Patients' and professionals' views on managing fibromyalgia

BACKGROUND: Managing fibromyalgia is a challenge for both health care systems and the professionals caring for these patients, due, in part, to the fact that the etiology of this disease is unknown, its symptoms are not specific and there is no standardized treatment. OBJECTIVE: The present study examines three aspects of fibromyalgia management, namely diagnostic approach, therapeutic management and the health professional-patient relationship, to explore specific areas of the health care process that professionals and patients may consider unsatisfactory. METHODS: A qualitative study involving semistructured interviews with 12 fibromyalgia patients and nine health professionals was performed. RESULTS: The most commonly recurring theme was the dissatisfaction of both patients and professionals with the management process as a whole. Both groups expressed dissatisfaction with the delay in reaching a diagnosis and obtaining effective treatment. Patients reported the need for greater moral support from professionals, whereas the latter often felt frustrated and of little help to patients. Patients and professionals agreed on one point: the uncertainty surrounding the management of fibromyalgia and, especially, its etiology. CONCLUSION: The present study contributes to a better understanding regarding why current management of fibromyalgia is neither effective nor satisfactory. It also provides insight into how health professionals can support fibromyalgia patients to achieve beneficial results. Health care services should offer greater support for these patients in the form of specific resources such as fibromyalgia clinics and health professionals with increased awareness of the disease.

Seasonal differences in migration patterns of a soaring bird in relation to environmental conditions: a multi-scale approach

Many studies suggest that migratory birds are expected to travel more quickly during spring, when they are en route to the breeding grounds, in order to ensure a high-quality territory. Using data recorded by means of Global Positioning System satellite tags, we analysed at three temporal scales (hourly, daily and overall journey) seasonal differences in migratory performance of the booted eagle (Aquila pennata), a soaring raptor migrating between Europe and tropical Africa, taking into account environmental conditions such as wind, thermal uplift and day length. Unexpectedly, booted eagles showed higher travel rates (hourly speed, daily distance, overall migration speed and overall straightness) during autumn, even controlling for abiotic factors, probably thanks to higher hourly speeds, more straight routes and less non-travelling days during autumn. Tailwinds were the main environmental factor affecting daily distance. During spring, booted eagles migrated more quickly when flying over the Sahara desert. Our results raise new questions about which ecological and behavioural reasons promote such unexpected faster speeds in autumn and not during spring and how events occurring in very different regions can affect migratory performance, interacting with landscape characteristics, weather conditions and flight behaviour.