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AnteayerInterdisciplinares

Protocol for a systematic review and meta-analysis on utilisation of palliative care service and predictors among adult cancer patients in Ethiopia

Por: Demeke · A. D. · Yeshiwas · A. · Gebrie · H. · Ayehu Akele · M. · Gashaw · A. · Dessie Gesssess · A. · Melkie · T. T. · Bogale · N. · Eba · W. W.
Introduction

Palliative cancer care is comprehensive, specialised medical care of patients that aims to alleviate physical, mental and emotional distress based on patients’ needs rather than on prognosis. In Ethiopia, the federal ministry of health started palliative care (PC) in 2016. Since then, services have been developed and integrated as important components of the Health Sector Transformation Plan II. However, there is a scarcity of nationally summarised data regarding PC service utilisation in Ethiopia. Therefore, this protocol describes a planned systematic review and meta-analysis that will evaluate utilisation of PC services and its predictors among adult cancer patients in Ethiopia.

Methods and materials

The online databases of PubMed, Hinari, EMBASE, CINHAL, Science Direct, Scopus and Google Scholar will be comprehensively searched from inception to 31 February 2025. To assess the quality of included studies, the Joanna Briggs Institute critical appraisal tools will be used. The statistical software STATA V.17 will be used for data analyses. To examine the heterogeneity between studies, inverse variance (I2) will be used. To calculate the pooled prevalence of PC service utilisation, a fixed or random effects meta-analyses model will be used with a 95% CI, depending on the presence or absence of heterogeneity between included studies. To look for publication bias, a visual inspection of the funnel plot and Egger and Begg’s regression test and a 5% level of significance will be used.

Ethics and dissemination

Ethical approval is not applicable. The results will be disseminated to academic beneficiaries and the public.

Eye check-up practice and its associated factors among adult diabetic patients attending primary hospitals of Central Gondar Zone, Northwest Ethiopia, 2024: a cross-sectional multicentre study

Por: Desalegn · G. K. · Birhan · G. S. · Bogale · Z. M. · Assefa · A. L.
Objectives

This study aimed to assess eye check-up practice and associated factors among patients with diabetes attending primary hospitals in the Central Gondar Zone, Northwest Ethiopia.

Design

A multicentre hospital-based cross-sectional study.

Setting

This study was conducted at primary hospitals in Central Gondar Zone, Northwest Ethiopia, from 10 June 2024 to 10 July 2024.

Participants

The study included 689 consecutive adult patients with diabetes who met the inclusion criteria.

Primary and secondary outcome measures

Participants were diagnosed with diabetes mellitus by a general practitioner. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire. Binary logistic regression was performed to identify associated factors, with significance considered at a p

Results

A total of 689 participants were involved in this study, with a response rate of 98.4%. The proportion of good eye check-up practice was 20.6% (95% CI: 17.6% to 23.8%). Factors associated with good eye check-up practice included urban residence (adjusted OR, AOR=4.10, 95% CI: 1.72 to 9.82), diabetes duration of 12+ years (AOR=4.98, 95% CI: 1.43 to 17.38), previous eye disease (AOR=3.78, 95% CI: 1.79 to 7.95), good knowledge of diabetic retinopathy (AOR=3.22, 95% CI: 1.42 to 7.29), higher family income (AOR=3.80, 95% CI: 1.27 to 11.36), referral from a diabetic clinic (AOR=3.48, 95% CI: 1.58 to 7.67) and a favourable attitude (AOR=3.75, 95% CI: 1.46 to 9.65).

Conclusions

This study revealed a low proportion of good eye check-up practices among patients with diabetes. Urban residency, longer duration of diabetes, higher income, clinic referrals, history of eye disease, knowledge of diabetic retinopathy and a favourable attitude were significantly associated with good eye check-up practices. Therefore, targeted health education and strengthened referral systems are recommended to improve regular eye check-up practices among individuals with diabetes.

Self-directed arm-crank exercise to improve volitional control of the trunk in patients with subacute spinal cord injury: a multicentre, parallel-group, randomised controlled trial protocol

Por: Hidalgo Mas · M. d. R. · Kearney · J. · Middleton · V. · Chiu · C.-Y. · Duda · J. L. · Nightingale · T. E. · Martinez-Valdes · E. · Ahmed · Z. · Chiou · S.-Y.
Introduction

A spinal cord injury (SCI) disrupts synaptic connections between the corticospinal tract and motor neurons, impairing muscle control below the injury site. Many individuals with an SCI have impaired trunk control, affecting the performance of activities of daily living and quality of life. Work has shown improvements in trunk control after home-based, unsupervised arm-crank exercise training (ACET) in people with chronic motor-incomplete SCI. However, no studies have examined ACET’s impact on trunk control in individuals with subacute SCI. This study aims to investigate ACET’s effects on trunk control in adults with subacute incomplete SCI, and its mechanisms, and its long-term benefits on neuropathic pain, psychological well-being, physical activity levels and health-related quality of life.

Methods and analysis

This multicentre, parallel-group, randomised controlled trial will evaluate self-directed ACET in 60 individuals with subacute SCI (

Ethics and dissemination

This study was approved by The Health Research Authority and Health and Care Research Wales (22/NS/0054). Results will be published in peer-reviewed journals. Findings will be presented at National and International conferences for researchers and clinicians. Finally, results will be disseminated to the SCI community.

Trial registration number

ISRCTN17247972

Protocol for the OPTIMSE-1 randomised clinical trial to test specialist-led identification and management of cardio-renal-metabolic-pulmonary disease in machine learning algorithm-detected high-risk community-dwelling individuals

Por: Nadarajah · R. · Wahab · A. · Joseph · T. · Reynolds · C. · Bennett · S. · Haris · M. · Smith · A. B. · Hayward · C. · Wu · J. · Gale · C. P.
Introduction

People identified as higher risk by a machine learning algorithm (Future Innovations in Novel Detection of Atrial Fibrillation [FIND-AF]) are at increased risk of cardio-renal-metabolic-pulmonary disease and cardiovascular death. The OPTIMISE-1 randomised controlled trial aims to test the effect of community-based specialist-led identification and management of cardio-renal-metabolic-pulmonary (CRMP) disease and risk factors compared with usual care on the use of therapeutic interventions over a follow-up of 6 months among high FIND-AF risk community-dwelling individuals.

Methods and analysis

OPTIMISE-1 is a multicentre, pragmatic, prospective, randomised, open-label, blinded-endpoint strategy trial that will recruit 138 participants aged 30 years or older, with a high FIND-AF risk score and previously enrolled in the FIND-AF pilot study (NCT05898165), to be randomised 1:1 to a specialist-led care intervention or usual care. The primary endpoint is a composite of initiation or increase of guideline-directed CRMP therapies. The secondary endpoints are the components of the primary endpoint, time to primary endpoint, diagnosis of new CRMP diseases or risk factors, time to diagnosis of new CRMP diseases or risk factors, initiation or increase of guideline-directed CRMP therapies for participants with recorded CRMP disease, initiation or increase of guideline-directed CRMP therapies for participants with newly diagnosed CRMP disease and change in participant-reported quality of life.

Ethics and dissemination

The study has ethical approval (the North East & North Tyneside 2 Research Ethics Committee reference 24/NE/0188). Findings will be announced at relevant conferences and published in peer-reviewed journals in line with the Funder’s open access policy.

Trial registration number

Clinicaltrials.gov NCT06444711.

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