Headache is a common condition frequently encountered by physiotherapists in clinical practice. 18 Cervicogenic headache has been classified by the International Headache Society (IHS) 1 and accounts for 15% to 20% of all chronic and recurrent headaches. 20 Individuals with chronic cervicogenic headache experience considerable restriction of daily function, limitation of social participation, and emotional distress. 5 In addition, these t sTudy design: Randomized, double-blind, placebo controlled trial.t objeCTives: To determine the effect of a C1-C2 self-sustained natural apophyseal glide (SNAG) on cervicogenic headache. t baCkground: Cervicogenic headache is a common condition causing significant disability. Recent studies have shown a high incidence of C1-C2 dysfunction, evaluated by the flexion-rotation test (FRT), in subjects with cervicogenic headache. To manage this dysfunction, Mulligan has described a C1-C2 self-SNAG, though no studies have investigated the efficacy of this intervention approach.t meTHods: A sample of 32 subjects (mean 6 SD age, 36 6 3 years) with cervicogenic headache and FRT limitation were randomized into a C1-C2 self-SNAG or placebo group. After an initial instruction and practice visit in the clinic, interventions consisted of exercises applied independently by the subject twice daily at home on a continual basis. FRT range was measured twice, before and immediately after the instruction and practice visit. Headache symptoms were determined by a headache index over time, assessed by questionnaire preintervention, at 4 weeks postintervention, and at 12 months postintervention.t resulTs: No differences were found in baseline measures between groups. Immediately after the initial instruction and practice visit performed with the supervision of the therapist, FRT range increased by 15° (SD, 9) for the C1-C2 self-SNAG group (P,.001), which was significantly more than 5° (SD, 5) for the placebo intervention (P,.001). There was also a significant interaction for the variable headache index between group and time (P,.001), indicating that group difference was dependent on time. There was no difference in headache index scores at baseline between groups. Headache index scores were substantially less in the C1-C2 self-SNAG group (mean 6 SD points at 4 weeks, 31 6 9; mean 6 SD points at 12 months, 24 6 9) compared to the placebo group (mean 6 SD points at 4 weeks, 51 6 15; mean 6 SD points at 12 months, 44 6 13) at 4 weeks (P,.001) and 12 months (P,.001), with an overall (6SD) reduction of 54% (617%) for the individuals in the C1-C2 self-SNAG group.t ConClusions: These results provide evidence for the efficacy of the C1-C2 self-SNAG technique in the management of individuals with cervicogenic headache.

Plant-based diets have been linked to both health benefits and a lower climate impact. However, plant-based diets may represent both healthy and unhealthy dietary practices. The present study aimed to develop a nationally adapted healthy plant-based diet based on the global EAT-Lancet reference diet. Development took place in a series of steps. First, the original EAT-Lancet reference diet was evaluated based on food availability, i.e., using Danish food data (Model 1). Then, the model was further modified to reflect national food based dietary guidelines (FBDG) and characteristics of current consumption pattern, e.g., by including processed food, discretionary foods and beverages in the diet (Model 2). The contents of macronutrients, vitamins and minerals, except for vitamin D and iodine, were found to be sufficient for Model 2, according to the recommended nutrient density to be used for planning diets for groups of individuals aged 6–65 years. In addition, the study gave an insight into the nutrients and foods to be aware of in planning a predominantly plant-based diet, thereby providing directions for future revisions of sustainable FBDGs. These include a stronger emphasis on the intake of legumes, nuts and seeds, fruit and vegetables including dark green vegetables, whole-grain products and vegetable oils as well as lowering meat intake.

Previous studies have shown that infaunal deposit feeders may enhance the loss of organic contaminants from sediments. However, the extent to which this occurs as a result of sediment microbial stimulation, porewater flushing, or biotransformation by infauna remains unclear. The purpose of this study was to determine whether the infaunal polychaete Capitella sp. I is able to metabolize the polycyclic aromatic hydrocarbon (PAH) fluoranthene and to provide an initial characterization of the metabolites produced. Our results showed that Capitella sp. I is able to metabolize fluoranthene to more hydrophilic products and that, after 24 h in clean sediment, fluoranthene could no longer be detected in worm tissues whereas a number of fluoranthene-derived metabolites were present. None of the metabolites released or retained by worms resembled known bacterial metabolites, suggesting that Capitella, and not bacteria associated with its gut or body surface, were responsible for the biotransformation of fluoranthene in our system. On the basis of ultraviolet maxima, peak shape, relative height, and order of elution, tentative identities of two metabolites (i.e., 3- and 8-hydroxyfluoranthene) are proposed. The results demonstrate that, in addition to their effects on sediment geochemical properties, infaunal polychaetes such as Capitella can enhance the degradation of sediment-associated contaminants by directly metabolizing them.

The aim of the present study was to compare total food intake, total and relative edible plate waste and self-reported food likings between school lunch based on the new Nordic diet (NND) and packed lunch from home. In two 3-month periods in a cluster-randomised controlled unblinded cross-over study 3rd- and 4th-grade children (n 187) from two municipal schools received lunch meals based on NND principles and their usual packed lunch (control). Food intake and plate waste (n 1558) were calculated after weighing lunch plates before and after the meal for five consecutive days and self-reported likings (n 905) assessed by a web-based questionnaire. Average food intake was 6 % higher for the NND period compared with the packed lunch period. The quantity of NND intake varied with the menu (P < 0·0001) and was positively associated with self-reported likings. The edible plate waste was 88 (sd 80) g for the NND period and 43 (sd 60) g for the packed lunch period whereas the relative edible plate waste was no different between periods for meals having waste (n 1050). Edible plate waste differed between menus (P < 0·0001), with more waste on soup days (36 %) and vegetarian days (23 %) compared with the packed lunch period. Self-reported likings were negatively associated with percentage plate waste (P < 0·0001). The study suggests that portion sizes need to be considered in new school meal programmes. New strategies with focus on reduction of plate waste, children's likings and nutritious school meals are crucial from both a nutritional, economic and environmental point of view.

No abstract

Background: Walking difficulties are common among pregnant women with pelvic girdle pain. This cross-sectional study investigated the influence of pelvic girdle pain, pregnancy and speed on spatiotemporal and trunk, pelvic and hip kinematics during gait in the 2nd trimester of pregnancy. Methods: Three-dimensional gait analysis at self-selected speed was performed in 25 pregnant women with pelvic girdle pain, 24 asymptomatic pregnant and 24 nonpregnant women. Linear mixed models were used to investigate between-group differences in gait variables. Adjustment for gait speed was included in the analysis. Correlations between speed and fear of movement, disability and pain were examined using Spearman correlation coefficient (r s). Findings: Pregnant women with pelvic girdle pain walked 18% slower (estimated marginal means (95% confidence intervals) 1.18 (1.22, 1.24) meter/s) compared to asymptomatic pregnant women (1.44 (1.38, 1.50) meter/s) (P < 0.001). Moreover, with longer double limb support (5%, P = 0.04), shorter contralateral step length (3%, P = 0.03) and more restricted pelvic and hip kinematics (0.001 ≤ P ≤ 0.01) adjusted for speed. Only stance, double limb support and thoracic rotation (0.001 ≤ P ≤ 0.04) differed between asymptomatic pregnant and non-pregnant women. Speed was negatively correlated with fear of movement (r s = −0.63, P = 0.01) and disability (r s = −0.46, P = 0.03) in the pelvic girdle pain group. Interpretation: Gait is primarily influenced by pelvic girdle pain and less by pregnancy. Pregnant women with pelvic girdle pain walked slower and with a more rigid gait pattern compared to asymptomatic pregnant women, presumably related to altered load transfer. Our results may assist clinical evaluation of pelvic girdle pain, as well as direct future research.

Policy actions to improve the nutritional environment include the provision of official food service guidelines. This study aimed to examine compliance with food service guidelines for hot meals as well as self-evaluated focus on food waste reduction across settings, i.e., elementary schools, upper secondary schools and workplaces, and different canteen characteristics. The same five criteria for hot meals were applied for all settings with regard to serving of fruit and vegetables, fish, wholegrain product and high fat meat and dairy products. A self-administered questionnaire survey was conducted as a cross-sectional study among 680 Danish canteens. Canteens having a high degree of organic food procurement were more likely to comply with the five criteria for hot meals combined (OR 2.00 (Cl 1.13,3.53)). Also, the use of organic food together with having a meal policy was associated with reported focus on food waste reduction (OR 1.91 (CI 1.12,3.25) and 1.84 (Cl 1.31,2.59), respectively). Compliance with individual criteria varied across settings with elementary schools being more likely to comply with criteria on, e.g., maximum serving of non-wholegrain products, whereas workplaces were more likely to comply with criteria on, e.g., minimum fruit and vegetable content and serving of fish. In addition, specific characteristics, e.g., serving system, were found to predict compliance with some of the criteria. These findings highlight the need to address differences in canteen characteristics when planning implementation support for both guideline and food waste reduction initiatives.

Previous studies have shown that infaunal deposit feeders may enhance the loss of organic contaminants from sediments. However, the extent to which this occurs as a result of sediment microbial stimulation, porewater flushing, or biotransformation by infauna remains unclear. The purpose of this study was to determine whether the infaunal polychaete Capitella sp. I is able to metabolize the polycyclic aromatic hydrocarbon (PAH) fluoranthene and to provide an initial characterization of the metabolites produced. Our results showed that Capitella sp. I is able to metabolize fluoranthene to more hydrophilic products and that, after 24 h in clean sediment, fluoranthene could no longer be detected in worm tissues whereas a number of fluoranthene-derived metabolites were present. None of the metabolites released or retained by worms resembled known bacterial metabolites, suggesting that Capitella, and not bacteria associated with its gut or body surface, were responsible for the biotransformation of fluoranthene in our system. On the basis of ultraviolet maxima, peak shape, relative height, and order of elution, tentative identities of two metabolites (i.e., 3- and 8-hydroxyfluoranthene) are proposed. The results demonstrate that, in addition to their effects on sediment geochemical properties, infaunal polychaetes such as Capitella can enhance the degradation of sediment-associated contaminants by directly metabolizing them.