| 1. |
- Guiraud, J., et al.
(författare)
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Sodium Oxybate for Alcohol Dependence: A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration
- 2023
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 58:2, s. 125-133
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. Methods: Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. Results: Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. Conclusions: In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes.
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| 2. |
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| 3. |
- Guiraud, J., et al.
(författare)
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Treating alcohol dependence with an abuse and misuse deterrent formulation of sodium oxybate: Results of a randomised, double-blind, placebo-controlled study
- 2021
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Ingår i: European Neuropsychopharmacology. - : Elsevier BV. - 0924-977X. ; 52, s. 18-30
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Tidskriftsartikel (refereegranskat)abstract
- Sodium oxybate (SMO) has been approved in Italy and Austria for the maintenance of abstinence in alcohol dependent (AD) patients. Although SMO is well tolerated in AD patients, cases of abuse and misuse have been reported outside the therapeutic setting. Here we report on a phase IIb double-blind, randomized, placebo-controlled trial for the maintenance of abstinence in AD patients with a new abuse and misuse deterrent formulation of SMO. A total of 509 AD patients were randomized to 12 weeks of placebo or one of four SMO doses (0.75, 1.25, 1.75 or 2.25 g t.i.d.) followed by a one-week medication-free period. The primary endpoint was the percentage of days abstinent (PDA) at end of treatment. An unexpectedly high placebo response (mean 73%, median 92%) was observed. This probably compromised the demonstration of efficacy in the PDA, but several secondary endpoints showed statistically significant improvements. A post-hoc subgroup analysis based on baseline severity showed no improvements in the mild group, but statistically significant improvements in the severe group: PDA: mean difference +15%, Cohen's d = 0.42; abstinence: risk difference +18%, risk ratio = 2.22. No safety concerns were reported. Although the primary endpoint was not significant in the overall population, several secondary endpoints were significant in the intent-to-treat population and post-hoc results showed that treatment with SMO was associated with a significant improvement in severe AD patients which is consistent with previous findings. New trials are warranted that take baseline severity into consideration. (C) 2021 The Authors. Published by Elsevier B.V.
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| 4. |
- Batel, A., et al.
(författare)
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Histological, enzymatic and chemical analyses of the potential effects of differently sized microplastic particles upon long-term ingestion in zebrafish (Danio rerio)
- 2020
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Ingår i: Marine Pollution Bulletin. - : Elsevier. - 0025-326X .- 1879-3363. ; 153
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Tidskriftsartikel (refereegranskat)abstract
- In microplastics (MPs) research, there is an urgent need to critically reconsider methodological approaches and results published, since public opinion and political decisions might be based on studies using debatable methods and reporting questionable results. For instance, recent studies claim that MPs induce intestinal damage and that relatively large MPs are transferred to, e.g., livers in fish. However, there is methodological criticism and considerable concern whether MP transfer to surrounding tissues is plausible. Likewise, there is an ongoing discussion in MP research if MPs act as vectors for adsorbed hazardous chemicals. In this study, effects of very small (4–6 μm) and very large (125–500 μm) benzo(a) pyrene (BaP)-spiked polyethylene (PE) particles administered via different uptake routes (food chain vs. direct uptake) were compared in a 21-day zebrafish (Danio rerio) feeding experiment. Particular care was taken to prevent cross-contamination of MPs during dissection and histological sample preparation. In contrast to numerous reports in literature describing similar approaches, independent of exposure route and MP size, no adverse effects could be detected. Likewise, no BaP accumulation could be documented, and MPs were exclusively seen in the lumen of the intestinal tract, which, however, did not induce any histopathological effects. Results indicate that in fish MPs are taken up, pass along the intestinal lumen and are excreted without any symptoms of adverse effects.
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| 5. |
- Brédart, A., et al.
(författare)
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A comprehensive assessment of satisfaction with care : preliminary psychometric analysis in French, Polish, Swedish and Italian oncology patients
- 2001
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Ingår i: Patient Education and Counseling. - 0738-3991 .- 1873-5134. ; 43:3, s. 243-252
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Tidskriftsartikel (refereegranskat)abstract
- Satisfaction with care may be closely related to quality of life in cancer patients. This evaluation is especially relevant when quality of care is considered. The present study assessed whether equivalent scaling properties could be found in a comprehensive assessment of satisfaction with care (CASC) administered in cancer patients from French, Polish and Swedish oncology settings, in comparison to the scaling properties previously evidenced in the CASC with an Italian sample. A total of 140, 186 and 133 oncology patients were approached in France, Poland and Sweden, respectively. Specific items in the CASC were identified as consistently omitted across country samples. Multitrait scaling analysis on an item-grouping adapted for the French, Polish, Swedish and Italian samples provided excellent internal consistencies and convergent validity estimates. Discriminant validity proved less satisfactory, evidencing overlap between hypothesised care dimensions across country samples. The identification of omitted or overlapping items will lead to the design of a revised CASC version to further test in larger cross-cultural samples.
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| 6. |
- Brédart, A., et al.
(författare)
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Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden
- 2003
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 12:1, s. 68-77
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Tidskriftsartikel (refereegranskat)abstract
- There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement for the same level of satisfaction across samples from oncology settings in France, Italy, Poland and Sweden, and whether age, gender, education level and type of items affected the relationships found. The CASC addresses patient's satisfaction with the care received in oncology hospitals. Patients are invited to rate aspects of care and to mention for each of these aspects, whether they would want improvement.One hundred and forty, 395, 186 and 133 consecutive patients were approached in oncology settings from France, Italy, Poland and Sweden, respectively. Across country settings, an increasing percentage of patients wanted care improvement for decreasing levels of satisfaction. However, in France a higher percentage of patients wanted care improvement for high-satisfaction ratings whereas in Poland a lower percentage of patients wanted care improvement for low-satisfaction ratings. Age and education level had a similar effect across countries. Confronting levels of satisfaction with desire for care improvement appeared useful in comprehending the meaning of response choice labels for the CASC across oncology settings from different linguistic and cultural background. Linguistic or socio-cultural differences were suggested for explaining discrepancies between countries.
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| 7. |
- Sataøen, Hogne L., 1979-, et al.
(författare)
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Towards a sustainable grid development regime? : A comparison of British, Norwegian, and Swedish grid development
- 2015
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Ingår i: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 9, s. 178-187
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Tidskriftsartikel (refereegranskat)abstract
- Currently, huge investments are being made in the electricity infrastructure in Europe. However, one third of the European grid investments are delayed, even though the majority of the population in Europe is in favour of a greener energy mix. This paradoxical situation is connected to the fact that although interdependent, the production and transportation sides of renewable energy sources are treated as two distinct processes. The two types of infrastructure undergo separate processes for development consent and are the target of opposition from various citizen groups. In this article we compare the British, Norwegian, and Swedish grid development regimes in order to analyse their opportunities and challenges. The comparison demonstrates that the regimes differ on significant aspects, e.g. different historical trajectories, technological setups, arguments, and main drivers. The article highlights the importance of achieving sustainable energy systems by relying on a sensible strategy for grid development, and the importance of moving beyond the focus on a sustainable, "green-fuelled" grid.
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