The Stigma of Migraine

Background People who have a disease often experience stigma, a socially and culturally embedded process through which individuals experience stereotyping, devaluation, and discrimination. Stigma has great impact on quality of life, behavior, and life chances. We do not know whether or not migraine is stigmatizing. Methods We studied 123 episodic migraine patients, 123 chronic migraine patients, and 62 epilepsy patients in a clinical setting to investigate the extent to which stigma attaches to migraine, using epilepsy as a comparison. We used the stigma scale for chronic illness, a 24-item questionnaire suitable for studying chronic neurologic diseases, and various disease impact measures. Results Patients with chronic migraine had higher scores (54.0±20.2) on the stigma scale for chronic illness than either episodic migraine (41.7±14.8) or epilepsy patients (44.6±16.3) (p\u3c0.001). Subjects with migraine reported greater inability to work than epilepsy subjects. Stigma correlated most strongly with the mental component score of the short form of the medical outcomes health survey (SF-12), then with ability to work and migraine disability score for chronic and episodic migraine and the Liverpool impact on epilepsy scale for epilepsy. Analysis of covariance showed adjusted scores for the stigma scale for chronic illness were similar for chronic migraine (49.3; 95% confidence interval, 46.2 to 52.4) and epilepsy (46.5; 95% confidence interval, 41.6 to 51.6), and lower for episodic migraine (43.7; 95% confidence interval, 40.9 to 46.6). Ability to work was the strongest predictor of stigma as measured by the stigma scale for chronic illness. Conclusion In our model, adjusted stigma was similar for chronic migraine and epilepsy, which were greater than for episodic migraine. Stigma correlated most strongly with inability to work, and was greater for chronic migraine than epilepsy or episodic migraine because chronic migraine patients had less ability to work

Chandra Observations of Abell 85: Merger of the South Subcluster

We present an analysis of a highly asymmetric cluster merger from a Chandra observation of Abell 85. The merger shows significant disruption of the less massive subcluster from ram pressure effects. Nevertheless, a cold core, coincident with the cD galaxy, is observed to persist in the subcluster. We derive dynamical information from the motion of the cold core through the main cluster's ICM. Multiple derivations of the velocity of the core suggest a Mach number of M ~ 1.4 or v ~ 2150 km/s, though with substantial uncertainty. We construct a consistent kinematic model for the merger based on this dynamical analysis. As has been found for other such "cold fronts," conduction appears to be suppressed across the front. Thermal conduction may be suppressed by a magnetic field with a significant component perpendicular to the subcluster's direction of motion. The effect of the merger interaction in creating and shaping the observed radio sources is also discussed. It appears most likely that the radio source is due to distorted and detached lobes from the subcluster cD galaxy, rather than being a radio halo.Comment: Accepted for publication in ApJ. 10 pages, 9 figures (3 color), uses emulateapj5. For version with high resolution figures, see http://www.astro.virginia.edu/~jck7k/research/papers/A85_south.ps.g