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
Effectiveness, Cost-effectiveness And Equity Of Strategies To Reduce The Burden Of Obesity-related Conditions
Funder
National Health and Medical Research Council
Funding Amount
$46,900.00
Summary
Decision-makers need a systematic, coordinated approach to the targeting and prioritisation of preventive strategies. But the evidence base for obesity interventions is for the most part small, narrow in approach, limited in impact, and lacking in cost-effectiveness and equity information. This thesis will add to the evidence base regarding the nature of the obesity epidemic in Australia and internationally and the relative cost-effectiveness of strategies to reduce the obesity burden.
Early Predictors And Body Composition Changes Associated With Adiposity Rebound
Funder
National Health and Medical Research Council
Funding Amount
$201,650.00
Summary
Overweight and obesity rates are increasing in children, and overweight children have higher risk of adult obesity and therefore diseases including heart attack, stroke and diabetes. The preschool years may offer opportunities to divert children from the path to obesity, before poor physical activity and nutritional habits become firmly established. Adiposity rebound is the time in a child's life (usually around 5 to 6 years of age) when body mass index (BMI) begins to increase after a steady de ....Overweight and obesity rates are increasing in children, and overweight children have higher risk of adult obesity and therefore diseases including heart attack, stroke and diabetes. The preschool years may offer opportunities to divert children from the path to obesity, before poor physical activity and nutritional habits become firmly established. Adiposity rebound is the time in a child's life (usually around 5 to 6 years of age) when body mass index (BMI) begins to increase after a steady decline in BMI in the preschool years. Early adiposity rebound is associated with increased BMI in later life. We don't yet know whether the early adiposity rebound causes the higher BMI, or whether it is simply an early sign of an already-established pathway of behavioural and environmental risk. We need a much better understanding of predictors of early adiposity rebound and the changes that occur to determine if age at adiposity rebound is a modifiable risk factor for adult obesity. This study will document the process and timing of adiposity rebound and the changes in percent body fat and lean body mass that occur during that time. We will also determine whether risk and protective factors for early adiposity rebound and overweight at age 6 years are the same or different. We will study over 400 children on whom extensive data have been collected since birth, including period of gestation, birth weight and length. At various stages during their first two years of life, height, weight, feeding patterns and development were recorded. We will measure BMI and perform bioimpedance analysis (BIA) on these children six times between 4 and 6 years of age. BIA provides a measure of body fat and lean mass that is well accepted by children. This will help determine the relationship between changing BMI at different ages and the fat-to-lean mass ratios associated with those changes. This study is the first to consider body composition changes during adiposity rebound.Read moreRead less
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
David Whiteman is a medical epidemiologist with a special interest in the causes, diagnosis, prevention and treatment of cancer. His work has focussed on melanoma and skin cancer, and more recently, on cancers of the upper gastro-intestinal tract.
Nutritional And Genetic Factors Associated With Genome Damage In Children
Funder
National Health and Medical Research Council
Funding Amount
$715,131.00
Summary
This project will investigate the link between children's diet and damage to their DNA. Damage to DNA is known to accumulate throughout life, and to be associated with risk of cancer and other diseases in adulthood. If we can show that poor diet in childhood increases DNA damage in childhood, it suggests that poor diet early in life may also increase risk of cancer and other diseases in adulthood. This will underpin important, salient health promotion messages we can provide to parents.
I am an epidemiologist whose research is concerned with investigating the behavioural, social, structural and environmental determinants of obesity and its antecedent behaviours
Risk Factors For Gastro-oesophageal Reflux Disease And Barretts Oesophagus In A Prospective Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$960,867.00
Summary
Heartburn caused by acid reflux is a common problem in Australia. In 2003, drugs used to treat disorders caused by acid problems, such as heartburn, cost the PBS more than $500 million. Heartburn probably causes a disease of the oesophagus called Barrett's oesophagus, which in turn is a cause of cancer of the oesophagus. The aim of this study is to identify risk factors for heartburn and Barrett's oesophagus, so that we can find ways to prevent them occurring.