A low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patients

Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, “fermentable oligo-, di- or mono-saccharides and polyols” [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders. Methods A longitudinal study using LFD intervention was performed on 38, 51 ± 10 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 – introduction of the protocol to participants; Moment 1 – first assessment and delivery of individual LFD dietary plans; Moment 2 – second assessment and reintroduction of FODMAPs; Moment 3 – last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman, t-student and Chi-square tests, using SPSS 22 software. Results The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0–31) – 22 ± 4.4; RFIQ (0–100) – 65 ± 17; IBS-SSS (0–500) – 275 ± 101; and EQ-5D (0–100) – 48 ± 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g/day vs. 2.5 g/day; p < 0.01). Comparisons between the three moments of assessment showed significant (p < 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138 ± 117, following LFD therapy. A significant correlation (r = 0.36; p < 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (r = 0.65; p < 0.01) between “satisfaction with improvement” after introduction of LFDs and “diet adherence”, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square χ2 = 6.16; p < .05), showing that the probability of improvement, depends on the severity of the RFIQ score. Conclusions Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM. Implications According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.

Quality of life in people with leg ulcer, integrative review

Objective: To identify the main changes in the daily life of people with leg ulcer and how that affects the person’s life’s quality. Methodology: We used the methodology PI [C] OD and were selected four research articles, taken from EBSCO, PubMed, and EWMA. Results: The main changes identified in the people’s daily live with leg’s ulcers are physical (pain, decreased mobility, presence of exudate, bad smell from the wound and change in the style of clothing), psychological (sleep disorders, depression, anxiety, feelings of rejection and low self-esteem), social (isolation, restriction in leisure activities, inability to perform household chores). Conclusions: The literature about person’s life’s quality with leg ulcer reported a significant impact in the daily life of that person. The care provided by nurses should be centred on the person itself, integrating all the kind of needs and the leg ulcer mustn’t be the sole focus of care.

Cante alentejano: entre o quotidiano e a patrimonialização de uma prática cultural.(O caso de Santo Aleixo da Restauração)

A presente dissertação pretende contribuir para a compreensão dos processos de patrimonialização. Especificamente, exploram-se contextos quotidianos associados à prática do Cante Alentejano, delineando as suas reconfigurações e manifestações contemporâneas. A pesquisa é ancorada metodologicamente em investigação etnográfica na localidade de Santo Aleixo da Restauração (Moura). Neste contexto empírico, caracterizam-se os espaços sociais onde é desenvolvido o quotidiano do Cante Alentejano, de forma a perceber o dualismo entre a sua prática quotidiana e aquilo que é a sua patrimonialização, tal como é percepcionada pelos atores sociais locais; Abstract: This dissertation aims to contribute to the understanding of processes of heritagization. Specifically, we explore contexts of daily practice of Cante Alentejano and identify the current manifestations and reconfigurations of this practice. Methodologically, research is based in an ethnography conducted in the locality of Santo Aleixo da Restauração (Moura). In this empirical context, we analyse daily social spaces where Cante Alentejano has been developed, with the purpose of understanding the dualism between this daily practice and the process of patrimonialization, as i tis perceived by local social actors.

La mine d'alunite de Wenzhou : mémoires et stratégies de valorisation

lNTRODUCTION; This part is the general introduction of this thesis. The research subject, alunite mine of Wenzhou, has a history of more than 600 years. Not only in the history, has it still played an important role in the people's daily life of Fanshan Town. According to the legend, it was Qin Fu, a refugee, found the way of produce the alum totally by accident. However, we try to find out the real history of its mining and production of alum. ln fact, we have found some ancient documents concerning its history. Especially in the book « The chronicles of Wenzhou Fu of Hongzhi », we found some original information, such as the ancient method of mining and producing alum, etc. ln some other ancient documents, we found some important information, too. With such a long history, the alunite mine has held a lot of heritage, no matter tangible or intangible. Unfortunately, due to some reasons, the condition of the mine becomes worse and worse. ln studying his history, technology and the present situation, we intend to find some ways to solve the problems, and restart its development in other fields. Certainly, we should make a brief introduction of the alunite as well as the alum. The second part of the introduction concentrates in the uses of alum, providing an easier comprehension of this object.