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Harvey AA, Morjaria P, Tousignant B. Priorities in school eye health in low and middle-income countries a scoping review. Eye (Lond) 2024:10.1038/s41433-024-03032-1. [PMID: 38565599 DOI: 10.1038/s41433-024-03032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/02/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
School eye health (SEH) has been on the global agenda for many years, and there is mounting evidence available to support that school-based visual screenings are one of the most effective and cost-efficient interventions to reach children over five years old. A scoping review was conducted in MEDLINE, Web of Science, PubMed, and CINHAL between February and June 2023 to identify current priorities in recent literature on school eye health in low- and middle-income countries (LMICs). Selection of relevant publications was performed with Covidence, and the main findings were classified according to the WHO Health Promoting Schools framework (HPS). A total of 95 articles were included: cross-sectional studies (n = 55), randomised controlled trials (n = 7), qualitative research (n = 7) and others. Results demonstrate that multi-level action is required to implement sustainable and integrated school eye health programmes in low and middle-income countries. The main priorities identified in this review are: standardised and rigorous protocols; cost-effective workforce; provision of suitable spectacles; compliance to spectacle wear; efficient health promotion interventions; parents and community engagement; integration of programmes in school health; inter-sectoral, government-owned programmes with long-term financing schemes. Even though many challenges remain, the continuous production of quality data such as the ones presented in this review will help governments and other stakeholders to build evidence-based, comprehensive, integrated, and context-adapted programmes and deliver quality eye care services to children all over the world.
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Affiliation(s)
- Alex-Anne Harvey
- Department of Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Priya Morjaria
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- Peek Vision, Berkhamsted, UK
| | - Benoit Tousignant
- Department of Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada.
- School of Optometry, Université de Montréal, Montreal, QC, Canada.
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Samuels I, Hamm LM, Silva JC, Tousignant B, Furtado JM, Goodman L, Watene R, Adams J, Ramke J, Harwood M. Use of the CONSIDER statement by eye health researchers when conducting and reporting research involving Indigenous peoples: an online survey. Eye (Lond) 2024:10.1038/s41433-023-02881-6. [PMID: 38195924 DOI: 10.1038/s41433-023-02881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Indigenous peoples experience worse eye health compared to non-Indigenous peoples. Service providers and researchers must avoid perpetuating this inequity. To help achieve this, researchers can use the CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER) statement. This study aimed to identify the degree to which the CONSIDER statement has been used by eye health researchers when conducting and reporting research with an Indigenous component, and how they perceive its relevance in their future research. METHODS We used purposive sampling to recruit eye health researchers from any country who have undertaken research with an Indigenous component. The online survey collected quantitative and qualitative data and was analysed using descriptive statistics and reflexive thematic analysis. Responses were gathered on a four-point Likert scale (1 to 4), with four being the most positive statement. RESULTS Thirty-nine eye health researchers from nine countries completed the survey (Aotearoa New Zealand, Argentina, Australia, Brazil, Canada, Colombia, Guatemala, Panama, Peru); almost two-thirds (n = 24) undertake epidemiological research. On average, participants disclosed only 'sometimes' previously reporting CONSIDER items (2.26 ± 1.14), but they thought the items were relevant to eye health research and were motivated to use these guidelines in their future research. Some participants requested clarity about how CONSIDER aligned with existing guidelines, and when and how to apply the statement. Others shared rich experiences of the benefits to their research of Indigenous leadership and collaboration. CONCLUSIONS The CONSIDER statement is perceived as a valuable tool by these eye health researchers, and there are opportunities to maximise uptake and use, including increasing awareness of the statement, clarity about when it applies, and availability of institutional-level support.
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Affiliation(s)
- Isaac Samuels
- Department of Ophthalmology, University of Auckland, Auckland, 1142, New Zealand
| | - Lisa M Hamm
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | | | - Benoit Tousignant
- School of Optometry, Université de Montréal, Montreal, H3T 1P1, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, H3C 3T4, QC, Canada
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Lucy Goodman
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | - Renata Watene
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | - Jaki Adams
- The Fred Hollows Foundation, Darwin, Australia
| | - Jacqueline Ramke
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand.
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | - Matire Harwood
- School of Population Health, University of Auckland, Auckland, 1142, New Zealand
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Blais N, Tousignant B, Hanssens JM. Comprehensive Primary Eye Care: A Comparison Between an In-Person Eye Exam and a Tele-Eye Care Exam. Clin Optom (Auckl) 2024; 16:17-30. [PMID: 38197048 PMCID: PMC10775700 DOI: 10.2147/opto.s436659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/16/2023] [Indexed: 01/11/2024]
Abstract
Introduction Proper access to primary eye care is essential in addressing vision impairment, and tele-eye care examinations are a promising solution that could facilitate this access in many rural or remote areas. Even though remote eye exams are becoming increasingly frequent, comprehensive tele-eye care exams are still limited by the lack of published data. The aim of this study is to compare a comprehensive tele-eye care exam with a gold standard in-person primary eye care exam with an emphasis on refractive measurements, ocular health assessment, confidence level of the eye care providers and patient satisfaction. Methods Sixty-six participants underwent two comprehensive eye exams performed by two eye care providers. One was a gold standard in-person exam, while the other was a remote exam performed by an eye care provider through videoconference. An overall patient satisfaction survey and a questionnaire for visual comfort with a trial frame from each modality were completed and the eye care providers scored their confidence level for each test. Exam results and diagnoses were compared between both modalities. Results Tele-refraction has a good to excellent agreement with in-person subjective refraction in terms of sphero-cylindrical power and best corrected visual acuity. There was no statistically significant difference for visual comfort between both modalities. The agreement between in-person and remote exams for ocular health assessment ranged from fair to almost perfect, but there was a low prevalence of ocular pathologies within the study sample. The confidence level of the eye care providers and patient satisfaction were statistically higher in-person. Conclusion Tele-eye care appears to be statistically and clinically non-inferior to in-person eye exams, especially for refraction, but the low prevalence of ocular pathologies somewhat limits the comparison of its efficacy for ocular health assessment. More studies on comprehensive tele-eye care exams are needed.
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Affiliation(s)
- Nicolas Blais
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Benoit Tousignant
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Department of Social and Preventive Medicine School of Public Health, Université de Montréal, Montréal, Québec, Canada
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Goodman L, Hamm L, Tousignant B, Black J, Misra S, Woodburn S, Keay L, Harwood M, Gordon I, Evans JR, Ramke J. Primary eye health services for older adults as a component of universal health coverage: a scoping review of evidence from high income countries. Lancet Reg Health West Pac 2023; 35:100560. [PMID: 37424679 PMCID: PMC10326716 DOI: 10.1016/j.lanwpc.2022.100560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
In pursuit of Universal Health Coverage (UHC) for eye health, countries must strengthen services for older adults, who experience the highest prevalence of eye conditions. This scoping review narratively summarised (i) primary eye health services for older adults in eleven high-income countries/territories (from government websites), and (ii) the evidence that eye health services reduced vision impairment and/or provided UHC (access, quality, equity, or financial protection) (from a systematic literature search). We identified 76 services, commonly comprehensive eye examinations ± refractive error correction. Of 102 included publications reporting UHC outcomes, there was no evidence to support vision screening in the absence of follow-up care. Included studies tended to report the UHC dimensions of access (n=70), equity (n=47), and/or quality (n=39), and rarely reported financial protection (n=5). Insufficient access for population subgroups was common; several examples of horizontal and vertical integration of eye health services within the health system were described. Funding This work was funded by Blind Low Vision New Zealand for Eye Health Aotearoa.
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Affiliation(s)
- Lucy Goodman
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Lisa Hamm
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Benoit Tousignant
- School of Optometry, Université de Montréal, 3774 Jean-Brillant, Montreal, Quebec H3T1P1, Canada
- School of Public Health, Université de Montréal, 3774 Jean-Brillant, Montreal, Quebec H3T1P1, Canada
| | - Joanna Black
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Stuti Misra
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, 85 Park Road, Grafton 1023, Auckland, New Zealand
| | - Sophie Woodburn
- Specsavers Queenstown, 12 Hawthorne Drive, Frankton, Queenstown 9300, New Zealand
| | - Lisa Keay
- School of Optometry and Vision Science, UNSW Sydney, Rupert Myers Building (M15), Southern Dr, Kensington, NSW 2052, Australia
- The George Institute for Global Health, UNSW Sydney, Level 5/1 King St, Newtown NSW 2042, Australia
| | - Matire Harwood
- Department of General Practice & Primary Health Care, School of Population Health, University of Auckland, 28 Park Ave, Grafton Auckland 1023, New Zealand
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
| | - Jennifer R. Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
- Centre for Public Health, Institute of Clinical Science, Block A, Royal Victoria Hospital, Queen's University Belfast BT12 6BA, United Kingdom
| | - Jacqueline Ramke
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
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Tousignant B, Chatillon A, Philibert A, Da Silva J, Fillion M, Mergler D. Visual Characteristics of Adults with Long-Standing History of Dietary Exposure to Mercury in Grassy Narrows First Nation, Canada. Int J Environ Res Public Health 2023; 20:4827. [PMID: 36981736 PMCID: PMC10049103 DOI: 10.3390/ijerph20064827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/23/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Since the 1960s, Grassy Narrows First Nation (Ontario, Canada) has been exposed to methyl mercury (Hg) through fish consumption, resulting from industrial pollution of their territorial waters. This cross-sectional study describes the visual characteristics of adults with documented Hg exposure between 1970 and 1997. Oculo-visual examinations of 80 community members included visual acuity, automated visual fields, optical coherence tomography [OCT], color vision and contrast sensitivity. Median age was 57 years (IQR 51-63) and 55% of participants were women. Median visual acuity was 0.1 logMAR (Snellen 6/6.4; IQR 0-0.2). A total of 26% of participants presented a Visual Field Index inferior to 62%, and qualitative losses assessment showed concentric constriction (18%), end-stage concentric loss (18%), and complex defects (24%). On OCT, retinal nerve fiber layer scans showed 74% of participants within normal/green range. For color testing with the Hardy, Rand, and Rittler test, 40% presented at least one type of color defect, and with the Lanthony D-15 test, median color confusion index was 1.59 (IQR 1.33-1.96). Contrast sensitivity showed moderate loss for 83% of participants. These findings demonstrate important loss of visual field, color vision, and contrast sensitivity in older adults in a context of long-term exposure to Hg in Grassy Narrows First Nation.
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Affiliation(s)
- Benoit Tousignant
- School of Optometry, Université de Montréal, 3744 Jean-Brillant, Montreal, QC H3T 1P1, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, 7101 Avenue du Parc, Montreal, QC H3N 1X9, Canada
| | - Annie Chatillon
- School of Optometry, Université de Montréal, 3744 Jean-Brillant, Montreal, QC H3T 1P1, Canada
| | - Aline Philibert
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et L’environnement (Cinbiose), Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC H3C 3P8, Canada
| | - Judy Da Silva
- Grassy Narrows First Nation, General Delivery, Grassy Narrows, ON P0X 1B0, Canada
| | - Myriam Fillion
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et L’environnement (Cinbiose), Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC H3C 3P8, Canada
- Département Science et Technologie, Université TÉLUQ, 5800, Rue Saint-Denis, Bureau 1105, Montréal, QC H2S 3L5, Canada
| | - Donna Mergler
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et L’environnement (Cinbiose), Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC H3C 3P8, Canada
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Etty MC, Michaelsen S, Yelle B, Beaulieu K, Jacques P, Ettaleb S, Samaha D, Tousignant B, Druetz T. The sociodemographic characteristics and social determinants of visual impairment in a homeless population in the Montreal area. Can J Public Health 2022; 114:113-124. [PMID: 35969355 PMCID: PMC9377295 DOI: 10.17269/s41997-022-00676-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/11/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Homelessness is a serious social and public health concern in Canada. Individuals experiencing homelessness face numerous health problems and barriers in accessing health services. Visual impairment can exacerbate the lower quality of life experienced by people who are homeless, but its incidence among this population has been poorly documented in the literature. Our study aimed to describe health and sociodemographic characteristics and determine their association with visual impairment, ocular pathology and uncorrected refractive errors in a homeless population in Montreal, Canada. METHODS This cross-sectional study was conducted between May 2019 and September 2020 in eight homeless shelters selected using a stratified random sampling approach on the island of Montreal. An eye examination was performed on all participants, who were also administered a survey on social determinants of health. Descriptive analysis was used to analyze survey data, and logistic regression was used for each of the three study outcomes. RESULTS A total of 124 individuals experiencing homelessness (93 men, 31 women) were recruited. Participants were mostly Caucasian (> 70%) with an average age of 48 years (standard deviation = 13 years). Our sample reported a high level of education (68% had a high school diploma or higher), a high level of health insurance coverage (77%), social assistance benefits (71%), and social support (over 50%). There was a high prevalence of chronic conditions including diabetes (14%), hypertension (25%), and HIV/AIDS (3%). Results from eye examinations showed a high prevalence of visual impairment (22%), ocular pathology (23%), and uncorrected refractive error (75%). Age was statistically significantly associated with each outcome variable. CONCLUSION Despite a high level of social and health support, individuals experiencing homelessness in Montreal, Canada, experience high levels of chronic conditions and visual impairment. Our study highlights the unmet need for eye healthcare among homeless populations, and that eye health can be a unique entry point for intervening with homeless populations.
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Affiliation(s)
- Marie-Christine Etty
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc, Montreal, QC H3N 1X9 Canada
| | - Sonia Michaelsen
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc, Montreal, QC H3N 1X9 Canada
| | - Brittany Yelle
- School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC H3T 1P1 Canada
| | - Kimberlie Beaulieu
- School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC H3T 1P1 Canada
| | - Patricia Jacques
- School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC H3T 1P1 Canada
| | - Sarah Ettaleb
- School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC H3T 1P1 Canada
| | - Dan Samaha
- School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC H3T 1P1 Canada
| | - Benoit Tousignant
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc, Montreal, QC H3N 1X9 Canada ,School of Optometry, University of Montreal, 3744 Rue Jean Bureau 110, Montreal, QC H3T 1P1 Canada ,Public Health Research Centre (CReSP), University of Montreal, C.P. 6128 Succursale Centre-Ville, Montreal, QC H3C 3J7 Canada
| | - Thomas Druetz
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada. .,Public Health Research Centre (CReSP), University of Montreal, C.P. 6128 Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada. .,Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA.
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Yelle B, Beaulieu K, Etty MC, Michaelsen S, Druetz T, Damaha D, Tousignant B. The prevalence and causes of visual impairment among the male homeless population of Montreal, Canada. Clin Exp Optom 2022; 106:431-435. [PMID: 35156540 DOI: 10.1080/08164622.2022.2036578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Homeless populations have lower health indicators, including in eye care. Few data exist on the levels and causes of visual impairment in Canadian homeless populations, and none in Montreal. BACKGROUND This study aims to characterise the causes and levels of visual impairment, as well as eye care services utilisation among the Montreal homeless. METHODS Using random sampling, five homeless shelters were selected. In each shelter, 20 participants were randomly selected. After obtaining informed consent, participants completed an ocular examination, which included: presenting visual acuity (pinhole as needed), intraocular pressure, confrontation visual field, dilated fundus examination, post-dilation autorefraction and questionnaire on social determinants of health. RESULTS A total of 95 participants were examined, of which 97.9% were male. The median age was 49 years old (interquartile range 38-56.5). The age-adjusted prevalence of visual impairment (presenting visual acuity <6/12) was 23.6% (95% CI 15.1-32.9) compared to 6.0% in the Canadian population (Z = 77.9, p < 0.0001). With pinhole correction, the prevalence of visual impairment dropped to 5.8% (95% CI 1.7-11.8). Prevalence was 8.2% (95% CI 3.7-15.9) for cataracts, 11.4% (95% CI 5.9-19.7) for glaucoma or suspects and 4.7% (95% CI 1.7-11.9) for diabetic retinopathy. Lastly, 18.9% of participants had an ocular examination within the last year compared to 41.4% in Canada (Z = -4.5, p < 0.0001) and 13.7% had never had a comprehensive eye examination. CONCLUSIONS This sample population shows a prevalence of visual impairment which is four times that of the general Canadian population, with highly prevalent uncorrected refractive error, while accessing primary eye care twice less often.
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Affiliation(s)
- Brittany Yelle
- School of Optometry, Université de Montréal, Montreal, QC, Canada
| | | | | | - Sonia Michaelsen
- School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Thomas Druetz
- School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Dan Damaha
- School of Optometry, Université de Montréal, Montreal, QC, Canada
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Tousignant B, Brûlé J. Refractive error, risk of amblyopia and eye care services utilisation among Nunavik Inuit in Northern Canada. Clin Exp Optom 2021; 105:872-877. [PMID: 34763614 DOI: 10.1080/08164622.2021.1993057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Nunavik Inuit patients, in Northern Canada, have a significant burden of refractive error. The frequency at which they access eye care is insufficient. This exposes children of this population to a substantial risk of refractive amblyopia. BACKGROUND No data are available on eye health and services among Nunavik Inuit in Quebec, Canada. This study aims to describe the prevalence of ametropias, risk of refractive amblyopia, and eye health services uptake amongst a sample of Nunavik Inuit. METHODS Retrospective cohort using data from electronic records of the sole government-contracted eye team travelling to all 14 Nunavik villages, from 2006 to 2018. RESULTS Some 26,541 examinations were analysed, with data from 6,341 patients (median age 27 years (IQR 30); 32% aged under 19 years; 60.3% female) representing 48% of the census population. Population weighted prevalence of ametropias was myopia 46.5% (95% CI 45.3 - 47.6), hyperopia 17.1% (95% CI 16.2 - 18.1), astigmatism 39.6% (95% CI 38.4 - 40.8) and presbyopia 30.0% (95% CI 28.9 - 31.0). Some 5.9% of patients aged 0-9 years present a risk of refractive amblyopia. Mean frequency of examinations for all ages was once per 4 years (95% CI 4.0 - 4.0) and for children aged 5 - 19 years, frequency was once per 4.8 years (95% CI 4.8 - 5.0). In 2018, 74% of patients who were prescribed spectacles purchased them, with a median time of procurement of 21 days (IQR 247, skewness 2.7). CONCLUSION There is a high prevalence of ametropias amongst the clinical population of Nunavik Inuit. Most patients needing spectacles obtain them within a few weeks. Frequency of eye health services is insufficient to meet recommended guidelines, especially in children, for whom the risk of refractive amblyopia is pervasive.
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Affiliation(s)
- Benoit Tousignant
- School of Optometry, University of Montreal, Montreal, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - Julie Brûlé
- School of Optometry, University of Montreal, Montreal, Canada
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Tousignant B, Brûlé J. [Visual Impairment and Eye Diseases in St. Louis, Senegal]. Med Trop Sante Int 2021; 1:mtsibulletin.2021.112. [PMID: 35586591 PMCID: PMC9022752 DOI: 10.48327/mtsibulletin.2021.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 06/14/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Few epidemiological data describe the prevalence of blindness and visual impairment in Senegal. Data from West African studies estimate blindness prevalence between 1.2 - 3.4% and that of visual impairment between 10.4 - 17.1%. IRIS Mundial (IM) is a non-governmental organization collaborating with l'Association St-Louisienne pour la Vue (ASV) to develop eye care in Senegal. OBJECTIVE Describe the relative importance of and causes of blindness and visual impairment in a population consulting for vision problems in the Senegalese region of St. Louis, to assist in planning of relevant eye care programs. METHODS Results from eye exams carried out by a team from IM in 2018 have been complied and analyzed. RESULTS In all, 1944 patients were examined (56.5% female). Some 25.7% of patients presented a visual impairment (22.5% moderate; 3.2% severe). Regarding refractive error, 15.3% of patients had myopia, 10.7% had hyperopia, 54.8% had astigmatism and 55.8% were presbyopic. Clinically significant cataracts is present in 17.4% of patients and glaucoma in 2.5%. CONCLUSION Our data give a glimpse of the prevalence of visual impairment and ocular disease in St. Louis, Senegal. Uncorrected refractive error, cataracts and glaucoma are present in this population and may guide the planning of relevant eye care interventions.
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Affiliation(s)
- B. Tousignant
- École d'optométrie, Université de Montréal, Québec, Canada,École de santé publique, Université de Montréal, Québec, Canada,*
| | - J. Brûlé
- École d'optométrie, Université de Montréal, Québec, Canada
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Abstract
Illicit drugs and substances of abuse are increasingly used by adults and teenagers, with novel substances constantly becoming available. Many substances can cause ocular effects or visually threatening conditions. Current literature informing eye-care practitioners on these effects is scant. The present scoping review reports the ocular effects of most commonly used drugs and substances of abuse in the teenage and adult populations of North America. Ovid MEDLINE and Ovid EMBASE databases were searched for publications from 1980 to 2019 regarding ocular effects of drug use. The selected papers regarded human subjects, in either teenage or adult population and included all types of studies, including case reports. Publications in English or in French were included. Exclusion criteria were publications about the use of prescriptions drugs, drug withdrawal, and publications about the use of alcohol, tobacco, or cannabis. Some 241 papers were retained and analysed. The use of various drugs and substances can lead to damage to structures throughout the eye, including but not limited to corneal conditions, glaucoma and other optic neuropathies, maculopathies and endophthalmitis. The data presented in this review may help guide clinicians in their diagnosis and treatment of certain ocular conditions, which could otherwise not be linked to drug use.
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Affiliation(s)
- Valérie Proulx
- School of Optometry, University of Montreal, Montréal, Canada
| | - Benoit Tousignant
- School of Optometry, University of Montreal, Montréal, Canada.,School of Public Health, University of Montreal, Montréal, Canada
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Tousignant B, Pearce MG, Brûlé J, Sikivou B, Nicholls G. State of the eye health system in the Pacific: is medical technology available and used by mid-level eye care workers? Rural Remote Health 2020; 20:5109. [PMID: 32188261 DOI: 10.22605/rrh5109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The aim of this study is to describe the availability, use and comfort with ophthalmic equipment and medications by mid-level eye care workers in Papua New Guinea and Pacific Island countries and territories as indicators of the state of eye care in the Pacific. METHODS Health information system data, from a workforce support program to Pacific mid-level eye care workers, were analysed for availability and comfort with use of ophthalmic equipment and topical medications. RESULTS For refraction equipment, access was excellent (98% for retinoscopes and trial lenses) 'very frequent use' range was 42-74% and 'high comfort of use' range was 54-86%. Equipment for ocular health assessment is widely available (slit lamps 67%), with high comfort levels (78-100% 'very comfortable'). Over 70% of respondents have access to topical diagnostic medications, 98% have access to at least one type of antibiotic drops and 63% have access to at least one topical corticosteroid. CONCLUSION Overall, trained mid-level eye care workers in the Pacific seem well equipped for ocular health and refractive assessments. Comfort levels are encouraging, but also highlight areas for continuing professional development. Access to ophthalmic medications appears acceptable in the region for low morbidity anterior segment conditions.
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Affiliation(s)
- Benoit Tousignant
- École d'optométrie, Université de Montréal, 3744 Jean-Brillant, #190-12, Montréal, Quebec H3T 1P1, Canada
| | - Matthew G Pearce
- Northwest Permanente, 22848 Weatherhill Rd, West Linn, OR 97068, USA
| | - Julie Brûlé
- École d'optométrie, Université de Montréal, 3744 Jean-Brillant, #190-12, Montréal, Quebec H3T 1P1, Canada
| | - Biu Sikivou
- Pacific Eye Institute, Brown St, GPO Box 18641, Suva, Fiji
| | - Graeme Nicholls
- Fred Hollows Foundation New Zealand, Level 5, The AIG Building, 41 Shortland St, Auckland Central, Auckland 1010, New Zealand
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Tousignant B, Garceau MC, Bouffard-Saint-Pierre N, Bellemare MM, Hanssens JM. Comparing the Netra smartphone refractor to subjective refraction. Clin Exp Optom 2019; 103:501-506. [PMID: 31773810 DOI: 10.1111/cxo.13003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 08/30/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Among technologies targeting mobile eye care, EyeNetra is a smartphone-based subjective refraction system. This study compared the results from this system with those of professional subjective refraction. Participant visual comfort and preference of results were also measured. METHODS Thirty-six optometry-naïve participants (n = 36 eyes, aged 18-35 years), were randomly subjected to three refraction methods: professional subjective refraction, unassisted Netra (participants alone) and refined Netra (sphere results refined by a practitioner). Using a randomised, double-blind design, refraction results were mounted in a trial frame and distance logMAR visual acuities were measured. Subjective appreciation and visual comfort were assessed by questionnaire. Overall preference was ranked. RESULTS Unassisted Netra yielded a median myopic overcorrection of 0.60 D (interquartile range [IQR] 0.25 to 0.94) compared to professional subjective refraction. Median equivalent sphere with unassisted Netra (-1.40 D, IQR -3.10 to -0.90) was significantly more myopic than refined Netra (-0.70 D, IQR -1.60 to -0.30) and then subjective refraction (-0.80 D, IQR -1.60 to -0.30) (all p-values < 0.01). Median visual acuity with professional subjective refraction (-0.16, IQR -0.22 to -0.09) was superior than unassisted Netra (-0.08, IQR -0.20 to 0.03) (p < 0.01). Subjective refraction was ranked first in preference of trial framed results by 72 per cent of participants; median preference rank favoured professional subjective refraction to both Netra results (all p < 0.01). For all questionnaire items, visual comfort was higher with subjective refraction than with unassisted Netra (all p < 0.04). CONCLUSION The Netra device - especially when used without professional assistance and compared to subjective refraction - induces significant myopic overcorrection and lower levels of visual acuity, subjective preference and visual comfort.
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Sirois K, Tousignant B, Boucher N, Achim A, Beauchamp MH, Bedell G, Massicotte E, Vera-Estay E, Jackson PL. The contribution of social cognition in predicting social participation following moderate and severe TBI in youth. Neuropsychol Rehabil 2017; 29:1383-1398. [DOI: 10.1080/09602011.2017.1413987] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K. Sirois
- École de psychologie, Université Laval, Quebec City, QC, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec City, QC, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale – site-Institut de Réadaptation en déficience Physique de Québec (IRDPQ), Quebec City, QC, Canada
| | - B. Tousignant
- École de psychologie, Université Laval, Quebec City, QC, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec City, QC, Canada
- Centre de recherche CERVO, Quebec City, QC, Canada
| | - N. Boucher
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec City, QC, Canada
| | - A.M. Achim
- Centre de recherche CERVO, Quebec City, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Quebec City, QC, Canada
| | - M. H. Beauchamp
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l’Hôpital Ste-Justine, Montreal, QC, Canada
| | - G. Bedell
- Department of Occupational Therapy, Tufts University, Medford, Massachusetts, USA
| | - E. Massicotte
- École de psychologie, Université Laval, Quebec City, QC, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec City, QC, Canada
- Centre de recherche CERVO, Quebec City, QC, Canada
| | - E. Vera-Estay
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - P. L. Jackson
- École de psychologie, Université Laval, Quebec City, QC, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec City, QC, Canada
- Centre de recherche CERVO, Quebec City, QC, Canada
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Brûlé J, Tousignant B, Nicholls G, Pearce MG. An in-country model of workforce support for trained mid-level eye care workers in Papua New Guinea and Pacific Islands. N Z Med J 2017; 130:83-86. [PMID: 28796774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
To alleviate the significant burden of vision impairment and blindness in low-resource settings, addressing the shortage in human resources in eye care is one of the fundamental strategies. With its postgraduate training programmes, The Fred Hollows Foundation New Zealand (FHFNZ) aims to increase workforce capacity in the Pacific Island countries and territories and Papua New Guinea. This paper presents an in-country model to offer support to graduates, an essential element to retain them in the workforce and ensure they are able to perform the tasks they were trained to do. FHFNZ has designed a workforce support programme employing a standardised process, allowing comparable reporting and providing data for FHFNZ to evaluate its training programmes, outputs as well as professional recognition and integration in the workplace.
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Affiliation(s)
- Julie Brûlé
- École d'optométrie, Université de Montréal, Canada
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Tousignant B, Brûlé J. Prevalence of eye disease and visual impairment in Île de la Gonave, Haïti. Med Sante Trop 2017; 27:326-328. [PMID: 28721935 DOI: 10.1684/mst.2017.0687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Epidemiological data describing the prevalence of blindness and visual impairment in Haiti are sparse. The Haitian National Committee for the Prevention of Blindness (CNPC) estimates the prevalence of blindness at 1 %. Other regional data estimate moderate and severe visual impairment at 5% and 22%, respectively. IRIS Mundial (IM) is a non-governmental organization collaborating with the CNPC to develop eye care infrastructure in Haiti. To estimate the prevalence and causes of blindness and visual impairment on the Haitian island of Gonâve, to assist in planning of relevant eye care infrastructure. Results from eye exams carried out by a team from IM in January 2013 have been compiled and analyzed. In all, 1724 patients were examined (38% men, 62% women). In the best eye, 87% of patients had visual acuity, 6% had moderate visual impairment, and 7% had severe visual impairment. Moreover, 1% of patients had high myopia, 1% high hyperopia, 1% high astigmatism, and 32% were presbyopic. Clinically significant binocular cataracts were found in 1.5 % of patients, while 2 % were diagnosed with probable glaucoma. Our data give a glimpse of the prevalence of visual impairment and ocular disease on Gonâve Island in Haiti. Uncorrected refractive error, cataracts, and glaucoma are confirmed as prevalent conditions in this population and their presence should guide the planning of relevant eye care interventions.
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Affiliation(s)
- B Tousignant
- Université de Montréal, École d'optométrie, H3T 1P1 Montréal, Canada
| | - J Brûlé
- Université de Montréal, École d'optométrie, H3T 1P1 Montréal, Canada
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Abstract
PURPOSE To estimate the prevalence of optic neuropathy (ON) among prisoners in a provincial prison in Papua New Guinea, and to explore risk factors for this condition among this population. METHODS Cross-sectional observation study of 148 male prisoners aged ≥18 years using an interview-based questionnaire, assessment of visual and nervous system function, ocular examination, and blood analysis (α-tocopherol, β-carotene, lutein, folate, homocysteine, holotranscobalamin II, riboflavin, selenium, thiamin, and vitamins A, B(12) and C). Likelihood of the presence of ON was based on ordered groups determined by weighted combination of optic nerve head appearance and visual dysfunction (acuity, field, color perception). Main outcome measures were prevalence and associations of ON. RESULTS Sample prevalence of clinical ON was 10.4% (95% confidence interval [CI], 6.2-16.8). No cases were found of unexplained non-visual nervous system dysfunction, including peripheral neuropathy. Increasing age (p = 0.001), length of current (p = 0.002) and lifetime (p = 0.03) incarceration, and duration of smoking by current smokers (p = 0.001) were associated with increased ON likelihood. However, when age-controlled, the smoking duration association was not maintained (p = 0.6). Prisoners were folate deficient. Adjusting for age and duration of current incarceration, whole blood (p = 0.02) and red blood cell (p = 0.04) folate concentrations were inversely associated with ON likelihood. No association was found for any other assessed demographic, lifestyle or biochemical measure. CONCLUSIONS A cluster of ON associated with folate deficiency has been identified. Recommendations for dietary change and micronutrient supplementation have been made.
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Gould C, Tousignant B, Brian G, McKay R, Gibson R, Bailey K, Venn BJ. Cross-sectional dietary deficiencies among a prison population in Papua New Guinea. BMC Int Health Hum Rights 2013; 13:21. [PMID: 23601963 PMCID: PMC3637570 DOI: 10.1186/1472-698x-13-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 04/09/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND To investigate the dietary adequacy of prisoners of Beon Prison, Madang, Papua New Guinea in response to a report of possible nutritional deficiency. METHODS We undertook an observational, cross-sectional study. All 254 male inmates (May 2010) were eligible to answer a validated interview-based questionnaire; to have a comprehensive dietary assessment; and to provide blood for biochemical analysis (α-tocopherol, β-carotene, lutein, thiamin, riboflavin, niacin, folate, homocysteine, zinc, ferritin, and vitamins A, B12 and C). Prison guards were invited to participate as a comparison group. RESULTS 148 male prisoners (58.3%) and 13 male prison guards participated. Prison rations consisted of white rice fortified with thiamin, niacin, and iron, tinned tuna, tinned corned beef, water crackers, and black tea, with occasional intakes of fruit and vegetables. Some prisoners received supplementary food from weekend visitors. From assessment of the prisoners dietary data, median intakes of calcium (137 mg), potassium (677 mg), magnesium (182 mg), riboflavin (0.308 mg), vitamin A (54.1 μg), vitamin E (1.68 mg), vitamin C (5.7 mg) and folate (76.4 μg) were found to be below estimated average requirements (EAR). CONCLUSIONS The prisoners diets are likely lacking in several micronutrients and recommendations for dietary change have been made to the prison authorities. Ongoing vigilance is required in prisons to ensure the basic human right of access to a nutritionally adequate diet is being observed.
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Affiliation(s)
- Camilla Gould
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Benoit Tousignant
- The Fred Hollows Foundation New Zealand, Private Bag 99909, Newmarket, Auckland 1149, New Zealand
- Faculty of Health Sciences, Divine Word University, Madang, Papua New Guinea, 1 Nabasa Road, Madang, Madang Province 511, Papua New Guinea
| | - Garry Brian
- The Fred Hollows Foundation New Zealand, Private Bag 99909, Newmarket, Auckland 1149, New Zealand
- Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin 9054, New Zealand
| | - Robert McKay
- The Fred Hollows Foundation New Zealand, Private Bag 99909, Newmarket, Auckland 1149, New Zealand
- Faculty of Health Sciences, Divine Word University, Madang, Papua New Guinea, 1 Nabasa Road, Madang, Madang Province 511, Papua New Guinea
| | - Rosalind Gibson
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Karl Bailey
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Bernard J Venn
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
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Tousignant B, Du Toit R. Adapting the World Federation for Medical Education standards for use in a self-audit of an eye care training programme. Educ Health (Abingdon) 2011; 24:641. [PMID: 22267360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION In 2006, a Postgraduate Diploma in Eye Care (PGDEC) for mid-level health personnel was initiated in Papua New Guinea, in partnership with The Fred Hollows Foundation New Zealand, the local government and Divine Word University. In the absence of national accreditation and with limited resources, an interim evaluation was needed. METHODS We adapted the World Federation for Medical Education (WFME) standards to use in a self-audit to evaluate nine areas and 38 subareas of programme structure, processes and implementation. We developed a rating system: each area and subarea was scored for partial or complete attainment of basic or quality development levels. Ratings were referenced with supporting documents. Data were gathered internally, through document census and meetings between stakeholders. FINDINGS A qualitative and quantitative portrait emerged: all nine programme areas completely attained at least basic level and two completely attained the quality development level. Twenty-six (68%) subareas completely attained the quality development level. Key successes included the administration of the PGDEC, synergies between the partnership's stakeholders and its relationship with the public health system. DISCUSSION AND CONCLUSIONS This self-audit adapted from WFME standards provided a simple, yet systematic and largely objective evaluation. It proved beneficial to further develop the programme, highlighting strengths and areas for improvement.
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Affiliation(s)
- B Tousignant
- Fred Hollows Foundation, Newmarket, Auckland, New Zealand.
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Abstract
PURPOSE To estimate the prevalence of vitamin A deficiency (VAD) and one of its clinical manifestations, xerophthalmia, and examine the predictive value of nyctalopia and ocular signs for serum retinol concentrations among a prison population in Papua New Guinea. METHODS A cross-sectional study of 148 prisoners and 9 guards; all males aged ≥18 years. Interview-based questionnaire; ocular examination; serum retinol concentration determination. RESULTS Two guards had marginal (retinol <1.05-≥0.70 µmol/L) VAD. For prisoners: mean retinol was 0.84 ± 0.49 µmol/L; 43.9% (95% CI 35.9, 52.2) had VAD (retinol <0.70 µmol/L); 9.6% (95% CI 5.1, 17.0) self-reported nyctalopia prior to, and 36.1% (95% CI 27.7, 45.5) after incarceration; 10.9% (95% CI 6.7, 17.0) exhibited at least one sign of xerophthalmia (2 had fundus changes; all 4 with more than conjunctival xerosis alone had severe [<0.35 µmol/L] retinol deficiency). Prisoners with ocular signs were more likely than those without to have VAD (OR 10.4; 95% CI 2.5, 70.3; P < 0.001) and severe retinol deficiency (OR 19.1; 95% CI 5.5, 77.2; P < 0.001). Positive (PPV) and Negative (NPV) Predictive Values: of nyctalopia for any (PPV 62.9%; NPV 32.8%) and severe (PPV 25.7%; NPV 85.9%) retinol deficiency; of ocular signs for any (PPV 93.3%; NPV 38.2%) and severe (PPV 73.1%; NPV 87.8%) retinol deficiency, and VAD (PPV 86.5%, NPV 38.2%). CONCLUSIONS VAD and xerophthalmia were present in this prison population. There may be VAD in the wider community. The former needs remedy and the latter deserves investigation. Self-reported nyctalopia was not a useful indicator of retinol deficiency. Absence of ocular signs was unhelpful for ruling out VAD.
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Affiliation(s)
- Garry Brian
- The Fred Hollows Foundation New Zealand, Auckland, New Zealand.
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Abstract
BACKGROUND Sufficient, appropriately trained health personnel need to be retained in the workforce, and their performance maintained, to achieve quality care. Mid-level ophthalmic personnel in Western Pacific Island Countries and Territories (WPICT) are no exception. AIM The study aims to assess influences on the quality of care provided by specialist mid-level ophthalmic personnel in WPICT and devise strategies to train, retain and maintain performance of these personnel. METHODS A situational assessment employed a checklist and semi-structured interviews with specialist mid-level ophthalmic personnel, nursing bodies and Ministry of Health representatives from seven WPICT. A selective literature review guided strategies to address the issues identified. RESULTS Appropriate training allows nurses to fulfill a mid-level role in WPICT as specialist ophthalmic nurses. Resources generally do not restrict practice. Nursing structures have generally failed to support professionalism: scope and conditions of service, clinical supervision, career structures, professional recognition and opportunities for continuing professional development are rudimentary. Ophthalmic nurses were dissatisfied with the lack of specialty recognition, career progression and salary increase. Regional and local strategies tailored to each country have been devised to establish sustainable processes for support. CONCLUSION Salary was a major cause of dissatisfaction. It should be addressed along with professional recognition and related processes. Without professional support, specialist and advanced cadres within nursing may cease to exist, nurses' performance may be affected or they may leave. Specialist ophthalmic nursing, recognized, situated within and properly supported by nursing structures can provide a model for specialist clinical care for other specialties and in other countries.
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Affiliation(s)
- R du Toit
- The Fred Hollows Foundation New Zealand, Auckland, New Zealand.
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St-Onge M, Mathieu MÈ, Tousignant B, Faraj M, Lavoie JM. Variability of Strength Measurement in Postmenopausal Women Who are Overweight or Obese: A Monet Study. J Strength Cond Res 2009; 23:2710-7. [DOI: 10.1519/jsc.0b013e3181bc1a4e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Karelis AD, Tousignant B, Nantel J, Proteau-Labelle M, Malita FM, St-Pierre DH, Brochu M, Doucet E, Rabasa-Lhoret R. Association of insulin sensitivity and muscle strength in overweight and obese sedentary postmenopausal women. Appl Physiol Nutr Metab 2007; 32:297-301. [PMID: 17486172 DOI: 10.1139/h07-002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective of this study was to examine the relationship between insulin sensitivity and lower body muscle strength in overweight and obese sedentary postmenopausal women. The design of the study was cross-sectional. The study population consisted of 82 non-diabetic overweight and obese sedentary postmenopausal women (age: 58.2 ± 5.1 y; body mass index (BMI): 32.4 ± 4.6 kg·m–2). Subjects were classified by dividing the entire cohort into quartiles based on relative insulin sensitivity expressed per kilograms of lean body mass (LBM) (Q1, < 10.3, vs. Q2, 10.3–12.4, vs. Q3, 12.5–14.0, vs. Q4, >14.0 mg·min–1·kg LBM–1). We measured insulin sensitivity (using the hyperinsulinemic–euglycemic clamp technique), body composition (using dual-energy X-ray absorptiometry), visceral fat and muscle attenuation (using computed tomography), and a lower-body muscle strength index expressed as weight lifted in kilograms per kilogram of LBM (kg·kg LBM–1) (using weight-training equipment). A positive and significant relationship was observed between insulin sensitivity and the muscle strength index (r = 0.37; p < 0.001). Moreover, a moderate but significant correlation was observed between the muscle strength index and muscle attenuation (r = 0.22; p < 0.05). Finally, the muscle strength index was significantly higher in the Q4 group compared with the Q2 and Q1 groups, respectively (3.78 ± 1.13 vs. 2.99 ± 0.77 and 2.93 ± 0.91 kg·kg LBM–1; p < 0.05). Insulin sensitivity is positively associated with lower-body muscle strength in overweight and obese sedentary postmenopausal women.
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Affiliation(s)
- Antony D Karelis
- Department of Kinanthropology, Université du Québec à Montréal, 1205 St-Denis, Montreal, QC H2X 3R9, Canada.
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