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Kaupapa Maori approaches to improve Maori eye health: a protocol for a scoping review

Por: Watene · R. · Ramke · J. · Te Ao · B. · Harwood · M. · Manuel · A.
Introduction and aim

Māori experience higher rates of disease and poorer health outcomes than non-Māori, highlighting inequities in the health system in Aotearoa New Zealand (Aotearoa). Māori eye health has historically been under-researched. Kaupapa Māori (by Māori, with Māori, for Māori) approaches to research have been recognised as critical for developing and informing equitable and inclusive health service solutions for Māori. This scoping review aims to summarise the literature on interventions to improve Māori eye health and investigate the extent to which Kaupapa Māori approaches have been used within these studies.

Methods and analysis

This scoping review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist and informed by Kaupapa Māori research and strengths-based methodologies. Electronic searches of MEDLINE (Ovid), Embase (Ovid) and Google Scholar were performed using keywords focused on Māori eye health, Kaupapa Māori and eye health interventions. The search was performed by an information specialist without language or time restrictions. Peer-reviewed and grey literature reports will be included if they report any intervention that aimed to improve eye health for Māori. Two reviewers will independently screen abstracts and full texts, followed by data charting in Covidence. Data items will include publication, study and intervention characteristics and whether a Kaupapa Māori approach was used, in which case the characteristics of the approach will be charted. The responsiveness to Māori of each included study will be assessed using the MĀORI framework and CONSIDER statement. Data will be summarised in tables, graphs, maps and text.

Ethics and dissemination

To the best of our knowledge, the scoping review is the first to investigate published and publicly accessible literature related to interventions for improving Māori eye health and Kaupapa Māori approaches. Ethical approval is not required for this review as we will include information available in the public domain. We anticipate that the findings will be useful for Hauora Māori providers, organisations, education training and research providers of eyecare services. The scoping review also informs a more extensive project examining Indigenous perspectives in optometry to achieve equitable outcomes. Dissemination will include publication of the scoping review findings in an open-access peer-reviewed journal, as well as presentations at conferences, to Māori community and service organisations, scholars and staff working in the field of Māori eye health.

Registration

Open science framework (https://osf.io/4vqaw/). On 27 February 2025.

State-wide analysis of trends and patterns of emergency department presentations of violence against women in New South Wales, Australia 2015-2022: a data linkage study

Por: Kaikhosrovi · M. · Berendsen Russell · S. · Seimon · R. · Foong · L. H. · Adily · P. · Sharwood · L. N. · Singh · H. · Johnson · G. · Dinh · M.
Objectives

To describe the features and rates of emergency department (ED) presentations identified as related to violence against women (VAW) and of confirmed cases of family domestic violence (FDV) inpatient admissions and to compare these across geographic locations in New South Wales (NSW) Australia.

Design

A retrospective data linkage study.

Setting

Routinely collected public hospital data from approximately 180 designated public hospital EDs in NSW, Australia.

Participants

Cases were included if female, aged ≥15 years, presenting to any NSW ED between 2015 and 2022 and with one or more criteria indicating VAW, leading to 21 219 cases being included.

Primary outcomes

The age-standardised rate of VAW ED presentations per year and confirmed FDV inpatient admissions within metropolitan and non-metropolitan areas in NSW, Australia.

Results

Women presenting with VAW were more likely to be aged 25–44 years (n=9705, 45.7%), with almost 20% of presentations from women who identified as Indigenous (n=4153, 19.6%). Indigenous presentations were greater in non-metropolitan areas (n=2675, 30.9%) compared with metropolitan areas (n=1478, 11.8%). Indigenous women in NSW represent only 4.2% of the estimated residential population. VAW presentation rates by age group varied over time, a gradual increase being seen in the 65–84 year-old age group who experienced 45 VAW presentations per year in 2015 to 79 presentations per year in 2022 with an annual rate of change of 7.3%.

Conclusion

VAW accounts for a substantial burden of ED presentations across NSW; the greatest impact on women aged 25–44 years and Indigenous women, particularly in non-metropolitan areas. Rising presentations among older women further highlight the need for strengthened ED screening and referral pathways and for targeted resource allocation to address inequities in family, domestic and sexual violence.

Brachial plexus nerve block versus haematoma block for closed reduction of distal radius fracture in adults: The BLOCK Trial - a protocol for a multicentre randomised controlled trial

Por: Dupont Harwood · C. · Jellestad · A.-S. L. · Bahuet · A.-X. R. · Knudsen · R. L. · Andersen · L. C. · Mathiesen · O. · Asko Andersen · J. · Jakobsen · J. C. · Rothe · C. · Jorgensen · C. C. · Viberg · B. · Brorson · S. · Brabrand · M. · Gundtoft · P. H. · Terndrup · M. · Lange · K. H.
Introduction

Distal radius fractures account for one-fifth of all fractures in the active elderly population and may cause chronic pain, loss of hand function and reduced work productivity, imposing a significant socioeconomic burden. Most are initially treated with closed reduction and casting, but 30% subsequently require surgery due to insufficient realignment. The current approaches for analgesia for closed reduction are suboptimal. A brachial plexus nerve block provides complete pain relief and muscle relaxation distal to the elbow, potentially creating better conditions for realignment of the fractured bone ends. This may ultimately translate into reduced need for surgery and result in better functional outcomes and fewer complications compared to a haematoma block, which is the current standard care in Denmark.

Methods and analysis

The BLOCK Trial is an investigator-initiated, parallel-group, allocation-concealed, outcome assessor and analyst-blinded, superiority, randomised, controlled, clinical multicentre trial performed at 11 Danish emergency departments. Eligible adult patients with a distal radius fracture who need closed reduction will be included and allocated 1:1 to either an ultrasound-guided brachial plexus nerve block or a haematoma block. The primary outcome is the proportion of patients with distal radius fracture surgery 90 days after closed reduction. We will include 1716 participants to detect or discard a relative risk reduction of surgery of 20%. Secondary outcomes include treatment-related complications, patient-reported wrist function, pain during closed reduction and proportion of patients with unacceptable radiographic fracture position immediately after closed reduction.

Ethics and disseminationf

The trial is approved by the Danish Medicines Agency and the Danish Research Ethics Committees (EU CT number: 2024-512191-35-00). All results will be summarised on www.theblocktrial.com, clinicaltrials.gov and euclinicaltrials.eu after publication. Primary and secondary outcome results from 0 to 90 days will be presented in the main article and submitted to a peer-reviewed journal. Results from outcomes on the 12-month follow-up will be presented separately.

Trial registration number

NCT06678438.

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