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Eye care interventions that reduce access inequities for women, rural residents and older people in low-middle-income countries: a scoping review
Get PDFINTRODUCTION: Women, older people and rural residents in low-middle-income settings are mainly impacted by the economic and psychosocial consequences of preventable blindness from undiagnosed and untreated cataracts diabetic retinopathy.METHODS: This review of PubMed 2002-2023 and the grey literature aimed to identify strategies effective in reducing access inequities to eye health screening and treatment for the above vulnerable groups.RESULTS: Thirty-nine publications from 16 countries were included. Fifteen focused on cataract, 17 on diabetic retinopathy, and seven on general ophthalmology. This article focuses on the twenty-four studies of moderate or high quality. Rural residents were more likely to benefit (16 studies) while direct effectiveness among women were reported in seven studies. Only three studies reported actual benefits for older people. Outreach services and teleophthalmology were effective interventions increasing screening attendance and referral rates for women and rural residents. Health financing to enhance cataract surgery acceptance and actual surgical rates reported effectiveness for rural residents but showed only modest improvements. Digital technology improved overall appointment uptake and referral adherence for rural residents but not significantly for women. Teleophthalmology was successful in building local capacity for accurate diagnosis but its impact on referral compliance was not demonstrated. Limited evidence was found for the effectiveness of health education alone to boost screening attendance for either subgroup.DISCUSSION: The evidence for effectiveness in reducing inequities is not always direct, uses mixed outcomes, and had heterogenous designs. Yet, the results of the higher quality publications in this review indicate modest improvements worth pursuing further.SYSTEMATIC REVIEW REGISTRATION: https://osf.io/yr7tg/files/osfstorage?view_only=968ba9e8c910470ca227dcdb0da3cda8
Discussing the potential consequences of a diagnostic label before routine non-cancer screening: qualitative study with general practitioners and consumers
No full textBackground:A diagnostic label can have harms and benefits, particularly when provided following routine health screening tests. Whether these are discussed in clinical encounters is unknown.Aims: To investigate whether potential impacts of diagnostic labelling are discussed before routine screening for non-cancer health conditions and explore the perceived value of such discussions by general practitioners (GPs) and healthcare consumers.Method: Eleven semi-structured interviews with GPs and two focus groups with eight consumers were conducted. Interviews and focus groups were audio-recorded, transcribed and analysed using thematic analysis methods based on framework analysis.Results: Prior to routine screening, most GPs did not discuss the potential consequences of diagnostic labelling, and no consumer recalled discussions of this nature. In contrast, many GPs provided information regarding the screening procedure and possible test limitations. Both GPs and consumers identified that it would be valuable to discuss the potential impacts of a diagnostic label; however, preferences varied as to the content and timing (i.e. before or after screening) of this discussion. Six themes that examine the utility of discussing the consequences of diagnostic labelling were identified: patient empowerment, patient variability, condition-specific information, GP and patient interactions and relationship, GP role and responsibilities, and characteristics of screening.Conclusions:The practice and perceived value of discussing diagnostic labelling consequences were recognised as important by both GPs and consumers. However, preferences regarding the content of discussions and whether these occurred in clinical encounters before or after screening varied
Mitigating the impact of climate change on poverty in Africa: the moderating role of financial inclusion
No full textThis study examines the role of financial inclusion in mitigating the impact of climate change on poverty, using the ninth wave of the Afrobarometer survey across 39 African countries. Using a battery of econometric estimators to address the endogeneity of financial inclusion, we highlight the following key findings. We find robust evidence that financial inclusion significantly moderates the adverse effect of climate-related disasters (i.e., droughts and flooding) on poverty in Africa. Heterogeneity analyses reveal that this effect is more pronounced among females than males and in lower-income countries than middle-income countries. Uniquely, we argue and empirically demonstrate that having a personal financial account is a more effective climate-mitigating strategy for reducing poverty than having a financial account belonging to someone else in the household. We outline the key implications of these findings to guide policy and practice
Enhancing building information modelling in existing complex built environment through advanced reality capture and point cloud processing techniques
No full textInferring Causation: Risks, 'Common Experience' and Social Facts"
No full textWhen determining causation in tort law, courts often infer causal links between a defendant’s negligence and a plaintiff’s injury, even where there is only limited evidence. This article considers the principles that govern the process of drawing inferences and their application in Australian law. Causal inferences are triggered by the defendant’s conduct that significantly increases the risk of precisely the type of harm to the plaintiff that occurred, absent other plausible causal explanations for the plaintiff’s harm. Importantly, however, courts have repeatedly substantiated causal inferences based on the ‘course of common experience’, ‘common sense’, etc. As Kylie Burns demonstrates, it is important to examine judicial statements about how the world operates (‘social facts’), especially when unsupported by evidence. Although reliance on unsupported assumptions may be problematic in some contexts, this article demonstrates that social facts in causation cases usually concern day-to-day matters and do not necessarily reflect social biases
Artificial intelligence versus humans: A comparative analysis of time, cost, and performance on a clinical code conversion task
Get PDFHealthcare services generate and store large quantities of data, requiring significant resources to manually analyze and gain meaningful insights. Recent advancements in automation tools—such as generative artificial intelligence (GenAI)—provide new opportunities to reduce human labor. This study explores the potential utilization of GenAI for a healthcare data analysis task—specifically, the conversion of clinical data from one diagnostic classification system to another (i.e., the Australian extension of the Systematized Nomenclature of Medicine Clinical Terms to the International Classification of Diseases, 10th Revision, Clinical Modification)—and examines the time and cost benefits of performing this using GenAI compared to a human rater. Conversions were completed using three methods: manual conversion using the National Library of Medicine’s I-MAGIC tool, ChatGPT-4o, and Claude 3.5 Sonnet. The accuracy of the GenAI tools was mapped against the manually extracted codes and examined in terms of a perfect, partial, or incorrect match. Task completion time was recorded and extrapolated to calculate and compare the cost associated with each method. When compared to the manually extracted codes, Claude 3.5 Sonnet yielded the highest level of agreement over ChatGPT-4o, whilst being the most time- and cost-effective. GenAI tools have greater utility than they have currently been given credit for. The automation of big data healthcare analytics, whilst still the domain of humans, is increasingly capable of being undertaken using automation tools with low barriers to entry. The further development of GenAI’s capabilities, alongside the capability of the healthcare system to use it appropriately, has the potential to result in significant resource savings
Glamping Ukraine: An entrepreneur's pivots, agility and resilience within war
No full textIt was a Monday morning in March 2025. Andrii Rodkin sat down at his desk and pulled out the small spiral notepad he had been scribbling in the night before. It was so full of things to do that he could barely see the ruled lines in between his handwriting. At last count, there were over 30 calls he had to make, and that was before he started his other work. Making it worse was the fact that his to-do list was filled with tasks he had never done before. Rodkin was the chief commercial officer (CCO) and co-founder of Glamping UA (https://glamping.ua/). His partner, Oleksandr (Alex) Konovalov, was the chief executive officer (CEO) and managed the operational side of the business so Rodkin could focus on strategic partnerships, client relations, and project execution. In the six years since they had founded their business, they’d grown their start-up to the point where it had 50 full-time employees; its own production facilities, which included a sewing factory and polyvinyl chloride, metal, and wood facilities; and a 3,000-square-metre warehouse. It was a full-cycle production business with exports to the United States, France, Poland, and other countries throughout Europe. Rodkin and Konovalov also owned three glamping sites in Ukraine and a glamping consultancy company. Their mission was “to give tourists around the world new experiences of vacations in exciting natural locations, creating reliable glamps and providing entrepreneurs with expert advice.” The slogan for their business informed all decision-making and captured the spirit of glamping: “Where nature meets luxury.” Glamping meant glamorous camping—it was a camping experience for people who wanted to spend time in nature while also enjoying the comforts of “real mattresses, running water, and an actual toilet instead of an outhouse.” With the glamping industry estimated to be worth US$3.79 billion in 2024 and the European glamping market accounting for 35 per cent of the global market, Glamping UA’s growth trajectory was looking good. Yet on that particular Monday, Rodkin was sad. He was also utterly exhausted through to his bones. His co-founder and best friend since childhood, Konovalov, had just been conscripted to join the Armed Forces of Ukraine. It had all happened so fast. They were together at work the Friday before, and then on Monday he was gone. He left behind his pregnant wife and two children. Rodkin and his own wife vowed to help them through this difficult time. He wasn’t sure how, but he knew they would. It was a snow-covered morning in yet another brutally cold winter in Ukraine, and despite feeling alone, Rodkin had to figure out a way to keep his organization operational without his business partner and lifelong friend by his side. As he sat there, pausing for a moment to sip his coffee, he felt overwhelmed by the responsibility. He had to ensure the business wouldn’t collapse with Konovalov now in the military and helping Ukraine win the war against Russia.<br/
Assessing Russia's Weaponization of Food and Its Compliance with International Law Safeguarding the Right to Food for Ukrainian Civilians and Ensuring Accountability for the War Crime of Starvation
No full textStarvation of civilians as a military tactic has a long history, which continues today. Despite protections enacted by the 1949 Geneva Conventions and their Additional Protocols, as well as the Rome Statute of the International Criminal Court, civilian access to food is still weaponized in armed conflicts. To date, no State has been sanctioned, and no individuals have been internationally prosecuted for engaging in the war crime of starvation. During its war against Ukraine, a significant part of Russia's strategy has entailed attacking and degrading critical resources and civilian infrastructure, such as food itself and agricultural infrastructure. This Article studies the denial of food to civilians in Ukraine as a method of warfare since 2022, including such attacks, as well as denial of access to relief supplies. Within the framework of the right to food, it assesses both Russia's culpability for the starvation of civilians as a method of warfare under international humanitarian law and that of individuals acting on its behalf under international criminal law. It also examines the practical challenges of holding them accountable for their actions
Barriers and facilitators to noviceoccupational therapists working effectivelywith children
No full textIntroduction: Over the last 30+ years, occupational therapy literature has explored some of the broad factors that influence a new graduates' experience of working in different practice settings. By contrast, limited evidence regarding the facilitators and barriers to novice occupational therapists working effectively with children aged 0–18 years, exists. Anecdotally, in Australia, a recent increase in new graduate occupational therapists working in the private paediatric context has been noted, raising the question around how to best support novice occupational therapists to work effectively with children and families.Objectives: To synthesise what is known about the barriers and facilitators to novice occupational therapists working effectively with children.Method: This scoping review followed the PRISMA-ScR method to identify the existing literature in terms of the characteristics, volume, and nature of the topic area. Searches were conducted through Scopus, PubMed, and CINAHL. Titles were included if they described occupational therapists with 0–3 years of practice experience and contained a description of an occupational therapy caseload of children aged 0–18 years of age. Covidence was used to screen and complete data extraction, and results were analysed thematically.Results: 1853 titles were located through searches of scholarly databases. Preliminary analysis identified themes relating to novice occupational therapists' confidence, knowledge, skills and support requirements when working with children and families in the first 3 years of practice.Conclusion: This scoping review provides insight into how novice occupational therapists can be better supported to work effectively with children and families, and informs future research priorities
Exploring safety violations of the construction workers in Hong Kong: a sociotechnical systems approach
Get PDFHuman is considered one of the key factors in construction accidents. When comparedto other countries, the Hong Kong construction industry has unique features.Therefore, it is crucial to understand why construction workers in Hong Kong violatesafety rules and procedures. This study aims to fill a gap in existing research, asprevious studies directly related to safety violations among Hong Kong constructionworkers are limited. A mixed methods strategy was adopted. Three hundred sixty-fivevalid responses from the quantitative questionnaire survey were analysed to examinethe relationships using the adapted Theory of Planned Behaviour. Qualitative semistructured interviews were then conducted to explore safety violations and dynamics ofHong Kong construction workers. The results substantiate the use of TPB in thiscontext. In terms of theoretical implications, the findings suggest a framework thatdepicts the micro (work progress, working environment, self-awareness, and norms),meso (quality of safety rules and procedures and high-reliability organising), and macrofactors (institutional contributors) affecting safety compliance. In terms of practicalimplications, in addition to implementing interventions to improve workers' intentionsregarding safety violations, construction companies should examine the currentweaknesses in safety training while enhancing and developing a mindful safety cultureto become high-reliability organisations