Identifying preferred format and source of exercise information in persons with multiple sclerosis that can be delivered by health-care providers

Background: There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health-care providers among persons with MS. Objective: We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health-care providers. Setting and participants: Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States. Methods: Fifty semi-structured interviews were conducted and analysed using thematic analysis. Results: Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in-person consultations with health-care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health-care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists). Conclusions: These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health-care providers including neurologists and physical therapists should be involved in exercise promotion

Four Zero Texture Fermion Mass Matrices in SO(10) GUT

We attempt the integration of the phenomenologically successful four zero texture of fermion mass matrices with the renormalizable SO(10) GUT. The resulting scenario is found to be highly predictive. Firstly, we examine the phenomenological implications of a class of the lepton mass matrices with parallel texture structures and obtain interesting constraints on the parameters of the charged lepton and the neutrino mass matrices. We combine these phenomenological constraints with the constraints obtained from SO(10) GUT to reduce the number of the free parameters and to further constrain the allowed ranges of the free parameters. The solar/atmospheric mixing angles obtained in this analysis are in fairly good agreement with the data.Comment: 14 pages, 3 figures, 1 tabl

Test of Lorentz and CPT violation with Short Baseline Neutrino Oscillation Excesses

The sidereal time dependence of MiniBooNE electron neutrino and anti-electron neutrino appearance data are analyzed to search for evidence of Lorentz and CPT violation. An unbinned Kolmogorov-Smirnov test shows both the electron neutrino and anti-electron neutrino appearance data are compatible with the null sidereal variation hypothesis to more than 5%. Using an unbinned likelihood fit with a Lorentz-violating oscillation model derived from the Standard Model Extension (SME) to describe any excess events over background, we find that the electron neutrino appearance data prefer a sidereal time-independent solution, and the anti-electron neutrino appearance data slightly prefer a sidereal time-dependent solution. Limits of order 10E-20 GeV are placed on combinations of SME coefficients. These limits give the best limits on certain SME coefficients for muon neutrino to electron neutrino and anti-muon neutrino to anti-electron neutrino oscillations. The fit values and limits of combinations of SME coefficients are provided.Comment: 14 pages, 3 figures, and 2 tables, submitted to Physics Letters

Supernova neutrino detection in NOvA

The NOvA long-baseline neutrino experiment uses a pair of large, segmented, liquid-scintillator calorimeters to study neutrino oscillations, using GeV-scale neutrinos from the Fermilab NuMI beam. These detectors are also sensitive to the flux of neutrinos which are emitted during a core-collapse supernova through inverse beta decay interactions on carbon at energies of O(10 MeV). This signature provides a means to study the dominant mode of energy release for a core-collapse supernova occurring in our galaxy. We describe the data-driven software trigger system developed and employed by the NOvA experiment to identify and record neutrino data from nearby galactic supernovae. This technique has been used by NOvA to self-trigger on potential core-collapse supernovae in our galaxy, with an estimated sensitivity reaching out to 10 kpc distance while achieving a detection efficiency of 23% to 49% for supernovae from progenitor stars with masses of 9.6 M☉ to 27 M☉, respectively

Long-Baseline Neutrino Facility (LBNF) and Deep Underground Neutrino Experiment (DUNE) Conceptual Design Report Volume 2: The Physics Program for DUNE at LBNF

The Physics Program for the Deep Underground Neutrino Experiment (DUNE) at the Fermilab Long-Baseline Neutrino Facility (LBNF) is described

Results of a feasibility randomised controlled study of the guidelines for exercise in multiple sclerosis project

There is increasing recognition that exercise is an efficacious strategy for managing many consequences of multiple sclerosis (MS), yet persons with MS are not engaging in sufficient exercise for accruing health benefits. Poor exercise uptake might be associated with the design of previous research. We conducted a randomised controlled trial (RCT) for examining the feasibility of a 4-month home-based, exercise-training program designed based on recent physical activity guidelines for MS and supplemented by behavioural strategies for compliance. Feasibility was assessed in the domains of process (e.g., recruitment), resource (e.g., monetary costs), management (e.g., personnel time requirements) and scientific outcomes (e.g., treatment effect). We recruited persons with mild-to-moderate MS who were randomised into an intervention or wait-list control condition. Intervention participants received a pedometer, elastic resistance bands, DVD, training manual, calendars, log-book, video coaching calls and newsletters. Participants in both conditions completed home-based assessments before and after the 4-month period. Ninety-nine persons with MS were assessed for eligibility, and 57 were randomised. Fifty-one persons completed the study (90%). Total costs of the study were US $5331.03. Personnel time to conduct the study totaled 263 h. Participants in the intervention group complied fully with 71% of all exercise sessions. There was a moderate increase in self-reported exercise behaviour of the intervention participants as measured by the Godin Leisure-Time Exercise Questionnaire (d ≥ 0.5). The results support the feasibility and acceptability of a home-based exercise intervention based on physical activity guidelines and supplemented with behavioural strategies for adults with mild-to-moderate MS

Feasibility study design and methods for Project GEMS: Guidelines for Exercise in Multiple Sclerosis

The Guidelines for Exercise in Multiple Sclerosis (GEMS) program is a randomized controlled trial (RCT) examining the feasibility and efficacy of a home-based exercise training program based on recent physical activity guidelines and principles of behavior change for improving symptoms and health-related quality of life (HRQOL) in adults with multiple sclerosis (MS). The primary aim is to assess program feasibility in the four domains of process (e.g., recruitment, retention, and adherence), resources (e.g., communication, staff requirements, and monetary costs), management (e.g., time and accuracy in data collection/entry, and reporting of adverse events) and scientific outcomes (e.g., safety, burden, participant feedback and efficacy/outcomes). The trial will recruit individuals with mild-to-moderate MS-related disability across the United States who will be randomized into intervention or waitlist control conditions. All participants will complete home-based assessments (including wearing an accelerometer for 7 days and completion of a questionnaire booklet) prior to and upon completion of the 4-month program. Participants in the intervention will receive a 4-month home-based exercise program emphasizing aerobic and resistance training. Participants will be provided with exercise equipment, a DVD, a manual and a log-book. The exercise program will be supplemented with periodic newsletters in the mail highlighting principles of behavior change, and video-chats with an exercise specialist to provide motivation and social accountability. This trial serves to inform development of Phase II and III RCTs which can determine the actual efficacy and effectiveness of home-based exercise based on the MS-specific physical activity guidelines for improving symptoms and HRQOL

Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: a qualitative study

Background: There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. Objective: We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Setting and participants: Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Methods: Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Results: Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Discussion and conclusion: Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise

Investigating the needs and wants of healthcare providers for promoting exercise in persons with multiple sclerosis: a qualitative study

Purpose: We undertook a qualitative study that explored the needs of healthcare providers for promoting exercise behaviour among persons with mild or moderate multiple sclerosis (MS). Methods: We used interpretive description methodology, and conducted semi-structured interviews with Neurologists (n = 13), occupational therapists (n = 10), physical therapists (n = 11), and nurses (n = 10). The interviews were analysed using thematic analysis. Results: We identified three themes with multiple subthemes regarding exercise promotion by healthcare providers. The first theme was “opportunities for exercise promotion” through the healthcare system, healthcare team, and clinical appointment. The second theme was “healthcare provider education” that included professional training, training among healthcare providers, and clear and defined exercise promotion protocols. The third theme was “patient tools/strategies” that should be delivered among persons with MS as part of the exercise prescription. Conclusions: Providers in MS healthcare consider the patient-provider interaction within the healthcare system, healthcare team, and clinical appointment as a novel opportunity for exercise promotion. Such an opportunity requires education of healthcare providers and provision of tools and strategies for exercise promotion among persons with MS. Implications for rehabilitation Healthcare providers are interested in and motivated for promoting exercise participation among persons with multiple sclerosis.Successful exercise promotion must consider opportunities at three different organisational levels, namely the healthcare system, the local healthcare team, and clinical appointment. Healthcare providers need further training for promoting exercise among persons with multiple sclerosis. The promotion of exercise among persons with multiple sclerosis will require resources and strategies that can be readily offered by providers