Epidemiology of myopia in a United Kingdom urban child population

The Aston Eye Study (AES) was instigated in October 2005 to determine the distribution of refractive error and associated ocular biometry in a sample of UK urban school children. The AES is the first study to compare outcome measures separately in White, South Asian and Black children. Children were selected from two age groups (Year 2 children aged 6/7 years, Year8 children aged 12/13 years of age) using random cluster sampling of schools in Birmingham, West Midlands UK. To date, the AES has examined 598 children (302 Year 2,296 Year 8). Using open-field cycloplegic autorefraction, the overall prevalence of myopia (=-0.50D SER in either eye) determined was 19.6%, with a higher prevalence in older (29.4%) compared to younger (9.9%) children (p<0.001). Using multiple logistic regression models, the risk of myopia was higher in Year 8 South Asian compared to White children and higher in children attending grammar schools relative to comprehensive schools. In addition, the prevalence of uncorrected ametropia was found to be high (Year 8: 12.84%, Year 2: 15.23%), which will be of concern to bodies responsible for the implementation of school vision screening strategies. Biometric data using non-contact partial coherence interferometry revealed a contributory effect of axial length (AL) and central corneal radius (CR) on myopic refraction, resulting in a strong coefficient of determination of the AL/CR ratio on refractive error. Ocular biometric measures did not vary significantly as a function of ethnicity, suggesting a greater miscorrelation of components in susceptible ethnic groups to account for their higher myopia prevalence. Corneal radius was found to be steeper in myopes in both age groups, but was found to flatten with increasing axial length. Due to the inextricable link between myopia and axial elongation, the paradoxical finding of the cornea demands further longitudinal investigation, particularly in relation to myopia onset. Questionnaire analysis revealed a history of myopia in parents and siblings to be significantly associated with myopia in Year 8 children, with a dose-dependent rise in the odds ratio of myopia evident with increasing number of myopic parents. By classifying socioeconomic status (SES) using Index of Multiple Deprivation values, it was found that Year 8 children from moderately deprived backgrounds were more at risk of myopia compared with children located at both extremities of the deprivation spectrum. However, the main effect of SES weakened following multivariate analysis, with South Asian ethnicity and grammar schooling remaining associated with Year 8 myopia after adjustment.

Teachers' conceptions of their role

An analysis is made of the conceptions which serving teachers have of their role, though no attempt is made to relate this to their practice of teaching. A series of role items was collected to afford a description of the teacher's role in terms of school and society expectations as well as classroom behaviours. These were taken from the literature and from interviews with teachers, and confirmed in a preliminary survey. Presented as a questionnaire, replies to the main investigation were made by 881 teachers, working in a variety of schools from nurseries to comprehensives. Two attempts have been made to construct a role model. The first, depending on the judgement of items fitting theoretically derived roles, failed, due to diffuseness in the role of teacher. The second used factor analysis; six factors were extracted which represent meaningful and distinct areas of role. The analysis has depended largely on examination of scores taken from these factors. Teachers in all types of school have similar conceptions of discipline. Nursery-infant and junior staff generally agree on the other areas investigated, but the concepts of secondary teachers are distinct. They are more conservative and less child-centered. When the class being taught is held constant, few differences in role conception are found to be related to sex, being a parent, graduate status, or personality, as measured in terms of the extrovert and neurotic dimensions. The first few years of teaching bring considerable changes in role conception, and further changes occur with prolonged experience. Deputy heads in junior schools and nursery nurses have quite distinct role conceptions; those of all other teachers, including those holding senior posts in secondary schools, are similar. The perception of school climate influences the role conception of primary teachers directly, but it does not influence that of secondary teachers. The greatest variation in role conception is related to scores on the radical scale of Oliver and Butcher. Primary school teachers experience little constraint, but that reported by secondary school teachers is considerable, especially that coming from the head. Despite difficulties caused by the wide division between primary and secondary education, teachers have an accurate perception of the roles their colleagues adopt. A few misunderstandings may be due to a feeling of idealism amongst nursery and infant teachers. There is evidence in their conception of role that would enhance the professional standing of teachers, but this is not in a form which is likely to be recognised by the public.

Reduction of noise levels in vaccum cleaners

The work described in this thesis is directed towards the reduction of noise levels in the Hoover Turbopower upright vacuum cleaner. The experimental work embodies a study of such factors as the application of noise source identification techniques, investigation of the noise generating principles for each major source and evaluation of the noise reducing treatments. It was found that the design of the vacuum cleaner had not been optimised from the standpoint of noise emission. Important factors such as noise `windows', isolation of vibration at the source, panel rattle, resonances and critical speeds had not been considered. Therefore, a number of experimentally validated treatments are proposed. Their noise reduction benefit together with material and tooling costs are presented. The solutions to the noise problems were evaluated on a standard Turbopower and the sound power level of the cleaner was reduced from 87.5 dB(A) to 80.4 db(A) at a cost of 93.6 pence per cleaner.The designers' lack of experience in noise reduction was identified as one of the factors for the low priority given to noise during design of the cleaner. Consequently, the fundamentals of acoustics, principles of noise prediction and absorption and guidelines for good acoustical design were collated into a Handbook and circulated at Hoover plc.Mechanical variations during production of the motor and the cleaner were found to be important. These caused a vast spread in the noise levels of the cleaners. Subsequently, the manufacturing processes were briefly studied to identify their source and recommendations for improvement are made.Noise of a product is quality related and a high level of noise is considered to be a bad feature. This project suggested that the noise level be used constructively both as a test on the production line to identify cleaners above a certain noise level and also to promote the product by `designing' the characteristics of the sound so that the appliance is pleasant to the user. This project showed that good noise control principles should be implemented early in the design stage.As yet there are no mandatory noise limits or noise-labelling requirements for household appliances. However, the literature suggests that noise-labelling is likely in the near future and the requirement will be to display the A-weighted sound power level. However, the `noys' scale of perceived noisiness was found more appropriate to the rating of appliance noise both as it is linear and therefore, a sound level that seems twice as loud is twice the value in noys and also takes into consideration the presence of pure tones, which even in the absence of a high noise level can lead to annoyance.

Entry characteristics and academic performance of students in a master of pharmacy degree program in the United Kingdom

Objective. Evaluate the characteristics of a cohort of Master of Pharmacy (MPharm) students upon entry and examine any associations between entry qualifications, type of school attended, socioeconomic deprivation, age and academic performance in the MPharm programme. Methods. A retrospective cohort analysis of data recorded on Aston University’s central database for each individual exiting the MPharm programme during the five year period 2005-6 – 2009-10 (n=644). Results. Entrants were disproportionately drawn from socioeconomically deprived areas and independent (private) schools. Achievement prior to admission was related to the type of school attended but not to deprivation. Performance on the programme was not related to type of school or deprivation but was strongly correlated with prior achievements. Conclusions. Prior achievement is the most important predictor of performance on the MPharm programme but the superior prior achievement of independent school pupils is not seen at the point of graduation. This may have implications for admissions policies.

Genetic analysis of dyslexia candidate genes in the European cross-linguistic NeuroDys cohort

Dyslexia is one of the most common childhood disorders with a prevalence of around 5-10% in school-age children. Although an important genetic component is known to have a role in the aetiology of dyslexia, we are far from understanding the molecular mechanisms leading to the disorder. Several candidate genes have been implicated in dyslexia, including DYX1C1, DCDC2, KIAA0319, and the MRPL19/C2ORF3 locus, each with reports of both positive and no replications. We generated a European cross-linguistic sample of school-age children-the NeuroDys cohort-that includes more than 900 individuals with dyslexia, sampled with homogenous inclusion criteria across eight European countries, and a comparable number of controls. Here, we describe association analysis of the dyslexia candidate genes/locus in the NeuroDys cohort. We performed both case-control and quantitative association analyses of single markers and haplotypes previously reported to be dyslexia-associated. Although we observed association signals in samples from single countries, we did not find any marker or haplotype that was significantly associated with either case-control status or quantitative measurements of word-reading or spelling in the meta-analysis of all eight countries combined. Like in other neurocognitive disorders, our findings underline the need for larger sample sizes to validate possibly weak genetic effects. © 2014 Macmillan Publishers Limited All rights reserved.

Clinical evaluation of a multifocal aspheric diffractive intraocular lens

Aim: To evaluate the performance of an aspheric diffractive multifocal acrylic intraocular lens (IOL), ZMB00 1-Piece Tecnis. Setting: Five sites across Europe. Methods: Fifty-two patients with cataracts (average age 68.5±10.5 years, 35 female) were bilaterally implanted with the aspheric diffractive multifocal IOL after completing a questionnaire regarding their optical visual symptoms, use of visual correction and their visual satisfaction. The questionnaire was completed again 4-6 months after surgery along with measures of uncorrected and best-corrected distance and near visual acuity, under photopic and mesopic lighting, reading ability, defocus curve testing and ocular examination for adverse events. Results: The residual refractive error was 0.01±0.47D with 56% of eyes within ±0.25D and 97% within ±1.0D. Uncorrected visual acuity was 0.02±0.10logMAR at distance and 0.15±0.30 logMAR at near, only reducing to 0.07±0.10logMAR at distance and 0.21±0.25logMAR at near in mesopic conditions.The defocus curve showed a near addition between 2.5-3.0 D allowing a reading acuity of 0.08±0.13 logMAR, with a range of clear vision <0.3 logMAR of ∼4.0 D. The average reading speed was 121.4±30.8 words per minute. Spectacle independence was 100% for distance and 88% for near, with high levels of satisfaction reported. Overall rating of vision without glasses could be explained (r=0.760) by preoperative best-corrected distance acuity, postoperative reading acuity and postoperative uncorrected distance acuity in photopic conditions (p<0.001). Only two minor adverse events occurred. Conclusions: The ZMB00 1-Piece Tecnis multifocal IOL provides a good visual outcome at distance and near with minimal adverse effects.

Development and psychometric tests of the Chinese-version low vision quality of life questionnaire

Background/Aims: To develop and assess the psychometric validity of a Chinese language Vision Health related quality-of-life (VRQoL) measurement instrument for the Chinese visually impaired. Methods: The Low Vision Quality of Life Questionnaire (LVQOL) was translated and adapted into the Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL). The CLVQOL was completed by 100 randomly selected people with low vision (primary group) and 100 people with normal vision (control group). Ninety-four participants from the primary group completed the CLVQOL a second time 2 weeks later (test-retest group). The internal consistency reliability, test-retest reliability, item-internal consistency, item-discrimination validity, construct validity and discriminatory power of the CLVQOL were calculated. Results: The review committee agreed that the CLVQOL replicated the meaning of the LVQOL and was sensitive to cultural differences. The Cronbach's α coefficient and the split-half coefficient for the four scales and total CLVQOL scales were 0.75-0.97. The test-retest reliability as estimated by the intraclass correlations coefficient was 0.69-0.95. Item-internal consistency was >0.4 and item-discrimination validity was generally <0.40. The Varimax rotation factor analysis of the CLVQOL identified four principal factors. the quality-of-life rating of four subscales and the total score of the CLVQOL of the primary group were lower than those of the Control group, both in hospital-based subjects and community-based subjects. Conclusion: The CLVQOL Chinese is a culturally specific vision-related quality-of-life measure instrument. It satisfies conventional psychometric criteria, discriminates visually healthy populations from low vision patients and may be valuable in screening the local community as well as for use in clinical practice or research. © Springer 2005.

Early predictors of phonological and morphological awareness and the link with reading:evidence from children with different patterns of early deficit

This study examines the contribution of early phonological processing (PP) and language skills on later phonological awareness (PA) and morphological awareness (MA), as well as the links among PA, MA, and reading. Children 4-6 years of age with poor PP at the start of school showed weaker PA and MA 3 years later (age 7-9), regardless of their language skills. PA and phonological and morphological strategies predict reading accuracy, whereas MA predicts reading comprehension. Our findings suggest that children with poor early PP are more at risk of developing deficits in MA and PA than children with poor language. They also suggest that there is a direct link between PA and reading accuracy and between MA and reading comprehension that cannot be accounted for by strategy use at the word level.

Cognitive-behavioural phenotype in a group of girls from 1.2 to 12 years old with the Incontinentia Pigmenti syndrome:recommendations for clinical management

Incontinentia Pigmenti (IP, OMIM#308300) is a rare X-linked genomic disorder (about 1,400 cases) that affects the neuroectodermal tissue and Central Nervous System (CNS). The objective of this study was to describe the cognitive-behavioural profile in children in order to plan a clinical intervention to improve their quality of life. A total of 14 girls (age range: from 1 year and 2 months to 12 years and 10 months) with IP and the IKBKG/NEMO gene deletion were submitted to a cognitive assessment including intelligence scales, language and visuo-spatial competence tests, learning ability tests, and a behavioural assessment. Five girls had severe to mild intellectual deficiencies and the remaining nine had a normal neurodevelopment. Four girls were of school age and two of these showed no intellectual disability, but had specific disabilities in calculation and arithmetic reasoning. This is the first description of the cognitive-behavioural profile in relation to developmental age. We stress the importance of an early assessment of learning abilities in individuals with IP without intellectual deficiencies to prevent the onset of any such deficit.