Jo Geere - Academia.edu (original) (raw)

Papers by Jo Geere

Research paper thumbnail of Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review-0

<b>Copyright information:</b>Taken from "Power grip, pinch grip, manual muscle t... more <b>Copyright information:</b>Taken from "Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review"http://www.biomedcentral.com/1471-2474/8/114BMC Musculoskeletal Disorders 2007;8():114-114.Published online 20 Nov 2007PMCID:PMC2213649. values.

Research paper thumbnail of s response to reviews Title : Domestic water carrying and its implications for health : a review and mixed methods pilot study in Limpopo Province , South Africa

Please find below our further responses to referees comments, in blue. As you say many of the com... more Please find below our further responses to referees comments, in blue. As you say many of the comments from Moe were made previously by the other two referees and have already been addressed in our previous revision.

Research paper thumbnail of Neurodynamics: Don't be scared of the upper quarter

Research paper thumbnail of Health impacts of water carriage

Research paper thumbnail of Men can make a significant difference to maternal and child health indicators by fetching water when it is located away from home

Research paper thumbnail of Drawers of water for life, but not for health : how water carriage is associated with the health of water carriers

Research paper thumbnail of Personal history of water carriage is associated with self-reported pain location and ratings of general health

Research paper thumbnail of The HPC audit: a personal perspective

Research paper thumbnail of Fair dinkum data for access to water:How should we engage communities to take part in generating and managing data which will benefit them directly and fairly?

Research paper thumbnail of Advancing urban water security: The urbanization of water–society relations and entry–points for political engagement

Water International, 2021

We seek to advance a critical and relational concept of urban water security that theorizes urban... more We seek to advance a critical and relational concept of urban water security that theorizes urban processes in relation to the hydro-social dynamics that produce experiences of water securities and insecurities at multiple scales. Our intention is to set out an analytical framework that both examines the social relations that underpin water insecurity and goes beyond the urban as merely the context in which water provision and risk take place. We seek to mobilize this concept to envision meaningful water policies and hydro-social practices to enhance social equity and empowerment for urban communities.

Research paper thumbnail of Psychedelics and Mindfulness: A Systematic Review and Meta-Analysis

Background and Aims: The benefits of classic serotonergic psychedelics (e.g. psilocybin, LSD, DMT... more Background and Aims: The benefits of classic serotonergic psychedelics (e.g. psilocybin, LSD, DMT, ayahuasca) are becoming more widely known with the resurgence in research in the past decade. Furthermore, the benefits of mindfulness are well documented. However, no systematic reviews have examined linkage of mindfulness and psychedelics use. The aim of this systematic review is to explore the link between psychedelics and characteristics of mindfulness. Methods: We conducted a systematic search across multiple databases, inclusive of grey literature and backwards/forward-citation tracking, on the 18 January 2021. The search strategy included terms relating to mindfulness and psychedelics, with no restriction on clinical or non-clinical conditions. Study quality was assessed. An exploratory random-effects meta-analysis was conducted on pre-post mindfulness data relative to psychedelic ingestion. Results: Of 1805 studies screened, 13 were included in the systematic review. There was ...

Research paper thumbnail of Water security in two megacities: observations on public actions during 2020 in São Paulo and London

Water International, 2021

ABSTRACT This paper discusses water security and wellbeing within a public health perspective and... more ABSTRACT This paper discusses water security and wellbeing within a public health perspective and focuses on urban areas with high population density. It analyses access to safe water and the multiple challenges to water security in two megacities: São Paulo and London, comparing differences and similarities. It illustrates how water security and health are related to Agenda 2030 Sustainable Development Goal 6 (SDG6): universal and equitable access to safe drinking water, sanitation, and hygiene, and SDG3: healthy lives and well-being for all, focusing on the problem exacerbated by the context of the COVID-19 pandemic, during 2020.

Research paper thumbnail of Water insecurity compounds the global coronavirus crisis

Water International, 2020

In recent weeks, people all over the world have been settling into a 'new normal' of restricted m... more In recent weeks, people all over the world have been settling into a 'new normal' of restricted mobility, online working, social distancing and enhanced hand hygiene. As part of the global fight against the spread of COVID-19 (the illness caused by SARS-CoV-2), we are repeatedly reminded by public health authorities that frequent and thorough hand-washing with soap and water is one of the best ways of limiting transmission. The rationale behind this is clear: washing regularly and thoroughly physically degrades and removes viral particles from hands, and therefore lowers the likelihood of infection transmission. Many health agencies are recommending washing hands for a minimum of 20 seconds up to 8-10 times per day. If washed in running water, the average hand basin tap uses 2-3 litres per minute, which implies a total water requirement of 8-10 litres of clean water per person per day, as well as appropriate soap and drying facilities (i.e. not a reused and possibly contaminated towel or rag). Achieving clean hands is not difficult in wealthier households that have long enjoyed water services so reliable that they have stopped thinking much about it. But if handwashing is so important to the fight against COVID-19, what does this mean for the many people around the world who do not have access to a sufficient and secure supply of safe water to support this life-critical activity? According to UNICEF and WHO (2019), as many as one in three of the world's people do not enjoy access to safe and reliable water services, and 3 billion people across the world do not have basic hand-washing facilities (soap and water) in their home. Research published by the Household Water Insecurity Experiences (HWISE) Research Coordination Network shows that rates of household water insecurity vary greatly between and within developing nations, with urban and rural areas often faring quite differently (Young et al., 2019). This research also reveals that many households depend on multiple sources of water, including tap stands CONTACT C.

Research paper thumbnail of Users' experiences of physiotherapy treatment in a semi-urban public hospital in Kenya

Rural and Remote Health, 2013

Introduction: Physiotherapy practice in Africa faces a number of challenges, one of which is the ... more Introduction: Physiotherapy practice in Africa faces a number of challenges, one of which is the limited number of therapists in most public hospitals. In Africa, physiotherapy is still mainly institution based with very little community-based practice, leading to lack of access to services for a large part of the population. This study explores users' perceptions of physiotherapy, challenges faced by users, possible options for management, and determines whether current physiotherapy practice in a rural Kilifi District general hospital in Kenya facilitates future self-management of chronic conditions. Methods: Eight in-depth interviews, 3 focus groups discussions and 4 participant observations were conducted for data collection. All interviews and focus group discussions were recorded using a digital recorder, transcribed into the Swahili language and then translated into English. The transcriptions were imported to NVivo 9 (www.qsrinternational.com) for management and storage. Inductive data analysis was used to generate themes from the rich-text data of the transcriptions. Results: Many of the users perceived physiotherapy as being effective. Challenges included distance from health facilities, negative experiences with some therapists, and lack of staff and equipment. Rehabilitation options included community-and home-based programs fostering self-management of chronic conditions. Current hospital practice lacks emphasis on self-management skills for patients with chronic conditions who can do their physiotherapy at home. Conclusions: Users' experiences of physiotherapy treatment in this rural hospital indicate that a host of challenges exist. In the face of these challenges, the needs of the users seemed to be compromised, especially those with chronic conditions. Rehabilitation services that are accessible and affordable would be better options in rural and low-resource settings. There is therefore need for © JK Gona, CR Newton, J-A Geere, S Hartley, 2013. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2 community-based services that place emphasis on self-management of chronic conditions for fostering better health outcomes in rural communities.

Research paper thumbnail of The association of water carriage, water supply and sanitation usage with maternal and child health. A combined analysis of 49 Multiple Indicator Cluster Surveys from 41 countries

International Journal of Hygiene and Environmental Health, 2019

Background: Millions of people carry water home from off-plot sources each day and lack improved ... more Background: Millions of people carry water home from off-plot sources each day and lack improved sanitation. Research on the health outcomes associated with water fetching is limited, and with usage of improved sanitation is inconclusive. Objectives: To analyse the association of water fetching, unimproved water supplies, and usage of improved sanitation facilities with indicators of women's and children's health. Methods: 49 Multiple Indicator Cluster Surveys from 41 countries were merged, creating a data set of 2,740,855 people from 539,915 households. Multilevel, multivariable analyses were conducted, using logistic regression for binary outcomes, negative binomial regression for count data and ordinary linear regression for linear data. We adjusted for confounding factors and accounted for clustering at survey, cluster and household level. Results: Compared to households in which no-one collects water, water fetching by any household member is associated with reduced odds of a woman giving birth in a health care facility (OR 0.88 to 0.90). Adults collecting water is associated with increased relative risk of childhood death (RR 1.04 to 1.05), children collecting water is associated with increased odds of diarrheal disease (OR 1.10 to 1.13) and women or girls collecting water is associated with reduced uptake of antenatal care (β-0.04 to −0.06) and increased odds of leaving a child under five alone for one or more hours, one or more days per week (OR 1.07 to 1.16). Unimproved water supply is associated with childhood diarhhoea (OR 1.05), but not child deaths, or growth scores. When the percentage of people using improved sanitation is more than 80% an association with reduced childhood death and stunting was observed, and when more than 60%, usage of improved sanitation was associated with reduction of diarhhoea and acute undernutrition. Conclusion: Fetching water is associated with poorer maternal and child health outcomes, depending on who collects water. The percentage of people using improved sanitation seems to be more important than type of toilet facility, and must be high to observe an association with reduced child deaths and diarhhoea. Water access on premises, and near universal usage of improved sanitation, is associated with improvements to maternal and child health. services, or usage of different types of water source and toilet facilities, should not or will not disadvantage specific individuals or households. In 2017, 785 million people still lacked even a basic drinking water service, defined as one requiring less than a 30 min round trip to fetch water from an improved source. Out of the people lacking a basic service, 206 million people spent over 30 min per round trip to collect water from an improved source (defined as a limited drinking water service) and the remainder relied on unimproved (435 million) or surface water sources (144 million), which most often also require more

Research paper thumbnail of Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam

Journal of global health, 2018

The Sustainable Development Goals include commitments to end poverty, and promote education for a... more The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household's water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence. We report the first large study of the health impacts of carrying water on women and children. A cross-sectional survey was conducted in South Africa, Ghana and Vietnam during 2012. It investigated water carrying methods and health status. Because areas of self-reported pain were correlated we undertook factor analysis of sites of reported pain, to interpret patterns of pain reporting. Regression analysis using Gene...

Research paper thumbnail of A time for action: Opportunities for preventing the growing burden and disability from musculoskeletal conditions in low- and middle-income countries

Best Practice & Research Clinical Rheumatology, 2014

information and evidence base; and reducing the incidence and disability of MSK conditions throug... more information and evidence base; and reducing the incidence and disability of MSK conditions through better prevention. Each of these elements is necessary to mitigate and reduce the growing burden from the MSKs.

Research paper thumbnail of Public Health and Social Benefits of At-House Water Supplies

Research paper thumbnail of Domestic water carrying and its implications for health: A review and mixed methods pilot study in Limpopo Province, South Africa

Environmental Health: A Global Access Science Source, 2010

Background: Lack of access to safe water remains a significant risk factor for poor health in dev... more Background: Lack of access to safe water remains a significant risk factor for poor health in developing countries. There has been little research into the health effects of frequently carrying containers of water. The aims of this study were to better understand how domestic water carrying is performed, identify potential health risk factors and gain insight into the possible health effects of the task. Methods: Mixed methods of data collection from six were used to explore water carrying performed by people in six rural villages of Limpopo Province, South Africa. Data was collected through semi-structured interviews and through observation and measurement. Linear regression modelling were used to identify significant correlations between potential risk factors and rating of perceived exertion (RPE) or self reported pain. Independent t-tests were used to compare the mean values of potential risk factors and RPE between subgroups reporting pain and those not reporting pain. Results: Water carrying was mainly performed by women or children carrying containers on their head (mean container weight 19.5 kg) over a mean distance of 337 m. The prevalence of spinal (neck or back) pain was 69% and back pain was 38%. Of participants who carried water by head loading, the distance walked by those who reported spinal pain was significantly less than those who did not (173 m 95%CI 2-343; p = 0.048). For head loaders reporting head or neck pain compared to those who did not, the differences in weight of water carried (4.6 kg 95%CI-9.7-0.5; p = 0.069) and RPE (2.5 95%CI-5.1-0.1; p = 0.051) were borderline statistically significant. For head loaders, RPE was significantly correlated with container weight (r = 0.52; p = 0.011) and incline (r = 0.459; p = 0.018) Conclusions: Typical water carrying methods impose physical loading with potential to produce musculoskeletal disorders and related disability. This exploratory study is limited by a small sample size and future research should aim to better understand the type and strength of association between water carrying and health, particularly musculoskeletal disorders. However, these preliminary findings suggest that efforts should be directed toward eliminating the need for water carrying, or where it must continue, identifying and reducing risk factors for musculoskeletal disorders and physical injury.

Research paper thumbnail of The diagnostic accuracy of MRI for the detection of partial- and full-thickness rotator cuff tears in adults

Magnetic Resonance Imaging, 2012

This review concluded that magnetic resonance imaging (MRI) had excellent accuracy for the detect... more This review concluded that magnetic resonance imaging (MRI) had excellent accuracy for the detection of fullthickness rotator cuff tears, but was less accurate for partial-thickness tears. The authors also concluded that higher field strength (3.0T) MRI systems were more accurate. These conclusions appear to be an over interpretation of the data presented. Authors' objectives To assess the diagnostic test accuracy of magnetic resonance imaging (MRI) in the detection of partial-and fullthickness rotator cuff tears in adults. Searching Several sources were searched from inception to May 2011 including Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and Zetoc. Grey literature was searched using the following databases: OpenSIGLE, International Clinical Trials Registry Platform, Current Controlled Trials, UKCRN Portfolio Database, National Technical Information Service and the UK National Research Register Archive. An example search strategy was reported. Experts in the field were contacted and the bibliographies of retrieved articles were screened for additional studies. Study selection Studies of any design that assessed the accuracy of MRI for diagnosing rotator cuff (supraspinatus, infraspinatus, teres minor, subscapularis) tear pathology in adults were eligible for inclusion. Studies were required to use to either arthroscopic or open surgical findings as the reference standard to confirm diagnosis. Studies that solely assessed the diagnostic test accuracy of magnetic resonance arthrography were excluded. The mean age of study participants was 47.8 years. Approximately half of the included studies used MRI field strength of 1.5T; field strengths ranged from 0.5 to 3.0T. Approximately half of the included studies reported that MRI examinations were reviewed by one or more specialist musculoskeletal radiologists. The time elapsing between MRI examination and reference standard confirmation ranged from less than two weeks to 3.8 months. One reviewer screened retrieved titles and abstracts for relevance. The full texts of potentially eligible studies were assessed for inclusion by one reviewer and independently checked by two other reviewers. Assessment of study quality The methodological quality of included studies was assessed using the 14-item QUADAS tool. Two reviewers independently assessed study quality and assessments were checked by a third reviewer. Disagreements were resolved by discussion. Data extraction Numbers of true positive, false negative, false positive and true negative MRI results were extracted. These data were used to calculate separate sensitivity and specificity values, with 95% confidence intervals (CIs) for the detection of partial-and full-thickness rotator cuff tears. Data were extracted by one reviewer and checked by a second reviewer. Study authors were contacted for additional information where necessary.

Research paper thumbnail of Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review-0

<b>Copyright information:</b>Taken from "Power grip, pinch grip, manual muscle t... more <b>Copyright information:</b>Taken from "Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review"http://www.biomedcentral.com/1471-2474/8/114BMC Musculoskeletal Disorders 2007;8():114-114.Published online 20 Nov 2007PMCID:PMC2213649. values.

Research paper thumbnail of s response to reviews Title : Domestic water carrying and its implications for health : a review and mixed methods pilot study in Limpopo Province , South Africa

Please find below our further responses to referees comments, in blue. As you say many of the com... more Please find below our further responses to referees comments, in blue. As you say many of the comments from Moe were made previously by the other two referees and have already been addressed in our previous revision.

Research paper thumbnail of Neurodynamics: Don't be scared of the upper quarter

Research paper thumbnail of Health impacts of water carriage

Research paper thumbnail of Men can make a significant difference to maternal and child health indicators by fetching water when it is located away from home

Research paper thumbnail of Drawers of water for life, but not for health : how water carriage is associated with the health of water carriers

Research paper thumbnail of Personal history of water carriage is associated with self-reported pain location and ratings of general health

Research paper thumbnail of The HPC audit: a personal perspective

Research paper thumbnail of Fair dinkum data for access to water:How should we engage communities to take part in generating and managing data which will benefit them directly and fairly?

Research paper thumbnail of Advancing urban water security: The urbanization of water–society relations and entry–points for political engagement

Water International, 2021

We seek to advance a critical and relational concept of urban water security that theorizes urban... more We seek to advance a critical and relational concept of urban water security that theorizes urban processes in relation to the hydro-social dynamics that produce experiences of water securities and insecurities at multiple scales. Our intention is to set out an analytical framework that both examines the social relations that underpin water insecurity and goes beyond the urban as merely the context in which water provision and risk take place. We seek to mobilize this concept to envision meaningful water policies and hydro-social practices to enhance social equity and empowerment for urban communities.

Research paper thumbnail of Psychedelics and Mindfulness: A Systematic Review and Meta-Analysis

Background and Aims: The benefits of classic serotonergic psychedelics (e.g. psilocybin, LSD, DMT... more Background and Aims: The benefits of classic serotonergic psychedelics (e.g. psilocybin, LSD, DMT, ayahuasca) are becoming more widely known with the resurgence in research in the past decade. Furthermore, the benefits of mindfulness are well documented. However, no systematic reviews have examined linkage of mindfulness and psychedelics use. The aim of this systematic review is to explore the link between psychedelics and characteristics of mindfulness. Methods: We conducted a systematic search across multiple databases, inclusive of grey literature and backwards/forward-citation tracking, on the 18 January 2021. The search strategy included terms relating to mindfulness and psychedelics, with no restriction on clinical or non-clinical conditions. Study quality was assessed. An exploratory random-effects meta-analysis was conducted on pre-post mindfulness data relative to psychedelic ingestion. Results: Of 1805 studies screened, 13 were included in the systematic review. There was ...

Research paper thumbnail of Water security in two megacities: observations on public actions during 2020 in São Paulo and London

Water International, 2021

ABSTRACT This paper discusses water security and wellbeing within a public health perspective and... more ABSTRACT This paper discusses water security and wellbeing within a public health perspective and focuses on urban areas with high population density. It analyses access to safe water and the multiple challenges to water security in two megacities: São Paulo and London, comparing differences and similarities. It illustrates how water security and health are related to Agenda 2030 Sustainable Development Goal 6 (SDG6): universal and equitable access to safe drinking water, sanitation, and hygiene, and SDG3: healthy lives and well-being for all, focusing on the problem exacerbated by the context of the COVID-19 pandemic, during 2020.

Research paper thumbnail of Water insecurity compounds the global coronavirus crisis

Water International, 2020

In recent weeks, people all over the world have been settling into a 'new normal' of restricted m... more In recent weeks, people all over the world have been settling into a 'new normal' of restricted mobility, online working, social distancing and enhanced hand hygiene. As part of the global fight against the spread of COVID-19 (the illness caused by SARS-CoV-2), we are repeatedly reminded by public health authorities that frequent and thorough hand-washing with soap and water is one of the best ways of limiting transmission. The rationale behind this is clear: washing regularly and thoroughly physically degrades and removes viral particles from hands, and therefore lowers the likelihood of infection transmission. Many health agencies are recommending washing hands for a minimum of 20 seconds up to 8-10 times per day. If washed in running water, the average hand basin tap uses 2-3 litres per minute, which implies a total water requirement of 8-10 litres of clean water per person per day, as well as appropriate soap and drying facilities (i.e. not a reused and possibly contaminated towel or rag). Achieving clean hands is not difficult in wealthier households that have long enjoyed water services so reliable that they have stopped thinking much about it. But if handwashing is so important to the fight against COVID-19, what does this mean for the many people around the world who do not have access to a sufficient and secure supply of safe water to support this life-critical activity? According to UNICEF and WHO (2019), as many as one in three of the world's people do not enjoy access to safe and reliable water services, and 3 billion people across the world do not have basic hand-washing facilities (soap and water) in their home. Research published by the Household Water Insecurity Experiences (HWISE) Research Coordination Network shows that rates of household water insecurity vary greatly between and within developing nations, with urban and rural areas often faring quite differently (Young et al., 2019). This research also reveals that many households depend on multiple sources of water, including tap stands CONTACT C.

Research paper thumbnail of Users' experiences of physiotherapy treatment in a semi-urban public hospital in Kenya

Rural and Remote Health, 2013

Introduction: Physiotherapy practice in Africa faces a number of challenges, one of which is the ... more Introduction: Physiotherapy practice in Africa faces a number of challenges, one of which is the limited number of therapists in most public hospitals. In Africa, physiotherapy is still mainly institution based with very little community-based practice, leading to lack of access to services for a large part of the population. This study explores users' perceptions of physiotherapy, challenges faced by users, possible options for management, and determines whether current physiotherapy practice in a rural Kilifi District general hospital in Kenya facilitates future self-management of chronic conditions. Methods: Eight in-depth interviews, 3 focus groups discussions and 4 participant observations were conducted for data collection. All interviews and focus group discussions were recorded using a digital recorder, transcribed into the Swahili language and then translated into English. The transcriptions were imported to NVivo 9 (www.qsrinternational.com) for management and storage. Inductive data analysis was used to generate themes from the rich-text data of the transcriptions. Results: Many of the users perceived physiotherapy as being effective. Challenges included distance from health facilities, negative experiences with some therapists, and lack of staff and equipment. Rehabilitation options included community-and home-based programs fostering self-management of chronic conditions. Current hospital practice lacks emphasis on self-management skills for patients with chronic conditions who can do their physiotherapy at home. Conclusions: Users' experiences of physiotherapy treatment in this rural hospital indicate that a host of challenges exist. In the face of these challenges, the needs of the users seemed to be compromised, especially those with chronic conditions. Rehabilitation services that are accessible and affordable would be better options in rural and low-resource settings. There is therefore need for © JK Gona, CR Newton, J-A Geere, S Hartley, 2013. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2 community-based services that place emphasis on self-management of chronic conditions for fostering better health outcomes in rural communities.

Research paper thumbnail of The association of water carriage, water supply and sanitation usage with maternal and child health. A combined analysis of 49 Multiple Indicator Cluster Surveys from 41 countries

International Journal of Hygiene and Environmental Health, 2019

Background: Millions of people carry water home from off-plot sources each day and lack improved ... more Background: Millions of people carry water home from off-plot sources each day and lack improved sanitation. Research on the health outcomes associated with water fetching is limited, and with usage of improved sanitation is inconclusive. Objectives: To analyse the association of water fetching, unimproved water supplies, and usage of improved sanitation facilities with indicators of women's and children's health. Methods: 49 Multiple Indicator Cluster Surveys from 41 countries were merged, creating a data set of 2,740,855 people from 539,915 households. Multilevel, multivariable analyses were conducted, using logistic regression for binary outcomes, negative binomial regression for count data and ordinary linear regression for linear data. We adjusted for confounding factors and accounted for clustering at survey, cluster and household level. Results: Compared to households in which no-one collects water, water fetching by any household member is associated with reduced odds of a woman giving birth in a health care facility (OR 0.88 to 0.90). Adults collecting water is associated with increased relative risk of childhood death (RR 1.04 to 1.05), children collecting water is associated with increased odds of diarrheal disease (OR 1.10 to 1.13) and women or girls collecting water is associated with reduced uptake of antenatal care (β-0.04 to −0.06) and increased odds of leaving a child under five alone for one or more hours, one or more days per week (OR 1.07 to 1.16). Unimproved water supply is associated with childhood diarhhoea (OR 1.05), but not child deaths, or growth scores. When the percentage of people using improved sanitation is more than 80% an association with reduced childhood death and stunting was observed, and when more than 60%, usage of improved sanitation was associated with reduction of diarhhoea and acute undernutrition. Conclusion: Fetching water is associated with poorer maternal and child health outcomes, depending on who collects water. The percentage of people using improved sanitation seems to be more important than type of toilet facility, and must be high to observe an association with reduced child deaths and diarhhoea. Water access on premises, and near universal usage of improved sanitation, is associated with improvements to maternal and child health. services, or usage of different types of water source and toilet facilities, should not or will not disadvantage specific individuals or households. In 2017, 785 million people still lacked even a basic drinking water service, defined as one requiring less than a 30 min round trip to fetch water from an improved source. Out of the people lacking a basic service, 206 million people spent over 30 min per round trip to collect water from an improved source (defined as a limited drinking water service) and the remainder relied on unimproved (435 million) or surface water sources (144 million), which most often also require more

Research paper thumbnail of Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam

Journal of global health, 2018

The Sustainable Development Goals include commitments to end poverty, and promote education for a... more The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household's water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence. We report the first large study of the health impacts of carrying water on women and children. A cross-sectional survey was conducted in South Africa, Ghana and Vietnam during 2012. It investigated water carrying methods and health status. Because areas of self-reported pain were correlated we undertook factor analysis of sites of reported pain, to interpret patterns of pain reporting. Regression analysis using Gene...

Research paper thumbnail of A time for action: Opportunities for preventing the growing burden and disability from musculoskeletal conditions in low- and middle-income countries

Best Practice & Research Clinical Rheumatology, 2014

information and evidence base; and reducing the incidence and disability of MSK conditions throug... more information and evidence base; and reducing the incidence and disability of MSK conditions through better prevention. Each of these elements is necessary to mitigate and reduce the growing burden from the MSKs.

Research paper thumbnail of Public Health and Social Benefits of At-House Water Supplies

Research paper thumbnail of Domestic water carrying and its implications for health: A review and mixed methods pilot study in Limpopo Province, South Africa

Environmental Health: A Global Access Science Source, 2010

Background: Lack of access to safe water remains a significant risk factor for poor health in dev... more Background: Lack of access to safe water remains a significant risk factor for poor health in developing countries. There has been little research into the health effects of frequently carrying containers of water. The aims of this study were to better understand how domestic water carrying is performed, identify potential health risk factors and gain insight into the possible health effects of the task. Methods: Mixed methods of data collection from six were used to explore water carrying performed by people in six rural villages of Limpopo Province, South Africa. Data was collected through semi-structured interviews and through observation and measurement. Linear regression modelling were used to identify significant correlations between potential risk factors and rating of perceived exertion (RPE) or self reported pain. Independent t-tests were used to compare the mean values of potential risk factors and RPE between subgroups reporting pain and those not reporting pain. Results: Water carrying was mainly performed by women or children carrying containers on their head (mean container weight 19.5 kg) over a mean distance of 337 m. The prevalence of spinal (neck or back) pain was 69% and back pain was 38%. Of participants who carried water by head loading, the distance walked by those who reported spinal pain was significantly less than those who did not (173 m 95%CI 2-343; p = 0.048). For head loaders reporting head or neck pain compared to those who did not, the differences in weight of water carried (4.6 kg 95%CI-9.7-0.5; p = 0.069) and RPE (2.5 95%CI-5.1-0.1; p = 0.051) were borderline statistically significant. For head loaders, RPE was significantly correlated with container weight (r = 0.52; p = 0.011) and incline (r = 0.459; p = 0.018) Conclusions: Typical water carrying methods impose physical loading with potential to produce musculoskeletal disorders and related disability. This exploratory study is limited by a small sample size and future research should aim to better understand the type and strength of association between water carrying and health, particularly musculoskeletal disorders. However, these preliminary findings suggest that efforts should be directed toward eliminating the need for water carrying, or where it must continue, identifying and reducing risk factors for musculoskeletal disorders and physical injury.

Research paper thumbnail of The diagnostic accuracy of MRI for the detection of partial- and full-thickness rotator cuff tears in adults

Magnetic Resonance Imaging, 2012

This review concluded that magnetic resonance imaging (MRI) had excellent accuracy for the detect... more This review concluded that magnetic resonance imaging (MRI) had excellent accuracy for the detection of fullthickness rotator cuff tears, but was less accurate for partial-thickness tears. The authors also concluded that higher field strength (3.0T) MRI systems were more accurate. These conclusions appear to be an over interpretation of the data presented. Authors' objectives To assess the diagnostic test accuracy of magnetic resonance imaging (MRI) in the detection of partial-and fullthickness rotator cuff tears in adults. Searching Several sources were searched from inception to May 2011 including Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and Zetoc. Grey literature was searched using the following databases: OpenSIGLE, International Clinical Trials Registry Platform, Current Controlled Trials, UKCRN Portfolio Database, National Technical Information Service and the UK National Research Register Archive. An example search strategy was reported. Experts in the field were contacted and the bibliographies of retrieved articles were screened for additional studies. Study selection Studies of any design that assessed the accuracy of MRI for diagnosing rotator cuff (supraspinatus, infraspinatus, teres minor, subscapularis) tear pathology in adults were eligible for inclusion. Studies were required to use to either arthroscopic or open surgical findings as the reference standard to confirm diagnosis. Studies that solely assessed the diagnostic test accuracy of magnetic resonance arthrography were excluded. The mean age of study participants was 47.8 years. Approximately half of the included studies used MRI field strength of 1.5T; field strengths ranged from 0.5 to 3.0T. Approximately half of the included studies reported that MRI examinations were reviewed by one or more specialist musculoskeletal radiologists. The time elapsing between MRI examination and reference standard confirmation ranged from less than two weeks to 3.8 months. One reviewer screened retrieved titles and abstracts for relevance. The full texts of potentially eligible studies were assessed for inclusion by one reviewer and independently checked by two other reviewers. Assessment of study quality The methodological quality of included studies was assessed using the 14-item QUADAS tool. Two reviewers independently assessed study quality and assessments were checked by a third reviewer. Disagreements were resolved by discussion. Data extraction Numbers of true positive, false negative, false positive and true negative MRI results were extracted. These data were used to calculate separate sensitivity and specificity values, with 95% confidence intervals (CIs) for the detection of partial-and full-thickness rotator cuff tears. Data were extracted by one reviewer and checked by a second reviewer. Study authors were contacted for additional information where necessary.