Effective low-cost pediatric vision screening by naive nonophthalmic examiners using the 'Arclight' device

Purpose: To explore whether a low-cost ophthalmoscope (Arclight) can be used by naive nonophthalmic examiners to effectively screen for pediatric eye disease. Methods: Fifty-four children (108 eyes) were examined by five medical students using an Arclight. Gold standard examination was performed by an ophthalmologist using a slit lamp and indirect ophthalmoscope. Examinations performed included ophthalmoscopy of the optic disc, estimation of the cup-to-disc ratio (CDR), corneal light reflex test (CRT), Bruckner’s reflex test (BRT), and evaluation of refractive error. We determined the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the nonophthalmologist’s Arclight exam compared to the gold standard findings of comprehensive evaluation by pediatric ophthalmologists. Results: Using the Arclight, the optic nerve exam was successfully completed in 65% of patients. CDRs above and below 0.5 could be determined with 66.7% sensitivity and 84.4% specificity. Arclight CRT measurements were significant (P < .00001) predictors of strabismus, with 80% sensitivity, 95.1%, specificity, 80% PPV, and 95.1% NPV. BRT was not a significant predictor of amblyopia, with a 34.6% sensitivity, 85.7% specificity, 69.2% PPV, and 58.5% NPV. Refractive error was estimated with a success rate of 81% for emmetropia, 38% for myopia, and 21% for hyperopia. The Arclight ease-of-use was rated on average as 4.4 (SD = 0.9) on a scale of 1 to 5, with 1 being the hardest and 5 being the easiest. Conclusions: Our study shows the Arclight as an affordable and effective alternative to the traditional ophthalmoscope for assessing eye disease in children. This device can improve eye health services in under-resourced regions.Peer reviewe

A level playing ‘field’? A Bourdieusian analysis of the career aspirations of further education students on sports courses

There is currently a distinct dearth of research into how sports students’ career aspirations are formed during their post-compulsory education. This article, based on an ethnographic study of sport students in tertiary education, draws on data collected from two first-year cohorts (n = 34) on two different courses at a further education college in England. The study draws on ethnographic observations, and semi-structured group interviews, to examine in-depth the contrasting occupational perspectives emergent within these two groups of mainly working-class students, and how specific cultural practices affect students’ career aspirations. Utilising a Bourdieusian framework, the paper analyses the internalised, often latent cultural practices that impact upon these students’ diverse career aspirations. The hitherto under-researched dimension of inter-habitus interaction and also the application of doxa are outlined. The article reveals how the two student cohorts are situated within a complex field of relations, where struggles for legitimisation, academic accomplishment and numerous forms of lucrative capital become habituated. The study offers salient Bourdieusian-inspired insights into the career aspirations of these predominantly working-class students and the ways in which certain educational practices contribute to the production and reproduction of class inequalities

Mixed-methods research: What’s in it for economists?

Empirical studies in economics traditionally use a limited range of methods, usually based on particular types of regression analysis. Increasingly, sophisticated regression techniques require the availability of appropriate data sets, often longitudinal and typically collected at a national level. This raises challenges for researchers seeking to investigate issues requiring data that are not typically included in regular large-scale data. It also raises questions of the adequacy of relying mainly or solely on regression analysis for investigating key issues of economic theory and policy. One way of addressing these issues is to employ a mixed-methods research framework to investigate important research questions. In this article, we provide an example of applying a mixed-methods design to investigate the employment decisions of mature age women working in the aged care sector. We outline the use of a coherent and robust framework to allow the integrated collection and analysis of quantitative and qualitative data. Drawing on particular examples from our analysis, we show how a mixed-methods approach facilitates richer insights, more finely grained understandings of causal relationships and identification of emergent issues. We conclude that mixed-methods research has the capacity to provide surprises and generate new insights through detailed exploratory data analysis

Likert scales: how to (ab)use them?

No abstract available

Indigenous knowledges and development: a postcolonial caution

As a result of the failure of formal top-down development, there has recently been increased interest in the possibilities of drawing upon the indigenous knowledges of those in the communities involved, in an attempt to produce more effective development strategies. The concept of indigenous knowledge calls for the inclusion of local voices and priorities, and promises empowerment through ownership of the process. However, there has been little critical examination of the ways in which indigenous knowledges have been included in the development process. Drawing upon postcolonial theory, this article suggests that indigenous knowledges are often drawn into development by both theorists and development institutions in a very limited way, failing to engage with other ways of perceiving development, and thus missing the possibility of devising more challenging alternatives

Cost-benefit analysis of BIM-enabled design clash detection and resolution

Building Information Modelling (BIM) is increasingly deployed as part of the processes in Architecture, Engineering and Construction (AEC) industry projects. While the benefits of BIM have been extensively proclaimed, explicit justification in terms of direct cost savings for BIM implementation on real-life projects, particularly for clash detection BIM workstream, are not well documented. This paper proposes and demonstrates a methodology to prove how BIM-based clash detection leads to cost savings. A schema is developed based on literature review and industrial expertise to quantify cost savings achieved by the utilisation of BIM-based clash detection and resolution. This paper provides validation of the proposed schema on a major infrastructure project. The developed schema includes the categorisation of identified clashes based on stakeholder involvement and required actions. The validation used the estimated cost of clashes were those not resolved before site operations took place. This schema simplifies both the categorisation and cost estimation of clashes in design. Estimated savings yielded 20% of contract value using the schema, for the multi-million-dollar project case study, thus extending evidence of BIM savings and benefits. The schema improves the existing process and valorises clash detection, thus allowing stakeholders to conduct a cost-benefit analysis. In addition, the categorisation methodology allows prioritising on the most costly clashes, and draw lessons learnt for further projects. This schema opens the path towards a systematic methodology to appraise the benefits of different BIM uses or processes

Doing social media analytics

'The era of Big Data has begun' (boyd and Crawford, 2012: 662). In the few years since this statement, social media analytics has begun to accumulate studies drawing on social media as a resource and tool for research work. Yet, there has been relatively little attention paid to the development of methodologies for handling this kind of data. The few works that exist in this area often reflect upon the implications of 'grand' social science methodological concepts for new social media research (i.e. they focus on general issues such as sampling, data validity, ethics, etc). By contrast, we advance an abductively-oriented methodological suite designed to explore the construction of phenomena played out through social media. To do this, we use a software tool - Chorus - to illustrate a visual analytic approach to data. Informed by visual analytic principles, we posit a two-by-two methodological model of social media analytics, combining two data collection strategies with two analytic modes. We go on to demonstrate each of these four approaches ‘in action’, to help clarify how and why they might be used to address various research questions

Gendered vulnerabilities to climate change: insights from the semi-arid regions of Africa and Asia

Emerging and on-going research indicates that vulnerabilities to impacts of climate change are gendered. Still, policy approaches aimed at strengthening local communities’ adaptive capacity largely fail to recognize the gendered nature of everyday realities and experiences. This paper interrogates some of the emerging evidence in selected semi-arid countries of Africa and Asia from a gender perspective, using water scarcity as an illustrative example. It emphasizes the importance of moving beyond the counting of numbers of men and women to unpacking relations of power, of inclusion and exclusion in decision-making, and challenging cultural beliefs that have denied equal opportunities and rights to differently positioned people, especially those at the bottom of economic and social hierarchies. Such an approach would make policy and practice more relevant to people’s differentiated needs and responses