BackgroundNoninvasive physical management is often prescribed for headache and neck pain. Systematic reviews, however, indicate that the evidence of its efficacy is limited. Our aim was to evaluate the effectiveness of a workplace educational and physical program in reducing headache and neck/shoulder pain.Methodology/Principal FindingsCluster-randomized controlled trial. All municipal workers of the City of Turin, Italy, were invited to participate. Those who agreed were randomly assigned, according to their departments, to the intervention group (IG) or to the control group and were given diaries for the daily recording of pain episodes for 1 month (baseline). Subsequently, only the IG (119 departments, 923 workers) began the physical and educational program, whereas the control group (117 departments, 990 workers) did not receive any intervention. All participants were again given diaries for the daily recording of pain episodes after 6 months of intervention. The primary outcome was the change in the frequency of headache (expressed as the proportion of subjects with a ≥50% reduction of frequency; responder rate); among the secondary outcomes there were the absolute reduction of the number of days per month with headache and neck/shoulder pain. Differences between the two groups were evaluated using mixed-effect regression models. The IG showed a higher responder rate [risk ratio, 95% confidence interval (CI)] for headache (1.58; 1.28 to 1.92) and for neck/shoulder pain (1.53; 1.27 to 1.82), and a larger reduction of the days per month (95% CI) with headache (−1.72; −2.40 to −1.04) and with neck/shoulder pain (−2.51; −3.56 to −1.47).ConclusionsThe program effectively reduced headache and neck/shoulder pain in a large working community and appears to be easily transferable to primary-care settings. Further trials are needed to investigate the program effectiveness in a clinical setting, for highly selected patients suffering from specific headache types.Trial RegistrationClinicalTrials.gov NCT00551980
The process of forensic identification of missing individuals is frequently reliant on the superimposition of cranial remains onto an individual's picture and/or facial reconstruction. In the latter, the integrity of the skull or a cranium is an important factor in successful identification. Here, we recommend the usage of computerized virtual reconstruction and geometric morphometrics for the purposes of individual reconstruction and identification in forensics. We apply these methods to reconstruct a complete cranium from facial remains that allegedly belong to the famous Italian humanist of the fifteenth century, Angelo Poliziano (1454-1494). Raw data was obtained by computed tomography scans of the Poliziano face and a complete reference skull of a 37-year-old Italian male. Given that the amount of distortion of the facial remains is unknown, two reconstructions are proposed: The first calculates the average shape between the original and its reflection, and the second discards the less preserved left side of the cranium under the assumption that there is no deformation on the right. Both reconstructions perform well in the superimposition with the original preserved facial surface in a virtual environment. The reconstruction by means of averaging between the original and reflection yielded better results during the superimposition with portraits of Poliziano. We argue that the combination of computerized virtual reconstruction and geometric morphometric methods offers a number of advantages over traditional plastic reconstruction, among which are speed, reproducibility, easiness of manipulation when superimposing with pictures in virtual environment, and assumptions control.
In a population of patients with headache and craniofacial pain, tinnitus was related to increased cervical muscle tenderness and pericranial muscle tenderness scores, rather than to any particular form of headache.
Little or no information is available regarding the effect of the personality characteristics of headache sufferers on the quality of pain perception. The aim of this study is to investigate, in head pain sufferers, the relationship between the personality profile, assessed by the MMPI, and the different dimensions of pain (sensory, affective and evaluative), as assessed by the MPQ. Three hundred and seventeen patients with Migraine and/or tension-type headache (episodic or chronic) and myogenic facial pain were included. The Italian versions of the MMPI-2 and MPQ were administered, and the pain level was measured by the VAS. Cluster analysis based on the clinical scales of MMPI identified four personality profiles closely corresponding to the MMPI profiles obtained by the previous researchers: "depressive" (Dep.), "emotionally overwhelmed" (Emot.), "conversive" (Conv.) and "Coper". Differences in MPQ scales between personality profiles were investigated by means of a general linear model (GLM), adjusting for sex, age and pain level and type. Results of GLM analysis showed that the affective dimension was significantly higher in cluster Emot. than in Dep. (p=0.027), Conv. (p=0.002) and Coper (p=0.003). Total PRI was significantly higher in Emot. than in Conv. (p=0.010). The findings of the present study suggest that a specific personality profile (Emot.), characterized by a heavy emotional burden, may increase the affective dimension of pain with respect to a depressive profile (Dep.), a conversive profile (Conv.) or a normal profile (Coper), independent of sex, age and pain level and type.
The study of frontal sinuses for personal identification is a considered approach in the forensic field. In Yoshino's system, the frontal sinus patterns of a given person were formulated as a code number (codY) obtained by arranging the class numbers in each classification item. The aim of this work was to use a new code number (codC) with eight digits that includes other two continuous variables obtained as ratios SOR1 (left frontal sinus area/left orbit area) and SOR2 (right frontal sinus area/right orbit area), comparing the results with that of Yoshino. Digital radiographic images of the skulls of 150 Chinese people were analyzed. Spearman's partial correlation coefficients were evaluated between variables characterizing frontal sinus patterns. We used a maximum‐weight dependence tree for statistical analysis. Results demonstrated that codC significantly reduced the probability of having the same personal code number compared with codY. Our scientific approach results valid for personal identification purposes.
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