Multiple Sclerosis Trust

Abstract Removing personally identifiable information (PII) from texts is necessary to comply with various data protection regulations and to enable data sharing without compromising privacy. However, recent works show that documents sanitized by PII-removal techniques are vulnerable to reconstruction attacks. Yet, we suspect that the reported success of these attacks is largely overestimated. We critically analyze the evaluation of existing attacks and find that data leakage and data contamination are not properly mitigated, leaving the question whether or not PII removal techniques truly protect privacy in real-world scenarios unaddressed. We investigate possible data sources and attack setups that avoid data leakage and conclude that only truly private data can allow us to objectively evaluate vulnerabilities in PII removal techniques. However, access to private data is heavily restricted—and for good reasons—which also means that the public research community cannot address this problem in a transparent, reproducible, and trustworthy manner.

Abstract Mangroves are a critical coastal habitat that provides a suite of ecosystem services and supports livelihoods. We undertake the first global analysis to estimate density and abundance of 37 commercially important fish and invertebrates that are known to extensively use mangroves. Geomorphic mangrove type, sea surface salinity and temperature, and length of mangrove forest edge were important in predicting the density of commercial fish and invertebrates, with deltaic systems supporting the highest densities. The model predicted high densities throughout parts of southeast Asia, the northern coast of South America, the Red Sea, and the Caribbean and Central America. Application of our model onto the global mangrove extent, estimates that mangroves support the annual abundance of nearly 800 billion young-of-year fish and invertebrates contained in our model. Our results confirm the critical role of mangroves globally in supporting fish and fisheries, and further builds the case for their conservation and restoration.

Findings from the MS Trust annual listening project show that some multiple sclerosis patients may not be discussing their mental health concerns with health professionals.

This article reports results of a phase 2 exploratory trial of a vocabulary program delivered in elementary schools to improve student’s reading ability, including their comprehension. The intervention was tested as a targeted intervention in classrooms with children aged 7–10 across 20 weeks during one school year, with eligible students learning in small groups of four. Teachers and support staff received training in this cooperative learning approach to develop children’s vocabulary with particular focus on Tier‐2 words. School staff received additional support and resources to equip them to develop and implement the vocabulary instruction sessions to targeted students. The trial was undertaken with a sample of 101 students in seven schools from three English district areas with high levels of socio‐economic disadvantage. A standardized reading test was used to measure reading outcomes, with significant gains found in student’s overall reading ability, including comprehension. Owing to the positive results found in this trial, including positive feedback about implementation of the technique, next steps should be a larger trial with 48 schools to avoid the risk of sampling error due to limited number of schools.

Multiple sclerosis (MS) affects approximately 100,000 people in the United Kingdom, with rising emergency admissions to the hospital. The multiple sclerosis specialist nurse plays a pivotal role in managing MS care in the United Kingdom, and there is anecdotal evidence that this role can help avoid emergency presentations and unnecessary hospital admissions. A retrospective service evaluation took place in one established MS nursing service. The impact of the introduction of proactive nurse-led management and a rapid response service on rates of emergency presentation, hospital admission, and bed use was examined. The primary intervention was the introduction of extra nursing hours (6 hours per week) and the reallocation of some routine administrative duties, which allowed the service to move to a proactive management model aimed at avoiding the need for unplanned care. In addition, a care pathway was implemented in the emergency department for patients with MS who did present. Reduction in utilization was from a mean of 2700 bed-days per year (2002-2006) to a mean of 198 bed-days per year (2007-2013). During a 10-year period, moving from reactive management to proactive management demonstrated an increase in complex specialist nursing interventions and led to a decrease in emergency presentation and bed use at the local acute-care center.

Background: There are 245 Multiple Sclerosis (MS) specialist nurses (MSSNs) across the UK, with variable caseloads, suggesting inequitable and, where caseloads are particularly high, inadequate provision. Aim: The MS Trust set out to establish a ‘sustainable’ caseload for an MS specialist nurse, providing a high-quality, proactive service to patients with MS throughout the disease trajectory. Method: An expert consensus group agreed standards for MSSN services and assumptions about their working patterns and practices; this process was informed by ‘real world’ data from 40 MSSNs taking part in the MS Trust GEMSS programme. A simple model was then used to determine the sustainable number of cases an MSSN could manage. Results: The model showed that a caseload of 358 people with MS per full-time specialist nurse is sustainable. Conclusions: A number of conditions must be met, including well thought out job plans, sufficient administrative support, an effective home visit policy and a high level of use of clinic capacity.

Bladder symptoms in multiple sclerosis (MS) are common and distressing but also highly amenable to treatment. A meeting of stakeholders involved in patients’ continence care, including neurologists, urologists, primary care, MS nurses and nursing groups was recently convened to formulate a UK consensus for management. National Institute for Health and Clinical Excellence (NICE) criteria were used for producing recommendations based on a review of the literature and expert opinion. It was agreed that in the majority of cases, successful management could be based on a simple algorithm which includes using reagent sticks to test for urine infection and measurement of the post micturition residual urine volume. This is in contrast with published guidelines from other countries which recommend cystometry. Throughout the course of their disease, patients should be offered appropriate management options for treatment of incontinence, the mainstay of which is antimuscarinic medications, in combination, if necessary, with clean intermittent self-catheterisation. The evidence for other measures, including physiotherapy, alternative strategies aimed at improving bladder emptying, other medications and detrusor injections of botulinum toxin A was reviewed. The management of urinary tract infections as well as the bladder problems as part of severe disability were discussed and recommendations agreed.

Multiple sclerosis (MS) specialist nurses are under increasing pressure as the government′s modernization programme moves toward the creation of a more cost-effective health service and trusts seek ways to reduce financial deficits. The emphasis of health policy is also shifting toward the provision of greater patient choice. MS nurses have always used a model of care that is focused on patients′ individual needs, and may have assumed that this approach was sufficient to justify their role. The new challenge for MS nurses is to ensure that their effective work for patients continues while meeting the new demands for cost-efficiency and patient choice. MS nurses must therefore understand these new demands and find ways to meet them. Most importantly, MS nurses need to learn how to explain their work and demonstrate their effectiveness in terms of the objectives of a more cost-effective NHS that offers greater patient choice. MS nurses have been confident about their contribution to the health-care system in the past. They must now adapt to meet the new requirements, ensure that their services will be viable into the future, and become the nurse leaders of tomorrow.