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We analyzed the responses of 448 participants who completed questions on attractiveness and other evolutionary fitness related traits, and long- and short-term mating potential, of a woman in either high heeled or flat shoes. We hypothesized that the woman in high heels would be rated as more attractive and evolutionarily fit by both men and women, and preferred for short-term mating by men. The hypothesis was partially supported. The woman in high heels was perceived as being more sexually attractive, physically attractive, feminine, and of a higher status. Additionally, women rated women as having a higher status regardless of the shoe, than men, while men rated women as having higher short- and long-term mating potential, than women did, regardless of the shoe. We discuss the implications of these findings. [ABSTRACT FROM AUTHOR]

Purpose of review: This review describes the pharmacology of each antidepressant class as it applies to migraine prevention, summarizes the evidence base for each medication, and describes relevant side effects and clinical considerations. Use of antidepressants for migraine prevention in clinical practice is also discussed. Recent findings: Antidepressants are commonly used as migraine preventives. Amitriptyline has the best evidence for use in migraine prevention. Nortriptyline is an alternative in patients who may not tolerate amitriptyline. The sedating effect of TCAs can be beneficial for patients with comorbid insomnia. SNRIs including venlafaxine and duloxetine also have evidence for efficacy and may be the most effective treatments in patients with comorbid depression and migraine. SSRIs including fluoxetine are not effective for most patients. The side effect burden of antidepressants can be substantial. Patients should be particularly counseled about the possibility of a withdrawal effect from SNRIs. Summary: Antidepressants are an important option for preventive treatment of migraine. Further research on the efficacy and tolerability of SNRIs as migraine preventives is needed. [ABSTRACT FROM AUTHOR]

Purpose Of Review: To review the pathophysiologic, epidemiologic, and clinical evidence for similarities and differences between migraine with and without aura.Recent Findings: The ICHD-3 has recently refined the diagnostic criteria for aura to include positive symptomatology, which better differentiates aura from TIA. Although substantial evidence supports cortical spreading depression as the cause of visual aura, the role (if any) of CSD in headache pain is not well understood. Recent imaging evidence suggests a possible hypothalamic origin for a headache attack, but further research is needed. Migraine with aura is associated with a modest increase in the risk of ischemic stroke. The etiology for this association remains unclear. There is a paucity of evidence regarding treatments specifically aimed at the migraine with aura subtype, or whether migraine with vs without aura responds to treatment differently. Migraine with typical aura is therefore often treated similarly to migraine without aura. Lamotrigine, daily aspirin, and flunarizine have evidence for efficacy in prevention of migraine with aura, and magnesium, ketamine, furosemide, and single-pulse transcranial magnetic stimulation have evidence for use as acute treatments. Although triptans have traditionally been contraindicated in hemiplegic migraine and migraine with brainstem aura, this prohibition is being reconsidered in the face of evidence suggesting that use may be safe. The debate as to whether migraine with and without aura are different entities is ongoing. In an era of sophisticated imaging, genetic advancement, and ongoing clinical trials, efforts to answer this question are likely to yield important and clinically meaningful results. [ABSTRACT FROM AUTHOR]

The authors discuss research on the vascular safety of the antimigraine drug triptan. They reference the study "Triptans and Serious Adverse Vascular Events: Data Mining of the FDA Adverse Event Reporting System Database" by G. Roberto and colleagues published in the current issue of the journal. They believe that the analysis of the database represents a useful complementary source of information about triptan safety.

There are a number of questions concerning human sexual psychology where pornography consumption may be particularly informative, yet evolutionary psychologists have been slow to incorporate it into research designs. This study examines the relationships between pornography preferences, individual's sex, proxies for short-term mating strategies (e.g., life history strategy, sociosexuality), and infidelity. For example, we predict that men, more than women, will be interested in group sex (i.e., threesomes and gangbang) scenarios in pornography as a result of selective pressures for sperm competition. Further, specific activities and sexual situations in pornography are likely to be differentially appealing based on the sexual strategies pursued by consumers. Thus, women who have higher, versus lower, intentions of committing infidelity will be more interested in activities like group sex, given the latter involves no commitment. Results suggest that men exhibit more interest in group sex scenarios than women, and intentions to commit infidelity are also associated with greater interest in group sex scenarios. Collectively, our findings demonstrate the usefulness of incorporating consumption of pornography measures in evolutionary social psychological research. [ABSTRACT FROM AUTHOR]

Flirting involves various signals communicated between individuals. To attract potential mates, men and women exhibit flirtatious behavior to get the attention of, and potentially elicit sexual or romantic interest from, a desired partner. In this first large, preregistered study of judgement of the effectiveness of flirtation tactics based on Sexual Strategies Theory, we considered the effects of flirter's (actor) sex and mating contexts in addition to rater's (participant) sex across two cultures, Norway and the U.S. Culturally relevant covariates such as sociosexuality, extraversion, mate value, age, and religiosity were examined. Participants from Norway (N = 415, 56% women) and the US (N = 577, 69% women) responded to one of four different randomized questionnaires representing a factorial design considering either short-term versus long-term mating context and either female or male sex of actor. We found that sexual availability cues were judged more effective when employed by women in short-term mating contexts. Friendly contact, such as hugs or kissing on the cheek, was not. Cues to generosity and commitment were judged more effective when employed by men in long-term mating contexts. Humor was rated as more effective when used by men and in long-term contexts, and least effective when used by women in short term contexts. However, laughing or giggling at someone's jokes was an effective flirtation tactic for both sexes. Overall, predictions for culturally relevant covariates were not supported, but cultural differences were found in bodily displays, initial contact, and generosity. These findings dovetail neatly with findings from the self-promotion literature, and further support that flirtation is a universal mate signaling strategy. [ABSTRACT FROM AUTHOR]

Objective: To identify factors associated with work productivity in adults with migraine, and accommodations or interventions to improve productivity or the workplace environment for them. Methods: We conducted a scoping review by searching MEDLINE, Embase, PsycINFO, Cumulative Index of Nursing and Allied Heath Literature, and Web of Science from their inception to 14 October 2019 for studies of any design that assessed workplace productivity in adults with migraine. Results: We included 26 articles describing 24 studies after screening 4139 records. Five prospective cohort studies showed that education on managing migraine in the workplace was associated with an increase in productivity of 29-36%. Two studies showed that migraine education and management in the workplace were associated with increased productivity (absenteeism decreased by 50% in one study). One prospective cohort study showed that occupational health referrals were associated with more than 50% reduction in absenteeism. Autonomy, social support, and job satisfaction were positively associated with productivity, while quantitative demands, emotional demands, job instability, and non-conducive work environment triggers are negatively associated with productivity in workers with migraine. Conclusion: Despite migraine being the second leading cause of disability worldwide, there is a paucity of strong data on migraine-related work factors associated with productivity. Registration: None (scoping review) [ABSTRACT FROM AUTHOR]

Objective Migraine with aura has been associated with increased risk of ischemic and hemorrhagic stroke. Prior studies have shown a further increase in risk in women using combined hormonal contraceptives (CHCs). This has led to guidelines recommending against use of CHCs in this population. We sought to assess whether the risk of stroke is associated with the dose of estrogen and whether there is evidence of synergism between migraine and CHCs. We also sought to assess whether an interaction effect exists between migraine and CHCs. Methods We searched PubMed, the Cochrane Library, and EMBASE from inception through January 2016 for relevant English-language studies of adults, of any design. We included studies that examined exposure to CHCs and reported outcomes of ischemic or hemorrhagic stroke. Data extraction and assessment of study quality were conducted independently by reviewer pairs and quality was assessed with the GRADE and Newcastle Ottawa scales. Results Of 2480 records, 15 studies met inclusion criteria and six provided odds ratios for the relevant population. The point estimates for the odds ratios for ischemic stroke in women with migraine who used CHCs with any dose of estrogen ranged from 2.08 to 16.9. Studies were generally small and confidence intervals were wide. No studies reported odds ratios for stroke risk as a function of estrogen dose in women with migraine, largely due to insufficient sample sizes. No interaction effect between migraine and CHCs was seen in the seven studies that assessed this. One study differentiated risk by presence or absence of migraine aura and found an increased risk in the migraine with aura population (OR 6.1; CI 3.1 to 12.1 in migraine with aura vs 1.8; CI 1.1 to 2.9 in the migraine without aura group). Studies generally had high Newcastle Ottawa scores and low GRADE levels of evidence. No studies met all three supplementary quality criteria (assessed migraine subtype, used International Classification of Headache Disorders criteria for diagnosis of migraine, and stratified risk by estrogen dose). Conclusions This systematic review shows a lack of good quality studies assessing risk of stroke associated with low dose estrogen use in women with migraine. Further study in this area is needed. The available evidence is consistent with an additive increase in stroke risk with CHC use in women with migraine with aura. Since the absolute risk of stroke is low even in the presence of these risk factors, use of CHCs in women who have migraine with aura should be based on an individualized assessment of harms and benefits. [ABSTRACT FROM AUTHOR]

Objective: Most patients with migraine require acute treatment for at least some attacks. This article reviews the approach to the acute treatment of migraine, migraine-specific and nonspecific treatment options, rescue treatment and options for management in the emergency department and inpatient settings, and treatment during pregnancy and lactation., Latest Developments: Triptans, ergot derivatives, and nonsteroidal anti-inflammatory drugs have historically been the main acute treatments for migraine. The development of new classes of acute treatment, including the small-molecule calcitonin gene-related peptide receptor antagonists (gepants) and a 5-HT1F receptor agonist (lasmiditan), expands available options. These new treatments have not been associated with vasospasm or increased cardiovascular risk, therefore allowing migraine-specific acute treatment for the more than 20% of adults with migraine who are at increased risk of cardiovascular events. Neuromodulation offers a nonpharmacologic option for acute treatment, with the strongest evidence for remote electrical neuromodulation., Essential Points: The number of available migraine treatments continues to expand, although triptans are still the mainstay of migraine-specific acute treatment. There is no one-size-fits-all acute treatment and multiple treatment trials are sometimes necessary to determine the optimal regimen for patients. Switching within and between classes, using the maximum allowed dose, using combination therapy, and counseling patients to treat early are all strategies that may improve patient response to acute treatment., (Copyright © 2024 American Academy of Neurology.)

Here we investigated how a history of experiencing unwanted advances-both sexual and romantic-impact a person's stress and strategies when rejecting future advances. In this study ( N = 465; 71% women), women reported experiencing unwanted advances earlier in life compared to men, and these women were more likely to have greater worry over such advances. Additionally, women tended to worry more than men about the repercussions of rejecting these advances (e.g., being hit, being yelled at). Lastly, women were more likely to employ a myriad of strategies (e.g., run away, call a friend) to ensure their safety when rejecting an advance. In contrast, men were more likely to remain friends with the rejected person. Ultimately, women have to deal with rejecting advances at an early age and this early onset has consequences for future dating.

The target article is focused on locating the popularity of imaginary worlds in our adaptations for exploration. This commentary touches on developmental influences, vicarious enjoyment, the challenging of societal mores, plot, and whether men and women are drawn to the same features in the same ways.

Purpose of Review: This article provides an overview of preventive interventions for migraine, including when to start and how to choose a treatment, pharmacologic options (both older oral treatments and new monoclonal antibodies to calcitonin gene-related peptide [CGRP] or its receptor), nonpharmacologic treatment such as neuromodulation, and preventive treatment of refractory migraine., Recent Findings: The migraine preventive treatment landscape has been transformed by the development of monoclonal antibodies targeting CGRP or its receptor. These treatments, which are given subcutaneously or intravenously monthly or quarterly, have high efficacy and were well tolerated in clinical trials. Emerging real-world studies have found higher rates of adverse events than were seen in clinical trials. They are currently recommended for use if two traditional preventive therapies have proven inadequate. Since the commonly cited 2012 American Headache Society/American Academy of Neurology migraine prevention guidelines were released, clinical trials supporting the preventive use of lisinopril, candesartan, and memantine have been published. Neuromodulation devices, including external trigeminal nerve stimulation and single-pulse transcranial magnetic stimulation devices, have modest evidence to support preventive use. The American Headache Society/American Academy of Neurology guidelines for the preventive treatment of migraine are currently being updated. A new class of oral CGRP receptor antagonists (gepants) is being tested for migraine prevention., Summary: Successful preventive treatment of migraine reduces disease burden and improves quality of life. Many pharmacologic and nonpharmacologic treatment options are available for the prevention of migraine, including newer therapies aimed at the CGRP pathway as well as older treatments with good evidence for efficacy. Multiple treatment trials may be required to find the best preventive for an individual patient., (Copyright © 2021 American Academy of Neurology.)

Migraine affects an estimated 12% of the population. Global estimates are higher. Chronic migraine (CM) affects 1% to 2% of the global population. Approximately 2.5% of persons with episodic migraine progress to CM. Several risk factors are associated with the progression to CM. There is significant short-term variability in migraine frequency independent of treatment. Migraine is associated with cardiovascular disease, psychiatric disease, and sleep disorders. It is the second most disabling condition worldwide. CM is associated with higher headache-related disability/impact, medical and psychiatric comorbidities, health care resource use, direct and indirect costs, lower socioeconomic status, and health-related quality of life., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Migraine and tension-type headache are highly prevalent. Migraine is associated with significant work- and family-related disability. Migraine is underdiagnosed; it reasonable to err on the side of migraine when choosing between primary headaches. Barriers to appropriate treatment of migraine include lack of access to providers, misdiagnosis, and acute and preventive therapies not being prescribed. Acute, rescue, and preventive treatment options are extensive, and new classes of treatments are either available or in development. This review addresses diagnostic challenges including recognizing migraine with aura. It also summarizes nonpharmacologic, acute, rescue, and preventive treatment options for migraine and treatment of tension-type headache., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Observational studies suggest that closure of a patent foramen ovale for other indications may reduce or even eliminate migraine attacks, particularly migraine with aura. The first randomized clinical trial of patent foramen ovale (PFO) closure for prevention of migraine, the MIST trial, showed negative results. The results of the other two completed studies in this area have recently been published in the last year. PRIMA and PREMIUM were also both negative for their primary endpoints. The PREMIUM trial did show a reduction in headache days in the migraine with aura subgroup but the final results of this subset analysis have not been published. There may be an as yet undetermined subgroup of patients with migraine who would benefit from closure, but slow recruitment has been a barrier to further study. Several potentially life-threatening procedure-related adverse events occurred in the clinical trials. At this time, we recommend against offering PFO closure as a preventive treatment for migraine. Based on available observational data, patients for whom PFO closure is indicated for other reasons may see some improvement in their migraines.