Prepararse para la jubilación: el papel del apoyo social en la gestión de la ansiedad

La jubilación puede ser definida como una transición que implica el abandono de un rol laboral y, por consiguiente, esto requiere la capacidad de reestructurar el sistema de funciones y actividades personales. Este estudio incluyó 250 empleados de dos administraciones públicas italianas de más de 48 años de edad, con el objetivo de entender cómo durante el tiempo previo a la jubilación el apoyo social recibido por fuentes laborales y extra-laborales puede influir en la ansiedad hacia su jubilación y cómo la última modula la edad a la que se desea jubilarse. Los resultados obtenidos mediante análisis de modelos de ecuaciones estructurales LISREL muestran cómo el apoyo social del superior y la implicación con el trabajo aumentarán la ansiedad debida a la pérdida de la identidad social, mientras que el apoyo de los miembros de la familia tiende a reducir el tamaño de la ansiedad anterior al retiro de la vida laboral. El apoyo de los amigos reduce la ansiedad ante la anticipación de exclusión social. Por lo último, la ansiedad parece influir la edad en la que se desea jubilarse. Retirement can be considered a transition that implies losing one's work role and therefore there is a need to be capable of restructuring one's systems of personal roles and activities. This study used a sample of 250 employees of public administration aged over 48 to find the extent to which work and non-work sources of social support can affect anxiety during the period of preparation for retirement. In addition, the study explored the relation between social support and intended retirement age. LISREL structural equation model analysis shows that supervisor's social support and job involvement increase the anxiety resulting from identity loss, whereas family social support decreases this anxiety. Moreover, friends' social support reduces the anxiety owing to anticipated social exclusion. Finally, retirement related anxiety predicts intended retirement age

Genes and primary headaches: discovering new potential therapeutic targets

Genetic studies have clearly shown that primary headaches (migraine, tension-type headache and cluster headache) are multifactorial disorders characterized by a complex interaction between different genes and environmental factors. Genetic association studies have highlighted a potential role in the etiopathogenesis of these disorders for several genes related to vascular, neuronal and neuroendocrine functions. A potential role as a therapeutic target is now emerging for some of these genes. The main purpose of this review is to describe new advances in our knowledge regarding the role of MTHFR, KCNK18, TRPV1, TRPV3 and HCRTR genes in primary headache disorders. Involvement of these genes in primary headaches, as well as their potential role in the therapy of these disorders, will be discussed

Migraine-specific quality of life questionnaire and relapse on medication overuse headache

Background: The management of Medication overuse headache (MOH) represents a difficult challenge for clinicians and headache experts, particularly for the responder rate after a successful withdrawal treatment. The purpose of this study was to investigate the role of demographic and clinical characteristics as well as the score of Migraine-Specific Quality of Life Questionnaire (MSQ), Migraine Disability Questionnaire and Leeds Dependence Questionnaire in predicting a response after a successful withdrawal treatment in patients with MOH. Methods: This ancillary study is part of a randomized trial that demonstrated the safety and the efficacy of a 3-month treatment with sodium valproate (VPA) (800 mg/day vs placebo) in MOH. Demographic and clinical characteristics and questionnaire results were obtained from the entire sample. Results: A significant correlation was found only between MOH relapse and the total MSQ score, the Role Preventive sub-scale and the Emotional Function sub-scale, suggesting a poorer quality of life in non responders. Conclusion: A high MSQ score could be associated with a poor short-term outcome in MOH patients after a successful treatment with detoxification followed by a new treatment

Noninvasive vagus nerve stimulation as acute therapy for migraine. The randomized PRESTO study

Objective: To evaluate the efficacy, safety, and tolerability of noninvasive vagus nerve stimulation (nVNS; gammaCore; electroCore, LLC, Basking Ridge, NJ) for the acute treatment of migraine in a multicenter, double-blind, randomized, sham-controlled trial. Methods: A total of 248 participants with episodic migraine with/without aura were randomized to receive nVNS or sham within 20 minutes from pain onset. Participants were to repeat treatment if pain had not improved in 15 minutes. Results: nVNS (n = 120) was superior to sham (n = 123) for pain freedom at 30 minutes (12.7% vs 4.2%; p = 0.012) and 60 minutes (21.0% vs 10.0%; p = 0.023) but not at 120 minutes (30.4% vs 19.7%; p = 0.067; primary endpoint; logistic regression) after the first treated attack. A post hoc repeatedmeasures test provided further insight into the therapeutic benefit of nVNS through 30, 60, and 120 minutes (odds ratio 2.3; 95% confidence interval 1.2, 4.4; p = 0.012). nVNS demonstrated benefits across other endpoints including pain relief at 120minutes and was safe and well-tolerated. Conclusion: This randomized sham-controlled trial supports the abortive efficacy of nVNS as early as 30 minutes and up to 60 minutes after an attack. Findings also suggest effective pain relief, tolerability, and practicality of nVNS for the acute treatment of episodic migraine

Topo-kinesthetic memory in chronic headaches. A new test for chronic patients: preliminary report

The objective of this study was to establish if chronic headaches with medication overuse can modify a topo\u2013kinesthetic memory test. Nineteen patients with medication overuse headache (MOH), 13 patients with chronic tension\u2013type headache (CTTH) without medication use and a group of "normal" subjects underwent a topo\u2013kinesthetic memory test at T0 and after one month (T1); a control group of healthy volunteers was also tested to establish the baseline in our experimental setting. After one month, in the MOH patients there was a reduction of medication overuse from 3.3\ub12.65 to 1.1\ub12.23 (p<0.01), but no significant reduction in headache frequency and severity index, quality of life, anxiety and depression scores. The navigation time at T0 was 14.3\ub14.97, 27.9\ub110.12, 34.3\ub115.38 and 7.5\ub12.33, 10.1\ub12.95, 11.4\ub13.21 for control, MOH and CTTH with closed and open eyes, respectively (p<0.02). At T1, the MOH patients reached performances with open eyes similar to the healthy controls, while with closed eyes the navigation test reached times similar to those of CTTH patients. The topokinesthetic memory test seems both able to discriminate MOH and CTTH from healthy volunteers and to be related to pain scores but is not influenced by the use of drugs