Japanese patients in this study showed a relatively low prevalence of chronic cluster headaches, and uncoupling of a sense of restlessness and restless behaviour. These features of cluster headache may be more common in Japanese and Taiwanese patients than in Caucasian patients.

Objective The first symptom of giant cell arteritis (GCA) is usually a headache. Japan has a low prevalence of GCA, and clinical features of this disorder have not been fully investigated. We conducted a retrospective evaluation of clinical features in patients with giant cell arteritis who visited a headache clinic in Japan. Methods Clinical and demographic data were obtained from clinical examinations, face-to-face interviews, and hospital records. Patients Subjects comprised 19 patients (9 men, 10 women). Results Mean age at disease onset was 78.1 ± 4.8 years (range, 71-86 years). Seventeen of 19 patients (89.5%) had consulted other medical institutions before consulting our hospital, but only 2 of those patients had been diagnosed with GCA at these medical institutions. Manifestations at disease onset included headache (89.5%), ear pain (5.3%), and jaw pain (5.3%). Ocular manifestations were reported in 2 patients (10.5%). No loss of vision occurred. One patient showed trigeminal nerve palsy involving the third division of the nerve. Jaw claudication was observed in 3 patients (15.8%). Concomitant polymyalgia rheumatica was seen in 3 patients (15.8%). No patient showed upper respiratory tract symptoms, arm claudication, or aortic aneurysms. Conclusion Although most patients had consulted other medical institutions before consulting our hospital, they were not diagnosed with GCA at these institutions. Infrequent clinical findings of GCA and lack of symptoms other than headache may contribute to the high rate of unrecognized and misdiagnosed cases of GCA.

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This short paper provides a brief overview of an undergraduate student project designed to identify wisdom from different cultures and historical periods that might enable engineering students to improve the quality of their internship experiences. Based on student surveys, interviews, focus sessions, and investigations to compare both modern and historical advice, team members identified useful wisdom from the past that they believe can improve student perspectives and behavior in ways that will deepen the quality of their internship experiences beyond that which modern advice is able to accomplish. This advice will be useful for independent reflection as well as for university class discussion and pre-internship orientation since it contains a range of ideas that many engineering students may not have had much exposure to.

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