Intraoperative electroencephalographic changes during transcarotid artery revascularization are more frequent than previously reported.

OBJECTIVE: Up to 14% of patients undergoing carotid endarterectomy with continuous electroencephalographic (EEG) neuromonitoring will require shunt placement because of EEG changes. However, the initial studies of transcarotid artery revascularization (TCAR) found only one patient with temporary EEG changes. We report our experience with intraoperative EEG monitoring during TCAR. METHODS: We conducted a retrospective review of patients who underwent TCAR at two urban hospitals within an integrated healthcare network from May 2017 to January 2020. The data included demographic information, patient comorbidities, symptom status, previous carotid interventions, anatomic details, contralateral disease, intraoperative vital signs and EEG changes, and postoperative major adverse events (transient ischemic attack, stroke, myocardial infarction [MI], and death) both initially and at 30 days postoperatively. The Fisher exact test was used for categorical data and the Wilcoxon rank sum test for continuous data. RESULTS: A total of 89 patients underwent TCAR during the study period, of whom 71 (79.8%) received intraoperative EEG neuromonitoring. Of the 89 patients, 70.8% were men and 29.2% were women. The median age was 75 years (IQR, 68-82.5 years). Symptomatic patients accounted for 41.6% of the cohort. Of the 71 patients who received continuous neuromonitoring, 9 experienced EEG changes during TCAR (12.7%). The changes resolved in seven patients with pressure augmentation in three and switching to a low flow toggle in three. One patient who had sustained EEG changes had a new postoperative neurologic deficit. The median carotid stenosis percentage on preoperative computed tomography angiography was lower for patients with EEG changes than for those without (67% vs 80%; P = .01). No correlation was found between symptom status or 30-day stroke in patients with and without EEG changes (P = .49 and P = .24, respectively). Overall, three postoperative strokes, two postoperative deaths, and one MI occurred, for a composite 30-day stroke, death, and MI rate of 6.7%. CONCLUSIONS: Changes in continuous EEG monitoring were more frequent in our study than previously reported. Less severe carotid stenosis might be associated with a greater incidence of EEG changes. Limited data are available on the prognostic ability of EEG to detect clinically relevant changes during TCAR, and further studies are warranted.

Goal Motives and Well-Being in Student-Athletes: A Person-Centered Approach.

Using a person-centered approach, the aim of this study was to examine how student-athletes' motives for multiple-goal pursuit relate to indices of well- and ill-being. Student-athletes (N = 362) from British universities identified the most important sporting and academic goals that they were pursuing over the academic year. The participants rated their extrinsic, introjected, identified, and intrinsic goal motives for each goal and completed measures of well- and ill-being. Latent profile analysis revealed six distinct profiles of goal motives, with variations in both the strength of motives and the motivational quality. Follow-up analyses revealed between-profile differences for well- and ill-being; students with more optimal goal motive profiles reported higher and lower well- and ill-being, respectively, than those with less optimal goal motives. To experience well-being benefits when pursuing multiple goals, student-athletes should strive for their academic and sporting goals with high autonomous and low controlled goal motives.

When the going gets tough: the "why" of goal striving matters.

No prior research has examined how motivation for goal striving influences persistence in the face of increasing goal difficulty. This research examined the role of self-reported (Study 1) and primed (Study 2) autonomous and controlled motives in predicting objectively assessed persistence during the pursuit of an increasingly difficult goal. In Study 1, 100 British athletes (64 males; M(age) = 19.89 years, SD(age) = 2.43) pursued a goal of increasing difficulty on a cycle ergometer. In Study 2, 90 British athletes (43 males; M(age) = 19.63 years, SD(age) = 1.14) engaged in the same task, but their motivation was primed by asking them to observe a video of an actor describing her or his involvement in an unrelated study. In Study 1, self-reported autonomous goal motives predicted goal persistence via challenge appraisals and task-based coping. In contrast, controlled goal motives predicted threat appraisals and disengagement coping, which, in turn, was a negative predictor of persistence. In Study 2, primed autonomous (compared to controlled) goal motives predicted greater persistence, positive affect, and future interest for task engagement. The findings underscore the importance of autonomous motivation for behavioral investment in the face of increased goal difficulty.

Goal striving and well-being in sport: the role of contextual and personal motivation.

This investigation sought to clarify mixed results in the literature exploring coach behaviors, basic psychological needs, goal motivation, and well- and ill-being. Regional-level team sport athletes (N = 241) completed questionnaires on the aforementioned variables at the beginning of the season. A subsample (n = 70) provided saliva samples to assess physical ill-being. At the end of the season, athletes (n = 98) reported their goal motivation and attainment. Structural equation modeling demonstrated that coach behaviors were related to needs satisfaction and thwarting, which were related to autonomous and controlled goal motives respectively. Autonomous motives were related to well- and ill-being; controlled motives were only related to ill-being. Over time, only end-of-season autonomous goal motives were related to goal attainment. The findings provide an insight into how coaches can facilitate optimum goal striving and well-being in their athletes.

What Effect Do Goal Setting Interventions Have on Physical Activity and Psychological Outcomes in Insufficiently Active Adults? A Systematic Review and Meta-Analysis.

BACKGROUND: Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. METHODS: In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3-24 wk) on both PA and psychological outcomes (eg, self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. RESULTS: All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P < .001]; 95% confidence interval, 0.74-1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P < .001]; 95% CI, 0.10-0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤ .003). No other significant moderators were found. CONCLUSION: Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals.

Determining factors of physical activity and sedentary behaviour in university students during the COVID-19 pandemic: A longitudinal study.

INTRODUCTION: Historically, university students demonstrate poor movement behaviours that could negatively impact current and future health. Recent literature has focused on identifying determinants of physical activity (PA) and sedentary behaviour (SB) in this population to inform the development of intervention strategies. However, the COVID-19 pandemic substantially restricted movement behaviours in this population, meaning findings of previous research may no longer be applicable within the current societal context. The present study explored the longitudinal relationships between pre-pandemic psychological, behavioural and anthropometric factors, and the movement behaviours of UK university students nine months following the outbreak of COVID-19. METHODS: Mental wellbeing (MWB), perceived stress (PS), body mass index (BMI), SB, and PA were assessed using an online self-report survey in 255 students prior to (October 2019) and nine months following (October 2020) the first confirmed case of COVID-19 in the UK. Path analysis was utilised to test relationships between pre-COVID mental wellbeing, perceived stress and BMI, and movement behaviours during the pandemic. RESULTS: The fit of the path analysis model was good (χ2 = 0.01; CMIN = 0.10, CFI = 1.00, RMSEA = 0.00). Pre-covid MWB and PS positively influenced PA (ß = 0.29; ß = 0.24; P < 0.01) but not SB (ß = -0.10; ß = 0.00; P = 0.79) during the pandemic. Additionally, pre-pandemic SB and PA positively influenced SB and PA during the pandemic respectively (SB: ß = 0.26; P < 0.01) (PA: ß = 0.55; P < 0.01). Pre-pandemic BMI did not influence any measured variable during the pandemic (PA: ß = 0.03 and P = 0.29; SB: ß = 0.06 and P = 0.56), and there was no mediating effect of PA on SB during the pandemic (ß = -0.26; P = 0.14). CONCLUSION: These findings indicate that pre-covid mental health and movement behaviours had a direct positive influence on PA during the pandemic, but not SB. This longitudinal study demonstrates the influence that prior psychological and behavioural factors have in determining university students' response to periods of elevated stress and uncertainty, furthering our understanding of determinants of health-related behaviours in students.

Embedding Physical Activity into Community-Based Peer Support Groups for those Severely Affected by Mental Illness.

Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.

Nine Months into the COVID-19 Pandemic: A Longitudinal Study Showing Mental Health and Movement Behaviours Are Impaired in UK Students.

Initial studies indicated that student mental health was impaired during the early stages of the pandemic and that maintaining/improving physical activity gave some protection from mental illness. However, as the pandemic persists, these data may not reflect current circumstances and may have been confounded by exam stress. METHODS: This study used an online survey to assess the changes in, and associations between, mental health and movement behaviours in 255 UK university students from before the COVID-19 pandemic (October 2019) to 9 months following the UK's first confirmed case (October 2020). Changes in and associations between mental wellbeing, perceived stress, physical activity, and sedentary behaviour were assessed using a mixed model ANOVA; a multiple linear regression model determined the predictive value of variables associated with Δ mental wellbeing. RESULTS: Mental wellbeing and physical activity decreased (45.2 to 42.3 (p < 0.001); 223 to 173 min/week (p < 0.001)), whereas perceived stress and time spent sedentary increased (19.8 to 22.8 (p < 0.001); 66.0 to 71.2 h/week (p = 0.036)). Δ perceived stress, Δ sedentary behaviour and university year accounted for 64.7%, 12.9%, and 10.1% of the variance in Δ mental wellbeing (p < 0.001; p = 0.006; p = 0.035). CONCLUSION: The COVID-19 pandemic is having a sustained negative impact on student mental health and movement behaviour.

Goal motives and multiple-goal striving in sport and academia: A person-centered investigation of goal motives and inter-goal relations.

OBJECTIVES: This investigation extended the goal striving literature by examining motives for two goals being pursued simultaneously. Grounded in self-determination theory, we examined how student-athletes' motives for their sporting and academic goals were associated with inter-goal facilitation and interference. DESIGN: Cross-sectional survey. METHODS: UK university student-athletes (n=204) identified their most important sporting and academic goals. They then rated their extrinsic, introjected, identified and intrinsic motives for these goals and completed questionnaires assessing inter-goal facilitation and interference. RESULTS: Using a person-centered approach via latent profile analysis, we identified three distinct profiles of goal motives. Auxiliary analyses showed that the profile with high identified motives for both goals reported greater inter-goal facilitation. CONCLUSIONS: Extending the previous literature, the findings demonstrate the benefits of autonomous motives when simultaneously pursing goals in sport and academia.

Predicting subsequent task performance from goal motivation and goal failure.

Recent research has demonstrated that the cognitive processes associated with goal pursuit can continue to interfere with unrelated tasks when a goal is unfulfilled. Drawing from the self-regulation and goal-striving literatures, the present study explored the impact of goal failure on subsequent cognitive and physical task performance. Furthermore, we examined if the autonomous or controlled motivation underpinning goal striving moderates the responses to goal failure. Athletes (75 male, 59 female, Mage = 19.90 years, SDage = 3.50) completed a cycling trial with the goal of covering a given distance in 8 min. Prior to the trial, their motivation was primed using a video. During the trial they were provided with manipulated performance feedback, thus creating conditions of goal success or failure. No differences emerged in the responses to goal failure between the primed motivation or performance feedback conditions. We make recommendations for future research into how individuals can deal with failure in goal striving.

Self-Regulatory Responses to Unattainable Goals: The Role of Goal Motives.

Does motivation for goal pursuit predict how individuals will respond when confronted with unattainable goals? Two studies examined the role of autonomous and controlled motives when pursuing an unattainable goal without (Study 1) or with (Study 2) the opportunity to reengage in alternative goal pursuit. Autonomous motives positively predicted the cognitive ease of reengagement with an alternative goal when the current goal was perceived as unattainable, especially when participants realized goal unattainability relatively early during goal striving. Autonomous motives, however, were negative predictors of cognitive ease of disengagement from an unattainable goal. When faced with failure, autonomously motivated individuals are better off realizing early the goal unattainability. Otherwise, they will find it difficult to disengage cognitively from the pursued goal (despite reengaging cognitively in an alternative goal), possibly due to interfering rumination.