Global trends in myopia management attitudes and strategies in clinical practice

PURPOSE: Myopia is a global public health issue; however, no information exists as to how potential myopia retardation strategies are being adopted globally. METHODS: A self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. RESULTS: Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5 (±37.8)% prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%). CONCLUSIONS: Regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.

Attitudes to language in literary sources:beyond post-colonialism in nigerian literature

All societies display attitudes to (varieties of) languages that tell us about the relative status of the groups that are associated to them. One method to document these is the systematic study of public discourses, including literary production. How (varieties of) languages are used, mentioned and characterised in a literary work tells us about their social status, and any change in this status should therefore be followed by changes in judgements on languages. This is demonstrated by the present paper with reference to the language attitudes in Nigeria, on the basis of two iconic Nigerian novels 2004 Purple Hibiscus and in 1958 classic postcolonial Things Fall Apart, separated by nearly fifty years. Ibo as well as Pidgin, Nigerian and European Englishes are presented in Purple Hibiscus in nuanced complementary configurations. A strong axiological polarisation is by contrast offered in Things Fall Apart between Ibo speakers and Ibo interpreters who are presented as cruel and ridiculous traitors siding with the English colonising power whose language, curiously, is not commented upon. Showing how a replicable method applied to language judgements can document social organisation and change, these results validate the view that the Nigerian society and culture has moved beyond the historically situated postcolonialist movement to embrace a globalised paradigm. © 2010 Taylor & Francis.