Conectar
In all countries, some population groups experience barriers to accessing eye health services, contributing to health inequities. Outreach is a common strategy used to deliver healthcare services to populations experiencing inequities. This scoping review aims to summarise the nature and extent of the existing literature describing outreach as a service delivery model to improve access to eye health services, particularly among populations experiencing inequities.
An information specialist will search academic databases (Medline, Embase and Global Health) without language restrictions to find peer-reviewed articles describing outreach eye health services, published in any country between 1 January 2010 and the search date. Grey literature sources will also be searched. In Covidence, two reviewers will independently screen titles and abstracts and subsequently relevant full texts against the inclusion criteria. Data extraction will also be performed independently by two reviewers in Covidence. This scoping review will summarise the characteristics of the included outreach eye health services, including the type of eye health service delivered, personnel involved, mode of transport, source of funding and whether the service targeted any specific PROGRESS-Plus group (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus). We will present our findings quantitatively using diagrams, tables and graphs.
Ethics approval was not sought, as this scoping review will use only publicly available reports. The results of this review will be disseminated through publication in a peer-reviewed journal and will be presented at eye health conferences. It will offer valuable insights for eye health providers, health and social service providers and policymakers who are interested in improving access to eye health services for populations experiencing inequities. This scoping review will inform a project in New Zealand which aims to develop outreach eye health services to populations experiencing inequities, such as unhoused people and refugees.
This protocol was registered on the Open Science Framework on 11 November 2025 (https://osf.io/vyz32).
by Diana Margot Rosenthal, Kate Guastaferro, Jasia Kubik, Melody Goodman
In January 2025, the nightly census revealed that over 120,000 people were staying in New York City (NYC) shelters, including more than 41,000 children, of whom almost half were aged 0–5 years. Children under five years old (under-5s) experiencing homelessness are especially vulnerable because the first five years of life are a critical period for child growth, including approximately 90% of brain development. Furthermore, under-5s experiencing homelessness have a higher risk for multiple adverse childhood experiences, developing chronic health conditions, and recurrent homelessness across the life course. Data available for under-5s experiencing homelessness is generally lacking, and what is available is of notably poor quality in the United States, leaving a wide evidence gap and an inability to determine the actual needs of this population. This proposed protocol employs community-based participatory research and was co-developed with families with under-5s who have lived experience of homelessness in NYC shelters. The aim is to determine what barriers exist in the physical and social environments to optimizing health and wellbeing (e.g., milestones, child mental health, parental mental health, safety) among under-5s living in NYC shelters. Using a sequential mixed-methods design, we propose to address a gap in the current literature by conducting an assets- and deficits-based health needs assessment comprising a quantitative survey and qualitative semi-structured interviews. In the long term, our objective is to enhance the quality and quantity of data for this vulnerable population, thereby laying the groundwork for the future co-development of a comprehensive, optimized intervention addressing the needs of under-5s experiencing homelessness.To examine demographic and occupational attributes associated with work-life balance (WLB) satisfaction among physician assistants/associates (PAs) using a national dataset.
This is a cross-sectional study using 2023 national data.
USA.
The study included 149 909 board certified PAs who updated, confirmed or verified their profile questions.
Descriptive and bivariate statistics, followed by multivariate logistic regression, were conducted to identify factors associated with WLB satisfaction among PAs. The primary outcome was a binary variable derived from a 7-point scale assessing PAs’ satisfaction with WLB. Responses of ‘Somewhat’, ‘Mostly’ and ‘Completely’ satisfied were coded as ‘Satisfied’, while ‘Neither/Nor’, ‘Somewhat’, ‘Mostly’ and ‘Completely’ dissatisfied were coded as ‘Not satisfied’. Our analytical sample comprised 86,000 PAs who responded to a question inquiring about their satisfaction with WLB.
Over two-thirds (71.7%) of PAs indicated satisfaction with WLB. The multivariate logistic regression revealed that the types of specialties that PAs practised were among the strongest factors associated with WLB satisfaction. Compared with PAs in primary care, those practising in dermatology (adjusted OR (aOR)=1.83; 95% CI 1.66 to 2.02), general surgery (aOR=1.64; 95% CI 1.48 to 1.83), pain medicine (aOR=1.63; 95% CI 1.41 to 1.89) and hospital medicine (aOR=1.52; 95% CI 1.37 to 1.68) had higher odds of being satisfied with WLB (all p
Our findings revealed that PAs practising in non-primary care specialties had the highest odds of reporting satisfaction with WLB. Identifying factors strongly associated with PA work-life balance can aid in developing targeted interventions. However, further research is needed to understand the intrinsic and extrinsic factors influencing PAs’ WLB.
Many patients receive oral anticoagulation for reduced stroke risk in atrial fibrillation or as treatment or prevention of venous thromboembolism. Oral factor Xa inhibitors (oral FXaI, eg, apixaban, edoxaban or rivaroxaban) are commonly prescribed for this indication. Dabigatran, an oral direct thrombin inhibitor, is similarly approved. In vitro and animal model evidence suggests that dabigatran also has direct effects on Staphylococcus aureus virulence and infection. Observational data have shown that dabigatran users are less likely to develop S. aureus bacteremia (SAB), and a small randomised controlled trial showed that dabigatran has anti-S. aureus effects when compared with low molecular weight heparins during bloodstream infection. We seek to answer whether dabigatran is superior to the oral FXaIs in achieving better SAB outcomes among patients who independently require oral anticoagulation. We report the intervention-specific protocol, embedded in an adaptive platform trial.
The S. aureus Network Adaptive Platform (SNAP) trial [NCT05137119] is a pragmatic, randomised, multicentre adaptive platform trial that compares different SAB therapies for 90-day mortality rates. For this intervention (‘Dabi-SNAP’), patients receiving therapy with an oral FXaI will be randomised to continue as usual or to change to dabigatran as of the next scheduled dose. All subjects will receive standard of care antibiotics and/or antibiotics allocated through other active domains in the platform. As the choice of anticoagulant may not demonstrate large differences in mortality, a ranked composite of death and adverse outcomes (Desirability of Outcome Ranking, or DOOR) was chosen as the primary outcome.
The study is conditionally approved by the research ethics board of the McGill University Health Centre: identifier 2025-10900. Trial results will be published open access in a peer-reviewed journal and presented at a global infectious disease conference. The trial is registered at clinicaltrials.gov with the identifier NCT06650501.
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