Showing papers in "Performance enhancement and health in 2022"
TL;DR: In this article , a qualitative study explored the attitudes around current harm reduction frameworks for performance and image enhancing drug (PIED) consumers in Australia and identified key stakeholders, who included a variety of PIED consumers as well as HCPs who come into frequent contact with PIED consumers.
Abstract: Research has documented the harms associated with performance and image enhancing drug (PIED) use and lack of disclosure of use to healthcare providers (HCPs). Given that the relationship between HCPs and PIED consumers plays an important role in harm reduction, research is required to understand the barriers and facilitators for consumers to engage in help-seeking. This qualitative study explored the attitudes around current harm reduction frameworks for PIED consumers in Australia. Interviews were conducted with identified key stakeholders, who included a variety of PIED consumers as well as HCPs who come into frequent contact with PIED consumers. All participants were asked questions regarding the key barriers and facilitators for PIED consumers to help-seek, and how to best increase engagement among PIED consumers with HCPs. HCPs in Australia are calling for education around PIEDs, which is reflected as a ‘therapeutic barrier’ by consumers. This barrier represents an ongoing need to upskill HCPs in working with PIED consumers. Our data also showed a ‘safe space’ dynamic among peer-consumers in this space. Optimising harm reduction frameworks requires more synergy between peers and needle and syringe programs (NSPs), which remain safe and trusted environments for PIED consumers. We recommend harm reduction frameworks be strengthened through an increase in, and leveraging of, peer-led education programs.
9 citations
TL;DR: In this paper , the authors investigate the phenomena of anabolics coaching, which describes the practice of providing support and guidance on the appropriate and effective use of image and performance enhancing drugs (IPEDs), either as part of a general PT relationship or as a stand-alone service.
Abstract: This article investigates the phenomena of ‘anabolics coaching’, which describes the practice of providing support and guidance on the appropriate and effective use of image and performance enhancing drugs (IPEDs), either as part of a more general PT relationship or as a stand-alone service. Building upon van de Ven and Mulrooney's (2017) notion of the ‘steroid mentor’, we utilise digital and offline ethnographic data as well as interviews with several anabolics coaches and their clients to shed light upon this practice and interrogate the nexus of harm-reduction, IPED normalisation, and the health and fitness industry. The article first examines the anabolics coaching market, before addressing coach and client motivation, as well as the troubling crossover between coaching and supply of IPEDs. It concludes by posing the question of whether anabolics coaching represents an ‘emic’ form of harm reduction, or whether it undermines and contradicts the public health efforts to promote safe consumption practices, where we ultimately argue that, although not unproblematic, anabolics coaching has the potential to bolster safer consuming practices and reduce IPED-related harm.
9 citations
TL;DR: In this article , the authors explored the subcategory of therapeutically-motivated IPED users, whose IPED use is targeted at repair, rehabilitation, and self-medicating for health conditions, and considered the specific needs of this user category.
Abstract: With the rising use of IPEDs, it is important to understand how user motivations and practices influence harms, in order to formulate effective harm reduction policy. Existing work has consequently developed user typologies to address this need for specific interventions for differing users. Within this, the ‘wellbeing’ user type is one of the most prominent, however this broad category encompasses a range of users with distinct motivations and needs. This paper consequently explores the subcategory of therapeutically-motivated IPED users, whose IPED use is targeted at repair, rehabilitation, and self-medicating for health conditions, and considers the specific needs of this user category. Findings are drawn from a connective ethnography of gyms in South-West England, and digital fitness platforms, to analyze the motivations of therapeutically-oriented users, and how their behaviors and experiences are important to formulating interventions and broader policy discussions. Motivations explored include: (1) repair and injury rehabilitation, including those who access IPEDs for repair relating to sporting or competitive endeavors, as well as those whose IPED use is self-medicating for chronic health conditions. (2) General ‘wellbeing’ motivations for which participants self-medicated with IPEDs, including: health-oriented fat loss, rehabilitation for sleep, irritable bowel syndrome, and offsetting the negative health effects of hard sporting training. And (3) self-medicated testosterone replacement therapy (TRT) to offset negative symptoms ascribed to ‘low testosterone’, in both older gym participants whose natural levels were declining and who were looking to offset this, as well as men who experienced mental health difficulties such as depression, and sought to restore wellbeing through use of black market testosterone. This article demonstrates the breadth of therapeutic motivations for IPED use, and points to the ways in which the specific needs of this user category may be distinct from broader ‘wellbeing’ users. Significantly, participant narratives regarding the medical community's perceived unwillingness to treat them, and their feelings that this pushed them to access illicit IPEDs, indicate the importance of understanding the specific needs in relation to harm reduction policy formation.Keywords: IPED; HED; TRT; self-medication; wellness enhancement
6 citations
TL;DR: In this paper , the theoretical foundations of anti-doping policies in esports were examined and the commercial partnership between esports organizations and the energy-drink industry may impact the theoretical underpinnings of these policies.
Abstract: In this paper, I examine the theoretical foundations of esports anti-doping policies. Specifically, I focus on the health- and integrity-related arguments on which esports organizations rely to justify their anti-doping efforts and how the arguments relate to esports organizations’ partnership with energy-drink companies. First, I briefly explain the creation and development of anti-doping policies in esports. Subsequently, I identify the theoretical foundations of such policies. Then, I expound how the commercial partnership between esports organizations and the energy-drink industry may impact esports anti-doping theoretical underpinnings. I conclude by critiquing this partnership.
5 citations
TL;DR: In this article , a study was conducted to understand the challenges of anti-doping education by examining the experience that Kenyan athletes and educators have had with these programs, where semi-structured interviews were conducted with eleven long-distance runners and two antidoping educators.
Abstract: Kenyan athletes are at a significantly higher risk of doping, with research suggesting that their anti-doping knowledge is poor. WADA actively promotes education to prevent doping however, these efforts should account for regional contexts. The purpose of this study was to understand the challenges of anti-doping education by examining the experience that Kenyan athletes and educators have had with these programs. Semi-structured interviews were conducted with eleven long-distance runners and two anti-doping educators. Athletes and educators were included to understand the experience of delivering and receiving anti-doping education. Thematic analysis was performed on the data. Three main themes were identified. First, the athletes questioned the quality of education and expressed skepticism about its effectiveness. Furthermore, issues of accessibility surfaced with elite athletes receiving priority. Second, in the absence of education, athletes relied upon coaches and managers as information sources, which opened avenues for athlete exploitation. Third, athletes perceived doping as prevalent and easy to engage in. Moreover, some athletes believed that the Anti-Doping Agency of Kenya and the Athletics Federation were colluding to protect some athletes and this perception challenged the legitimacy of these organizations. While efforts to deliver anti-doping education in Kenya have improved, sub-elite and developing athletes may be neglected. This leads to an overreliance on informal sources of information and the potential for athlete exploitation. In developing countries, anti-doping organizations may need to leverage the existing infrastructure of coaches to promote anti-doping education information delivery.
3 citations
TL;DR: In this article , an anonymous online survey was completed by participants recruited through the Internet forum website Reddit: 555 bodybuilders, 889 powerlifters, and 157 participants in the control group.
Abstract: This research explored whether levels of muscle dysmorphia (MD), orthorexia nervosa (ON), depression, and obsessive-compulsive tendencies differed among bodybuilders, powerlifters, and a control group of neither bodybuilders nor powerlifters. Each athlete group was further divided into a steroid-using subgroup and a non-steroid-using subgroup. An anonymous online survey was completed by participants recruited through the Internet forum website, Reddit: 555 bodybuilders, 889 powerlifters, and 157 participants in the control group. Regardless of athlete group, levels of MD, ON, depression, and obsessive-compulsive tendencies were greater among steroid users than non-users. Differences among athlete groups were found only for those who did not report using steroids. Among these non-users, both the bodybuilders and powerlifters reported greater levels of MD, ON, and obsessive-compulsive tendencies than the control group; the only significant difference between bodybuilders and powerlifters was for MD. These results can be interpreted within the context of the lifestyle associated with these sports. Many bodybuilders and powerlifters develop very strict (obsessive-compulsive) dietary and training regimes for the purpose of gaining and maintaining the perfect degree of muscle mass and physique, often with the assistance of steroids.
3 citations
TL;DR: In this article , the authors conducted a systematic search of the PubMed, Scopus and SPORTDiscus databases with no language or publication restrictions from July 2020 until September 2020 to investigate the impact of MHL initiatives, including education, resources and information, on the mental health of youth elite athletes.
Abstract: Several evidence-based programs to improve mental health literacy (MHL) are available; however, few have been adapted for youth athletes and sport-club settings. This systematic review aimed to investigate the impact of MHL initiatives, inclusive of education, resources and information, on the mental health of youth elite athletes. Studies were included if they examined a mental health program for young athletes (10–24 years) and reported MHL outcomes in either young people or their extended support network. A systematic search of the PubMed, Scopus and SPORTDiscus databases was conducted with no language or publication restrictions from July 2020 until September 2020. Thirteen studies were included for analysis in the review. Six studies included adolescent athletes, four studies included parents of adolescent athletes, six studies included coaching staff and three studies included female athletic populations. Five of these studies were qualitative and eight quantitative. The broad study search identified a lack of well designed, intervention-based research on MHL programs for youth elite athletes despite high demand for context specific programs. No literature that met eligibility criteria addressed MHL in youth female elite athletes exclusively. These findings limit dissemination and program transferability. This study also reinforces the influence parents and coaches have on the mental wellbeing of young elite athletes. To enhance the quality of MHL initiatives, programs developers should focus on the development of tailored resources for youth athletes with a gendered focus and incorporating opportunities for coach and parent engagement.
2 citations
TL;DR: In this article , the authors explored how RED-S is experienced from a psychological perspective; sources of psychological conflict in the ongoing management of energy availability; and athlete responses to psychological conflicts in the pursuit of optimal EA.
Abstract: This study aimed to explore qualitatively the psychological experience of recovery from relative energy deficiency in sport (RED-S). More specifically, it sought to understand: how RED-S is experienced from a psychological perspective; sources of psychological conflict in the ongoing management of energy availability (EA); and athlete responses to psychological conflict in the pursuit of optimal EA. Eight female endurance athletes identifying as “in recovery” or “recovered” from RED-S (M age = 29.78 years) participated in this integrated methods multiple case-study. Participants engaged in an initial topical life history interview, before completing an online diary over a 21-day period, taking photographs of psychological triggers for seven days, and participating in a follow-up interview. Data were analysed using reflexive thematic analysis. The theme in too deep and treading water captured the significant psychological implications of RED-S. Seven sources of psychological conflict reported while managing EA were identified. The theme a constant tug of war represented the responses to these sources of psychological conflict in the ongoing management of EA. Within this theme, the subthemes in two minds and an emotional rollercoaster illustrated the cognitive and affective responses to psychological conflict, while giving in and the only way is through represented the adaptive and maladaptive behavioural responses during recovery, respectively. This study offers novel insights into the complex nature of recovery from RED-S and highlights the importance of considering psychological factors underpinning improved physiological functioning and overall wellbeing during RED-S recovery.
2 citations
TL;DR: In this paper , the authors explore players' perceptions of the use of drugs and other performance-enhancing substances such as energy drinks and gaming boosters in professional esports competitions, and the core findings that emerged out of the data are a high performance pressure related to FIFA competitions as perceived by players, an ambivalent perception towards the legitimacy of different forms of performance enhancement and a lack of anti-doping measures on the part of organisations involved.
Abstract: Along with the rapid rise of esports across the globe, the esports industry is increasingly confronted with issues concerning governance, regulations and manipulations. Software-cheating, match-fixing as well as doping seem to be widespread phenomena within professional esports competitions. Addressing these issues is challenging due to complex and fragmented governance structures and the lack of any central steering authority. This study looks into doping and performance enhancement in particular. Based on semi-structured interviews with (n = 9) selected professional FIFA esports players, we explore their perceptions of the use of drugs and other (allegedly) performance-enhancing substances such as energy drinks and gaming boosters. The core findings that emerged out of the data are a high performance pressure related to FIFA competitions as perceived by players, an ambivalent perception towards the legitimacy of different forms of performance enhancement and a lack of anti-doping measures on the part of organisations involved. The study is among the first to explore the view of players as one of the key stakeholders in the esports ecosystem.
2 citations
2 citations
TL;DR: In this article , the authors employed a qualitative secondary analysis (QSA) approach to re-analyse in-depth life-story interviews of 14 elite athletes (9 males/5 females) from Germany, Italy, and the UK, representing 11 sports across high, medium, and low risk (n = 3) categories for doping.
Abstract: • Commitment to clean sport and anti-doping compliance are two different things. • Clean sport concepts are individualized and differently situated along a continuum. • The way personal values are operationalized and enacted is both complex and fluid. • Clean sport mindset among athletes extends beyond the sporting environment. • Personal integrity and commitment to clean sport matter in values-based education. Despite widespread reference to protecting ‘clean sport’ and the rights of ‘clean athletes’ in anti-doping, to date very little attention has been paid to athletes who are, in majority, committed to clean sport. Understanding elite athletes’ conceptions of ‘clean sport’ and integrity, the psychosocial factors related specifically to athletes’ commitment to personal integrity and clean sport behaviour (as opposed to factors influencing anti-doping rule-breaking) provides a crucial, but currently missing, piece for anti-doping education. Drawing upon two complimentary theories (the Incremental Model of Doping Behaviour, and Personal Integrity) for coding frame, we employed a qualitative secondary analysis (QSA) approach to re-analyse in-depth life-story interviews of 14 elite athletes (9 males/5 females) from Germany, Italy, and the UK, representing 11 sports across high (n = 8), medium (n = 3) and low risk (n = 3) categories for doping. Interview data were originally collected for the SAFE YOU+ project to underpin illustrative case studies produced as educational material. QSA was conducted on this evidence within the constructivist research paradigm using thematic analysis through adductive reasoning. Elite athletes' conceptions of clean sport and commitment to personal integrity presented on a continuum from a strict position to use no substances at all through to the carefully calibrated use of non-prohibited substances/methods for the purpose of enhancing performance. There was a clear distinction between commitment to clean sport and anti-doping. Factors that threaten elite athletes’ personal commitment to clean sport, and thus could push them towards doping included intrinsic concerns (medical, financial, performance), perceptions of legitimacy in the anti-doping system, descriptive doping norms and identity. Factors that may help athletes build and maintain personal commitment to clean sport, and their personal commitment to a clean sport environment, involved acceptance, anti-doping environment, motivation, permitted means to enhance performance and multi-dimensional identity. Doping was seen as the consequence of lapse in, or a lack of, personal commitment to clean sport. For the first time, empirical evidence has differentiated between commitment to clean sport, and anti-doping. Results from this investigation highlighted that the process by which abstract values are operationalized into personal value-systems and priorities, and enacted, are complex and fluid. Values-based, anti-doping education therefore should adopt a holistic and broad approach to reach beyond the values of sport within the context of anti-doping and consider the complex role of personal integrity and commitment to clean sport. Emphasis on the impact of anti-doping rule breaking on peers, society and culture is recommended in addition to greater awareness of one's responsibility for performance-enhancement related actions, and a clean sport mindset among athletes which extends beyond the sporting environment.
TL;DR: In this paper , the authors investigated football players' preferences for anti-doping education and found that most players preferred short explanatory videos and online education that would be applied to the whole team/club.
Abstract: Research suggests that doping use is an underrecognized problem in football and is on the rise during the last years. Anti-doping education is one of the most important pillars in the fight against doping. The aim of the present study was to investigate football player's preferences for anti-doping education. Participants were 630 football players (456 players were males; 72.4%) from Norway ( n = 302), Greece ( n = 186) and Lithuania ( n = 142). They were administered a questionnaire including questions on demographic information (e.g., age, gender, years of experience, trainings per week) and factual information related to players’ preferences about anti-doping education. Results showed that the majority of players weren't willing to receive anti-doping education, with females, older players and players from Lithuania and Greece reporting higher willingness. With respect to the preferences about education, most players preferred short explanatory videos and online education that would be applied to the whole team/club. Concerning the content, participants requested for information on health side-effects, and case studies with doped and clean athletes’ experiences. Male and older players, as well as players from Norway and Greece preferred online courses, while adolescent and female players and players from Lithuania preferred both online and group courses. The findings of the study provide valuable information for the development of tailor-made and effective anti-doping education.
TL;DR: In this paper , the authors found that mindset positively predicted self-regulatory efficacy (SRE), moral disengagement (MD), and susceptibility to intentional and inadvertent doping susceptibility.
Abstract: Mindset refers to the way in which one attributes his or her abilities and traits as either ‘fixed’ (e.g., immutable), ‘growth’ (e.g., highly malleable), or somewhere in between. It is possible that mindset may be related to psychological factors linked to doping – such as doping moral disengagement (MD) and doping self-regulatory efficacy (SRE) – though no research as yet has confirmed this. In the present study, 322 student-athletes completed a questionnaire pack measuring mindset and various psychological factors linked to doping. Structural equation modeling provided strong support for all study hypotheses. Specifically, we established: (a) mindset positively predicted doping SRE, (b) mindset negatively predicted doping MD, (c) doping MD positively predicted susceptibility to intentional and inadvertent doping, (d) doping MD negatively predicted anticipated guilt, (e) anticipated guilt negatively predicted susceptibility to intentional and inadvertent doping. In addition, significant negative correlations were found between MSA and doping moral disengagement ( r = -.19, p < .01), MSA and susceptibility to inadvertent doping ( r = -.11, p < .01), MMC and moral disengagement ( r = -.12, p < .05), and MMC and susceptibility to inadvertent doping ( r = -.13, p < .05). A significant positive correlation was found between MSA and doping SRE ( r = .23, p < .01). Implications of the findings include the potential for early identification of athletes at risk of doping based on their mindset. Future research should look to explore the effectiveness of mindset interventions on reducing transgressive doping attitudes and behaviours.
TL;DR: In this paper , the authors conducted semi-structured interviews with 13 recreational Welsh rugby players who admitted to a substantial disregard of anti-doping policy and practice and concerns surface across three main themes: (1) perceived lack of frequency related to doping control tests; (2) perceived lacking of testing efficacy; and (3) advanced warning of doping controls by coaches.
Abstract: Understanding the attitudes and dispositions of athletes towards doping has been the subject of increasing research. Few studies, however, manage to capture these attitudes and dispositions from athletes who have committed anti-doping rule violations. According to UK Anti-Doping (2020) data, 10% of all sanctioned athletes came from recreational levels of Welsh rugby union. Although there are significant doping concerns within Welsh rugby, no research investigations exist that examine this specific population. Uniquely, the present research sheds light on “doped” athletes within recreational Welsh rugby union. Semi-structured interviews were conducted with (n = 13) “doped” recreational Welsh rugby players. Interviews revealed a wide range of factors, including motivations for doping, drug use patterns, perceived harms and athletes’ experiences and perceptions of Anti-Doping Policy and practice. This study focuses on interviews where participants reveal a substantial disregard of Anti-Doping policy and practice and concerns surface across three main themes: (1) perceived lack of frequency related to doping control tests; (2) perceived lack of testing efficacy; and (3) advanced warning of doping controls by coaches. Not only does this data raise serious concerns for the integrity of sport at recreational levels, but it also challenges the discourses around perceived legitimacy of anti-doping therein.
TL;DR: The use of substances by professionals in Canada has been explored in this paper , with participants recruited outside treatment programs or professional monitoring programs and data collection including indicators of "positive" or desired effects.
Abstract: This study was undertaken to explore the use of substances by professionals in Canada. A non-problem-focussed approach informed study design, with participants recruited outside treatment programs or professional monitoring programs and data collection including indicators of ‘positive’ or desired effects. Participants were 19-years or older and residing in Canada. An anonymous online survey (n = 515) collected information about demographics, prevalence of substance use, substances previously used, and mental health. Interviews (n = 52) focused on personal use of substances and effects, perspectives on professional regulation of substance use, and experiences around disclosure. Gender patterns were similar for use of licit and illicit substances, while women reported using greater numbers of pharmaceuticals and higher use of substances targeted at improving mood, decreasing pain, and improving sleep. Men and women discussed volition regarding choices around substance use and described substances as contributing to improved productivity and mood. Whereas men discussed stressors as occurring outside the home, with ‘home’ being a place to return to and unwind, women are predominantly responsible for coordinating family activities and events and saw both work and social spaces as stressful. Women's use of substances was subject to social scrutiny intertwined with normative ideals around mothering, pregnancy, and breastfeeding. Substance use occurs in the context of ‘busy’ lives, where people have little time and energy for other healthy lifestyle alternatives; as one participant explained, substance use is “a reward for surviving the day.” In the West, societal expectations continue to attribute predominant responsibility for parenting to women, where being a ‘good mother’ requires one to be a ‘happy mother’ and experiences of distress are silenced. Women strive to attain the status of an ‘ideal worker’ while balancing multiple roles and responsibilities. Substances are a means to instantaneously enhance individual performance and pleasure in response to troubling social structures and systems that remain largely unchallenged.
TL;DR: In this paper , the authors examined the relationship between perceptions of masculinity and body image (BI) to eating disorder (ED) risk in male collegiate wrestlers and found that male wrestlers engage in rapid weight loss methods to maximize performance at lower weight classes.
Abstract: Successful wrestling performance is largely dictated by weight. Some wrestlers engage in rapid weight loss methods to maximize performance at lower weight classes. Data from other sports suggest these methods can negatively affect body image (BI) and physical health and put athletes at risk for disordered eating behaviors, but the actual impact in wrestling is unknown. The present study examined the relationship between perceptions of masculinity and BI to eating disorder (ED) risk in male collegiate wrestlers. Survey data were collected from active male NCAA wrestlers (n= 63). Wrestlers completed the Eating Attitudes Test, the Multidimensional Body-Self Relations Questionnaire, the Hoffman Gender Scale, and three open-ended response items. ED risk was positively correlated to appearance self-importance (r= 0.361, p < 0.01) and body weight vigilance (r= 0.618, p < 0.01) and negatively correlated to BI satisfaction (r = -0.328, p < 0.05). Gender self-acceptance was correlated to lower importance placed on BI (r= 0.402, p < 0.01). Additionally, 35 (53.9%) participants reported at least one maladaptive eating behavior (e.g. binging, vomiting, laxative use). Qualitative data indicates similarities in traits associated with successful wrestlers and the traditional ideal male (mental and physical strength, toughness, surpassing limits). The masculine traits exemplified by the sport of wrestling may negatively impact BI and encourage maladaptive eating and/or weight-control behavior and increase ED risk. The information in this study can be used to inform the development of safer weight loss practices and specialized educational programs for ED risk for wrestlers. This study highlights a need for further qualitative analysis of weight-control behaviors in collegiate wrestling.
TL;DR: In this paper , the frequency of rapid weight-loss (RWL) methods are adopted by male and female powerlifting athletes in the United Kingdom (UK) during competition preparation, and a Chi-square cross tabulation was used to identify any significant differences between independent and dependent variables.
Abstract: Previous research in Powerlifting (PL) has qualitatively investigated rapid weight-loss (RWL) in PL athletes and body image, however limited research exists in quantifying such methods adopted in PL. This study aimed to assess the frequency of RWL methods are adopted by male and female PL athletes in the United Kingdom (UK) during competition preparation. A total of n = 37 ( n = 19 female, n = 18 male) competitive powerlifters completed an anonymous online questionnaire assessing RWL methods. A Chi-square cross tabulation was utilised to identify any significant differences between independent and dependent variables. Multiple regression analyses were then conducted to assess the contribution of biological sex and PL category on RWL methods. Commonly reported methods of weight loss were gradual dieting (49%), fluid restriction (46%), and water loading (51%). Differences between PL category (Junior, Open, Masters One) and adopting RWL were observed ( X 2 =4.220 , p <0.05 ) . PL category was a predictor of undertaking RWL ( R 2 adj = 0.160, F (2, 34) = 4.429, p ≤ 0.05), whilst biological sex was a predictor of timeframe of undertaking RWL ( R 2 adj = 0.123, F (2, 34) = 3.534, p ≤ 0.05). RWL strategies are adopted by PL athletes in order to make weight for competition. Despite known effects of RWL on strength performance, limited research currently exists on these strategies specifically within PL, therefore this may be a consideration for future research. Practitioners working with PL athletes may wish to consider appropriate nutrition and weight loss strategies in preparation for PL competitions.
TL;DR: In this article , the authors investigated the knowledge and experience of PIED use amongst attendees of a Needle and Syringe Program (NSP) in Australia and investigated their experience of seeking medical advice and accessing the NSP service.
Abstract: The availability and utilisation of performance and image enhancing drugs (PIEDs) have been increasing in the last decade. This study aimed to understand the knowledge and experience of PIED use amongst attendees of a Needle and Syringe Program (NSP) in Australia. It also investigated their experience of seeking medical advice and accessing the NSP service. Semi-structured interviews were conducted with 19 participants between September 2016 and April 2017. Audio recordings of the interviews were transcribed verbatim and content analysis was conducted. All 19 participants were male, with 10 participants aged 18–25 and 15 working. Participants showed sound knowledge of injecting practices and side effects; however, their understanding about blood-borne virus transmission risks was limited. Most of them reported experiencing injection-related injuries and considered this as common. They would seek general medical advice; however, they would not disclose their PIED use if not required as their past experience indicated that general practitioners lacked knowledge and support. Participants expressed concerns before their first visit to the NSP service, but thought staff were open minded, non-judgemental and helpful after the visit. They also highlighted the difficulty in accessing the service for injection equipment during business hours and provided suggestions on service improvement including extending the opening hours, using vending machines and providing a peer support program. The findings suggest there is a need to educate PIED users about blood-borne virus transmission risks, improve general practitioners’ understanding about PIED use, and investigate the feasibility of extending the NSP service hours and for the service to provide a peer support program to clients who use PIEDs.
TL;DR: In this paper , a qualitative study explored the attitudes around current harm reduction frameworks for performance and image enhancing drug (PIED) consumers in Australia and identified key stakeholders, who included a variety of PIED consumers as well as HCPs who come into frequent contact with PIED consumers.
Abstract: Research has documented the harms associated with performance and image enhancing drug (PIED) use and lack of disclosure of use to healthcare providers (HCPs). Given that the relationship between HCPs and PIED consumers plays an important role in harm reduction, research is required to understand the barriers and facilitators for consumers to engage in help-seeking. This qualitative study explored the attitudes around current harm reduction frameworks for PIED consumers in Australia. Interviews were conducted with identified key stakeholders, who included a variety of PIED consumers as well as HCPs who come into frequent contact with PIED consumers. All participants were asked questions regarding the key barriers and facilitators for PIED consumers to help-seek, and how to best increase engagement among PIED consumers with HCPs. HCPs in Australia are calling for education around PIEDs, which is reflected as a ‘therapeutic barrier’ by consumers. This barrier represents an ongoing need to upskill HCPs in working with PIED consumers. Our data also showed a ‘safe space’ dynamic among peer-consumers in this space. Optimising harm reduction frameworks requires more synergy between peers and needle and syringe programs (NSPs), which remain safe and trusted environments for PIED consumers. We recommend harm reduction frameworks be strengthened through an increase in, and leveraging of, peer-led education programs.
TL;DR: The most commonly used recovery strategies during normal training weeks were active recovery (51%), stretching (47%), and additional sleep (32%), while foam rolling (35%), massage guns (20%), and compression garments (19%) were the most frequently used recovery devices as discussed by the authors .
Abstract: To minimise the deleterious effects of fatigue and muscle soreness and maintain availability for training and competition, triathletes may implement recovery strategies that act on various physiological, biomechanical, neurological or psychological domains. However, the use of common recovery strategies is yet to be investigated in this population. 322 triathletes (109 female, 212 male) of varying competition levels from 39 countries participated in the current study. Participants completed an anonymous online survey to determine their use and perceived effectiveness of various recovery strategies. Multiple chi-square tests were conducted to examine the association between training week type (normal vs post-competition), preferred event distance (short or long course), competition level and use of recovery strategies. The most frequently used recovery strategies during normal training weeks were active recovery (51%), stretching (47%) and additional sleep (32%), while foam rolling (35%), massage guns (20%) and compression garments (19%) were the most commonly used recovery devices. The use of active recovery, additional sleep and professional massage was significantly (p = <.002) more common in the week following a competitive event than during a normal training week. Long course triathletes were more likely to use intermittent pneumatic compression (IPC) devices (p = .008) and hydrotherapy (p = .05) than were short-course triathletes. Active recovery, additional sleep and stretching are the preferred recovery choices for triathletes of all levels, though the use of foam rolling, massage guns and compression garments is common in this population. Active recovery, additional sleep and professional massage are more frequently used by triathletes in the week following a competitive event and are perceived to be the most effective recovery strategies overall.