Editor's Choice: Contemporary treatment of popliteal artery aneurysm in eight countries: A Report from the Vascunet collaboration of registries.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.To study contemporary popliteal artery aneurysm (PA) repair.Vascunet is a collaboration of population-based registries in 10 countries: eight had data on PA repair (Australia, Finland, Hungary, Iceland, New Zealand, Norway, Sweden, and Switzerland).From January 2009 until June 2012, 1,471 PA repairs were registered. There were 9.59 operations per million person years, varying from 3.4 in Hungary to 17.6 in Sweden. Median age was 70 years, ranging from 66 years in Switzerland and Iceland to 74 years in Australia and New Zealand; 95.6% were men and 44% were active smokers. Elective surgery dominated, comprising 72% of all cases, but only 26.2% in Hungary and 39.7% in Finland, (p < .0001). The proportion of endovascular PA repair was 22.2%, varying from 34.7% in Australia, to zero in Switzerland, Finland, and Iceland (p < .0001). Endovascular repair was performed in 12.2% of patients with acute thrombosis and 24.1% of elective cases (p < .0001). A vein graft was used in 87.2% of open repairs, a synthetic or composite graft in 12.7%. Follow-up was until discharge or 30 days. Amputation rate was 2.0% overall: 6.5% after acute thrombosis, 1.0% after endovascular, 1.8% after open repair, and 26.3% after hybrid repair (p < .0001). Mortality was 0.7% overall: 0.1% after elective repair, 1.6% after acute thrombosis, and 11.1% after rupture.Great variability between countries in incidence of operations, indications for surgery, and choice of surgical technique was found, possibly a result of surgical tradition rather than differences in case mix. Comparative studies with longer follow-up data are warranted

Challenges in the impact evaluation of behaviour change interventions: The case of sea turtle meat and eggs in São Tomé

Robust impact evaluations are needed for conservation to learn and grow as a field. Currently we lack a large body of evidence on the effects of behaviour change interventions in social‐ecological systems. By uncovering mechanistic relationships and establishing causality we can refine future programmes to enhance likelihood of effectiveness. Although a range of sophisticated methodological approaches to evaluation have been developed, conceptually linking project outcomes with conservation impacts remains difficult in complex systems. For example, sea turtles are one taxon in which unsustainable harvesting has been a particular problem. There have been a number of campaigns to reduce demand for sea turtle products, but we still have little evidence documenting their outcomes. We conducted the first formal impact evaluation of a conservation marketing campaign aimed at reducing the consumption of sea turtle meat and eggs. The campaign took place on the island of São Tomé, Central Africa, and included traditional mass media advertisements as well as community events. This is one of few demand reduction evaluations that has assessed both human behaviour and biological conservation outcomes. It benefited from an advantageous setting for evaluation, as nesting sea turtles are relatively easy to monitor and the island's small size and geographic isolation increased the detectability of potentially confounding factors. We found a decrease in self‐reported sea turtle egg consumption and a decrease in poaching of adult sea turtles. However, multiple unforeseen difficulties arose which complicated attempts at causal attribution. We were hampered by spatial spillovers, design effects from the sensitive questioning technique, concurring law enforcement and changes in biological monitoring effort. These challenges highlight the difficulties faced by practitioners seeking to apply impact evaluations in the field. We reflect on what this means for future impact evaluations of behaviour change interventions in conservation. Our recommendations include combining multiple outcome measures to triangulate hard‐to‐measure behaviours and theory‐based evaluation methods to explore causal impacts

Cost-effectiveness of Screening for Abdominal Aortic Aneurysm in Combination with Medical Intervention in Patients with Small Aneurysms.

Screening for abdominal aortic aneurysm (AAA) among 65 year old men has been proven cost-effective, but nowadays is conducted partly under new conditions. The prevalence of AAA has decreased, and endovascular aneurysm repair (EVAR) has become the predominant surgical method for AAA repair in many centers. At the Malmö Vascular Center pharmacological secondary prevention with statins, antiplatelet therapy, and blood pressure reduction is initiated and given to all patients with AAA. This study evaluates the cost-effectiveness of AAA screening under the above mentioned conditions

Invasive Treatment for Infrainguinal Claudication Has Satisfactory 1 Year Outcome in Three out of Four Patients: A Population-based Analysis from Swedvasc.

In spite of recommendations advocating conservative best medical treatment, many patients with infrainguinal intermittent claudication (IC) are treated by invasive open and endovascular methods. This study aims to evaluate the incidence and 1-year results of all such treatments during 2009 in Sweden