Jo-Anne Geere

@article{d00e1c1a50db455fa1e6a346d8f5288c,

title = {The impact of extreme weather events on primary healthcare facilities in Vietnam: results from a cross-sectional survey of 128 commune health centers affected by Super Typhoon Yagi (2024)},

author = {Do Thi Hanh Trang and Hoang Van Minh and Tran Thi Tuyet Hanh and Le Thi Thanh Huong and Jo-Anne Geere and Brahim Herbane and Paul Hutchings and Mike Vanderes and Duong Duc Thien and Do Manh Cuong and Nguyen Huy Minh and Nguyen Quynh Anh and Ho Thi Tu and Paul Hunter},

doi = {10.21037/jphe},

year  = {2026},

date = {2026-05-19},

journal = {Journal of Public Health and Emergency},

volume = {10},

abstract = {Background: Health system resilience is crucial for minimizing mortality and morbidity during emergencies and extreme weather events (EWEs). Vietnam is among the countries with the highest disaster risk globally. However, evidence on the immediate impacts of EWEs on grassroots primary healthcare facilities remains limited. This study aimed to investigate the immediate impacts of super Typhoon Yagi (7-9 September 2024) on various aspects of commune health centers (CHCs) across the 10 most severely affected provinces in northern Vietnam. Methods: A cross-sectional survey using a structured, self-administered questionnaire was conducted in December 2024 with 128 CHCs most severely affected, accounted for 6.9% of the total CHCs in the 10 selected provinces. The survey assessed damage to infrastructure, the healthcare workforce capacity, and service delivery within one-week following Typhoon Yagi. Results: Typhoon Yagi caused widespread infrastructure damage, with 27.3% to 52.3% of CHCs reporting physical impacts across service areas. Severe damage or destruction was most frequent in utility systems, including clean water tanks (10.8%) and lighting (14.0%). One-quarter (25.8%) of CHCs reported staff shortages due to absenteeism, while 51.4% noted mental health impacts on workers. Service delivery was significantly hampered: 40.6% of CHCs lost electricity and 39.8% experienced complete communication failure. Consequently, about a half of the facilities reported interruptions in important curative services, and 13.4% saw severe or complete disruption of vaccination services. There were strong associations between infrastructure damage and impacts on key clinical and preventive services and reduced staff presence. Conclusions: While the study focuses on an extreme scenario by sampling the most severely impacted CHCs, the findings highlight acute vulnerabilities in CHC infrastructure and workforce stability, which resulted in critically limited service delivery under maximum stress. These results reflect localized gaps in disaster preparedness rather than nationwide deficiencies; however, they serve as a critical “stress test” for the primary healthcare system. Strengthening resilience must be prioritized, particularly in high-risk regions, to ensure service continuity amidst Vietnam’s ongoing administrative restructuring.},

note = {Data Sharing Statement: Available at https://jphe.amegroups.com/article/view/10.21037/jphe-2026-1-00},

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pubstate = {published},

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}

@article{dc5d08f8c7144b28bbb7e8a82f7c8897,

title = {Extreme weather impacts on health services and communities in lower income countries : A thematic systematic review},

author = {Julii Brainard and Yovitha Sedekia and Natalia R. Jones and Michael Matte and Patrick Sunday and Deborah Watson-Jones and Daniel Dennis Mapemba and Severin A Kabakama and Edgar Mugema Mulogo and Moses Ntaro and Hanh Thi Tran and Paul Hunter and Jo-Anne Geere},

issn = {0035-9203},

year  = {2026},

date = {2026-01-12},

journal = {Transactions of the Royal Society of Tropical Medicine and Hygiene},

publisher = {Elsevier},

abstract = {Background Most previous research about the dangers of extreme weather events was applicable to populations in high income countries. Data summarising harms related to extreme weather events in lower income settings are lacking. Methods A systematic review thematically summarised evidence about weather-event-linked harms and responses in low- and lower-middle income countries. Peer review and grey literature were systematically searched and selected. Data were extracted about harms, responses and outcomes relevant to six WHO Building Blocks of health care systems. Framework analysis was used to identify predominant themes related to harms, responses and the WHO Building Blocks. Results Included reports numbered 183. Flooding and high winds were the most common type of extreme weather event documented. The main community experience themes identified were displacement of populations and disruption. The main themes identified for health service delivery were: Vulnerability, Disruption and Resilience. Documented examples of resilience or recovery were far fewer for all six WHO healthcare system Building Blocks than descriptions of vulnerability and disruption. Conclusions Extreme weather events can be highly disruptive and harmful to health care systems and communities in LMIC settings that are often already highly vulnerable.},

note = {Data availability: The data matrices are are available as Supplementary file S1 at https://osf.io/c95xq/files.},

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pubstate = {published},

tppubtype = {article}

}

@article{c959a326ed0d4fe58c66db7b49dabb0f,

title = {Prevalence and patterns of gender-based violence among adolescent girls fetching water in peri-urban settings of Kinshasa, DR Congo},

author = {Jean-Marie Mukiese Nlunda and Jo-Anne Geere and Clémentine Biduaya Sangana and Joêl Nkiama Konde Konde and Guillaume Mbela Kiyombo},

doi = {10.2166/washdev.2024.155},

issn = {2043-9083},

year  = {2024},

date = {2024-08-01},

journal = {Journal of Water, Sanitation and Hygiene for Development},

volume = {14},

number = {8},

pages = {603–615},

publisher = {IWA Publishing},

abstract = {In water-scarcity contexts, girls fetching water are exposed to gender-based violence (GBV), for which prevalence, types, and forms were unknown in the Peri-Urban Settings of Kinshasa. A cross-sectional study using multi-stage random sampling technique to select 684 adolescent girls was conducted to assess the extent of water scarcity and GBV affecting adolescent girls while fetching water. Findings indicate that 98.2% of adolescent girls were dealing with water shortage; 99.9% experienced at least one type of GBV, of which 97.1, 95.5, and 44.9% experienced sexual, psychological, and physical violence, respectively. Moral violence was more frequent at water points; physical violence in the household, while sexual violence was prevalent on the water route. Adolescent girls' age, weekly involvement in water collection, and distance were found to be the main factors associated with GBV, whereas reducing the number of daily round-trips, the distance travelled, and time devoted to water collection were found to be mitigating factors limiting GBV experience among adolescent girls. Policies promoting the at-home provision of water and community awareness-raising interventions will mitigate the GBV incidence.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{d92f34267ae74cdb9091b205da9c14d7,

title = {The effects of Pilates exercise in comparison to other forms of exercise on pain and disability in individuals with chronic non-specific low back pain: A systematic review with meta-analysis},

author = {Chi Ming Wong and Bradley Rugg and Jo-Anne Geere},

doi = {10.1002/msc.1667},

issn = {1478-2189},

year  = {2023},

date = {2023-03-01},

journal = {Musculoskeletal Care},

volume = {21},

number = {1},

pages = {78–96},

publisher = {Wiley},

abstract = {Objective: To compare the effects of Pilates exercise (PE) with other forms of exercise on pain and disability in individuals with chronic non-specific low back pain (CNSLBP) and to inform clinical practice and future research. Study design: Systematic review with meta-analysis conducted and reported in line the Preferred Reporting Items for Systematic review and Meta-analysis. Literature search: Six electronic databases were searched from inception to April 2021. Study selection criteria: Randomised controlled trials (RCTs) comparing the effect of PE with other forms of exercise for adults with CNSLBP on pain and disability. Data synthesis: Two reviewers assessed the risk of bias of the trials, guided by the Cochrane RoB2 tool. Available data were extracted for meta-analysis with subgroup analysis. Pilates exercise was compared to general exercise (GE), direction-specific exercise (DSE) and spinal stabilisation exercise (SSE). Certainty of evidence was interpreted following the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Eleven RCTs were included. A low certainty of evidence supported PE was more effective than GE in pain reduction [Effect size (ES) 0.44]. Moreover, very low levels of certainty were revealed for effectiveness of PE compared with DSE for pain reduction (ES 0.65) and equivalence of PE and SSE for pain and disability. Conclusions: This review found no strong evidence for using one type of exercise intervention over another when managing patients with CNSLBP. Existing evidence does not allow this review to draw definitive recommendations. In the absence of a superior exercise form clinicians should work collaboratively with the patient, using the individual's goals and preferences to guide exercise selection. Further appropriately designed research is warranted to explore this topic further.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{cb4bbb28a77a48ad8a4d0dd76f30bc80,

title = {Psychedelics and mindfulness: A systematic review and meta-analysis},

author = {Chelsea Radakovic and Ratko Radakovic and Guy Peryer and Jo-Anne Geere},

doi = {10.1556/2054.2022.00218},

issn = {2559-9283},

year  = {2022},

date = {2022-09-23},

journal = {Journal of Psychedelic Studies},

volume = {6},

number = {2},

pages = {137–153},

publisher = {Akademiai Kiado},

abstract = {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 substantial variability in participant characteristics, psychedelic administration method and measurement of mindfulness. The ingestion of psychedelics is associated with an increase in mindfulness, specifically relating to domains of acceptance, which encompasses non-judgement of inner experience and non-reactivity. The meta-analysis of a subset of studies (N = 6) showed small effects overall relative to ayahuasca ingestion, increasing mindfulness facets of non-judgement of inner experience and non-reactivity, as well as acting with awareness. Conclusions: Further methodologically robust research is needed to elucidate the relationship between psychedelics and mindfulness. However, mindfulness and specific facets relating to acceptance have been shown to increase following ingestion of psychedelics in a number of studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{3d846b06483141a5be69914febfef18b,

title = {Water security in two megacities: Observations on public actions during 2020 in São Paulo and London},

author = {Estela Macedo Alves and Jo-Anne Geere and Mariana Gutierres Arteiro Da Paz and Pedro Roberto Jacobi and Edson Grandisoli and Samia Sullaiman},

doi = {10.1080/02508060.2021.1970376},

issn = {0250-8060},

year  = {2021},

date = {2021-01-01},

journal = {Water International},

volume = {46},

number = {6},

pages = {883–899},

publisher = {Routledge},

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},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{8324daa1dabc4f3aa423b8409bd4a3c5,

title = {Water insecurity compounds the global coronavirus crisis},

author = {Chad Staddon and M. Everard and Julie Mytton and T. Octavianti and W. Powell and N. Quinn and S. M. N. Uddin and S. L. Young and J. D. Miller and J. Budds and Jo-Anne Geere and Katie Meehan and K. Charles and E. V. J. Stevenson and J. Vonk and J. Mizniak},

doi = {10.1080/02508060.2020.1769345},

issn = {0250-8060},

year  = {2020},

date = {2020-07-03},

journal = {Water International},

volume = {45},

number = {5},

pages = {416–422},

publisher = {Routledge},

abstract = {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).},

note = {Correction at 10.1080/02508060.2020.1769345},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{84967468030542f1bbf2dd772ca04607,

title = {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},

author = {Jo-Anne Geere and Paul Hunter},

doi = {10.1016/j.ijheh.2019.08.007},

issn = {1438-4639},

year  = {2020},

date = {2020-01-01},

journal = {International Journal of Hygiene and Environmental Health},

volume = {223},

number = {1},

pages = {238–247},

publisher = {Elsevier},

abstract = {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.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{2dcabb5d79b4478c8cbb7f50b84f1eab,

title = {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},

author = {Jo-Anne Geere and Jamie Bartram and Laura Bates and Leslie Danquah and Barbara Evans and Michael B. Fisher and Nora Groce and Batsirai Majuru and Michael M. Mokoena and Murembiwa S Mukhola and Hung Nguyen-Viet and Phuc Pham Duc and Ashley Rhoderick William and Wolf-Peter Schmidt and Paul R. Hunter},

doi = {10.7189/jogh.08.010406},

issn = {2047-2978},

year  = {2018},

date = {2018-06-01},

journal = {Journal of Global Health},

volume = {8},

number = {1},

publisher = {University of Edinburgh},

abstract = {Background: 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. Methods: 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 Generalised Estimating Equations (GEE) investigated water carrying as a risk factor for general health and self-reported pain. Findings: People who previously carried water had increased relative risk of reporting pain in the hands (RR 3.62, 95%CI 1.34-9.75) and upper back (RR 2.27, 95%CI 1.17-4.40), as did people who currently carry water (RR hand pain 3.11, 95%CI 1.34-7.23; RR upper back pain 2.16, 95%CI 1.25-3.73). The factor analysis results indicate that factor 1, ‘axial compression’, which is correlated with pain in the head and upper back, chest/ribs, hands, feet and abdomen/stomach, is associated with currently (0.30, 95%CI 0.17-0.43) or previously (0.21, 95%CI 0.01-0.42) carrying water. Factor 2, ‘soft tissue strain’, which is correlated with pain in the neck, shoulders/arms, lower back and hips/pelvis or legs, is marginally negatively associated with currently (-0.18, 95%CI-0.32 - -0.04) carrying water. The factor ‘axial compression’ was more strongly associated with carrying water containers on the head. Conclusions: Participants who reported a history of current or past water carrying more frequently reported pain in locations most likely to be associated with sustained spinal axial compression in the cervical region. Given the fact that cervical spinal conditions are globally one of the more common causes of disability, our findings suggest that water carrying, especially by head loading is a major contributing factor in musculoskeletal disease burden in low income countries. Our findings support the proposed indicator for monitoring SDG6.1: “Percentage of population using safely managed drinking water services at home“ (our emphasis).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{267f966ac1354cf0befee8750b337126,

title = {Who carries the weight of water? Fetching water in rural and urban areas and the implications for water security},

author = {Jo-Anne Geere and Moa Cortobius},

issn = {1965-0175},

year  = {2017},

date = {2017-06-01},

journal = {Water Alternatives},

volume = {10},

number = {2},

pages = {513–540},

publisher = {Water Alternatives Association},

abstract = {The global burden of fetching water, particularly its effects on individuals and societies, is largely unknown because comparative analysis of the global data available is incomplete and scarce. To address this information gap, this article presents a synthesis of the data on water-fetching from households in 23 countries. In rural areas of the dataset almost 50% of the population still have to bring water from a source outside of their home or yard. Women generally carry the main responsibility for fetching water; however, in many countries and in particular in urban areas, men also take on a great share of this work. The mean single trip time to collect water ranges from 10 to 65 minutes in urban areas with an average increase or decrease of 2 to 13 minutes in rural areas. Further, up to 60% of children support the collection of wood and water, in some countries spending up to 11.3 hours per week. Water fetching continues to have the greatest impact on women and children in poorer rural areas and is likely to be a substantial barrier to household water security and sustainable development in regions most in need of sustainable development.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{da8ef9350d344d60b74646b10ea05d9b,

title = {Factors that impact on access to water and sanitation for older adults and people with disability in rural South Africa: An occupational justice perspective},

author = {Laura Wrisdale and Matodzi Michael Mokoena and Lutendo Sylvia Mudau and Jo-Anne Geere},

doi = {10.1080/14427591.2017.1338190},

issn = {1442-7591},

year  = {2017},

date = {2017-01-01},

journal = {Journal of Occupational Science},

volume = {24},

number = {3},

pages = {259–279},

publisher = {Taylor and Francis},

abstract = {Limited access to water and sanitation is a risk to health, dignity, and ability to engage in occupations. This article aims to: 1) discuss the current and historical factors affecting access to water and sanitation in rural South Africa, and 2) explore the occupational implications of water access, particularly for older adults and people with disability in rural South Africa. A literature review was carried out through searching JSTOR, Scopus, and MEDLINE databases and using framework analysis to interpret the retrieved documents. This paper also reports a thematic analysis of semi-structured interviews, conducted in 2012 in a rural area of South Africa. Environmental, political, social-economic and attitudinal factors were identified as impacting water access and occupation, in both the documentary analysis and the semi-structured interviews. Due to South Africa’s history, injustice has occurred in the forms of occupational apartheid and occupational deprivation. We argue that supply systems must enable people to easily access more water than is essential for survival, so that people can participate in meaningful and productive occupations. Therefore, access to water should be considered part of an occupational right. Recognising this right will be an integral step in ensuring that water supplies are improved to support better livelihoods, and to achieve economic and social empowerment, and quality of life for all, in line with many of the United Nations’ new Sustainable Development Goals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{a31d3f72f23c4482990590c9f736cce1,

title = {Survey of rehabilitation support for children 0-15 years in a rural part of Kenya},

author = {Karen Bunning and Joseph K Gona and Victor Odera-Mung'ala and Charles R Newton and Jo-Anne Geere and Chia Swee Hong and Sally Hartley},

doi = {10.3109/09638288.2013.829524},

issn = {0963-8288},

year  = {2014},

date = {2014-06-01},

journal = {Disability and Rehabilitation},

volume = {36},

number = {12},

pages = {1033–1041},

publisher = {Informa Healthcare},

abstract = {Abstract Purpose: Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. Method: A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Results: Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. Conclusions: The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. Implications for Rehabilitation There needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed.},

note = {© 2014 The Author(s). Published by Taylor & Francis. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted. Permission is granted subject to the terms of the License under which the work was published. Please check the License conditions for the work which you wish to reuse. Full and appropriate attribution must be given. This permission does not cover any third party copyrighted material which may appear in the work requested.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{6446262c4fbd4c9db259b4e8d7ef1886,

title = {A time for action: Opportunities for preventing the growing burden and disability from musculoskeletal conditions in low- and middle-income countries},

author = {Damian Hoy and Jo-anne Geere and Fereydoun Davatchi and Belinda Meggitt and Lope H. Barrero},

doi = {10.1016/j.berh.2014.07.006},

issn = {1521-6942},

year  = {2014},

date = {2014-06-01},

journal = {Best Practice & Research: Clinical Rheumatology},

volume = {28},

number = {3},

pages = {377–393},

publisher = {Bailliere Tindall Ltd},

abstract = {Musculoskeletal (MSK) conditions cause an enormous global burden, and this is dramatically increasing in developing countries, particularly due to rapidly ageing populations and increasing obesity. Many of the global non-communicable disease (NCD) initiatives need to expand beyond the traditional ‘top four’ NCD groups by incorporating MSK diseases. It is critical that MSK initiatives in developing countries integrate well with health systems, rather than being stand-alone. A better inclusion of MSK conditions will avoid doubling of efforts and wasting of resources, and will help to promote a more streamlined, cost-effective approach. Other key opportunities for action include the following: ensuring the principles of ‘development effectiveness’ are met; strengthening leadership and commitment; building the research, 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.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{1fa8d2a49cb64745b14b319d1d35fb31,

title = {Users' experiences of physiotherapy treatment in a semi-urban public hospital in Kenya},

author = {Joseph K. Gona and Charles R. Newton and Jo-Anne Geere and Sally Hartley},

issn = {1445-6354},

year  = {2013},

date = {2013-09-05},

journal = {Rural and Remote Health},

volume = {13},

publisher = {James Cook University},

abstract = {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 community-based services that place emphasis on self-management of chronic conditions for fostering better health outcomes in rural communities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{12b53a7370c54cb584c6c1f54b9d4df8,

title = {Meta-analysis identifies Back Pain Questionnaire reliability influenced more by instrument than study design or population},

author = {Jonathan H. Geere and Jo-Anne Geere and Paul Hunter},

doi = {10.1016/j.jclinepi.2012.06.024},

issn = {0895-4356},

year  = {2013},

date = {2013-03-01},

journal = {Journal of Clinical Epidemiology},

volume = {66},

number = {3},

pages = {261–267},

publisher = {Elsevier},

abstract = {Objective To assess if predefined variables in study design, instrument type, and patient characteristics account for variance in reported retest reliability for the Oswestry Disability Index (ODI) and Roland–Morris Questionnaire (RMQ). A second aim was a more precise estimate of instrument reliability. Study Design and Setting A systematic literature search of MEDLINE, EMBASE, AMED, PsycINFO, and CINAHL was performed from inception to January 2011. Hand search, gray literature, and reference retrieval completed the search. Two blinded reviewers extracted the data. Original authors were contacted for the missing data. A meta-analysis was performed with the intraclass correlation coefficient as the outcome measure. Results Fifty studies on 31 ODI and 28 RMQ cohorts were retrieved that met the inclusion criteria. Meta-analysis found the ODI more reliable than the RMQ (coefficient, -0.2840; P = 0.009) and lower reliability on increased days to retest (coefficient, -0.0089; P = 0.005) and in low back pain (LBP) with leg pain than LBP only cohorts (coefficient, -0.2194; P = 0.046). The use of a transition item to identify stable patients and percentage of cohort not included at retest were significant only on single variable analysis. Conclusion Study design and population influence the reliability of a given instrument, however, a greater difference in reliability exists between instruments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{5402b2af5a6245ef95c93fcde60e2b49,

title = {The diagnostic accuracy of MRI for the detection of partial- and full-thickness rotator cuff tears in adults},

author = {Toby O. Smith and Helena Daniell and Jo-Anne Geere and Andoni P. Toms and Caroline B. Hing},

doi = {10.1016/j.mri.2011.12.008},

issn = {1873-5894},

year  = {2012},

date = {2012-04-01},

journal = {Magnetic Resonance Imaging},

volume = {30},

number = {3},

pages = {336–346},

publisher = {Elsevier},

abstract = {This study assessed the diagnostic test accuracy of magnetic resonance imaging (MRI) in the detection of partial- and full-thickness rotator cuff tears in the adult population. A systematic review was conducted of the following electronic databases: Cochrane Central Register of Controlled Trials, Medline, Embase, CINAHL, AMED, ISI Web of Science, Current Controlled Trials, National Technical Information Service, the National Institute for Health Research Portfolio, the UK National Research Register Archive and WHO International Clinical Trials Registry Platform database and reference lists of articles. All studies assessing the sensitivity and/or specificity of MRI for adult patients with suspected rotator cuff tear where surgical procedures were the reference standard were included in the study. A meta-analysis was performed to calculate pooled sensitivity, specificity, likelihood and diagnostic odds ratio values, and summary receiver operating characteristic plots were constructed. Forty-four studies were included. These included 2751 shoulders in 2710 patients. For partial-thickness rotator cuff tears, the pooled sensitivity and specificity values were 0.80 [95% confidence interval (CI): 0.79-0.84] and 0.95 (95% CI: 0.94-0.97), respectively. For full-thickness tears, the sensitivity and specificity values were 0.91 (95% CI: 0.86-0.94) and 0.97 (95% CI: 0.96-0.98), respectively. While there was no substantial difference in diagnostic test accuracy between MRIs reviewed by general radiologists and those reviewed by musculoskeletal radiologists, higher-field-strength (3.0 T) MRI systems provided the greatest diagnostic test accuracy.},

note = {Copyright © 2012 Elsevier Inc. All rights reserved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ce09dca62185406ca16f599ad6e17d7b,

title = {Domestic water carrying and its implications for health: a review and mixed methods pilot study in Limpopo Province, South Africa},

author = {Jo-Anne Geere and Paul R. Hunter and Paul Jagals},

doi = {10.1186/1476-069X-9-52},

issn = {1476-069X},

year  = {2010},

date = {2010-08-26},

journal = {Environmental Health},

volume = {9},

number = {1},

publisher = {BioMed Central},

abstract = {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 sub-groups 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.},

note = {© 2010 Geere et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}