The primary aim of this large pilot survey was to demonstrate the use and benefits of electronic data collection with respect to rapidly monitoring the access, delivery, and outcome of cataract ...surgery in the NHS and to update benchmark standards for these parameters of care.
Eight NHS departments that currently use specialty-specific electronic clinical systems or Electronic Patient Records (EPR) to collect a minimum preoperative, operative, and anaesthetic data set for cataract surgery agreed to pool their data.
A total of 162 surgeons from 50 consultant teams and eight NHS Trusts agreed to submit their data on a total of 16,541 operations for age-related cataract. This report describes the age, sex, and ethnic profiles of the patients, waiting time for surgery, ocular copathology causing a reason for a guarded visual prognosis, visual impairment on admission, visual acuity in the operated eye, and the characteristics of the anaesthetic and surgical procedures.
This survey has raised the benchmark standards established by the last National Survey in 1997. There has been a near universal switch to day case, phacosurgery under local anaesthesia (all used in > or =99.1% of cases compared with 70, 77, and 86%, respectively in 1997). The visual impairment in the operated eye is lower with 45% having 6 / 12 or better compared with 27% in 1997. Waiting times and visual impairment in the fellow eye have probably improved although data collection for these variables was incomplete. All departments require specialty-specific clinical systems to efficiently collect and analyse these data and this survey proves their potential to form the basis for national electronic surveys in the future.
This study utilizes newly developed direct DNA typing methods for human leukocyte antigens (HLA) to provide new information about the peopling of New Guinea. The complete polymorphism of eight ...Melanesian populations was examined. The groups included were highlanders, northern and southern highlands fringe populations, a Sepik population, northern and southern coastal New Guinea populations, and populations from the Bismarck Archipelago and New Caledonia. The study concluded that, based on HLA and other evidence, Melanesians are likely to have evolved largely from the same ancestral stock as Aboriginal Australians but to have since differentiated. Highlanders are likely to be descendants of earlier migrations who have been isolated for a long period of time. Northern highlands fringe and Sepik populations are likely to share a closer common ancestry but to have differentiated due to long term isolation and the relative proximity to the coast of the Sepik. Southern fringe populations are likely to have a different origin, possibly from the Gulf region, although there may be some admixture with neighboring groups. Coastal populations have a wider range of polymorphisms because of the genetic trail left by later population movement along the coast from Asia that did not reach Australia or remote Oceania. Other polymorphisms found in these populations may have been introduced by the movement of Austronesian-speaking and other more recent groups of people into the Pacific, because they share many polymorphisms with contemporary southeast Asians, Polynesians, and Micronesians that are not found in highlanders or Aboriginal Australians. There is evidence suggestive of later migration to Melanesia from Polynesia and Micronesia.
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