Diagnosis and treatment of headache in the ambulatory care setting: a review of classic presentations and new considerations in diagnosis and management.

Headaches represent the most common constellation of neurologic disorders and are a very common cause of morbidity, lost work time, and decreased quality of life among sufferers. In this article, the diagnostic features, workup, and treatment of common, nuanced, and difficult-to-diagnose headache conditions were addressed. The future will hold a number of changes, with respect to both the diagnosis and treatment of headache disorders. As the aging population continues to grow, primary care providers will need to become increasingly familiar with differentiating between benign primary and more serious secondary headache disorders and will need to be able to treat the headache disorders unique to the elderly. With respect to therapeutic options, the future for treatment of the various headache disorders is promising. With the rise in popularity of complementary medical practices, there is likely to be more research on the roles of acupuncture, herbal and alternative remedies, massage therapy, and mind-body techniques. Further, new research is suggesting that neurostimulation may be useful in certain chronic, intractable headache conditions. Finally, the pathophysiology of headache disorders is still poorly understood and there is great hope that better understanding of the underlying mechanics of headache might contribute to improved treatment modalities and better quality of life for patients.

Use of physiological responses in Mytilus trossulus as integrative bioindicators of sewage pollution.

Mussels, Mytilus trossulus (average shell length 43+/-0.8 mm), were sampled from a beach in Alaska that received untreated sewage for several years, a second beach adjacent to a secondary wastewater outfall, and two nearby reference beaches. Survival time in air, byssal thread production rate, and prevalence of trematode parasites were determined for each group. Tolerances to aerial exposure was significantly lower (P<0.05) at both sewage outfall sites than at the reference sites. Mussels exposed to untreated sewage produced fewer byssal threads and had a significantly higher prevalence of encysted trematodes than mussels from the other beaches, including the secondary wastewater site. Survival in air, byssal thread production, and trematode prevalence in mussels may be useful indicators in evaluating the longterm health of beaches exposed to sewage.

Predictors of Cheating among Early Adolescents: Academic and Social Motivations.

This study examined the relations between middle school students' self-reported cheating and several indicators of academic and social motivation. It was hypothesized that students' academic self-efficacy and personal and classroom goal orientations would predict cheating. Social motivations were presumed to predict cheating above and beyond achievement motivation. Four dimensions of relationships within schools were measured: participation structure, teacher commitment and competence, teacher respect, and sense of school belonging. Logistic regression analyses were used to predict classification as a cheater or noncheater. Although academic motivation variables predicted cheating, the addition of the relationship variables significantly improved the classification rates. The final model included grade in school, academic self-efficacy, extrinsic goal orientation, participation structure, teacher commitment, and teacher respect. Copyright 2001 Academic Press.