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Part, Chapter, Paragraph
1 II, 4. 1 | individual EU Member States (MS) and the EU as a whole.
2 II, 4. 1 | EUROSTAT algorithm, and MS death counts and population
3 II, 4. 1 | 2005 for the 27 current MS were also computed with
4 II, 4. 1 | values estimated each year at MS level within EU27.~ ~Table
5 II, 4. 1 | longevity gaps between the MS since 1995.~ ~Table 4.1.
6 II, 4. 1 | Member States in 2005. At MS level, values of life expectancy
7 II, 4. 1 | the same throughout all MS.~ ~Detailed values of life
8 II, 4. 1 | level (EU25) and for all MS has disclosed striking gaps
9 II, 4. 1 | 2005 the gaps between the MS with the highest and lowest
10 II, 4. 1 | women. Gaps in HLY between MS are even wider: over 20
11 II, 4. 1 | be uniform throughout all MS. Equivalent gaps are evident
12 II, 4. 1 | made by EHEMU showed that MS experienced a marked convergence
13 II, 4. 1 | to improve health of all MS equally.~ ~Moreover, improving
14 II, 4. 1 | working together with the MS to improve the reliability
15 II, 4. 1 | socio-economic status (SES) between MS. This is a necessary step
16 II, 5. 5. 3| Introduction~ ~Multiple sclerosis (MS) is a chronic progressive
17 II, 5. 5. 3| Sadovnick and Ebers, 1993).~ ~MS is an acquired inflammatory
18 II, 5. 5. 3| degeneration (Trapp et al, 1998). MS etiology is unknown. The
19 II, 5. 5. 3| Lucchinetti et al, 1996).~ ~MS clinically manifests itself
20 II, 5. 5. 3| sources~ ~The distribution of MS incidence and prevalence
21 II, 5. 5. 3| and disability,and that of MS mortality was reviewed for
22 II, 5. 5. 3| on the clinical course, MS is typified as Primary Progressive (
23 II, 5. 5. 3| RR-MS, PR-SP-MS and PP-MS.~ ~MS case registers in ”Europe”~
24 II, 5. 5. 3| information on the epidemiology of MS; some examples follow. The
25 II, 5. 5. 3| Registry (DMSR) has collected MS cases since 1948 (www ),
26 II, 5. 5. 3| recording information on MS cases from multiple sources,
27 II, 5. 5. 3| diagnostic validity for definite MS of 94%. It links with Denmark’
28 II, 5. 5. 3| multiple assessments of MS epidemiological indices
29 II, 5. 5. 3| obligatory information serving MS population-based studies
30 II, 5. 5. 3| history and physiopathology of MS (Confavreux et al, 2000;
31 II, 5. 5. 3| information of all prevalent MS patients in Norway (Myhr
32 II, 5. 5. 3| serum) from all available MS patients was implemented.~ ~
33 II, 5. 5. 3| nationwide epidemiological MS register was initiated under
34 II, 5. 5. 3| the auspices of the German MS Society (Flachenecker et
35 II, 5. 5. 3| number of patients with MS, course of the disease,
36 II, 5. 5. 3| standardised data sets of ca. 5800 MS patients were recorded from
37 II, 5. 5. 3| Nearly 200 surveys on MS epidemiology published in
38 II, 5. 5. 3| epidemiological patterns of MS distribution in time and
39 II, 5. 5. 3| and increased awareness of MS; and the subsequent tendency
40 II, 5. 5. 3| latitudinal gradient of MS prevalence across the UK
41 II, 5. 5. 3| the Scottish border. The MS prevalence in Northern Ireland
42 II, 5. 5. 3| Ireland, the prevalence of MS is similar to that in the
43 II, 5. 5. 3| comparable latitudes.~The MS prevalence in the Nordic
44 II, 5. 5. 3| higher prevalence rates of MS reported in some regions
45 II, 5. 5. 3| the Fennoscandian focus of MS. This extended from western
46 II, 5. 5. 3| regional differences in MS prevalence and incidence
47 II, 5. 5. 3| epidemiological data on MS in Denmark that appear to
48 II, 5. 5. 3| background for susceptibility to MS.~Iceland provides a 50-year
49 II, 5. 5. 3| The threefold increase of MS prevalence up to 119 in
50 II, 5. 5. 3| assessment over time. The MS risk in Iceland is similar
51 II, 5. 5. 3| Scandinavian countries.~The MS prevalence in Germany has
52 II, 5. 5. 3| geographical distribution of MS prevalence was heterogeneous
53 II, 5. 5. 3| northeast-to-southwest gradient of MS distribution in France was
54 II, 5. 5. 3| a focal distribution of MS in ethnic groups with different
55 II, 5. 5. 3| Several prevalence surveys on MS have been conducted in Italy
56 II, 5. 5. 3| an area at low risk for MS, is believed to account
57 II, 5. 5. 3| account for the low absolute MS risk in the Maltese.~Prevalence
58 II, 5. 5. 3| susceptibility in increasing MS frequency cannot be ruled
59 II, 5. 5. 3| 64.~The total annual mean MS incidence in Europe is estimated
60 II, 5. 5. 3| Italy.~ ~The distribution of MS in Europe by disease course~ ~
61 II, 5. 5. 3| countries~The distribution of MS in Europe by severity~The
62 II, 5. 5. 3| proportion range for mild MS (EDSS 0-3.5) was 33% (UK)
63 II, 5. 5. 3| and 48% (UK) for moderate MS (EDSS 4-6.5) and between
64 II, 5. 5. 3| Netherlands) for severe MS (EDSS 7-9.5)~ ~Table 5.5.
65 II, 5. 5. 3| selected EUGLOREH countries~ ~MS mortality rates and survival
66 II, 5. 5. 3| survival time in Europe~Data on MS mortality must be taken
67 II, 5. 5. 3| system over time. Also, when MS patients die from other
68 II, 5. 5. 3| certificates is likely to occur as MS is not mentioned (Ford et
69 II, 5. 5. 3| mentioned (Ford et al, 2002).~MS is associated with an elevated
70 II, 5. 5. 3| highest mortality rates from MS in Austria were observed
71 II, 5. 5. 3| median age at death from MS was 59 years between 1990-
72 II, 5. 5. 3| Mortality (per 100 000) of MS patients in selected EUGLOREH
73 II, 5. 5. 3| countries~ ~The epidemiology of MS in Europe: methodological
74 II, 5. 5. 3| epidemiological studies on MS conducted over the past
75 II, 5. 5. 3| geographical pattern of MS in Europe is a hard task
76 II, 5. 5. 3| public awareness about MS; (d) the impact of different
77 II, 5. 5. 3| gradient in the distribution of MS prevalence rates across
78 II, 5. 5. 3| to predict the degree of MS prevalence according to
79 II, 5. 5. 3| underlying the differences in MS distribution.~A general
80 II, 5. 5. 3| current epidemiology of MS in Europe was categorisation,
81 II, 5. 5. 3| socio-economic burden of MS in Europe~ ~The disability
82 II, 5. 5. 3| evaluating the burden of MS in health economics. DALYs
83 II, 5. 5. 3| disability. The total DALY for MS in Europe is 307 000 years
84 II, 5. 5. 3| been carried out so far for MS as compared to other neurological
85 II, 5. 5. 3| Furthermore, comorbidity in MS and associated symptoms (
86 II, 5. 5. 3| when measuring DALYs in MS.~The general decreasing
87 II, 5. 5. 3| increased survival time after MS onset will increase the
88 II, 5. 5. 3| found to also have higher MS incidence (WHO, 2004), thus
89 II, 5. 5. 3| of disease in the future.~MS social costs are high. Cost
90 II, 5. 5. 3| The economic burden of MS for the year 2005 was €13
91 II, 5. 5. 3| 8 billion. The cost per MS case in Europe ranges from €
92 II, 5. 5. 3| Distribution of total cost of MS in Europe (year 2005) by
93 II, 5. 5. 3| 5.3.5.4. Risk factors~ ~MS is a complex multifactorial
94 II, 5. 5. 3| influential risk factor for MS is hypothesised to operate
95 II, 5. 5. 3| genes operate in determining MS risk especially at familial
96 II, 5. 5. 3| relevance for the prevention of MS have not received adequate
97 II, 5. 5. 3| tests for the diagnosis of MS. Diagnostic criteria require
98 II, 5. 5. 3| widely used criteria in MS epidemiological research
99 II, 5. 5. 3| for definite and probable MS, and relevant subcategories:
100 II, 5. 5. 3| subcategories: clinically definite MS (CDMS), laboratory-supported
101 II, 5. 5. 3| laboratory-supported definite MS (LSDMS), clinically probable
102 II, 5. 5. 3| LSDMS), clinically probable MS (CPMS) and laboratory-supported
103 II, 5. 5. 3| laboratory-supported probable MS (LSPMS). In 2001, an international
104 II, 5. 5. 3| the category of probable MS and reintroducing that of
105 II, 5. 5. 3| reintroducing that of possible MS (McDonald et al, 2001).
106 II, 5. 5. 3| can receive a diagnosis of MS or possible MS. Because
107 II, 5. 5. 3| diagnosis of MS or possible MS. Because of the retrospective
108 II, 5. 5. 3| retrospective methods used in MS epidemiological studies
109 II, 5. 5. 3| classification in such surveys. MS is diagnosed more often
110 II, 5. 5. 3| The clinical course of MS shows heterogeneity among
111 II, 5. 5. 3| following categorisation of MS clinical course has been
112 II, 5. 5. 3| a) relapsing-remitting MS (RR-MS), a clearly defined
113 II, 5. 5. 3| b) progressive-relapsing MS (PR-MS), progressive disease
114 II, 5. 5. 3| c) secondary-progressive MS (SP-MS), initial RR course
115 II, 5. 5. 3| d) primary-progressive MS (PP-MS), disease with progression
116 II, 5. 5. 3| epidemiological studies on MS, the disease course is often
117 II, 5. 5. 3| to measure disability in MS, aimed at evaluating the
118 II, 5. 5. 3| interventional programs. In MS epidemiological descriptive
119 II, 5. 5. 3| 1983). Disability due to MS can be measured within functional
120 II, 5. 5. 3| helpless and 10 is death due to MS.~ ~Treatment~There is no
121 II, 5. 5. 3| Treatment~There is no cure for MS, but there are drugs able
122 II, 5. 5. 3| symptoms. Goals for treating MS may include reducing the
123 II, 5. 5. 3| warranted in all patients with MS or at risk of developing
124 II, 5. 5. 3| or at risk of developing MS (eg., ‘clinically isolated
125 II, 5. 5. 3| cases in the early stages of MS is difficult and there is
126 II, 5. 5. 3| the initial management of MS are available in Europe,
127 II, 5. 5. 3| of worsening forms of RR- MS and SP-MS. Besides the method
128 II, 5. 5. 3| life and productivity of MS patients’ . An understanding
129 II, 5. 5. 3| cladribine.~Rehabilitation in MS implies comprehensive, multidisciplinary,
130 II, 5. 5. 3| many people affected by MS are forced to give up work
131 II, 5. 5. 3| effectively to the symptoms of MS and ensure both access and
132 II, 5. 5. 3| towards people affected by MS. The Code of Good Practice
133 II, 5. 5. 3| Code of Good Practice on MS ( see below) calls for information
134 II, 5. 5. 3| for those diagnosed with MS regarding the Directive,
135 II, 5. 5. 3| redress.~A new study on MS and employment in the EU
136 II, 5. 5. 3| Early published studies on MS patients and their employment
137 II, 5. 5. 3| unemployed individuals with MS. The important conclusion
138 II, 5. 5. 3| workforce. Keeping people with MS in the workforce can be
139 II, 5. 5. 3| situation of people with MS in Europe, but only reports
140 II, 5. 5. 3| unemployed people due to MS, number of people actively
141 II, 5. 5. 3| from unemployed people with MS;~o identifying factors that
142 II, 5. 5. 3| enable employed people with MS to stay in the workforce;~
143 II, 5. 5. 3| the rights of people with MS to obtain and maintain employment,
144 II, 5. 5. 3| employment of people with MS to help guarantee appropriate
145 II, 5. 5. 3| treatment towards people with MS in the European Union~In
146 II, 5. 5. 3| Finland -herself a person with MS - analysed the experiences
147 II, 5. 5. 3| experiences of people with MS in Europe. It did so with
148 II, 5. 5. 3| Code of Best Practice” for MS patients.~European Code
149 II, 5. 5. 3| Life of People Affected by MS~ ~The Code was drawn up
150 II, 5. 5. 3| lives of people affected by MS, including policy makers
151 II, 5. 5. 3| the person affected by MS.~The Code is a political
152 II, 5. 5. 3| importance to people affected by MS. It provides a practical
153 II, 5. 5. 3| empowerment of people affected by MS;~· It signposts core consensus
154 II, 5. 5. 3| Life of People affected by MS.~· Equal rights and access
155 II, 5. 5. 3| Sclerosis;~· A shared agenda in MS research;~· Employment and
156 II, 5. 5. 3| and care of people with ms within and across the EU
157 II, 5. 5. 3| reference papers in the areas of MS referred to in the Code~·
158 II, 5. 5. 3| The European Map of MS database provides information
159 II, 5. 5. 3| data on the epidemiology of MS and the availability and
160 II, 5. 5. 3| resources for people with MS at country level. The contents
161 II, 5. 5. 3| Immunomodulatory Therapy of MS Consensus Paper~· Current
162 II, 5. 5. 3| Recent clinical studies in MS provide new data on the
163 II, 5. 5. 3| for the optimised care of MS patients. The multiple sclerosis
164 II, 5. 5. 3| ensuring Europeans with MS have access to the best
165 II, 5. 5. 3| Paper based on the German MS Society’s report “Mehr Lebensqualität,
166 II, 5. 5. 3| Sympomatische Therapie bei MS”. (Henze et al, 2006).~Although
167 II, 5. 5. 3| critically edited by a group of MS neurologists. The Consensus
168 II, 5. 5. 3| some of the most important MS symptoms such as motor function
169 II, 5. 5. 3| patients severely affected by MS in Europe to have access
170 II, 5. 5. 3| Excellence Guideline on MS Services (UK)~The National
171 II, 5. 5. 3| Guideline on the management of MS provides clear, evidence-based
172 II, 5. 5. 3| managing all aspects of MS and offers a blueprint for
173 II, 5. 5. 3| quality of life of people with MS (Trisolini et al, 2002)~
174 II, 5. 5. 3| organizations for people with MS.~ ~UN Convention on the
175 II, 5. 5. 3| life of people affected by MS. The UN Convention, once
176 II, 5. 5. 3| life of people affected by MS, drawing on key policy developments
177 II, 5. 5. 3| National Level~There are active MS societies in all 27 member
178 II, 5. 5. 3| participation of people with MS in society. Advances in
179 II, 5. 5. 3| policies for people with MS and the creation of an economic
180 II, 5. 5. 3| the cost of the disease of MS on the individual and society
181 II, 5. 5. 3| issues on which national MS societies campaign tenaciously.~
182 II, 5. 5. 3| disease. There is no cure for MS, but medicines may slow
183 II, 5. 5. 3| and voices of people with MS must be formally sought.
184 II, 5. 5. 3| i.e. the strengthening of MS society foothold in the
185 II, 5. 5. 3| advocacy role of national MS societies in contributing
186 II, 5. 5. 3| affected by Multiple Sclerosis (MS). It will create a standardised
187 II, 5. 5. 3| national care approaches to MS, which will allow good practice
188 II, 5. 5. 3| treatment and management of MS. More specifically, the
189 II, 5. 5. 3| strategy to analyse and compare MS data; prevalence and epidemiology
190 II, 5. 5. 3| good practice review of MS treatments and therapies,
191 II, 5. 5. 3| benefits of best management of MS. The project will also analyse
192 II, 5. 5. 3| the cost of illness of) MS.~This project will contribute
193 II, 5. 5. 3| knowledge database available on MS, with the long-term added
194 II, 5. 5. 3| reports on the status of MS using the Open Method of
195 II, 5. 5. 3| mortality rates among Danes with MS. Int MS J 13:66-71.~Buehler
196 II, 5. 5. 3| among Danes with MS. Int MS J 13:66-71.~Buehler JW.
197 II, 5. 5. 3| Götze U, et al (2005): [MS registry in Germany—design
198 II, 5. 5. 3| Elias WG, et al (2007): MS Register in Germany – results
199 II, 5. 5. 3| AE (1993): Prevalence of MS in South Estonia. Evidence
200 II, 5. 5. 3| unemployment of patients with MS. Journal of Chronic Disability
201 II, 5. 5. 3| Immunomodulatory Therapy of MS Consensus Paper , Revised
202 II, 5. 5. 3| worldwide prevalence of MS. Clinical Neurology and
203 II, 5. 5. 3| 2001). The prevalence of MS in the world: an update.
204 II, 5. 5. 3| Estimation of the cost of MS in Europe: Extrapolations
205 II, 5. 5. 3| quality of life of people with MS (International Federation
206 II, 5. 5. 3| Magnetic Resonance Imaging~MS~Multiple Sclerosis~MS-ID~
207 II, 5. 8. 7| Zheng JP, Zhong NS, Ip MS, Vermeire PA. Increasing
208 II, 5. 15.Acr| Mendelian Inheritance in Man~MS~Member States~NORD~National
209 II, 5. 15. 4| level or at Member States (MS) level.~Regulation No 141/
210 II, 5. 15. 4| programmes; encourage EU MS in developing national health
211 II, 5. 15. 4| policies and initiatives at MS level and EU level.~ ~A
212 II, 5. 15. 5| developments~ ~The EU and several MS have well identified the
213 II, 8. 1. 4| first discussion with all MS on this module has been
214 II, 8. 2. 1| participating countries (13 MS and 1 EEA country).~The
215 II, 9. 1. 1| Huang DY, Usher RH, Kramer MS, Yang H, Morin L, Fretts
216 II, 9. 1. 1| Paris, 2000:173-192.~Kramer MS, Demissie K, Yang H, Platt
217 II, 9. 1. 1| Gibson KA, Wu YW, Croughan MS (2004): Perinatal outcomes
218 II, 9. 1. 1| 103(3):551-63.~ ~Kramer MS, Demissie K, Yang H, Platt
219 II, 9. 1. 1| Jama 284(7):843-9.~ ~Kramer MS, Seguin L, Lydon J, Goulet
220 II, 9. 1. 1| 14(3):194-210.~ ~Kramer MS, Platt RW, Yang H, Haglund
221 II, 9. 3. 2| singleton deliveries in European MS for 1990 to 2005~ ~ ~ ~ ~
222 II, 9. 3. 2| Huang DY, Usher RH, Kramer MS, Yang H, Morin L, Fretts
223 II, 9. 3. 2| Gibson KA, Wu YW, Croughan MS (2004): Perinatal outcomes
224 II, 9. 3. 2| 2000:173-192.~ ~Kramer MS, Demissie K, Yang H, Platt
225 II, 9. 3. 2| 2000;284(7):843-9.~ ~Kramer MS, Platt RW, Yang H, Haglund
226 II, 9. 3. 2| 2002;16(1):16-22.~ ~Kramer MS, Seguin L, Lydon J, Goulet
227 III, 10. 1. 3| 147-164.~Jebb SA, Moore MS (1999): Contribution of
228 III, 10. 1. 3| Miller NS, Giannini AJ, Gold MS (1992): Suicide risk associated
229 III, 10. 1. 3| Miller NS, Mahler JC, Gold MS (1991): Suicide risk associated
230 III, 10. 2. 1| Data from 5 additional MS as well as from 4 West Balkan
231 III, 10. 2. 1| Health Promotion Studies.~ ~Kramer MS, Morin I, Yang H, Platt
232 III, 10. 4. 2| MRLs~Maximum Residue Limits~MS~Mass Spectrometry~OECD~Organisation
233 III, 10. 4. 2| consumption data from 14 MS, 41 diet sets for different
234 III, 10. 4. 2| DAR at EU level with all MS, applicant(s) and public
235 IV, 13. 2. 2| been carried out so far for MS as compared to other neurological
236 IV, 13. 2. 2| Furthermore, comorbidity in MS and associated symptoms (
237 IV, 13. 2. 2| when measuring DALYs in MS.~· In terms of years lived
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