Preparation and Characterization Mustard Oil, Nutmeg and Cloves to Treat Headache

Headache is an extremely common symptom and collectively headache disorders are among the most common of the nervous system disorders, with a prevalence of 48.9% in the general population.1 Headache affects people of all ages, races and socioeconomic status and is more common in women. Some headaches are extremely debilitating and have significant impact on an individual’s quality of life, imposing huge costs to healthcare and indirectly to the economy in general. Only a small proportion of headache disorders require specialist input. The vast majority can be effectively treated by a primary care physician or generalist with correct clinical diagnosis that requires no special investigation. Primary headache disorders – Headaches, tension headache and cluster headache – constitute nearly 98% of all headaches; however, secondary headaches are important to recognise as they are serious and may be life threatening. This article provides an overview of the most common headache disorders and discusses the red flag symptoms that help identify serious causes that merit urgent specialist referral. The current pathway of headache care in the UK is discussed with a view to proposing a model that might fit well in the financially constrained National Health Service (NHS) and with new NHS reforms. The role of the national society, the British Association for the Study of Headache, and the patient organisations such as Headaches Trust in headache education to the professionals and the general public in shaping headache care in the UK is described. The article concludes by summarising evidence-based management of common headache diagnoses. Keywords: Headache, Headaches, tension headache, cluster headache, medication overuse headache

Foreigners and Religion at Ugarit

During the Late Bronze Age, Syria was mostly dominated by the larger powers of the ancient Near East—Mitanni (the Hurrians), the Hittite Empire, and Egypt. The ancient city of Ugarit yielded numerous texts and artifacts that attest to the presence of foreigners and their influences on local religious traditions. Textually, the best-preserved influences are those of Hurrian origin, although these were probably promoted thanks to the Hittites, who incorporated many Hurrian deities and cults. Hurrian traditions thus influenced both Ugaritic cults and divine pantheons. Egyptian influences, in contrast, are observable mostly in art and material evidence. Art of Egyptian origin was considered prestigious and because of that was prominently seen in trade and international exchange gifts, but it also entered the religious sphere in the form of cultic statues and ex-voto gifts for deities. Egyptian art was also often imitated by local artists. The same can be said of art from the Mediterranean area. Some evidence suggests that foreigners actively related to local traditions as well. Ritual tablets from Ugarit (namely KTU3 1.40 and its variants) illustrate that there were always frictions in a multicultural/national society. These tablets also indicate that such frictions could have been dealt with through ritual action, and thus emphasize the role religion played. The city of Ugarit is used in this paper to illuminate some processes that can be observed in the whole of ancient Syria. Nevertheless, every site has its own outcome of interactions with other cultures.

Ways of Seeing Advertising: Law and the Making of Visual Commercial Culture

This article examines the role of law in shaping visual commercial culture by telling the story of the hoarding—the outdoor advertising surface for posters—in the formative decades of mass advertising in Britain, from roughly 1840 to 1914. The hoarding emerged in this period as a distinct property and a focal point of contestation over ways of seeing. Its meaning as a visual environment hinged on questions, which are still resonant today, about the interaction between economic and aesthetic categories: advertising and art, capital and beauty, commerce and culture. Historical actors—among them the organized billposting trade, the National Society for Checking the Abuses of Public Advertising, a civil society organization that took up the cause of protecting public spaces from advertising, governmental and local lawmakers, and citizens—enlisted private and public legal means to respond to these questions. This analysis draws on an expansive interdisciplinary archive to trace them. As it shows, legal means were engaged in cultural demarcation or what Thomas Gieryn has aptly termed boundary work. In establishing cultural boundaries, law defined the terms on which advertising became an integral element of daily visual experience, at once omnipresent and derided. The legal history of advertising thus offers deep insights for visual legal studies.

Transitioning from Training to Breast Imaging Practice: Building an Academic Career

Launching an academic career in breast imaging presents both challenges and opportunities for the newly graduated trainee. A strategic plan aligned with one’s personal strengths and interests facilitates career success and professional satisfaction. Academic departments offer multiple tracks to accommodate diverse faculty goals. The specific requirements of various tracks vary across institutions. The clinician-educator track typically encourages a focus on medical education and educational scholarship. The clinician-investigator or clinician-scholar track supports original research and grant-funded clinical trials. Finally, the clinical and clinician-administrator tracks allow for emphasis on clinical program development and leadership. As definitions of scholarship broaden, many opportunities are accessible to demonstrate excellence in the traditional areas of clinical practice, education, and research, as well as the broader fields of leadership and administration. Departmental and national society resources that advance knowledge in one’s chosen area of interest are available and should be explored. Mentorship and sponsorship can provide valuable insight into identifying such resources and devising a plan for sustainable career success and work-life integration.

Even experts cannot agree on the optimal use of platelet-rich plasma in lateral elbow tendinopathy: an international Delphi study

Background Platelet-rich plasma (PRP) is widely used in the management of lateral elbow tendinopathy (LET) despite conflicting evidence on its effectiveness. With high levels of user experience, this study aimed to assess consensus amongst experts on its clinical use. Methods A three-round international Delphi study was conducted. Participants were invited through national society mailing lists and contact lists derived from a systematic search of the literature on PRP. In round one, a primary working group developed 40 statements on PRP preparation and clinical application. In rounds two and three, an international group of researchers on PRP and clinical users of the device scored their levels of agreement with the statements on a five-point scale. Consensus was defined as an interquartile range of ≤ 1. Results Consensus of agreement was only reached for 17/40 (42.5%) statements. For statements on PRP formulation, consensus of agreement was reached in 2/6 statements (33%). Only limited consensus on the contraindications, delivery strategy and delivery technique was achieved. Conclusion Experts reached very limited consensus on the use of PRP in LET. High levels of user experience have not resulted in a convergence of opinion on the technical components of PRP formulation and delivery, substantiating the need for further studies and improved trial reporting.

Pathways to Positive Development for Muslim Immigration Youth in Western Contexts

<p>Muslim youth growing up in Western contexts face a complex set of issues as a result of meeting the various, and often incongruent, expectations placed upon them by their family, religion, ethnic community and host national society. This group of young people is often thought to face high risks of maladaptation, as they potentially experience the negative effects of acculturation more so than host nationals or other immigrant youth. Recent research, however, has suggested that many Muslim migrant young people are successfully negotiating their experiences of cultural transition in Western societies. Therefore, the major aim of this thesis was to obtain systematic data on young Muslim migrant’s “pathways to positive development”, or how these young people achieve successful adaptation in the face of adversity. To examine the complexities of Muslim migrant youth acculturation fully, it is necessary to have a comprehensive understanding of their lived experiences within and across contexts. In order to achieve this, four studies were conducted utilising mixed methodologies and drawing on a range of psychological and sociological theories, predominantly focusing on acculturation, development and religiosity. Study 1 qualitatively investigated the indicators and determinants of participation and success for Muslim youth in the New Zealand environment. The results of this study enabled a framework to be developed that illustrates the most salient ecological resources youth access (family, religion and the intercultural environment), the risks they face (discrimination and cultural differences) and outcomes of the acculturation process. In study 2, this framework was refined by drawing upon theories of resilience, and subsequently was tested quantitatively with a sample of Muslim youth in New Zealand. Results from this study indicate that while Muslim youth in New Zealand may be at risk of maladaptative outcomes because of their exposure to discrimination and cultural transition, ecological resources may counteract some of the negative effects of these stressors. Study 3 sought to test whether the results found in study 2 were generalisable to Muslim youth in other contexts by carrying out a comparative analysis of youth outcomes in New Zealand and the United Kingdom. These societies were chosen to be compared because they share a similar historic culture but have taken very different routes to social cohesion and the inclusion of minorities. The major aim of this study was to investigate whether the country of settlement has an impact on the adaptation of Muslim migrant youth. The results demonstrate that the cultural environment of migration plays an important contributing factor to both the experience of stress and the achievement of positive adaptation above and beyond the effects of resources. Finally, study 4 utilised techniques of multilevel modelling to examine the acculturation experiences of Muslim youth cross-culturally. Drawing on the International Comparative Study of Ethnocultural Youth (ICSEY) data, Muslim migrant youth from 9 Western receiving nations were examined. Results indicate that the ideological context (cultural values and host national attitudes towards immigrants) has important effects on individual levels of adaptation and the experience of perceived discrimination. The findings of this thesis contribute novel perspectives to acculturation and development research as well as cross-cultural psychology more generally. Using multiple methods in the study of psychological phenomena enables a move beyond traditional descriptions of acculturation processes as situated predominantly within one cultural setting and advances our understanding of how Muslim youth fare in a global context.</p>

Pathways to Positive Development for Muslim Immigration Youth in Western Contexts

<p>Muslim youth growing up in Western contexts face a complex set of issues as a result of meeting the various, and often incongruent, expectations placed upon them by their family, religion, ethnic community and host national society. This group of young people is often thought to face high risks of maladaptation, as they potentially experience the negative effects of acculturation more so than host nationals or other immigrant youth. Recent research, however, has suggested that many Muslim migrant young people are successfully negotiating their experiences of cultural transition in Western societies. Therefore, the major aim of this thesis was to obtain systematic data on young Muslim migrant’s “pathways to positive development”, or how these young people achieve successful adaptation in the face of adversity. To examine the complexities of Muslim migrant youth acculturation fully, it is necessary to have a comprehensive understanding of their lived experiences within and across contexts. In order to achieve this, four studies were conducted utilising mixed methodologies and drawing on a range of psychological and sociological theories, predominantly focusing on acculturation, development and religiosity. Study 1 qualitatively investigated the indicators and determinants of participation and success for Muslim youth in the New Zealand environment. The results of this study enabled a framework to be developed that illustrates the most salient ecological resources youth access (family, religion and the intercultural environment), the risks they face (discrimination and cultural differences) and outcomes of the acculturation process. In study 2, this framework was refined by drawing upon theories of resilience, and subsequently was tested quantitatively with a sample of Muslim youth in New Zealand. Results from this study indicate that while Muslim youth in New Zealand may be at risk of maladaptative outcomes because of their exposure to discrimination and cultural transition, ecological resources may counteract some of the negative effects of these stressors. Study 3 sought to test whether the results found in study 2 were generalisable to Muslim youth in other contexts by carrying out a comparative analysis of youth outcomes in New Zealand and the United Kingdom. These societies were chosen to be compared because they share a similar historic culture but have taken very different routes to social cohesion and the inclusion of minorities. The major aim of this study was to investigate whether the country of settlement has an impact on the adaptation of Muslim migrant youth. The results demonstrate that the cultural environment of migration plays an important contributing factor to both the experience of stress and the achievement of positive adaptation above and beyond the effects of resources. Finally, study 4 utilised techniques of multilevel modelling to examine the acculturation experiences of Muslim youth cross-culturally. Drawing on the International Comparative Study of Ethnocultural Youth (ICSEY) data, Muslim migrant youth from 9 Western receiving nations were examined. Results indicate that the ideological context (cultural values and host national attitudes towards immigrants) has important effects on individual levels of adaptation and the experience of perceived discrimination. The findings of this thesis contribute novel perspectives to acculturation and development research as well as cross-cultural psychology more generally. Using multiple methods in the study of psychological phenomena enables a move beyond traditional descriptions of acculturation processes as situated predominantly within one cultural setting and advances our understanding of how Muslim youth fare in a global context.</p>

Primary Non-adherence to Treatment with New Oral Anticoagulants: The Results of a Prospective Observational Study «ANTEY»

Aim: To assess the main characteristics of patients with non-valvular Atrial Fibrillation (AF) who are initially non-adherent to New Oral Anticoagulants (NOAC), and to identify factors associated with this version of non-adherence. Materials and Methods: The ANTEY study included 201 patients with non-valvular AF, who had indications and without contraindications for NOAC treatment. The patients had previously been advised to take oral anticoagulants but they did not comply with all medical recommendations. The observation period was 1 year, during which 2 in-person visits were performed: an inclusion visit (V0) and a visit (V1), as well as 1 telephone contact/follow up (FU); the interval between contacts was 6 months. All patients were recommended to take the NOAC by decision of the physician. During the V0, V1 and FU visits, the “National Society for Evidence-Based Pharmacotherapy (NSEPh) Adherence Scale” questionnaire was used to assess overall adherence and associated factors. 15 (7.5%) patients had not started NOAC therapy by the end of the study (primary non-adherent patients). Their characteristics are analysed in this work. Results: The main reasons for primary non-adherence to NOAC were high cost (33.3%), fears of adverse effects (AE) (33.3%), doubts about the need for treatment (13.3%) and the complex therapy regimen (13.3%). In the group of primary non-adherent patients in comparison with the rest of the patients there were significantly more patients with 1 point according to CHADS2VASc (20% and 2.2%, respectively, p = 0.029) and patients with 3 points according to HAS-BLED (33.3% and 9.1%, respectively, p = 0.006); they took antiplatelet drugs more often 73.3% versus 21.5%, respectively (p = 0.001). Full employment at work (OR = 5.2; CI95% [1.5; 18.1], p = 0.009), history of quitting smoking (OR = 5.1; CI95% [1.5; 17.0], p = 0,008), the presence of any pharmacotherapy AE (OR = 4.0; CI95% [1.01; 16.0], p = 0.048) increased the chance of primary non-adherence to NOAC by 4-5 times. Conclusion: The most vulnerable in relation to initiation of NOAC therapy for the prevention of thromboembolic complications in AF are those patients who continue to work or have any pharmacotherapy AE. The leading factors preventing the initiation of NOAC administration are their high cost, fear of the development of AE from the therapy, and patients’ doubts about the need for treatment with these drugs. The clinical trial registration number is NCT 03790917.

Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost

Patients with phenylketonuria (PKU) are reliant on special low protein foods (SLPFs) as part of their dietary treatment. In England, several issues regarding the accessibility of SLPFs through the national prescribing system have been highlighted. Therefore, prescribing patterns and expenditure on all SLPFs available on prescription in England (n = 142) were examined. Their costs in comparison to regular protein-containing (n = 182) and ‘free-from’ products (n = 135) were also analysed. Similar foods were grouped into subgroups (n = 40). The number of units and costs of SLPFs prescribed in total and per subgroup from January to December 2020 were calculated using National Health Service (NHS) Business Service Authority (NHSBSA) ePACT2 (electronic Prescribing Analysis and Cost Tool) for England. Monthly patient SLPF units prescribed were calculated using patient numbers with PKU and non-PKU inherited metabolic disorders (IMD) consuming SLPFs. This was compared to the National Society for PKU (NSPKU) prescribing guidance. Ninety-eight percent of SLPF subgroups (n = 39/40) were more expensive than regular and ‘free-from’ food subgroups. However, costs to prescribe SLPFs are significantly less than theoretical calculations. From January to December 2020, 208,932 units of SLPFs were prescribed (excluding milk replacers), costing the NHS £2,151,973 (including milk replacers). This equates to £962 per patient annually, and prescribed amounts are well below the upper limits suggested by the NSPKU, indicating under prescribing of SLPFs. It is recommended that a simpler and improved system should be implemented. Ideally, specialist metabolic dietitians should have responsibility for prescribing SLPFs. This would ensure that patients with PKU have the necessary access to their essential dietary treatment, which, in turn, should help promote dietary adherence and improve metabolic control.