Compliance and Predictors of Spectacle Wear in Schoolchildren and Reasons for Non-Wear: A Review of the Literature.

Purpose: Uncorrected refractive errors are the leading cause of visual impairment in children, affecting children in all settings. The majority of refractive errors can be corrected with spectacles. High compliance with spectacle wear is required for children to realize the benefit, such as higher academic achievement. This review collates evidence on compliance with spectacle wear, factors which predict spectacle wear and reasons for non-compliance among schoolchildren.Methods: Literature searches were conducted on Medline, Embase, Global Health and the Cochrane Library. The date range was January 2000 to November 2017 and there were no language restrictions. The search retrieved a total of 1299 references, 522 duplicate records were removed leaving 777 references to assess. Twenty-five studies were included in the review.Results: Evidence suggests that greater severity of uncorrected refractive error and lower levels of uncorrected visual acuity are associated with higher levels of spectacle wear. Addressing socio-demographic reasons for non-compliance is complex as they are context specific. Evidence that children become less compliant with spectacle wear with increasing age is not consistent. Quantitative data indicate girls are more likely to be compliant with spectacles wear than boys, but qualitative studies highlight specific challenges faced by girls.Conclusion: There was considerable variation between studies in how spectacle compliance was defined, the time interval between dispensing the spectacles and assessment, and how compliance was assessed. There is need to standardize all aspects of the assessment of compliance. Further qualitative and quantitative studies are required in a range of settings to assess the biomedical and socio-demographic factors which affect spectacle wear compliance using standard definitions

The value of domiciliary medication reviews – a thematic analysis of pharmacist's views

Background: Domiciliary medication reviews are thought to enable comprehensive medication reviews centred around the needs of individuals. However, there is no clear consensus on where the value of these services lie. / Aim: To determine the value of domiciliary medication reviews to service providers through semi-structured focus groups, interviews and thematic analysis. / Method: Study participants were recruited from domiciliary medication review services provided in the United Kingdom. Semi-structured focus groups and interviews were analysed using thematic analysis. / Results: Six themes were identified: the scope of domiciliary medication review services, the professional role, advantages over traditional settings, disadvantages of domiciliary medication reviews for the professional, levels of engagement and outcomes. / Conclusion: Pharmacy professionals believe that the domiciliary setting provides advantages over traditional healthcare settings when conducting medication reviews. They believe it enables a more in-depth review of an individual’s medications and needs. The traditional clinical outcomes recorded by services may not be capturing the holistic impact of domiciliary medication reviews

The Ontario Court of Appeal and Speedy Justice

The authors use a data sample collected from the Ontario Court of Appeal minute books between 1983 and 1987 to analyze how appeals move through the province\u27s highest court. Criminal and, chiefly, sentence appeals dominate the Court\u27s agenda. Hearing times-the duration of argument and rendering of judgment-are shorter than commonly believed, most often lasting less than twenty minutes. Elapsed times-the period between end of trial and beginning of hearing-are, on average, 77 per cent longer for civil than criminal appeals, 52 per cent longer for defendant than crown appeals, and 23 per cent longer for fall than spring appeals. Elapsed times are also compared with data on United States appeal courts, and the use of appellate case-flow management is considered

The Ontario Court of Appeal and Speedy Justice

The authors use a data sample collected from the Ontario Court of Appeal minute books between 1983 and 1987 to analyze how appeals move through the province\u27s highest court. Criminal and, chiefly, sentence appeals dominate the Court\u27s agenda. Hearing times-the duration of argument and rendering of judgment-are shorter than commonly believed, most often lasting less than twenty minutes. Elapsed times-the period between end of trial and beginning of hearing-are, on average, 77 per cent longer for civil than criminal appeals, 52 per cent longer for defendant than crown appeals, and 23 per cent longer for fall than spring appeals. Elapsed times are also compared with data on United States appeal courts, and the use of appellate case-flow management is considered

English Proficiency Assessments of Primary and Secondary Teachers and Students Participating in English in Action: Second Cohort (2013)

Background The purpose of the study was to assess the student learning outcomes of English in Action’s (EIA’s) School Based Teacher Development programme, in terms of improved English language (EL) competence, against recognised international frameworks (specifically, the Graded Examinations in Spoken English (GESE) (Trinity College London [TCL] 2013), which map onto the Common European Framework of Reference for Languages (Trinity College London 2007)). Measurably improved student learning outcomes are the ultimate test of success of a teacher development programme. A secondary purpose of the study was to explore whether there was any related increase in teachers’ EL competence. English Proficiency Assessments 2013 is a repeat of the study on the pilot EIA programme (Cohort 1) (EIA 2012). The students and teachers of Cohort 2 are sixfold greater in number (4,368 teachers, compared with 751 teachers, in schools). To enable this increase in scale, the programme has been delivered through a more decentralised model, with much less direct contact with English language teaching (ELT) experts, a greater embedding of expertise within teacher development materials (especially video), and a greater dependence upon localised peer support. This report addresses two research questions: 1. To what extent do the teachers and students of Cohort 2 show improved post-intervention EL proficiencies, in speaking and listening, compared with the Cohort 1 2010 pre-intervention baseline? 2. To what extent has the programme been successful in repeating the 2011 post-intervention improvements in EL proficiencies seen in Cohort 1, at the much larger scale of Cohort 2

Population-based rapid assessment of avoidable blindness survey in Sohag governorate in Egypt.

OBJECTIVES: To determine the prevalence and causes of blindness and vision impairment, and the coverage and quality of cataract surgical services, among population aged 50 years and older in Sohag governorate in Egypt. DESIGN: A population-based cross-sectional survey using two-stage cluster random sampling following the rapid assessment of avoidable blindness methodology. SETTING: A community-based survey conducted by six teams of ophthalmologists, assistants and local guides. Enrolment and examination were door-to-door in selected clusters. PARTICIPANTS: Using 2016 census data, 68 population units were randomly selected as clusters (of 60 people) with probability proportionate to population size. Anyone aged 50 years and older, residing in a non-institutional setting in a cluster for at least 6 months, was eligible to participate. PRIMARY AND SECONDARY OUTCOME MEASURES: The prevalence and causes of blindness and vision impairment. Secondary outcomes were CSC and effectiveness and participant-reported barriers to cataract surgery. RESULTS: Of 4078 participants enrolled, 4033 (98.9%) were examined. The age-adjusted and sex-adjusted prevalence of blindness, severe vision impairment and moderate vision impairment were 5.9% (95% CI 4.8% to 6.9%), 4.7% (95% CI 3.8% to 5.7%) and 18.9% (95% CI 16.8% to 21.0%), respectively. Cataract caused most of blindness (41.6%), followed by non-trachomatous corneal opacity (15.7%) and posterior segment diseases (14.5%). Cataract surgical coverage (CSC) for persons for visual acuity <3/60 was 86.8%, the proportion of cataract surgeries with poor visual outcome was 29.5% and effective CSC (eCSC) was 44.9%. eCSC was lower in women than men. The most frequently reported barrier to surgery was cost (51.5%). CONCLUSIONS: The prevalence of blindness in Sohag governorate is higher than districts in other middle-income countries in the region. CSC was high; however, women suffer worse quality-corrected CSC than men. The quality of cataract surgery needs to be addressed, while health system strengthening across government and private settings could alleviate financial barriers

3D biofabrication for tubular tissue engineering

The therapeutic replacement of diseased tubular tissue is hindered by the availability and suitability of current donor, autologous and synthetically derived protheses. Artificially created, tissue engineered, constructs have the potential to alleviate these concerns with reduced auto-immune response, high anatomical accuracy, long term patency and growth potential. The advent of 3D bio-printing technology has further supplemented the technological toolbox, opening up new biofabrication research opportunities and expanding the therapeutic potential of the field. In this review, we highlight the challenges facing those seeking to create artificial tubular tissue with its associated complex macro and microscopic architecture. Current biofabrication approaches, including 3D printing techniques, are reviewed and future directions suggested

Towards non-invasive characterisation of re-endothelialisation and restenosis following coronary stenting : an in vitro investigation using impedance spectroscopy

Following the permanent implantation of a coronary stent, optimal arterial wall healing is characterised by re-endothelialisation, the regrowth of a functional Endothelial Cell (EC) monolayer over the exposed stent surface, which reduces the risk of thrombosis. However restenosis, arising from the proliferation and migration of medial Smooth Muscle Cells (SMCs) can cause luminal narrowing to reoccur. Previous research has suggested that the stent itself could be used as an electrode and, when combined with non-invasive impedance spectroscopy techniques, monitor post stenting recovery. This could then inform clinicians on cell regrowth without the need for invasive imaging techniques. In this study we investigated the feasibility of this concept using two in-vitro models representing the cellular regrowth scenarios: re-endothelialisation and restenosis. Primary porcine ECs and SMCs were seeded onto platinum electrodes and electrical impedance spectroscopy measurements were made for up to 10 days in the frequency range 1 KHz to 100 KHz. Endothelium function was assessed through the measurement of the impedance response of confluent EC monolayers to the addition of a gap junction enhancer, dipyridamole, or an inhibitor (heptanol or carbenoxolone). Our results show that confluent, stent surface comparable populations of SMCs and ECs give rise to distinct impedance signatures, providing a novel method of non-invasively characterising these cell types. Gap junction inhibition of EC monolayers dose dependently reduced total impedance. Conversely dipyridamole’s enhancing effect on gap junction formation caused an increase in total impedance. These novel findings show the importance of intercellular gap junction communication in maintaining EC barrier function. Our current work is focused on the translation of this technology towards in-vivo monitoring of in-stent restenosis and recovery of a functional endothelium

Value Creation framework to assess MOOC based learning

Massive Open Online Courses (MOOCs) have the potential to scale up and democratise participation in professional education. Medical advances and growing demand for health providers require adoption of new flexible, team-based and lifelong learning approaches beyond the current “silo” medical training model focused specific professional roles. MOOCs provide opportunities to address pressing global health training challenges through collaborative development and globally networked learning environments. This project considered the extent to which individuals could gain and apply their learning from a global health MOOC within their local contexts. // In 1996 the World Health Organization launched the international initiative ‘GET 2020’ to eliminate trachoma, an avoidable blinding eye disease, across 44 endemic countries. In 2016, 16 London School of Hygiene and Tropical Medicine (LSHTM)staff and 37 collaborators from 12 countries developed the first MOOC in “Eliminating Trachoma’ aimed at improving access to training, equipping and mobilising health workers, to achieve ‘GET 2020’. Over 5000 people have participated in the MOOC from a diverse range of professional cadres and disciplines, including clinicians providing surgical services, programme managers, field workers administrating antibiotics, and teams implementing water and sanitation improvements.// We adapted a ‘value -creation framework’ to evaluate the impact of MOOC-based learning on trachoma elimination practices at the local level. Online surveys were designed to capture personal experiences of ‘cycles’ of value creation during participation in the MOOC and after the course. The results provide unique and emergent insights into the ongoing value of the MOOC experience for respondents, their teams and the communities affected by trachoma with whom they are engaging towards the goal of elimination