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
Value Of Androgen Deprivation And Bisphosphonate In Patients Treated By Radiotherapy For Localised Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$2,533,827.00
Summary
Following on from significant findings in the TROG 96.01 trial, the 03.04 trial, known as the RADAR trial was developed. This is a large-scale randomised controlled clinical trial currently conducted at 23 cancer treatment centres throughout Australia and New Zealand. The RADAR trial aims to recruit 1000 men with localised but inoperable prostate cancer. It was anticipated that the length of time required to enrol 1000 participants to the trial would be 5 years. However, because enrolment has ex ....Following on from significant findings in the TROG 96.01 trial, the 03.04 trial, known as the RADAR trial was developed. This is a large-scale randomised controlled clinical trial currently conducted at 23 cancer treatment centres throughout Australia and New Zealand. The RADAR trial aims to recruit 1000 men with localised but inoperable prostate cancer. It was anticipated that the length of time required to enrol 1000 participants to the trial would be 5 years. However, because enrolment has exceeded expectations and 728 patients have already been recruited, it is anticipated that the recruitment target will be reached in mid 2007. Patients are randomly assigned to receive one of four treatment options in the RADAR trial. The first option: Option A: Radiation Therapy and 6 months of Hormone Therapy (Leuprorelin acetate), is currently the standard of care. Option C is a further 12 months of hormone therapy after the current standard of care. Two of the options (B and D) are identical to options A and C except that subjects also receive 18 months of zoledronate (a 'bone' drug) in addition to hormone therapy and radiotherapy. The main goal of the RADAR trial is to determine whether 12 months of hormone therapy using Leuprorelin acetate starting immediately after standard therapy (ie 6 months of Leuprorelin acetate before and during radiotherapy) will reduce risk of return of the cancer, either within the prostate region or at remote sites in the body, and prolong life. An additional goal is to see whether 18 months of bisphosphonate therapy (bone density therapy) using zoledronate will reduce the risk of cancer returning in the bones as well as stopping dangerous bone thinning which can sometimes be caused by hormone therapy. The trial also seeks to determine whether the additional therapy given in this trial alters quality of life.Read moreRead less
Optimal Duration Of Neoadjuvant Androgen Deprivation Therapy In Localised Prostate Cancer Treated By Radiotherapy
Funder
National Health and Medical Research Council
Funding Amount
$422,335.00
Summary
The 96.01 trial aims to find out whether androgen deprivation (AD) administered prior to and during radiotherapy (i.e., neo-adjuvant AD) will improve outcomes in patients with locally advanced prostate cancer that is considered inoperable and is treated for cure by radiotherapy. The trial also aims to find out whether six months AD produces outcomes superior to those achieved by three months AD. The trial has been running since 1996 and involves 802 men who attend 19 cancer treatment centres acr ....The 96.01 trial aims to find out whether androgen deprivation (AD) administered prior to and during radiotherapy (i.e., neo-adjuvant AD) will improve outcomes in patients with locally advanced prostate cancer that is considered inoperable and is treated for cure by radiotherapy. The trial also aims to find out whether six months AD produces outcomes superior to those achieved by three months AD. The trial has been running since 1996 and involves 802 men who attend 19 cancer treatment centres across Australia and New Zealand. It would not have been possible without the continuous funding support of the NHMRC. So far this trial has shown that AD does prevent prostate cancer from returning after radiotherapy. This is very important because the need for treatment of recurrent cancer (usually AD for the rest of the patient's life) is halved by 6 months AD compared to standard treatment (radiotherapy alone). However, it is now necessary to observe the patients in this trial for another 5 years to find out whether AD also prolongs life, and whether 6 months AD is more effective than 3 months. Further patient follow up is also necessary to identify whether some men respond better to treatment than others. This is very important because it will enable treatment to be tailored to individual patients, in particular those who require more treatment than is given in this trial. This funding application is therefore to enable patient follow up on this large scale trial for another 5 years.Read moreRead less
It is now well established that there are genetic factors contributing to risk of depression but it is far from clear what these are and how they interact with environmental risk factors such as stressful life events (SLE) and poor social support (SS). A recent, highly cited paper has claimed that those carrying a particular genotype at the sertonin transporter gene are much more badly affected by stressful life events than other genotypes, and that this puts these people at much higher risk of ....It is now well established that there are genetic factors contributing to risk of depression but it is far from clear what these are and how they interact with environmental risk factors such as stressful life events (SLE) and poor social support (SS). A recent, highly cited paper has claimed that those carrying a particular genotype at the sertonin transporter gene are much more badly affected by stressful life events than other genotypes, and that this puts these people at much higher risk of depression. If true, this could have important practical implications for preventative mental health, in identifying those at greatest risk if depression and counselling them to avoid stressful situations. However, success in replicating this finding has been mixed, and this is possibly because another important risk factor, social support, has not been taken into account. We have DNA samples from over 5000 twins who have been assessed for depression and risk factors including SLE and SS. This will give us unprecedented power to estimate the importance of the genotype x environment interaction. We shall also type other genes that have been implicated in depression and check for interactions with life events and social support. Our results will inform preventative strategies in mental health practice.Read moreRead less
There are 140 million contact lens wearers worldwide. Use of contact lenses is associated with ocular inflammation (approximately 2-7% per year). We have developed novel antimicrobial coatings for contact lenses which we have shown in laboratory and animal models can reduce the ability of microbes to adhere to lenses and reduce associated inflammation. This Development project will enable us to generate proof-of-principle in a clinical cohort using existing contact lenses that have been coated u ....There are 140 million contact lens wearers worldwide. Use of contact lenses is associated with ocular inflammation (approximately 2-7% per year). We have developed novel antimicrobial coatings for contact lenses which we have shown in laboratory and animal models can reduce the ability of microbes to adhere to lenses and reduce associated inflammation. This Development project will enable us to generate proof-of-principle in a clinical cohort using existing contact lenses that have been coated using our patented processes.Read moreRead less
Improving The Safety And Quality Of Emergency Nursing Care
Funder
National Health and Medical Research Council
Funding Amount
$1,498,877.00
Summary
Failure to assess, treat comprehensively and escalate emergency patient care can be catastrophic. However, there is no emergency nursing framework in use for the 29,000+ emergency nurses working in Australia. We aim to improve access, consistency, safety and quality of emergency care for the best possible patient outcomes through system wide implementation of HIRAID - the only validated framework designed to teach emergency nurses how to systematically assess and manage emergency patients.
Immunisation Safety And Adverse Events: Improving Our Understanding Of Causes And Management
Funder
National Health and Medical Research Council
Funding Amount
$295,223.00
Summary
As the incidence of vaccine preventable diseases declines, adverse events following vaccination become increasingly important for both public and providers. This fellowship aims to improve our understanding of the risks of vaccination, potential causes, including genetic predisposition and long term clinical outcomes. A range of epidemiological, clinical and genetics studies will be performed. All these studies are targeted to understand who, what, how and why vaccine reactions occur and what ca ....As the incidence of vaccine preventable diseases declines, adverse events following vaccination become increasingly important for both public and providers. This fellowship aims to improve our understanding of the risks of vaccination, potential causes, including genetic predisposition and long term clinical outcomes. A range of epidemiological, clinical and genetics studies will be performed. All these studies are targeted to understand who, what, how and why vaccine reactions occur and what can be done to prevent or manage them better.Read moreRead less