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Parkinsonism and Parkinson's disease (PD) have been described as consequences of repetitive head impacts (RHI) from boxing, since 1928. Autopsy studies have shown that RHI from other contact sports can also increase risk for neurodegenerative diseases, including chronic traumatic encephalopathy (CTE) and Lewy bodies. In vivo research on the relationship between American football play and PD is scarce, with small samples, and equivocal findings. This study leveraged the Fox Insight study to evaluate the association between American football and parkinsonism and/or PD Diagnosis and related clinical outcomes.
Participants and Methods:
Fox Insight is an online study of people with and without PD who are 18+ years (>50,000 enrolled). Participants complete online questionnaires on motor function, cognitive function, and general health behaviors. Participants self-reported whether they "currently have a diagnosis of Parkinson's disease, or parkinsonism, by a physician or other health care professional." In November 2020, the Boston University Head Impact Exposure Assessment was launched in Fox Insight for large-scale data collection on exposure to RHI from contact sports and other sources. Data used in this abstract were obtained from the Fox Insight database https://foxinsight-info.michaeljfox.org/insight/explore/insight.jsp on 01/06/2022. The sample includes 2018 men who endorsed playing an organized sport. Because only 1.6% of football players were women, analyses are limited to men. Responses to questions regarding history of participation in organized football were examined. Other contact and/or non-contact sports served as the referent group. Outcomes included PD status (absence/presence of parkinsonism or PD) and Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15) for assessment of cognitive symptoms. Binary logistic regression tested associations between history and years of football play with PD status, controlling for age, education, current heart disease or diabetes, and family history of PD. Linear regressions, controlling for these variables, were used for the PDAQ-15.
Results:
Of the 2018 men (mean age=67.67, SD=9.84; 10, 0.5% Black), 788 (39%) played football (mean years of play=4.29, SD=2.88), including 122 (16.3%) who played youth football, 494 (66.0%) played high school, 128 (17.1%) played college football, and 5 (0.7%) played at the semi-professional or professional level. 1738 (86.1%) reported being diagnosed with parkinsonism/PD, and 707 of these were football players (40.7%). History of playing any level of football was associated with increased odds of having a reported parkinsonism or PD diagnosis (OR=1.52, 95% CI=1.14-2.03, p=0.004). The OR remained similar among those age <69 (sample median age) (OR=1.45, 95% CI=0.97-2.17, p=0.07) and 69+ (OR=1.45, 95% CI=0.95-2.22, p=0.09). Among the football players, there was not a significant association between years of play and PD status (OR=1.09, 95% CI=1.00-1.20, p=0.063). History of football play was not associated with PDAQ-15 scores (n=1980) (beta=-0.78, 95% CI=-1.59-0.03, p=0.059) among the entire sample.
Conclusions:
Among 2018 men from a data set enriched for PD, playing organized football was associated with increased odds of having a reported parkinsonism/PD diagnosis. Next steps include examination of the contribution of traumatic brain injury and other sources of RHI (e.g., soccer, military service).
White matter hyperintensity (WMH) burden is greater, has a frontal-temporal distribution, and is associated with proxies of exposure to repetitive head impacts (RHI) in former American football players. These findings suggest that in the context of RHI, WMH might have unique etiologies that extend beyond those of vascular risk factors and normal aging processes. The objective of this study was to evaluate the correlates of WMH in former elite American football players. We examined markers of amyloid, tau, neurodegeneration, inflammation, axonal injury, and vascular health and their relationships to WMH. A group of age-matched asymptomatic men without a history of RHI was included to determine the specificity of the relationships observed in the former football players.
Participants and Methods:
240 male participants aged 45-74 (60 unexposed asymptomatic men, 60 male former college football players, 120 male former professional football players) underwent semi-structured clinical interviews, magnetic resonance imaging (structural T1, T2 FLAIR, and diffusion tensor imaging), and lumbar puncture to collect cerebrospinal fluid (CSF) biomarkers as part of the DIAGNOSE CTE Research Project. Total WMH lesion volumes (TLV) were estimated using the Lesion Prediction Algorithm from the Lesion Segmentation Toolbox. Structural equation modeling, using Full-Information Maximum Likelihood (FIML) to account for missing values, examined the associations between log-TLV and the following variables: total cortical thickness, whole-brain average fractional anisotropy (FA), CSF amyloid ß42, CSF p-tau181, CSF sTREM2 (a marker of microglial activation), CSF neurofilament light (NfL), and the modified Framingham stroke risk profile (rFSRP). Covariates included age, race, education, APOE z4 carrier status, and evaluation site. Bootstrapped 95% confidence intervals assessed statistical significance. Models were performed separately for football players (college and professional players pooled; n=180) and the unexposed men (n=60). Due to differences in sample size, estimates were compared and were considered different if the percent change in the estimates exceeded 10%.
Results:
In the former football players (mean age=57.2, 34% Black, 29% APOE e4 carrier), reduced cortical thickness (B=-0.25, 95% CI [0.45, -0.08]), lower average FA (B=-0.27, 95% CI [-0.41, -.12]), higher p-tau181 (B=0.17, 95% CI [0.02, 0.43]), and higher rFSRP score (B=0.27, 95% CI [0.08, 0.42]) were associated with greater log-TLV. Compared to the unexposed men, substantial differences in estimates were observed for rFSRP (Bcontrol=0.02, Bfootball=0.27, 994% difference), average FA (Bcontrol=-0.03, Bfootball=-0.27, 802% difference), and p-tau181 (Bcontrol=-0.31, Bfootball=0.17, -155% difference). In the former football players, rFSRP showed a stronger positive association and average FA showed a stronger negative association with WMH compared to unexposed men. The effect of WMH on cortical thickness was similar between the two groups (Bcontrol=-0.27, Bfootball=-0.25, 7% difference).
Conclusions:
These results suggest that the risk factor and biological correlates of WMH differ between former American football players and asymptomatic individuals unexposed to RHI. In addition to vascular risk factors, white matter integrity on DTI showed a stronger relationship with WMH burden in the former football players. FLAIR WMH serves as a promising measure to further investigate the late multifactorial pathologies of RHI.
Tippins et al. (2023) challenge I-O psychologists to more actively – in Miller’s oft-quoted APA presidential address – “give psychology away.” Their article provides stirring examples of the impact several of our colleagues have made in giving psychology away. In thinking about how to encourage and facilitate more of us to volunteer, we’d like to share several thoughts on our roles as I-Os, both as individuals and as a community. In particular, we propose that volunteerism is an expression of our calling as I-Os; suggest five roles we can play as individuals; discuss three roles for the community at-large; and conclude with a call to action.
The epistemic community research programme, which in the last generation helped frame International Relations understandings of the relationship between knowledge and power, rested on the influence of scientists and experts on policymaking through framing, persuasion, and socialization. In this chapter, we argue that while pioneering, the epistemic-community research programme was incomplete, since it neglected the relationship between knowledge, power, and practice. Because practices are at the core of what epistemic communities are, do, and aim to achieve, we suggest a pragmatist practice-based approach, according to which knowing requires active participation in social communities and knowledge is not a product but is bound with action. We, therefore, explain the political adoption of knowledge-generated practices by the very nature of practicing and joining communities of practice. With this purpose in mind, we propose understanding epistemic communities as epistemic communities of practice. By identifying epistemic communities as a special and heuristically important case of communities of practice, we will open new and exciting avenues of theory-making and empirical research. We illustrate our approach by examining the establishment of nuclear arms control verification practices during the Cold War and the recent spread of a populist ‘post-truth’ epistemic community of practice.
The mechanisms of unsteadiness in nominally two-dimensional (2-D) shock/turbulent-boundary-layer interactions (STBLIs) cannot be directly extended to three-dimensional (3-D) STBLIs, because of differences in interaction structure; swept 3-D interactions, including the sharp-fin and swept-compression-ramp configurations, are of particular interest in this work. Complications arise from the observation that the separation length employed to scale low-frequency unsteadiness in 2-D (spanwise homogeneous) interactions is not a global property of 3-D (swept) interactions, due to the quasi-conical symmetry of the latter. Also, flow separation in 3-D interactions is topologically different, in that closure of the primary separation cannot occur without breaking the quasi-conical symmetry of the interaction – consequently, the unsteady properties of the separation are different. To address these points, large-eddy simulations are performed to assess unsteadiness in 3-D interactions, with the aim of understanding key differences relative to analogous 2-D interactions, the former of which have received less attention in the literature. The mechanism underlying the prominent band of low-frequency unsteadiness (two decades below the characteristic boundary-layer frequency) is shown to be significantly muted in swept interactions. An interesting scaling for the band of mid-frequency unsteadiness is uncovered (at least one decade below the characteristic boundary-layer frequency). This is a consequence of the observed connection between coherent fluctuations in the separated shear layer and local mean-flow gradients, indicating a mix between competing 2-D and 3-D free-interaction scaling laws. In contrast, high-frequency fluctuations largely retain the 2-D scaling introduced by the incoming turbulent boundary layer. The spatial structure of the mid-frequency coherence in 3-D STBLIs is isolated, revealing the significant influence of these convective coherent structures on shock rippling/corrugation, as well as a spanwise dependence of coherence size consistent with the 3-D mean-flow similarity scaling. Finally, the dynamic linear response of a representative 3-D interaction is compared to that of a representative 2-D interaction; the absolute instability present in the 2-D interaction is not present in the 3-D interaction. The coincident absence of both the absolute instability and associated band of low-frequency unsteadiness in 3-D STBLIs underscores the significance of this absolute instability in facilitating low-frequency unsteadiness in 2-D interactions.
Comprehensive experimental and computational investigations have revealed possible mechanisms underlying low-frequency unsteadiness observed in spanwise homogeneous shock-wave/turbulent-boundary-layer interactions (STBLI). In the present work, we extend this understanding by examining the dynamic linear response of a moderately separated Mach 2.3 STBLI to small perturbations. The statistically stationary linear response is analysed to identify potential time-local and time-mean linear tendencies present in the unsteady base flow: these provide insight into the selective amplification properties of the flow at various points in the limit cycle, as well as asymmetry and restoring mechanisms in the dynamics of the separation bubble. The numerical technique uses the synchronized large-eddy simulation method, previously developed for free shear flows, significantly extended to include a linear constraint necessary for wall-bounded flows. The results demonstrate that the STBLI fosters a global absolute linear instability corresponding to a time-mean linear tendency for upstream shock motion. The absolute instability is maintained through constructive feedback of perturbations through the recirculation: it is self-sustaining and insensitive to external forcing. The dynamics are characterized for key frequency bands corresponding to high–mid-frequency Kelvin–Helmholtz shedding along the separated shear layer $(St_{L}\sim 0.5)$, low–mid-frequency oscillations of the separation bubble $(St_{L}\sim 0.1)$ and low-frequency large-scale bubble breathing and shock motion $(St_{L}\sim 0.03)$, where the Strouhal number is based on the nominal length of the separation bubble, $L$: $St_{L}=fL/U_{\infty }$. A band-pass filtering decomposition isolates the dynamic flow features and linear responses associated with these mechanisms. For example, in the low-frequency band, extreme shock displacements are shown to correlate with time-local linear tendencies toward more moderate displacements, indicating a restoring mechanism in the linear dynamics. However, a disparity between the linearly stable shock position and the mean shock position leads to an observed asymmetry in the low-frequency shock motion cycle, in which upstream motion occurs more rapidly than downstream motion. This is explained through competing linear and nonlinear (mass depletion through shedding) mechanisms and discussed in the context of an oscillator model. The analysis successfully illustrates how time-local linear dynamics sustain several key unsteady broadband flow features in a causal manner.
This paper combines an empirical analysis of national and international attempts to deal with the problem of poverty in China with a normative analysis of capability theory, as developed by Amartya Sen and Martha Nussbaum. In this way, it attempts to highlight the centrality of normative approaches to poverty and its elimination. The paper is in five parts. Section I analyses the history, development and effectiveness of social assistance under the Minimum Living Standards Scheme (MLSS) in China; Section II provides an outline of capability theory; Section III analyses the history, development and effectiveness of the United Nations Development Program's (UNDP) Millennium Development Goals, with a focus on the elimination of poverty in China; Section IV emphasises the importance of a capability approach to the measurement of poverty and outlines what needs to be done to reduce poverty in China; while Section V discusses what still needs to be done to promote an effective anti-poverty strategy in China.
We examined the prospective associations of objective and subjective measures of stress during pregnancy with infant stress reactivity and regulation, an early-life predictor of psychopathology. In a racially and ethnically diverse low-income sample of 151 mother–infant dyads, maternal reports of stressful life events (SLE) and perceived stress (PS) were collected serially over gestation and the early postpartum period. Infant reactivity and regulation at 6 months of age was assessed via maternal report of temperament (negativity, surgency, and regulation) and infant parasympathetic nervous system physiology (respiratory sinus arrhythmia [RSA]) during the Still Face Paradigm. Regression models predicting infant temperament showed higher maternal prenatal PS predicted lower surgency and self-regulation but not negativity. Regression models predicting infant physiology showed higher numbers of SLE during gestation predicted greater RSA reactivity and weaker recovery. Tests of interactions revealed SLE predicted RSA reactivity only at moderate to high levels of PS. Thus, findings suggest objective and subjective measures of maternal prenatal stress uniquely predict infant behavior and physiology, adjusting for key pre- and postnatal covariates, and advance the limited evidence for such prenatal programming within high-risk populations. Assessing multiple levels of maternal stress and offspring stress reactivity and regulation provides a richer picture of intergenerational transmission of adversity.
Despite years of research and practice, dissatisfaction with performance appraisal is at an all-time high. Organizations are contemplating changes to their performance management systems, the most controversial of which is whether to eliminate performance ratings. The pros and cons of retaining performance ratings were the subject of a lively, standing-room-only debate at the 2015 Society for Industrial and Organizational Psychology conference in Philadelphia (Adler, 2015). Given the high interest in this topic, this article recaps the points made by the panelists who participated in the debate. The arguments for eliminating ratings include these: (a) the disappointing interventions, (b) the disagreement when multiple raters evaluate the same performance, (c) the failure to develop adequate criteria for evaluating ratings, (d) the weak relationship between the performance of ratees and the ratings they receive, (e) the conflicting purposes of performance ratings in organizations, (f) the inconsistent effects of performance feedback on subsequent performance, and (g) the weak relationship between performance rating research and practice in organizations. The arguments for retaining ratings include (a) the recognition that changing the rating process is likely to have minimal effect on the performance management process as a whole, (b) performance is always evaluated in some manner, (c) “too hard” is no excuse for industrial–organizational (I-O) psychology, (d) ratings and differentiated evaluations have many merits for improving organizations, (e) artificial tradeoffs are driving organizations to inappropriately abandon ratings, (f) the alternatives to ratings may be worse, and (g) the better questions are these: How could performance ratings be improved, and are we conducting the entire performance management process properly? The article closes with questions organizational members have found useful for driving effective performance management reform.
Since 1945, authors and scholars have intensely debated what form literary fiction about the Holocaust should take. The works of H. G. Adler (1910-1988) and W. G. Sebald (1944-2001), two modernist scholar-poets who settled in England but never met, present new ways of reconceptualizing the nature of witnessing, literary testimony, and the possibility of a "poetics" after Auschwitz. Adler, a Czech Jew who survived Theresienstadt and Auschwitz, was a prolific writer of prose and poetry, but his work remained little known until Sebald, possibly the most celebrated German writer of recent years, cited it in his 2001 novel, Austerlitz. Since then, a rediscovery of Adler has been under way. This volume of essays by international experts on Adler and Sebald investigates the connections between the two writers to reveal a new hybrid paradigm of writing about the Holocaust that advances our understanding of the relationship between literature, historiography, and autobiography. In doing so, the volume also reflects on the wider literary-political implications of Holocaust representation, demonstrating the shifting norms in German-language "Holocaust literature." Contributors: Jeremy Adler, Jo Catling, Peter Filkins, Helen Finch, Frank Finlay, Kirstin Gwyer, Katrin Kohl, Michael Krüger, Martin Modlinger, Dora Osborne, Ruth Vogel-Klein, Lynn L. Wolff. Helen Finch is an Academic Fellow in German at the University of Leeds. Lynn L. Wolff is an Alexander von Humboldt Research Fellow in German at the University of Stuttgart.
The act of bearing witness is ineluctably dependent on real places, real events, and the utterances of real people. As such it stands in tension with Aristotelian poetics, which suggests that poets should leave the stuff of actuality to the historiographers: “It is not the poet's function to relate actual events, but the kinds of things that might occur and are possible in terms of probability or necessity.” Whereas the historian relates actual events and focuses on “the particular,” poetry is “more philosophical” and “elevated” since it “relates more of the universal.” In the German context, this philosophically oriented approach to literature was given aesthetic underpinning in the Age of Idealism, which evolved the antirhetorical ideal of the “free,” autonomous literary work of art that is liberated from the lowly constraints of historical fact and moral argument. More than any other literary tradition, however, German literature has come under pressure from historical reality. The crimes perpetrated against the Jews under National Socialism have posed an ongoing challenge, demanding conceptualization, articulation, and engagement. German literature was automatically implicated because it depends on the language used to instigate, perpetrate, and conceal those crimes, and because German was the natural language of most of those who—in various roles—witnessed the crimes as participants.
Two writers, born within 350 miles of each other, and yet worlds apart. Two writers, who would come to live, as exiles, within 100 miles of each other, work in the same academic field, share at least one important friend (Michael Hamburger) as well as an obsession with the Holocaust and its representation in literature and scholarship, and yet who never met or corresponded with one another. Two writers, the younger of whom not only read the other's works extensively but also placed him as a figure in his own text while openly using maps and figures from the elder writer's works, though the younger never wrote on or discussed the importance of the other writer in any article or interview. Finally, two writers, the older one having lived in almost complete obscurity despite publishing twenty-six books in his lifetime and several posthumous volumes since, while the younger rocketed to literary fame in middle age only to have his life end early in a terrible car crash—the elder writer having died peacefully in London years before at age seventy-eight despite having suffered the cataclysms of Theresienstadt, Auschwitz, Niederorschel, and Langenstein.
At first, one is alarmed to hear H. G. Adler and W. G. Sebald's names uttered in the same breath. Why these two in particular, and not two or three others? However, if one ponders this a few moments longer—and coincidentally happened to know both of them as I did—suddenly a network of connections arises, the entanglement of which only allows for the following conclusion: yes, these two solitary men, who likely never met one another personally, belong together.
When Winfried Georg Sebald was born in Wertach im Allgäu in 1944 at the end of the hopeless war, the Nazis deported Hans Günther Adler to Auschwitz, the second stage of his governmentally decreed humiliation, through a land whose language he loved and in which he wrote his works. The horror of Theresienstadt already lay behind him. It always remained a mystery to me how H. G. Adler, the survivor, managed to raise the strength and will to record the system of degradation which he had to experience on his own body. I imagine how he would sit in front of his typewriter in London and write—page by page, as uninvolved as possible and at the same time involved like no other—the record and the analytical penetration of the camp in which he was supposed to perish. Why did he put himself through this—to return to that prison, guided by the “muse of remembrance” which does not want to differentiate between good and evil? Why would the other survivors, those who had built this camp and who obviously had never anticipated ever being held accountable or punished, why would they not write of their crimes themselves? Why aren’t there thousands of precise descriptions of the brutality of all those executioners who, for the most part, even had time as pensioners in West Germany to come to terms with their past?
In the “Guardian Profile” which appeared in September 2001 in anticipation of the UK launch of Anthea Bell's translation of W. G. Sebald's Austerlitz (2001), interviewer Maya Jaggi describes how Sebald “loathes the term ‘Holocaust literature.’” While the assertion no doubt owes something to Adorno's famous dictum, Sebald is quoted as stating, “It's a dreadful idea that you can have a sub-genre and make a speciality out of it; it's grotesque.” Attempts at “recreations” are described as “an obscenity”—according to Jaggi, Sebald commends Lanzmann's Shoah but condemns Schindler's List—and he asserts: “I don't think you can focus on the horror of the Holocaust. It's like the head of the Medusa: you carry it with you in a sack, but if you looked at it you'd be petrified.” Turning to his own practice (referring to Die Ausgewanderten (1992; The Emigrants, 1996), but also by implication to the recently published Austerlitz), Sebald claims that “I was trying to write the lives of some people who'd survived—the ‘lucky ones.’ If they were so fraught, you can extrapolate. But I didn't see it; I only know things indirectly.”