Effect of providing free glasses on children's educational outcomes in China: cluster randomized controlled trial

Objective: To assess the effect of provision of free glasses on academic performance in rural Chinese children with myopia. Design: Cluster randomized, investigator masked, controlled trial.Setting 252 primary schools in two prefectures in western China, 2012-13. Participants: 3177 of 19 934 children in fourth and fifth grades (mean age 10.5 years) with visual acuity <6/12 in either eye without glasses correctable to >6/12 with glasses. 3052 (96.0%) completed the study.Interventions Children were randomized by school (84 schools per arm) to one of three interventions at the beginning of the school year: prescription for glasses only (control group), vouchers for free glasses at a local facility, or free glasses provided in class. Main outcome measures: Spectacle wear at endline examination and end of year score on a specially designed mathematics test, adjusted for baseline score and expressed in standard deviations. Results: Among 3177 eligible children, 1036 (32.6%) were randomized to control, 988 (31.1%) to vouchers, and 1153 (36.3%) to free glasses in class. All eligible children would benefit from glasses, but only 15% wore them at baseline. At closeout glasses wear was 41% (observed) and 68% (self reported) in the free glasses group, and 26% (observed) and 37% (self reported) in the controls. Effect on test score was 0.11 SD (95% confidence interval 0.01 to 0.21) when the free glasses group was compared with the control group. The adjusted effect of providing free glasses (0.10, 0.002 to 0.19) was greater than parental education (0.03, −0.04 to 0.09) or family wealth (0.01, −0.06 to 0.08). This difference between groups was significant, but was smaller than the prespecified 0.20 SD difference that the study was powered to detect. Conclusions: The provision of free glasses to Chinese children with myopia improves children’s performance on mathematics testing to a statistically significant degree, despite imperfect compliance, although the observed difference between groups was smaller than the study was originally designed to detect. Myopia is common and rarely corrected in this setting. Trial Registration: Current Controlled Trials ISRCTN03252665.

Associations between near work, outdoor activity, and myopia among adolescent students in rural China: the Xichang Pediatric Refractive Error Study report no. 2.

OBJECTIVE:

To study the associations between near work, outdoor activity, and myopia among children attending secondary school in rural China.

METHODS:

Among a random cluster sample of 1892 children in Xichang, China, subjects with an uncorrected acuity of 6/12 or less in either eye (n = 984) and a 25% sample of children with normal vision (n = 248) underwent measurement of refractive error. Subjects were administered a questionnaire on parental education, time spent outdoors, and weekly time spent engaged in and preferred working distance for a variety of near-work activities.

RESULTS:

Among 1232 children with refraction data, 998 (81.0%) completed the near-work survey. Their mean age was 14.6 years (SD, 0.8 years), 55.6% were girls, and 83.1% had myopia of -0.5 diopters or less (more myopia) in both eyes. Time and diopter-hours spent on near activities did not differ between children with and without myopia. In regression models, time spent on near activities and time outdoors were unassociated with myopia, adjusting for age, sex, and parental education.

CONCLUSIONS:

These and other recent results raise some doubts about the association between near work and myopia. Additional efforts to identify other environmental factors associated with myopia risk and that may be amenable to intervention are warranted.

Attitudes of students, parents, and teachers toward glasses use in rural China.

OBJECTIVE:

To use focus groups to understand barriers to glasses use among children in rural China.

METHODS:

Separate focus groups were conducted between December 17, 2007, and August 5, 2008, for the following 3 groups at each of 3 schools in rural China: children aged 14 to 18 years with myopia of less than -0.5 diopters in both eyes, those children's parents, and those children's teachers. Participants were also asked to rank their responses to questions about glasses use. The focus group transcripts were coded independently by 2 investigators using qualitative data management software.

RESULTS:

Respondents of all 3 types indicated that glasses purchase and wear should be delayed in children with early myopia and might be harmful to the eyes. Parents and students reported being uncertain about children's actual myopia status and whether glasses should be worn. Parents ranked their most common reason for not buying glasses as being "too busy with work," whereas "too expensive" ranked low. Inconvenience was ranked as an important reason for not wearing glasses among all 3 student groups. "Accuracy of lens power" was the first-ranked requirement for glasses among all student groups, whereas "new and attractive styles" was ranked last by all. All 3 types of respondents believed that wearing glasses or failing to wear them might worsen myopia.

CONCLUSIONS:

Educational programs are needed to address significant knowledge gaps in families and schools about glasses use in rural China. Cost and the need for attractive styles may not be significant barriers to use in this setting, raising the possibility of paying for such programs through cost recovery.

Ophthalmology. 2011 Dec;118(12):2343-50. doi: 10.1016/j.ophtha.2011.06.016. Epub 2011 Sep 1. Randomized, controlled trial of an educational intervention to promote spectacle use in rural China: the see well to learn well study.

OBJECTIVE: To test an educational intervention promoting the purchase of spectacles among Chinese children. DESIGN: Randomized, controlled trial. PARTICIPANTS: Children in years 1 and 2 of all 20 junior and senior high schools (ages 12-17 years) in 3 rural townships in Guangdong, China. METHODS: Children underwent visual acuity (VA) testing, and parents of participants with presenting VA worse than 6/12 in either eye improving by more than 2 lines with cycloplegic refraction were recommended to purchase glasses. Children at 10 randomly selected schools received a lecture, video, and classroom demonstration promoting spectacle purchase. MAIN OUTCOME MEASURES: Self-reported purchase of spectacles (primary outcome) and observed wear or possession of newly purchased glasses (secondary outcome) at follow-up examinations (mean, 219 ± 87 days after the baseline visit). RESULTS: Among 15 404 eligible children, examinations were completed for 6379 (74.6%) at intervention schools and 5044 (73.6%) at control schools. Spectacles were recommended for 2236 (35.1%) children at intervention schools and for 2212 (43.9%) at control schools. Of these, 417 (25.7%) intervention schools children and 537 (34.0%, P = 0.45) control schools children reported buying glasses. Predictors of purchase in regression models included female gender (P = 0.02), worse uncorrected VA (P < 0.001), and higher absolute value of refractive error (P = 0.001). Neither the rate of self-reported purchase of glasses or observed wear or possession of newly purchased glasses differed between control schools and intervention schools in mixed-effect logistic regression models. Among children not purchasing glasses, 21.7% had better-eye VA of worse than 6/18. CONCLUSIONS: An intervention based on extensive pilot testing and focus groups in the area failed to promote spectacle purchase or wear. The high burden of remaining uncorrected poor vision underscores the need to develop better interventions. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Professional Educational Psychology and Community Relations Education in Northern Ireland.

This article provides an account of practice-based research of, at least, one-star quality in terms of its contribution to both theory and practice. Aimed at practitioner (as opposed to academic) psychologists, the article addresses a dimension of the practitioner role that has remained silent in the literature. The article makes creative and original connections between school effectiveness, school improvement and education in a divided society. Post 11th September, the article was described as being highly original, significant and relevant to all practising educational psychologists. Concrete evidence for this is gained from, eg: hits on the online electronic version (2002-2003 Annual Report of the Association of Educational Psychologists), citations in reviews of research, and author invitations to present his work at UK and international practitioner psychology conferences. The article is published in the premier journal reporting on quality applied educational research and practice within the United Kingdom and beyond.

The general and specific effects of educational programmes aimed at promoting awareness of and respect for diversity among young children

This article reports the findings of a mixed-method evaluation of a pilot educational programme undertaken with 6-7 year olds in a sample of primary schools in England with the aim of increasing their awareness of and respect for diversity through theatre, workshops and related teacher-led classroom activities. The qualitative feedback from the teachers involved was extremely positive and encouraging and an analysis of the actual impact of the pilot programme on the children’s attitudes and awareness, using an experimental design, demonstrated some positive effects. In particular, the programme was found to increase the children’s general awareness of diversity and their ability to recognise instances of exclusion. While not a planned objective of the pilot programme, the evaluation also examined whether it had any effects on the children’s attitudes to specific differences, in this particular case racial differences. Interestingly, however, no evidence was found of any change in the children’s racial attitudes. With this in mind the article suggests that there is a need to distinguish between the general and specific effects of such educational programmes. The article considers the implications of this for future work in the area and also stresses the need to undertake more thorough and rigorous evaluations of such initiatives.

Possible futures for social work with children and families in Australia, the United Kingdom and the United States

There has been considerable interest in recent years in comparing the operation of social work services to children and families internationally, particularly between Australia, the United Kingdom and the United States. Reviewing the respective policy environments and drawing on recent research experience in these three nations the author speculates as to how such services may be placed to respond to a converging agenda to tackle the high social and economic costs of social exclusion. It is argued that a conspiracy of circumstances have led child and family social work away from its more general child welfare objectives of the past and created consolidation of functions in relation to child protection work. This has left services ill prepared to play a central role within a new and resurgent child welfare agenda.

'Research Training and Professional Social Work Education: Developing Research-Minded Practice' Social Work Education, .

The movement towards developing practice more firmly grounded on empirical research has, arguably, been one of the most significant international trends in social work during the past decade. However, in the UK the implications of this trend for pedagogical practices and the design of educational programmes have still to be fully explored. This paper reports on the findings of a repeated cross-sectional survey of MSW students in Queen's University Belfast which focused on their perceptions of the value of research training to professional practice. The study, conducted over a four year period, explored students' awareness of the relationship between research and practice and their readiness to engage with research training. The findings suggested that the majority of students perceived research training as a valuable component of professional development. However, the study also found a level of scepticism among students about its practical utility along with some resistance towards actively embracing a research agenda. The paper evaluates the significance of these findings for developing research and evidence-based practice as integral components of the new degrees in social work in the UK and for social work education programmes in other countries aiming to develop research-minded practice.

Do dynamic work instructions provide an advantage over static instructions in a small scale assembly task?

Recent studies exploring the effects of instructional animations on learning compared to static graphics have yielded mixed results. Few studies have explored their effectiveness in portraying procedural-motor information. Opportunities exist within an applied (manufacturing) context for instructional animations to be used to facilitate build performance on an assembly line. The present study compares build time performance across successive builds when using animation, static diagrams or text instructions to convey an assembly sequence for a handheld device. Although an immediate facilitating effect of animation was found, yielding a significantly faster build time for Build 1, this advantage had disappeared by Build 3. (C) 2009 Elsevier Ltd. All rights reserved.

Crossing borders through cyberspace: a discussion of a social work education electronic exchange pilot project across the Atlantic

This article discusses a trial electronic exchange project developed between social work education departments in the Republic of Ireland and the USA. It outlines the contemporary significance and challenges of integrating global content into national social work curricula, which are often strongly tied to statutory or accreditation requirements. The mechanics of the exchange are explained and critiqued in detail. An illustrative example of how the transnational students discussed two questions is analyzed. The article finds that an international electronic exchange has great potential to make global social work real to students by allowing them to cross borders through cyberspace, however it requires careful planning and attention to cultural and educational system differences.