Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle-income contexts.

BACKGROUND: Qualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs). METHODS: We conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted. RESULTS: One hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%). CONCLUSIONS: A reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.

Increased prevalence of idiopathic scoliosis in patients treated for childhood haematopoietic malignancy.

AIMS: The aim of this study was to determine whether there is an increased prevalence of scoliosis in patients who have suffered from a haematopoietic malignancy in childhood. METHODS: Patients with a history of lymphoma or leukaemia with a current age between 12 and 25 years were identified from the regional paediatric oncology database. The medical records and radiological findings were reviewed, and any spinal deformity identified. The treatment of the malignancy and the spinal deformity, if any, was noted. RESULTS: From a cohort of 346 patients, 19 (5.5%) had radiological evidence of scoliosis, defined as a Cobb angle of > 10°. A total of five patients (1.4% of the total cohort) had a Cobb angle of > 40°, all of whom had corrective surgery. No patient with scoliosis had other pathology as a possible cause of the scoliosis and all had been treated with high doses of steroids for leukaemia, either acute or chronic myeloid, or acute lymphoblastic. CONCLUSION: There is an increased prevalence of idiopathic-like scoliosis and larger curves (Cobb angle of > 40°) associated with childhood leukaemia, which has not been previously reported in the literature. Causative factors may relate to the underlying disease process and/or its treatment. Cite this article: Bone Joint J 2021;103-B(8):1400-1404.

The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: an observational study.

OBJECTIVE: To investigate whether amateur golfers with self-reported low back pain have reduced hip rotation compared to asymptomatic controls. DESIGN: Observational case-control study. SETTING: Data collection took place at 2 amateur golf clubs in southern England. PARTICIPANTS: On initial contact, all participants completed a screening questionnaire used to allocate participants into LBP (n=28) and control groups (n=36). LBP group were found to be heavier than controls (t=2.242, 95% CI 0.763-13.332) but were matched for age, height, handedness, handicap, rounds played per week and years of play. MAIN OUTCOME MEASURES: Primary outcome measures were lead and non-lead hip medial and lateral rotation in 0 degrees of flexion as measured by inclinometer. Secondary measures included inter and intra-rater reliability. RESULTS: The LBP group had significantly reduced lead hip passive (LBP 21.14+/-10.17 degrees; controls 31.06+/-8.06 degrees, t=-4.228, 95% CI -14.621--5.205) and lead hip active medial rotation (LBP 21.46+/-10.01; controls 28.06+/-7.49 degrees, t=-2.908, 95% CI -11.147--2.036) compared to controls. No between group differences were found in non-lead hips or any passive or active lateral rotation measures. CONCLUSION: Although there is lack of causality between LBP and hip rotation, the deficit in lead leg medial hip rotation in amateur golfers who suffer LBP may be relevant for screening or treatment selection.