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"Sander, Beate"
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التنمية المستدامة لمصادر الطاقة المتجددة : الشمس-الرياح-المياه-حرارة باطن الأرض
by
Sander-Jaenicke, Beate مؤلف
,
Sander-Jaenicke, Beate. Nachhaltig investieren : in Sonne, Wind, Wasser, Erdwärme und Desertec
,
Fath, Peter, 1967- مؤلف
in
مصادر الطاقة البديلة جوانب اقتصادية
,
التنمية المستدامة جوانب بيئية
2014
يسد هذا الكتاب الفريد \"عن الطاقة المتجددة\" ثغرة واسعة وعميقة في السوق، ويوضح لنا إمكانيات استثمارية واعدة وجاذبة في مجالات توليد الكهرباء من الطاقة الشمسية وطاقة الرياح والطاقة المائية وحرارة باطن الأرض وفي الوقت نفسه، يفتح الباب على مصراعيه أمام مبادرة صناعية فريدة من نوعها؛ ألا وهو مشروع ديزرتيك Projekt-Desertec الذي يهدف إلى تحقيق الإمداد بالطاقة الصديقة للبيئة بصورة آمنة ومستدامة ولأنه يحتاج المستثمرون الأفراد بشكل عام والمؤسسات الاستثمارية على وجه الخصوص ـفي أوقات الأزمات الاقتصاديةـ إلى معلومات متخصصة وجادة حول الأنماط والأوعية الاستثمارية وإستراتيجيات الاستثمار في مجال الطاقة المتجددة.
The economic burden of Lyme disease and the cost-effectiveness of Lyme disease interventions: A scoping review
by
Sander, Beate
,
Mac, Stephen
,
da Silva, Sara R.
in
Antibiotics
,
Biology and Life Sciences
,
Citation management software
2019
While Lyme disease (LD) is mostly treatable, misdiagnosed or untreated LD can result in debilitating sequelae and excessive healthcare usage. The objective of this review was to characterize the body of literature on the economic burden of Lyme disease (LD) and the cost-effectiveness of LD interventions, such as antibiotic treatment and vaccination.
We followed Joanna Briggs Institute scoping review methodologies. We systematically searched terms related to LD, economic evaluations, costs, and cost-effectiveness in Medline, Embase, PsycInfo, Cochrane Library, and the grey literature up to November 2017. We included primary economic evaluations conducted in North America and Europe, reporting LD-related costs or cost-effectiveness of human interventions. Two reviewers screened articles and charted data independently. Costs were standardized to 2017 United States dollars (USD).
We screened 923 articles, and included 10 cost-effectiveness analyses (CEA) and 11 cost analyses (CA). Three CEAs concluded LD vaccination was likely cost-effective only in endemic areas (probability of infection ≥1%). However, LD vaccination is not currently available as an intervention in the US or Europe. Six studies assessed economic burden from a societal perspective and estimated significant annual national economic impact of: 735,550 USD for Scotland (0.14 USD per capita, population = 5.40M), 142,562 USD in Sweden (0.014 USD per capita, 9.96M), 40.88M USD in Germany (0.51 USD per capita, 80.59M), 23.12M USD in the Netherlands (1.36 USD per capita, 17.08M), and up to 786M USD in the US (2.41 USD per capita, 326.63M).
Lyme disease imposes an economic burden that could be considered significant in the US and other developed countries to justify further research efforts in disease control and management. Societal costs for Lyme disease can be equally impactful as healthcare costs, but are not fully understood. Economic literature from countries with historically high incidence rates or increasing rates of Lyme disease are limited, and can be useful for future justification of resource allocation.
Journal Article
Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy
by
Jain, Puneet
,
Widjaja, Elysa
,
Tomlinson, George
in
Amygdala - surgery
,
Anterior Temporal Lobectomy
,
Bias
2018
ObjectiveTo evaluate the effectiveness of anterior temporal lobectomy (ATL) versus selective amygdalohippocampectomy (SAH) on seizure-free outcome in patients with temporal lobe epilepsy, using both direct and indirect evidence from the literature.MethodsMEDLINE, Embase and Cochrane databases were searched for original research articles and systematic reviews comparing ATL versus SAH, and ATL or SAH versus medical management (MM). The outcome was seizure freedom at 12 months of follow-up or longer. Direct pairwise meta-analyses were conducted, followed by a random-effect Bayesian network meta-analysis (NMA) combining direct and indirect evidence.ResultsTwenty-eight articles were included (18 compared ATL vs SAH, 1 compared ATL vs SAH vs MM, 8 compared ATL vs MM, and 1 compared SAH vs MM). Direct pairwise meta-analyses showed no significant differences in seizure-free outcome of ATL versus SAH (OR 1.14, 95% CI 0.93 to 1.39; p=0.201), but the odds of seizure-free outcome were higher for ATL versus MM (OR 29.16, 95% CI 10.44 to 81.50; p<0.00001), and SAH versus MM (OR 28.42, 95% CI 10.17 to 79.39; p<0.00001). NMA also showed that the odds of seizure-free outcome were no different in ATL versus SAH (OR 1.15, 95% credible interval (CrI) 0.84–1.15), but higher for ATL versus MM (OR 27.22, 95% CrI 15.38–27.22), and SAH versus MM (OR 23.57, 95% CrI 12.67–23.57). There were no significant differences between direct and indirect comparisons (all p>0.05).ConclusionDirect evidence, indirect evidence and NMA did not identify a difference in seizure-free outcome of ATL versus SAH.
Journal Article
Long-term sequelae of West Nile virus-related illness: a systematic review
by
Patel, Hetal
,
Nelder, Mark P
,
Sander, Beate
in
Cardiovascular diseases
,
Europe
,
Heterogeneity
2015
We systematically reviewed the clinical outlook of West Nile virus (WNV)-related illness in North America and western Europe. As of March, 2015, more than 45 000 cases of WNV-related illness have been reported in North America. Unlike acute morbidity and mortality, the long-term physical, cognitive, and functional sequelae associated with WNV-related illness are not well characterised. An understanding of WNV-related sequelae and their prognostic factors can support physicians with early diagnosis and tertiary prevention efforts. We searched Ovid Medline, Embase, Scopus, and Environment Complete for studies published between 1999 and 2015. We included 67 studies in our Review. Although muscle weakness, memory loss, and difficulties with activities of daily living were among the most common physical, cognitive, and functional sequelae, respectively, some population groups were reported to be at greater risk of severe neurological disease or death (ie, older men with underlying illnesses such as cardiovascular disease or cancer). A high level of heterogeneity was reported among studies included in this Review, suggesting a need for consistent methods for collecting data and reporting findings. Further, more than half of the studies reporting sequelae relied exclusively on subjective assessment and only two studies used matched control groups. Therefore, opportunities exist for more robust primary studies in future research.
Journal Article
Health-related quality of life of patients with type 2 diabetes mellitus at a tertiary care hospital in Ethiopia
by
Biratu, Selam
,
Welie, Abraham Gebregziabiher
,
Gebremariam, Girma Tekle
in
Aged
,
Biology and Life Sciences
,
Care and treatment
2022
Type 2 diabetes mellitus (T2DM) and its treatment impact patients' physical health as well as emotional and social wellbeing. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients with T2DM at a tertiary care hospital in Ethiopia.
A face-to-face cross-sectional survey was conducted among patients with T2DM at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. We collected data using a validated Amharic version of the 5-level EuroQoL-5 dimensions (EQ-5D-5L) questionnaire. Descriptive statistics were used to present patient characteristics. Kruskal-Wallis and Mann-Whitney U tests were performed to explore differences in the median scores of EQ-5D-5L utility and visual analog scale (EQ-VAS). Multivariable Tobit regression models were used to identify predictors of HRQoL. Utility scores were calculated using disutility weights of the Ethiopian general population. Statistical significance was determined at p < 0.05.
A total of 360 patients with T2DM participated. Mean (SD) age was 64.43(10.61) years. Reported health problems were mostly in the pain/discomfort (67.3%) dimension followed by mobility (60.5%), whereas the usual activities domain (34.1%) was the least health problem being reported. The median (IQR) EQ-5D-5L utility and EQ-VAS scores were 0.95 (0.88-0.96) and 80 (75.0-85.0), respectively. In multivariable Tobit regression models older age, having poor glycemic control, longer duration of diabetes, insulin usage, obesity, and having diabetes-related complications were significant negative predictors of HRQoL.
Overall, patients with T2DM had lower HRQoL than the general population, which was attributed to being older age, longer duration of diabetes, insulin use, obesity, inadequate glycemic control, and diabetes-related complications. The utility index we generated can be used in future economic evaluations to inform decisions about alternative interventions and resource allocation.
Journal Article
Measuring and valuing patient and caregiver productivity costs: a scoping review protocol
by
Sahakyan, Yeva
,
Loshak, Hannah
,
Sillcox, Carly
in
Absenteeism
,
Caregivers
,
Caregivers - economics
2025
IntroductionEconomic evaluations are essential for informing healthcare resource allocation. When conducted from a societal perspective, they may include productivity costs such as paid and unpaid productivity losses for patients and their caregivers. Although several methods exist to measure and value productivity costs, there is limited methodological consensus on which methods should be used. This scoping review aims to synthesise existing methods for measuring and valuing patient and caregiver productivity costs.Methods and analysisThis review will follow the Arksey and O’Malley framework, enhanced by subsequent methodological guidance from Levac and the Joanna Briggs Institute. The six stages include identifying the research question; identifying relevant studies; selecting studies; charting the data; collating, summarising and reporting the results; and consultation. We will search MEDLINE, Embase and EconLit from 1996 to July 2025. Eligible sources will include peer-reviewed literature that reports methods for the measurement or valuation of productivity costs related to paid or unpaid work among patients or caregivers. Screening and data extraction will be conducted independently by two reviewers. Extracted data will include types of productivity costs, instruments used, valuation approaches, as well as recommendations on preferred measurement and valuation methods. Results will be synthesised thematically and reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews checklist.Ethics and disseminationEthics approval is not required as this review will rely exclusively on publicly available literature and does not involve human participants or the use of primary data. The findings will first be shared with Canada’s Drug Agency as a report and then disseminated through peer-reviewed publication and academic presentations to inform future research and practice.RegistrationThis protocol has been registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/FK9D4).
Journal Article
Identifying cirrhosis, decompensated cirrhosis and hepatocellular carcinoma in health administrative data: A validation study
by
Feld, Jordan J.
,
Holder, Laura
,
Flemming, Jennifer A.
in
Adequacy
,
Algorithms
,
Biology and life sciences
2018
To evaluate screening and treatment strategies, large-scale real-world data on liver disease-related outcomes are needed. We sought to validate health administrative data for identification of cirrhosis, decompensated cirrhosis and hepatocellular carcinoma among patients with known liver disease.
Primary patient data were abstracted from patients of the Toronto Center for Liver Disease with viral hepatitis (2006-2014), and all patients with liver disease from the Kingston Health Sciences Centre Hepatology Clinic (2013). We linked clinical information to health administrative data and tested a range of coding algorithms against the clinical reference standard.
A total of 6,714 patients had primary chart data abstracted. A single physician visit code for cirrhosis was sensitive (98-99%), and a single hospital diagnostic code for cirrhosis was specific (91-96%). The most sensitive algorithm for decompensated cirrhosis was one cirrhosis code with any of: a hospital diagnostic code, death code, or procedure code for decompensation (range 88-99% across groups). The most specific was one cirrhosis code and one hospital diagnostic code (range 89-98% across groups). Two physician visit codes or a single hospital diagnostic code, death code, or procedure code combined with a code for cirrhosis were sensitive and specific for hepatocellular carcinoma (sensitivity 94-96%, specificity 93-98%).
These sensitive and specific algorithms can be used to define patient cohorts or detect clinical outcomes using health administrative data. Our results will facilitate research into the adequacy of screening and treatment for patients with chronic viral hepatitis or other liver diseases.
Journal Article
Early economic evaluation of MRI-guided laser interstitial thermal therapy (MRgLITT) and epilepsy surgery for mesial temporal lobe epilepsy
by
Widjaja, Elysa
,
Snead, Carter
,
Pechlivanoglou, Petros
in
Adult
,
Censuses
,
Computer Simulation
2019
MRI-guided laser interstitial thermal therapy (MRgLITT) is a new minimally invasive treatment for temporal lobe epilepsy (TLE), with limited effectiveness data. It is unknown if the cost savings associated with shorter hospitalization could offset the high equipment cost of MRgLITT. We examined the cost-utility of MRgLITT versus surgery for TLE from healthcare payer perspective, and the value of additional research to inform policy decision on MRgLITT.
We developed a microsimulation model to evaluate quality adjusted life years (QALYs), costs, and incremental cost-effectiveness ratio (ICER) of MRgLITT versus surgery in TLE, assuming life-time horizon and 1.5% discount rate. Model inputs were derived from the literature. We conducted threshold and sensitivity analyses to examine parameter uncertainties, and expected value of partial perfect information analyses to evaluate the expected monetary benefit of eliminating uncertainty on probabilities associated with MRgLITT.
MRgLITT yielded 0.08 more QALYs and cost $7,821 higher than surgery, with ICER of $94,350/QALY. Influential parameters that could change model outcomes include probabilities of becoming seizure-free from disabling seizures state and returning to disabling seizures from seizure-free state 5 years after surgery and MRgLITT, cost of MRgLITT disposable equipment, and utilities of disabling seizures and seizure-free states of surgery and MRgLITT. The cost-effectiveness acceptability curve showed surgery was preferred in more than 50% of iterations. The expected monetary benefit of eliminating uncertainty for probabilities associated with MRgLITT was higher than for utilities associated with MRgLITT.
MRgLITT resulted in more QALYs gained and higher costs compared to surgery in the base-case. The model was sensitive to variations in the cost of MRgLITT disposable equipment. There is value in conducting more research to reduce uncertainty on the probabilities and utilities of MRgLITT, but priority should be given to research focusing on improving the precision of estimates on effectiveness of MRgLITT.
Journal Article
The impact of acute pneumococcal disease on health state utility values: a systematic review
by
Boyle, Justin
,
Kwong, Jeffrey C.
,
O’Reilly, Ryan
in
Cost-Benefit Analysis
,
Ear diseases
,
Humans
2022
Purpose
Streptococcus pneumoniae
infections remain a significant source of morbidity and mortality worldwide. The purpose of this review was to summarize the impact of pneumococcal disease on health state utilities (HSU) in the acute phase of illness.
Methods
We searched MEDLINE, EMBASE, EconLit, the Health Technology Assessment Database, the National Health Economic Evaluation Database, and Tufts Cost-Effectiveness Registry (up to January 2020) for primary studies. Eligible studies elicited HSU estimates using preference-based instruments for the acute phase of infection of pneumococcal syndromes including acute otitis media, pneumonia/lower respiratory tract infections, bacteremia/sepsis, and meningitis. Two reviewers independently conducted screening, data extraction and quality appraisal.
Results
We screened 10,178 studies, of which 26 met our inclusion criteria. Cohort sizes ranged from 8 to 2060 respondents. The most frequently studied syndrome was pneumonia (
n
= 17), followed by acute otitis media (
n
= 9), meningitis (
n
= 7) and bacteremia/sepsis (
n
= 4). Overall, each syndrome was associated with a substantial impact on HSU. Bacteremia/sepsis (range: − 0.331 to 0.992) and meningitis (range: − 0.330 to 0.977) were generally associated with the lowest HSU, followed by pneumonia (range: − 0.054 to 0.998) and acute otitis media (range: 0.064 to 0.970). HSU estimates varied considerably by treatment setting, elicitation method and type of respondent. The only study to compare pneumococcal infections to non-pneumococcal infections in the same population revealed significantly lower HSU estimates among pneumococcal infections.
Conclusions
Pneumococcal syndromes are associated with decreased HSU estimates. Given the considerable heterogeneity in methods and source populations as well as study quality, care should be taken to select the most appropriate estimates.
Journal Article
Estimation of COVID-19–induced depletion of hospital resources in Ontario, Canada
2020
The global spread of coronavirus disease 2019 (COVID-19) continues in several jurisdictions, causing substantial strain to health care systems. The purpose of our study was to predict the effect of the COVID-19 pandemic on patient outcomes and use of hospital resources in Ontario, Canada.
We developed an individual-level simulation to model the flow of patients with COVID-19 through the hospital system in Ontario. We simulated different combined scenarios of epidemic trajectory and hospital health care capacity. Our outcomes included the number of patients who needed admission to the ward or to the intensive care unit (ICU) with or without the need for mechanical ventilation, number of days to resource depletion, number of patients awaiting resources and number of deaths.
We found that with effective early public health measures, hospital system resources would not be depleted. For scenarios with late or ineffective implementation of physical distancing, hospital resources would be depleted within 14–26 days, and in the worst case scenario, 13 321 patients would die while waiting for needed resources. Resource depletion would be avoided or delayed with aggressive measures to increase ICU, ventilator and acute care hospital capacities.
We found that without aggressive physical distancing measures, the Ontario hospital system would have been inadequately equipped to manage the expected number of patients with COVID-19 despite a rapid increase in capacity. This lack of hospital resources would have led to an increase in mortality. By slowing the spread of the disease using public health measures and by increasing hospital capacity, Ontario may have avoided catastrophic stresses to its hospitals.
Journal Article