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Current status of school vision screening—rationale, models, impact and challenges: a review
Full text linkUncorrected refractive error is the leading cause of vision impairment in children globally, and studies have demonstrated that spectacle correction addresses the large majority of childhood vision impairment. Furthermore, trial evidence illustrates the beneficial impact of spectacles on learning, with effect sizes exceeding that of other school health interventions. While it is established that good vision is important for learning and optimising childhood development and quality of life, many countries lack healthcare systems that provide vision screening or universal access to eyecare for all citizens. This review examined school vision screening across several regions/countries, focusing on conditions that should be targeted and the corresponding interventions. The range of international models, the status of global refractive service coverage and measures needed for improvement are discussed. Vision screening protocols need to effectively detect vision impairment, seamlessly connect with intervention services to deliver spectacles and signpost for future access to eyecare. Conditions which may not be treatable with spectacles alone, including amblyopia, strabismus and other ocular diseases, also warrant signposting for treatment. The vision community must unite to urge governments to invest in building service capacity; allocating the necessary resources and effectively developing public health systems to support vision screening and access to eyecare. Schools play a crucial role in enabling population-based vision screening and need to be supported with eyecare interventions and resources. This will ensure optimised approaches to correct avoidable vision loss and provide children with the educational and health outcomes they deserve
Effective refractive error coverage in adults: a systematic review and meta-analysis of updated estimates from population-based surveys in 76 countries modelling the path towards the 2030 global target
Full text linkBackground: In 2024, WHO included effective refractive error coverage (eREC) into the results framework of the 14th General Programme of Work, which sets a road map for global health and guides WHO's work between 2025 and 2028. eREC is a measure of both the availability and quality of refractive correction in a population. This study aimed to model global and regional estimates of eREC as of 2023 and evaluate progress towards the WHO global target of a 40 percentage-point absolute increase in eREC by 2030. Methods: For this systematic review and meta-analysis, the Vision Loss Expert Group analysed data from 237 population-based eye surveys conducted in 76 countries since 2000, comprising 815 273 participants, to calculate eREC (met need / met need + undermet need + unmet need]) and the relative quality gap between eREC and REC ([REC – eREC] / REC × 100, where REC = [met + undermet need] / [met need + undermet need + unmet need]). An expert elicitation process was used to choose covariates for a Bayesian logistic regression model used to estimate eREC by country–age–sex grouping among adults aged 50 years and older. Country–age–sex group estimates were aggregated to provide estimates according to Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions. Findings: Global eREC was estimated to be 65·8% (95% uncertainty interval [UI] 64·7–66·8) in 2023, 6 percentage points higher than in 2010 (eREC 59·8% [59·4–60·2]). There were marked differences in eREC between GBD super-regions in 2023, ranging from 84·0% (95% UI 83·0–85·0) in high-income countries to 28·3% (26·4–30·4) in sub-Saharan Africa. In all super-regions, eREC was lower in females than males, and decreased with increasing age among adults aged ≥50 years. Since 2000, the relative increase in eREC was 60·2% in sub-Saharan Africa, 45·7% in North Africa and the Middle East, 41·5% in southeast Asia, east Asia and Oceania, 40·3% in south Asia, 16·2% in Latin America and the Caribbean, 8·3% in central Europe, eastern Europe and central Asia, and 6·8% in the high-income super-region. The relative quality gap ranged from 2·9% to 78·3% across studies, with larger gaps characteristically in regions of lower eREC. Globally, the percentage of those with a refractive need that was undermet reduced between 2000 and 2023, from 10·0% (95% UI 9·5–10·5) to 5·3% (5·1–5·5). Interpretation: The current trajectory of improvement in eREC and the relative quality gap are insufficient to meet the 2030 target. Global efforts to equitably increase spectacle coverage, such as the WHO SPECS 2030 initiative, and to address equity failings associated with geography, age, and sex, are crucial to accelerating progress towards the 2030 targets. No region is close to achieving universal coverage. Funding: WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, University of Heidelberg, German Federal Ministry for Education and Research. Translations: For the French, Chinese and Spanish translations of the abstract see Supplementary Materials section.</p
An investigation of the potential effect of microbial biosurfactants against nosocomial bacteria
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Morphology characterisation of additive manufacturing powder through automated image analysis algorithms
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A mixed-methods process evaluation of the ‘Walk with Me’ peer-led walking intervention to increase physical activity in inactive older adults
No full textWho is at risk from accidental dwelling fire fatalities, what can be done to reduce this risk and how can this be delivered in the community?
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The (poly)phenolic content and antioxidant capacity of apple varieties grown in or imported to Northern Ireland
Full text linkApples have benefits to health through protection against chronic disease, largely attributed to their (poly)phenolic and antioxidant content. As this content is unknown in apples grown or available in Northern Ireland, thirteen common (poly)phenols, proanthocyanidins, ascorbic acid and antioxidant capacity were determined in 74 apple varieties. Varieties were categorized into five groups: imported dessert, locally grown dessert, culinary, locally grown cider, and Irish heritage apples. (Poly)phenol content ranged from 5.16 to 33.2 g kg−1 DW and ascorbic acid from 0.03 to 1.4 g kg−1 DW across all apples investigated. Lower concentrations of total flavanols, phenolic acids, dihydrochalcones, proanthocyanidins, ascorbic acid and antioxidant capacity were found in imported dessert apples when compared to locally grown dessert, culinary, locally grown cider and Irish heritage apples. Principal component analysis (PCA) located dessert and culinary apples in two distinct groups, while many heritage and cider apples were scattered throughout the plot, suggesting that these varieties may have unique bioactive profiles. The results indicate that many older Irish varieties are a rich source of bioactives worthy of commercial exploitation, while the culinary Bramley’s seedling variety contains the highest bioactive content currently available to consumers in Northen Ireland and possibly the wider UK market