title: Management of patients with early stage lung cancer - why do some patients not receive treatment with curative intent?

authors: Lawrenson, Ross

subjects: Lung cancer

abstract: BACKGROUNDS: This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment. 
METHODS: Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death. 
RESULTS: In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8-91.8%) and 5-year survival of 69.6% (95% CI: 63.2-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori. 
CONCLUSIONS: The majority of patients with stage I and II lung cancer are managed with potentially curative treatment - mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.

text: Management of patients with early stage lung cancer - why do some patients not receive treatment with curative intent? BACKGROUNDS: This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment. 
METHODS: Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death. 
RESULTS: In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8-91.8%) and 5-year survival of 69.6% (95% CI: 63.2-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori. 
CONCLUSIONS: The majority of patients with stage I and II lung cancer are managed with potentially curative treatment - mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.

year: 2020

title: Investigating commentary on the fifth labour-led government’s third way approach

authors: Piercy, Gemma Louise

abstract: After the 1999 election of a Labour-led coalition government in Aotearoa New Zealand, a raft of policy reforms adopted characteristics of the ‘Third Way’ ideology promoted by Anthony Giddens. We argue, however, that Third Way characteristics were not implemented in Aotearoa New Zealand without attracting criticism. This article reviews academic analysis and wider commentary on the Third Way in Aotearoa New Zealand, much of which particularly focused on social policy reforms made by the Labour-led coalition government (1999-2008). We have used this literature to identify the varied ways in which the Third Way was defined and the extent to which Third Way ideology was considered to have influenced policy and practice the Aotearoa New Zealand context. Our semi-systematic literature review shows that many commentators argued that New Zealand did indeed implement a policy platform consistent with Third Way ideological characteristics but these were also adapted to the unique context of Aotearoa New Zealand. We explore in detail two key examples of adaptation di scussed in the literature: the Labour-led government’s early focus on reducing inequalities between Māori and non-Māori and on renewing civil society through subsidiarity and a partnership approach.

text: Investigating commentary on the fifth labour-led government’s third way approach After the 1999 election of a Labour-led coalition government in Aotearoa New Zealand, a raft of policy reforms adopted characteristics of the ‘Third Way’ ideology promoted by Anthony Giddens. We argue, however, that Third Way characteristics were not implemented in Aotearoa New Zealand without attracting criticism. This article reviews academic analysis and wider commentary on the Third Way in Aotearoa New Zealand, much of which particularly focused on social policy reforms made by the Labour-led coalition government (1999-2008). We have used this literature to identify the varied ways in which the Third Way was defined and the extent to which Third Way ideology was considered to have influenced policy and practice the Aotearoa New Zealand context. Our semi-systematic literature review shows that many commentators argued that New Zealand did indeed implement a policy platform consistent with Third Way ideological characteristics but these were also adapted to the unique context of Aotearoa New Zealand. We explore in detail two key examples of adaptation di scussed in the literature: the Labour-led government’s early focus on reducing inequalities between Māori and non-Māori and on renewing civil society through subsidiarity and a partnership approach.

year: 2017

title: Retention capacity of biochar-amended New Zealand dairy farm soil for an estrogenic steroid hormone and its primary metabolite

authors: Sarmah, Ajit K.

abstract: We examined the retention ability of a New Zealand dairy farm soil amended with 3 types of biochar produced from a variety of feedstocks for a steroid hormone (oestradiol, E2) and its primary transformation product (estrone, E1). Biochars produced from corn cob (CC), pine sawdust (PSD) and green waste (GW) were characterised by scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and solid-state 13C nuclear magnetic resonance spectroscopy. Batch sorption studies were performed on soil amended with each biochar (0.5% and 1% by weight) using a complex solvent extraction scheme, and isotherms were fitted to the Freundlich model.
All isotherms were highly non-linear, with N values in the range 0.46–0.83 (E2) and 0.66–0.88 (E1) in soil amended with different percentages of biochars. Overall, addition of all 3 biochars was found to increase the soil sorption affinity for the hormones, with E2 sorption being the highest in the soil amended with 1% PSD biochar. There was no marked difference in hormone sorption ability in the other 2 treatments (soil treated with 1% CC biochar and 1% GW biochar). Overall, the effective distribution coefficient (Kdeff) values for E2 at the lowest equilibrium concentration (Cw 0.5 mg/L) ranged from 35 to 311 L/kg in soil amended with the 3 types of biochar. Addition of 0.5% of PSD biochar resulted in ~560% increase in the Kdeff value for E2, while at 1% addition of PSD biochar, uptake of E2 was nearly 1400% higher than the control. For E1, the percentage increase in Kdeff was comparatively smaller than E2; however, it still ranged from 40 to 280%, and 60 to >320% at addition of 0.5% and 1% PSD biochar, respectively, compared with the control soil. Highest treatment temperature and associated greater surface area, low ash content, higher carbon content, and the abundance of polar functional groups (e.g. –OH, C=O) may explain why the soil amended with PSD biochar exhibited high sorptive capacity for the hormones.

text: Retention capacity of biochar-amended New Zealand dairy farm soil for an estrogenic steroid hormone and its primary metabolite We examined the retention ability of a New Zealand dairy farm soil amended with 3 types of biochar produced from a variety of feedstocks for a steroid hormone (oestradiol, E2) and its primary transformation product (estrone, E1). Biochars produced from corn cob (CC), pine sawdust (PSD) and green waste (GW) were characterised by scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and solid-state 13C nuclear magnetic resonance spectroscopy. Batch sorption studies were performed on soil amended with each biochar (0.5% and 1% by weight) using a complex solvent extraction scheme, and isotherms were fitted to the Freundlich model.
All isotherms were highly non-linear, with N values in the range 0.46–0.83 (E2) and 0.66–0.88 (E1) in soil amended with different percentages of biochars. Overall, addition of all 3 biochars was found to increase the soil sorption affinity for the hormones, with E2 sorption being the highest in the soil amended with 1% PSD biochar. There was no marked difference in hormone sorption ability in the other 2 treatments (soil treated with 1% CC biochar and 1% GW biochar). Overall, the effective distribution coefficient (Kdeff) values for E2 at the lowest equilibrium concentration (Cw 0.5 mg/L) ranged from 35 to 311 L/kg in soil amended with the 3 types of biochar. Addition of 0.5% of PSD biochar resulted in ~560% increase in the Kdeff value for E2, while at 1% addition of PSD biochar, uptake of E2 was nearly 1400% higher than the control. For E1, the percentage increase in Kdeff was comparatively smaller than E2; however, it still ranged from 40 to 280%, and 60 to >320% at addition of 0.5% and 1% PSD biochar, respectively, compared with the control soil. Highest treatment temperature and associated greater surface area, low ash content, higher carbon content, and the abundance of polar functional groups (e.g. –OH, C=O) may explain why the soil amended with PSD biochar exhibited high sorptive capacity for the hormones.

year: 2010