Conscious patients with Grade III fourth ventricular compression should undergo urgent clot evacuation before deterioration. Surgical evacuation of the clot may not be required for large hematomas (>3 cm) if the fourth ventricle is not totally obliterated at the level of the clot.
Athletes are often described as thriving in sport; however, extant research on this construct in sport has been divergent. This study aimed to provide the first dedicated exploration of thriving in elite sport performers by considering its characteristics, outcomes, and facilitators. Semistructured interviews (n = 15) were conducted with athletes, coaches, and sport psychology practitioners and were analyzed using applied thematic analysis. Thriving was perceived to comprise a sustained high-level of performance and dimensions of well-being. Furthermore, predominantly positive outcomes of thriving were described, and participants identified a network of personal and contextual enablers that could facilitate thriving.
This study explored patterns of change in stress variables (i.e., stressors, appraisals, emotions) encountered by wounded, injured, and sick military veterans in the build up to, during, and following an international sporting competition. The study also examined interactions between psychosocial variables and salivary biomarkers of stress and how these relate to veterans’ health, well-being, illness, and performance. 40 Invictus Games (IG) athletes and a control group of 20 military veteran athletes completed questionnaires at seven time points over a 12-week period. Furthermore, participants provided morning and evening saliva samples at four time points to measure cortisol and secretory immunoglobulin A. Multilevel growth curve analyses revealed significant changes in growth trajectories of stress-related variables. For example, team and culture stressors and anger and dejection emotions significantly increased in the build up to competition, whilst challenge appraisals and excitement and happiness emotions significantly decreased over the same time-frame. A number of the stress related variables also predicted performance, well-being, and mental health. Specifically, organizational stressors and threat appraisals were found to negatively relate to performance, well-being, and mental health. Furthermore, whilst challenge appraisals and problem focused coping positively related to veterans’ well-being, adopting emotion-focused and avoidance coping strategies negatively predicted well-being and mental health. Turning to emotions, experiencing anger, anxiety, and dejection negatively related to mental health, well-being and performance; whereas happiness and excitement displayed a positive relationship with these outcomes. The findings also highlighted that organizational stressor intensity was positively related to cortisol exposure at competition. To conclude, this study not only provides a novel, longitudinal, interdisciplinary insight into psychological and biological markers of the stress response as it relates to the performance, health, and well-being of military veterans, but also further contributes to theoretical understanding on the transactional nature of stress. Moreover, the findings significantly contribute to practice regarding how best to support this unique population in adaptively responding to and engaging with competitive sport.
The prevalence of elevated Lp(a) levels in these families and the high degree of association of raised Lp(a) levels with the presence of IAs in several family members warrants follow up of angiographically negative young subjects. We require a case-control study to establish whether particular polymorphisms at the apoprotein (a) gene level are associated with the occurrence of IAs in these families.
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