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Developing consensus definitions and methods for non-visually impairing eye conditions for population-based eye surveys in Nigeria: a Delphi study

Por: Aghaji · A. · Okoye · O. · Nwachukwu · N. Z. · Ezegwui · I. · Okoye · O. · Umeh · R. · Gilbert · C. E. · The Nigeria National Non-Visually Impairing Conditions Study Group · Ada · Onochie · Nkiru · Ifeoma · Obiekwe · Rich · Clare · Lawan · Emem · Ebere · Dupe · Korede · Feyi · Kayo
Objective

To establish consensus definitions for non-visually impairing eye conditions (NVICs) and their methods of assessments to provide standards for use in population-based eye surveys.

Design

A literature review of NVICs in sub-Saharan Africa, a questionnaire of inquiry based on the literature review developed by an expert panel and a modified Delphi exercise with three iterative rounds with eye health experts.

Setting

Eye health academia and community eye health in Nigeria.

Participants

Nigerian ophthalmologists, including subspecialists experienced in population-based eye health surveys.

Main outcome measures

Definitions and statements where at least 70% of the respondents agreed or strongly agreed.

Results

Forty-two ophthalmologists practising in Nigeria with experience in conducting population-based eye health surveys were invited to take part in the Delphi exercise. There were three rounds with response rates of 39/42 (92.9%) in round 1, (94.9%) in round 2 and 100% in round 3. Consensus for NVICs to be included in population-based eye surveys, their definitions and methods for assessment was reached by the third round.

Conclusions

We propose case definitions for NVICs to be assessed in population-based eye surveys through a modified Delphi approach with an expert panel of ophthalmologists from across Nigeria. These case definitions will allow for standardisation of NVICs in population-based eye surveys to assess the prevalence and magnitude of the different types of NVICs for planning purposes. Further studies are needed to validate these case definitions and inform their evolution.

“Kuchoka”: Investigation of research fatigue in Mosoriot, Kenya

by Felishana Cherop, Violet Naanyu, Juddy Wachira, Lukoye Atwoli

Background

Health research is key to the promotion of population and community health, however, conducting many research studies in a community can cause research fatigue.

Purpose

We determined the prevalence of research fatigue and associated factors in Mosoriot, Kenya.

Methods

We conducted a cross-sectional study in the Mosoriot community from Wednesday 28, May 2014, to Thursday 30, April 2015, involving (n = 327) community members who were randomly sampled to respond to self-administered and/or guided questionnaires. We analyzed descriptive statistics to summarise the data and used the Pearson Chi-Square test to assess the bivariate associations between the variables and conducted multivariate analyses using logistic regression models to test the hypotheses. The odds ratios and the corresponding 95% confidence limits were reported.

Results

Research fatigue prevalence was 56.3% and the factors associated included being >35 years (OR: 2.28, 95% CL: 1.27, 4.15), being male (OR: 2.80, 95% CL:1.59, 5.00), self-employment (OR: 2.05, 95% CL: 1.06, 4.01), participating in hospital-based studies (OR: 3.59, 95% CL:1.88, 7.09), involvement in multiple researches (OR: 3.86, 95% CL:1.87, 8.27), desire to drop out of a study (OR: 11.49, 95% CL: 3.69, 43.83) and being asked personal questions (OR: 6.23, 95% CL: 3.28, 12.23).

Conclusion

There is a high prevalence of research fatigue (56.3%) among community members in Mosoriot who have participated in repeated research, which is associated with age, gender, income source, research setting, frequency of research engagement, desire to drop out of studies, and discomfort with questions. Addressing research fatigue would enhance ethical research conduct and promote sustained community participation in research.

Left Write Hook: trial protocol for a community-based type II hybrid effectiveness-implementation cluster randomised controlled trial of a boxing and writing-based intervention for adult survivors of child sexual abuse and gender-based violence in Austral

Por: Butler · M. · Veltman · E. · Lyon · D. · Koye · D. N. · Fitzpatrick · P. · Alisic · E. · Ney · L. · Goode · A. · Healy · G. · Hitchcock · C.
Introduction

Sexual and gender-based violence can have long-term impacts on the physical and mental health of survivors, with demonstrated impairments to immune, endocrine and nervous systems, and increased risk of chronic conditions such as cardiovascular disease, depression and post-traumatic stress. Moreover, survivors commonly experience low self-efficacy and lack of perceived control over their lives. Creating space for survivors to feel empowered through a multidimensional approach to health promotion, considering both physical and psychological influences on health, is necessary to reduce chronic disease.

Methods and analysis

In this type II hybrid effectiveness-implementation cluster randomised controlled trial, we evaluate a novel peer-led intervention that combines expressive writing and trauma-informed boxing, Left Write Hook, against trauma-informed boxing alone—an intervention approach that is currently accessible in the community and has been shown to improve both mental and physical health. 20 clusters of 8–10 adults (n=150) with a self-reported history of child sexual abuse or other gender-based violence will be recruited in Melbourne, Australia, through health services and the community. Clusters will be randomly assigned to complete either 8x weekly group sessions of Left Write Hook (intervention) involving both expressive writing and trauma-informed boxing led by a trained peer facilitator, or 8x weekly group boxing sessions led by a trauma-informed boxing facilitator (control). Implementation will be evaluated against the PRISM Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. The primary effectiveness outcome is change in self-efficacy from preintervention to postintervention (8 weeks). Secondary effectiveness outcomes are changes in symptoms of complex post-traumatic stress disorder, trauma-related cognition and indicators of physical fitness (strength, flexibility, aerobic fitness and balance). Assessment will be completed online or over the phone with a member of the research team at preintervention (0 weeks), postintervention (8 weeks) and at 1 month following completion of the intervention (12 weeks). The primary implementation outcome is the fidelity of the train-the-champion implementation strategy for intervention training and delivery, and the secondary implementation outcome is adoption of the intervention and training delivery.

Ethics and dissemination

Ethical approval was received from the Human Research Ethics Committee of The University of Melbourne (2024-28998-60131-11) and the Alfred Hospital Ethics Committee (110810). Results will be disseminated via publication in a peer-reviewed journal, and data will be made available via Open Science Framework at the conclusion of the trial.

Trial registration number

ACTRN12624000862549.

Exploring the correlations of lung ultrasound with delirium and other clinical outcomes in older patients with respiratory failure admitted in acute geriatric units (ECO-AGE): protocol for a multicentre, prospective, observational study from the GRETA Gro

Por: Okoye · C. · Ticinesi · A. · Finazzi · A. · Bruni · A. A. · Guarino · D. · Cerundolo · N. · Nouvenne · A. · Siniscalchi · C. · Meschi · T. · Lauretani · F. · Maggio · M. · Zucchini · I. · Torrini · M. · Cerasuolo · M. · Rizzo · M. R. · Monzani · F. · Antonelli Incalzi · R. · Ungar · A. · B
Introduction

Point-of-care lung ultrasound (LUS) can assist in diagnosing acute respiratory diseases for its high accuracy and immediate availability at the bedside, including older patients with frailty. Delirium represents a frequent complication of hospitalisation in this setting, frequently triggered by acute respiratory diseases. LUS may therefore help identify individuals at risk of delirium, but the association between LUS abnormalities and delirium remains unexplored.

Methods and analysis

This study is a prospective, observational, multicentre study, with the main objective of assessing the correlation between LUS abnormalities and incident delirium during hospitalisation (primary outcome). The secondary objectives are to assess correlations between lung and diaphragm ultrasound parameters and clinical outcomes including duration of delirium, severity of respiratory failure and mortality. 480 patients aged ≥65 years old, urgently hospitalised after an emergency department visit for acute respiratory complaints, will be recruited in eleven acute geriatric wards located in eight teaching hospitals across Italy. LUS examinations will be performed by skilled clinicians prior to treatment whenever feasible, and in any case within 48 hours from admission. They will also undergo comprehensive geriatric assessment, and daily delirium assessment through the 4-AT tool. The association between LUS abnormalities, related parameters (LUS score, Pleural Effusion Score) and outcomes will be assessed by linear and logistic regression models.

Ethics and dissemination

Ethics Committee approval of the coordinating centre (Comitato Etico Territoriale Lombardia 3, reference ID 4369_20.03.2024_M) and collaborative centres has been obtained. All participants will provide written informed consent. Study results will be publicly available following peer-reviewed publication in international scientific journals.

Trial registration number

NCT06670118.

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