Corneal biomechanics, refractive error, and axial length in Chinese primary school children.

PURPOSE: Low corneal hysteresis is associated with longer axial length in Chinese secondary school children. The authors sought to explore this association in primary school children. METHODS: LogMAR presenting visual acuity, cycloplegic refractive error, ocular biometry, central corneal thickness (CCT), and corneal hysteresis (CH) was assessed for children in grades 1 to 3 at an academically competitive urban school in Shantou, China. RESULTS: Among 872 eligible children (mean age, 8.6 ± 2.1 years), 651 (74.7%) completed the examination. Among 1299 examined eyes, 111 (8.5%) had uncorrected vision ≤6/12. Mean spherical equivalent refractive error for all eyes was +0.26 ± 1.41 D, and axial length (AL) was 22.7 ± 0.90 mm. CH for the lowest (mean AL, 21.7 ± 0.39 mm), two middle (mean AL, 22.4 ± 0.15 and 22.9 ± 0.15 mm), and highest quartiles (mean AL, 23.7 ± 0.74 mm) of AL were 10.6 ± 2.1 mm Hg, 10.4 ± 2.1 mm Hg, 10.3 ± 2.3 mm Hg, and 10.2 ± 2.3 mm Hg respectively (age- and gender-adjusted Pearson's correlation coefficient r = -0.052; P = 0.001). In generalized estimating equation models adjusting for age, gender, and CCT, lower CH was significantly associated with longer AL (P < 0.001) and more myopic refractive error (P = 0.001). CONCLUSIONS: CH measurement is practical in young children because this is when myopia undergoes its most rapid progression. Prospective follow-up of this cohort at high risk for myopia is under way to determine whether low CH is predictive, or a consequence, of long AL.

School-based approaches to the correction of refractive error in children.

The World Health Organization estimates that 13 million children aged 5-15 years worldwide are visually impaired from uncorrected refractive error. School vision screening programs can identify and treat or refer children with refractive error. We concentrate on the findings of various screening studies and attempt to identify key factors in the success and sustainability of such programs in the developing world. We reviewed original and review articles describing children's vision and refractive error screening programs published in English and listed in PubMed, Medline OVID, Google Scholar, and Oxford University Electronic Resources databases. Data were abstracted on study objective, design, setting, participants, and outcomes, including accuracy of screening, quality of refractive services, barriers to uptake, impact on quality of life, and cost-effectiveness of programs. Inadequately corrected refractive error is an important global cause of visual impairment in childhood. School-based vision screening carried out by teachers and other ancillary personnel may be an effective means of detecting affected children and improving their visual function with spectacles. The need for services and potential impact of school-based programs varies widely between areas, depending on prevalence of refractive error and competing conditions and rates of school attendance. Barriers to acceptance of services include the cost and quality of available refractive care and mistaken beliefs that glasses will harm children's eyes. Further research is needed in areas such as the cost-effectiveness of different screening approaches and impact of education to promote acceptance of spectacle-wear. School vision programs should be integrated into comprehensive efforts to promote healthy children and their families.

Following instructions in a virtual school: Does working memory play a role?

Accumulating evidence that working memory supports the ability to follow instructions has so far been restricted to experimental paradigms that have greatly simplified the practical demands of performing actions to instructions in everyday tasks. The aim of the present study was to investigate whether working memory is involved in maintaining information over the longer periods of time that are more typical of everyday situations that require performing instructions to command. Forty-two children 7–11 years of age completed assessments of working memory, a real-world following-instructions task employing 3-D objects, and two new computerized instruction-following tasks involving navigation around a virtual school to complete a sequence of practical spoken commands. One task involved performing actions in a single classroom, and the other, performing actions in multiple locations in a virtual school building. Verbal working memory was closely linked with all three following-instructions paradigms, but with greater association to the virtual than to the real-world tasks. These results indicate that verbal working memory plays a key role in following instructions over extended periods of activity.

Implications of aligning full registration of doctors with medical school graduation:a qualitative study of stakeholder perspectives

OBJECTIVES: The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders' views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis.

SETTING: Four UK study sites, one in each country.Save

PARTICIPANTS: 185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25).

RESULTS: We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and 'sign off' to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a 'radical review' of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal.

CONCLUSIONS: A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers' decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical practice and professionalism domains need development, and good practice in postgraduate supervision and support must be shared.

Public health risk communication by text message in response to a cluster of invasive meningococcal infection in a primary school

Public health risk communication during emergencies should be rapid and accurate in order to allow the audience to take steps to prevent adverse outcomes. Delays to official communications may cause unnecessary anxiety due to uncertainty or inaccurate information circulating within the at-risk group. Modern electronic communications present opportunities for rapid, targeted public health risk communication. We present a case report of a cluster of invasive meningococcal disease in a primary school in which we used the school's mass short message service (SMS) text message system to inform parents and guardians of pupils about the incident, to tell them that chemoprophylaxis would be offered to all pupils and staff, and to advise them when to attend the school to obtain further information and antibiotics. Following notification to public health on a Saturday, an incident team met on Sunday, sent the SMS messages that afternoon, and administered chemoprophyaxis to 93% of 404 pupils on Monday. The use of mass SMS messages enabled rapid communication from an official source and greatly aided the public health response to the cluster.

Peer tutoring in a medical school: perceptions of tutors and tutees

Background: Peer tutoring has been described as “people from similar social groupings who are not professional teachers helping each other to learn and learning themselves by teaching”. Peer tutoring is well accepted as a source of support in many medical curricula, where participation and learning involve a process of socialisation.
Peer tutoring can ease the transition of the junior students from the university class environment to the hospital workplace. In this paper, we apply the Experienced Based Learning (ExBL) model to explore medical students’ perceptions of their experience of taking part in a newly established peer tutoring program at a hospital based
clinical school.
Methods: In 2014, all students at Sydney Medical School – Central, located at Royal Prince Alfred Hospital were invited to voluntarily participate in the peer tutoring program. Year 3 students (n = 46) were invited to act as tutors for Year 1 students (n = 50), and Year 4 students (n = 60) were invited to act as tutors for Year 2 students (n = 51). Similarly, the ‘tutees’ were invited to take part on a voluntary basis. Students were invited to attend focus groups, which were held at the end of the program. Framework analysis was used to code and categorise data into themes.
Results: In total, 108/207 (52 %) students participated in the program. A total of 42/106 (40 %) of Year 3 and 4 students took part as tutors; and of 66/101 (65 %) of Year 1 and 2 students took part as tutees. Five focus groups were held, with 50/108 (46 %) of students voluntarily participating. Senior students (tutors) valued the opportunity to practice and improve their medical knowledge and teaching skills. Junior students (tutees) valued the opportunity for additional practice and patient interaction, within a relaxed, small group learning environment.
Conclusion: Students perceived the peer tutoring program as affording opportunities not otherwise available within the curriculum. The peer teaching program provided a framework within the medical curriculum for senior students to practice and improve their medical knowledge and teaching skills. Concurrently, junior students were provided with a valuable learning experience that they reported as being qualitatively different to traditional teaching by faculty.

The influence of experimental design on the magnitude of the effect size -peer tutoring for elementary, middle and high school settings: A meta-analysis

A meta-analysis was undertaken on a form of cooperative learning, peer tutoring. The effects of experimental design on outcomes were explored, as measured by Effect Size (ES). Forty three articles with 82 effect size studies were included in the meta-analysis. Highest ES were reported for quasi-experimental studies. ES reduced as experimental design moved from single pre-test factor matched, to multiple-factor matched randomized controlled trials. ES reduced when designs used standardised, rather than self-designed measures. The implications for future meta-analyses and research in cooperative learning are explored.

Interpretations of national identity in post-conflict Northern Ireland: A comparison of different school settings

It is generally accepted that education has a significant role to play in anysociety transitioning from conflict to a more peaceful dispensation. Indeed,some have argued that the education system potentially represents the singlemost effective agent of social change with the capacity to bridge ethnicdivision in conflict affected countries. Despite the potential, educationalpolicy-makers grapple with the dilemma as to precisely how school systemscan best facilitate this agenda. This paper thus attempts to shed lightupon the dilemma by exploring pupil identity and associated intergroupattitudes across various school types in Northern Ireland. Five schools wereselected for the study with each one representing a particular sector withinthe Northern Irish education system (maintained grammar, maintainedsecondary, controlled grammar, controlled secondary, integrated). This led toa total sample size of 265 pupils. The main findings show that children acrossseparate Catholic, separate Protestant and mixed Catholic and Protestanteducational contexts construct and interpret identity differently. At thesame time, our data suggest that no one school setting has supremacy inpromoting social cohesion. The implications of these findings are discussed.

School's out forever: Postsecondary educational trajectories of students with autism

Objective:Postsecondary educational attainment is the key for successful transition to adulthood, economic self-sufficiency, and good mental and physical health.Method:Secondary analyses of school leavers’ data were carried out to establish postsecondary educational trajectories of students on the autism spectrum in the United Kingdom.Results:Findings show that students with autism who had attended mainstream secondary schools enter Further Education (post-16 vocational training) and Higher Education (University) institutions at a similar rate to other students to study the full range ofsubjects on offer. However, they are more likely to be younger, study at a lower academic level, and remain living at home.Conclusion:While course completion data were not yet available, attainment data showed that prospects were improving, although more needs to be done to enable these young adults to a achieving their post secondary educational potential.

'This is a beautiful school.' 'This school is useless!' Explaining disengagement in a Greek vocational school through the examination of teacher ideologies

This multimethod case study of a Greek vocational school explored teachers’ culture (including beliefs about education, teachers’ role, and students’ nature) using the concept of Pupil Control Ideology to explain problems of disengagement and low morale among staff and students, as well as tensions in relationships. A prominent custodial culture was identified in the school using a functional/apolitical pedagogy to transmit ‘legitimate’ knowledge to students whose working-class background did not produce desired outcomes. This generated deficit views of students, teachers’ sympathy, and a seemingly caring school ethos which was, nevertheless, oppressive. Students’ failings were naturalised and vocational education misinterpreted as merely a streaming device in a system honouring academic achievement and middle-class ways. Teachers were blind to these cultural subtleties, believing they acted ‘rationally’ and altruistically. A humanistic subculture emphasising student empowerment and social transformation consisted of a minority of teachers and was rather marginalised. This disallowed meaningful dialogue and the identification of an alternative rationale for the sector, generating strong feelings of futility. Positive change in this school necessitated the deconstruction and (subsequent) reconstruction of custodial teachers’ worldview as embedded in their practice.

Determinants of uptake and maintenance of active commuting to school

The objective was to identify determinants of uptake and maintenance of active school travel (AST) over 4 years in children aged 9 at baseline. Data from wave 1 (n=8502) and 2 (n=7479) of the Growing Up in Ireland study were analysed. At 9- and 13-years 25% and 20% engaged in AST. Children were more likely to maintain or take-up AST if they lived in an urban area. Change in distance to school influenced both maintenance and adoption of AST, with a negative impact seen for increased distance between 9 and 13 years and a positive impact seen for decreased distance. Some factors which predict uptake and maintenance of AST are modifiable and can inform intervention development.