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The purpose of this study was to examine the lived experiences of people diagnosed with Multiple Sclerosis (MS). Seven active exercisers with MS participated in semi-structured interviews regarding their exercise experiences since diagnosis. Data were analysed using Interpretative Phenomenological Analysis (IPA; Smith & Osborn, 2003). Interpretive Phenomenological Analysis. The results and interpretations of narratives revealed a number of functional limitations due to the severity of MS symptoms, which were found to have a major effect on the ability of the participants to exercise. Furthermore, psychological problems and the heightened behavioural adjustments to the progressive disability led to re-appraisal of ability to exercise. Previous, relevant exercise experience made participants more determined to continue to be able to exercise after diagnosis. The wider exercise experience narratives were related to concerns about safety, dependability on others to overcome the challenges, and potential environmental hazards. The loss of spontaneous opportunities to exercise because of these actual and perceived barriers was key to this population. This research highlighted the need to rethink the health and social service arrangements in relation to exercise provision for individuals with MS. [ABSTRACT FROM AUTHOR]

The present work aims at presenting consistent data both from laboratory characterization and from blast tests to see how a computer model performs when only data from mechanical tests are being fed to the constitutive model. A sand (Ottawa 20-30) that meets ASTM C778 requirements, i.e., well characterized microscopically, was tested in triaxial compression under confinement pressures ranging from 50 to 300 MPa and moisture contents of 0 to 15% as well as high strain-rates. These tests provided both the experimental equation of state (pressure vs. volume) and compaction curves as well as the strength vs. pressure properties to build a constitutive model both in LS-DYNA and CTH. Blast tests were subsequently performed by burying explosive at three different depths inside a sand pot with a rigid steel plate on top. During flight, the height of the steel plate was tracked with Phantom high-speed cameras to determine the impulse transmitted to the plate as well as the maximum jump height. Simulations were performed with both an Eulerian code (CTH) and a Lagrangian/ALE code (LS-DYNA) using the constitutive model determined during the material characterization. The predictions of both codes are as close as 7% and as far as 22%, depending on the test configuration.

Although whistleblowing is thought to represent an effective mechanism for detecting and uncovering doping in sport, it has yet to become a widely adopted practice. Understanding the factors that encourage or discourage whistleblowing is of vital importance for the promotion of this practice and the development of pedagogical material to enhance the likelihood of whistleblowing. The current study employed a qualitative methodology to explore the personal and organisational factors that underpin intentions to blow the whistle or that may lead to engagement in whistleblowing behaviours in sport. Thirty-three competitive athletes across a range of sports took part in a semi-structured interview which sought to explore what they would do should they encounter a doping scenario. Content analysis revealed that whistleblowing is a dynamic process characterised by the interaction of a range of personal and organisational factors in determining the intention to report PED use. These factors included moral reasoning, a desire to keep the matter "in-house", perceived personal costs, institutional attitudes to doping, and social support. Analysis revealed a number of "intervening events", including a perceived lack of organisational protection (e.g., ethical leadership) within some sporting sub-cultures, which present an important obstacle to whistleblowing. The intention to report doping was underpinned by a "fairness-loyalty trade-off" which involved athletes choosing to adhere to either fairness norms (which relate to a sense that all people and groups are treated equally) or loyalty norms (which reflect preferential treatment towards an in-group) when deciding whether they would blow the whistle. The promotion of fairness norms that emphasise a group's collective interests might encourage athletes to view whistleblowing as a means of increasing group cohesiveness and effectiveness and thereby increase the likelihood of this practice., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Toner, Jones, Fairs, Mantis, Barkoukis, Daroglou, Perry, Micle, Theodorou, Shakhverdieva, Stoicescu, Pompiliu-Nicolae, Vesic, Dikic, Andjelkovic, Revilla, García-Grimau, Martínez, Amigo, Schomöller and Nicholls.)

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., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

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., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nicholls, Madigan and Earle.)

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.

Objectives: Sports coaches are influential in whether athletes dope, but receive very little antidoping education, particularly within entry-level coaching qualifications. We tested the feasibility of an antidoping intervention, delivered via a mobile application, which was designed to increase coaches' knowledge of doping and to reduce favourable doping attitudes., Methods: A two-arm randomised controlled trial, with grassroots coaches who coach young amateur athletes aged between 14 and 18 years of age, was conducted. The Anti-Doping Values in Coach Education (ADVICE) mobile application included modules on fair play, substances, nutritional supplements, rules and leadership. The primary outcome was the change in doping knowledge, 6 weeks after receiving the mobile application. The secondary outcome was changes in doping attitudes., Results: Grassroots coaches (n=200; aged between 18 and 71 years, with between 1 and 42 years of coaching experience) from 29 different countries completed baseline assessments, and 85 completed follow-up assessments, and were included in mixed analysis of variance analyses. The intervention increased coaches' knowledge about doping and also reduced favourable doping attitudes in the experimental arm., Conclusion: The ADVICE mobile application is a feasible method for delivering and increasing grassroots coaches' knowledge of banned substances and the potential side effects of doping. Mobile application-based resources could facilitate a much wider dissemination of antidoping education., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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.

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., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

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., (Copyright © 2020 Nicholls, Levy, Meir, Sanctuary, Jones, Baghurst, Thompson and Perry.)

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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Objective: This study aimed to measure depressive symptoms, anxiety symptoms and psychological well-being among a sample of Super League players, the highest tier of professional rugby league in the northern hemisphere., Methods: Between November 2018 and July 2019, a sample of 233 Super League players completed questionnaires that assessed depressive symptoms, anxiety symptoms and psychological well-being., Results: Players exhibited normal (85.8%), mild (11.6%) or moderate/severe (2.6%) depressive symptoms. Additionally, players reported normal (67.4%), mild (18.9%) or moderate/severe (13.7%) anxiety symptoms. The mean psychological well-being score across the sample was 25.07 (SD=4.34). 35.2% of players scored below average for this construct., Conclusion: The prevalence of mild depressive symptoms, moderate/severe depressive symptoms and mild anxiety symptoms among Super League players preliminary appear higher than in the general population from the UK. Much more research is needed to understand mental health among elite athletes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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).

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.

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.

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.

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, ((c) 2017 APA, all rights reserved).)

There is an ever growing coping and sports performance literature, with researchers using many different methods to assess performance and different classifications of coping. As such, it makes it difficult to compare studies and therefore identify how coping is related to performance. Furthermore, there are no quantitative syntheses of the results from these studies. A quantitative synthesis would facilitate a more comprehensive understanding of how coping is associated with athletic performance. In order to accurately compare studies, our first aim was to develop a new coping classification that would make this possible. Firstly, we reviewed the strengths and limitations of the different coping classifications and then identified the commonalities and differences between such classifications. We opted for a three-factor classification of coping, because the evidence suggests that a three-factor classification provides a superior model fit to two-factor approaches. Our new classification of coping was based on an existing model from the developmental literature, which received an excellent model fit. We made some adaptations, however, as our classification was intended for an athletic population. As such, we classified coping as mastery (i.e., controlling the situation and eliminating the stressor), internal regulation (i.e., managing internal stress responses), or goal withdrawal (i.e., ceasing efforts toward goal attainment). Undertaking a meta-analysis, our second aim was to identify which coping strategies correlated with sports performance and whether this relationship varied according to moderator variables. Articles were sourced from online electronic databases and manual journal searches. PRISMA guidelines were used to search, select, and synthesize relevant studies. Random effects meta-analyses were performed to identify associations between coping classification and sport performance. Q, I 2 , and R 2 values assessed heterogeneity. Eighteen published investigations, including 3900 participants and incorporating fifty-nine correlations, indicated an overall positive effect for mastery coping, a negligible negative effect for internal regulation coping, and a negative effect for goal withdrawal strategies. The findings of this meta-analysis could be used by sports practitioners to help them deliver effective coping interventions. In order to maximize performance, practitioners could encourage the use of mastery coping, but advise their athletes not to use goal withdrawal strategies.

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., (© 2016 John Wiley & Sons Ltd.)

Most attempts to manage stress involve at least one other person, yet coping studies in sport tend to report an athlete's individual coping strategies. There is a limited understanding of coping involving other people, particularly within sport, despite athletes potentially spending a lot of time with other people, such as their coach. Guided by the systemic-transactional model of stress and coping among couples (Bodenmann, 1995), from relationship psychology, we assessed dyadic coping, perceptions of relationship quality, and primary stress appraisals of challenge and threat among 158 coach-athlete dyads (n = 277 participants). The athletes competed at amateur (n = 123), semi-professional (n = 31), or professional levels (n = 4). Coaches and athletes from the same dyad completed a measure of dyadic coping, coach-athlete relationship, and stress appraisals. We tested an Actor-Partner Interdependence Mediation Model to account for the non-independence of dyadic data. These actor-partner analyses revealed differences between athletes and coaches. Although the actor effects were relatively large compared to partner effects, perceptions of relationship quality demonstrated little impact on athletes. The mediating role of relationship quality was broadly as important as dyadic coping for coaches. These findings provide an insight in to how coach-athlete dyads interact to manage stress and indicate that relationship quality is of particular importance for coaches, but less important for athletes. In order to improve perceptions of relationship quality among coaches and athletes, interventions could be developed to foster positive dyadic coping among both coaches and athletes, which may also impact upon stress appraisals of challenge and threat.

The Model of Motivational Dynamics (MMD; Skinner and Pitzer, 2012) infers that peers influence behavioral engagement levels, which in turn is linked to coping and resilience. Scholars, however, are yet to test the MMD among an athletic population. The purpose of this paper was to assess an a priori model that included key constructs from the MMD, such as resistance to peer influence, behavioral engagement and disaffection, coping, and resilience among athletes. Three hundred and fifty-one athletes (male n = 173, female n = 178; M age = 16.15 years) completed a questionnaire that measured each construct. Our results provide support for the model. In particular, there were positive paths between resistance to peer influence and behavioral engagement, behavioral engagement and task-oriented coping, and task-oriented coping with resilience. There was also a positive path between resilience and resistance to peer influence, but a negative path from resistance to peer influence to behavioral disaffection. Due to the reported benefits of enhancing resistance to peer influence and behavioral engagement, researchers could devise sport specific interventions to maximize athletes' scores in these constructs.

Human growth hormone (GH) was first isolated from the human pituitary gland in 1945 and found to promote the growth of children with hypopituitarism. Since the formation of the World Anti-Doping Association, human GH has appeared on the list of forbidden substances. There is a significant amount of anecdotal evidence that human GH is misused by athletes to enhance performance, and there have been a number of high-profile cases of GH use in professional sport. GH secretagogues (GH-Ss), which increase GH secretion, and insulin-like growth factor (IGF-1), which mediates many of the effects of GH, are also misused, although there is less evidence for this. The effectiveness of GH, IGF-1, and GH-Ss as performance-enhancing drugs remains unclear. Evidence from studies of GH use in people with hypopituitarism show several desirable outcomes, including increased lean body mass, increased strength, and increased exercise capacity. These anabolic and metabolic properties, coupled with the difficulty in detecting them, make them attractive as agents of misuse. Studies in healthy young adults have also demonstrated a performance benefit with GH and IGF-1., (© 2016 S. Karger AG, Basel.)

Aim: This study explored the mediating role of sport confidence upon (1) sources of sport confidence-performance relationship and (2) imagery-performance relationship., Methods: Participants were 157 competitive athletes who completed state measures of confidence level/sources, imagery type and performance within one hour after competition., Results: Among the current sample, confirmatory factor analysis revealed appropriate support for the nine-factor SSCQ and the five-factor SIQ. Mediational analysis revealed that sport confidence had a mediating influence upon the achievement source of confidence-performance relationship. In addition, both cognitive and motivational imagery types were found to be important sources of confidence, as sport confidence mediated imagery type- performance relationship., Conclusion: Findings indicated that athletes who construed confidence from their own achievements and report multiple images on a more frequent basis are likely to benefit from enhanced levels of state sport confidence and subsequent performance.

Aim: We conducted two studies that examined different models, which included mental toughness and psychological constructs that are thought to be related to this construct., Methods: In Study 1, 531 athletes completed measures of mental toughness, resilience, and emotional intelligence. In Study 2, 522 athletes completed measures of mental toughness, sport motivation, and self-efficacy., Results: There were positive paths between the constructs in the model, which were mediated by mental toughness in Study 1. Further, there was a positive path between mental toughness and self-efficacy, but negative paths with introjected regulation and amotivation in Study 2., Conclusion: This two study paper suggests that it might also be the presence of constructs such as resilience, emotional intelligence, motivation, and/or self-efficacy that enable mentally tough individuals to excel under stressful circumstances rather than just coping.

Purpose: A new measure of sportspersonship, which differentiates between compliance and principled approaches, was developed and initially validated in 3 studies., Method: Study 1 developed items, assessed content validity, and proposed a model. Study 2 tested the factorial validity of the model on an independent sample. Study 3 further tested the factorial validity on another independent sample as well as the construct validity., Results: In Study 1, a 71-item questionnaire was developed. Exploratory factor analysis reduced the questionnaire to a 6-factor, 33-item scale explaining 47.70% of the variance. Study 2 tested this revised questionnaire in a series of confirmatory factor analyses, presenting a 24-item and 5-factor model with acceptable fit, χ(2)(242) = 455.9, comparative fit index = .93, Tucker-Lewis Index = .92, standardized root mean square residual = .05, root mean square error of approximation = .04. Study 3 provided some evidence to support the construct validity of the 24-item scale using theoretically associated measures., Conclusions: This series of studies provided some initial validity evidences of the Compliant and Principled Sportspersonship Scale.

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.

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.

The primary aim of this study was to investigate the relationship between confidence and subjective performance in addition to exploring whether coping mediated this relationship. A sample of 414 athletes completed a measure of confidence before performance. Athletes also completed a measure of coping and subjective performance after competing. Correlational findings revealed that confidence was positively and significantly associated with subjective performance. Furthermore, mediational analysis found that coping partly mediated this relationship. In particular, task-oriented coping (i.e., mental imagery) and disengagement-oriented coping (i.e., resignation) had positive and negative mediational effects, respectively. Additionally, athletes who employed mental imagery generally coped more effectively than those using resignation. These findings imply mental imagery has the potential not only to improve confidence, but also subsequent performance, while resignation coping may have the opposite effect. Overall, these results lend some credence to Vealey's integrated sports confidence model., (© 2010 John Wiley & Sons A/S.)

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.

The aims of this study were to (a) explore the emotions generated during or as a consequence of stress appraisals, after coping, and after the event outcome, (b) explore whether multiple emotions were generated from the initial stress appraisal through to event outcome, and (c) to explore whether outcomes that were perceived as favorable resulted in positive emotions and outcomes that were perceived as unfavorable or neither favorable nor unfavorable resulted in negatively toned emotions. Participants were 10 male English international adolescent golfers (mean+/-SD; age 16.7+/-1.6 years), who were interviewed regarding their experiences of stress appraisals, emotions, and coping during competitive golf. Results revealed that emotions were generated within or as a consequence of stress appraisals, after coping, and after the event outcome. Additionally, multiple emotions were generated from the stressful appraisal to the event outcome. Positively toned emotions were cited more frequently than negatively toned emotions after favorable events, whereas negatively toned emotions were reported more frequently than positively toned emotions after unfavorable events. Coping appears important in generating positively toned emotions.

The purpose of this study was to examine acute sport-related stressors, coping, and emotion among a sample of professional rugby union players during training and matches. Five professional rugby union players maintained diaries for 31 days. The diaries consisted of a stressor checklist and an open-ended stressor response section, an open-ended coping response section, a Likert-type evaluation of coping effectiveness, a best-of-fit emotional response section, and a Likert-type evaluation of emotional intensity. Six out of the 10 stressors reported had a higher mean frequency in training compared with matches. Blocking was the most frequently cited coping strategy on match days, whereas increased concentration was the most frequently cited coping strategy on training days. Coping effectiveness was significantly higher during training compared with matches. Additionally, higher levels of emotional intensity were significantly associated with lower levels of coping effectiveness. Significant individual differences were found for both coping effectiveness and emotional intensity.

The purpose of the present study was to examine (a) the sources of sport and non-sport stress and their associated symptoms on rest days, training days, and match days and (b) the temporal aspects of sources and symptoms of stress and affective states. Professional male rugby union players (n=16) completed the Daily Analysis of Life Demands in Athletes (DALDA) and the Activation Deactivation Adjective Check List (AD ACL) for 28 days. On match days players reported that few stressors were "worse than normal." Most stressors were "worse than normal" on training days followed by rest days and more stressors were "worse than normal" on the day after a match than on match days. Further, players reported an unpleasant, low activation state across the three analysis days, suggesting they were in an overtrained state. The findings of this study demonstrate that professional rugby players experience negative affect and a multitude of sport and non-sport stressors. Early detection of stressors and negative affective states could help prevent symptoms of overtraining and burnout and facilitate optimal training and sporting performance. Coaches and practitioners are encouraged to integrate the DALDA and AD ACL in their training and performance monitoring regimes.

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 aim of this study was to examine stressors, coping, and coping effectiveness as a function of gender, type of sport, and skill. The sample consisted of 749 undergraduate athletes (455 males, 294 females) aged 18-38 years (mean= 19.8 years). Skill was classified as international/national, county, university, and club standard. Participants completed a stressor and coping concept map (Novak & Gowin, 1984). The results revealed gender, type of sport, and skill differences in relation to stressor frequencies, coping strategy deployment, and coping effectiveness. In contrast to previous research, females used a variety of problem-focused (e.g. planning, communication, technique-orientated coping) strategies more frequently than males. Team sport athletes reported a variety of sport-specific stressors relating to the demands of playing in a team environment. The group of national/international athletes reported using more planning, blocking, and visualization, and also reported that their coping was more effective than that of less-skilled athletes.

In this study, we examined the relationship between home and away matches on mood. In addition, the relationships between game location, game outcome, behavioural factors, and mood were investigated among 12 professional English rugby league players competing in the Super League. Participants completed daily diaries for 27 days. The diary consisted of six analogue scales measuring mood (relaxed-tense, energetic-weary, depressed-elated, tired-alert, anxious-calm, cheerful-miserable) as well as behavioural factors and self-rated performance. There were no significant differences in self-reported mood states leading up to home or away matches except for players feeling more tired when playing away. Significant relationships between mood and behaviours (e.g. sleep and eating) and subjective performance were observed. The outcome of the match was found to influence mood, with a defeat resulting in decreased mood. Our results show that game location did not influence mood and therefore does not provide an explanation for the home advantage.

The aim of this paper was to systematically review the literature on coping in sport, examining evidence for both the trait and process perspectives, the types of coping strategies used by athletes, gender differences, age-related differences, and coping effectiveness. A comprehensive literature search of SPORTdiscus, PsychLIT, and PsychINFO in November 2004 yielded 64 studies spanning 16 years (1988 - 2004). The results indicated that athletes use a variety of coping strategies. Forty-six papers supported or adopted the process perspective (Lazarus, 1999; Lazarus & Folkman, 1984). There were also gender and age-related differences. Evidence was found to support three of the different models of coping effectiveness (goodness-of-fit approach, choice of coping strategy, and automacity). Based on this evidence, future research should address some of the methodological and measurement limitations of the sport psychology coping literature. In particular, prospective research designs that minimize the time delay between recall and the stressful experience are required to assess how coping changes over time. More attention to developmental issues to guide the formulation of sport-specific models to enhance our theoretical understanding is also required. Finally, coping effectiveness should be examined both in the short and long term, as a greater understanding of coping effectiveness has the potential to make a significant impact on applied practice.