High INtensity Interval Training in pATiEnts with Intermittent Claudication: A Qualitative Acceptability Study.

BACKGROUND: A novel high-intensity interval training (HIIT) program has demonstrated feasibility for patients with intermittent claudication (IC). The aim of this study was to explore patient perspectives of the HIIT program to inform refinement and future research. METHODS: All patients screened and eligible for the 'high intensity interval training in patients with intermittent claudication (INITIATE)' study were eligible to take part in a semistructured interview. A convenience subsample of patients was selected from 3 distinct groups: 1) those who completed the HIIT program, 2) those who prematurely discontinued the HIIT program, and 3) those who declined the HIIT program. Interviews considered patients views of the program and experiences of undertaking and/or being invited to undertake it. Interviews were audio recorded, transcribed verbatim, and analyzed via thematic analysis. RESULTS: Eleven out of 31 participants who completed the program and 12 out of 38 decliners were interviewed. No participants who withdrew from the program agreed to interview. The 3 key themes were; personal reflections of the program; program facilitators and barriers; and perceived benefits. Completers enjoyed taking part, reported symptomatic improvement and would complete it again. Practical and psychological barriers exist, such as transport and motivation. Changes to the program were suggested. CONCLUSIONS: Findings support the acceptability of this novel HIIT program, which in combination with the feasibility findings, suggest that a fully powered randomized controlled trial, comparing HIIT to usual-care supervised exercise programs is warranted.

High-intensity interval training in patients with intermittent claudication.

OBJECTIVE: Provision, uptake, adherence, and completion rates for supervised exercise programs (SEP) for intermittent claudication (IC) are low. A shorter, more time-efficient, 6-week, high-intensity interval training (HIIT) program may be an effective alternative that is more acceptable to patients and easier to deliver. The aim of this study was to determine the feasibility of HIIT for patients with IC. METHODS: A single arm proof-of-concept study, performed in secondary care, recruiting patients with IC referred to usual-care SEPs. Supervised HIIT was performed three times per week for 6 weeks. The primary outcome was feasibility and tolerability. Potential efficacy and potential safety were considered, and an integrated qualitative study was undertaken to consider acceptability. RESULTS: A total of 280 patients were screened: 165 (59%) were eligible, and 40 (25%) were recruited. The majority (n = 31; 78%) of participants completed the HIIT program. The remaining nine patients were withdrawn or chose to withdraw. Completers attended 99% of training sessions, completed 85% of sessions in full, and performed 84% of completed intervals at the required intensity. There were no related serious adverse events. Maximum walking distance (+94 m; 95% confidence interval, 66.6-120.8 m) and the SF-36 physical component summary (+2.2; 95% confidence interval, 0.3-4.1) were improved following completion of the program. CONCLUSIONS: Uptake to HIIT was comparable to SEPs in patients with IC, but completion rates were higher. HIIT appears feasible, tolerable, and potentially safe and beneficial for patients with IC. It may provide a more readily deliverable, acceptable form of SEP. Research comparing HIIT with usual-care SEPs appears warranted.

Pleasant Emotions Widen Thought-Action Repertoires, Develop Long-Term Resources, and Improve Reaction Time Performance: A Multistudy Examination of the Broaden-and-Build Theory Among Athletes.

The authors investigated relationships between emotions, coping, and resilience across two studies. In Study 1a, 319 athletes completed dispositional questionnaires relating to the aforementioned constructs. In Study 1b, 126 athletes from Study 1a repeated the same questionnaires 6 months later. In Study 2, 21 athletes were randomly allocated to an emotional (e.g., pleasant or unpleasant emotions) or control group and undertook a laboratory-based reaction-time task across three time points. Questionnaires and salivary cortisol samples were collected before and after each performance with imagery-based emotional manipulations engendered during the second testing session. Partial longitudinal evidence of the broaden-and-build effects of pleasant emotions was found. Pleasant emotions may undo lingering cognitive resource losses incurred from previous unpleasant emotional experiences. In Study 2, pleasant and unpleasant emotions had an immediate and sustained psychophysiological and performance impact. Taken together, this research supports the application of broaden-and-build theory in framing emotional interventions for athletes.

The treatment experiences of people living with ileostomies: an interpretative phenomenological analysis.

AIMS: The aim of this study was to explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice while caring for these patients. BACKGROUND: Ileostomies, where the small intestine is re-directed out of a stoma in the abdominal wall so waste is collected using a bag, are used to treat conditions including inflammatory bowel disease. Existing research suggests that although life with a stoma can be challenging, ileostomy patients are largely supported by multi-disciplinary teams. However, more research is needed to understand the nuances of these relationships and experiences of treatment, with a view to improving clinical care. DESIGN: Participants took part in semi-structured interviews consisting of open-ended questions about their experiences of life with an ileostomy and their treatments and time in hospital. Points of interest were followed up. Data were collected between July-December of 2014. METHODS: The qualitative method interpretative phenomenological analysis was used to analyse interviews with 21 people living with ileostomies. FINDINGS: We present findings from two clinical themes: Issues around treatment and Relationships with multi-disciplinary teams. Surgical complications were common and several participants reported concerns about addiction to painkillers. Varying attitudes were found around reversal surgery. Many reported experiencing distressing, dehumanizing care, while some felt supported by excellent healthcare providers. CONCLUSION: People living with ileostomies have a very mixed experience of multi-disciplinary teams and treatments and much could be done to support them more fully. For example, more information about ileostomies could be given to patients and more training given to nurses around stomas.

Precompetitive achievement goals, stress appraisals, emotions, and coping among athletes.

Grounded in Lazarus's (1991, 1999, 2000) cognitive-motivational-relational theory of emotions, we tested a model of achievement goals, stress appraisals, emotions, and coping. We predicted that precompetitive achievement goals would be associated with appraisals, appraisals with emotions, and emotions with coping in our model. The mediating effects of emotions among the overall sample of 827 athletes and two stratified random subsamples were also explored. The results of this study support our proposed model in the overall sample and the stratified subsamples. Further, emotion mediated the relationship between appraisal and coping. Mediation analyses revealed that there were indirect effects of pleasant and unpleasant emotions, which indicates the importance of examining multiple emotions to reveal a more accurate representation of the overall stress process. Our findings indicate that both appraisals and emotions are just as important in shaping coping.

Dispositional coping, coping effectiveness, and cognitive social maturity among adolescent athletes.

It is accepted among scholars that coping changes as people mature during adolescence, but little is known about the relationship between maturity and coping. The purpose of this paper was to assess a model, which included dispositional coping, coping effectiveness, and cognitive social maturity. We predicted that cognitive social maturity would have a direct effect on coping effectiveness, and also an indirect impact via dispositional coping. Two hundred forty-five adolescent athletes completed measures of dispositional coping, coping effectiveness, and cognitive social maturity, which has three dimensions: conscientiousness, peer influence on behavior, and rule following. Using structural equation modeling, we found support for our model, suggesting that coping is related to cognitive social maturity. This information can be used to influence the content of coping interventions for adolescents of different maturational levels.

Multi-wave analyses of coping, athlete burnout, and well-being among F. A. Premier League academy players.

Being a player with an F. A. Premier football academy is very prestigious for young players, but it can also be very stressful too. Coping with stress is particularly important given that one of the undesirable consequences linked to chronic stress is athlete burnout, which may also negatively impact psychological well-being. Understanding the most effective ways to cope with stress, therefore, is important for optimizing academy athlete education. Consequently, the aim of the present study was to examine whether coping predicted changes in athlete burnout, and whether athlete burnout predicted changes in well-being across 14 weeks of the competitive season. A sample of 26, under-18 and under-23, male F.A. Premier academy athletes completed weekly assessments of coping (task-, distraction-, and disengagement-oriented), athlete burnout, and psychological well-being on 14 separate occasions. The results of within-person analyses revealed that task-oriented coping predicted decreases in athlete burnout, which in turn predicted decreased well-being. Teaching high-level academy athletes task-oriented coping strategies may be useful in reducing athlete burnout, which may additionally protect athletes' well-being.

Snitches Get Stitches and End Up in Ditches: A Systematic Review of the Factors Associated With Whistleblowing Intentions.

Blowing the whistle on corruption or wrongdoing can facilitate the detection, investigation, and then prosecution of a violation that may have otherwise gone undetected. The purpose of this systematic review was to identify the factors that are associated with intentions to blow the whistle on wrongdoing. We searched Academic Search Premier, CINAHL Complete, Education Research Complete, ERIC, Medline, PsycARTICLES, PsycINFO, Regional Business News, and SPORTDiscus in January 2020. The quality of evidence was assessed using the Cochrane risk of bias tool. Of the 9,136 records identified, 217 studies were included in this systematic review. We identified 8 dimensions, 26 higher-order themes, and 119 lower-order themes. The whistleblowing dimensions were personal factors, organizational factors, cost and benefits, outcome expectancies, the offense, reporting, the wrongdoer, and social factors. Based on the findings, it is apparent that organizations should empower, educate, protect, support, and reward those who blow the whistle, in order to increase the likelihood on individuals blowing the whistle on corruption and wrongdoing. A combined approach may increase whistleblowing intentions, although research is required to test this assertion. From a policy perspective, more consistent protection is required across different countries.

Type D personality, stress, and symptoms of burnout: the influence of avoidance coping and social support.

OBJECTIVE: This study investigated whether approach coping, avoidance coping, or perceptions of available social support mediated the relationship between Type D personality and perceived stress. Furthermore, this research also examined whether Type D moderated the relationship between perceived stress and symptoms of burnout. METHODS: In this cross-sectional study, 334 (male N=180; female N=154) first-year undergraduate students completed the Type D Scale-14 (DS14), the Brief Approach/Avoidance Coping Questionnaire, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and the Oldenburg Burnout Inventory. DESIGN: Cross-sectional. RESULTS: Multiple mediation analysis revealed that only resignation and withdrawal coping, but not social support partially mediated the relationship between Type D and perceived stress. A small moderation effect was found for the disengagement subscale of the burnout inventory, with Type D individuals experiencing higher levels of disengagement at low and average stress levels. The correlations between variables provided support for most of the prediction from the literature with regard to Type D. CONCLUSION: Of the participants in the present study, 24.9% were classified as Type D. These individuals tend to use more passive and maladaptive avoidance coping strategies such as resignation and withdrawal. This is associated with higher levels of perceived stress and linked to increased levels of burnout symptoms.

Cheater, cheater, pumpkin eater: the Dark Triad, attitudes towards doping, and cheating behaviour among athletes.

We examined the relationships between the Dark Triad personality traits (Machiavellianism, narcissism, and psychopathy), attitudes towards doping, and cheating behaviour among athletes. One-hundred and sixty-four athletes completed a completed a matrix solving task within a specific time limit. Participants were told they would receive a financial reward for the total number matrices they could solve, but only 13 of the 20 matrices were solvable. This provided the incentive and opportunity for the athletes to cheat. Following this, athletes completed two questionnaires, which assessed the Dark Triad and their attitudes towards doping. All three Dark Triad personality traits correlated positively with attitudes towards doping and cheating behaviour. Regression analyses revealed that psychopathy and narcissism positively predicted attitudes towards doping, and narcissism emerged as a positive predictor of cheating behaviour. Attitudes towards doping correlated positively with cheating behaviour. The Dark Triad appears to be important in relation to both attitudes towards doping and cheating behaviour among athletes. In addition, our findings illustrate that favourable attitudes towards doping are linked with actual cheating among athletes. National Anti-Doping Organizations, sports federations, and coaches could assess athletes' Dark Triad scores and attitudes towards doping in order to identify who may be more likely to cheat.

The Susceptibles, Chancers, Pragmatists, and Fair Players: An Examination of the Sport Drug Control Model for Adolescent Athletes, Cluster Effects, and Norm Values Among Adolescent Athletes.

Although there are few high-profile cases of adolescent athletes being caught doping, up to a third of young athletes may dope. In order to generate a more accurate understanding of why adolescent athletes dope, it is important to validate models that help to explain this behavior. The aims of this study were 3-fold: firstly, to test the Sport Drug Control Model for Adolescent Athletes (SDCM-AA); secondly, to generate athlete profiles that would help quantify the proportion of athletes who are at risk of doping; and thirdly, to create norm values for the Adolescent Sport Doping Inventory (ASDI), which would allow national doping organizations, sporting organizations, and clubs to benchmark the scores of their athletes for key psycho-social variables linked to doping. A total of 2208 adolescent athletes from the United Kingdom, Australia, Hong Kong, and the United States completed the ASDI. The data presented an appropriate fit to the SDCM-AA model, in which 54% of the variance in susceptibility to doping was explained in the model, and 44.8% of attitudes toward doping was accounted for. Four distinct clusters of athletes emerged: the Susceptibles (i.e., identified with the benefits of doping, were willing to cheat, and viewed little threat), the Chancers (i.e., identified with the benefits of doping, scored high on willingness to cheat, and were highly influenced by their reference group, but had an average score for threat, self-esteem, and legitimacy), the Pragmatists (i.e., did not engage with any aspects of doping, but were more susceptible than the fair players), and Fair Players (i.e., high levels of sportspersonship, unwilling to cheat, and viewed doping as a threat). The revised SDCM-AA appears a valid model that helps explain the factors associated with doping attitudes and doping susceptibility. Adolescent athletes can be classified into one of four clusters, in relation to doping. Their cluster group could influence the content of the anti-doping education they receive.

The effects of the iPlayClean education programme on doping attitudes and susceptibility to use banned substances among high-level adolescent athletes from the UK: A cluster-randomised controlled trial.

Background This study examined the effects of the iPlayClean anti-doping intervention on attitudes towards doping and susceptibility, and whether delivery mode affected the results. Methods A total of 1081 high-level UK athletes (14-18 years old, 904 males, 177 females) were cluster-randomised to the control (11 teams/organisations/schools, 314 athletes), face-to-face group presentation (8 teams/organisations/schools, 254 athletes), online (11 teams/organisations/schools, 251 athletes), or face-to-face presentation with online access (5 teams/organisations/schools, 262 athletes). Results Compared to the control group, all modes of the iPlayClean anti-doping education programme reduced favourable attitudes towards doping immediately after the intervention, which was sustained across all intervention groups 8 weeks later. All delivery modes impacted doping susceptibility immediately after the intervention, in comparison to the control group, but the effects were only sustained for the face-to-face presentation group. Conclusion Contrary to findings within previous anti-doping interventions, we have shown that doping attitudes can be changed and that the results can be sustained across all modes of delivery, 8 weeks later. Research is required to assess for how long these changes are sustained, and how often anti-doping education should be delivered to high-level athletes to reinforce clean play values.

High INtensity Interval Training In pATiEnts with intermittent claudication (INITIATE): protocol for a multicentre, proof-of-concept, prospective interventional study.

INTRODUCTION: The first-line recommended treatment for patients with intermittent claudication (IC) is a supervised exercise programme (SEP), which includes a minimum of 2-hours of exercise per week over a 12-week period. However, provision, uptake and adherence rates for these SEP programmes are poor, with time constraints cited as a common participant barrier. High-intensity interval training (HIIT) is more time-efficient and therefore has the potential to overcome this barrier. However, evidence is lacking for the role of HIIT in those with IC. This proof-of-concept study aims to consider the safety, feasibility, tolerability and acceptability of a HIIT programme for patients with IC. METHODS AND ANALYSIS: This multicentre, single-group, prospective, interventional feasibility study will recruit 40 patients with IC, who will complete 6 weeks of HIIT, 3 times a week. HIIT will involve a supervised programme of 10×1 min high-intensity cycling intervals at 85%-90% peak power output (PPO), interspaced with 10×1 min low intensity intervals at 20%-25% PPO. PPO will be determined from a baseline cardiopulmonary exercise test (CPET) and it is intended that patients will achieve ≥85% of maximum heart rate from CPET, by the end of the second HIIT interval. Primary outcome measures are safety (occurrence of adverse events directly related to the study), programme feasibility (including participant eligibility, recruitment and completion rates) and HIIT tolerability (ability to achieve and maintain the required intensity). Secondary outcomes include patient acceptability, walking distance, CPET cardiorespiratory fitness measures and quality of life outcomes. ETHICS AND DISSEMINATION: Ethical approval was obtained via a local National Health Service research ethics committee (Bradford Leeds - 18/YH/0112) and recruitment began in August 2019 and will be completed in October 2020. Results will be published in peer-reviewed journals and presented at international conferences and are expected to inform a future pilot randomised controlled trial of HIIT versus usual-care SEPs. TRIAL REGISTRATION NUMBER: NCT04042311; Pre-results.

The development and validation of the Adolescent Sport Drug Inventory (ASDI) among athletes from four continents.

A significant barrier to understanding the psychosocial antecedents of doping use among adolescent athletes is the lack of valid measures. In order to address this issue, the first aim of this paper was to develop and validate the Adolescent Sport Drug Inventory (ASDI) among adolescent athletes from Asia, Europe, North America, and Oceania. The second aim was to assess the construct validity of the ASDI. As such, this paper is divided into two parts. Part 1 relates to the development of the ASDI and contains two studies: item development (Study 1) and factorial validity (Study 2). Part 2 contains information on how the psychosocial variables measured in the ASDI are associated with situational temptation, and honesty (Study 3), maturation (Study 4), stress and coping (Study 5), and coaching (Study 6). In devising the ASDI, 19 different models were examined, which culminated in a 9-factor, 43-item ASDI. Coping, mastery-approach goals, and cognitive-social maturity were associated with doping attitudes. Caring motivational climates, strong coach-athlete relationships, and positive coach behaviors were associated with athletes being less susceptible toward doping, which provides construct validity for the ASDI. The ASDI is a valid tool to assess the psychosocial factors associated with doping among adolescent athletes. This questionnaire can be used to identify athletes who are the most at risk of doping, assess how the psychosocial factors associated with doping change over time, and to monitor the impact of antidoping interventions for adolescent athletes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Think aloud: acute stress and coping strategies during golf performances.

A limitation of the sport psychology coping literature is the amount of time between a stressful episode and the recall of the coping strategies used in the stressful event (Nicholls & Polman, 2007). The purpose of this study was to develop and implement a technique to measure acute stress and coping during performance. Five high-performance adolescent golfers took part in Level 2 verbalization think aloud trials (Ericsson & Simon, 1993), which involved participants verbalizing their thoughts, over six holes of golf. Verbal reports were audio-recorded during each performance, transcribed verbatim, and analyzed using protocol analysis (Ericsson & Simon, 1993). Stressors and coping strategies varied throughout the six holes, which support the proposition that stress and coping is a dynamic process that changes across phases of the same performance (Lazarus, 1999). The results also revealed information regarding the sequential patterning of stress and coping, suggesting that the golfers experienced up to five stressors before reporting a coping strategy. Think aloud appears a suitable method to collect concurrent stress and coping data.

The Prevalence of Pseudoscientific Ideas and Neuromyths Among Sports Coaches.

There has been an exponential growth in research examining the neurological basis of human cognition and learning. Little is known, however, about the extent to which sports coaches are aware of these advances. Consequently, the aim of the present study was to examine the prevalence of pseudoscientific ideas among British and Irish sports coaches. In total, 545 coaches from the United Kingdom and Ireland completed a measure that included questions about how evidence-based theories of the brain might enhance coaching and learning, how they were exposed to these different theories, and their awareness of neuromyths. Results revealed that the coaches believed that an enhanced understanding of the brain helped with their planning and delivery of sports sessions. Goal-setting was the most frequently used strategy. Interestingly, 41.6% of the coaches agreed with statements that promoted neuromyths. The most prevalent neuromyth was "individuals learn better when they receive information in their preferred learning style (e.g., auditory, visual, or kinesthetic)," which 62% of coaches believed. It is apparent that a relatively large percentage of coaches base aspects of their coaching practice on neuromyths and other pseudoscientific ideas. Strategies for addressing this situation are briefly discussed and include changing the content of coach education programs.

Can an athlete be taught to cope more effectively? The experiences of an international-level adolescent golfer during a training program for coping.

The purpose of this descriptive paper was to examine the experiences of an internationally ranked golfer during a training program for coping. A 16-yr.-old male English golfer maintained an audio diary for seven competitive rounds over 21 days. He answered the same five questions after each competitive round concerning his experiences of stress and coping. The training program for coping was based upon the previous research of Nicholls and colleagues with adolescent golfers at the international level. The training program reduced the number of ineffective coping strategies that the participant used.

Perceptions of the Coach-Athlete Relationship Predict the Attainment of Mastery Achievement Goals Six Months Later: A Two-Wave Longitudinal Study among F. A. Premier League Academy Soccer Players.

All football teams that compete within the F. A. Premier League possess an academy, whose objective is to produce more and better home-grown players that are capable of playing professionally. These young players spend a large amount of time with their coach, but little is known about player's perception of the coach-athlete relationship within F. A. Premier League Academies. The objectives of this study were to examine whether perceptions of the coach-athlete relationship changed over six months and if the coach-athlete relationship predicted self-reported goal achievement among F. A. Premier League academy players. This study included cross-sectional (n = 104) and longitudinal (n = 52) assessments, in which academy soccer players completed a measure of the coach-athlete relationship and goal achievement across either one or two time periods. The cross-sectional data were subjected to bivariate correlations, whereas the longitudinal data were analyzed using multiple regressions. Perceptions of the coach-athlete relationship remained stable over time. The coach-athlete relationship predicted the achievement of mastery goals six months later. Enhancing the quality of the coach-athlete relationship among elite adolescent athletes appears to be a suitable way of maximizing mastery achievement goals, particularly among developmental athletes who participate in team sports.

The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis.

OBJECTIVES: Ileostomy, in which the small intestine is redirected out of an abdominal wall so that waste is collected using a bag, is used to treat conditions including inflammatory bowel disease and colorectal cancer. This article reports an in-depth idiographic analysis of the experience of living with an ileostomy. METHOD: Twenty-one participants took part in semistructured interviews about their lives and relationships. Those interviews were transcribed verbatim and analyzed using the experiential qualitative methodology interpretative phenomenological analysis. RESULTS: Two superordinate themes arose from the data: ileostomy's intrapersonal impact and the impact of ileostomy on relationships with others. The authors found that ileostomy may destabilize the sense of self, disrupt body image, and alter experience of age and sexuality. Other participants were able to use their illness to positively reframe the self. Disclosure of ileostomy status was difficult for some. Intimate and friend relationships were often challenged by stoma status, whereas other family relationships were largely characterized as supportive. CONCLUSIONS: Ileostomy may impact upon both intra- and interpersonal aspects of the lives of those who live with it, in both negative and positive ways. Consequently, the sense of self can appear challenged, and relationships with partners, family members and friendships could be causes of distress. On the other hand, some partners were supportive, and children were found to be sources of comfort. (PsycINFO Database Record

Children's First Experience of Taking Anabolic-Androgenic Steroids can Occur before Their 10th Birthday: A Systematic Review Identifying 9 Factors That Predicted Doping among Young People.

Taking performance-enhancing drugs (PEDs) can cause serious and irreversible health consequences, which can ultimately lead to premature death. Some young people may take PEDs without fully understanding the ramifications of their actions or based on the advice from others. The purpose of this systematic review was to identify the main factors that predicted doping among young people. The literature was systematically reviewed using search engines, manually searching specialist journals, and pearl growing. Fifty-two studies, which included 187,288 young people aged between 10 and 21 years of age, 883 parents of adolescent athletes, and 11 adult coaches, who were interviewed regarding young athletes, were included in this review. Nine factors predicted doping among young people: gender; age; sports participation; sport type; psychological variables; entourage; ethnicity; nutritional supplements; and health harming behaviors. In regards to psychological variables, 22 different constructs were associated with doping among young people. Some psychological constructs were negatively associated with doping (e.g., self-esteem, resisting social pressure, and perfectionist strivings), whereas other were positively associated with doping (e.g., suicide risk, anticipated regret, and aggression). Policy makers and National Anti-Doping Organizations could use these findings to help identify athletes who are more at risk of doping and then expose these individuals to anti-doping education. Based on the current findings, it also appears that education programs should commence at the onset of adolescence or even late childhood, due to the young age in which some individuals start doping.