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

authors: Lao, Chunhuan

subjects: Active surveillance

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: Osobiste i zawodowe rozważania nad wartością Szkoły Lwowsko-Warszawskiej

authors: Ulatowski, Joseph W.

abstract: Rok 2025 stanowi kamień milowy dla Szkoły Lwowsko--Warszawskiej . Obchodzimy 130 . rocznicę jej założenia przez Kazimierza Twardowskiego (1866–1938), ucznia wie-deńskiego filozofa i psychologa Franza Brentana (1838–1917) .Podejście Twardowskiego do zagadnień filozoficznych jest wyjątkowe w historii filozofii, a jego dziedzictwo kon-tynuowali jego uczniowie, każdy na swój indywidualny spo-sób   . Choć rocznica ta nie jest obchodzona jako stulecie czy półtorawiecze, które zazwyczaj są okazją do uroczystości, rok ten pozostaje znaczący.

text: Osobiste i zawodowe rozważania nad wartością Szkoły Lwowsko-Warszawskiej Rok 2025 stanowi kamień milowy dla Szkoły Lwowsko--Warszawskiej . Obchodzimy 130 . rocznicę jej założenia przez Kazimierza Twardowskiego (1866–1938), ucznia wie-deńskiego filozofa i psychologa Franza Brentana (1838–1917) .Podejście Twardowskiego do zagadnień filozoficznych jest wyjątkowe w historii filozofii, a jego dziedzictwo kon-tynuowali jego uczniowie, każdy na swój indywidualny spo-sób   . Choć rocznica ta nie jest obchodzona jako stulecie czy półtorawiecze, które zazwyczaj są okazją do uroczystości, rok ten pozostaje znaczący.

year: 2025-10-31

title: Inclusion of indigenous peoples in CONFINTEA VI and follow-up processes

authors: Morrison, Sandra L.

subjects: indigenous people and CONFINTEA VI

abstract: This paper discusses key issues raised by indigenous peoples during CONFINTEA VI and proposes strategies to enable them to participate in ongoing processes. Indigenous peoples are not involved in the design, implementation and monitoring of adult education programmes, and this often results in a “one-size-fits-all” model. This article takes the position that indigenous people must have full and effective participation in all matters which concern them and that well-meaning policy statements are only as effective as the display of real effort to make them work. One example of an indigenous community taking initiative in order to free itself of overwhelming deficit positioning by mainstream educational and other systems is the Māori community of Aotearoa/New Zealand. The paper argues that through CONFINTEA VI, there is still space for the voice of indigenous peoples to be heard.

text: Inclusion of indigenous peoples in CONFINTEA VI and follow-up processes This paper discusses key issues raised by indigenous peoples during CONFINTEA VI and proposes strategies to enable them to participate in ongoing processes. Indigenous peoples are not involved in the design, implementation and monitoring of adult education programmes, and this often results in a “one-size-fits-all” model. This article takes the position that indigenous people must have full and effective participation in all matters which concern them and that well-meaning policy statements are only as effective as the display of real effort to make them work. One example of an indigenous community taking initiative in order to free itself of overwhelming deficit positioning by mainstream educational and other systems is the Māori community of Aotearoa/New Zealand. The paper argues that through CONFINTEA VI, there is still space for the voice of indigenous peoples to be heard.

year: 2011