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Yes / Background: Small-area analysis of National Health Service (NHS)-funded sight test uptake in Leeds showed significant inequalities in access among people aged <16 or ≥60. Methods: Data were extracted from 604 126 valid General Ophthalmic Services (GOS)1 claim forms for eye examinations for Essex residents between October 2013 and July 2015. Expected GOS1 uptake for each lower super output area was based on England annual uptake. Poisson regression modelling explored associations in GOS1 uptake ratio with deprivation. Results: People aged ≥60 or <16 living in the least deprived quintile were 15% and 26%, respectively, more likely to have an NHS funded eye examination than the most deprived quintile, although all are equally entitled. GOS1 uptake is higher in the more deprived quintiles among 16-59-year old, as means tested social benefits are the main eligibility criteria in this age-group. Inequalities were also observed at local authority level. Conclusions: Inequalities in access among people ≥60 years were not as large as those reported in Leeds, although inequalities in <16-year old were similar. However, demonstrable inequalities in this data set over a longer time period and a larger and more diverse area than Leeds, reinforce the argument that interventions are needed to address eye examination uptake inequalities. / The College of Optometrists.

No / Objectives: Poor knowledge of eye health, concerns about the cost of spectacles, mistrust of optometrists and limited geographical access in socio-economically deprived areas are barriers to accessing regular eye examinations and result in low uptake and subsequent late presentation to ophthalmology clinics. Personal Medical Services (PMS) were introduced in the late 1990s to provide locally negotiated solutions to problems associated with inequalities in access to primary care. An equivalent approach to delivery of optometric services could address inequalities in the uptake of eye examinations. Study design: One-way and multiway sensitivity analyses. Methods: Variations in assumptions were included in the models for equipment and accommodation costs, uptake and length of appointments. The sensitivity analyses thresholds were cost-per-person tested below the GOS1 fee paid by the NHS and achieving breakeven between income and expenditure, assuming no cross-subsidy from profits from sales of optical appliances. Results: Cost per test ranged from £24.01 to £64.80 and subsidy required varied from £14,490 to £108,046. Unused capacity utilised for local enhanced service schemes such as glaucoma referral refinement reduced the subsidy needed. / Yorkshire Eye Research, NHS Leeds, RNIB

Išsėtinė sklerozė — lėtinė demielinizuojanti uždegiminė centrinės nervų sistemos, t.y. galvos ir nugaros smegenų liga (Daubarienė ir Šakalienė, 2007; Ambrozaitis ir kt., 2009, Coote et al., 2009; Liutkienė, 2011; Borghi et al., 2013) ir viena jaunų žmonių negalios priežasčių (Graves & Balcer, 2010; Frohman et al., 2011; Connik et al., 2011; Kizlaitienė ir kt., 2011; Dӧring et al., 2012). Visame pasaulyje išsėtine skleroze (IS) serga apie 2,5 mln. žmonių (Ambrozaitis ir kt., 2009; Potera, 2009; Liutkienė, 2011; Nilsagard et al., 2012). 2007 metais Lietuvoje IS paplitimas yra 55,2 atvejai (Daubarienė ir Šakalienė, 2007), 2008 metais jau 78 atvejai 100 000 gyventojų (Liutkienė, 2011). Lietuvos išsėtinės sklerozės sąjungos generalinės sekretorės Aldonos Droseikienės teigimu, Lietuvoje užregistruota apie 2,6 tūkst. išsėtine skleroze sergančių žmonių, nors tikrasis pacientų skaičius gali būti gerokai didesnis (Lietuvos gydytojo žurnalas, 2012). Regos sutrikimas nuo nežymaus regėjimo pablogėjimo iki visiško aklumo dėl regos nervo uždegimo dažniausiai yra negrįžtamas (Graves & Balcer, 2010). Ūmus regos nervo uždegimas yra vienas dažniausių klinikinių simptomų, sergantiems išsėtine skleroze, pasireiškiantiems maždaug dviems trečdaliams pacientų (Green et al.,2010; Frohman et al., 2011; Wang et al., 2012). Gali vystytis ne tik regos aštrumo pokyčiai, bet ir akių judesių sutrikimai (Frohman et al., 2011). Pusiausvyros sutrikimams, sergantiems išsėtine skleroze, įtakos turi regėjimo ir... [toliau žr. visą tekstą] / Multiple sclerosis – chronic demyelinating inflammatory disease of central nervous system, what means disease of brain and spinal cord (Daubarienė and Šakalienė, 2007; Ambrozaitis et al., 2009; Coote et al., 2009; Liutkienė, 2011, Borghi et al., 2013) and one of the cause of young adult people disability (Graves & Balcer, 2010; Frohman et al., 2011; Connik et al., 2011; Kizlaitienė et al., 2011; Dӧring et al., 2012). Globally, multiple sclerosis (MS) affects about 2,5 million people (Ambrozaitis et al., 2009; Potter, 2009, Liutkienė, 2011; Nilsagard et al., 2012). In 2007, Lithuania MS prevalence is 55,2/100 000 inhabitants (Daubarienė and Šakalienė, 2007), in 2008 already 78/100 000 (Liutkienė, 2011). Lithuania Multiple Sclerosis Association General Secretary said Aldona Droseikienės, Lithuania recorded about 2,6 thousand multiple sclerosis in human patients, although the actual number of patients may be significantly higher (Lithuanian Doctor Magazine, 2012). Eye disorder is general disability symptom for this population of patients and mostly irreversible (Graves & Balcer, 2010). Acute optic neuritis is the most common clinical symptom of multiple sclerosis, and affects approximately two thirds of patients in the course of the disease (Green et al., 2010; Frohman et al., 2011; Wang et al., 2012), which can be from LEGV form to complete blindness. It can also lead to disability for eye movement disorders (Frohman et al., 2011). In patients with multiple sclerosis, loss of... [to full text]

Objectives: Poor knowledge of eye health, concerns about the cost of spectacles, mistrust of optometrists and limited geographical access in socio-economically deprived areas are barriers to accessing regular eye examinations and result in low uptake and subsequent late presentation to ophthalmology clinics. Personal Medical Services (PMS) were introduced in the late 1990s to provide locally negotiated solutions to problems associated with inequalities in access to primary care. An equivalent approach to delivery of optometric services could address inequalities in the uptake of eye examinations. Study design: One-way and multiway sensitivity analyses. Methods: Variations in assumptions were included in the models for equipment and accommodation costs, uptake and length of appointments. The sensitivity analyses thresholds were cost-per-person tested below the GOS1 fee paid by the NHS and achieving break-even between income and expenditure, assuming no cross-subsidy from profits from sales of optical appliances. Results: Cost per test ranged from £24.01 to £64.80 and subsidy required varied from £14,490 to £108,046. Unused capacity utilised for local enhanced service schemes such as glaucoma referral refinement reduced the subsidy needed. Conclusions: In order to support the financial viability of primary eye care in socio-economically deprived communities, income is required from additional subsidies or from sources other than eye examinations, such as ophthalmic or other optometric community services. This would require a significant shift of activity from secondary to primary care locations. The subsidy required could also be justified by the utility gain from earlier detection of preventable sight loss. / Yorkshire Eye Research, NHS Leeds and RNIB

The thesis objectives were to a) create environmental health indicators (EHIs) of the use and risk of crop farming pesticides; b) conduct an epidemiological study of the association between the pesticide EHIs and health outcomes, in rural crop farming areas of Manitoba. Pesticide indicators included the average annualized percent of Census Consolidated Subdivision land acreage where any pesticides, herbicides, fungicides, or insecticides were applied as well as an indicator of pesticide risk. In multilevel models, the use of insecticides was significantly associated with perinatal conditions (males: OR=1.08, p=0.005; females: OR=1.07, p=0.01), congenital anomalies in males (OR=1.04, p=0.04), and eye disorders (males: OR=1.03, p<0.001; females: OR=1.02, p=0.012). Eye disorders in males were also significantly associated with the use of any pesticide (OR=1.001, p<0.001) and pesticide risk (OR=1.06, p<0.001). Regular pesticide use in crop farming, especially insecticides, may be adversely affecting the health of the rural residents of Southern Manitoba.

The thesis objectives were to a) create environmental health indicators (EHIs) of the use and risk of crop farming pesticides; b) conduct an epidemiological study of the association between the pesticide EHIs and health outcomes, in rural crop farming areas of Manitoba. Pesticide indicators included the average annualized percent of Census Consolidated Subdivision land acreage where any pesticides, herbicides, fungicides, or insecticides were applied as well as an indicator of pesticide risk. In multilevel models, the use of insecticides was significantly associated with perinatal conditions (males: OR=1.08, p=0.005; females: OR=1.07, p=0.01), congenital anomalies in males (OR=1.04, p=0.04), and eye disorders (males: OR=1.03, p<0.001; females: OR=1.02, p=0.012). Eye disorders in males were also significantly associated with the use of any pesticide (OR=1.001, p<0.001) and pesticide risk (OR=1.06, p<0.001). Regular pesticide use in crop farming, especially insecticides, may be adversely affecting the health of the rural residents of Southern Manitoba.