Trends in contact lens prescribing 2012

The 13th annual survey of Australian contact lens prescribing was conducted between January and April 2012. The same format as in previous years was employed. About 3,000 members of Optometrists Association Australia were sent an e-mail message with a link to a downloadable questionnaire, and a request that this be accessed, printed and completed to provide details of the first 10 patients fitted with contact lenses after receipt of the questionnaire.

Contact lens prescribing in the Australian states and territories 2001

Background: This study was conducted to ascertain current preferences for contact lens prescribing in the Australian states and territories.

Methods: One thousand questionnaires were randomly distributed to proportionate samples of optometrists in each state of Australia. We requested details of the first 10 patients fitted with contact lenses after receipt of the questionnaire.

Results: One hundred and seventy-eight completed questionnaires were returned, detailing contact lens fits to 1,611 patients. The mean age of the patient group was 32.1 $pL 13.0 yrs (65 per cent female). For Australia as a whole: 53 per cent of patients were existing wearers, the remainder were new fits; 93 per cent of new fits were with soft lenses, of which seven per cent were for extended wear. Of the refits, 89 per cent were soft lenses and 18 per cent for extended wear. The lens material of first choice was mid-water-content (62 per cent of all soft lens fits). Only eight per cent of all soft fits were for lenses that were not replaced on a planned basis, with two weeks being the replacement interval of choice in all states and territories. The majority of rigid lenses were prescribed using mid-Dk materials (50 per cent). Analysis of solution prescribing indicates that multi-purpose products were the most common regimens for planned replacement soft lenses. The percentage of hydrogen peroxide prescribed increased as lens replacement became less frequent. By state or territory: practitioners in Tasmania prescribed more extended wear than those in any other state (p = 0.007) and practitioners in Queensland prescribed more daily disposable contact lenses than those in any other state (p = 0.009).

Conclusions: Non-planned replacement lenses are now rarely prescribed to patients. Extended-wear lenses and rigid lenses continue to be prescribed more to existing contact lens wearers than to new patients. The impact of soft multifocal lens designs on contact lens prescribing is very small, ranging from 2.6 per cent in Queensland to 4.7 per cent in Victoria, despite 20 per cent of patients being more than 45 years of age.

An international survey of toric contact lens prescribing

To characterize toric contact lens prescribing worldwide. Up to 1,000 survey forms were sent to contact lens fitters in up to 39 countries between January and March every year for 5 consecutive years (2007–2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Only data for toric and spherical soft lens fits were analyzed. Survey data collected since 1996 were also analyzed for 7 nations to assess toric lens fitting trends since that time. Data were collected in relation to 21,150 toric fits (25%) and 62,150 spherical fits (75%). Toric prescribing ranged from 6% of lenses in Russia to 48% in Portugal. Compared with spherical fittings, toric fittings can be characterized as follows: older age (29.8 ± 11.4 years vs. 27.6 ± 10.8 years for spherical lenses); men are overrepresented (38% vs. 34%); greater proportion of new fits (39% vs. 32%); use of silicone hydrogel lenses (49% vs. 39%); and lower proportion of daily disposable lenses (14% vs. 28%). There has been a continuous increase in toric lens prescribing between 1996 and 2011. The proportion of toric lens fits was positively related to the gross domestic product at purchasing power parity per capita for year 2011 (r2 = 0.21; P=0.004). At the present time, in the majority of countries surveyed, toric soft contact lens prescribing falls short of that required to correct clinically significant astigmatism (≥0.75 diopters) in all lens wearers.

An international survey of daily disposable contact lens prescribing

The aim was to determine the extent of daily disposable contact lens prescribing worldwide and to characterise the associated demographics and fitting patterns. Up to 1,000 survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected since 1996 were also analysed for seven nations to assess daily disposable lens fitting trends since that time. Data were collected in relation to 97,289 soft lens fits, of which 23,445 (24.1 per cent) were with daily disposable lenses and 73,170 (75.9 per cent) were with reusable lenses. Daily disposable lens prescribing ranged from 0.6 per cent of all soft lenses in Nepal to 66.2 per cent in Qatar. Compared with reusable lens fittings, daily disposable lens fittings can be characterised as follows: older age (30.0 ± 12.5 versus 29.3 ± 12.3 years for reusable lenses); males are over-represented; a greater proportion of new fits versus refits; 85.9 per cent hydrogel; lower proportion of toric and presbyopia designs and a higher proportion of part-time wear. There has been a continuous increase in daily disposable lens prescribing between 1996 and 2011. The proportion of daily disposable lens fits (as a function of all soft lens fits) is positively related to the gross domestic product at purchasing power parity per capita (r(2) = 0.55, F = 46.8, p < 0.0001). The greater convenience and other benefits of daily disposable lenses have resulted in this modality capturing significant market share. The contact lens field appears to be heading toward a true single-use-only, disposable lens market.

Globalisation, the environment and recent trends in international trade

The process of globalization has had far-reaching social as well as economic effects. The term "globalization" is generally taken to mean an increase in international transactions in markets for goods, services and factors of production and a growth in institutions .that straddle international borders. This development has also meant that the corporate-governance mechanisms have to be reinforced to ensure fairness and transparency as well as social responsibility. Finally, international infrastructure and institutions have to evolve to facilitate and ameliorate the effects of the growth in this world trade on the environment, sustainable development and bio-diversity. This paper provides an overview of the current developments in all these areas.

Prescribing exercise for Osteoporosis

Osteoporosis is a major public health problem because of the morbidity and mortality associated with fracture. Minimizing the risk of fracture is the primary objective of osteoporosis management. The role of exercise in osteoporosis management is to increase and maintain peak bone density and reduce the rate of bone loss and the risk of falling. This article provides recommendations focusing on a life-span approach to minimizing the risk of fracture associated with osteoporosis. Osteoporosis prevention begins in childhood, when exercise can increase peak bone strength. In young adults, it can maintain peak bone mineral density. In elderly individuals, physical activity can slow bone loss and improve fitness and muscle strength, helping prevent falls and lower the risk of fracture. Exercise goals for individuals with osteoporosis should include reducing pain, increasing mobility, and improving muscle endurance, balance, and stability in order to improve the quality of life and reduce the risk of falling. Thus, exercise plays a significant part in reducing fractures in later life.

Tax incentives for foreign direct investment part I : Recent trends and countertrends

According to the conventional wisdom, tax incentives for investment - in particular for foreign direct investment (FDI) - are not recommended. That is the view held almost universally by theorists and by the international bodies that advise on tax matters.' Tax incentives are bad in theory and bad in practice. They are bad in theory principally because they cause distortions: investment decisions are made that would not have been made without the inducement of special tax concessions. They are bad in practice, being both ineffective and inefficient. They are ineffective in that tax considerations are only rarely a major determinant in FDI decisions; they are inefficient because their cost, in terms of tax revenue foregone, often far exceeds any benefits they may produce. Other criticisms are also frequently levelled against tax incentives for FDI - they are inequitable (since they benefit some investors but not others), they are difficult to administer and open to abuse, and they lack transparency. Thus, it is not surprising that ''the standard advice given by institutions like the World Bank and the lMF to developing countries is to refrain from offering tax incentives to foreign investors".2 The purpose of this article is not to question that advice or to challenge the conventional wisdom - except in one respect. Recent evidence does suggest that tax considerations are an increasingly important factor in investment decisions and that special tax incentives have become substantially more effective as instruments for attracting FDI than they were 10 or 20 years ago.3 The first part of this article, published here, examines some of that evidence, reviews some recent trends in national policies towards FDI, attempts to suggest why investment incentives have become more important and more effective, and looks at the pressures that are exerted on governments, especially in developing countries, to compete for FDI by offering special incentives. The second part of the article, to be published in the Bulletin next month, assumes that many countries will continue to offer tax incentives to investors regardless of the best advice, and considers how incentives might be designed in order to increase their effectiveness and efficiency.

Analytical methodology for the determination of urea: current practice and future trends

The determination of urea is important in a wide range of fields, including clinical diagnostics, environmental monitoring and food science. Numerous analytical techniques have been developed for the determination of urea, with no single technique dominant in all areas because of the diversity of applications. An overview of the existing analytical methodologies for urea is presented, and some new approaches are discussed, particularly those based on chemiluminescence detection to improve the sensitivity and the selectivity for the determination of this important analyte.

Long-term trends in the Australaian gannet (Morus serrator) population in Australia: the effect of climate change and commercial fisheries

The Australasian gannet (Morus serrator) population has increased considerably over the past century, both in New Zealand and Australia. Since 1980, the population in Australian waters has increased threefold, from 6,600 breeding pairs to approximately 20,000 pairs in 1999-2000, a rate of 6% per year. Reasons for the increase in the Australasian gannet population are poorly understood; here we consider the possible effects of recent fluctuations in climatic and oceanographic conditions, and changes in major local commercial fisheries. A significant trend towards more frequent, and stronger, El Niño Southern Oscillation events, warmer summer sea surface temperatures in Bass Strait, increased annual catches and catch per unit effort in the Victorian pilchard (Sardinops sagax) fishery and potential increased discarding of fisheries bycatch may account for at least some of the observed increase in the Australasian gannet population. The potential interactive effects of these factors on prey distribution and abundance and consequently on gannet numbers are discussed.