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  1. Article ; Online: Repetitive head impacts among professional fighters: a pilot study evaluating Traumatic Encephalopathy Syndrome and postural balance.

    Conway Kleven, Brooke / Chien, Lung-Chang / Young, Daniel L / Cross, Chad L / Labus, Brian / Bernick, Charles

    The Physician and sportsmedicine

    2024  , Page(s) 1–7

    Abstract: Objectives: Clinical criteria for Traumatic Encephalopathy Syndrome (ccTES) were developed for research purposes to reflect the clinical symptoms of Chronic Traumatic Encephalopathy (CTE). The aims of this study were to 1) determine whether there was an ...

    Abstract Objectives: Clinical criteria for Traumatic Encephalopathy Syndrome (ccTES) were developed for research purposes to reflect the clinical symptoms of Chronic Traumatic Encephalopathy (CTE). The aims of this study were to 1) determine whether there was an association between the research diagnosis of TES and impaired postural balance among retired professional fighters, and 2) determine repetitive head impacts (RHI) exposure thresholds among both TES positive and TES negative groups in retired professional fighters when evaluating for balance impairment.
    Methods: This was a pilot study evaluating postural balance among participants of the Professional Athletes Brain Health Study (PABHS). Among the cohort, 57 retired professional fighters met the criteria for inclusion in this study. A generalized linear model with generalized estimating equations was used to compare various balance measures longitudinally between fighters with and without TES.
    Results: A significant association was observed between a TES diagnosis and worsening performance on double-leg balance assessments when stratifying by RHI exposure thresholds. Additionally, elevated exposure to RHI was significantly associated with increased odds of developing TES; The odds for TES diagnosis were 563% (95% CI = 113, 1963; p-value = 0.0011) greater among athletes with 32 or more professional fights compared to athletes with less than 32 fights when stratifying by balance measures. Likewise, the odds for TES diagnosis were 43% (95% CI = 10, 102; p-value = 0.0439) greater with worsening double leg stance balance in athletes exposed to 32 or more fights.
    Conclusion: This pilot study provides preliminary evidence of a relationship between declining postural balance and a TES diagnosis among retired professional fighters with elevated RHI exposure. Further research exploring more complex assessments such as the Functional Gait Assessment may be of benefit to improve clinical understanding of the relationship between TES, RHI, and balance.
    Language English
    Publishing date 2024-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 753046-8
    ISSN 2326-3660 ; 0091-3847
    ISSN (online) 2326-3660
    ISSN 0091-3847
    DOI 10.1080/00913847.2024.2325331
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Longitudinal Changes in Regional Brain Volumes and Cognition of Professional Fighters With Traumatic Encephalopathy Syndrome.

    Conway Kleven, Brooke D / Chien, Lung-Chang / Labus, Brian / Cross, Chad L / Ritter, Aaron / Randall, Rebekah / Montes, Arturo / Bernick, Charles

    Neurology

    2023  Volume 101, Issue 11, Page(s) e1118–e1126

    Abstract: Background and objectives: Due to current limitations in diagnosing chronic traumatic encephalopathy (CTE) clinically, traumatic encephalopathy syndrome (TES) has been proposed as the clinical presentation of suspected CTE. This study aimed to determine ...

    Abstract Background and objectives: Due to current limitations in diagnosing chronic traumatic encephalopathy (CTE) clinically, traumatic encephalopathy syndrome (TES) has been proposed as the clinical presentation of suspected CTE. This study aimed to determine whether there was an association between a clinical diagnosis of TES and subsequent temporal decline in cognitive or MRI volumetric measures.
    Methods: This was a secondary analysis of the Professional Athletes Brain Health Study (PABHS), inclusive of active and retired professional fighters older than 34 years. All athletes were adjudicated as TES positive (TES+) or TES negative (TES-) based on the 2021 clinical criteria. General linear mixed models were used to compare MRI regional brain volumes and cognitive performance between groups.
    Results: A total of 130 fighters met inclusion criteria for consensus conference. Of them, 52 fighters (40%) were adjudicated as TES+. Athletes with a TES+ diagnosis were older and had significantly lower education. Statistically significant interactions and between-group total mean differences were found in all MRI volumetric measurements among the TES+ group compared with those among the TES- group. The rate of volumetric change indicated a significantly greater increase for lateral (estimate = 5,196.65; 95% CI = 2642.65, 7750.66) and inferior lateral ventricles (estimate = 354.28; 95% CI = 159.90, 548.66) and a decrease for the hippocampus (estimate = -385.04, 95% CI = -580.47, -189.62), subcortical gray matter (estimate = -4,641.08; 95% CI = -6783.98, -2498.18), total gray matter (estimate = -26492.00; 95% CI = -50402.00, -2582.32), and posterior corpus callosum (estimate = -147.98; 95% CI = -222.33, -73.62). Likewise, the rate of cognitive decline was significantly greater for reaction time (estimate = 56.31; 95% CI = 26.17, 86.45) and other standardized cognitive scores in the TES+ group.
    Discussion: The 2021 TES criteria clearly distinguishes group differences in the longitudinal presentation of volumetric loss in select brain regions and cognitive decline among professional fighters 35 years and older. This study suggests that a TES diagnosis may be useful in professional sports beyond football, such as boxing and mixed martial arts. These findings further suggest that the application of TES criteria may be valuable clinically in predicting cognitive decline.
    MeSH term(s) Humans ; Brain Injuries, Traumatic ; Brain/diagnostic imaging ; Cognition ; Cognitive Dysfunction/diagnostic imaging ; Cognitive Dysfunction/etiology ; Chronic Traumatic Encephalopathy/diagnostic imaging
    Language English
    Publishing date 2023-06-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000207594
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: School absenteeism is linked to household food insecurity in school catchment areas in Southern Nevada

    Coughenour, Courtney / Conway Kleven, Brooke / Gakh, Maxim / Stephen, Haroon / Chien, Lung-Chang / Labus, Brian / Whaley, Regis

    Public health nutrition. 2021 Oct., v. 24, no. 15

    2021  

    Abstract: Food security and school attendance are both important for health, well-being and academic performance of children and adolescents. However, their intersection remains underexamined, especially in the USA. The current study considered the association ... ...

    Abstract Food security and school attendance are both important for health, well-being and academic performance of children and adolescents. However, their intersection remains underexamined, especially in the USA. The current study considered the association between elementary school-level absenteeism and household food insecurity. The current study linked school-level absenteeism and household food insecurity rates using geographic information system mapping and applied the tobit regression model to examine their association. The Clark County, Nevada, public school district – the fifth largest in the USA and in a state with disproportionate food insecurity and chronic school absenteeism rates. Data consisted of school-level absenteeism rates from 185 elementary schools and census tract-level household food insecurity rates. Average daily attendance rates were lower for schools with catchment areas that had higher average household food insecurity (FI), decreasing by −0·0232 % per 1 % increase in FI rate (P-value = 0·022). They were also significantly associated with most absenteeism risk factors. Average daily attendance rate was negatively associated with Free and Reduced Lunch eligibility percentage (−0·010 per 1 % increase in FI, P-value < 0·001) and Individualized Education Program participation percentage (−0·039 % per 1 % increase in FI, P-value = 0·033), but positively associated with parent–teacher conference participation rate (0·006 % per 1 % increase in FI, P-value = 0·025) and white student percentage (0·011 % per 1 % increase in FI, P-value = 0·022). The current study suggests a link between household food insecurity and elementary school-level absenteeism. Understanding this link is important for policy and practice because schools are frequent settings for food insecurity mitigation interventions.
    Keywords academic achievement ; education programs ; food security ; geographic information systems ; issues and policy ; lunch ; public health ; public schools ; regression analysis ; watersheds ; Nevada
    Language English
    Dates of publication 2021-10
    Size p. 5074-5080.
    Publishing place Cambridge University Press
    Document type Article
    ZDB-ID 1436024-x
    ISSN 1475-2727 ; 1368-9800
    ISSN (online) 1475-2727
    ISSN 1368-9800
    DOI 10.1017/S136898002100063X
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: School absenteeism is linked to household food insecurity in school catchment areas in Southern Nevada.

    Coughenour, Courtney / Conway Kleven, Brooke / Gakh, Maxim / Stephen, Haroon / Chien, Lung-Chang / Labus, Brian / Whaley, Regis

    Public health nutrition

    2021  Volume 24, Issue 15, Page(s) 5074–5080

    Abstract: Objectives: Food security and school attendance are both important for health, well-being and academic performance of children and adolescents. However, their intersection remains underexamined, especially in the USA. The current study considered the ... ...

    Abstract Objectives: Food security and school attendance are both important for health, well-being and academic performance of children and adolescents. However, their intersection remains underexamined, especially in the USA. The current study considered the association between elementary school-level absenteeism and household food insecurity.
    Design: The current study linked school-level absenteeism and household food insecurity rates using geographic information system mapping and applied the tobit regression model to examine their association.
    Setting: The Clark County, Nevada, public school district - the fifth largest in the USA and in a state with disproportionate food insecurity and chronic school absenteeism rates.
    Participants: Data consisted of school-level absenteeism rates from 185 elementary schools and census tract-level household food insecurity rates.
    Results: Average daily attendance rates were lower for schools with catchment areas that had higher average household food insecurity (FI), decreasing by -0·0232 % per 1 % increase in FI rate (P-value = 0·022). They were also significantly associated with most absenteeism risk factors. Average daily attendance rate was negatively associated with Free and Reduced Lunch eligibility percentage (-0·010 per 1 % increase in FI, P-value < 0·001) and Individualized Education Program participation percentage (-0·039 % per 1 % increase in FI, P-value = 0·033), but positively associated with parent-teacher conference participation rate (0·006 % per 1 % increase in FI, P-value = 0·025) and white student percentage (0·011 % per 1 % increase in FI, P-value = 0·022).
    Conclusions: The current study suggests a link between household food insecurity and elementary school-level absenteeism. Understanding this link is important for policy and practice because schools are frequent settings for food insecurity mitigation interventions.
    MeSH term(s) Absenteeism ; Adolescent ; Child ; Food Insecurity ; Food Supply ; Humans ; Nevada ; Schools
    Language English
    Publishing date 2021-02-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1436024-x
    ISSN 1475-2727 ; 1368-9800
    ISSN (online) 1475-2727
    ISSN 1368-9800
    DOI 10.1017/S136898002100063X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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