Review of school vision screening guidelines

Abstract: Background: Vision screenings are important in identifying visual anomalies likely to disrupt the physical, intellectual, social and emotional development of children. School health services globally include vision screenings, complementing a variety of associated screening services. Aim: This review article provides evidence for content, provision and efficacy of the vision screening services for children of school-going age and reports on the current practice of children’s vision screenings worldwide including in South Africa. Methods: Studies were identified from PubMed, Ebscohost and Science Direct with the search terms utilised during the selection of electronic articles and journals for the review. The target population includes children of school-going age from 6 to 19 years without previously known conditions associated with visual anomalies and learning-related problems. The quality of vision screening programmes and policies for the school-going age children in different countries were evaluated using Wilson and Jungner criteria.1 Results: Vision screening programmes worldwide appear to support comprehensive vision screening methods among pre-schoolers (from birth to ≤ 6 years vs. children of school-going age). The development of vision screening procedures in some countries in the United States of America (USA) was found to be grounded on epidemiologic findings and principles. These may have contributed towards the formulation of national vision screening guidelines for preschoolers that supported the detection of amblyopia and its associated conditions such as strabismus, anisometropia and myopia. School-going children’s vision screenings are not supported worldwide as research has shown that there is lack of benefits for detecting other visual anomalies such as vergence and accommodative dysfunctions. This is despite evidence provided by the literature reviewed that an association exists between prevalent accommodation and vergence dysfunctions including poor ocular motilities and poor near-vision, among children of school-going age with poor academic performance. Conclusion: The guidelines worldwide support school vision screenings, especially for the pre-schoolers by the school health nurses, with other programs having considered the teachers, optometrists or orthoptists as the appropriate personnel to conduct the school vision screenings. There is still a need for the effectiveness of the school vision-screening programmes to be investigated related to the importance of detecting convergence and accommodative dysfunctions for the school going age children

British Society of Paediatric Dentistry : a policy document on dental neglect in children

This policy document was prepared by J.C. Harris, R.C. Balmer, and P.D. Sidebotham on behalf of the British Society of Paediatric Dentistry (BSPD). Policy documents produced by the BSPD represent a majority view, based on consideration of currently available evidence. They are produced to provide guidance with the clear intention that the policy be regularly reviewed and updated to take account of changing views and developments

Documenting social determinants of health-related clinical activities using standardized medical vocabularies

Objectives:Growing recognition that health is shaped by social and economic circumstances has resulted in a rapidly expanding set of clinical activities related to identifying, diagnosing, and intervening around patients' social risks in the context of health care delivery. The objective of this exploratory analysis was to identify existing documentation tools in common US medical coding systems reflecting these emerging clinical practices to improve patients' social health. Materials and Methods:We identified 20 social determinants of health (SDH)-related domains used in 6 published social health assessment tools. We then used medical vocabulary search engines to conduct three independent searches for codes related to these 20 domains included in common medical coding systems (LOINC, SNOMED CT, ICD-10-CM, and CPT). Each of the 3 searches focused on one of three clinical activities: Screening, Assessment/Diagnosis, and Treatment/Intervention. Results:We found at least 1 social Screening code for 18 of the 20 SDH domains, 686 social risk Assessment/Diagnosis codes, and 243 Treatment/Intervention codes. Fourteen SDH domains (70%) had codes across all 3 clinical activity areas. Discussion:Our exploratory analysis revealed 1095 existing codes in common medical coding vocabularies that can facilitate documentation of social health-related clinical activities. Despite a large absolute number of codes, there are addressable gaps in the capacity of current medical vocabularies to document specific social risk factor screening, diagnosis, and interventions activities. Conclusions:Findings from this analysis should help inform efforts both to develop a comprehensive set of SDH codes and ultimately to improve documentation of SDH-related activities in clinical settings