Tension-type headache and sleep apnea in the general population

The main objective of this study is to investigate the relationship between tension-type headache and obstructive sleep apnea in the general population. The method involves a cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. Included in this study were 297 persons with high risk and 134 persons with low risk of sleep apnea, aged 30–65 years. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Tension-type headache was diagnosed according to the International Classification of Headache Disorders. Results showed the prevalence of frequent and chronic tension-type headache was 18.7 and 2.1% in the participants with obstructive sleep apnea. The logistic regression analyses showed no significant relationship between tension-type headache and obstructive sleep apnea, with adjusted odds ratios for frequent tension-type headache of 0.95 (0.55–1.62) and chronic tension-type headache of 1.91 (0.37–9.85). The results did not change when using cut-off of moderate (AHI ≥15) and severe (AHI ≥30) obstructive sleep apnea. Thus, we did not find any significant relationship between tension-type headache and the AHI. The presence and severity of sleep apneas seem not to influence presence and attack-frequency of tension-type headache in the general population

International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study

Background: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. Objectives: To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. Design/methods: Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. Results: Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. Conclusions: Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache

Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to investigate the temporal relationship between autonomic changes and pain activation in migraine and tension-type headache induced by stress in a model relevant for everyday office-work.</p> <p>Methods</p> <p>We measured pain, blood pressure (BP), heart rate (HR) and skin blood flow (BF) during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free periods, 18 patients with tension-type headache (TTH) and 44 healthy controls. The stress lasted for one hour and was followed by 30 minutes of relaxation.</p> <p>Results</p> <p>Cardiovascular responses to cognitive stress in migraine did not differ from those in control subjects. In TTH patients HR was maintained during stress, whereas it decreased for migraineurs and controls. A trend towards a delayed systolic BP response during stress was also observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was associated with less vasoconstriction in TTH during recovery.</p> <p>Conclusion</p> <p>It is hypothesized that TTH patients have different stress adaptive mechanisms than controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control system inhibition.</p

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Perspectives on Sustainability in Cultural Heritage Conservation

In the last few years, ‘sustainability’ has become one of the greatest and most inevitable topics of discussion. Investigating contemporary approaches to sustainability in the cultural heritage sector shows how current development needs are perceived in order to better address the future. In the field of cultural heritage management, an increased focus on sustainability is both a stress factor and an opportunity. Despite the challenges and issues caused by development needs, increasing motivation seems to be the current direction within the field. This thesis aims to investigate contemporary approaches towards sustainability in the cultural heritage sector and how it affects the field of cultural heritage conservation. With a starting point in the United Nations Sustainability Development Goals 2030 Agenda, examples of how the increased focus on sustainability manifest itself within the cultural heritage sector will be analysed through qualitative studies of selected study material. Despite being a small field in a small sector, cultural heritage conservation must face the demands for sustainable development like all other sectors within our society. Society determine the preconditions for cultural heritage management, regardless of the individual’s approach to sustainability, the world is changing and so are the conditions for cultural heritage. Conservation of large selections in museum and art institutions is often of great costs, and the professional cultural heritage conservator has great impact on the overall management of cultural heritage. Therefore, the cultural heritage conservator can contribute to sustainable development in various ways. However, requirements for sustainable conservation procedures and new approaches to materiality are not always easily compatible with contemporary theories of conservation, why further discussion on contemporary theories of conservation should be revised to ensure the high professional standard. The profession of cultural heritage conservation has strong global networks, and with international cooperation and implementation of sustainable procedures in everyday practice, the engagement of professionals within the cultural heritage sector contributes to sustainable development.Degree project for Bachelor of Science in Conservation 2020, 180 HEC Second Cycle 2020:2

Tillgänglighetsbedömningar och åtgärdsplaner för havsbadsanläggningar i Helsingfors : En processinriktad metod för utvecklingsarbete

Syftet med examensarbetet var att utarbeta åtgärdsplaner till hur man gör två badstränder i Helsingfors tillgängliga. Ämnesområdet i arbetet var tillgänglighet på strandmiljö. Undersökningsobjekten i examensarbetet var: Marudds badstrand, Rastböle badstrand, Solviks badstrand och Sandstrands badstrand. Frågeställningarna i arbetet var: (1) Vilka hinder i tillgängligheten finns på de fyra badstränderna i Helsingfors? (2) Vilka åtgärder behövs göras för att göra två av de befintliga havsbaden tillgängliga? Begränsningar i arbetet är att man endast undersökt/bedömt fyra stränder. Metod som användes är en processinriktad metod för utvecklingsarbete. Tillgängligheten på stränderna bedömdes med Housing Enabler, delen A. Utomhusmiljö. Enablerkonceptet bygger på Lawtons ekologiska modell och mottaglighetshypotes vilken användes som teoretisk referensram i examensarbetet. Resultatet påvisade att det i nuläget finns stora och många tillgänglighetshinder på alla fyra av stränderna. Alla de fyra stränderna hade tillgänglighetshinder i form av bl.a. oregelbundet, instabilt och ojämnt ytbelägg vilket orsakar att många individer inte kan röra sig självständigt på stranden. På två av de fyra stränderna fanns det störst förutsättningar miljömässigt för att kunna göra åtgärder och förändringar i miljön för att göra stränderna tillgängliga. Utifrån resultaten gjordes det åtgärdsplaner för Solviks badstrand och Sandstrands badstrand. Fortsatt forskning inom området kunde innehålla att utarbeta åtgärdsplaner ytterligare i form av t.ex. ritningar

GIS in a simulator environment and efficient inverse mapping of roads

This thesis investigates the possibilities of using GIS (Geographic Information System) data with an airborne autonomous vehicle developed in the WITAS project. Available for the thesis are high resolution (0.16 meter sample interval) aerial photographs over Stockholm, and vector data in a common GIS format containing all roads in the Stockholm area. A method for removing cars from aerial photographs is presented, using the filtering method normalized convolution, originally developed for filtering uncertain and incomplete data. By setting the certainty to zero over the cars, this data is disregarded in the filtering process, resulting in an image without cars. This method is further improved by choosing an anisotropic applicability function, resulting in a filtering that preserves structures oriented in certain directions. The available vector data is investigated with regard to its use in a simulator for vehicle movement, and is found to be missing much of the essential information needed in such a simulator. A new data format better suited to these requirements is created, using the extensible markup language (XML) which generates a humanreadable data format and can use existing parsers to make the implementation simpler. The result is a somewhat complex, but highly general data format that can accurately express almost any type of road and intersection. Cars can follow arbitrary paths in the road database and move with a smooth motion suitable for use as input to image processing equipment. The simulator does not allow any dynamic behaviour such as changing speeds, starting or stopping, or interaction between cars, takeovers or intelligent behavior in intersections. In the airborne vehicle, a mapping from pixels in a camera image (like the ones output from the simulator) to locations in the road database is needed. This is an inverse mapping with respect to visualizing as described above. This gives important information to a car tracking system regarding the probable movement of cars and also making it possible to determine if a car breaks traffic regulations. A mapping of this kind is created using a simplified form of ray tracing known as ray casting, together with space partitioning methods used to vastly improve efficiency. All above mentioned tasks are implemented using C++ and object oriented methods, giving maintainable and extendable code suiting a quickly changing research area. The interface to the simulator is designed to be compatible to the existing simulation software used in the WITAS project. Visualization is done through the OpenGL graphics library, providing realistic effects such as lighting and shading

GIS in a simulator environment and efficient inverse mapping of roads

This thesis investigates the possibilities of using GIS (Geographic Information System) data with an airborne autonomous vehicle developed in the WITAS project. Available for the thesis are high resolution (0.16 meter sample interval) aerial photographs over Stockholm, and vector data in a common GIS format containing all roads in the Stockholm area. A method for removing cars from aerial photographs is presented, using the filtering method normalized convolution, originally developed for filtering uncertain and incomplete data. By setting the certainty to zero over the cars, this data is disregarded in the filtering process, resulting in an image without cars. This method is further improved by choosing an anisotropic applicability function, resulting in a filtering that preserves structures oriented in certain directions. The available vector data is investigated with regard to its use in a simulator for vehicle movement, and is found to be missing much of the essential information needed in such a simulator. A new data format better suited to these requirements is created, using the extensible markup language (XML) which generates a humanreadable data format and can use existing parsers to make the implementation simpler. The result is a somewhat complex, but highly general data format that can accurately express almost any type of road and intersection. Cars can follow arbitrary paths in the road database and move with a smooth motion suitable for use as input to image processing equipment. The simulator does not allow any dynamic behaviour such as changing speeds, starting or stopping, or interaction between cars, takeovers or intelligent behavior in intersections. In the airborne vehicle, a mapping from pixels in a camera image (like the ones output from the simulator) to locations in the road database is needed. This is an inverse mapping with respect to visualizing as described above. This gives important information to a car tracking system regarding the probable movement of cars and also making it possible to determine if a car breaks traffic regulations. A mapping of this kind is created using a simplified form of ray tracing known as ray casting, together with space partitioning methods used to vastly improve efficiency. All above mentioned tasks are implemented using C++ and object oriented methods, giving maintainable and extendable code suiting a quickly changing research area. The interface to the simulator is designed to be compatible to the existing simulation software used in the WITAS project. Visualization is done through the OpenGL graphics library, providing realistic effects such as lighting and shading