title: Obesity and breast cancer outcomes in chemotherapy patients in New Zealand - a population-based cohort study

authors: Elwood, J. Mark

subjects: Breast cancer

abstract: Background: Obesity has been reported as an adverse prognostic factor in breast cancer, but inconsistently, and under-treatment with chemotherapy may occur. We provide the first assessment of obesity and breast cancer outcomes in a population-based, multi-ethnic cohort of New Zealand patients treated with chemotherapy.
Methods: All 3536 women diagnosed with invasive breast cancer in the Waikato region of New Zealand from 2000-2014 were registered and followed until last follow-up in specialist or primary care, death or Dec 2014; median follow-up 4.1 years. For the 1049 patients receiving chemotherapy, mortality from breast cancer, other causes, and all causes, and rates of loco-regional and of distant recurrence, were assessed by body mass index (BMI), recorded after diagnosis, adjusting for other clinico-pathological and demographic factors by Cox regression.
Results: BMI was known for 98% (n=1049); 33% were overweight (BMI 25-29.9), 21% were obese (BMI 30-34.9), and 14% were very obese (BMI 35+). There were no significant associations between obesity and survival, after adjustment for demographic and clinical factors (hazard ratios, HR, for very obese compared to BMI 21-24, for breast cancer deaths 0.96 (0.56-1.67), and for all deaths 1.03 (0.63-1.67), respectively, and only small non-significant associations for loco-regional or metastatic recurrence rates (HR 1.17 and 1.33 respectively). Subgroup analyses by age, menopausal status, ethnicity, stage, post-surgical radiotherapy, mode of diagnosis, type of surgery, and receptor status, showed no associations. No associations were seen with BMI as a continuous variable. The results in all patients irrespective of treatment but with recorded BMI data (n=2296) showed similar results.
Conclusions: In this population, obesity assessed post-diagnosis had no effect on survival or recurrence, based on 1049 patients with chemotherapy treatment with follow-up up to 14 years.

text: Obesity and breast cancer outcomes in chemotherapy patients in New Zealand - a population-based cohort study Background: Obesity has been reported as an adverse prognostic factor in breast cancer, but inconsistently, and under-treatment with chemotherapy may occur. We provide the first assessment of obesity and breast cancer outcomes in a population-based, multi-ethnic cohort of New Zealand patients treated with chemotherapy.
Methods: All 3536 women diagnosed with invasive breast cancer in the Waikato region of New Zealand from 2000-2014 were registered and followed until last follow-up in specialist or primary care, death or Dec 2014; median follow-up 4.1 years. For the 1049 patients receiving chemotherapy, mortality from breast cancer, other causes, and all causes, and rates of loco-regional and of distant recurrence, were assessed by body mass index (BMI), recorded after diagnosis, adjusting for other clinico-pathological and demographic factors by Cox regression.
Results: BMI was known for 98% (n=1049); 33% were overweight (BMI 25-29.9), 21% were obese (BMI 30-34.9), and 14% were very obese (BMI 35+). There were no significant associations between obesity and survival, after adjustment for demographic and clinical factors (hazard ratios, HR, for very obese compared to BMI 21-24, for breast cancer deaths 0.96 (0.56-1.67), and for all deaths 1.03 (0.63-1.67), respectively, and only small non-significant associations for loco-regional or metastatic recurrence rates (HR 1.17 and 1.33 respectively). Subgroup analyses by age, menopausal status, ethnicity, stage, post-surgical radiotherapy, mode of diagnosis, type of surgery, and receptor status, showed no associations. No associations were seen with BMI as a continuous variable. The results in all patients irrespective of treatment but with recorded BMI data (n=2296) showed similar results.
Conclusions: In this population, obesity assessed post-diagnosis had no effect on survival or recurrence, based on 1049 patients with chemotherapy treatment with follow-up up to 14 years.

year: 2018

title: Exploring the landscapes of external supervision

authors: Flintoff, Vivianne

subjects: counselling supervision

abstract: External supervision offers health and social service practitioners opportunities for exploring their work, professional development, and associated relationships. Within a context outside of the workplace, the supervision relationship allegedly supports practice within the workplace. There is a range of understanding within the sectors about the relationship between supervisor and practitioner. This paper explores the potential of closer relationships between agency and supervisor and the subsequent possibilities for greater accountability of the supervision work. Reflecting on our own practice as supervisors both within agencies and external to agencies, this paper invites readers (supervisors and practitioners) to draw on their own supervision experiences. The intention is to critique, challenge, and support critical reflection upon current and potential supervision arrangements for practitioners who participate in supervision that is external to their agencies.

text: Exploring the landscapes of external supervision External supervision offers health and social service practitioners opportunities for exploring their work, professional development, and associated relationships. Within a context outside of the workplace, the supervision relationship allegedly supports practice within the workplace. There is a range of understanding within the sectors about the relationship between supervisor and practitioner. This paper explores the potential of closer relationships between agency and supervisor and the subsequent possibilities for greater accountability of the supervision work. Reflecting on our own practice as supervisors both within agencies and external to agencies, this paper invites readers (supervisors and practitioners) to draw on their own supervision experiences. The intention is to critique, challenge, and support critical reflection upon current and potential supervision arrangements for practitioners who participate in supervision that is external to their agencies.

year: 2010

title: Review of Mareikura-Messengers of Io

authors: Crawford, Terri Ripeka

subjects: Mareikura-Messengers of Io

abstract: Review of Tru Paraha's "Mareikura - Messages of Io", Soundings Theatre, Te Papa Tongarewa, Wellington, 6 June 2008.

text: Review of Mareikura-Messengers of Io Review of Tru Paraha's "Mareikura - Messages of Io", Soundings Theatre, Te Papa Tongarewa, Wellington, 6 June 2008.

year: 2009