Evaluating digital diabetic retinopathy screening in people aged 90 years and over

Introduction: The English National Screening Programme determines that all people with diabetes aged 12 and over should be screened annually for diabetic retinopathy (DR) until they die. Purpose: This study aimed to evaluate digital DR screening in patients aged 90 and over to establish whether it is appropriate to cease screening at age 90. Methods: A retrospective analysis of 200 randomly selected patients with diabetes aged 90 and over within the Birmingham and Black Country Screening Programme. Results: 179 (90%) patients attended screening at least once after turning 90 years of age. To date, the mean number of screens per person 90+ was two (range 1–6) and the mean age of the first of these screens was 91 years (range 90–98 years). 133 (74%) were put on annual recall after their first screen in their 90’s, of which 58% had no visible DR bilaterally. 38 (21%) were referred to ophthalmology - 35 (92%) for non-DR reasons and three for maculopathy. Of the 133 patients put on annual recall, 75 (56%) were screened at least once more. Seven improved, 36 remained stable, three became unsuitable and 29 deteriorated. Of the latter, 18 patients were referred to ophthalmology; one of these for DR. Conclusion: Patients with diabetes aged 90 and over are at low risk of sight threatening DR and annual screening in this age group may be unnecessary. However, annual screening does provide opportunistic identification.

On plagiarism, patchwriting and the problems of overseas students in British universities

Although according to Angélil-Carter (2002: 2) ‘plagiarism is a modern Western concept which arose with the introduction of copyright laws in the Eighteenth century’, its avoidance is now a basic plank of respectable academic scholarship. Student plagiarism is currently a hot topic, at least for those who teach and study in British and American universities. There are companies selling both off-the-shelf and written-to-order term papers and others, like Turnitin.com, offering an electronic detection service. Recently an Australian Rector was dismissed for persistent plagiarism earlier in his career and most Anglo-American universities have warnings against and definitions of plagiarism on their websites – indeed Pennycook notes that in the mid-90s Stanford University's documents about plagiarism were reproduced by the University of Oregon apparently without attribution, and suggests, whimsically, that there is 'one set of standards for the guardians of truth and knowledge and another for those seeking entry' (1996: 213), (example and quote taken from Pecorari, 2002, p 29).