The clinical and public health implications and risks of widening the definition of chronic migraine

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 407-410 ◽  
Author(s):  
Martina Guglielmetti ◽  
Alberto Raggi ◽  
Raffaele Ornello ◽  
Simona Sacco ◽  
Domenico D’Amico ◽  
...  
Keyword(s):  
Public Health ◽  
Chronic Migraine ◽  
High Frequency ◽  
Episodic Migraine ◽  
Headache Frequency ◽  
Allocation Of Resources ◽  
Independent Entity ◽  
Definition Of ◽  
The Impact

Background The definition of chronic migraine has long been debated. Recently, it was suggested to define subjects with at least 8/migraine days as chronic migraine; that is, incorporating so-called high frequency episodic migraine (eight or more migraine days but less than 15 headache days per month). Methods We addressed the possible problems that might arise based on this proposal accounting for clinical, pathophysiological, impact and public health aspects. Results and conclusions Defining chronic migraine on the basis of headache frequency alone does not account for clinical and pathophysiological aspects, as well as for the impact of chronic migraine in terms of disability and quality of life. Moreover, it is potentially harmful for patients in terms of allocation of resources. These issues are discussed in the present manuscript, and we support the idea of defining high frequency episodic migraine as an independent entity as a viable path to follow.

Disability, burden, and symptoms related to sensitization in migraine patients associate with headache frequency

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Stefano Di Antonio ◽  
Matteo Castaldo ◽  
Marta Ponzano ◽  
Francesca Bovis ◽  
Paola Torelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Migraine ◽  
High Frequency ◽  
Low Frequency ◽  
Episodic Migraine ◽  
Headache Frequency ◽  
Headache Attack ◽  
Burden Of Headache ◽  
The Difference

Abstract Objectives This observational study aimed to assess the difference in disability, burden, and sensitization between migraine patients with low-frequency headache attack (1–8 headache days/month), high-frequency headache attack (9–14 headache days/months), and patients with chronic migraine (>14 headache days/months). Methods Migraine patients with or without aura were divided into three groups according to headache frequency (low-frequency episodic migraine; high-frequency episodic migraine; chronic migraine). Questionnaires were used to assess the burden of headache, quality of life, phycological burden, and symptoms related to sensitization (estimated by the Central Sensitization Inventory). Differences among migraine groups were assessed using Chi-Quadro test, ANOVA, or Kruskal–Wallis as appropriate. Results 136 patients were included (68 low-frequency episodic migraine, 45 high-frequency episodic migraine, 23 chronic migraine). Patients with high frequency episodic migraine and chronic migraine differed from patients with low frequency episodic migraine showing a worse burden of headache (p=0.002; p=0.002), worse level of physical (p=0.001; p<0.001) and mental (p=0.002; p=0.001) quality of life, worse level of depression (p=0.008; p=0.003), and increase presence of symptoms related to sensitization (p<0.001; p=0.003). No differences were found in any variables between patients with high-frequency episodic migraine and patients with chronic migraine (p>0.05). Conclusions Patients with high-frequency episodic migraine and chronic migraine could be considered in the same segment of the migraine population, with similar degrees of disability and sensitization related symptoms.

scholarly journals The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results

Cephalalgia ◽  
2014 ◽  
Vol 35 (7) ◽  
pp. 563-578 ◽  
Author(s):  
Aubrey Manack Adams ◽  
Daniel Serrano ◽  
Dawn C Buse ◽  
Michael L Reed ◽  
Valerie Marske ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Episodic Migraine ◽  
Family Burden ◽  
Headache Frequency ◽  
Cross Sectional ◽  
The Core ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
The Impact

Background Longitudinal migraine studies have rarely assessed headache frequency and disability variation over a year. Methods The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study is a cross-sectional and longitudinal Internet study designed to characterize the course of episodic migraine (EM) and chronic migraine (CM). Participants were recruited from a Web-panel using quota sampling in an attempt to obtain a sample demographically similar to the US population. Participants who passed the screener were assessed every three months with the Core (baseline, six, and 12 months) and Snapshot (months three and nine) modules, which assessed headache frequency, headache-related disability, treatments, and treatment satisfaction. The Core also assessed resource use, health-related quality of life, and other features. One-time cross-sectional modules measured family burden, barriers to medical care, and comorbidities/endophenotypes. Results Of 489,537 invitees, we obtained 58,418 (11.9%) usable returns including 16,789 individuals who met ICHD-3 beta migraine criteria (EM (<15 headache days/mo): n = 15,313 (91.2%); CM (≥15 headache days/mo): n = 1476 (8.8%)). At baseline, all qualified respondents ( n = 16,789) completed the Screener, Core, and Barriers to Care modules. Subsequent modules showed some attrition (Comorbidities/Endophenotypes, n = 12,810; Family Burden (Proband), n = 13,064; Family Burden (Partner), n = 4022; Family Burden (Child), n = 2140; Snapshot (three months), n = 9741; Core (six months), n = 7517; Snapshot (nine months), n = 6362; Core (12 months), n = 5915). A total of 3513 respondents (21.0%) completed all modules, and 3626 (EM: n = 3303 (21.6%); CM: n = 323 (21.9%)) completed all longitudinal assessments. Conclusions The CaMEO Study provides cross-sectional and longitudinal data that will contribute to our understanding of the course of migraine over one year and quantify variations in headache frequency, headache-related disability, comorbidities, treatments, and familial impact.

Proposed new diagnostic criteria for chronic migraine

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 399-406 ◽  
Author(s):  
Mona Ameri Chalmer ◽  
Thomas Folkmann Hansen ◽  
Elena R Lebedeva ◽  
David W Dodick ◽  
Richard B Lipton ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Diagnostic Criteria ◽  
High Frequency ◽  
Treatment Options ◽  
Episodic Migraine ◽  
Treatment Needs ◽  
Cash Assistance ◽  
Number Of Patients ◽  
Definition Of ◽  
Significant Disease

Introduction ICHD-3 criteria for chronic migraine (CM) include a mixture of migraine and tension-type-like headaches and do not account for patients who have a high frequency of migraine but no other headaches. Materials and methods Patients from the Danish Headache Center and their relatives with ICHD-3 defined CM were compared with patients with high frequency episodic migraine (HFEM). Danish registries were used to compare the socioeconomic impact in these two groups. A Russian student population was used to determine the generalizability of the number of patients fulfilling CM and the proposed diagnostic criteria for CM. Results There was no difference in the demographic profile between the two groups in the Danish cohort. The number of lifelong or annual attacks ( p > 0.3), comorbid diseases, or self-reported effect of triptans ( p = 1) did not differ. HFEM patients purchased more triptans than CM patients ( p = 0.01). CM patients received more early pension ( p = 0.00135) but did not differ from HFEM patients with regard to sickness benefit ( p = 0.207), cash assistance ( p = 0.139), or rehabilitation benefit ( p = 1). Discussion Patients with HFEM are comparable to CM patients with regard to chronicity and disability. We therefore suggest classifying CM as ≥ 8 migraine days per month (proposed CM), disregarding the need for ≥ 15 headache days per month. The proposed diagnostic criteria for CM approximately doubled the number of patients with CM in both the Danish and the Russian materials. Extending the definition of CM to include patients with HFEM will ensure that patients with significant disease burden and unmet treatment needs are identified and provided appropriate access to the range of treatment options and resources available to those with CM. Conclusion Patients with migraine on eight or more days but not 15 days with headache a month are as disabled as patients with ICHD-3 defined CM. They should be included in revised diagnostic criteria for chronic migraine.

scholarly journals P.036 Burden of illness in patients with migraine in Canada: A patient survey and retrospective chart review

2021 ◽  
Vol 48 (s3) ◽  
pp. S30-S30
Author(s):  
S Sauriol ◽  
I Hasani ◽  
D Rochdi ◽  
N Bastien ◽  
F Amoozegar
Keyword(s):  
Chronic Migraine ◽  
Economic Burden ◽  
High Frequency ◽  
Annual Cost ◽  
Chart Review ◽  
Burden Of Illness ◽  
Retrospective Chart Review ◽  
Patient Survey ◽  
Episodic Migraine ◽  
The Impact

Background: There are limited Canadian data on the impact of migraine on quality of life, economic, and societal burden. Therefore, the aim of this study was to characterize the humanistic and economic burden of illness of migraine in Canada. Methods:Retrospective medical chart review and prospective patient survey were used to evaluate the clinical, social, and economic burden of migraine in patients who failed at least two prior prophylactic therapies.Results: 287 migraine patients were included. High- frequency episodic migraine (8 to 14 MMDs) and chronic migraine (15+ MMDs) made up the majority of the cohort (35.2% and 35.9%, respectively). 72.8% of the patients had underlying comorbidities 78% indicated that they experienced severe disability on their daily life due to their headaches. The total estimated annual cost of chronic migraine was $25,669 per patient while high-frequency episodic and low-frequency episodic migraine was associated with an annual cost of $24,885 and $15,651 per patient respectively. Conclusions: This study provides a recent and comprehensive assessment of the burden of illness associated with migraine in Canada and showed that migraine is associated with a substantial humanistic and economic burden for patients and healthcare systems.

Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110603
Author(s):  
Ignacio Elizagaray-García ◽  
Gabriela F Carvalho ◽  
Tibor M Szikszay ◽  
Waclaw M Adamczyk ◽  
Gonzalo Navarro-Fernández ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Chronic Tension Type Headache ◽  
Psychophysical Testing ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Neck Disability ◽  
Painful Area

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

THE PROBLEMS OF THE INVESTIGATOR’S FORENSIC THINKING FORMATION

2021 ◽  
pp. 68-73
Author(s):  
Руслан Юрьевич Павлов
Keyword(s):  
Cognitive Abilities ◽  
Educational Process ◽  
Criminal Cases ◽  
Factors Affecting ◽  
Factors Associated ◽  
Personal Qualities ◽  
Definition Of ◽  
The Impact ◽  
Objective Investigation

Актуальность статьи связана с поиском новых способов и методов повышения эффективности борьбы с преступностью, оперативного раскрытия преступлений, а также с набирающим популярность среди криминалистов направлением «криминалистического мышления», овладение навыками которого будет способствовать наиболее полноценному и объективному расследованию уголовных дел. Проблемным в настоящее время является недостаточное качество следствия и необходимость повышения когнитивных способностей следователей (дознавателей). Задачей исследования являлось выявление факторов, влияющих на развитие и формирование криминалистического мышления следователей. Цель работы - провести анализ составных частей процесса становления следователя и особенностей его практической деятельности, влияющих на когнитивные способности с точки зрения криминалистики, путем изучения и сравнения имеющихся материалов по данной тематике. Анализу подвергнуты личностные качества следователя, особенности образовательного процесса и влияние опыта на результаты работы, а также факторы, сопутствующие следственной деятельности (организация труда, уровень стресса, нагрузки и т. д.). Результат проведенного исследования выражен в определении проблемных факторов, влияющих на формирование криминалистического мышления следователя (дознавателя) и возможных путей их преодоления, важности такого мышления, которое остается знанием, постоянно сориентированным в сторону практики. The relevance of the article is related to the search for new ways and methods to improve the effectiveness of the fight against crime, the prompt detection of crimes, as well as the trend of «forensic thinking», which is gaining popularity among criminalists, mastering the skills of which will contribute to the most complete and objective investigation of criminal cases. Problems at present are insufficient quality of investigation and the need to improve the cognitive abilities of investigators (inquirers). The task of the study was to identify factors that influence the development and formation of forensic thinking of investigators. The purpose of the work is- to analyze the components of the process of formation of an investigator and features of his practical activities affecting the cognitive abilities in terms of forensics by studying and comparing existing materials on this topic. The analysis is subjected to the personal qualities of an investigator, the peculiarities of the educational process and the impact of experience on the results of work, as well as factors associated with the investigative activity (organization of work, stress and stress levels, etc.). The result of the study is expressed in the definition of problematic factors affecting the formation of forensic thinking of an investigator (inquirer) and possible ways to overcome them, the importance of such thinking, which remains knowledge, constantly oriented towards practice

scholarly journals Rated definition of degree of cutter coating influence upon parameters of surface layer quality of parts worked

2017 ◽  
Vol 2 (7) ◽  
pp. 20-24
Author(s):  
Вячеслав Безъязычный ◽  
Vyacheslav Bezyazychnyy ◽  
Максим Басков ◽  
Maksim Baskov
Keyword(s):  
Surface Roughness ◽  
Surface Layer ◽  
Residual Stresses ◽  
Layer Surface ◽  
Wear Resistant Coatings ◽  
Cutter Wear ◽  
Definition Of ◽  
Surface Layer Quality ◽  
The Impact

The impact of cutter wear-resistant coatings upon cutting process parameters and characteristics of surface layer quality in the parts worked: residual stresses, a degree and a depth of work hardening of a surface layer, surface roughness is investigated.

scholarly journals The prevalence of scabies in Monrovia, Liberia: a population-based survey

2020 ◽  
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K Zayay ◽  
Karsor K Kollie ◽  
Eglantine Lebas ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Health Problem ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Local Health ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundScabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking.MethodsWe conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression.Results1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies.ConclusionsOur study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.Plain English summaryScabies is an infestation with a microscopic mite which affects many people living in low-resource tropical countries. It causes intense itching, which can lead to complications through bacterial infection and poor quality of life. To help develop global scabies control programmes, we need a better understanding of how common it is across different tropical settings. We conducted a survey to assess the burden of scabies and bacterial skin infection in a random sample of people living in a community in Monrovia, Liberia. Information about participants and their household were collected and their skin was examined; those with skin conditions were asked about its impact on quality of life.We examined 1,318 participants and found that almost 10% of people had scanies. Scabies was more common in young children, and was more common in male children than female children. We found that there was a large impact on quality of life due mostly to the itching that scabies causes and to people feeling embarrassed or sad because of their skin condition. This scabies survey is one of the first conducted across all age groups in recent years in sub-Saharan Africa and indicates a substantial burden and impact on quality of life. More work is needed to understand how common scabies is in different settings and the impact that different treatment strategies may have.

Organizational Effects of Information Technology

2010 ◽  
pp. 157-173
Author(s):  
Johan Tetzlaff ◽  
Jonny Holmström
Keyword(s):  
Organizational Change ◽  
Lean Manufacturing ◽  
Paper Mill ◽  
Production Quality ◽  
Organizational Effects ◽  
Increase Productivity ◽  
Product And Process ◽  
Definition Of ◽  
The Impact

The aim of this chapter is to better understand the enabling and inhibiting impacts IT has on lean manufacturing. This chapter provides a rich picture of a paper mill producing liner reels and the impact of a reel administration system on the manufacturing process. It is important that an IT tool supporting lean manufacturing reflects its organization. When it does the IT tool can act as an enabler of organizational change that in turn increase productivity and the production quality, when it fails to do so it inhibits organizational change and hampers the quality of production. The conclusion is that framing the definition of high production quality regarding product and process is important and that teambuilding would be a contribution to this end by enhancing perspective taking among the employees.

Irradiation of Food for Public Health Protection1

1982 ◽  
Vol 45 (4) ◽  
pp. 363-366 ◽  
Author(s):  
R. B. MAXCY
Keyword(s):  
Public Health ◽  
Food Additive ◽  
Subsequent Growth ◽  
Psychrotrophic Bacteria ◽  
Public Health Significance ◽  
Pure Cultures ◽  
Health Significance ◽  
Definition Of ◽  
Public Health Protection

Irradiation of food has a long history and has potential for improving public health protection, yet the technology is still not being used commercially. Public acceptance of the process has been hindered by fear and controversy, which involved erroneous definition of radiation as a food additive followed by some ill-conceived and ill-interpreted research. In general, all research has indicated radiation to be bactericidal with various degrees of effectiveness, depending on the specific bacteria being studied. The gram-negative psychrotrophic bacteria, as well as other Enterobacteriaceae, are quite sensitive to radiation and these bacteria are of particular interest to those persons responsible for protecting the quality of fresh red meat. Bacteria resisting less than sterilization doses in irradiation processes have been studied. Acquired increased resistance of bacteria through exposure survival, and subsequent growth of pure cultures can be obtained only through special laboratory manipulations. None of the presently available data indicate bacteria surviving irradiation are of special public health significance.

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