We have a friend who calls
daily to report and get advice on treatment.He knows we read about it and follow what is happening in the
world.We were following patients in a
village near Oaxaca where he works.Three
days ago he mentioned he had three patients aged 40 (male) and two females aged
65 and 70 who had difficulties breathing.He did not find a hospital to place them and he treated them at
home.Saturation in the 80’s without oxygen.It was not possible to find oxygen at home
for them and he decided to keep them walking and moving around their home as
much as possible.We told him what
Christian Drosten thinks about the problem when the virus reaches the lungs;
the circulation system should resist at this stage.The first stage was passed already, the virus
reached the lungs.The protocol for
admission in a hospital in Oaxaca says that the patient returns home in ashes
or in a wheelchair accompanied by medical personnel. They do not see family
during hospitalization.Most of the patients
prefer to live the experience at home.
We discussed the protocol
previously regarding the use of steroids and antibiotics with our friend.We mentioned a New York report where they did
not find a positive culture for bacteria when treated with antivirals, but my
friend decided to give Azithromycin because it is difficult to trust cultures and
the patients looked too sick.He decided
to give steroids at this point of the infection because the patient is already
experiencing a cytokine storm; this is what we know as in the case of meningeal
tuberculosis.Antivirals were given at
the same time, availability and price were the reason for choosing them. Three days later after treatment, the patient’s
oxygen saturation is in the 90´s and the patients looked much improved.Five family members were positive for
coronavirus and they were asymptomatic.
Why here and why
triathlon?We work with triathletes and
the problem with family members is there.At the same time, we have not a place to publish this experience.This experience gives more hope about the survival
of patients and it worries our team members less about the situation.It raises more questions about
hospitalization and treatment modalities.We did not have any other option any way, the hospitals are full and
they have their own problems to be of any help.The authorities continue to lie about what is happening or they are so mediocre
to think they are doing a good job.
We started learning since the beginning of the pandemic about the virus, to face the situation.We have learned the following:
1)The
virus is transmitted via aerosol in addition to saliva drops. Why?We
have the story about the chorus rehearsing and apparently keeping the distance between two people.They said: “No one sneezed or coughed.”One-day rehearsal, 60 people practicing, 45
sick, two deaths. https://edition.cnn.com/2020/04/01/us/washington-choir-practice-coronavirus-deaths/index.htmlThis is more anecdotal, if you wish, but
we have other sources of information.
We
have the studies mentioned in the New England Journal of Medicine:
Surgical Masks
Provide Source Control of Respiratory Viruses
Richard T.
Ellison III, MD reviewing Leung NHL et al. Nat Med 2020
Apr 2 Bae S et al. Ann Intern Med 2020 Apr 6
Surgical face masks were
found to reduce presence of influenza and coronavirus RNA in respiratory
droplets and aerosols from infected individuals.
The CDC has just
recommended that the general U.S. population begin wearing cloth face coverings
to decrease the community-based transmission of the SARS-CoV-2 virus. Two new
studies provide some support for the CDC guidelines.
In the first,
researchers at a Hong Kong hospital obtained nasal and throat swabs and
respiratory droplet and aerosol samples from 246 individuals with presumed
symptomatic acute respiratory viral infection seen year-round between March
2013 and May 2016. During a 30-minute collection of exhaled breaths when
patients were breathing and coughing normally, 124 individuals were wearing a
face mask and 122 were not; 49 provided second 30-minute samples of the
alternate type.
By reverse transcriptase
polymerase chain reaction (RT-PCR) there were 54 individuals with rhinovirus
infection, 43 with influenza infection, and 17 with human seasonal coronavirus
infection. For all three viruses, the viral load was higher in nasal than in
oral secretions, and all three viruses were detectable in both respiratory
droplet (particles >5 μm) and aerosol (particles <5 μm) fractions of the
exhaled breath. Masks led to a notable reduction in the number of
RT-PCR–positive respiratory droplet and aerosol samples for patients with
either coronavirus (in respiratory droplets, from 30% to 0%; aerosols, 40% to
0%) or influenza infection (respiratory droplets, 26% to 4%; aerosols, 35% to
22%); there was no meaningful reduction seen with rhinovirus infections.
Influenza virus was able to be grown from 4 of 5 studied RT-PCR–positive
aerosol samples from individuals not wearing masks.
The second study, by Bae
and colleagues, recruited 4 patients with SARS-CoV-2 infection to cough five
times onto petri dishes containing viral transport media approximately 20 cm
from their face while wearing either no mask, a surgical face mask, or a
two-ply cotton mask. The median nasopharyngeal viral load was 5.66 log
copies/mL, and the cough samples found viral loads of 1.4 to 3.5 logs/mL
whether or not a mask was present for three of the four patients. Swabs of the
outer surfaces of both types of masks were positive for all four patients.
COMMENT
The
work by Leung raises the theoretical concern of viral transmission through
aerosols as well as respiratory droplets although, as the authors note, there
was no attempt to grow either coronavirus or rhinovirus from the RT-PCR respiratory
samples to confirm the presence of viable virus. Still, this novel study
provides strong evidence that the use of surgical masks can provide source
control for both human coronavirus and influenza virus infections when
individuals are sitting for 30 minutes. In contrast, the very small study by
Bae shows that neither surgical nor cotton face masks will prevent the spread
of virus from a coughing individual — at least at a distance of only 20 cm.
While both studies have clear limitations, together they suggest that the use
of a surgical face mask can provide some source control in individuals infected
with coronavirus or influenza, although the efficacy is likely diminished in
coughing individuals (and we can't extrapolate the findings to other types of
masks). Still, in my mind these limited data do support the broad use of face
masks until this pandemic is brought under control.
2)The German
expert who instituted the program in Germany challenged the notion that the
virus is primarily acquired touching infected material.The assumption was that the coronavirus is transmitted via air and
not so much by contact.
Researchers
have so far come to different conclusions on how long the virus can survive on
surfaces. But now a team of scientists in Germany are trying to find answers.
"So
far, no transmission of the virus in supermarkets, restaurants or hairdressers
has been proven," explained Bonn virologist Hendrik Streeck on the ZDF
Markus Lanz talk show.
Instead,
the major outbreaks have been the result of close get-togethers over a longer
period of time, he said.
That's
demonstrated in, for example, outbreaks that have stemmed from après-ski
parties in Ischgl, at football matches in Bergamo or at carnival celebrations
in the municipality of Gangelt in the Heinsberg district of North
Rhine-Westphalia.
3)The
lakes, ocean are not infected to the degree of being a source of
infection.The problem is that we still
get aerosol from infected people because those places are crowded most of the
time.The infection is not in the water.
Coronaviruses (CoV) are a large family of viruses that cause
illness ranging from the common cold to more severe diseases. According to WHO,
while persistence in drinking-water is possible, there is no current evidence
that coronaviruses are present in surface or groundwater sources or transmitted
through contaminated drinking-water.
The spread of the virus is closely related to water and
sanitation.Cleaning hands can reduce the transmission and help people stay
healthy but today billions of people lack safe water, sanitation and
handwashing and funding is inadequate.
Based on the above:
1)Keep
your distance, two meters from other human being.
2)Wear
a face mask according to what you do.Driving a car with other triathletes, wear a N95 mask; use a surgical
mask when riding or running with other mates, keeping most of the time the two meters
of separation.
3)Swim
in an empty swimming pool, one member per lane or in a lake (keeping distance).
4)Wash
your hand as frequently as you can or use gel (alcohol above 60%).
5)Avoid
public places or wear your N95 if you need to be in a close room, even if you
keep the two meters distance (remember the chorus rehearsal).
6)Train
with responsible people that is concerned about his/her health and the health
of others.This is the moment to define
your friends.
7)This
should be in place until we obtain the vaccine or we get 70% infected people.I hope the vaccine comes first.
Eric Topol speaks of
betrayal to the medical establishment on the part of the government but I would
say that they betrayal the whole country.The same phenomenon is happening in Mexico.The bozos directing the frontline of the pandemic
(who are not on the frontline) are lying; the same for the ones directing at
the WHO:
The year 2020 started with American physicians, nurses,
and the whole healthcare workforce dispirited, in a deep state of
burnout, with the worst rates of clinical depression and suicides
that have been recorded. Indeed, this was not confined to the United
States; a global epidemic of
burnout had been diagnosed. But things were about to get
considerably worse for the healthcare workforce.
In December 2019 an epidemic of pneumonia, with many
fatalities, erupted in Wuhan, China. The pathogen was sequenced and determined
to be a novel coronavirus on January 5,
2020, and was subsequently named SARS-CoV-2. The first patient in the United
States with COVID-19, the disease caused by SARS-CoV-2, was diagnosed in
Seattle on January 21, which was within 24 hours of the first patient diagnosed
in South Korea, a key country for comparison.
The First Phase: "Silent" US Spread
Unlike South Korea, which quickly started testing for
COVID-19 using the World Health Organization (WHO) test, the United States
refused the WHO test, opting to develop its own through the Centers for Disease
Control and Prevention (CDC). But the CDC test was ultimately found to be
flawed and represents one of many government stumbles.
Without an adequate test, there were nearly 50 days from the first patients in
both countries before the United States started to ramp up testing. Why
was this so critically important?
During this extended phase in the United States, there
were countless numbers of patients presenting with pneumonia and respiratory
tract symptoms to emergency rooms, urgent care centers, and doctors' offices.
Without the ability to make the diagnosis of COVID-19 or even suspect it, these
patients unwittingly spread their infections to healthcare workers. Also,
during this first phase of spread, there was likely — albeit still not yet
validated — a high rate (approximately 30%) of asymptomatic carriers for
COVID-19, which further amplified the chances for doctors and health
professionals to be infected.
For the sake of comparison, during the month of February,
South Korea performed more than 75,000 tests (versus just 352 in the United
States) and adopted all of the WHO best practices, which includes massive
testing, tracing every contact of a person infected and testing that person,
quarantine of all known cases, and social distancing.
The United States did none of these. Instead, officials
repeatedly made bad choices that put public health in jeopardy, along with the
healthcare workers charged with caring for the public.
South Korea, meanwhile, got ahead of its outbreak and
became a model in the world for how that was achieved. But it wasn't just South
Korea that reacted well. As Atul Gawande summarized, Singapore and Hong Kong also adopted
all of the WHO practices, including providing protection for their healthcare
workers. In both places, healthcare professionals were expected to wear
surgical masks for all patient
interactions. That practice turns out to foreshadow the second phase of failure
in the United States.
The Second Phase: The War Without Ammo
Although Seattle is where the first cluster of cases
occurred, it was the unchecked number of patients diagnosed in New York City in
early March that led to the full realization of how ill-equipped the country is
in terms of personal protective equipment (PPE), intensive care unit beds, and
mechanical ventilators.
Together, a situation was set up for healthcare workers to
not have masks — or to reuse them for days on end — and lack other protective
gear. And this is about plain 75 cent masks, not the N95s that are better for
blocking aerosol droplets.
But the required sharing of equipment is not just among
doctors and nurses; it even extends to patients sharing a ventilator in some
intensive care units. To put some numbers on ventilators, we will need several
hundred thousand to a million but have fewer than 160,000 throughout the
country.
It's bad enough that the United States was totally
unprepared for a pandemic and has such an unimaginable shortage of requisite
resources. But the situation still gets worse. On a widespread basis, doctors
and nurses are being gagged and muzzled by
administrators for expressing their concerns, and penalized or
even fired when they do
speak out.
Meanwhile, the unconscionable lack of COVID-19 testing has
continued in this second phase. And with that, systematic testing of the
workforce has yet to start, despite being desperately needed.
The Third Phase: Healthcare Professionals Broadly Infected
and Dying
Back in Wuhan, Li Wenliang, a 33-year-old ophthalmologist, was one, if not
the first, doctor to alert people in China of the outbreak. He died on February
7, 2020. But he certainly wasn't the youngest doctor to die in China. Xia Sisi, a 29-year-old gastroenterologist,
also died after a 35-day hospitalization.
Yet on March 11, from the Oval Office, President Trump stated, "Young and
healthy people can expect to recover fully and quickly."
By late March more than 54 doctors in Italy had already
died, and in the Lombardy region of northern Italy, one of the worst hit
regions in the world, 20% of the healthcare
workforce have become confirmed cases. Now, in the United
States, as large numbers of healthcare professionals are getting diagnosed with
COVID-19 in Boston, New York, and other hotspot cities, young doctors are writing their wills and making
provisional funeral plans.
COVID-19 was not supposed to kill young people, but young
nurses and doctors are dying in the United States. There are many theories as
to why this is happening, perhaps the best one is the viral load — the mass of
COVID-19 inoculum.
Because healthcare workers are exposed to the sickest
patients — often without access to the proper protective equipment — the heavy
viral load may be overwhelming even young clinicians' ability to mount a
sufficient immune response to counter the infection.
That doctors and clinicians are succumbing to the virus is
beyond a tragedy, as many of these dedicated individuals are dying
unnecessarily, as a result of the no-testing and no-PPE fiascos.
Yet a far greater toll in numbers is the temporary loss of
clinicians to infections and sickness. This is the other poorly recognized
exponential growth curve: As each doctor, nurse, respiratory therapist, paramedic,
and patient-care person takes care of tens to hundreds of patients at any given
time, the loss of even one of these individuals has a dramatic
ripple effect on the shortage of professionals trained to care for
affected patients, no less the non-COVID-19 usual patient mix. No number of
accelerated medical school graduations (which are being
announced) can compensate for these losses, not just by numbers but
also by experience.
The handling of the COVID-19 pandemic in the United States
will go down as the worst public health disaster in the history of the country.
The loss of lives will make 9/11 and so many other catastrophes appear much
smaller in their scale of devastation. Perhaps what we in the medical community
will remember most is how our country betrayed us at the moment when our
efforts were needed most.
One of my patients told me
that at the hospital she works eight people died, and they went without being reported
because they were not tested.The
diagnosis was pneumonia.The number of
deaths in my State (Oaxaca) is just one digit because they stopped testing.The bozo that directs the policies regarding
the pandemic says that face masks are not necessary because the WHO said so,
and we do not have a valid research to say that face masks protect us.We can see the professional liars when it
comes to see our present reality.
As would more of I will bluntly call adult behavior. We must put an end
to the idea that the best way to get through this crisis is to say things we
know are not true in the hope of getting people to behave a certain way. This
means not saying masks are useless when what you really mean is, "Masks
are in short supply, please consider before you start hoarding them whether you
really need them at present and if so how many." Ditto the painfully
relentless attempts to give young people the impression that they are horribly
likely to die from the new virus. Even in Italy, the country with the worst
measured fatality rate so far, around 86 percent of all the deceased have been
aged 70 or older, and 50 percent were at least 80. We do not need to zero in on
statistical anomalies or otherwise engage in scaremongering. It should be
enough to say, "Even though you are very unlikely to die from coronavirus,
remember that you could contract the disease and spread it to more vulnerable
people without even experiencing symptoms, so please don't revel with 5000
strangers at the beach and then run home to give Grandma a hug."
We depend on the viral load and our immune system to survive this
virus. We know what we should do as
triathletes, rest, eat well and follow a training plan according to our ability
to tolerate it (time training); our immune system will respond
accordingly. The “but” would be the
viral load. What can we do to decrease
the viral load? Distance yourself and
wear a face mask; the one that is denied by the criminal authorities. If for some reason you got infected, because
you did not wash your hand sufficiently and on time, the viral load must be low
and your chances of dying lower. Wearing
a mask prevent you from infecting others.
Greta Thunberg is really
touching at the point of how bad we want it.More of one third of the population is
confined.How bad we want it to
control the epidemic.
"Though it must be in a different way to
how we have acted in this case, we can act fast and change our habits and treat
a crisis like a crisis."
How bad we want it to win in
triathlon.How bad we want to control
global warming.Boris Johnson, Trump and
our president denied the pandemic until lately, pressured by the virus’
consequences.In our previous post we
mentioned that Irvin Yalom learned empathy pressured by an angry father who
confronted him when he was twelve.
The difference between the
winner and the loser in triathlon has to do with the ability to learn because
we want
it bad.How bad you want to
learn in order to perform is the key.Overcoming handicaps culturally, handicaps in the family and handicaps
individually, regarding education is what somebody in the third world
country needs to do. Do not wait for the
coronavirus to come or being confronted by life in a similar way; it is too
late by then.And sadly, even then, one’s
chances of learning depend on how much one has already learned to grasp the situation.Sometimes we are already dead before realizing
that we lost a chance in life.
I had a patient who died
from cancer, who used to say to his teenage son: “Do I have to die in order for
you to understand life.”
I will reproduce what Irvin
Yalom says about his way of learning what empathy is.
Irvin D. Yalom has made a career of investigating the lives of others.
In this profound memoir, he turns his writing and his therapeutic eye on
himself. He opens his story with a nightmare: He is twelve and is riding his
bike past the home of an acne-scarred girl. Like every morning, he calls out,
hoping to befriend her, "Hello Measles!" But in his dream, the girl's
father makes Yalom understand that his daily greeting had hurt her. For Yalom,
this was the birth of empathy; he would not forget the lesson. As Becoming Myself unfolds, we
see the birth of the insightful thinker whose books have been a beacon to so
many. This is not simply a man's life story, Yalom's reflections on his life
and development are an invitation for us to reflect on the origins of our own
selves and the meanings of our lives.
Empathy is what is needed in
this coronavirus epidemic.Most of us
will not die from it, but we should have empathy for the most vulnerable
people, elderly, chronically sick, etc.Empathy is needed to improve as an athlete and human being. It is something lacking in some athletes due
to the policies followed by countries where the athlete is created by the system
with the purpose of performing as such; Sun Yang is an example.The developed nations create athletes with
the purpose of creating a good human being, college sports were originated for
this purpose.Many filters are on the
way in order to become professionals.Athletes need to pass many filters to end up as professional players;
even basketball or football players need to pass filters as school point
average –it says a lot about focusing on things other than delinquency.We have witnessed the problems with some
basketball or football recruiters when the recruiters bypass the filters
looking for performance without looking at creating a great human being; Aaron
Hernandez and many others are examples.Empathy is a sine-qua-non to create a good human being and coronavirus epidemic
is an opportunity to learn it.The same
situation lived by Irvin Yalom when he was confronted by an angry father.
We know the rules to follow
to avoid the spreading of the virus, hand washing, hand washing, hand washing,
including the controversial mask. The following by Leora
Horwitz, associate professor of population health and medicine at NYU Langone
Health regarding spreading of the virus:
What are masks
good for, then? First, they are crucial for people who have the disease.
Remember those drops of saliva? Wearing a mask if you're sick can help catch a
large number of them, greatly reducing the amount of virus that gets into the
environment or onto other people. Second, they help health care workers, who
are constantly in close contact with lots of sick people coughing in their
faces, to avoid infection. Third, they may help you avoid infection if you live
with someone who has the disease or, perhaps, if you live in an area with a
very high rate of disease in the community, as long as you are careful not to
touch your face more because of it.
Wearing a mask
is not a big deal and it says how much empathy we have for the elderly, the
chronically sick or our very small contribution to control the spreading of the virus.
We work with athletes and
patients.The key to have results is
self-awareness; we cannot lie to ourselves if we want results.An example of what we should not want from
athletes is lack of self-awareness as in the case of the highest rank official
of the FMTRI which comment highlights lack of self-awareness:
“It is not stupidity to say
that Crisanto Grajales could be in the top six in Tokyo.” His premise is based
on the fact that 65 competitors started the Tokyo race last year and just finished
46, and Grajales run a second faster than Mislowchuk and Stornes (the first
two), a minute behind on the bike; not counting that Mola, Gómez, Luis and others
were not there.And the fact the event’s
page said: price money TBA for competing in that race.Some competitors were there to test the bike
course.That comment gives information
about the lack of self-awareness or perhaps he is just “Trumping.”
Researchers are working on
how to measure self-awareness in athletes.The constructs are not easy to develop but as any science, it does not
proof anything, it just probes.We have
known the facts empirically for centuries.
Introduction
Mental toughness (MT) is
widely recognised as a fundamental attribute for attaining success in sport.1 Mentally
tougher athletes maintain performance levels during adversity; perceive
pressure as a challenge and a catalyst for prospering; and maintain emotional,
cognitive and behavioural control despite situational stressors.2 Considering
the appeal that these cognitive and behavioural signatures have to athletes, MT
has become a prominent research area in the sport performance literature.3
Scholars' primary interest
in MT is based on the capacity to acquire MT attributes through sport and
non-sport developmental influences and experiences4, as well as
through psychological interventions5. However, determining the MT
dimensions that may be taught and the most effective approaches to develop them
requires resolutions to the current conceptual and operational disparities that
exist. Some researchers contend that MT is a narrow personality trait that is
situationally stable5,6, whereas others suggest MT is state-specific
and may fluctuate depending on the situation7,8. In addition to MT
manifestation distinctions, these conceptualisations differ in the extent to
which MT may be developed. However, in support of the mutual inclusivity of
these perspectives, Gucciardi et al.3 reported that a
combination of intraindividual (i.e. within person) and interindividual (i.e.
between person) differences may be attributed to the variability of MT.
Accordingly, an athlete may display enduring patterns of MT across similar
situations, but varied levels of MT across dissimilar situations.
Although the
multidimensionality of MT has generally been supported9, the type
and quantity of constituents comprising MT remains unclear10. In
addition to dimensional discrepancies between sport types,11 within-sport
MT differences have been found. For instance, Coulter et al.12 reported
that risk-taking is an integral MT component in soccer, whereas Thelwell et al.13 indicated
that MT in a soccer player involved affecting one's opponents. The
characterisation of MT variations are reflected in the range of instruments
that often diverge in the types of MT that are measured. To illustrate,
affective intelligence is included as a subfactor on the Cricket Mental
Toughness Inventory14, but is not contained within the Australian
Football Mental Toughness Inventory15.
Although unequivocally
determining the components that constitute MT is necessary, there are several
components that are repeatedly referred to in the literature.16 These
components include confidence or self-belief; emotional and cognitive control;
accepting, persevering and thriving through challenges; and commitment and
determination.2,17 Accordingly, MT refers to a collection of
personal resources (inherent and developed) associated with athletes' pursuit
of optimal athletic performance levels, irrespective of positive and negative
situational demands.18,19
In the extant literature,
considerable attention has been devoted towards examining the characteristics
associated with MT. Commonly identified correlates of MT include effective
coping, the use of self-talk, relaxation strategies and mental imagery.20-22 Mentally
tougher athletes have greater flow experiences (concentration, autotelism)23,
perceive stressors as less intense24, and utilise performance- and
mastery-approach achievement goals25. Collectively, MT is related to
a number of positive psychological characteristics. However, self-awareness,
also referred to as psychological self-mindedness, is one concept that has
received limited quantitative MT research attention. Self-awareness represents
the capacity to attend to, recognise and examine one's thoughts, physiological sensations,
emotions and behavioural reactions, either as they occur or retrospectively.26,27
Although the
self-awareness process is multifaceted and associated with an array of
corollaries and self-directed attention areas26, common
conceptualisations encompass two primary components: engagement in
self-reflection and the attainment of self-insight28-30.
Self-reflection involves emotional, cognitive and behavioural
self-introspection, whereas self-insight refers to clarifying and obtaining a
deeper understanding of such experiences.29
Even though
self-reflective activities may not automatically result in self-insight31,
self-awareness represents an important process for identifying and replacing
maladaptive responses as well as establishing progress towards achieving
positive psychobehavioural changes28,32.
In sport, awareness of
one's emotions has been linked to superior performance.33 In
particular, maintaining peak performance levels is at least partly dependent on
the ability to recognise negative emotions and cognitions and effectively
control or avoid the detrimental effects of such experiences.34 With
research supporting the emotional and cognitive control of mentally tough
athletes35, along with the understanding that MT is associated with
positive performance outcomes3, self-awareness attributes may be
relevant to athletes' MT.
Recent qualitative
research has posited the relevance of several forms of self-awareness (e.g.
emotional and cognitive) in relation to MT. Bull et al.25, for
instance, qualitatively established thinking
clearly (awareness, focus and control of thoughts) as an essential
component of MT in elite cricket. Slack et al.36 extended this
finding to denote cognitive awareness
of own emotions as indicative of mentally tough English Premier
League football referees. There is also evidence to suggest that self-awareness
promotes or facilitates heightened levels of MT37 - a finding
that supports early heuristic MT perspectives38.
Taken together, these
findings provide preliminary support for the applicability of self-awareness
characteristics to the MT of athletes. However, prior MT studies have not
specified what embodies self-awareness, and, despite recent qualitative
findings, there is a dearth of knowledge about the role of emotional, cognitive
and behavioural self-awareness in relation to MT. Therefore, the purpose of the
current study was to explore the relationships between MT and self-awareness
components (i.e. self-reflection and self-insight) in competitive tennis
players. It was hypothesised that MT and each of its subcomponents would be
significantly predicted by both (1) self-reflection and (2) self-insight.
…The finding that self-insight was the single significant
predictor of global MT suggests the phase is particularly important to
athletes' MT. However, given that attaining insight requires introspection and
evaluation of the self,31 self-reflection is a necessary part of the
self-awareness process. Considering the markedly larger effect size between MT
and self-insight, as compared to self-reflection, mentally tougher athletes
appear to be better at progressing from self-reflective activities to achieve
higher levels of self-insight. With prior studies reporting that self-awareness
promotes the development of MT,37 attaining maximal MT benefits might require athletes to
engage in and proceed beyond mere self-introspection toward generating a
profounder level of psychobehavioural clarity and understanding.
Conclusion
The findings in this study
support the positive association between MT and self-awareness in competitive
tennis players. Most notably, the strongest predictor of MT and its
subcomponents was self-insight. Notwithstanding the necessity of
self-reflection in the process toward obtaining insight, the latter appears to
be particularly important when considering MT and its development among
athletes. Research identifying the contextual demands and situation-based use
of self-awareness among mentally tough athletes is warranted, along with
whether self-reflection and insight may be used to develop MT through
interventions.
We work on education with
the purpose of increasing self-awareness to have better triathletes.
I looked at the biological
passports of different athletes, including the one on Lance Armstrong.It is incredible how malnourished these
athletes were according to the passports.Eufemiano Fuentes mentioned when doping these athletes that he was
treating them when he was caught at the Operación Puerto.Looking at the Biological Passport of these
athletes we should agree with him; but the remedy is not the appropriate
one.
We have mentioned that if somebody
needs steroids for asthma, he or she is not in any condition to remain
competing for at least a few months, by then it is too late to come back for
the year: of course, athletes are not that ill to require steroids.Steroids are used for other reasons. Eufemiano’s
intention is not to treat them but to help them in the “rat race.” Please read
our posts related to doping.
19 oct.
2019
Triathlon and TUEs
8 oct.
2019
Triathlon and Asthma
I remembered when the Swiss
fixed addicts in mobile units located at parks to avoid spreading infections,
criminal behavior or overdoses.The
“fix” was not for “treatment” but to decrease the trouble behavior.Eufemiano’s declarations remind me of these
remedies:
P. Siempre se ha dicho eso, que de un burro no se hace
un caballo de carreras. Pero, ¿eso sirve también después de la aparición de
hormonas como la EPO? ¿No convirtió la EPO a algunos burros, con perdón, en
caballos de carreras? R. Creo
que no. Evidentemente hay tratamientos que mejoran el rendimiento, pero habría
que valorar más cosas, como por ejemplo si ese rendimiento fue mejorado sólo
por uno o por dos o por todos. Es decir, habría que saber quién recurrió a la
EPO y quién no.
P. La justicia está estudiando si, con sus prácticas,
cometió o no un delito contra la salud pública. Pero a estas alturas no negará
que había dopaje, ¿no? R. ¿Dopaje?
Estamos hablando de hechos que ocurrieron antes de que saliera la ley
antidopaje. Dopaje deportivo es posible que hubiera, pero yo le llamaría dopaje
terapéutico, que sería el uso de sustancias dopantes con finalidad terapéutica,
para evitar males mayores.
También
se podría emplear una sustancia dopante, haciendo un mal uso, y tener
consecuencias no deseables. Pero, al igual que ocurre en algunos deportes, no
de este continente pero sí del americano, como la NBA o el fútbol americano,
donde las sustancias dopantes son utilizadas con fines terapéuticos. Y están permitidas.
P. ¿Usted realizaba entonces dopaje terapéutico?
R. Así lo entendía yo. Parece ser que no todos lo entendían así, pero yo
buscaba siempre proteger la salud de mis deportistas. Buscaba protegerles del
daño, inmenso daño, que les hacía el entrenamiento a los niveles que lo hacían
y del calendario competitivo tan exigente que tenían.
Eufemiano touches areas
related to poor nutrition and recovery.He decided to treat them with “whole blood” instead of teaching them how
to eat right.Eufemiano was right that
“whole blood” was the way to go because it was very difficult to educate to
change habits; EPO, steroid or other drug does not work with a poor nutrition.The objective was to keep them in “the rat
race.”He claims that they did not have
time to do the teaching and recovery for cyclists because of the racing
schedule: “Professional cycling is not good for your health; I help cyclists to
avoid more trouble with their health so they can continue racing.”
Based on the above, we say
to our athletes that triathlon has to do with the administration of our
time.The winner is who administers
his/her time the best way where nutrition, recovery and education are
priority.There is not talent, just
repetition with intention to improve and administration of our time.The need for doping is not there if we have
educated athletes.Eufemiano was acquitted
from doping athletes after Operación Puerto trial.Ferrari was suspended after his second trial
for trafficking performance enhancing drugs (Al Capone ended up in jail for not
paying taxes).
