This study aimed to identify the Greatest of All Time (GOAT) athlete in running events held at the Olympic Games and World Athletics championships. The achievements of 1294 men and 824 women who won at least one medal in any sprint, hurdles, or distance event at major global championships since 1896, or set a World Record (WR) since 1912, were collated. A scoring system was used to award points, with Olympic gold medals and WRs ranked joint highest. Fewer points were awarded for Olympic silver and bronze medals and for medals in World Championships (outdoor, indoor, and cross-country). Bonus points were awarded for WR longevity and the setting of WRs during Olympic finals. Athletes were also ranked by event and within historical eras. As of March 2026, Usain Bolt (Jamaica) was ranked as the male GOAT, and the highest-scoring woman was Faith Kipyegon (Kenya). Both athletes notably won "doubles" during their careers (over 100/200 m and 1500 m/5000 m, respectively) and set WRs over both distances. Marathon, steeplechase, and hurdle specialists usually competed in one event only. In an earlier era, Paavo Nurmi (Finland) had the highest combined Olympic Games/WR score across a range of distances. Athletes who successfully competed over physiologically and tactically similar events ("doubles"), such as Bolt and Kipyegon, had a greater opportunity to become the GOAT. An increase in global competition since 1972 meant greater opportunities for winning medals, especially for women. This study provides a foundation on which future performances could be evaluated.
To assess the oral health status and treatment needs of Special Olympics athletes with intellectual disabilities (ID) in the United Arab Emirates (UAE), addressing a data gap in the Gulf Cooperation Council (GCC) region. A cross-sectional study was conducted in accordance with STROBE guidelines, using data from 817 Special Olympics athletes across 10 events in the UAE between September 2022 and July 2025. After excluding 161 incomplete records, 656 forms were analyzed. Data were collected using the standardized Special Olympics Healthy Athletes System (HAS) form. Trained and calibrated dentists performed visual oral examinations to assess oral hygiene habits, signs of gingival disease, presence of untreated decay, oral pain, and treatment urgency. Descriptive statistics with 95% confidence intervals and chi-square tests were used to assess gender-based stratification. The cohort of 656 athletes had a median age of 20 years, with 68% being male. Over one-third (36%) reported not brushing daily. Clinical examination revealed high rates of oral disease: 67% presented with signs of gingivitis (95% CI: 63.4%-70.6%) and 64% had untreated dental decay (95% CI: 60.3%-67.7%). Furthermore, 20% reported oral pain (95% CI: 17.0%-23.2%). A substantial majority (72.1%) required dental care. Special Olympics athletes in the UAE exhibit a significant burden of untreated dental decay and gingivitis, reflecting substantial unmet treatment needs. These findings, the first comprehensive data from this population in the UAE, highlight a critical need for targeted prevention programs and enhanced access to specialized dental care.
Differentiating exercise-induced cardiac remodelling from early dilated cardiomyopathy remains challenging in athletes, as conventional echocardiographic parameters may overlap in cardiomyopathies and physiologic remodelling. Myocardial work indices (MWI) have been proposed as a promising tool to improve characterization of physiologic remodelling and eventually help in this distinction. However, reference values in athletic populations are currently lacking. The aim of this study was to define sex-specific and sport-independent reference values for MWI in a large cohort of Olympic athletes. 662 Olympic athletes (51.7% males, mean age 25.5±5.3 years) undergoing standardized pre-participation cardiovascular screening, including comprehensive transthoracic echocardiography with two-dimensional speckle-tracking. Global myocardial work index (GWI), constructive work (GCW), wasted work (GWW), and global work efficiency (GWE) were calculated using non-invasive LV pressure-strain loops. Athletes were categorized into power, skill, endurance, and mixed disciplines. Sex- and discipline-specific comparisons were performed, reference values were derived using the 2.5th-97.5th percentiles, and associations with age were explored. In the overall cohort, mean GWI was 1806.1±250 mmHg%, GCW 2188.9±282 mmHg%, GWW 85.8±42.4 mmHg%, and GWE 95.7±2.0%. GWI and GCW did not differ between males and females, whereas males showed higher GWW (91.5±45.7 vs. 79.7±37.7 mmHg%, p=0.0008) and slightly lower GWE (95.4±2.3 vs. 95.9±1.7%, p=0.0004). No significant differences in MWI were observed across sport disciplines. Segmental analysis revealed sex-related differences mainly in basal and mid-LV segments. Age showed only weak, clinically negligible associations with MWI. Proposed limit thresholds were 1346.7 mmHg% for GWI, 1656.1 mmHg% for GCW, GWW >206.8 mmHg% in males and >174 mmHg% in females, and GWE <91% in males and <92% in females. In Olympic athletes, myocardial work is largely independent of sport discipline and age, while sex-specific differences are driven by myocardial efficiency and wasted work. This study establishes sport-independent, sex-specific reference values and preliminary thresholds for MWI, observed in a large cohort of elite athletes, that may help in guiding diagnosis when evaluating doubtful cases of cardiac remodelling.
Urbanization is a key pathway for regional transformation and an important lens for assessing the legacy of mega sporting events. Focusing on Zhangjiakou City, co-host city of the Beijing 2022 Winter Olympics, this study constructs a multidimensional urbanization index covering population, economy, built-environment, and ecology using the CRITIC weighting method, and applies spatial autocorrelation analysis and GeoDetector to examine urbanization dynamics from 2017 to 2022. The main findings are as follows: (1) Zhangjiakou's total urbanization level increased by 20.68%; population, economic, and spatial urbanization improved, whereas ecological urbanization followed an inverted-U trajectory and declined by the end of the study period. (2) High-level urbanization areas expanded from the central urban core toward the northern region, and the share of districts/counties at medium level or above increased markedly. (3) Economic urbanization showed significant positive spatial autocorrelation, with high-high clusters concentrated in the central urban area and later extending to Zhuolu County. (4) The economic dimension consistently showed the strongest explanatory power, while urban economic density, per capita urban road area, population density distribution, and total urban population were the most stable explanatory factors. These findings show multidimensional and spatially uneven urbanization during the Olympic preparation period in a medium-sized co-host city.
Priming refers to the psychological phenomenon whereby a prior stimulus modulates cognitive processes and behavioural responses. To date, perceptual-cognitive mechanisms through which priming influences sporting performance remain underexplored. Olympic Bouldering provides a compelling and ecologically valid context for investigating psychological priming, as it involves perceptual-cognitive processes sensitive to priming while offering robust performance indicators and a controllable experimental environment. This study aimed to advance theoretical and empirical understanding of psychological priming by examining the impact of manipulated difficulty labels, assigned to boulders (short climbing routes) and serving as primes, on climbers' performance outcomes and their perceived difficulty judgments (targets). Twenty-eight female climbers previewed and attempted four boulders that were equivalent in movement demands and difficulty, but presented with manipulated difficulty labels: B1 (labelled easier than actual difficulty), B2 (true difficulty), B3 (labelled harder than actual difficulty), and B4 (no difficulty label). Measures included climbing performance and perceived boulder difficulty. Among the boulders included in the priming manipulation (B1-B3), climbing performance (successful completion, number of attempts) was lowest in B3, labelled as most difficult (negative priming), and highest in B1, labelled as easiest (positive priming). Although all four boulders were of identical difficulty, participants perceived B3 as most difficult and B1 as easiest. Findings indicate that priming through manipulated difficulty labels can influence athletes' climbing performance and perceived boulder difficulty. The study provides empirical evidence that exposure to prime stimuli can activate pre-existing internal representations, modulating both procedural and expectancy processes, and ultimately shaping sporting performance.
Anomalous aortic origin of a coronary artery (AAOCA) is an uncommon congenital abnormality associated with sudden cardiac death (SCD), particularly in young athletes. We present a case of a 4-time Olympic medalist track cyclist who experienced sporadic anginal symptoms during maximal efforts and was found to have an anomalous aortic origin of the right coronary artery (AAORCA). The athlete had a successful surgical reimplantation and returned to elite sport. Management decisions are complex: The investigations used to confirm ischemia and to stratify SCD risk are imperfect, and the surgical treatment carries potential risk. Furthermore, the impact of a sternotomy and coronary reimplantation on competitive sports performance has not been detailed. In the absence of definitive ischemic evidence from history or diagnostic tests, diagnosing high-risk AAOCA can be challenging. The decision to pursue surgical intervention should carefully consider the low rate of SCD and the risk/impact of surgery.
Background: Persons with intellectual disability have a significantly higher prevalence of diabetes than the general population. Special Olympics Fit Feet, a major screening process for evaluating foot health in persons with intellectual disability, has not included an assessment for the risk of diabetic foot ulcers thus far. A probable reason for this may be that clinicians in the past have felt that persons with intellectual disability were not capable of understanding how to complete the Semmes-Weinstein test for lack of protective sensation. A study was designed to assess whether the Special Olympics athletes could complete the Semmes-Weinstein test for lack of protective sensation. Methods: 31 Special Olympics athletes with intellectual disability participating in a Fit Feet foot screening underwent a Semmes-Weinstein test for lack of protective sensation (LOPS). An assessment was completed using predetermined criteria to establish whether the subject understood what was required and could satisfactorily complete the test. Likewise, it was also determined if the Special Olympics athletes believed they understood the test. Results: Study findings determined that approximately 67% of the athletes in the study were able to successfully complete the test and 90% of the Special Olympics athletes reported they completely understood the test. These results do not apply to the intellectual disability population at large. Conclusion: A significant percentage of the test population appeared able to successfully undergo the Semmes-Weinstein test for lack of protective sensation (LOPS). Therefore, it is recommended that any foot screening process for Special Olympics athletes should include an assessment for loss of protective sensation including use of monofilament testing.
Nurses often lack training and self-confidence to provide care for people living with intellectual disabilities. We explored experiences and levels of preparedness among junior nurses trained to deliver cardiovascular health promotion to Special Olympics athletes. A qualitative descriptive approach was used among junior nurses (n = 20) who participated in the delivery of a cardiovascular health promotion intervention, with semi-structured individual interviews or focus-group discussions and qualitative content analysis. Nurses showed evidence of advanced beginner and competent levels of expertise in their approaches to Special Olympics athletes in relation to 5 themes linked to strengths-based nursing and health (SBNH) values: Endorsing person-centeredness; Fostering self-determination and empowerment; Building collaborative partnerships; Recognising interconnections between athletes and their surroundings; and Seizing learning opportunities. Junior nurses who participated in this cardiovascular health promotion initiative perceived the experience as educationally enriching, advocating for practical, real-life opportunities to better prepare them to deliver health promotion care for special-needs populations.
In line with sport psychology's growing focus on wellbeing and mental health, meaning (i.e., experiencing life as coherent, significant, oriented, and belonging) has been gaining attention in elite sport. Its study is theoretically and practically relevant, since athletes often refer to meaning, especially when it is lacking. However, while wider research highlights its role for physical and mental health, empirical inquiry in sport psychology has produced diverse conceptualizations and lacking alignment with psychological theory. This makes it difficult for practitioners to address meaning when its nature, threats, and supports remain unclear. To address this gap, our study sought to (a) provide an empirical account of athletes' lived experience of meaning, (b) advance theoretical integration with psychological frameworks by proposing a contextualized model of meaning in elite sport that draws on pertinent meaning in life theory, and (c) facilitate applied work. To this end, we interviewed 13 international Olympic athletes multiple times from February 2022 to August 2024. Through framework analysis, we developed an empirical model, incorporating the dimensions of coherence, significance, purpose, belonging, alongside the psychological needs for autonomy, competence, relatedness, and contribution. The model identifies two routes to experiencing meaning in elite sport: Self-actualization arises when athletes connect to themselves through feeling self-determined, competent, mattering to themselves, and having a personal purpose. Self-transcendence emerges when athletes connect with others by pursuing a wider purpose, mattering to others, contributing through giving back, and nurturing relationships. We conclude with critical reflections and recommendations for supporting both routes in practice.
This study examines the characteristics of feinting plays performed by women's national handball teams from Asia and Europe, emphasizing the contrasting approaches and tactical tendencies between regions. It identifies key factors that provide an advantage in one-on-one situations. The sample comprised feinting plays observed in one-on-one situations from three matches per focal team in each of the 2019 World Championship, 2021 Olympic Games, and 2021 World Championship. After systematically observing and analyzing match footage, descriptive performance analysis was conducted using chi-square tests and residual analyses. The findings revealed distinct regional patterns: (i) European teams most frequently executed feinting plays with slow approaches, moderate distances, frontal positions, and two-leg stops, highlighting their methodical and structural style; (ii) Asian teams most frequently employed rapid approaches, greater distances, dominant arm side positions, and 0-1 stops, reflecting a dynamic and speed-oriented approach; and (iii) for both European and Asian teams, feinting plays at greater distances were more effective. These results elucidate the specific characteristics of feinting plays across regions, generating insights that should guide feinting coaching strategies tailored to the regional strengths and styles.
Hip arthroscopy for femoroacetabular impingement (FAI) in professional athletes is associated with significant improvements in postoperative pain and function and a return-to-sport (RTS) rate >80%. However, RTS rate after hip arthroscopy for FAI in professional athletes with borderline dysplasia is unknown. To assess RTS rates exclusively in professional athletes with borderline dysplasia after hip arthroscopy for treatment of FAI. Cohort study; Level of evidence, 3. A total of 40 professional and Olympic athletes (42 hips) with borderline dysplasia (lateral center edge angle [LCEA] 18°-25°) underwent hip arthroscopy for FAI between 2005 and 2022. RTS was defined as competing in a single professional game at an equal level after surgery. Data were retrospectively obtained for each athlete from publicly available sport-specific data sources. The study included 42 hips. Patients undergoing primary hip arthroscopy demonstrated a 79% RTS rate, whereas patients undergoing revision hip arthroscopy demonstrated a 25% RTS rate (P = .006). Among athletes who successfully returned, RTS occurred at a median of 7.5 months (range, 3.1-24.3 months) after surgery. The mean age at the time of surgery was 28.9 years (range, 18-53.5 years). In total, 21 hips (50%) had an Outerbridge grade 3 or 4 defect at the time of surgery, and 10 (24%) underwent a microfracture procedure. Older age (P = .041) and history of previous hip arthroscopy (P = .008) were associated with a lower likelihood of return to professional sport. No statistically significant association was found between femoral version, LCEA, alpha angle, the presence of Outerbridge grade 3 or 4 defect, or minimum joint space and RTS. In the primary setting, professional athletes with borderline hip dysplasia who underwent hip arthroscopy for FAI demonstrated a 79% RTS rate. The mean time to return was 7.5 months, with older age and a history of prior hip arthroscopy predictive of a lower likelihood of RTS (25% RTS among revision cases). Hip arthroscopy for FAI in professional athletes with borderline dysplasia was effective for returning the majority of these athletes to their preoperative level, especially in the primary setting.
High-intensity judo bouts induce oxidative stress and muscle damage, impairing recovery. This randomized, double-blind, placebo-controlled pilot trial examined whether acute β-hydroxy-β-methylbutyrate free acid (HMB-FA) supplementation influences muscle damage, oxidative stress, and antioxidant biomarkers in elite judoka. Twenty-two male elite judoka were randomized to HMB-FA (1.0 g BetaTOR®) or placebo. Supplements were ingested after four simulated Olympic judo bouts. Blood was sampled pre-exercise, post-fourth bout, and 2 h post-bout for creatine kinase (CK), lactate dehydrogenase (LDH), catalase (CAT), glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA), and total antioxidant capacity (TAC). Twenty-one completed the protocol (one placebo dropout due to injury). Data were analyzed via 2 × 3 mixed ANOVA with partial η². No group differences were seen for CK, MDA, or TAC (p > 0.05). Significant group × time interactions were observed for CAT (p < 0.001), GPX (p = 0.031), and SOD (p = 0.025), indicating greater enzyme increases in HMB-FA (CAT + 54%, GPX + 38%, and SOD + 16%) than placebo (+7-14%). LDH declined in both groups (interaction, p = 0.001), but more so in the placebo group (-29.9%) than in the HMB-FA group (-18.6%). Acute post-exercise HMB-FA supplementation in elite judo athletes did not significantly influence muscle damage or oxidative stress markers but transiently increased antioxidant enzyme activities (CAT, GPX, and SOD). These findings suggest an enzyme-specific effect and highlight the need for future studies using more precise oxidative-stress markers and cellular assays to better evaluate antioxidant responses; however, these effects should be interpreted with caution due to potential limitations related to assay sensitivity and the timing of measurements.
Taekwondo is a high-intensity Olympic combat sport that requires the integration of physical performance, tactical decision-making, and psychological resilience. Athletes face unique challenges such as rapid weight management, fatigue accumulation, injury risk, and competitive anxiety. While sports nutrition and psychological readiness are critical determinants of performance, they are often addressed separately, creating a gap in holistic, individualized athlete monitoring systems. This narrative review synthesizes interdisciplinary evidence from sport science, nutrition, psychology, and artificial intelligence. A structured literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies related to Taekwondo performance, weight-category nutrition strategies, psychological readiness, and AI-driven technologies including wearable systems, machine learning, and digital twin frameworks. The findings indicate that AI-driven digital twin technology enables the integration of multidimensional athlete data, including nutritional intake, psychological state, training load, and physiological biomarkers (e.g., HRV and cortisol). These systems can generate actionable outputs such as readiness scoring, personalized nutrition strategies, early detection of fatigue and stress dysregulation, and prediction of injury or overtraining risk. Digital twin technology represents a promising framework for transforming Taekwondo athlete management from fragmented monitoring to a holistic, data-driven approach. Practically, this may support coaches in making real-time decisions regarding training load, weight management, recovery, and psychological interventions. However, further empirical validation, ethical considerations, and applied research are required to support real-world implementation in elite combat sport environments.
Judo is one of the most widely practiced martial arts worldwide and carries a notable risk of musculoskeletal injuries, especially at the elite level. Prospective data on injury patterns are limited. This study aimed to describe injuries and contextual factors in elite judoka to inform prevention strategies. Injuries in elite judoka were prospectively recorded at eight German Olympic training centers from January 2020 to June 2022 using a standardized online questionnaire. Data were analyzed descriptively. A total of 105 injuries were included. The cohort was estimated at around 200 elite athletes; due to variable participation, no exposure data or incidence rates could be calculated. In total, 105 injuries were documented (41.9% female n = 44, 58.1% male n = 61). The knee (31.4%), shoulder (17.1%), and elbow (13.3%) were most affected. Ligament injuries predominated (40.0%), including anterior cruciate ligament ruptures (7.6%). Most injuries occurred during throwing actions (78.1%), including the opponent's throwing action (40.0%) and the athlete's own throwing action (38.1%). The majority occurred during training (64.8%). Athletes aged 21-23 years were most affected, often in association with increased training load. Injuries in elite judo occur mainly during throwing actions, with the knee, shoulder, and elbow most commonly affected. Anterior cruciate ligament rupture is a relevant diagnosis. These findings support the development of targeted prevention strategies, particularly for knee injuries. HINTERGRUND: Judo zählt weltweit zu den am häufigsten ausgeübten Kampfsportarten und ist besonders im Leistungssportbereich mit einem erhöhten Risiko für muskuloskelettale Verletzungen verbunden. Prospektive Daten zu Verletzungsmustern bei Elite-Judoka sind begrenzt. Ziel der vorliegenden Studie war die Beschreibung von Verletzungen und damit verbundene Kontextfaktoren zu beschreiben sowie Daten zu liefern, die ggf. zur Entwicklung von Strategien zur Verletzungsprävention beitragen könnten. Verletzungen von Elite-Judoka wurden zwischen Januar 2020 und Juni 2022 an acht deutschen Olympiastützpunkten prospektiv erfasst. Die Datenerhebung erfolgte mittels standardisiertem Online-Fragebogen und wurde deskriptiv ausgewertet. Insgesamt wurden 105 Verletzungen eingeschlossen. Die Kohorte wurde auf etwa 200 Athleten geschätzt. Aufgrund variabler Trainingsbeteiligung konnten keine Expositionsdaten erhoben und keine Inzidenzen berechnet werden. Es wurden 105 Verletzungen dokumentiert (41,9% Frauen, 58,1% Männer). Am häufigsten betroffen waren Knie (31,4%), Schulter (17,1%) und Ellenbogen (13,3%). Bandverletzungen dominierten (40,0%), darunter vordere Kreuzbandrupturen (7,6%). Die meisten Verletzungen traten bei Wurfaktionen auf (78,1%), sowohl durch gegnerische (40,0%) als auch eigene Würfe (38,1%). 64,8% ereigneten sich im Training. Besonders betroffen waren 21–23-Jährige, häufig im Zusammenhang mit erhöhter Trainingsbelastung. Verletzungen im Elite-Judo treten überwiegend bei Wurfaktionen auf, mit Schwerpunkt an Knie, Schulter und Ellenbogen. Kreuzbandrupturen sind eine relevante Diagnose. Die Ergebnisse liefern wichtige Hinweise für gezielte Präventionsstrategien, insbesondere für Knieverletzungen.
Health literacy is important for effective disease prevention and health promotion. People with disabilities may require especially strong health literacy because they have higher unmet healthcare needs and more chronic disease. Although some studies suggest lower health literacy among people with disabilities, evidence from nationally representative data is limited. Using the 2021 Korea Health Panel Survey, we assessed health literacy among adults aged 19+ (N = 11,057) and compared those with and without disabilities defined by the National Disability Registration System. Sensitivity analyses used an alternative definition of disability derived from self-reported difficulties in daily activities. Linear regressions adjusted for gender, age, education, income, and chronic conditions. Adults with disabilities scored 0.94 points lower on the 16-point European Health Literacy Survey Questionnaire scale than those without (p < 0.001). Under the alternative definition, the gap was larger at 1.49 points (p < 0.001). Differences varied by disability type: cognitive limitations were associated with the largest deficit (- 3.93, p < 0.001), followed by hearing limitations (- 2.01, p < 0.001); physical disabilities did not differ significantly. These findings indicate clear disparities in health literacy by disability status and heterogeneity across disability types in Korea. Programs and policies to improve health literacy among people with disabilities should be tailored to disability type.
The purpose of this explorative study was to investigate the association between anatomic factors and risk for non-contact anterior cruciate ligament (ACL) injuries among female team sport players. A total of 225 players from basketball, floorball, and volleyball aged 12-38 years (median 16) participated in baseline physical examination including measurements of static knee and pelvic alignment, leg length, pelvic width, and femoral and tibial condyle widths. Players were then prospectively followed for new ACL injuries for 2.5-4.5 years. Legs were analyzed separately. After excluding eight players with a history of ACL injury, the final sample included 217 players and 434 legs. Associations between variables of interest and ACL injury risk were analyzed using generalized linear mixed models with binomial distribution and player and club as random effects. During the follow-up, 20 new non-contact ACL injuries were registered. None of the measures investigated showed a significant relationship with the risk of new non-contact ACL injuries. In conclusion, anatomic factors showed no association with increased risk of ACL injury in female team sport players.
Acid mine drainage (AMD) environments host complex mineral-water systems that are not well represented by spectral libraries derived solely from pure minerals. We present an open dataset that integrates spectroscopy of natural AMD materials with co-located mineralogical and geochemical measurements from the Kirki (Saint Philippos) mine in NE Greece. The dataset includes: (i) laboratory mineral reflectance spectra spanning 350-15,375 nm (visible-near infrared (VNIR)-shortwave infrared (SWIR)-mid-wave infrared (MWIR)-longwave infrared (LWIR)) for 26 compositionally diverse solid samples; (ii) in situ water VNIR spectra from 337-823 nm collected over AMD-impacted streams and lakes; (iii) co-located field measurements (e.g., temperature, pH, electrical conductivity, turbidity); and (iv) an extensive suite of laboratory analyses for both solids and waters, including mineralogical, major-element, and trace-element data. All spectral and analytical products are provided in a harmonized format, with detailed metadata, instrument specifications, and processing documentation. The dataset is designed to support the development and testing of spectral analysis methods, quantitative retrieval algorithms, and cross-sensor comparisons in AMD settings, and to serve as a high-fidelity analog resource for planetary spectroscopy where sulfate- and Fe-oxide detection and longwave infrared mineral characterization are of interest.
This study aimed to investigate the association of high-density lipoprotein cholesterol (HDL-C) levels with cardiovascular diseases (CVDs) and all-cause mortality and to determine differences based on the presence or absence of a history of CVDs. This retrospective cohort study included 343,321 adults aged ≥ 40 years whose survey data were recorded in the Korean National Health Insurance Service database from 2009 to 2010. HDL-C levels were divided into five groups. The association among HDL-C levels, CVDs, and all-cause mortality was examined using multivariate Cox proportional hazards regression models. During a mean follow-up period of 9.5 ± 2.0 years, CVDs, all-cause mortality, and composite outcomes occurred in 8.3%, 5.9%, and 13.2% of the study population, respectively. HDL-C levels were inversely associated with CVDs and composite outcomes, with a U-shaped association between HDL-C levels and all-cause mortality. Compared with normal HDL-C levels, very low HDL-C levels and very high HDL-C levels were associated with a higher risk of all-cause mortality. Individuals without preexisting CVDs showed similar patterns. Very low HDL-C and low HDL-C levels in individuals with preexisting CVDs were associated with a higher risk of outcomes. Our results suggest that very high HDL-C levels are associated with a decreased risk of CVDs and an increased risk of all-cause mortality. These associations varied according to preexisting CVDs status, sex, and age, challenging the notion that a higher HDL-C level is universally beneficial.
In Australia, volunteers represent a ubiquitous-and critical-feature of organised sport. Sporting events, be they the Olympic Games or a grassroots football match, require the services of a human resource whose engagement, in turn, necessitates consideration from a legal and governance standpoint. For the organisations administering sporting activities, however, volunteers represent an anomaly in an hierarchical sport system. Volunteers are often subject to the whim and caprice of institutions deficient in processes for engaging an unpaid workforce. Issues concerning employment terms and volunteer rights have proved contentious, especially in the community sport sector. Although volunteer numbers have fluctuated, legal problems ensue, resulting in various "injuries" and other considerations relating to the treatment of sport volunteers. There is a dilemma for sport organisations: the governance model for community sport is flawed due to the paradox between top-down policy edicts and the ability of volunteers to manage themselves by virtue of their non-professional roles. By way of a narrative literature review, this paper identifies issues impacting sport organisations and points to the irony that volunteers are unlikely to be able to fulfil expectations based on existing governance structures.
While COVID-19 had a devastating impact on mental health worldwide, little is known about its effects on adults with intellectual and developmental disabilities. We used a community-based participatory approach to study this population's mental health experiences. Six focus groups were conducted: four with adults with intellectual and developmental disabilities (n = 21) and two with caregivers (n = 13). Conventional content analysis and thematic network analysis were utilised. We identified cascading impacts of the pandemic on the mental health of this population. Sub-themes included: (1) environmental effects, (2) emotional effects and (3) physical and behavioural effects of COVID-19. Five modifying factors were identified. The COVID-19 pandemic, while specific in its restrictions and timing, illustrated and exacerbated unmet mental health needs of adults with intellectual and developmental disabilities. These results suggest opportunities for empirical research and policy development, relevant for future emergencies and ongoing medical and non-medical support of this population.