Spatial and temporal change in trace element profiles in seawater, sediment and mussels associated with an earthquake rubble sea-fill.

Elemental profiles in seawater, sediment and green-lipped mussels (Perna canaliculus) were determined, following the deposition of earthquake demolition rubble into a newly developed sea-fill located adjacent to a busy commercial port with a history of diverse contaminant inputs. Zinc and lead displayed environmental concentrations that varied over time during sea-fill construction, and which declined with distance from the sea-fill, indicating that the sea-fill activity was the source of these two contaminants. A transplantation study using reference site mussels caged near the sea-fill, supported this finding. However, none of the trace metal burdens in resident or transplanted mussels were of regulatory concern. An integrated approach comprising the monitoring of multiple environmental matrices, examination of contaminant burdens as a function of time and distance from a putative point source, and the use of active biomonitoring techniques, is necessary to robustly identify novel contamination inputs in historically-polluted marine settings.

A situational analysis of clinical refraction services in the capital city of the Maldives.

Background: Uncorrected refractive error is a leading cause of visual impairment globally. This study aimed to determine the current state of clinical refraction services and barriers to service provision in the capital city of the Maldives. Methods: This cross-sectional, descriptive-analytical study used a purposive sampling technique. The list of facilities providing refraction services in the city of Malé was compiled through a desk review and finalized after verification by personnel from the Ministry of Health. The availability of human resources and infrastructure was measured using a pre-coded questionnaire that also listed barriers to service provision, followed by on-site observations and subsequent data analysis. Results: Three clinical ophthalmology departments within hospitals, two ophthalmology hospitals, and nine primary eye care centers were selected for this study. The private sector (n = 12, 85.7%) was the primary provider of refractive error services. All facilities possessed the essential equipment required for refraction. Only optometrists and ophthalmologists conducted refraction. Contact lens assessment and low vision services were not available at any facility. The number of refractions conducted in Malé annually was 145,392. Human resources and management-related factors were the major barriers to the provision of clinical refraction services (n = 21, 44.7%). Conclusions: Accessibility to refractive error management and low vision services is needed in Malé to meet current population needs. Existing resources, including humans and equipment, require augmentation regarding service provision and enhancement. Knowledge of these barriers could lead to the upscaling of refraction services in Malé, Maldives by health policy makers.

Compliance and hygiene behaviour among soft contact lens wearers in the Maldives.

BACKGROUND: Significant levels of non-compliance and poor hygiene among contact lens wearers have been reported previously from different parts of the world. This survey aimed at identifying the scope of hygiene and non-compliant behaviour of soft contact lens wearers in the Maldives. METHODS: Established soft lens wearers attending two eye clinics in Male' city, were interviewed in office or via telephone. A set of interviewer-administered questions was used to access the subjective response on compliance and hygiene behaviour (hand and lens case hygiene, water exposure, adherence to lens replacement schedule, dozing and overnight wear, awareness of aftercare visits and reuse of disinfecting solution). Participants were also asked to rate themselves as a contact lens user based on their perceived compliance and hygiene practices. RESULTS: Out of 107 participants, 79 (74.8 per cent) were interviewed in the office and the rest via telephone. The majority of lens wearers were female, office workers and students, with a mean age of 20.64 ± 4.4 years. Mean duration of lens wear was 28.04 ± 8.36 months. Most of them were using spherical lenses (86.9 per cent) on a daily wear basis (96.3 per cent). Major reported forms of non-compliance were poor hand hygiene (60.7 per cent), lack of aftercare awareness (39.3 per cent), water exposure (35.5 per cent) and over-use of lenses (24.3 per cent). While females were more likely to overuse their lenses than males (p < 0.005), other socio-demographic factors were not associated with reported non-compliance. Although around 90 per cent of the participants considered themselves average or good contact lens wearers, most exhibited some form of non-compliant and poor hygienic behaviour. CONCLUSION: A significant number of Maldivian contact lens wearers exhibited poor levels of hygiene and compliance with contact lenses and lens care systems. An effective educational reinforcement strategy needs to be developed to modify lens wearers' non-compliance.