Seva Foundation

This pilot study employed a decolonised, youth-centred methodology to challenge dominant discourses and hierarchies in knowledge production. The Distributed Data Generation (DDG) approach facilitated participatory workshops across Australia, India, and Indonesia, involving collaboration with local research centres and a youth organisation. This cross-cultural partnership aimed to unsettle Western assumptions about research methodologies and knowledge representation. DDG prioritises marginalised perspectives and has been used to collaborate with global South organisations for rights-based youth research. It enables rich data collection through participatory, child-centred workshops conducted simultaneously in multiple countries. This approach supports the decolonisation of youth knowledge by co-producing it with children and young people, addressing child-adult power imbalances. The research engaged 128 participants aged 9 to 18 from diverse backgrounds, including urban and rural areas, culturally and linguistically diverse communities, migrants, and disadvantaged youth. Each participant attended a workshop to explore cultural expressions, ethics, responsibilities, and aspirations for culture-centred digital design. Findings reveal that digital technology influences and shapes the cultural practices of young people in Australia, India, and Indonesia. Indian participants view culture through nationalism and ideology, while Australian children associate culture with material practices and the environment. Digital technologies were found to strengthen cultural identity and cross-cultural understanding, though concerns about minority culture representation were expressed. Indian and Indonesian youth use digital platforms to learn about their own and other cultures, more so than Australian participants. Concerns about cultural exclusion, inappropriate content, and digital disharmony were highlighted, emphasising the need for inclusive digital design that reflects the lived experiences of diverse youth.

Agriculture, a cornerstone of human civilization, exerts a significant impact on natural resources to fulfill societal food demands. Climate change, exacerbated by anthropogenic activities and environmental consequences, poses a critical threat to agricultural productivity. While modern agronomic practices have enhanced yields, they have also resulted in detrimental consequences such as habitat loss, reduced biodiversity, and resource depletion.This study investigates crop suitability in Hassan District, India, by integrating Artificial Intelligence (AI) with Geographic Information Systems (GIS). Eight key geo-climatic and pedological factors, relatively stable over time, were considered. Determining optimal land use for targeted crop cultivation is crucial in the face of climate change and global food security concerns.Geospatial technologies and Sequential AI have demonstrated significant potential in addressing agricultural and environmental challenges through data-driven approaches. This research assesses the suitability of land for paddy, maize, and gram cultivation during the kharif season in Hassan District. A weighted metric approach was employed within a GIS environment, utilizing a Sequential Artificial Neural Network (ANN) model. Initially, an equal-weighted arithmetic mean was used to evaluate seven criteria encompassing soil, climate, and topographic factors. Likewise, criterion weights were derived from a sequential regression model, reflecting their relative importance in crop suitability prediction.Slope, soil depth, and rainfall emerged as the most influential factors, collectively accounting for 76% of the total weight. The results demonstrated an improvement in site suitability assessment compared to conventional methods, highlighting the efficacy of this integrated AI-GIS approach.

BackgroundRoutine examination after cataract surgery, including a refraction test 4 to 6 weeks after surgery, is mandatory in most hospitals. In recent years, there has been growing interest in exploring alternative approaches to postoperative follow-up in cataract surgery patients due to the increasing number of cataract surgeries being performed, the limited availability of health care resources, and the need to optimize the use of health care services.ObjectiveWe aim to compare postoperative visual outcomes after a day 0 examination in patients with 2 follow‑ups, one on day 7 and other on day 30, and patients with a single ophthalmic follow‑up between days 25 to 30.MethodsA prospective, quantitative, experimental control study will be carried out in Reiyukai Eiko Masunaga Eye Hospital, located in Banepa, Kavrepalanchok, Nepal. All patients undergoing cataract surgery meeting the inclusion and exclusion criteria irrespective of the type of surgery (small-incision cataract surgery or phacoemulsification) will be included in the study. The patients will be randomly assigned to 1 of 2 groups. Patients in group 1 will be examined on day 1, day 7, and day 30, whereas patients in group 2 will be examined on day 1 and once between days 25 to 30. The minimum clinically important difference (MCID) in our study will be set according to the improvement in the Snellen visual acuity chart.ResultsThe study is expected to be completed within 6 to 8 months from the start of the project. Data analysis and report writing will be carried out in a 2-month period. Best-corrected visual acuity will be compared between the 2 groups to determine if the MCID is achieved. The cost-effectiveness of the new approach will also be analyzed.ConclusionsWe aim to conclude that we can safely defer the 1-week postoperative follow-up visit in patients undergoing uncomplicated cataract surgery and that, moreover, we can reduce the patient load at the hospital and decrease patient expenses by decreasing the frequency of hospital visits.International Registered Report Identifier (IRRID)PRR1-10.2196/48616

BackgroundDiabetic Retinopathy (DR) is an important public health issue in Nepal. Despite the availability of retinal services, people may not access them because of the lack of knowledge about DR and poor referral systems. DR screening uptake was low at Reiyukai Eiko Masunaga Eye Hospital(REMEH) since retina services were started. Scheer Memorial Hospital is a multispeciality hospital near to REMEH. It has no eye department but has been running a regular diabetic clinic. This was a site for referring diabetic patients for DR screening. Improving DR awareness among general physicians has the potential to address these challenges.MethodsThe aim of our study was to investigate the effectiveness of providing health education to selected health personnel and establish a referral pathway on the attendance of diabetic patients for retinal screening at REMEH. This was a non-randomized, pre-post intervention study design. Total of three health education sessions were provided to the health care professionals of Scheer on diabetic retinopathy using Power Point presentations, posters, pamphlets and videos. The study period was 16 months (2020 June –2021 September) and divided into 8 months pre-intervention(baseline data collection) and 8 months post intervention period. The proportional increase in number of diabetes attendance pre and post intervention was calculated by Z test. The change in knowledge of health care personnels pre and post intervention was scored and evaluated through a questionnaire and calculated by paired- t test. Data was analyzed using Excel and Epi Info 7.The Protocol was published on August 21, 2021, in JMIR Publications.ResultsThe proportional increase in number of referrals of diabetes attendance post intervention increased from 50 to 95% and was statistically significant (p < 0.001, 95% CI: 0.214–0.688). The mean score of knowledge gained by physicians on DR awareness was more at post intervention (8.8 ± 1.32) than pre intervention (6.4 ± 1.51). It was statistically significant (p < 0.001).ConclusionThis study shows that a well-planned health education intervention changes the knowledge in physicians about DR. There is an increase in the number of referrals and attendance of patients for DR screening with the change in knowledge and referral mechanism.Trial RegistrationClinical Trials.gov NCT04829084; https://clinicaltrials.gov/ct2/show/NCT04829084:02/04/2021.

ABSTRACT Purpose: Previous studies have used subjective assessments to implicate darker skin color as a risk factor for glaucoma. This study used objective measurements to determine whether skin melanin is a risk factor for glaucoma. Methods: In a case-control study conducted at a tertiary eye hospital in Nepal, patients aged 40 years or older from the glaucoma clinic were enrolled as cases and age-matched patients without glaucoma from other clinics at the eye hospital were enrolled as controls. A colorimeter was used to capture melanin measurements in triplicate from the inner arm and forehead of each participant. The exposure variable of interest was the median skin melanin value, in arbitrary units. The outcome of interest was the presence of glaucoma. Results: 100 glaucoma cases and 100 matched controls were enrolled. Agreement between the triplicate melanin measurements was high, with an intra-class correlation of 0.99 (95% CI, 0.99–0.99) for inner arm measurements and 0.97 (95% CI 0.96–0.98) for forehead measurements. Mean inner arm melanin values were 604 units (standard deviation [SD] 177) in cases and 602 units (SD 179) in controls; forehead values were 650 (SD 146) in cases and 652 (SD 152) in controls. After adjusting for sex and country of residence, skin melanin was not associated with the presence of glaucoma (odds ratio 1.04, 95%CI 0.78–1.38 for inner arm values and 0.97, 95%CI 0.70–1.35 for forehead values). Conclusion: This study failed to find a significant association between skin pigmentation and glaucoma.

AimTo determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox’s Bazar, Bangladesh.MethodsWe used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis.ResultsWe examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction.ConclusionThe prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp’s good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.

AimsTo assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake.MethodsPopulation-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Between August and November 2014, participants answered a questionnaire (based on Delphi process/previous focus groups) on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake. Presenting visual acuity was assessed, fundus photography performed and images graded by trained graders. Potential predictors of accepting care were evaluated and confounders adjusted for using logistic regression.ResultsA total of 562 people (9.6% (256/5825), mean age 66.2±9.84 years, 207 (36.8%) men) had diabetes, 118 (22.3%) previously diagnosed. ‘Very likely’ or ‘likely’ acceptance of laser treatment (140/530=26.4%) was lower than for eye exams (317/530=59.8%, p<0.001). Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis (409/454, 97.2%), while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs (387/562, 73.0%), video or other health education (359/562, 67.7%) and phone call reminders (346/562, 65.3%).ConclusionsImproving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.

Medical shops in Nepal are a main point of treatment for many diseases including ophthalmic conditions. We sought to evaluate pharmaceutical shop worker knowledge of corneal ulcers and abrasions. A pharmaceutical shop worker from each of 117 different pharmacies surrounding Bharatpur, Nepal, was presented four different eye photographs (i.e., corneal ulcer, corneal abrasion, conjunctivitis, and a normal eye) and asked about diagnosis and management. Of 117 participants, 86 (74%) identified conjunctivitis correctly but few were able to identify corneal abrasion (50/117; 43%) or corneal infection (47/117; 40%). When presented with an illustrated diagram of potential medications to dispense, 15 (13%) participants chose a topical medication containing a corticosteroid for the corneal abrasion and 25 (21%) did so for the corneal ulcer. The appropriate use of corticosteroids for external eye infections is an important topic for additional training, given the potential for these medications to worsen corneal abrasions and ulcers.

The cyclical pattern of violence in the lives of homeless female ex-offenders may precipitate ongoing substance use and recidivism; all of which have shown to be mounting public health issues affecting successful reentry. This paper, which analyzed baseline data from a longitudinal study of 126 female ex-offenders in Los Angeles and Pomona, California, highlighted the factors found to be associated with violent crime among homeless female ex-offenders. A multiple logistic regression model for whether or not the last conviction was for a violent offense indicated that poor housing (p = .011) and self-reported anger or hostility (p < .001) were significant correlates. An ordinal regression model for the number of violent offenses also indicated that affectionate support was associated with committing fewer number of violent crimes (p = .001), while positive social interactions (p = .007), and anger/hostility (p = .015) were associated with greater number of violent crimes. Implications for developing a comprehensive array of strategies that can mitigate the pattern of violence often seen in the lives of homeless female who have recently exited jails and prisons is discussed.