Between memory and erasure: Zézé Gamboa’s O Grande Kilapy and the legacy of portuguese colonialism

While the 40th anniversary of the “fall of the Portuguese Empire” has provoked fresh critical approaches to the colonial legacy within Portugal, much less attention has been paid to how memories of colonialism are being reconfigured within contemporary lusophone African cultural production. The films of Angolan director Zézé Gamboa have thus far received very little academic attention, particularly his most recent feature, O Grande Kilapy (2012) (The Great Kilapy), which is the focus of this article. Yet the film demonstrates the urgency of redeeming memory in a postcolonial society, and how the power to silence such memories is embedded in the geopolitical structures of the lusophone world. This article will demonstrate how Gamboa decolonises the imagination by reclaiming memories and reframing history, but also how this very redemption and transmission of memories is limited by production and distribution constraints imposed upon the film itself, defined by configurations of power within the postcolonial lusophone space. Therefore, while recognising the importance of the archive for memory, as Pierre Nora proposes, this article will posit that alternative strategies, present within O Grande Kilapy, such as the oral transmission of stories, are essential for working around such constraints

Speech and swallowing rehabilitation in the home: A comparison of two service delivery models for stroke survivors

Background and Aims Speech and swallowing difficulties are common sequelae for people who have suffered a stroke. Recently, there has been an increase in early discharge, community rehabilitation and the use of therapy assistants to support health professionals in stroke rehabilitation. However, the impact of these factors on communication and swallowing outcomes remains under researched. This research explored Rehabilitation in the Home (RITH) Speech Pathology (SP) services for stroke survivors with dysarthria and dysphagia. More specifically, this research investigated whether traditional speech pathology interventions, supplemented with a home practice program are effective, as well as compare usual treatment to that provided by a therapy assistant. Additionally, the experiences of the key stakeholders were also examined. Methods and Procedures Stroke survivors and their carers were recruited from RITH services in Perth, Western Australia into this pilot comparative group study. Stroke survivors with a recent stroke diagnosis and associated dysarthria and/or oral stage dysphagia were randomly allocated to either: a) treatment as usual with a speech pathologist (TAU) or b) intensive treatment with a speech pathologist and a supervised therapy assistant (INT). Evidence-based dysarthria and dysphagia treatment program content was controlled for both groups and all participants were encouraged to complete independent home practice daily. The stroke survivors were assessed at three time points, at baseline, immediately post therapy and at two months post stroke with a range of speech, swallowing and psycho-social outcome measures. The perceptions, experiences and preferences of the stroke survivors and the carers were collected through questionnaires after therapy had ceased. The speech and swallowing outcome measures were analysed using a 2x2 mixed model ANOVA and the questionnaires were analysed using qualitative content analysis. Results Ten stroke survivors and their carers (n= 10) were recruited into TAU (n=5) or INT (n=5) intervention groups. The stroke survivors had an average time post onset of stroke of 39.6 days. Stroke survivors participated in regular and intensive levels of RITH SP and all completed some degree of home practice. Therapy was provided over a three week period and TAU participants received M= 470 mins (SD=85.22) and INT participants received M= 909 mins (SD=175.58) of professionally led therapy. Within groups analyses revealed a statistically significant treatment effect over time for scores on the Dysarthria Impact Profile, oral motor function, speech intelligibility, water swallow test and the chewed cookie test. There was no significant difference over time for speech rate. There were no statistically significant differences between the TAU and the INT groups on any of the measures. Carers and stroke survivors gave positive reports of RITH SP with both groups noting improvements in the stroke survivors’ speech and swallowing and commenting on the benefits of receiving rehabilitation in the home. Many stroke survivors valued and desired intensive speech pathology services; with the use of therapy assistants viewed positively by those in the INT group. Stroke survivors reported that they had difficulty practicing independently with most carers being involved with home-based speech pathology intervention. Conclusions Stroke survivors in an early phase of recovery were able to participate in RITH SP and benefitted from a speech pathology intervention program targeting dysarthria and dysphagia. Intensive speech pathology and therapy assistant intervention was as effective as usual care by a speech pathologist with improvements made by all stroke survivors across the majority of speech and swallowing measures. Stroke survivors were able to complete home practice and provided positive reports on the program, staff and setting. Home practice may be difficult for stroke survivors in the early stages post stroke, and may require support with its completion. Further investigation into the effectiveness and acceptability of home based therapy, the use of therapy assistants and the role of the carer as well as the ease and impact of home programs is require

Carer experiences with rehabilitation in the home: speech pathology services for stroke survivors

Caring for a stroke survivor can be a complex role with carers at an increased risk of mental health difficulties. Early supported discharge from hospital with rehabilitation in the home (RITH) allows stroke survivors to return home at an earlier stage in the recovery process, potentially placing an extra burden on carers. Being involved in intensive therapy,in the home, in the early days post-stroke may be difficult with the role and experiences of carers in RITH being underresearched. This paper identifies the roles, experiences and preferences of ten carers of stroke survivors with dysarthia and dysphagia. Many carers were involved with RITH speech pathology rehabilitation and reported positively on services. Cultural and linguistic issues and the implications of home practice for carers are also discussed

Entre a memória e o seu apagamento: O Grande Kilapy de Zézé Gamboa e o legado do colonialismo português

O 40º aniversário da “queda do império português” tem suscitado novas abordagens críticas ao legado colonial em Portugal. No entanto, a reconfiguração das memórias do colonialismo na produção cultural contemporânea da África dita lusófona tem recebido muito menos atenção. Até hoje, os filmes do cineasta angolano Zézé Gamboa têm sido pouco discutidos de um ponto de vista académico, em particular o seu filme mais recente, O Grande Kilapy (2012), que constitui o tema deste artigo. O filme revela a urgência de redimir a memória numa sociedade pós-colonial, bem como a forma como o poder de silenciar tais memórias se encontra situado nas estruturas geopolíticas do chamado mundo lusófono. Este artigo demonstrará como Gamboa contribui para a descolonização do imaginário ao reclamar memórias e ao reenquadrar a história, mas também como esta redenção e transmissão da memória se encontra limitada pelos constrangimentos de produção e de distribuição enfrentados pelo próprio filme e determinados pelas configurações de poder características do espaço lusófono pós-colonial. Desta forma, e embora reconhecendo a importância do arquivo para a memória, tal como propôs Pierre Nora, este artigo proporá que as estratégias alternativas empregues pelo O Grande Kilapy, tais como a transmissão oral de histórias, são essenciais para superar estes limites

Cardiac death in the young in Scotland: implications for screening

Cardiovascular pre-participation screening in sport remains a controversial area. The general consensus is that it should be available given the increased risk of sudden cardiac death with exercise, but debate exists to the format of this screening. Part 1 of this thesis examines the incidence and epidemiology of death in young people to set the context; Part 2 evaluates the results of the Cardiac Assessment in Young Athletes (CAYA) programme in Scotland. Part 1 investigated a database of 41,049 deaths in those aged 0-35 years in Scotland from 1986-2008. Information such as location of death, whether a PM had taken place and cause of death was examined for all subjects with deaths categorised as those which occurred in-hospital or out-of-hospital and by age category and sex. Cardiac deaths (n=2084) were then investigated further. Analysis showed that the majority of deaths in young people in Scotland are due to accidents (27%), self-harm (16.2%) and cancers (11.8%). Coronary artery disease is the largest contributor of cardiac deaths in young people in Scotland (30%) with the greatest number occurring out-of-hospital (55.3%). Only a relatively small number of deaths (0.9% of total) were due to conditions that would be identified and potentially prevented by a cardiac screening programme. Part 2: The CAYA study was based on the Italian Model of screening by personal and family history, physical examination and resting 12-lead ECG, with the addition of an echocardiogram for all participants. Data was available for 1713 subjects from the CAYA study from October 2009-December 2012. Results showed a high incidence of hypertension in this young, athletic population, with a pilot study suggesting that this is likely to be 'white coat hypertension'. Screening with ECG identified 3 subjects with Wolff Parkinson-White syndrome and 1 with Long QT syndrome. Around 5% of subjects demonstrated left ventricular hypertrophy out with normal limits on echo (>13mm), but no structural abnormalities such as cardiomyopathy were diagnosed. Use of the ECG in cardiac screening remains controversial but these results suggest that, although the ECG is not a useful diagnostic tool for identifying those with left ventricular hypertrophy, it has a high negative predictive value meaning it can identify those without pathology. In conclusion, these results do not support the inclusion of echocardiography as a tool in cardiovascular screening in Scotland. The majority of cardiovascular deaths identified in this study were due to undiagnosed coronary heart disease which would not be identified by screening. Other causes of sudden cardiac death which may be identified by screening, such as familial arrhythmias and cardiomyopathies, are rare in Scotland. A screening service with ECG should be available to athletes and young people in Scotland but this should remain voluntary for those with symptoms or a positive family history. Improved first aid education and provision of defibrillators at sporting facilities would perhaps help to reduce the number of fatalities that occur in young athletes

The role of negative urgency in risky alcohol drinking and binge-eating in United Kingdom male and female students

Identifying students at risk of developing binge-eating and alcohol use disorders is a priority in the United Kingdom (UK). Although relationships between negative urgency (impulsive behavior during times of negative emotion), risky drinking, and binge-eating have been established in students from other countries, these links have yet to be replicated in male and female UK students. UK students aged 18–30 (n = 155) completed the: (1) the Urgency, Pre-meditation, Perseverance, Sensation Seeking (UPPS-P) negative urgency subscale; (2) Alcohol Use Disorders Identification Test (AUDIT); and (3) Binge-Eating Scale (BES). For categorical analysis, participants were assigned to one of four groups as a function of AUDIT and BES clinical cut-off scores: (1) no risk (28%); (2) risky drinkers (47%); (3) binge-eaters (6%); and (4) risky drinkers + binge-eaters (19%). For dimensional analysis, across students with non-zero AUDIT and BES scores (n = 141), BES, AUDIT, gender, and their interactions were entered as predictors in the same block of a regression. UPPS-P negative urgency was the dependent variable. Categorical results indicated that binge-eaters with and without risky drinking endorsed significantly higher negative urgency than students with no risk. Dimensional results showed that although higher BES and AUDIT scores were positively linked to higher negative urgency, but only the BES was significantly associated. Furthermore, BES shared substantially more variance with negative urgency than the AUDIT, and the BES-negative urgency relationship was stronger in male students than female students. High risk students may benefit the most from interventions that help regulate negative emotion

Football’s InfluencE on Lifelong health and Dementia risk (FIELD): protocol for a retrospective cohort study of former professional footballers

Introduction: In the past decade, evidence has emerged suggesting a potential link between contact sport participation and increased risk of late neurodegenerative disease, in particular chronic traumatic encephalopathy. While there remains a lack of clear evidence to test the hypothesis that contact sport participation is linked to an increased incidence of dementia, there is growing public concern regarding the risk. There is, therefore, a pressing need for research to gain greater understanding of the potential risks involved in contact sports participation, and to contextualise these within holistic health benefits of sport. Methods and analysis: Football’s InfluencE on Lifelong health and Dementia risk is designed as a retrospective cohort study, with the aim to analyse data from former professional footballers (FPF) in order to assess the incidence of neurodegenerative disease in this population. Comprehensive electronic medical and death records will be analysed and compared with those of a demographically matched population control cohort. As well as neurodegenerative disease incidence, all-cause, and disease-specific mortality, will be analysed in order to assess lifelong health. Cox proportional hazards models will be run to compare the data collected from FPFs to matched population controls. Ethics and dissemination: Approvals for study have been obtained from the University of Glasgow College of Medical, Veterinary and Life Sciences Research Ethics Committee (Project Number 200160147) and from National Health Service Scotland’s Public Benefits and Privacy Panel (Application 1718-0120)

Neurodegenerative disease mortality among former professional soccer players

Background: Neurodegenerative disorders have been reported in elite athletes who participated in contact sports. The incidence of neurodegenerative disease among former professional soccer players has not been well characterized. Methods: We conducted a retrospective cohort study to compare mortality from neurodegenerative disease among 7676 former professional soccer players (identified from databases of Scottish players) with that among 23,028 controls from the general population who were matched to the players on the basis of sex, age, and degree of social deprivation. Causes of death were determined from death certificates. Data on medications dispensed for the treatment of dementia in the two cohorts were also compared. Prescription information was obtained from the national Prescribing Information System. Results: Over a median of 18 years, 1180 former soccer players (15.4%) and 3807 controls (16.5%) died. All-cause mortality was lower among former players than among controls up to the age of 70 years and was higher thereafter. Mortality from ischemic heart disease was lower among former players than among controls (hazard ratio, 0.80; 95% confidence interval [CI], 0.66 to 0.97; P=0.02), as was mortality from lung cancer (hazard ratio, 0.53; 95% CI, 0.40 to 0.70; P<0.001). Mortality with neurodegenerative disease listed as the primary cause was 1.7% among former soccer players and 0.5% among controls (subhazard ratio [the hazard ratio adjusted for competing risks of death from ischemic heart disease and death from any cancer], 3.45; 95% CI, 2.11 to 5.62; P<0.001). Among former players, mortality with neurodegenerative disease listed as the primary or a contributory cause on the death certificate varied according to disease subtype and was highest among those with Alzheimer’s disease (hazard ratio [former players vs. controls], 5.07; 95% CI, 2.92 to 8.82; P<0.001) and lowest among those with Parkinson’s disease (hazard ratio, 2.15; 95% CI, 1.17 to 3.96; P=0.01). Dementia-related medications were prescribed more frequently to former players than to controls (odds ratio, 4.90; 95% CI, 3.81 to 6.31; P<0.001). Mortality with neurodegenerative disease listed as the primary or a contributory cause did not differ significantly between goalkeepers and outfield players (hazard ratio, 0.73; 95% CI, 0.43 to 1.24; P=0.24), but dementia-related medications were prescribed less frequently to goalkeepers (odds ratio, 0.41; 95% CI, 0.19 to 0.89; P=0.02). Conclusions: In this retrospective epidemiologic analysis, mortality from neurodegenerative disease was higher and mortality from other common diseases lower among former Scottish professional soccer players than among matched controls. Dementia-related medications were prescribed more frequently to former players than to controls. These observations need to be confirmed in prospective matched-cohort studies. (Funded by the Football Association and Professional Footballers’ Association.

Restraint, disinhibition and food-related processing bias

This study examined associations between restraint, disinhibition and food-related processing bias (FPB, assessed by the emotional Stroop task) in males and females in the UK, Greece and Iran. Results showed high restraint was associated with higher FPB. However, high restrained current dieters showed lower FPB that high restrained non-dieters. There was no significant difference in FPB for those showing high versus low disinhibition. Results are discussed in relation to theories of incentive salience and current concerns

Association of field position and career length with risk of neurodegenerative disease in male former professional soccer players

Importance: Neurodegenerative disease mortality is higher among former professional soccer players than general population controls. However, the factors contributing to increased neurodegenerative disease mortality in this population remain uncertain. Objective: To investigate the association of field position, professional career length, and playing era with risk of neurodegenerative disease among male former professional soccer players. Design, Setting, and Participants: This cohort study used population-based health record linkage in Scotland to evaluate risk among 7676 male former professional soccer players born between January 1, 1900, and January 1, 1977, and 23 028 general population control individuals matched by year of birth, sex, and area socioeconomic status providing 1 812 722 person-years of follow-up. Scottish Morbidity Record and death certification data were available from January 1, 1981, to December 31, 2016, and prescribing data were available from January 1, 2009, to December 31, 2016. Database interrogation was performed on December 10, 2018, and data were analyzed between April 2020 and May 2021. Exposures: Participation in men’s soccer at a professional level. Main Outcomes and Measures: Outcomes were obtained by individual-level record linkage to national electronic records of mental health and general hospital inpatient and day-case admissions as well as prescribing information and death certification. Risk of neurodegenerative disease was evaluated between former professional soccer players and matched general population control individuals. Results: In this cohort study of 30 704 male individuals, 386 of 7676 former soccer players (5.0%) and 366 of 23 028 matched population control individuals (1.6%) were identified with a neurodegenerative disease diagnosis (hazard ratio [HR], 3.66; 95% CI, 2.88-4.65; P < .001). Compared with the risk among general population control individuals, risk of neurodegenerative disease was highest for defenders (HR, 4.98; 95% CI, 3.18-7.79; P < .001) and lowest for goalkeepers (HR, 1.83; 95% CI, 0.93-3.60; P = .08). Regarding career length, risk was highest among former soccer players with professional career lengths longer than 15 years (HR, 5.20; 95% CI, 3.17-8.51; P < .001). Regarding playing era, risk remained similar for all players born between 1910 and 1969. Conclusions and Relevance: The differences in risk of neurodegenerative disease observed in this cohort study imply increased risk with exposure to factors more often associated with nongoalkeeper positions, with no evidence this association has changed over the era studied. While investigations to confirm specific factors contributing to increased risk of neurodegenerative disease among professional soccer players are required, strategies directed toward reducing head impact exposure may be advisable in the meantime