Hyatt Regency Chicago
`
`Chicago. Illinois
`
`June 59, 2002
`
`Second Intemational
`
`Multiple Sclerosis I/I/Pele
`
`Multiple Sclerosis: A World View
`
`ultiple sclerosis is llw most common disorder af-
`let-ting young adults in the prime of their lives.
`The new millennium brings a fresh perspective on MS
`cans: a new vision of empowerment for patients and
`families and positive appioaclics to inanage the dis-
`
`me. its symninnu, and in psychosocial implications.
`This new View of MS cart: has spanned the oceans and
`has resulted in the development oi worldwide net-
`works of health care providers in multiple sclerosis.
`The Consortium of Multiple Sclerosis Centers. RIMS
`(Rt§lIabililalion in Multiple Sclerosis). LACTRIMS
`(Latin American Committee on ‘iii:-atment and Re-
`search in Multiple Scle-rosisJ,.1nd IOMSN (Internation-
`al Organization of Multiple Sclerosis Nurses} have set
`global standards in MS care and reseanch and have col-
`laborated to organize and co-sponsor this meeting‘
`
`Multiple Helm-.455: A World View oil-3:5 an interim-
`tlonal View on cllincal and u=sean:|1 issues in multiple
`
`sclerosis. The opportunity to meet. confer and network
`with calleagut-s lrom nations located throughout the
`world make this annual meeting one you will not want
`to miss. This is the Second .-tnnuai international Multi-
`
`ple Sclomsis week (the first taking place in Basel. In
`1999) leatunng an littegratt-d rcscaitli lI‘dL'l(. numtruus
`Workshops,
`.1 day totally in Spanish lor our Latin
`American drzlcgates. satellite S)'lll|Jl.l‘Sla. and an inter-
`national datahasejregistries meeting [lCODlM$].
`
`Conference llighiights:
`Basic research and clinical liials
`
`Collaborative inlcmalloual approaches lu managing
`multiple sclerosis
`Gender issues in multiple sclerosis
`Technological advances in clinical can: and re-searrli
`Netwnriting opportunities
`Exliibils Willi llxt: lalcsl in :itl‘:"ullCl‘:i and pruducls
`Evening events in Chicago's "Magnificent Mile. '
`
`l I. .- .~..',‘,l‘-.. - 51l'l‘.l.ll-‘I'.ll|l\.I'-‘ill|llI'le*4.iHill“~.'w unis
`
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`
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`73
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`AMNEAL
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`EXHIBIT NO. 1028 Page 1
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` AMNEAL
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`

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`NONADHERENCE T0 IMMUNMODULKHON IN MULTIPLE SCLEROSIS
`
`Purpose: The primary objective of this study is to outline factors leading to nonadherenoe or cessation of imrnunmodulation therapy in a multiple sclerosis clinic pop-
`ulation. The secondary aim is to provide related recommendations to MS patients and muse educators.
`
`Rationale: Nonadherenoe has been estimated at greater than 50%. Encouraging adherence to therapy is an integral part of the MS nurse's role. If only half of all pa
`tients starting therapy will succeed, we need to learn more about factors relating to unsuccessful therapy attempts.
`Metlnds: A retrospective study of individuals attending a multiple sclerosis outpatient clinic (tt= 1,000) will be conducted to identify patients who have recdved im-
`munmodulating therapy. in addition, patients who have ceased or changed therapy will be identified. Key factors relating to nonadherenoe will be categorized and
`unlined as they conespond to individual meditations. Resulting implications for N8 patients and nurse educators will be ptesmted.
`BvdynVeeMcBrlde.nN.moN.KhgItonGeneralHupitaLKingstm.0nud0.Canada
`
`EVALUATION OF A NEW SENSORISED UPPER LIMB TREMOR MEASUREMENT SYSTEM IN MS
`
`Developed under the EU programme 'l'itt-ZMOR (DESZI6) the system consists of linked movement sensors mounted on a lightweight frame. It measures angular di-
`rection, change, velocity and acceleration in 7 degrees of freedom (Do?) at the shoulder, elbow and wrist joints. it is the first system to simultaneously measure
`upper limb kinetic and intention tremor at all tiuee joints and at full range of movement (ROM). Bespoke software allows the collection. storage. retrieval, and
`analysis of recorded signals. A graphic display enables the operator to see whole or part recordings and pinpoint the part of me movement trajectory where tremor
`occurs. Three movement tests were perfonned encompassing normal functional ROM the ‘finger to nose test‘. the ‘police, stop" test and the “OK” test. Reliabili-
`ty of the system was tested in 10 control subjects (mean age 45 years). ‘lest-retest values for 10 control subjects showed. modest to good agreement for all move-
`ments and at all linkages. Movements at the wrist showed the poorest agreement. Level of trunor was measured in six MS patients (mean age 47 years, EDSS
`range 6.0 to 7.5). Subjects were clinitally assewed using the l-‘ahn tremor rating scale. Mean time taken to accurately perform each test was significantly longer in
`the patient group compared with the control group and longest in those with the geatest tremor (controls 7.6 1 1.9: MS subjects 12.4 t 6.25). Recorded test time
`and frequency and amplitude of oscillations correlated well with the Palm score. Wlulst elements of the rig and linkage construction need to be improved these
`preliminary studies indicate that the evaluation of tremor at different angular velocities and limb positions is possible with this system. Such information will help
`to develop better therapeutic strategies.
`
`A. Davies Sm'lh.R.Jone9. [UK]; P.Peyn,G.Nuycns. I’. Ketelaet (BE);A.lbtnlJeI3 (F);G.GorneI.G.Johnson.J.0otter't‘ll (Ul();and& Scattarcgla (l'l'J:
`MSllesearchUnlt.BrlslolGent:alliospltal, KISIDIUK
`
`THE PSYCHOLOGICAL AND EMOTIONAL EFFECT OF A STRES MANAGEMENT PROIDCDL
`ON PERSONS WITH MUIIIPLE SCLHIOSIS
`
`This study examined the effect of a behavioral stress management intervemion, including relaxation and visualization components. on the psychological and etno-
`tional aspects of patients’ response to Ms. Subjects were randomly divided into treatment and oomrol SIWPS. which upon completion of the study had 227 subjects
`and 150 subjects respectively. The treatment group participated in a one-day workshop where they learned systematic relaxation techniques and a visualtation aer-
`cise specific to the effects of Ms on the participant‘: rteural system and functioning. The treatment group was asked to practice these techniques on a regular sched-
`ule. Participation was monitored weekly via telephone contact or e-mail. Anxiety and depression were assed using the State-Trait Personality Inventory (Spell-
`berger. Ritterband. Sydeman, Rehdser & Unger, in Butcher. 1995), Self Efficacy was assessed with the Multiple Sclerosis self Efficacy [Mssl-Z) scale (Schwartz.
`Coulthard-Morris, Zeng, & Retzlaff, i996) and the Attributional Style Questionnaire [ASQ-Peterson. et al. 1984). Pretesting of both groups was done immediately pri-
`or to the stress workshop and post-testing was 12 weeks later. lnhial data analysis suggests self-efficacy is negatively correlated with depression and anxiety. Males
`tended to present themselves as more hostile than depresod and anxious.
`Joanli.Read,rnn,andG.DeanErlcson,nro,MsOenteratShepherd,Atlanta,GA
`
`ACOUSTIC ANALYSIS :
`A PREDICTIVE INSTRUMENT HJR DIAGNOSIS AND OONTROL OF DYSAKTHRIA IN MS
`
`Acoustic analysis provides an interface between speech production and perception and can be used to detect and document the progressive course of motor speech
`disorders and identify subclinical manifestations.
`
`Material and Method: All analyses are performed on the Computer Speed‘: Lab [Model 43008] of Kay. Acoustic characteristics are identified in wide-
`band spectrograms. with frequency range from 0 to 50.000 Hz and time intervals of 3 sec. The linear predictive coding (LPCJ method and the analysis of
`the variations of amplitude and fundamental frequency from cycle to cycle may detect symptoms such as phonatory instability and nazalisation. Addi-
`tional acoustic data are obtained through the Multidimensional Voice Profile and the Motor Speech Program. These programs analyze the intonation
`variations. the dladocholtlnetic rate, the voice tremor and second formant variations during speech productions. All subjects had to sustain the vowel
`/a/ for at least 5 sec.. to repeat the syllabes /pa-ta-ka/ and /i-u/ as quickly as possible, and speak standard productions at "normal" rate without un-
`necessary pauses.
`
`Subjects: All subjects perfonned a perceptual screening of dysanhria [Prenchay - Enderby); 20 normal adult subjects are defined as non dysarthric (10 males, 10 fe-
`males) and 20 individuals with MS (10 males, 10 females) present dysarthria (spastic, spastic ataxic) at different grads (moderate. mild. severe).
`Discussion: At this stage of the study, it scents that some acoustic parameters are sensitive to the fluctuations of voice and speech disorders in MS. Degree of voice
`less, deviation of fundamental frequency, variations of amplitude, tremor, temporal deregulation (dysdiadocholcinesy) and imprecise articulation could be considered
`a predictive parameters of specific voice and speech disorders in MS. Results of clinical cases will also be discussed.
`
`Guy Ganty, Speech Therapy Department, National MS Centre, Melsbtoek. Belgium
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`85
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`AMNEAL
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`EXHIBIT NO. 1028 Page 2
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` AMNEAL