Heading Frequency and Risk of Cognitive Impairment in Retired Male Professional Soccer Players

Importance Although professional soccer players appear to be at higher risk of neurodegenerative disease, the reason remains unknown.Objective To examine whether heading frequency is associated with risk of cognitive impairment in retired professional soccer players.Design, Setting, and Participants A UK nationwide cross-sectional study was conducted between August 15, 2020, and December 31, 2021, in 459 retired male professional soccer players older than 45 years and registered with the Professional Footballers’ Association or a League Club Players’ Association.Exposure Data on heading frequency in 3 bands—0 to 5, 6 to 15, and more than 15 times per match or training session and other soccer-specific risk factors, such as player position and concussion—were collected through a self-reported questionnaire.Main Outcomes and Measures Cognitive impairment was defined using the Telephone Interview for Cognitive Status-modified as scores of less than or equal to 21. Hopkins Verbal Learning Test, verbal fluency, and independent activities of daily living were also assessed. Test Your Memory and physician-diagnosed dementia/Alzheimer disease were self-reported via the questionnaire. Adjusted odds ratios (AORs) with 95% CIs were calculated.Results Of 468 retired male professional soccer players who completed questionnaires (mean [SD] age, 63.68 [10.48]; body mass index, 27.22 [2.89]), 459 reported heading frequency: 114 headed 0 to 5 times, 185 headed 6 to 15 times, 160 headed more than 15 times per match, and 125 headed 0 to 5 times, 174 headed 6 to 15 times, and 160 headed more than 15 times per training session during their careers. The prevalence of cognitive impairment was 9.78% (0-5 times), 14.78% (6-15 times), and 15.20% (>15 times) per match (P = .51). Compared with players reporting 0 to 5 headers per match, the AORs were 2.71 (95% CI, 0.89-8.25) for players reporting 6 to 15 headers per match and 3.53 (95% CI, 1.13-11.04) for players reporting more than 15 headers per match (P = .03 for trend). Corresponding AORs for heading frequency per training session were 2.38 (95% CI, 0.82-6.95) for those reporting 6 to 15, and 3.40 (95% CI, 1.13-10.23) for those reporting more than 15 in comparison with those who reported 0 to 5 (P = .03 for trend). Concussion involving memory loss was also associated with a greater risk of cognitive impairment (AOR, 3.16; 95% CI, 1.08-9.22). Similar results were observed with other cognitive tests and self-reported physician-diagnosed dementia/Alzheimer disease.Conclusions and Relevance The findings of this study suggest that repetitive heading during a professional soccer career is associated with an increased risk of cognitive impairment in later life. Further study is needed to establish the upper threshold for heading frequency to mitigate this risk

'Being European': UK production companies and Europe

This article discusses the relationship between UK film producers and Europe, offering a historical overview and an extended case study of an existing company, Number 9 Films. It argues that although UK film production and the attitude of policy makers have been shaped by American economic interests, Europe represents an important conceptual and cultural space that encourages producers to make films that are distinctively different from the dominant Hollywood model. Drawing on a range of commentators and original interviews, the article argues that in an era of regional porosity and transnationalism, the traditional polarity between European art cinema and commercial Hollywood is being reimagined and the boundaries re-drawn. This has created a shifting ‘middle ground’ that can be occupied by producers who are prepared to seek collaborations and funding from a varied range of sources. The case study of Number 9 Films analyses how these processes work in detail, examining the company’s multiple and cosmopolitan identities and its business model. It concludes by discussing the company’s move into ‘high end’ television drama production arguing that this shift is typical of independent UK film producers, demonstrating the increasing convergence between the two forms and also a further stage in the evolution of European audiovisual production

Star products, star capital, fan markets: Examining 1940s British film stardom through fan club publications

This paper examines the development of British film stars and fan club culture during the mid to late 1940s, through studio-sanctioned fan or star-produced magazines for the official fan clubs of British actors Jean Kent, Anne Crawford, Patricia Roc and Richard Attenborough and the British fan club for American actor Deanna Durbin. These previously unexamined resources are contextualised with contemporaneous newspaper articles, novels, film magazines andindustry publications that discuss the British star system and film star fandom. Combined, these artefacts raise prescient issues around the uncredited but essential star labour that nurtured and maintained stars’ brands, star capital and fan followings and around stars as signifiers of Britishness, wealth and status during a period of socio-cultural and film industry upheaval in austerity Britain . By considering the labour and ideologies at the heart of British film star personae and film star fan culture at its zenith, this paper broadens understandings of the British film industry and its relationship with Hollywood, and offers valuable new insights into film fandom more generally, revealing a more complex, differentiated culture of British film fan consumption and authority, British star construction and dissemination, studio control, reflexivity and economic function, than commonly assumed