Baseline health-related quality-of-life data as prognostic factors in a phase III multicentre study of women with metastatic breast cancer.

The potential value of baseline health-related quality-of-life (HRQOL) and clinical factors in predicting prognosis was examined using data from an international randomised phase III trial which compared doxorubicin and paclitaxel with doxorubicin and cylophosphamide as first line chemotherapy in 275 women with metastatic breast cancer. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the related breast module (QLQ-BR23) were used to assess baseline HRQOL data. The Cox proportional-hazards regression model was used for both univariate and multivariate analyses of survival. In the univariate analyses, performance status (P<0.001) and number of sites involved (P=0.001) were the most important clinical prognostic factors. The HRQOL variables at baseline most strongly associated with longer survival were better appetite, physical and role functioning, as well as less fatigue (P<0.001). The final multivariate model retained performance status (P<0.001) and appetite loss (P=0.005) as the variables best predicting survival. Substantial loss of appetite was the only independent HRQOL factor predicting poor survival and was strongly correlated (/r/>0.5) with fatigue, role and physical functioning. In addition to known clinical factors, appetite loss appears to be a significant prognostic factor for survival in women with metastatic breast cancer. However, the mechanism underlying this association remains to be precisely defined in future studies.

Health status of an elderly population in Sharpeville, South Africa

The objective of this cross-sectional study was a comprehensive nutrition and health assessment to provide a basis for future intervention strategies for an elderly population attending a day-care centre. Socio-demographic, health and 24-hour recall dietary intake questionnaires were administered and anthropometric and biochemical measurements taken. The results indicate that the majority of respondents had an income of between R501 and R1 000 (South African rand) per month and most of them reported an occasional lack of funds to meet basic household needs, confirming the presence of food insecurity. Daily dietary intakes (mean [+ or -] Standard Deviation [SD]) of the women were 5 395 [+ or -] 2 946 kJ energy, 47 [+ or -] 27 g protein, 28 [+ or -] 21 g fat and 196 [+ or -] 123 g carbohydrates compared to 8 641 [+ or -] 3 799 kJ, 86 [+ or -] 48 g, 49 [+ or -] 32 g and 301 [+ or -] 139 g of the men, respectively. The majority (83.6%) of the women were overweight (body mass index [BMI] [greater than or equal to] 25) or obese (BMI [greater than or equal to] 30) whilst 78% had a mid-upper arm circumference (MUAC) of [greater than or equal to] 21.7 cm. Mean intakes of micronutrients were low in comparison to reference standards and serum zinc levels were suboptimal. Obesity, hypertension and raised total serum cholesterol levels indicated an increased risk for coronary heart disease. It can be concluded that a low income, household food insecurity and risk factors associated with malnutrition and non-communicable diseases were prevalent in this elderly population. OPSOMMING Die doelwit van hierdie dwarssnitstudie was ‘n omvattende bepaling van voeding- en gesondheidstatus om as basis te dien vir toekomstige intervensiestrategieë vir ’n groep bejaardes wat ’n dagsentrum besoek. Sosiodemografiese, gesondheid- en 24-uur herroep-dieetinname vraelyste is voltooi en antropometriese en biochemiese metings is geneem. Die resultate het bevestig dat die meerderheid respondente ‘n maandelikse inkomste van tussen R501 en R1 000 (Suid-Afrikaanse rand) gehad het. Die meeste het ‘n geldtekort vir basiese huishoudelike behoeftes gerapporteer wat dui op huishoudelike voedselinsekuriteit. Daaglikse dieetinnames (gemiddeld±standaardafwyking [SA]) van die vroue was onderskeidelik 5 395±2 946 kJ energie, 47±27 g proteïen, 28±21 g vet en 196±123 g koolhidrate in vergelyking met 8 641±3 799 kJ, 86±48 g, 49±32 g en 301±139 g vir die mans. Die meerderheid (83.6%) van die vroue was oorgewig (liggaamsmassa-indeks [LMI] >25) of vetsugtig (LMI > 30) en 78% het ’n middel-bo-armomtrek (MUAC) van > 21.7 cm gehad. Gemiddelde mikronutriëntinnames was laag in vergelyking met die verwysingstandaarde en serumsink was suboptimaal. Vetsug, hipertensie en verhoogde totale serumcholesterolvlakke het op ‘n verhoogde risiko van kardiovaskulêre siekte gedui. Die resultate het dus bewys dat lae inkomste, huishoudelike voedselinsekuriteit en die risikofaktore wat met wanvoeding en leefstylsiektes geassosieer word, teenwoordig was.

Current Status of Offshore Wind Power Development in China

In July 2010, the Shanghai Donghai Bridge wind farm, the first commercial offshore wind project was connected to the main grid in China. Three months later, four contracts were handed out to build a total of 1GW wind power capacity in the first round of an offshore concession project by the Chinese central government. At that time, there was a worldwide expectation that Chinese offshore wind power capacity would expand rapidly. However, China only achieved a total offshore wind power installed capacity of 389.2 MW by the end of 2012. This paper studies the recent development of offshore wind power in China by dividing the offshore wind power projects into three categories. This paper presents the difficulties for the Chinese government to achieve its 12th Five Year Plan for offshore wind power. Some policy recommendations to overcome the current difficulties are made in the conclusions.

Improvement of Food Security in Bangladesh through Socio-Economic Empowerment of Women

Empowerment is one possible approach to increase political, social and economic participation of a target group and thus decrease food insecurity among vulnerable people. The objective of this research was to evaluate a socio-economic empowerment project implemented for 8 years in rural northern Bangladesh by using secondary data from 2000 and primary data from 2009. Three hundred women were primarily selected out of all existing and active 121 women groups formed during 8 years project implementation. Standardized interviews were conducted to collect quantitative data. In addition an overall qualitative analysis included focus group discussions, the review of project summaries and discussions with implementing staff. Data was collected on socio-economic status, rice storages and food consumption. In addition knowledge was gained on current activities of the women groups. The empowerment concept implemented in this setting was successful to increase the participants’ political, social and economic engagement and visibility. Apart from that the utilization of skills for income generation led to an improvement of the socio-economic status and food insecurity became less common. Recommendations for future projects include the increase of female members among the NGO staff as well as the further follow-up and strengthening of political acceptance and visibility of the empowered participants to sustain the outcome of the project.

An overview of the current status of research into adopting high levels of renewables in Ireland

This paper provides an overview of the reduction targets that Ireland has set in the context of decarbonising their electricity generation through the use of renewables. The main challenges associated with integrating high levels (>20% of installed capacity) of non-dispatchable renewable generation are identified. The rising complexity of the challenge as renewable penetration levels increase is highlighted. A list of relevant research questions is then proposed, and an overview is given into the previous work that has gone into answering some of them. In particular, studies into the Irish energy market are identified, the current knowledge gap is described, and areas of necessary future research are suggested