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- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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- Ali, M, et al.
(author)
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Protocol for the development of the international population registry for aphasia after stroke (I-PRAISE)
- 2022
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In: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:4, s. 534-554
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Journal article (peer-reviewed)abstract
- Background: We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia.Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia.Methods & Procedures: Multi-centre, prospective, non-randomised, open study, employing blinded outcome assessment, where appropriate, including people with post-stroke aphasia, able to attend for 30 minutes during the initial language assessment, at first contact with a speech and language therapist for assessment of aphasia at participating sites. There is no study-mandated intervention. Assessments will occur at baseline (first contact with a speech and language therapist for aphasia assessment), discharge from Speech and Language Therapy (SLT), 6 and 12-months post-stroke. Our primary outcome is changed from baseline in the Amsterdam Nijmegen Everyday Language Test (ANELT/Scenario Test for participants with severe verbal impairments) at 12-months post-stroke. Secondary outcomes at 6 and 12 months include the Therapy Outcome Measure (TOMS), Subjective Index of Physical and Social Outcome (SIPSO), Aphasia Severity Rating Scale (ASRS), Western Aphasia Battery Aphasia Quotient (WAB-AQ), stroke and aphasia quality of life scale (SAQoL-39), European Quality of Life Scale (EQ-5D), lesion description, General Health Questionnaire (GHQ-12), resource use, and satisfaction with therapy provision and success. We will collect demography, clinical data, and therapy content. Routine neuroimaging and medication administration records will be accessed where possible; imaging will be pseudonymised and transferred to a central reading centre. Data will be collected in a central registry. We will describe demography, stroke and aphasia profiles and therapies available. International individual participant data (IPD) meta-analyses will examine treatment responder rates based on minimal detectable change & clinically important changes from baseline for primary and secondary outcomes at 6 and 12 months. Multivariable meta-analyses will examine associations between demography, therapy, medication use and outcomes, considering service characteristics. Where feasible, costs associated with treatment will be reported. Where available, we will detail brain lesion size and site, and examine correlations with SLT and language outcome at 12 months.Conclusion: International differences in care, resource utilisation and outcomes will highlight avenues for further aphasia research, promote knowledge sharing and optimise aphasia rehabilitation delivery. IPD meta-analyses will enhance and expand understanding, identifying cost-effective and promising approaches to optimise rehabilitation to benefit people with aphasia.
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- Karthikesalingam, A., et al.
(author)
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Comparative analysis of the outcomes of elective abdominal aortic aneurysm repair in England and Sweden
- 2018
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In: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 105:5, s. 520-528
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Journal article (peer-reviewed)abstract
- BackgroundThere is substantial international variation in mortality after abdominal aortic aneurysm (AAA) repair; many non-operative factors influence risk-adjusted outcomes. This study compared 90-day and 5-year mortality for patients undergoing elective AAA repair in England and Sweden.MethodsPatients were identified from English Hospital Episode Statistics and the Swedish Vascular Registry between 2003 and 2012. Ninety-day mortality and 5-year survival were compared after adjustment for age and sex. Separate within-country analyses were performed to examine the impact of co-morbidity, hospital teaching status and hospital annual caseload.ResultsThe study included 36 249 patients who had AAA treatment in England, with a median age of 74 (i.q.r. 69–79) years, of whom 87·2 per cent were men. There were 7806 patients treated for AAA in Sweden, with a median of age 73 (68–78) years, of whom 82·9 per cent were men. Ninety‐day mortality rates were poorer in England than in Sweden (5·0 versus 3·9 per cent respectively; P < 0·001), but were not significantly different after 2007. Five‐year survival was poorer in England (70·5 versus 72·8 per cent; P < 0·001). Use of EVAR was initially lower in England, but surpassed that in Sweden after 2010. In both countries, poor outcome was associated with increased age. In England, institutions with higher operative annual volume had lower mortality rates.ConclusionMortality for elective AAA repair was initially poorer in England than Sweden, but improved over time alongside greater uptake of EVAR, and now there is no difference. Centres performing a greater proportion of EVAR procedures achieved better results in England. Improving in England
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- Sanchez-Cano, B., et al.
(author)
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Total electron content in the Martian atmosphere : A critical assessment of the Mars Express MARSIS data sets
- 2015
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In: Journal of Geophysical Research - Space Physics. - 2169-9380 .- 2169-9402. ; 120:3, s. 2166-2182
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Journal article (peer-reviewed)abstract
- The total electron content (TEC) is one of the most useful parameters to evaluate the behavior of the Martian ionosphere because it contains information on the total amount of free electrons, the main component of the Martian ionospheric plasma. The Mars Express Mars Advanced Radar for Subsurface and Ionosphere Sounding (MARSIS) radar is able to derive TEC from both of its operation modes: (1) the active ionospheric sounding (AIS) mode and (2) the subsurface mode. TEC estimates from the subsurface sounding mode can be computed from the same raw data independently using different algorithms, which should yield similar results. Significant differences on the dayside, however, have been found from two of the algorithms. Moreover, both algorithms seem also to disagree with the TEC results from the AIS mode. This paper gives a critical, quantitative, and independent assessment of these discrepancies and indicates the possible uncertainty of these databases. In addition, a comparison between the results given by the empirical model of the Martian ionosphere developed by Sanchez-Cano et al. (2013) and the different data sets has been performed. The main result is that for solar zenith angles higher than 75 degrees, where the maximum plasma frequency is typically small compared with the radar frequencies, the two subsurface algorithms can be confidently used. For solar zenith angles less than 75 degrees, where the maximum plasma frequency is very close to the radar frequencies, both algorithms suffer limitations. Nevertheless, despite the solar zenith angle restrictions, the dayside TEC of one of the two algorithms is consistent with the modeled TEC.
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- Morales-Suarez-Varela, M.M., et al.
(author)
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Occupational sun exposure and mycosis fungoides : A european multicenter caseg-control study
- 2006
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In: Journal of Occupational and Environmental Medicine. - : Ovid Technologies (Wolters Kluwer Health). - 1076-2752 .- 1536-5948. ; 48:4, s. 390-393
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Journal article (peer-reviewed)abstract
- OBJECTIVE: We sought to study the association between occupational sun exposure and mycosis fungoides (MF), a peripheral T-cell lymphoma. SUBJECTS and METHODS: A European multicenter case-control study including seven rare cases (one being MF) was conducted between 1995 and 1997. From the 118 accepted cases, 104 were interviewed, of which 76 were definite cases. Population controls were selected randomly from the regions of case ascertainment. Information based on occupational experiences was coded according to industry types. A job exposure matrix was created according to the expected exposure to sunlight. RESULTS: Once exposures to aromatic halogenated hydrocarbons were eliminated (odds ratio = 2.3, 95% confidence interval = 0.9-6.2), a high MF risk was associated with exposures to solar radiation. CONCLUSION: It would appear that workers exposed to sunlight have a higher risk of MF. However, this factor is not the only one involved. Copyright © 2006 by American College of Occupational and Environmental Medicine.
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- Tosteson, ANA, et al.
(author)
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Challenges for model-based economic evaluations of postmenopausal osteoporosis interventions
- 2001
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In: Osteoporosis international. - : Springer Nature. - 1433-2965 .- 0937-941X. ; 12:10, s. 849-857
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Journal article (peer-reviewed)abstract
- Assessing the cost-effectiveness of long-term treatment for osteoporosis requires use of mathematical models to estimate health effects and costs for competing interventions. The primary motivations for model-based analyses include the lack of long-term clinical trial outcome data and the lack of data comparing all relevant treatments within randomized clinical trials. We report on specific modeling challenges that arose in the development of a model of the natural history of postmenopausal osteoporosis that is suitable for assessing the cost-effectiveness of osteoporosis interventions among various population subgroups in diverse countries. These include choice of modeling changes in bone mineral density (BMD) or in fracture rate, definition of health states, modeling mortality and costs of long-term care following fracture, incorporation of health utility, and model validation. This report should facilitate future postmenopausal osteoporosis model development and provide insight for decisionmakers who must evaluate model-based economic analyses of postmenopausal osteoporosis interventions.
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