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 sleeping beauty motif in the short stories of D. H. Lawrence

In this thesis, ten tales covering almost the whole of D.H. Lawrence's writing career have been analysed in terms of the 'Sleeping Beauty' motif or "the myth of the awakened sleeper" - a motif which has been noted briefly in Lawrence's fiction by several critics. Chapter one begins with a discussion of the Sleeping Beauty legend, its origins and its variants, and leads on to a comparison and contrast of two early tales. The Mitch a la Mode and The Daughters of the Vicar; these are, respectively, examples of Lawrence's treatment of the motif in symbolic and realistic terms. There is a further contrast in that these stories introduce the two types of 'Sleeping Beauty’ women, respectively - i.e. those who reject the awakening which offers liberation, and those who accept "the lover's kiss that awakens the Sleeping Beauty.” In Chapter Two The Horse-Dealer’s Daughter, You Touched We and The Fox are examined; they possess marked similarities of character and setting, but are sufficiently-varied treatments of the motif to warrant individual analysis. Chapter Three is concerned with The Princess and None of That, both variants on the negative aspect of the theme, in that they deal with 'Sleeping Beauty' heroines who ultimately reject any awakening. The Princess is a mature and skilful treatment of this aspect of the theme, whereas None of That is shown to be technically and artistically a regression. With Sun, Glad Ghosts and The Virgin and the Gipsy, all written during the last period, there is a return to the Sleeping Beauty- women who are awakened to new states of being. Symbolism, particularly in Sun, plays an important role, and it is fully discussed. The thesis concludes with a general discussion of the motif as it appears elsewhere in Lawrence's fiction, and of its relevance to his own life; in this connection, evidence is adduced from the novels and the correspondence

What Do We Know About Behavioral Crises in Dementia? A Systematic Review

Background: Behavioral crises in dementia are represented by a wide variety of symptoms, regularly require external intervention from professionals, and are reported as a risk factor for hospital admission. Little is known about the factors that are associated with them. Objective: To determine the factors associated with dementia-related behavioral crises. Methods: We searched MEDLINE, CINAHL, PsycINFO, EMBASE, and AMED databases. An additional lateral search including reference lists was conducted. Two researchers screened all records for potential eligibility. Narrative synthesis was used to bring together the findings. Results: Out of the 5,544 records identified, 24 articles (18 distinct studies) met the eligibility criteria. Aggression and agitation were the most common behaviors present at crises. Delusions, wandering/absconding, and hallucinations were also key behaviors contributing to crises. Behavioral crises predominantly happened in the severe stages of dementia (according to MMSE scores), in people with dementia residing in their own homes and in long-term care, and were the catalyst for admissions to psychiatric inpatient settings, specialist-care units, long-term care settings, or for referrals to psychiatric community services. Lack of consistency in assessment of behavior, and management of agitation/aggression in dementia crises were evident. Conclusion: Interventions to reduce the likelihood of people with dementia-related behaviors reaching crisis point need to focus on both family and care home settings and incorporate aggression and agitation management. Future research should focus on determining the factors that could be addressed to prevent behavioral crises and the interventions and models of care that may help to prevent crises. Keywords: Behavior; behavioral symptoms; crisis intervention; dementia; hospitalization; institutionalization

Changing player behaviour in sport during the COVID-19 pandemic: Shake on it?

To prevent the spread of infection during matches and training activities is a major challenge facing all sports returning from the enforced COVID-19 shutdown. During training and matches, rugby league players make contact with others which can result in SARS-CoV-2 virus transmission. While these interactions characterise the appeal of the game, a number of them can be avoided, including shaking hands and conversing after the match. This paper presents a framework underpinned by behavioural science (capability, opportunity, motivation and behaviour model, COM-B) to support stakeholders in helping players adopt new social distance norms and behaviours. This framework helps to ensure the players have the capability, opportunity, and motivation to adopt new COVID-19 risk minimising behaviours, which they will need to commit to 100%