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Non-randomised trial of a hepatitis C same-day test and treat model using antibody test only for people who inject drugs in Armenia, Georgia and Tanzania: a CUTTS HepC study protocol

Por: Draper · B. L. · Flynn · M. · Schroeder · S. · Wisse · E. · Aikaeli · F. · Han · Z. M. · Ayako · M. · Bajis · S. · Butsashvili · M. · Davtyan · K. · Kordzadze · T. · Lamand · P. · Luhmann · N. · Sargsyan · K. · Senkoro · M. · Scott · N. · Stone · J. · Vickerman · P. · Voloshin · A. · Walker
Introduction

Despite the availability of curative treatments, hepatitis C diagnosis and treatment coverage is suboptimal globally with few countries on track to achieve the WHO’s 2030 elimination targets. In 2022, an estimated 50 million people were living with hepatitis C, with 1 million new infections annually. Most people living with hepatitis C reside in low- and middle-income countries, and people who inject drugs are disproportionately affected by hepatitis C.

Continuing simplification of diagnostic pathways and treatment care models is required to improve linkage to care and reduce costs associated with hepatitis C treatment and cure.

Methods and analysis

This study is a multi-country non-randomised, quasi-experimental, prospective comparative two-arm trial. It aims to assess the feasibility of implementation, retention in hepatitis C care and achievement of cure and cost-effectiveness outcomes, comparing two simplified hepatitis C testing and treatment pathways.

Arm 1 is a standard simplified test and treat model of care following global guidance, and arm 2 is an innovative rapid, same-day treatment initiation model of care using a presumptive treatment approach based on shortened read-time of the point-of-care OraQuick hepatitis C antibody test result. Secondary outcomes include assessing the accuracy of the OraQuick hepatitis C antibody test in predicting viraemia and the acceptability of each pathway.

This study will be implemented in Armenia, Georgia and Tanzania. Treatment-naïve people who inject drugs aged over 18 years in each country will be eligible for enrolment.

Recruitment commenced in October 2024 in Armenia, June 2025 in Georgia and August 2025 in Tanzania and is anticipated to close by December 2026.

Ethics and dissemination

This trial has been reviewed by WHO Ethics Review Committee (ERC), Alfred Hospital Ethics Committee (Australia) and local country ERCs. Alongside journal publications and conferences, the results from this study will be disseminated through summary reports and workshops with key stakeholders and with communities of people affected by HCV through relevant organisations/networks, including the global Community Advisory Board (CAB). The study results will inform national scale-up of simplified care models and inform potential pathways for further simplification of care models, including the potential for one-step diagnostic pathways and same-day treatment in particular scenarios for the three study countries, and other low- and middle-income countries globally.

Trial registration number

NCT06159504.

European research Priorities for Osteopathic Care (PROCare): a sequential exploratory investigation and survey

Por: Vaucher · P. · Carnes · D. · Hohenschurz-Schmidt · D. · Thomson · O. · Vogel · S. · Arienti · C. · Bright · P. · Alvarez Bustins · G. · Esteves · J. · Koch Esteves · N. · Fawkes · C. · Rinne · S. · Roura · S. · Treffel · L. · Wagner · A. · Draper-Rodi · J.
Objectives

The aim of this study is to identify and analyse research priorities across the osteopathic profession internationally, to determine how different interested parties conceptualise research importance and to examine how contextual factors influence research prioritisation.

Design

A mixed methods sequential exploratory design combining an umbrella review, a thematic analysis, an expert consensus agreement and an international cross-sectional survey was used to define, validate and evaluate research priorities.

Setting

An international online survey, available in nine languages, was distributed through professional osteopathic organisations and network worldwide, a patient representative organisation and social media.

Participants

2229 respondents including patients (7.4%), practitioners (42.1%), students (17.4%), educators (13.5%), researchers (5.0%) and policy makers (4.3%) from across 42 countries.

Primary and secondary outcome measures

Primary outcomes were interested party’s conceptualisation of research importance and validation of the priorities in Research for Osteopathic Care (PROCare) framework. Secondary outcomes included current research priorities across interested parties groups and influence of contextual factors on prioritisation.

Results

Three distinct approaches to priority-setting emerged: conservative (42.9%), sceptic (20.2%) and enthusiast (36.9%). Organising research priorities as a construct built from domains and subdomains was shown to be internally valid (Cronbach’s α=0.911). ‘Patient safety’ (nominated by 82% of relevant countries) and ‘physical activities and mobility’ (51.0%) were the most prioritised subdomains. ‘Digital health’ ranked lowest (28th of 28 subdomains). Significant geographic variations were observed mainly for the overall importance to most research domains. Strong consensus emerged around core priorities including patient safety, physical activity promotion and understanding treatment mechanisms.

Conclusions

The PROCare framework provides a validated structure for evaluating osteopathic research priorities across diverse interested parties. While geographic variations exist in priority emphasis, fundamental agreement on key research domains suggests potential for internationally coordinated research strategies. Future work should focus on developing mechanisms to ensure balanced representation of conservative, sceptic and enthusiast perspectives in research planning.

Differences in practice among osteopaths in the UK with more than or less than 10 years of experience: a cross-sectional study

Por: Bailey · D. · Fawkes · C. · Draper-Rodi · J.
Objectives

To explore possible factors related to the increased likelihood of retirement from practice and increased number of complaints and concerns received by osteopaths in practice 10 years or more.

Design

Online cross-sectional survey.

Setting

UK osteopathic healthcare.

Participants

UK-based osteopaths registered with the General Osteopathic Council.

Results

570 questionnaires were eligible for analysis. Respondents were mostly women (57.5%), working in England (90.7%), white or white British (91.8%), 50–59 years of age (29.6%) and practicing for 0–5 years (16.9%). Osteopaths who had been in practice for 10 years or more were significantly (² tests, p

Conclusions

Osteopaths who have been in practice for 10 years or more have some significantly different demographics and aspects of clinical practice and patient management to those in practice less than 10 years. However, it is not clear whether these differences are influential in decisions for leaving practice or the increased number of concerns and issues received.

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