Living with migraine: A meta-synthesis of qualitative studies

Introduction: Migraine is one of the top ten causes of disability worldwide. However, migraine is still underrated in society, and the quality of care for this disease is scant. Qualitative research allows for giving voice to people and understanding the impact of their disease through their experience of it. This study aims at synthesising the state of the art of qualitative studies focused on how people with migraine experience their life and pathology.Methods: MEDLINE via PubMed, EMBASE, CINAHL, PsycINFO, and Cochrane Library were consulted up to November 2021 for qualitative studies. Studies to be eligible had to focus on adults (age > 18 years) with a diagnosis of primary episodic or chronic migraine following the International Classification of Headache. The quality of the study was analysed using the CASP (Critical Appraisal Skills Programme) tool. The synthesis was done through a thematic analysis. CERQual (Confidence in Evidence from Reviews of Qualitative research) approach was used to assess the confidence in retrieved evidence.Results: Ten studies were included, counting 262 people with migraine. Our synthesis produced four main themes. (1) “Negative impact of migraine symptoms on overall life” as migraine negatively impacts people's whole life. (2) “Impact of migraine on family, work and social relationship” as migraine reduces the possibility to focus at work and interact with people. (3) “Impact of migraine on emotional health” as people with migraine experience psychological distress. (4) “Coping strategies to deal with migraine” such as keep on living one's own life, no matter the symptoms.Conclusions: Migraine negatively impacts people's whole life, from private to social and work sphere. People with migraine feel stigmatised as others struggle with understanding their condition. Hence, it is necessary to improve awareness among society of this disabling condition, and the quality of care of these people, tackling this disease from a social and health-policy point of view

Soy-Based Infant Formula: Are Phyto-Oestrogens Still in Doubt?

Although Scientific Societies have stated that there are very few indications for the use of soy-based formula (SF) in infant nutrition, their utilization rates have been repeatedly found to be higher than expected. It is likely that a significant role in this regard is played by the belief that the use of SF during infancy can reduce the risk of the development of several diseases later in life. Although no definitive data that can substantiate these claims have been collected, many people perceive soy consumption to confer significant health benefits and might also use soy for infant nutrition. However, not all the problems regarding safety of SF in infants have been definitively solved. Among risks, the potentially toxic role of the phyto-oestrogens contained in SF is not definitively established. In vitro and animal studies have raised suspicions that SF could have potentially negative effects on sexual development and reproductive function, neurobehavioral development, immune function, and thyroid function. Several studies in humans have aimed to assess whether the results of animal studies can be applied to humans and whether SF can be used in infants following the official recommendations. The results are somewhat conflicting. The aim of this narrative review is to discuss what is presently known regarding the impact of phyto-oestrogens in SF on early and late child development. PubMed was used to search for the studies published from January 1980 to June 2017 using the keywords: “soy,” “soy formula,” “child,” “phytoestrogens.” Analysis of the literature showed that a global evaluation of the impact of modern SFs on human development seems to suggest that their use is not associated with relevant abnormalities. Only children with congenital hypothyroidism need adequate monitoring of thyroid function

A Methodological Approach For The Effective Infiltration Assessment In A Coastal Groundwater

Accurate estimates of spatial and temporal distribution of groundwater recharge are of utmost importance to protect groundwater systems. In coastal areas, the fragility of the systems makes such estimates critical for the correct management and protection of water resources from saltwater intrusion. The Muravera coastal plain, in the south-eastern Sardinia, has been studied since 1960, due to important saltwater intrusion phenomena. Since the early fifties, the natural hydrodynamic equilibrium between groundwater, surface-water and seawater has been deeply modified by the construction of four dams across the Flumendosa river and the development of agriculture, tourism and aquaculture activities along the coast. To implement an integrated and sustainable management system addressed to slow down the process of saltwater intrusion and, on the other, satisfy human requirements, it is important to develop a flexible scenario analysis system that considers changes of land-use and inputs to the hydrogeological system, also in relation to climate change. In this study, the innovative Soil Water Balance code (SWB) has been applied to the Muravera plain groundwater body to calculate spatial and temporal variations of groundwater recharge. The code calculates the recharge (R) by using geographic system (GIS) data layers in combination with tabular climatological data. It is based on a modified Thornthwaite - Mather soil water balance approach, with components of the soil water balance calculated at a daily time-step. A combined experimental approach of hydrogeological, satellite remote sensing and pedological methodologies has been applied to derive data layers describing local features of: (1) land-use classification, (2) hydrologic soil group, (3) flow direction, and (4) soil-water capacity. The code has proved to be promising for the effective infiltration assessment and it can be easily updated with high resolution data acquired in the field and from satellite images

Protect, promote and support: a warm chain of breastfeeding for oncological women\u2014results from a survey of young Italian cancer mothers

The objective of this article was to analyse the experience of breastfeeding in new mothers with a history of cancer compared to women without a cancer diagnosis. First, we explored the impact of the cancer diagnosis on the breastfeeding choice. Second, we evaluated the relationship between different feeding methods and the mother\u2019s mood states in women with and without a history of cancer. The sample was composed of 74 mothers divided into two groups: 34 with a cancer history (clinical sample) and 40 without a cancer diagnosis (control group). Participants were requested to complete a questionnaire three months after childbirth which assessed: socio-demographic and clinical data, feeding modes (breastfeeding, formula and mixed feeding) and the profile of mood states (POMS). Results showed that women in the clinical group breastfeed significantly less and use formula more than those in the control group. Moreover, in the clinical group, women who breastfeed feel reported higher levels of confusion (according to POMS) than mothers who bottle-feed or use a mixed feeding method. On the contrary, in the control sample, women who breastfeed feel significantly more vigorous than puerperae who bottle-feed or use mixed methods according to POMS. Our findings suggest the need for a specific warm chain of support and the development of guidelines with clear and specific information for women with a cancer diagnosis in order to reduce their confusion around breastfeeding

Indici per la valutazione della qualit? ecologica dei laghi

Collection of methods to evaluate lake quality using biological element

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Riorganizzazione dei flussi logistici di un magazzino ricambi in ottica lean: il caso Toyota Material Handling Europe

Lo studio di cui tratta l’elaborato si sviluppa durante il periodo di tirocinio in azienda. L’obbiettivo del lavoro si concretizza nell’applicazione di metodologie lean all’interno del magazzino Toyota TMHE di Bologna, per ottenere un miglioramento in termini di bilanciamento dei flussi presenti e quindi di efficienza operativa dello stesso. Nello studio vengono descritte le metodologie e gli aspetti che stanno alla base delle scelte effettuate durante la riprogettazione del magazzino, evidenziando tutti i fattori che ivi concorrono. Il primo passo è un dettagliato periodo di analisi dello stato attuale del magazzino, in cui si cerca di individuare tutti i muda, ovvero gli sprechi, che concorrono nel generare inefficienza. In seguito, viene determinato un set di soluzioni possibili alle criticità individuate, all’interno del quale vengono selezionate le soluzioni più congrue alle esigenze dell’azienda, tenendo conto dei vincoli di tipo strutturale e informativo che concorrono alla complessità del problema. Il progetto viene poi concretizzato implementando effettivamente la soluzione in azienda, controllandone gli effetti sui flussi, sulle strutture presenti e sui lavoratori. Infine, viene verificata la sua efficacia tramite l’utilizzo di strumenti qualitativi e quantitativi, che si conclude con il riscontro di un miglioramento in linea con gli obiettivi prefissati

The role of setting in the oral self-administration of alcohol in the rat

RATIONALE We have previously found that rats that were kept at all times in the self-administration (SA) chambers (resident group) self-administered more heroin than rats that were transferred to the SA chambers immediately before testing (Non-Resident group). Alcohol resembles heroin in its ability to produce, at recreational doses, mood elevation, euphoria, drowsiness, and sedation. Furthermore, alcohol presents some similarities with the mechanisms of action of heroin at the levels of the mesostriatal circuitry. Therefore, we predicted that, as for heroin, alcohol intake would be greater in the Resident than in the Non-Resident group. MATERIALS AND METHODS In Experiment 1, oral self-administration of ethanol and wine solutions (2.5%, 5%, and 10%, v/v) was assessed in Resident and Non-Resident rats using both one-bottle (three sessions) and two-bottle (seven sessions) tests. In addition, we also assessed the intake of water (Experiment 2) and of 0.04% saccharin-0.003% quinine solution (Experiment 3). RESULTS During the one-bottle sessions, alcohol intake of Resident rats was up to two times that of Non-Resident rats. During the two-bottle sessions, Resident rats drank two times more 5% alcohol than water, whereas Non-Resident rats took equal amount of the two fluids. The average daily intake of pure ethanol for Resident rats given access to 5% solutions was 0.71 ± 0.076 vs. 0.46 ± 0.078 g/kg for Non-Resident rats. No group differences in the intake of water and of saccharin-quinine solution were found. CONCLUSION The present report demonstrates at a preclinical level the importance of setting for alcohol self-administration