Adverse Outcomes Following Cataract Surgery In Western Australia: A Population Study Using Record Linkage
Funder
National Health and Medical Research Council
Funding Amount
$359,150.00
Summary
Cataract is a major cause of correctable visual loss with surgery the only treatment available. Cataract surgery is now one of the most commonly performed operations. With the ageing population, the number of operations is set to double within the next 12 years in Western Australia, from 10,000 procedures a year currently. Although surgery is successful in most cases, complications do occur. Endophthalmitis (infection of internal structures of the eye), incomplete cataract removal, detachment of ....Cataract is a major cause of correctable visual loss with surgery the only treatment available. Cataract surgery is now one of the most commonly performed operations. With the ageing population, the number of operations is set to double within the next 12 years in Western Australia, from 10,000 procedures a year currently. Although surgery is successful in most cases, complications do occur. Endophthalmitis (infection of internal structures of the eye), incomplete cataract removal, detachment of the retina and corneal decompensation (opacity of the clear front of the eye) are four major complications of cataract surgery. These complications may cause blindness and are expensive to treat. We propose to investigate these serious, potentially blinding, complications of cataract surgery by measuring how often these complications occur and to examine if changes in surgical technique over the past 20 years have resulted in better outcomes. We will also evaluate risk factors for endophthalmitis; and determine the quality of life and economic costs of endophthalmitis after cataract surgery. Our study findings will enable us to better inform eye surgeons, the general community, health policy makers and the scientific community about the cost versus safety of different forms of cataract surgery. Unless effective strategies can be found to reduce the rate of complications, the personal and community burden of these devastating complications will only increase as the number of operations continues to increase.Read moreRead less
Low-yield Cigarettes And Diminution Of Small Airways Lung Function In Long-term Smokers
Funder
National Health and Medical Research Council
Funding Amount
$209,500.00
Summary
The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The ....The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The concern is that adenocarcinoma of the lung, a type of lung cancer that is most common in the small peripheral airways, has increased in frequency. This could be because the low-yield cigarette, with reduced yields of nicotine as well as tar, is smoked more intensely by smokers to compensate for the low nicotine. By smoking more intensely, we mean taking larger and more frequent puffs, inhaling the smoke deeply into the lungs, and holding the breath before expiring. This method of smoking would result in more tar particles being deposited in the peripheries of the lung where adenocarcinoma is most common. Because cigarette smoking has been linked also with other structural changes in the small airways of the lung, resulting in obstruction of airflow, we will test whether smoking low-yield cigarettes is associated with greater obstruction of the small airways than is smoking higher-yield cigarettes. To test whether the mechanism is the method of smoking, we will carefully describe and quantify each subject's pattern of smoking including the deposition of smoke-like Technegas particles in the peripheral lung.Read moreRead less
Population Health Modelling, With Applicationsto Asbestos-related Diseases, Cervical Cancer And Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$380,558.00
Summary
Population health modelling can be used to understand complex systems, through bringing together diverse data sources to answer questions of public health importance. We will apply modelling techniques to three public health areas, including: the effects of HPV testing on cervical cancer screening; the impact of the rapid uptake of PSA screening on prostate cancer incidence and mortality; and projections of the incidence of asbestos-related diseases.
ENDOPHTHALMITIS IN WESTERN AUSTRALIA (1980-2002): INCIDENCE, MANAGEMENT AND EFFECTIVENESS OF CHEMOPROPHYLAXIS
Funder
National Health and Medical Research Council
Funding Amount
$348,942.00
Summary
Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to p ....Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to prevent the infection that have not, as yet, been demonstrated beneficial. Our study will use a multidisciplinary team consisting of consultant ophthalmologists, public health researchers, a biostatistician and health economist to assess the impact of endophthalmitis in WA from 1980-2002 (around 480 cases). The population-based WA Linked Database provides a unique opportunity to produce what will be the largest population study of endophthalmitis. Data from the study will provide important information to develop best-practice treatment guidelines to prevent endophthalmitis following cataract surgery. The significance of this study will be that accurate information on the clinical epidemiology and true cost of endophthalmitis will be obtained for WA. By studying the records of patients with endophthalmitis and comparing them with matched patients, who did not have post-operative endophthalmitis following cataract surgery, we will characterise the risks for this severe complication by identifying the underlying factors that are responsible for the infection. We will also better understand the effect of methods used to prevent the infection. The use of a whole population-based study to assess methods of endophthalmitis prevention has not been done before and will have a significant beneficial impact on health policy and best-practice, not only in Australia, but also internationally.Read moreRead less
Asthma, Lung Function, Snoring And Passive Smoking In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$115,110.00
Summary
Respiratory diseases such as asthma, chronic obstructive airway disease, and sleep apnoea are common in the community, and asthma is becoming more and more common. These diseases are a major cause of morbidity, lost time from work, use of health and community resources and death. Using information collected by the Busselton Health Studies between 1966 and 2000, we will investigate some new epidemiological aspects of respiratory diseases. Some of the questions we will examine are: * How much more ....Respiratory diseases such as asthma, chronic obstructive airway disease, and sleep apnoea are common in the community, and asthma is becoming more and more common. These diseases are a major cause of morbidity, lost time from work, use of health and community resources and death. Using information collected by the Busselton Health Studies between 1966 and 2000, we will investigate some new epidemiological aspects of respiratory diseases. Some of the questions we will examine are: * How much more common has asthma become in the Busselton population? Has the increase been more pronounced in some groups than in others (eg younger people)? Have other respiratory diseases also become more common? * Is decline in FEV1 over time a more useful measure of lung health than a single FEV1 measurement? How is decline in FEV1 related to age and other factors such as asthma, smoking, chronic respiratory diseases and hay fever? * Do the following put people at increased risk of sleep apnoea: overweight, recent weight gain, smoking, heavy alcohol intake, respiratory illness, cardiovascular disease and use of sedatives? * Do non-smoking spouses of smokers suffer more respiratory illness than spouses of non-smokers? We expect that results from this study will increase our understanding of the causes and progression of respiratory diseases, and may eventually point to ways of reducing the burden of these diseases in the community. Since all the information needed has already been collected in the course of earlier health surveys, this study will be particularly cost-effective.Read moreRead less
Risk Factors For Chronic Respiratory Diseases In Middle Age: 36-year Follow-up Of The Tasmanian Asthma Study
Funder
National Health and Medical Research Council
Funding Amount
$358,750.00
Summary
This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1 ....This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1961, is one of the worlds most important resources of such information. The probands, their parents (16,267) and siblings (21,044) were first investigated for respiratory problems in 1968. Subsequently, three follow-up surveys were carried out at ages 13 (1974), 20 (1981) and 31 (1992) on either the total or sub-samples of the probands. In 1992, the children and spouses of the probands were also surveyed. Information on all respiratory problems was collected in all the follow-ups, although the main focus of the TAS to date has been asthma. The probands are now reaching the age at which all CRD as a group are beginning to inflict an increasing disease burden, which will become greater in the next two decades. Hence, TAS now provides an ideal opportunity to examine the potential risk factors and natural history of and of CRDs using data collected to date and new data collected at age 43. Also, it will provide a platform for future studies to investigate the progression of CRDs in this cohort. Hence, we propose to carry out the 36 year follow-up of this cohort focusing on CRDs. This will provide important information for preventing chronic respiratory morbidity and disability in the future, which will be original and significant not only in Australia but also internationally.Read moreRead less
Epidemiology Of Middle-age BHR: A Prospective Study From Childhood To Middle Age
Funder
National Health and Medical Research Council
Funding Amount
$593,840.00
Summary
Increased airway reactivity (BHR) in middle-age increases the risk of chronic respiratory diseases (CRDs) in old age, which are recognised as a major public health problem. Knowledge on the causes of these conditions is currently limited. This project will improve our understanding of the childhood and adult causes of increased reactivity of the airways in middle-age. Such knowledge will help in identifying preventive strategies for middle age BHR and thereby CRDs in old age.
Evaluation And Planning Of Coronary Revascularization Services.
Funder
National Health and Medical Research Council
Funding Amount
$591,527.00
Summary
This project concerns operations to unblock or bypass the coronary arteries that supply the muscle of the heart. The project has two parts. One is concerned with checking that changes in medical and surgical treatment of coronary artery disease have been followed by improvements in survival of affected patients. The second will use data on changes in the Australian population, changes in the frequency of heart disease and changes in treatments for heart disease to predict how many coronary opera ....This project concerns operations to unblock or bypass the coronary arteries that supply the muscle of the heart. The project has two parts. One is concerned with checking that changes in medical and surgical treatment of coronary artery disease have been followed by improvements in survival of affected patients. The second will use data on changes in the Australian population, changes in the frequency of heart disease and changes in treatments for heart disease to predict how many coronary operations will be needed in Australia over the next decade. This is a vital step in planning hospital services for patients with coronary disease.Read moreRead less