identity beyond sport; (iii) self-control; and (iv) resilience to social group pressures. Situational factors included secure attachments to people at all stages of the athlete's life. This facilitated both the promotion of moral decision making and assisted in the development of anti-doping attitudes. When situational factors – such as a pro-doping climate – arose, key attachments in the athletes' lives interplayed with personal factors to reduce the risk of doping. Conclusions: These findings offer insights into factors that protect competitive athletes against using PEDs in sport and further our understanding of the complex interaction between risk and protective factors at individual, psychosocial and societal levels among competitive athletes. As a complex behaviour, doping in sport cannot be prevented by solely focussing on the individual athlete; contextual factors beyond the athlete's control also impact on this behaviour. Thus, a paradigm shift is warranted to move beyond an athlete-centred approach to anti-doping

Effective communication in eliciting and responding to suicidal thoughts: a systematic review protocol

Background In the UK, over 6500 people die by suicide each year. In England alone, this is one person every 2 h. Professionals assess risk of suicide in face-to-face contacts with people potentially at risk. The National Confidential Inquiry into Suicide found that most people who took their life were classified as ‘low risk’ in their final contact with mental health services. Training for front-line staff in reducing suicide is a NHS priority. While there is considerable evidence on what to assess when exploring suicidal ideation, there is little evidence on how to ask sensitive questions to effectively identify suicide risk and how to respond in the treatment encounter to reduce patient distress and suicidal ideation. This is critical for identifying risk and putting appropriate care in place. Methods An electronic search will be conducted using MEDLINE, CINAHL, Cochrane Library, EMBASE and PsycINFO databases. Controlled studies of effectiveness will be identified using a predefined search strategy. The focus will be on suicidal thoughts/feelings rather than self-harm without intent to die. Two authors will independently screen articles using predefined inclusion and exclusion criteria and relevant data will be extracted using the Cochrane Collaboration data extraction form for randomised controlled trials (RCTs). Discrepancies between the two authors will be resolved by consensus or by consulting a third author at all levels of screening. We will assess the quality of evidence as well as risk of bias. A meta-analysis will be conducted if participants, interventions and comparisons are sufficiently similar, and we will perform the meta-analysis using Stata data analysis and statistical software. Discussion The results of this systematic review will be used to guide training and practice for health care professionals