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THE CONTROL OF TYPE 2 DIABETES THROUGH WEIGHT LOSS IN INDIGENOUS AUSTRALIANS: THE FEASIBILITY AND ACCEPTABILITY OF LAGB
Funder
National Health and Medical Research Council
Funding Amount
$600,854.00
Summary
Our recent clinical trial showed that 3 out of every 4 obese people with type 2 diabetes who undergo substantial weight loss have their diabetes go into remission. In this project we recognise in the Indigenous people specific cultural and socio-economic factors and family and community approach to health care and seek to test if the Lap-Band procedure is acceptable to them and if it is feasible to achieve substantial weight loss and control of diabetes as was seen in a European population.
A Randomised Controlled Trial Of The Effect Of Substantial Weight Loss On Obstructive Sleep Apnoea.
Funder
National Health and Medical Research Council
Funding Amount
$404,061.00
Summary
Obstructive sleep apnea is now commonly recognized as a major health problem and frequently ocurrs in overweight or obese individuals. Several studies have now demonstrated that weight loss can be an effective treatment for sleep apnea in those with a weight problem. But, it is extremely difficult to achieve and sustain the major weight loss required to adequately treat this condition. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in very obese ....Obstructive sleep apnea is now commonly recognized as a major health problem and frequently ocurrs in overweight or obese individuals. Several studies have now demonstrated that weight loss can be an effective treatment for sleep apnea in those with a weight problem. But, it is extremely difficult to achieve and sustain the major weight loss required to adequately treat this condition. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in very obese individuals, and several studies have found that along with weight loss there are major improvements in sleep symptoms, and sleep apnea following weight loss surgery. Despite these findings surgery is rarely advised and has never been formally tested as a therapy for sleep apnea. We propose to formally test, for the first time, the effectiveness of weight loss surgery, as an addition to best conventional therapy, in those individuals with the combination of problems; obesity and significant sleep apnea. We propose that significant weight loss, following surgery, may indeed be the best therapy for those with these combined problems, and that weight loss may have additional benefits for other common problems related to obesity, including high blood pressure, poor body image and impaired quality of life. Forty appropriate patients who suffer these combined problems will be randomly allocated to either conventional therapy for their sleep apnea and weight problems or to a similar program that includes placement of a Lap-Band, a minimially invasive form of obesity surgery. We will follow the patients for 2-years and serially measure a broad range of health and quality of life outcomes and compare the effects of each program. This study will help us assess the role of obesity surgery in this group of patients with major health problems.Read moreRead less
Evaluating And Disseminating The Implementation Success Of A Surgical Training Program
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
Removal of the uterus (hysterectomy) is the most commonly performed major surgical procedure in women (30,000/yr in Australia). Internationally, only about 25% of hysterectomies are still performed through an open abdominal approach, compared to 40% in Australia. This means that too many women in Australia will suffer unnecessary side-effects, pain and long recovery, keeping them away from their family and usual tasks longer than necessary.
Economic Evaluation And Health Outcomes Of Arthritis And Its Treatments
Funder
National Health and Medical Research Council
Funding Amount
$360,660.00
Summary
Musculoskeletal diseases are the most common single cause of chronic disability in Australia and total joint replacement is rapidly becoming one of the most commonly performed operations. This burden of illness is likely to increase with our ageing population and there is an urgent need to obtain data relating to the costs and outcomes in the Australian context so that appropriate planning of health services and resources can be carried out. The WHO (World Health Organisation) has declared 2000 ....Musculoskeletal diseases are the most common single cause of chronic disability in Australia and total joint replacement is rapidly becoming one of the most commonly performed operations. This burden of illness is likely to increase with our ageing population and there is an urgent need to obtain data relating to the costs and outcomes in the Australian context so that appropriate planning of health services and resources can be carried out. The WHO (World Health Organisation) has declared 2000 to 2010 the Bone and Joint Decade, recommending that research into musculoskeletal disorders be a priority. We have been recruiting and following a unique cohort of osteoarthritis and rheumatoid arthritis patients, from both the public and private health sectors, who have been carefully documenting their health outcomes, health care costs (including primary, revision and bilateral hip and knee joint replacement surgery), out-of-pocket and indirect costs related to their arthritis. Long-term follow-up is now essential to obtain a clear picture of the impact of living with arthritis over time and the cost-effectiveness and predictors of good and bad outcomes of joint replacement surgery. The information derived from this study will be useful for patients and doctors in making their decisions about treatments, as well as for health care providers in planning of health services for arthritis sufferers. Given that the cohorts are already established, the study is in a unique position to provide ongoing important longer-term data for relatively low cost.Read moreRead less
CROSSFIRE: Combined Randomised And Observational Study Of Surgery For Fractures In The Distal Radius In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$551,077.00
Summary
Fractures (breaks) near the wrist are the most common fractures treated. Treatment previously consisted of straightening and plaster casting in the emergency department, but standard treatment now includes admission to hospital and surgery to apply a plate and screws to the bone. The best evidence we have (which is limited) is that surgical plating does not provide important benefits over plastering. We aim to perform a multicentre trial comparing plating to plaster for these common fractures.
The WA Safety And Quality Of Surgical Care Project: Improving The Safety, Quality And Provision Of Surgical Care.
Funder
National Health and Medical Research Council
Funding Amount
$583,500.00
Summary
The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the W ....The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the WA Data Linkage System, which brings together 15 million records from hospital morbidity, death, cancer, midwives notification and mental health databases. Surgical procedures have been selected for review based on national priorities and after consultation with the WA Branch of the Royal Australasian College of Surgeons (RACS) and other clinical Colleges. This application proposes to continue the core research activities of the SQSCP. A special focus will be on the use of minimally invasive surgical techniques including laparoscopic, endoscopic and endoluminal procedures, which have increased dramatically during the last decade. The study will also evaluate differences in the outcomes of surgical care in rural and metropolitan settings. The findings of the SQSCP will be comprehensively disseminated to surgeons, the RACS, hospital managers, health policy makers and consumers. The rationale of this project is that by providing high quality data on the epidemiology, utilisation and outcomes of surgical care, we will be able to increase the knowledge-base that will contribute to improvements in the safety, quality and provision of surgical care in Australia and internationally. The aims of the SQSCP are consistent with national health priorities and the recommendations of the Taskforce on Quality of Australian Health Care Study, the Australian Council for Safety and Quality in Health Care and the National Institute of Clinical Studies.Read moreRead less
The Quality Of Surgical Care Project: Quality Assurance, Clinical Audit And Outcomes Evaluation In Western Australia
Funder
National Health and Medical Research Council
Funding Amount
$346,018.00
Summary
The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA ....The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA. The QSCP is only possible because of the unique population-based record linkage available in this state and is consistent with priorities identified in the National Health Information Development Plan in the areas of record linkage and health outcomes, as well as with the monitoring of interventions recommended by the Taskforce on Quality in Australian Health Care. The surgical procedures reviewed are selected to include a broad range of surgical specialties on the basis of national priority, in consultation with the RACS and with input from the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S). This application proposes to continue the core program in promoting best practice in procedural care by reviewing selected procedures including the outcomes of laparoscopic and endoscopic procedures, and endoluminal stenting surgery due to their rapid proliferation during the 1990's. This second stage of the QSCP proposes the introduction of two new quality assurance themes. Firstly, to promote the clinical safety and post-implementation surveillance of new surgical interventions and other medical technology by establishing the WA Registry and Surgical Audit of New Surgical Interventions. Secondly, to comprehensively and independently audit all surgical mortality at a population level. A dissemination strategy will be established to 'complete the loop' in the evaluation and audit processes.Read moreRead less
Developing A Novel Glaucoma Surgery For Clinical Use And Commercialisation
Funder
National Health and Medical Research Council
Funding Amount
$565,893.00
Summary
Glaucoma is a potentially blinding eye condition that affects more than 60 million people. The greatest risk factor in glaucoma is high intraocular pressure. Surgical treatment for glaucoma seeks to lower the pressure inside the eye by increasing the drainage of fluid from the eye. There are numerous techniques available but all have risks of complications. This grant seeks to develop a novel approach to the problem using intra-ocular delivery of laser pulses to cut a drainage channel.
Quality Of Life And Arm Symptoms Following Axillary Surgery For Breast Cancer
Funder
National Health and Medical Research Council
Funding Amount
$32,003.00
Summary
The aim of this project is determine how best to measure, analyse and compare the effects of different operations for women with breast cancer. This will be done with information on measurements of arm swelling, symptoms, functions, and other aspects of quality of life collected in over 1,000 women taking part in a national randomised trial. This research will provide important information about the effects of these operations, and about how best to design future surgical trials.