An evaluation of prevention initiatives by 53 National Anti-Doping Organizations: Achievements and Limitations

Background One main purpose of the World Anti-Doping Agency is to harmonize anti-doping efforts, including the provision of anti-doping education. A multifaceted approach to doping prevention can play a key role in preventing intentional and unintentional doping. This article aims to systematically record and evaluate doping prevention approaches in the form of information and education activities of national anti-doping organizations (NADOs) and assess the extent to which a multifaceted doping prevention approach has been realized. Methods Data on anti-doping information and education activities of 53 NADOs were collected via a survey and an online search of the NADOs’ websites. Prevention activities were classified into knowledge focused, affective focused, social skills, life skills, and ethics and values based. The implementation of the prevention activities was assessed by 4 independent raters using a modified visual analogue scale. Results In total, 59% of the NADOs (n = 38) returned the survey and 70% (n = 45) had information available online. The data were combined for the visual analogue scale assessment. Overall, 58% of the NADOs (n = 37) reported offering activities including elements of all 5 approaches. Results of the raters’ assessments indicated that the knowledge-focused approach was best implemented; the implementation of the other 4 approaches was largely unsatisfactory. The most common barriers to implementing doping prevention programs reported by the NADOs were lack of resources (n = 26) and difficulties in collaborating with sports organizations (n = 8). Conclusion Results show a discrepancy between NADOs’ self-report data and the implementation assessment. Even though the NADOs indicated otherwise, most of their education-based approaches did not address aspects of the visual analogue scale (e.g., resisting peer pressure) and only a few programs were ongoing. Possible explanations might be found in the reported barriers (e.g., financial). Concrete guidelines defining multifaceted, values-based education, and best practice examples should be developed to indicate how to include all 5 approaches in prevention

Concentric and eccentric endurance exercise reverse hallmarks of T-Cell senescence in pre-diabetic subjects

The peripheral T-cell pool undergoes a striking age associated remodeling which is accelerated by progressive insulin resistance. Exercise training is known to delay several aspects of T-cell senescence. The purpose of the current study was to investigate the effect of 3 weeks regular concentric or eccentric endurance exercise training on the composition of the T-cell compartment in pre-diabetic subjects. Sixteen male older adults with impaired glucose tolerance were recruited and performed either concentric exercise (CE) or eccentric exercise (EE) walking 3 times a week for 3 weeks. Fasting venous blood sampling was performed before training and after the training intervention. Various T-cell subpopulations were analyzed by flow cytometry. We did not find significant time × group effects (interaction) but found several significant time effects for cell type ratios and cell subsets proportions. There was an increase of the CD4+/CD8+ (0.55 ± 0.85%; p = 0.033) and CD4+/CD3+ ratio (5.63 ± 8.44%; p = 0.018) and a decrease of the CD8+/CD3+ ratio (-0.95 ± 1.64%; p = 0.049) after training. We found proportional increases of CD4+/CCR7+/CD45RO+ central memory cells (5.02 ± 7.68%; p = 0.030), naïve CD8+/CCR7+/CD45RO- (3.00 ± 6.68%; p = 0.047) and CD8+/CCR7+/CD45RO+ central memory cells (3.01 ± 3.70%; p = 0.009), while proportions of CD4+/CCR7-/CD45RO- TEMRA cells (-2.17 ± 4.66%; p = 0.012), CD8+/CCR7-/CD45RO- TEMRA cells (-5.11 ± 7.02%; p = 0.018) and CD16+ cells (-4.67 ± 6.45%; p = 0.016) decreased after training. 3 weeks of either CE or EE were effective in reversing hallmarks of T-cell senescence in pre-diabetic subjects. It is suggested that exercise stimulates production and mobilization of naïve T-cells, while differentiated TEMRA cells might disappear by apoptosis

GRADE IT : a literacy-based assessment tool for 'Generating Research-Based Assessment Data to Evidence the ImpacT of Anti-doping Education' via athletes' capability to make the right decision

The International Standard for Education (ISE) mandates Code Signatories to plan, deliver, and evaluate anti-doping education. Performance-based evaluation of anti-doping education requires alignment between educational goals, content, and defined outcomes. Based on an existentialist teaching and learning philosophy, we aimed to develop and test an anti-doping impact evaluation tool, to assess the impact of anti-doping education on doping awareness, literacy (DAL), perceived trust, and legitimacy. We propose that the impact of anti-doping education is best captured through assessment of situation-specific (social) cognitive mediators of actions that influence athletes' choices in the context of sport-related goals. In phase one, we aimed to develop and test the Generating Research-based Assessment Data to Evidence the ImpacT of anti-doping education (GRADE IT) evaluation tool that comprised a set of social cognitive components: anti-doping knowledge, DAL, perceived trust, and legitimacy of anti-doping (organizations). In phase two we assessed whether anti-doping education impacts knowledge, the three DAL stages (functional, interactive, and critical literacy), perceived trust and legitimacy. Phase one enrolled 986 junior elite athletes, and we showed that all GRADE IT components performed well. After revision of the tool for phase two, we validated the assumption that anti-doping education impacts the likelihood that athletes will make the “right” choice (based on a new set of data from 1,255 junior elite athletes). Comprehensive education was associated with higher scores for all stages of DAL, as well as perceived trust and legitimacy. Even athletes reporting no education had positive scores for all included outcomes, supporting the assumption that most athletes wish to engage in clean sport behaviors and might need anti-doping education not to prevent them from doping, but rather to reinforce their commitment to clean sport. In conclusion, GRADE IT, which is available in 23 languages, is a suitable tool for application to young, emerging athletes to satisfy the ISE requirement for evaluating anti-doping education programs. Researchers and practitioners alike are advised to collect additional data to further validate the tool for adult athletes, and to apply it longitudinally to identify if changes in doping prevention policies have a delayed effect on DAL, perceived trust, and legitimacy

Isolated high altitude psychosis, delirium at high altitude, and high altitude cerebral edema: are these diagnoses valid?

Psychosis is a psychopathological syndrome that can be triggered or caused by exposure to high altitude (HA). Psychosis can occur alone as isolated HA psychosis or can be associated with other mental and often also somatic symptoms as a feature of delirium. Psychosis can also occur as a symptom of high altitude cerebral edema (HACE), a life-threatening condition. It is unclear how psychotic symptoms at HA should be classified into existing diagnostic categories of the most widely used classification systems of mental disorders, including the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11). We provide a diagnostic framework for classifying symptoms using the existing diagnostic categories: psychotic condition due to a general medical condition, brief psychotic disorder, delirium, and HACE. We also discuss the potential classification of isolated HA psychosis into those categories. A valid and reproducible classification of symptoms is essential for communication among professionals, ensuring that patients receive optimal treatment, planning further trips to HA for individuals who have experienced psychosis at HA, and advancing research in the field

Doping Sanctions in Sport: Knowledge and Perception of (Legal) Consequences of Doping—An Explorative Study in Austria

Anti-doping rule violations (ADRVs) can lead to sports-related and legal sanctions, thus, being knowledgeable is important. Research into this knowledge and how athletes and their support personnel (ASP) perceive the control mechanisms and the appropriateness of (legal) sanctions is still scarce. This explorative study aimed to examine the knowledge and perception of existing (legal) sanctions in Austria, by distributing a questionnaire to Austrian athletes and ASP covering the topics of knowledge related to legal and sports-related consequences associated with a specific ADRV presented in a case study, their trust and satisfaction with specific agencies (based on the European Social Survey (ESS)) and perceived efficiency and effectiveness of the doping control system. Data were analyzed descriptively. All respondents (N = 59) agreed on a ban from sport to be appropriate. Knowledge about legal consequences and the trust in the judiciary and the sport governing bodies was moderate (6.82 out of 10). Perceived appropriate consequences were on average higher than the likely sanctions to be faced. Future prevention should include trust building measures in the institutions and the control system, improvement in terms of access to law and education for the target group and critical reflection on the existence of social norms. Furthermore, the implementation of risk management aspects should be part of future approaches

Short Vacation Improves Stress-Level and Well-Being in German-Speaking Middle-Managers—A Randomized Controlled Trial

Stress in the work place has a detrimental effect on people’s health. Sufficient recovery is necessary to counteract severe chronic negative load reactions. Previous research has shown that vacationing for at least seven consecutive days provided an efficient recovery strategy. Yet, thus far, the effects of short vacations and the mode of vacation (whether at home or in a new environment) have rarely been studied. We investigated the immediate and long-term effects of a short vacation (four nights) on well-being and perceived stress and whether the mode of vacation impacted on these results. Data was obtained from 40 middle managers (67.5% men and 32.5% women). The intervention group (n = 20) spent a short vacation in a hotel outside their usual environment. The control group (n = 20) spent their vacation at home. Results indicated that one single short-term vacation, independent of the mode, has large, positive and immediate effects on perceived stress, recovery, strain, and well-being. Strain levels decreased to a greater extent in the intervention group compared to the control group. The effects can still be detected at 30 days (recovery) and 45 days (well-being and strain) post-vacation. Encouraging middle management employees to take short vacations seems to be an efficient health promotion strategy; environmental effects seem to play a minor role

Isolated high altitude psychosis, delirium at high altitude, and high altitude cerebral edema: are these diagnoses valid?

: Psychosis is a psychopathological syndrome that can be triggered or caused by exposure to high altitude (HA). Psychosis can occur alone as isolated HA psychosis or can be associated with other mental and often also somatic symptoms as a feature of delirium. Psychosis can also occur as a symptom of high altitude cerebral edema (HACE), a life-threatening condition. It is unclear how psychotic symptoms at HA should be classified into existing diagnostic categories of the most widely used classification systems of mental disorders, including the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11). We provide a diagnostic framework for classifying symptoms using the existing diagnostic categories: psychotic condition due to a general medical condition, brief psychotic disorder, delirium, and HACE. We also discuss the potential classification of isolated HA psychosis into those categories. A valid and reproducible classification of symptoms is essential for communication among professionals, ensuring that patients receive optimal treatment, planning further trips to HA for individuals who have experienced psychosis at HA, and advancing research in the field