Multiple Sclerosis Society of Ireland

Background Chronic musculoskeletal pain is a key societal challenge in Ireland, affecting one in three adults over the age of 50, with societal and healthcare costs of over €5.34 billion per year. Physical activity can form a key part of the management of people living with chronic pain, along with providing a myriad of health-enhancing and disease-prevention benefits for older adults. However, pain can limit engagement in physical activity, leading to the negative effects of chronic pain in older adults. Public and Patient involvement in this study identified that people with chronic pain fear exacerbation of their symptoms with exercise, and value having an experienced exercise leader who understands their needs. The primary aim of this study was to examine the feasibility and acceptability of a community-based exercise intervention, ComEx Pain, specifically tailored to older adults with chronic musculoskeletal pain. This paper reports a protocol designed to evaluate the feasibility of conducting a two-arm randomized controlled trial (RCT). Methods ComEx Pain is a randomised controlled feasibility trial with embedded economic and process evaluations. Community-dwelling adults aged ≥50 years living with chronic musculoskeletal pain will be recruited in the mid-western region of Ireland. Randomisation will be conducted using a 1:1 allocation ratio into two groups: (1) an intervention group receiving a community-based exercise program led by trainers educated in supporting people with chronic pain and (2) a control group who will receive a paper-based education manual. Primary outcomes for feasibility include recruitment rate, retention rate, and adherence to the intervention. The secondary outcomes will include changes in pain, physical function, emotional function, and physical activity. Discussion If this pilot feasibility study finds evidence to support feasibility and acceptability, a future larger-scale definitive trial will be conducted to examine the effectiveness of ComEx Pain in older adults living with chronic musculoskeletal pain. Trial registration number: Registered at Clinical Trials.gov NCT06535633.

Introduction Clinical trials evaluating the effectiveness of falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson’s Disease (PD) and stroke measure heterogeneous outcomes, often omitting those meaningful to patients. A core outcome set (COS) is a standardised set of outcomes that should be assessed in all trials within a research area. The aim of this study was to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke in non-acute and community settings, with input from relevant stakeholder groups. Methods Previously published research undertaken by the team, including a qualitative study with 20 patients and a review of the literature, were used to derive a longlist of potential outcomes. Outcomes were prioritised for inclusion in the COS using a three-round online Delphi survey. A multi-stakeholder, consensus meeting was conducted to agree upon the final COS and to provide a recommendation for a single outcome measure for each outcome in the COS. Results Forty-eight participants were recruited across four stakeholder groups (researchers, patients, clinicians, and service-planners/policymakers). A total of 42 participants (87.5%) completed all three rounds of the surveys. Sixty-two outcomes were considered for inclusion in the COS throughout the Delphi process. A total of 15 participants attended the consensus meeting where they agreed upon the final COS and accompanying measurement instruments: fall incidence, injurious fall incidence, quality of life, falls self-efficacy, fear of falling, activity curtailment due to fear of falling, and cost-effectiveness. Attendees at the consensus meeting recommended that the proposed mechanism of impact of an intervention is considered when selecting additional outcomes outside of those in the COS to assess. Conclusions This study identified a COS for evaluating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. It is recommended that this COS and accompanying measurement instruments be used in all future trials in this research area so that findings can be combined and compared.

The prevention of musculoskeletal disorders (MSDs)is defined in accordance with specific European Union directives, enforced in Italy with Legislative Decree 81/2008.Ergonomic conditions of the workplace are considered, inorder to properly assess risks, from the planning of activities and work tasks related to human beings. To combatMSDs, companies should apply the principles of ergonomics, together with the satisfaction of customer needs, ina Total Quality Management logic (TQM).Lean Manufacturing aims to increase production but at the same time toreduce waste. The proposed case shows that Ergonomics and Lean Manufacturing, if well integrated, can representan opportunity for the entire organisation, putting the worker at the centre of improvement. The objective of the caseis the study of workstations in a Company in the wood sector located in the Marche Region. The aim is to reduce riskindices resulting from manual handling of loads and repetitive movements, with reference to mandatory and voluntarysafety regulations. Therefore, demonstrating that, by decreasing risk factors indices, production down-time can bereduced, and production levels increased. As a result of the analysis of the production line, ergonomically inadequateworkstations have been modified, but productivity requirements have not been neglected. For the prevention to beeffective on an ongoing basis, it requires the participation and the collaboration of various professionals with thecommon objective of leading companies to improved productive performances but, without neglecting the health andsafety of their workers.

Background:Vibration intervention has recently become a popular modality in professional sport and fitness and has also been suggested to offer potential in augmenting exercises in the rehabilitation field for various neurological conditions.Objectives:The main objective of this review was to assess the effects of whole-body vibration (WBV) intervention on body functions, activity limitations, and participation restrictions in people with neurological conditions. The second objective was to assist healthcare professionals in their clinical practice by evaluating the main parameters of WBV intervention that may be of benefit.Methods:Electronic databases (EMBASE, Academic Search Complete, AMED, MEDLINE, CINAHL Plus, SPORTDiscus, PEDro, and Cochrane library) were searched. Intervention studies with a comparison group, investigating the effect of WBV intervention on people with neurological conditions, were included. The methodological quality of papers was independently assessed by two raters using the Physiotherapy Evidence Database scale.Results:Sixteen randomized controlled trials (RCTs) were included. Only one paper was considered ‘excellent’ methodological quality study (9 out of 10 points). Four studies evaluated changes when WBV was compared to no intervention and two found significant improvements for strength, gait, and balance. Twelve compared WBV to other interventions and only two found significant differences in favour of the WBV group, for strength and gait.Conclusion:The cumulative findings for strength, balance, and gait suggest that while groups improve following WBV, this improvement is not consistently greater than either no intervention or a comparison intervention. This suggests insufficient evidence to support the effects of WBV training.

ABSTRACTIn this article, a design methodology and equations necessary for a second‐order absorptive, reflective‐type, transmission zero notch filter are introduced, derived, and described in detail. Initially, a single (first order), absorptive, reflective‐type transmission zero notch filter is described. Based on this, improvements to the first‐order reflective‐type notch filter are discussed and a novel circuit that achieves a second‐order absorptive, reflective‐type, transmission zero notch response is proposed. The necessary conditions for the achievement of the second‐order absorptive, reflective‐type, transmission zero from the proposed circuit are derived. As an experimental verification, first‐ and second‐order absorptive, reflective‐type, transmission zero circuits are fabricated and their performance measured. It is shown that the first‐order notch circuit introduces a zero into the response of a main filter with a depth of over 12 dB in the frequency range 2.19–2.27 GHz, while the second‐order notch circuit introduces a transmission zero with a depth of over 20 dB GHz, in the same frequency range as its first‐order counterpart. © 2014 Wiley Periodicals, Inc. Microwave Opt Technol Lett 56:2542–2545, 2014

The eighth Annual Conference of the Rehabilitation and Therapy Research Society (RTRS) was held on Friday, 25 May 2012, hosted by the School of Public Health, Physiotherapy and Population Science at the University of Dublin. The society provides a forum for the dissemination of current research within the three professions of occupational therapy, physiotherapy, and speech and language therapy across the island of Ireland.The theme of this year’s conference was ‘Promoting Health and Wellbeing across the Lifespan’. Keynote speaker Professor Elizabeth Dean, University of British Columbia, highlighted the need for focussed attention on maintaining and reversing chronic lifestyle-related conditions, and Professor Virpi Timonen, Trinity College Dublin, presented research data on trends in ageing and challenges for the provision of care for older people in Ireland. Invited speakers, oral and poster presentations highlighted the diversity of current, clinically relevant research within the three professions from BSc to PhD and post-doctoral level. This year, in addition to research abstracts, the society sought abstract submissions that reflected clinical practice and service development innovations across the three professions. All abstracts underwent a blind review process and the RTRS committee sought clarification that all research studies had ethics committee approval and service development abstracts had approval as appropriate.The society looks forward to continued support from researchers within the three professions and the ongoing development of the society’s role in fostering the dissemination of therapy research within Ireland through the hosting of our annual conference. Updates on the society are available on our website www.rtrs.org

We consider a buyer who outsources the manufacturing of a product to multiple symmetric make‐to‐stock suppliers who compete on price and service (fill rate). The buyer allocates demand to the suppliers using a score function with an exponential form, which specifies the relative importance of price vs. service, in order to minimize his costs, while the suppliers choose their prices and fill rates to maximize their profits. For the case of dual‐sourcing, we characterize the optimal parameter of the exponential score function, considering the impact of the buyer's decisions on the suppliers, and considering how the suppliers compete against each other to earn a portion of the buyer's demand. We prove the existence of a unique equilibrium and characterize the equilibrium behavior of the system. We then consider a general number of suppliers and show that the equilibrium prices and fill rates, and the buyer's cost, are increasing in the number of suppliers. We compare these results to a model of single‐sourcing, in which the buyer is the Stackelberg leader and extracts all profits from the supplier. We find that the buyer always prefers single‐sourcing to multisourcing. Finally, we study a centralized system and use the results to develop a coordinating contract for the decentralized system.

Abstract Sexual dysfunction is a highly prevalent, but undertreated symptom in multiple sclerosis (MS). The current study utilized focus groups and individual interviews with 24 MS Society staff from 14 different countries in order to determine the phenomenological perspective of MS Society staff regarding obstacles in addressing sexual dysfunction. Focus groups were audiotaped, transcribed, and qualitatively analyzed by two independent raters. Results identified 6 key elements that contributed to difficulties in addressing sexuality: 1) lack of comfort in discussing intimacy and/or sexuality-related issues; 2) lack of basic knowledge about the sexually-related aspects of MS; 3) lack of local educational and healthcare resources with expertise in sexuality; 4) obstacles to effective communication about sexuality; 5) failure to address the needs of MS caregivers who are partners; and 6) cultural differences that demand local problem-solving and solutions. Recommendations are provided for MS Societies that may be helpful in addressing some of these complex issues.