Inge Kryger Pedersen

Doping and the perfect body expert: social and cultural indicators of performance-enhancing drug use in Danish gyms

Most doping studies focus on the incidence of performance-enhancing drugs and devote little attention to the training sphere or the social factors involved in this process. In this study, Danish doping data from different social arenas of sport and physical exercise (7,039 respondents) form the basis for analyses of the relative importance of social indicators. More respondents from gyms admitted to having experimented with legal as well as banned performance-enhancing substances than did respondents among elite athletes, and the relative importance of education is only indicated among gym users with experience of anabolic-androgenic steroids compared to respondents within the sphere of competitive sport. These results are discussed in the light of findings from qualitative studies of the doping phenomenon. Two patterns of doping practices are discernible in the analysis: whereas aesthetic modification appears to be a primary goal behind certain training regimes and the potential use of pharmaceutical substances in gym and fitness culture, the desire to improve physical capacity appears to underlie the training regimes as well as the use of certain pharmaceutical substances in competitive sports. It is argued that the notion of the perfect body expert is useful in developing a theoretical understanding of the role of drug use within physical training spheres while conceiving different patterns of doping practices.

Combination treatment of people with multiple sclerosis based on collaboration between conventional healthcare providers and alternative practitioners--patient perspectives on outcomes.

The use of alternative and complementary medicine (CAM) is prevalent among People with Multiple Sclerosis (PwMS) in Denmark as well as in other Western countries. Many PwMS combine conventional treatments and CAM; however there is little research-based knowledge about the outcomes that PwMS achieve from combined treatments. The purpose of this article is to describe which outcomes PwMS have experienced from combination treatment based on collaboration between conventional healthcare providers and CAM practitioners. A second purpose is to identify and study aspects of the courses of treatment that have generally characterized the achieved outcomes. During the course of their treatment, 59 PwMS participated in semi-structured individual or group interviews. The analyses show that the participants’ experienced outcomes can be classified in four ways 1) short-term positive outcomes; 2) long-term positive outcomes in specific areas; 3) long-term positive outcomes on the patient’s overall life situation; 4) no and/or negative outcomes. The analyses also show that two aspects of the courses of treatment have generally characterized the outcomes achieved: a) participants’ perception of the patient’s role; b) participants’ perception of treatment function. Outcomes are shown to differ for different PwMS, and results indicate that the combined interventions have played a role in a dynamic and process-oriented interaction with the entire life situation of the individual patient. The results described in the article further suggest that physical as well as cognitive learning constitutes an important element in understanding the dynamics of complex courses of treatment.

Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis’ views on risks of negative interactions between herbal medicine and conventional drug therapies

BackgroundMost users of complementary and alternative medicine (CAM) combine it with conventional medicine. Recent risk assessment studies have shown risks of negative interactions between CAM and conventional medicine, particularly when combining herbal medicine and conventional drug therapies (CDT). Little is known about the way users consider such risks. The present paper aims to gain knowledge about this issue by exploring views on risks of negative interactions when combining herbal medicine and CDT among people with multiple sclerosis (MS).MethodsThis paper draws on a qualitative follow-up study on a survey among members of the Danish MS Society. Semi-structured, in-depth qualitative interviews were conducted with a strategic selection from the survey respondents. The study was inspired by a phenomenological approach and emerging themes were extracted from the data through meaning condensation.ResultsFour themes characterized the informants’ views on risks of negative interactions when combining herbal medicine and CDT: 1) ‘naturalness’ in herbal medicine; 2) ‘bodily sensations’ as guidelines; 3) trust in the CAM practitioner; 4) lack of dialogue with medical doctor.ConclusionsGenerally, the combination of herbal medicine and CDT was considered by the informants to be safe. In particular, they emphasized the ‘non-chemical’ nature of herbal medicine and of their own bodily sensations as warrants of safety. A trustful relation to the CAM practitioner furthermore made some of them feel safe in their use of herbal medicine and CDT in combination. The informants’ use of bodily sensations as a non-discursive risk assessment may be a relevant element in understanding these issues.

What is ‘Good Doctoring’ When Antibiotic Resistance is a Global Threat?

This chapter presents results from an exploratory enquiry into ‘good doctoring’ in the case of antibiotic prescribing. Drawing on 21 in-depth interviews with Danish general practitioners (GPs) about diagnosing and prescribing, the chapter demonstrates how GPs manage dilemmas in clinical practice if and when decisions about antibiotic prescriptions cannot be based on facts about molecular conditions. In this light, the chapter identifies how GPs understand and evaluate jurisdictional boundaries, that is, how they control and apply their expert knowledge in regard to the public health issue of antibiotic resistance. This chapter contributes insights into new jurisdictional tasks in a risky environment and concludes that the broader external forces of global antimicrobial resistance must be seen as shaping medical practice in the locations of primary care.

The Antibiotic Challenge: Justifications for Antibiotic Usage in the World of Medicine

This chapter is a micro-sociological exploration of the justifications that Danish general practitioners adopt to support antibiotic usage in their clinical practices. Based on qualitative in-depth interviews with 21 general practitioners in Denmark, the chapter looks upon the clinic as a particular social world (a justificatory regime) in which different antibiotic treatment strategies are qualified and justified in regard to moral and societal concerns. The chapter demonstrates how the medical application of antibiotics is accompanied by different justifications concerned with efficiencies, general civic interests, localized knowledge and more pervasive ‘green issues’ linked to how to secure sustainable societal usage through political intervention.

Shaping of ‘Embodied Expertise’ in Alternative Medicine

By exploring ‘embodied expertise’ in alternative treatments, this chapter endeavours to help us to account for the popularity of alternative medicine. Embodied expertise has been a much-neglected area in healthcare research for alternative medicine compared with ‘negative’ explanations such as studies of practitioners’ (lack of) education, treatment effects and effectiveness, or users’ dissatisfaction with conventional healthcare. Drawing on a concept of expertise different from ‘expert’ and ‘profession’ allows us to identify dimensions such as skills, knowledge, and spatiality developed not only by practitioners but also in the practitioner-user encounter. Based on a study of three of the most popular forms of alternative medicine in Denmark, we demonstrate how these dimensions are central to developing relationships between (1) expert and lay, (2) experience and evidence-based knowledge, and (3) clinic and home. We argue that such relationships develop the embodied expertise of practitioners, as well as that of users of alternative medicine.

Genetically modified athletes. Biomedical ethics, gene doping and sport

Scand J Med Sci Sports 2003 Aug: 13(4): 244–50 Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric