Impact Of Chronic Traumatic Encephalopathy On American Football

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League of Denial

Author : Mark Fainaru-Wada
Publisher : Crown
ISBN 13 : 0770437567
Total Pages : 457 pages
Book Rating : 4.7/5 (74 download)

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Book Synopsis League of Denial by : Mark Fainaru-Wada

Download or read book League of Denial written by Mark Fainaru-Wada and published by Crown. This book was released on 2014-08-26 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: NEW YORK TIMES BESTSELLER • The story of how the NFL, over a period of nearly two decades, denied and sought to cover up mounting evidence of the connection between football and brain damage “League of Denial may turn out to be the most influential sports-related book of our time.”—The Boston Globe “Professional football players do not sustain frequent repetitive blows to the brain on a regular basis.” So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new scourge: a chronic brain disease that was driving an alarming number of players—including some of the all-time greats—to madness. In League of Denial, award-winning ESPN investigative reporters Mark Fainaru-Wada and Steve Fainaru tell the story of a public health crisis that emerged from the playing fields of our twenty-first-century pastime. Everyone knows that football is violent and dangerous. But what the players who built the NFL into a $10 billion industry didn’t know—and what the league sought to shield from them—is that no amount of padding could protect the human brain from the force generated by modern football, that the very essence of the game could be exposing these players to brain damage. In a fast-paced narrative that moves between the NFL trenches, America’s research labs, and the boardrooms where the NFL went to war against science, League of Denial examines how the league used its power and resources to attack independent scientists and elevate its own flawed research—a campaign with echoes of Big Tobacco’s fight to deny the connection between smoking and lung cancer. It chronicles the tragic fates of players like Hall of Fame Pittsburgh Steelers center Mike Webster, who was so disturbed at the time of his death he fantasized about shooting NFL executives, and former San Diego Chargers great Junior Seau, whose diseased brain became the target of an unseemly scientific battle between researchers and the NFL. Based on exclusive interviews, previously undisclosed documents, and private emails, this is the story of what the NFL knew and when it knew it—questions at the heart of a crisis that threatens football, from the highest levels all the way down to Pop Warner.

Sports-Related Concussions in Youth

Author : National Research Council
Publisher : National Academies Press
ISBN 13 : 0309288037
Total Pages : 215 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Sports-Related Concussions in Youth by : National Research Council

Download or read book Sports-Related Concussions in Youth written by National Research Council and published by National Academies Press. This book was released on 2014-02-04 with total page 215 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms. The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.

CTE, Media, and the NFL

Author : Travis R. Bell
Publisher : Rowman & Littlefield
ISBN 13 : 1498570577
Total Pages : 183 pages
Book Rating : 4.4/5 (985 download)

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Book Synopsis CTE, Media, and the NFL by : Travis R. Bell

Download or read book CTE, Media, and the NFL written by Travis R. Bell and published by Rowman & Littlefield. This book was released on 2019-06-25 with total page 183 pages. Available in PDF, EPUB and Kindle. Book excerpt: CTE, Media, and the NFL: Framing a Public Health Crisis as a Football Epidemic examines the central role of mediain constructing an entangled relationship between chronic traumatic encephalopathy (CTE) and the National Football League (NFL), challenging a predominately symbiotic sports/media complex. The authors of this book analyze more than a decade of media coverage, along with three prominent films, to unpack how media discourse resurrects CTE, a preventable degenerative brain disease linked to boxing in 1928, and subsequently frames it as a football epidemic dating back to 2005. The authors position CTE as a public health crisis, whereby media coverage of CTE and the NFL’s vigorous reliance on controversial published research by the Mild Traumatic Brain Injury (MTBI) Committee parallels the moral panic of the HIV/AIDS epidemic and Big Tobacco’s manufacturing of doubt through faulty science. This book argues that the continued aspiration and idolization of the NFL, and its lack of accountability for health concerns surrounding brain injuries, highlight the firm grasp of hegemonic masculinity on the ideology of American football - further problematizing media’s glorification of the sport. Scholars of sports media, health communication, and general media studies will find this book particularly useful to discuss longitudinal effects of media framing centered on critical health risks in sport and the challenge of translating accurate scientific knowledge to the public domain.

Brain Injury Medicine E-Book

Author : Blessen C. Eapen
Publisher : Elsevier Health Sciences
ISBN 13 : 0323779441
Total Pages : 594 pages
Book Rating : 4.3/5 (237 download)

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Book Synopsis Brain Injury Medicine E-Book by : Blessen C. Eapen

Download or read book Brain Injury Medicine E-Book written by Blessen C. Eapen and published by Elsevier Health Sciences. This book was released on 2020-07-17 with total page 594 pages. Available in PDF, EPUB and Kindle. Book excerpt: The only review book currently available in this complex field, Brain Injury Medicine: Board Review focuses on the prevention, diagnosis, treatment, and management of individuals with varying severity levels of brain injury. Focused, high-yield content prepares you for success on exams and in practice, with up-to-date coverage of traumatic brain injury (TBI), stroke, CNS neoplasms, anoxic brain injury, and other brain disorders. This unique review tool is ideal for residents, fellows, and practitioners studying or working in the field and preparing to take the brain injury medicine exam. - Supports self-assessment and review with 200 board-style questions and explanations. - Covers the information you need to know on traumatic brain injury by severity and pattern, neurologic disorders, systemic manifestations, rehabilitation problems and outcomes, and basic science. - Includes questions on patient management including patient evaluation and diagnosis, prognosis/risk factors, and applied science. - Discusses key topics such as neurodegeneration and dementia; proteomic, genetic, and epigenetic biomarkers in TBI; neuromodulation and neuroprosthetics; and assistive technology. - Reviews must-know procedures including acute emergency management and critical care; post-concussion syndrome assessment, management and treatment; diagnostic procedures and electrophysiology; neuroimaging, and brain death criteria. - Ensures efficient, effective review with content written by experts in physical medicine and rehabilitation, neurology, and psychiatry and a format that mirrors the board exam outline.

Chronic Traumatic Encephalopathy (CTE)

Author : Charles J. Golden
Publisher : Springer
ISBN 13 : 3030232883
Total Pages : 67 pages
Book Rating : 4.0/5 (32 download)

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Book Synopsis Chronic Traumatic Encephalopathy (CTE) by : Charles J. Golden

Download or read book Chronic Traumatic Encephalopathy (CTE) written by Charles J. Golden and published by Springer. This book was released on 2019-06-20 with total page 67 pages. Available in PDF, EPUB and Kindle. Book excerpt: The term chronic traumatic encephalopathy (CTE) has recently gained a significant amount of media coverage. However, a large proportion of the information disseminated through the media pertaining to the etiology, neuropathology, and clinical manifestations of CTE are not corroborated by empirical research, and are disputed by prominent researchers who study sports related head injury. This book reviews the existing literature pertaining to these components of CTE and includes unique case studies of several retired NFL players that received a comprehensive neuropsychological battery from a board certified neuropsychologist, among other populations. It investigates the claim that CTE causes depression, violent behavior, and an increased risk for suicide by providing an in depth discussion using empirical data. Highlighting the importance of adhering to post concussion protocol and appreciating the long-term consequences of repeated head trauma, this unique review of the current research on CTE will be useful to students and professionals in psychology and neurology.

Impact of Chronic Traumatic Encephalopathy on American Football

Author :
Publisher : GRIN Verlag
ISBN 13 : 3346264742
Total Pages : 24 pages
Book Rating : 4.3/5 (462 download)

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Book Synopsis Impact of Chronic Traumatic Encephalopathy on American Football by :

Download or read book Impact of Chronic Traumatic Encephalopathy on American Football written by and published by GRIN Verlag. This book was released on 2020-10-07 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pre-University Paper from the year 2018 in the subject Health - Sport - Sport Medicine, Therapy, Prevention, Nutrition, grade: 1,0, , language: English, abstract: This paper gives an overview about the current discussion oft he impact of Chronic Traumatic Encephalopathy (CTE) on American Football. Therefore, chapter 2 gives a brief historic overview on the research of head injuries, defines the disease, analyses symptoms, risk factors and stages of CTE as well as the current medical therapies. Football is not only a multi-million-dollar business but represents the American dream and way of life like no other sport. An overview of the different involved stakeholders and their economic and individual interests will be given. This economic and cultural importance of football for the nation will be highlighted and explored in chapter 3. Chapter 4 explores the impact of CTE on the sport. This covers the current research and development of new materials and future technologies in personal protection equipment and also changes in the rules and format of the game. Consequences of awareness campaigns and controversial debates will be highlighted. Chapter 5 evaluates the different aspects, discusses the impact CTE will have on American football and gives an outlook for the future of the game.

Unintended Impact: One Athlete's Journey from Concussions in Amateur Football to CTE Dementia

Author : Jim Proebstle
Publisher :
ISBN 13 : 9781592988839
Total Pages : 266 pages
Book Rating : 4.9/5 (888 download)

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Book Synopsis Unintended Impact: One Athlete's Journey from Concussions in Amateur Football to CTE Dementia by : Jim Proebstle

Download or read book Unintended Impact: One Athlete's Journey from Concussions in Amateur Football to CTE Dementia written by Jim Proebstle and published by . This book was released on 2015-05-01 with total page 266 pages. Available in PDF, EPUB and Kindle. Book excerpt: After suffering concussions in high school and college, Dick struggled unknowingly with the onset of Chronic Traumatic Encephalopathy (CTE) dementia. For decades, he fought the demons trapping him in an ever-shrinking world: diminished short-term memory, limited executive functioning, interpersonal shortcomings, paranoia, and failed physical capabilities. As an athlete, he was revered, yet success turned traitor as getting his ''bell rung'' in football led to a world of confusion and confinement. Nobody will remember a backup college quarterback, but Dick's story bridges the glamour of NFL football--its high-profile athletes and the preliminary $765 million settlement for CTE dementia--with the harsh reality that millions of former amateur players may be suffering anonymously with the same concussion-induced devastation of CTE dementia.

Medical Aspects of Boxing

Author : Barry Jordan
Publisher : CRC Press
ISBN 13 : 9780849342813
Total Pages : 354 pages
Book Rating : 4.3/5 (428 download)

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Book Synopsis Medical Aspects of Boxing by : Barry Jordan

Download or read book Medical Aspects of Boxing written by Barry Jordan and published by CRC Press. This book was released on 1992-11-23 with total page 354 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medical Aspects of Boxing is a comprehensive text that serves as an excellent general reference for all healthcare providers involved with boxing. The major focus of the book is geared toward the neurological aspects of boxing. An entire section of the volume is devoted to such topics as acute and chronic brain injury, neuroradiology, neuropsychology, electrophysiology, and epidemiology of brain injury. General concepts of boxing, including the role of the ringside physician, differences between amateur and professional boxing, socio-medical aspects of boxing, and non-neurological medical aspects of boxing are also discussed.

Translational Research in Traumatic Brain Injury

Author : Daniel Laskowitz
Publisher : CRC Press
ISBN 13 : 1498766579
Total Pages : 388 pages
Book Rating : 4.4/5 (987 download)

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Book Synopsis Translational Research in Traumatic Brain Injury by : Daniel Laskowitz

Download or read book Translational Research in Traumatic Brain Injury written by Daniel Laskowitz and published by CRC Press. This book was released on 2016-04-21 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme

Research Anthology on Business Strategies, Health Factors, and Ethical Implications in Sports and eSports

Author : Management Association, Information Resources
Publisher : IGI Global
ISBN 13 : 1799877523
Total Pages : 1008 pages
Book Rating : 4.7/5 (998 download)

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Book Synopsis Research Anthology on Business Strategies, Health Factors, and Ethical Implications in Sports and eSports by : Management Association, Information Resources

Download or read book Research Anthology on Business Strategies, Health Factors, and Ethical Implications in Sports and eSports written by Management Association, Information Resources and published by IGI Global. This book was released on 2020-11-27 with total page 1008 pages. Available in PDF, EPUB and Kindle. Book excerpt: From issues of racism to the severity of concussions to celebrity endorsements, the sports industry continues to significantly impact society. With the rise of eSports and its projection as the next billion dollar industry, it is vital that a multifaceted approach to sports research be undertaken. On one side, businesses are continually offering new methods for marketing and branding and finding the best ways to enhance consumer engagement and the consumer experience. On the other side, there has been progress and new findings in the physical fitness and training of the athletes themselves along with discussions on their psychology and wellbeing. This two-tiered approach to analyzing sports and eSports from a practical business perspective, along with a lens placed on the athletes themselves, provides a comprehensive view of the current advancements, technologies, and strategies within various aspects of the sports and esports industry. Research Anthology on Business Strategies, Health Factors, and Ethical Implications in Sports and eSports covers the latest findings on all factors of sports: the branding and marketing of sports and eSports, studies on athletes and consumers, a dive into the ethics of sports, and the introduction of eSports to the industry. This wide coverage of all fields of research recently conducted leads this book to be a well-rounded view of how sports are functioning in modern times. Highlighted topics include branding tactics, consumer engagement, eSports history and technologies, ethics and law, and psychological studies of athlete wellness. This book is ideal for sports managers, athletes, trainers, marketers, brand managers, advertisers, practitioners, stakeholders, researchers, academicians, and students interested working in the fields of sports medicine, law, physical education, assistive technologies, marketing, consumer behavior, and psychology.

Ferri's Clinical Advisor 2021

Author : Fred F. Ferri
Publisher : Elsevier Health Sciences
ISBN 13 : 0323713343
Total Pages : 4158 pages
Book Rating : 4.3/5 (237 download)

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Book Synopsis Ferri's Clinical Advisor 2021 by : Fred F. Ferri

Download or read book Ferri's Clinical Advisor 2021 written by Fred F. Ferri and published by Elsevier Health Sciences. This book was released on 2020-06-10 with total page 4158 pages. Available in PDF, EPUB and Kindle. Book excerpt: Find fast answers to inform your daily diagnosis and treatment decisions! Ferri’s Clinical Advisor 2021 uses the popular "5 books in 1" format to deliver vast amounts of information in a clinically relevant, user-friendly manner. This bestselling reference has been significantly updated to provide you with easy access to answers on 1,000 common medical conditions, including diseases and disorders, differential diagnoses, clinical algorithms, laboratory tests, and clinical practice guidelines—all carefully reviewed by experts in key clinical fields. Extensive algorithms, along with hundreds of new figures and tables, ensure that you stay current with today's medical practice. Contains significant updates throughout, covering all aspects of current diagnosis and treatment. Features 27 all-new topics including chronic rhinosinusitis, subclinical brain infarction, reflux-cough syndrome, radiation pneumonitis, catatonia, end-stage renal disease, and genitourinary syndrome of menopause, among others. Includes new appendices covering common herbs in integrated medicine and herbal activities against pain and chronic diseases; palliative care; and preoperative evaluation. Offers online access to Patient Teaching Guides in both English and Spanish.

Kids, Sports, and Concussion

Author : William Paul Meehan III
Publisher : Bloomsbury Publishing USA
ISBN 13 :
Total Pages : 210 pages
Book Rating : 4.2/5 (161 download)

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Book Synopsis Kids, Sports, and Concussion by : William Paul Meehan III

Download or read book Kids, Sports, and Concussion written by William Paul Meehan III and published by Bloomsbury Publishing USA. This book was released on 2018-02-08 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive summary of sport-related concussion for parents, coaches, and athletes that considers the physics behind the injury, identifies what can be done to reduce the risk of its occurrence, and describes how to respond to a suspected concussion. Concussion injury among athletes continues to be a subject of great concern. Increasing attention and research is focusing on the most vulnerable of athletes—children. What strategies can be taken to best protect young athletes in sports from grammar school football leagues to high school hockey and soccer teams from concussion? How do we treat youngsters who suffer head injuries in sports? What are the ethical considerations in allowing children to play such sports, given the risks to still-developing brains? In this updated and expanded guide, William Meehan, MD, explains simply and clearly how coaches, parents, and others who work with young athletes can recognize concussion; best help children and youths recover from concussion injuries; and take steps to become proactive to prevent concussion. Readers will learn what causes a sport-related concussion; what happens to brain cells during a concussion; and why concussion, which in the past was dismissed as a trivial injury, is taken so much more seriously now. The book explains how to decrease the risk of concussion; addresses the potential for cumulative effects from multiple concussions, including chronic traumatic encephalopathy; and discusses the ethical dimensions of deciding whether an athlete with multiple concussions should continue to participate in high-risk sports.

The Alzheimer's Prevention Program

Author : Gary Small
Publisher : Workman Publishing Company
ISBN 13 : 076117639X
Total Pages : 305 pages
Book Rating : 4.7/5 (611 download)

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Book Synopsis The Alzheimer's Prevention Program by : Gary Small

Download or read book The Alzheimer's Prevention Program written by Gary Small and published by Workman Publishing Company. This book was released on 2012-12-11 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: Want to keep Alzheimer’s at bay for years—ideally, forever? Prevention is the way, and this is the guide. Now in paperback and updated throughout, The Alzheimer’s Prevention Program is essential for everyone with a family history of Alzheimer’s, and for the 80 million baby boomers who worry whenever they forget someone’s name. It’s the book that shows how to strengthen memory and avoid everyday lapses. How to incorporate the top ten brain-protecting foods into your diet. How to cross-train your brain, exercising both the right and left hemisphere. And how to reduce stress, a risk factor for developing dementia and Alzheimer’s, through meditation and 11 other relaxation strategies. Written by the New York Times bestselling authors of The Memory Bible, this book is an easy-to-follow regimen based on the latest comprehensive research into Alzheimer’s disease, and especially the critical connection between lifestyle and susceptibility. The paperback edition is updated with a brand-new section that answers the most compelling questions asked of Dr. Small after publication of the first edition, including: the power of exercise to offset a genetic predisposition; antibodies that can clear Alzheimer’s plaques from the brain; and promising new treatments, from drugs to deep brain stimulation. It’s the science-based, breakthrough program that will bring mental clarity to every day and help you take control of your brain’s health.

Throwaway Players

Author : Gay Culverhouse
Publisher : Behler Publications
ISBN 13 : 1933016701
Total Pages : 167 pages
Book Rating : 4.9/5 (33 download)

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Book Synopsis Throwaway Players by : Gay Culverhouse

Download or read book Throwaway Players written by Gay Culverhouse and published by Behler Publications. This book was released on 2012 with total page 167 pages. Available in PDF, EPUB and Kindle. Book excerpt: The underbelly of the National Football League: a rare insider's look into the world of arthritis, dementia, and suicide.

Neuroimmune Pharmacology

Author : Tsuneya Ikezu
Publisher : Springer
ISBN 13 : 3319440225
Total Pages : 1045 pages
Book Rating : 4.3/5 (194 download)

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Book Synopsis Neuroimmune Pharmacology by : Tsuneya Ikezu

Download or read book Neuroimmune Pharmacology written by Tsuneya Ikezu and published by Springer. This book was released on 2016-12-22 with total page 1045 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of Neuroimmune Pharmacology bridges the disciplines of neuroscience, immunology and pharmacology from the molecular to clinical levels with particular thought made to engage new research directives and clinical modalities. Bringing together the foremost field authorities from around the world, Neuroimmune Pharmacology will serve as an invaluable resource for the basic and applied scientists of the current decade and beyond.

Demystifying Psychiatry

Author : Charles F. Zorumski
Publisher :
ISBN 13 : 019538640X
Total Pages : 241 pages
Book Rating : 4.1/5 (953 download)

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Book Synopsis Demystifying Psychiatry by : Charles F. Zorumski

Download or read book Demystifying Psychiatry written by Charles F. Zorumski and published by . This book was released on 2010 with total page 241 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychiatry is arguably the most misunderstood specialty in modern medicine and psychiatrists are often thought of as part physician, part confessor, part police officer, and part shaman. In Demystifying Psychiatry, two eminent psychiatrists offer an illuminating look at the entire field, offering a clear and informative portrait of a medical specialty often clouded in myth. Zorumski and Rubin range from a basic discussion of what psychiatry is, to the types of illnesses psychiatrists treat, the training of psychiatrists, the treatment of psychiatric disorders (covering medications, psychotherapy, lifestyle interventions, electroconvulsive therapy, and much more), and how families can help with treatment. They caution the consumer about practices that should raise red flags. The book also covers new trends in psychiatry and explores the future of the field, predicting that major advances in genetics and neuroscience will lead to rapid and amazing changes in psychiatry. The book concludes with extensive reference materials that will be valuable both to general readers and medical practitioners.

Never Ran, Never Will

Author : Albert Samaha
Publisher : PublicAffairs
ISBN 13 : 1541767861
Total Pages : 368 pages
Book Rating : 4.5/5 (417 download)

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Book Synopsis Never Ran, Never Will by : Albert Samaha

Download or read book Never Ran, Never Will written by Albert Samaha and published by PublicAffairs. This book was released on 2018-09-04 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: This uplifting story of a boys' football team shines light on the under-appreciated virtues that can bloom in impoverished neighborhoods, even as nearby communities exclude them from economic progress. Never Ran, Never Will tells the story of the working-class, mostly black neighborhood of Brownsville, Brooklyn; its proud youth football team, the Mo Better Jaguars; and the young boys who are often at the center of both. Oomz, Gio, Hart, and their charismatic, vulnerable friends, come together on a dusty football field. All around them their community is threatened by violence, poverty, and the specter of losing their homes to gentrification. Their passionate, unpaid coaches teach hard lessons about surviving American life with little help from the outside world, cultivating in their players the perseverance and courage to make it. Football isn't everybody's ideal way to find the American dream, but for some kids it's the surest road there is. The Mo Better Jaguars team offers a refuge from the gang feuding that consumes much of the streets and a ticket to a better future in a country where football talent remains an exceptionally valuable commodity. If the team can make the regional championships, prestigious high schools and colleges might open their doors to the players. Never Ran, Never Will is a complex, humane story that reveals the changing world of an American inner city and a group of unforgettable boys in the middle of it all.