Quality of Life

The Secretariat of the United Nations Conference on Environment and Development (UNCED) asked IIASA to provide scientific support to the conference by examining the usefulness of systems analysis in: (1) identifying some of the important linkages among population, development and the environment and; (2) in helping decisionmakers in formulating and implementing policies for sustainable development. Part of the work of the resulting Environment and Development Study involved the formulation of conceptual models describing the socio-ecological system in which we live. Quality of Life was a central component of these models; it was concluded that the aim of development was: (i) to enhance the quality of people's lives, considering both material and nonmaterial factors and; (ii) to lessen disparities across social groups, regions and generations

Poverty, Ethnicity and Migration Potentials in Eastern Europe

This paper analyzes migration streams within and out of the former USSR, here called Eastern Europe. It also discusses potential streams during the coming decades. The main part of the paper, however, is descriptive and builds on information from census data. A short historical part of the paper gives a background for the discussion on the character and form of present and future migration flows. A simple dynamic model of economic growth in two parts of Europe (Eastern and Northern/Western) show that the present welfare gap will continue to exist, even with a large capital transfer to Eastern Europe. A potential for large migration flows westward will thus be present even during the coming decades

Sustainable Development: A Systems Approach

This Status Report summarizes the final report of the IIASA Environment and Development Study which was submitted to the Secretariat of the United Nations Conference on Environment and Development (UNCED) in December 1991. As a systems analysis institute, IIASA was asked by UNCED in mid-1990 to explore the usefulness of systems analysis in: identifying some of the important linkages among population, environment, and development; examining some of the underlying causes of environmentally unsustainable development; and in formulating and implementing policies for more sustainable development. The work first involved the formulation of conceptual models of the socio-ecological system in which we live. The application of systems analysis to environment and development was then examined in several case studies. The case studies, based mainly upon past and present work carried out here at IIASA, indicated that systems analysis is potentially very useful in helping us towards a sustainable future. However, the work that is described in the report gives only a few examples of what could be done in the years following UNCED

Phase III study of pasireotide long-acting release in patients with metastatic neuroendocrine tumors and carcinoid symptoms refractory to available somatostatin analogues

In a randomized, double-blind, Phase III study, we compared pasireotide long-acting release (pasireotide LAR) with octreotide long-acting repeatable (octreotide LAR) in managing carcinoid symptoms refractory to first-generation somatostatin analogues. Adults with carcinoid tumors of the digestive tract were randomly assigned (1:1) to receive pasireotide LAR (60 mg) or octreotide LAR (40 mg) every 28 days. Primary outcome was symptom control based on frequency of bowel movements and flushing episodes. Objective tumor response was a secondary outcome. Progression-free survival (PFS) was calculated in a post hoc analysis. Adverse events were recorded. At the time of a planned interim analysis, the data monitoring committee recommended halting the study because of a low predictive probability of showing superiority of pasireotide over octreotide for symptom control (n=43 pasireotide LAR, 20.9%; n=45 octreotide LAR, 26.7%; odds ratio, 0.73; 95% confidence interval [CI], 0.27–1.97; P=0.53). Tumor control rate at month 6 was 62.7% with pasireotide and 46.2% with octreotide (odds ratio, 1.96; 95% CI, 0.89–4.32; P=0.09). Median (95% CI) PFS was 11.8 months (11.0 – not reached) with pasireotide versus 6.8 months (5.6 – not reached) with octreotide (hazard ratio, 0.46; 95% CI, 0.20–0.98; P=0.045). The most frequent drug-related adverse events (pasireotide vs octreotide) included hyperglycemia (28.3% vs 5.3%), fatigue (11.3% vs 3.5%), and nausea (9.4% vs 0%). We conclude that, among patients with carcinoid symptoms refractory to available somatostatin analogues, similar proportions of patients receiving pasireotide LAR or octreotide LAR achieved symptom control at month 6. Pasireotide LAR showed a trend toward higher tumor control rate at month 6, although it was statistically not significant, and was associated with a longer PFS than octreotide LAR

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pathology: Diagnosis and Prognostic Stratification.

The European Neuroendocrine Tumor Society (ENETS) proposed standard of care guidelines for pathology in 2009. Since then, profound changes in the classification have been made, dividing neuroendocrine neoplasia (NEN) into well-differentiated neuroendocrine tumors (NET) and poorly differentiated neuroendocrine carcinomas (NEC) in the 2010 WHO classification. The 7th edition of the TNM classification (2009) included NEN for the first time, widely adapting ENETS proposals but with some differences for NEC and for NET of the pancreas and the appendix. Therapy guidelines for gastroenteropancreatic NET were updated in 2016. The need for an update of the standards of care prompted the ENETS to organize a consensus conference which was held in Antibes in 2015; a working group was designated to propose pathological standards of car