title: The cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer

authors: Lao, Chunhuan

subjects: Science & Technology

abstract: Background
Radical prostatectomy is the most common treatment for localised prostate cancer in New Zealand. Active surveillance was introduced to prevent overtreatment and reduce costs while preserving the option of radical prostatectomy. This study aims to evaluate the cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy.

Methods
Markov models were constructed to estimate the life-time cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer patients aged 45–70 years, using national datasets in New Zealand and published studies including the SPCG-4 study. This study was from the perspective of the Ministry of Health in New Zealand.

Results
Radical prostatectomy is less costly than active surveillance in men aged 45–55 years with low risk localised prostate cancer, but more costly for men aged 60–70 years. Scenario analyses demonstrated significant uncertainty as to the most cost-effective option in all age groups because of the unavailability of good quality of life data for men under active surveillance. Uncertainties around the likelihood of having radical prostatectomy when managed with active surveillance also affect the cost-effectiveness of active surveillance against radical prostatectomy.

Conclusions
Active surveillance is less likely to be cost-effective compared to radical prostatectomy for younger men diagnosed with low risk localised prostate cancer. The cost-effectiveness of active surveillance compared to radical prostatectomy is critically dependent on the ‘trigger’ for radical prostatectomy and the quality of life in men on active surveillance. Research on the latter would be beneficial.

text: The cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer Background
Radical prostatectomy is the most common treatment for localised prostate cancer in New Zealand. Active surveillance was introduced to prevent overtreatment and reduce costs while preserving the option of radical prostatectomy. This study aims to evaluate the cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy.

Methods
Markov models were constructed to estimate the life-time cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer patients aged 45–70 years, using national datasets in New Zealand and published studies including the SPCG-4 study. This study was from the perspective of the Ministry of Health in New Zealand.

Results
Radical prostatectomy is less costly than active surveillance in men aged 45–55 years with low risk localised prostate cancer, but more costly for men aged 60–70 years. Scenario analyses demonstrated significant uncertainty as to the most cost-effective option in all age groups because of the unavailability of good quality of life data for men under active surveillance. Uncertainties around the likelihood of having radical prostatectomy when managed with active surveillance also affect the cost-effectiveness of active surveillance against radical prostatectomy.

Conclusions
Active surveillance is less likely to be cost-effective compared to radical prostatectomy for younger men diagnosed with low risk localised prostate cancer. The cost-effectiveness of active surveillance compared to radical prostatectomy is critically dependent on the ‘trigger’ for radical prostatectomy and the quality of life in men on active surveillance. Research on the latter would be beneficial.

year: 2017

title: Groundwater study - The eight lakes catchment

authors: White, Paul

abstract: I would like to quickly romp over some of the science we have done since 2002 in the Greater Tarawera catchment, focusing on results. I hope to give people a flavour of what we think is going on in each of the 8 lakes in the catchment:-
• The greater Tarawera catchment
• Purpose of Tarawera project
• Overview of scientific results
- drilling and some early results
- geological model
- catchment hydrology of the 8 lakes
- groundwater flow
- nitrogen generation an

text: Groundwater study - The eight lakes catchment I would like to quickly romp over some of the science we have done since 2002 in the Greater Tarawera catchment, focusing on results. I hope to give people a flavour of what we think is going on in each of the 8 lakes in the catchment:-
• The greater Tarawera catchment
• Purpose of Tarawera project
• Overview of scientific results
- drilling and some early results
- geological model
- catchment hydrology of the 8 lakes
- groundwater flow
- nitrogen generation an

year: 2017

title: Honouring Te Tiriti o Waitangi through addressing racism in universities

authors: Waitoki, Waikaremoana

abstract: Executive summary
The WERO team conducted two studies on university documents to identify how universities articulate
their commitments to Te Tiriti o Waitangi and address inequities for Māori within tertiary education. The
first study, which is a case study of a university’s Treaty Statement, highlighted the university’s limitations
in empowering Māori to exercise tino rangatiratanga within various decision-making structures. The
second study, which scrutinises Māori representation across strategic documents of all universities,
revealed that universities reify whiteness by selectively interpreting Te Tiriti articles, pursuing targeted
Māori recruitment, portraying Māori as reliant on the Crown for success, commodifying mātauranga
Māori, and evading discussions about settler colonialism and racial equity.
Drawing from our findings and constitutional transformation documents such as Matike Mai (2016), we
proffer three recommendations to enable universities to more effectively uphold Te Tiriti o Waitangi:
1. Universities must clearly define the operation of settler colonialism and racism in each institution so
that sustainable anti-racist initiatives can be identified.
2. Each university must grow relational spheres where Māori are empowered to make collective
decisions with the Crown representatives in the university.
3. Universities must invest in a Māori-led independent body to develop and deliver a Te Tiriti-centric
programme that decolonises university processes

text: Honouring Te Tiriti o Waitangi through addressing racism in universities Executive summary
The WERO team conducted two studies on university documents to identify how universities articulate
their commitments to Te Tiriti o Waitangi and address inequities for Māori within tertiary education. The
first study, which is a case study of a university’s Treaty Statement, highlighted the university’s limitations
in empowering Māori to exercise tino rangatiratanga within various decision-making structures. The
second study, which scrutinises Māori representation across strategic documents of all universities,
revealed that universities reify whiteness by selectively interpreting Te Tiriti articles, pursuing targeted
Māori recruitment, portraying Māori as reliant on the Crown for success, commodifying mātauranga
Māori, and evading discussions about settler colonialism and racial equity.
Drawing from our findings and constitutional transformation documents such as Matike Mai (2016), we
proffer three recommendations to enable universities to more effectively uphold Te Tiriti o Waitangi:
1. Universities must clearly define the operation of settler colonialism and racism in each institution so
that sustainable anti-racist initiatives can be identified.
2. Each university must grow relational spheres where Māori are empowered to make collective
decisions with the Crown representatives in the university.
3. Universities must invest in a Māori-led independent body to develop and deliver a Te Tiriti-centric
programme that decolonises university processes

year: 2024-06-30