Creating a FACETS digital toolkit to promote quality of life of people with multiple sclerosis through Participatory Design

In this paper, we report on the first stages of creating a stand-alone digital toolkit focusing on the homework elements of FACETS (Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle). FACETS is an evidence-based face-to-face fatigue management group programme for people with multiple sclerosis. This paper details the participatory design process from requirements elicitation to initial prototyping and how offline activities linked to each session have been mapped in the digitised solution (mobile app)

Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ)

Objectives: To explore cross-sectional patterns of use of fatigue management strategies in people with multiple sclerosis (MS) who had attended a groupbased fatigue management programme, Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ('FACETS'). In a multicentre randomised controlled trial (RCT) the FACETS programme was shown to reduce fatigue severity and improve self-efficacy and quality of life. Design: A questionnaire substudy within a RCT involving the self-completed Fatigue Management Strategies Questionnaire (FMSQ). The FMSQ includes: (1) closed questions about the use and helpfulness of fatigue management strategies taught in FACETS and (2) open items about changes to lifestyle, attitudes or expectations, barriers or difficulties encountered and helpful strategies not covered in FACETS. Participants: All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Methods: Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. Results: 82% (59/72) of participants returned the FMSQ. The fatigue management strategies most frequently used since attending FACETS were prioritisation (80%), pacing (78%), saying no to others (78%), grading tasks (75%) and challenging unhelpful thoughts (71%). Adding in those participants who were already using the respective strategies prior to FACETS, the three most used strategies at 4 months were prioritisation (55/59), grading (54/59) and pacing (53/58). Free-text comments illustrated the complex interplay between attitudes/expectations, behaviours, emotions and the environment. Issues related to expectations featured strongly in participants' comments. Expectations (from self and others) were both facilitators and barriers to effective fatigue management. Conclusions: Individuals' comments highlighted the complex, multifaceted nature of fatigue management. Revising expectations and a greater acceptance of fatigue were important shifts following the programme. Findings support the relevance of a cognitive behavioural approach for fatigue management. Booster sessions might be a useful addition to the FACETS programme

Microbiota of Exposed Root Surfaces After Fluoride, Chlorhexidine, and Periodontal Maintenance Therapy: A 3â Year Evaluation

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142203/1/jper1580.pd

Virtual Reality – Von der 3D-Erfassung bis zum immersiven Erlebnis

Die technologischen Fortschritte in dem Bereich der virtuellen Realität (VR) werden zukünftig erhebliche Auswirkungen auf unser Alltagsleben haben. Denn durch VR ist es heute schon möglich, eine computererzeugte Welt als virtuelle Wirklichkeit praktisch zu erforschen. So kann man z.B. in die Vergangenheit oder in ein virtuelles Museum eintauchen, ohne die gegenwärtige Position im realen Leben zu verlassen. Für so eine ultimative VR-Erfahrung sieht der Anwender nur die virtuelle Welt, in dem er ein Head-Mounted-Display (HMD) aufsetzt, um sich so von der physikalischen Welt abzutrennen. Baudenkmäler sind ideal geeignet für eine mehrdimensionale geometrische Dokumentation und für realistische interaktive Visualisierungen in immersiven VR-Anwendungen. Unterstützend bietet die Spieleindustrie mit den entsprechenden Game Engines Werkzeuge für interaktive Visualisierungen von Objekten an, um so die Nutzer zu motivieren, Objekte und deren Umgebung virtuell zu besichtigen. In diesem Beitrag wird die Generierung von verschiedenen virtuellen 3D-Modellen wie z.B. die Selimiye-Moschee von Edirne (Türkei) oder das Holzmodell des Salomonischen Tempels und andere bis hin zur Datenintegration in die Game Engines Unreal oder Unity aufgezeigt. Der Arbeitsablauf von der Datenerfassung bis zur immersiven VR-Visualisierung mit dem VR-System HTC Vive wird einschließlich der notwendigen Programmierung für die Navigation in VR beschrieben. Außerdem wird der mögliche Einsatz (einschließlich der simultanen Teilnahme multipler Anwender) von solchen VR-Visualisierungen für z.B. Baudenkmäler in diesem Beitrag diskutiert.Recent advances in contemporary Virtual Reality (VR) technologies are going to have a significant impact on everyday life. Through VR it is possible to virtually explore a computer-generated environment as a different reality, and to immerse oneself into the past or in a virtual museum without leaving the current real-life situation. For such an ultimate VR experience, the user should only see the virtual world. Currently, the user must wear a VR headset which fits around the head and over the eyes to visually separate himself from the physical world. Via the headset images are fed to the eyes through two small lenses. Cultural heritage (CH) monuments are ideally suited both for thorough multi-dimensional geometric documentation and for realistic interactive visualisation in immersive VR applications. Furthermore, VR is increasingly in use for virtual museums to enhance a museum visitor’s experience by providing access to additional materials for review and knowledge deepening either before or after the real visit. Using today’s available 3D technologies a virtual museum is no longer just a presentation of collections on the Internet or a virtual tour of an exhibition using panoramic photography. Additionally, the game industry offers tools for interactive visualisation of objects to motivate users to virtually visit objects and places. In this paper the generation of virtual 3D models for different cultural heritage monuments (e.g. the Selimiye mosque in Edirne, Turkey and the wooden model of Solomon´s Temple and others) and its processing for data integration into the two game engines Unity and Unreal are presented. The workflow from data acquisition to VR visualisation using the VR system HTC Vive, including the necessary programming for navigation and interactions, is described. Furthermore, the use (including simultaneous use of multiple end-users) of such a VR visualisation for CH monuments is discussed in this presentation

Design considerations for a multiple sclerosis fatigue mobile app MS Energize: A pragmatic iterative approach using usability testing and resonance checks.

Multiple sclerosis (MS) is a chronic neurological condition affecting around 2.2 million people worldwide. The illness includes a range of symptoms, with fatigue considered to be one of the most disabling. This paper describes how a pragmatic and iterative approach, supported by usability and resonance testing, was used to build a minimum viable product of MS Energize-or MS Energise in UK English regions. MS Energise is a mobile application focused on self-management of fatigue for people with MS. The iterative approach included various stages of testing, during which user feedback including comments about interface, navigation and content, was sought to inform incremental app development and continual improvement. Usability testing was conducted with 11 people with longstanding multiple sclerosis in New Zealand and the United Kingdom, and focused on particular sections of the app as well as the accessibility of the app to users with MS. Two participants contributed to further resonance testing post-release to ensure the app was perceived as relevant and useful to the user. The usability testing and resonance testing phases suggested that user experience of MS Energise was mostly positive. Participants provided a number of suggestions for improvements to aspects of content and design; some of which we implemented during our app development process. Findings will also contribute to future planning and design iteration to enhance the user experience. The next step is further improvement of MS Energise prior to a trial of its clinical and cost effectiveness

Relations among neutrino observables in the light of a large theta_13 angle

The recent T2K and MINOS indications for a "large" theta_13 neutrino mixing angle can be accommodated in principle by an infinite number of Yukawa flavour structures in the seesaw model. Without considering any explicit flavour symmetry, there is an instructive exercise one can do: to determine the simplest flavour structures which can account for the data with a minimum number of parameters, simply assuming these parameters to be uncorrelated. This approach points towards a limited number of simple structures which show the minimum complexity a neutrino mass model must generally involve to account for the data. These basic structures essentially lead to only 4 relations between the neutrino observables. We emphasize that 2 of these relations, |sin theta_13|=(tan theta_23/cos delta)*(1-tan theta_12)/(1+tan theta_12) and |sin theta_13| = sin theta_12 R^1/4, with R= Delta m^2_21/Delta m^2_32, have several distinctive properties. First, they hold not only with a minimum number of parameters, but also for complete classes of more general models. Second, any value of theta_13 within the T2K and MINOS ranges can be obtained from these relations by taking into account small perturbations. Third, they turn out to be the pivot relations of models with approximate conservation of lepton number, which allow the seesaw interactions to induce observable flavour violating processes, such as mu -> e gamma and tau -> mu gamma. Finally, in specific cases of this kind, these structures have the rather unique property to allow a full reconstruction of the seesaw Lagrangian from low energy data.Comment: 13 pages, 3 figure

Classification of polynomial integrable systems of mixed scalar and vector evolution equations. I

We perform a classification of integrable systems of mixed scalar and vector evolution equations with respect to higher symmetries. We consider polynomial systems that are homogeneous under a suitable weighting of variables. This paper deals with the KdV weighting, the Burgers (or potential KdV or modified KdV) weighting, the Ibragimov-Shabat weighting and two unfamiliar weightings. The case of other weightings will be studied in a subsequent paper. Making an ansatz for undetermined coefficients and using a computer package for solving bilinear algebraic systems, we give the complete lists of 2nd order systems with a 3rd order or a 4th order symmetry and 3rd order systems with a 5th order symmetry. For all but a few systems in the lists, we show that the system (or, at least a subsystem of it) admits either a Lax representation or a linearizing transformation. A thorough comparison with recent work of Foursov and Olver is made.Comment: 60 pages, 6 tables; added one remark in section 4.2.17 (p.33) plus several minor changes, to appear in J.Phys.

Multi-centre parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based cognitive behavioural approach to managing fatigue in people with multiple sclerosis

Abstract (provisional) Background Fatigue is one of the most commonly reported and debilitating symptoms of multiple sclerosis (MS); approximately two-thirds of people with MS consider it to be one of their three most troubling symptoms. It may limit or prevent participation in everyday activities, work, leisure, and social pursuits, reduce psychological well-being and is one of the key precipitants of early retirement. Energy effectiveness approaches have been shown to be effective in reducing MS-fatigue, increasing self-efficacy and improving quality of life. Cognitive behavioural approaches have been found to be effective for managing fatigue in other conditions, such as chronic fatigue syndrome, and more recently, in MS. The aim of this pragmatic trial is to evaluate the clinical and cost-effectiveness of a recently developed group-based fatigue management intervention (that blends cognitive behavioural and energy effectiveness approaches) compared with current local practice. Methods This is a multi-centre parallel arm block-randomised controlled trial (RCT) of a six session group-based fatigue management intervention, delivered by health professionals, compared with current local practice. 180 consenting adults with a confirmed diagnosis of MS and significant fatigue levels, recruited via secondary/primary care or newsletters/websites, will be randomised to receive the fatigue management intervention or current local practice. An economic evaluation will be undertaken alongside the trial. Primary outcomes are fatigue severity, self-efficacy and disease-specific quality of life. Secondary outcomes include fatigue impact, general quality of life, mood, activity patterns, and cost-effectiveness. Outcomes in those receiving the fatigue management intervention will be measured 1 week prior to, and 1, 4, and 12 months after the intervention (and at equivalent times in those receiving current local practice). A qualitative component will examine what aspects of the fatigue management intervention participants found helpful/unhelpful and barriers to change. Discussion This trial is the fourth stage of a research programme that has followed the Medical Research Council guidance for developing and evaluating complex interventions. What makes the intervention unique is that it blends cognitive behavioural and energy effectiveness approaches. A potential strength of the intervention is that it could be integrated into existing service delivery models as it has been designed to be delivered by staff already working with people with MS. Service users will be involved throughout this research. Trial registration: Current Controlled Trials ISRCTN7651747