Bradford Scholars
Bradford Scholars is the University of Bradford online research archive. Access is free to anyone interested in research being conducted at Bradford. In the repository you will find a range of materials from journal articles and conference papers to research reports and theses.
Contact the repository team via openaccess@bradford.ac.uk with any queries about Open Access or how to deposit your research papers.
Communities in Bradford Scholars
Select a community to browse its collections.
Recent Submissions
Publication Prevalence of refractive errors in Vietnamese school children: a meta-analysis(2025)Clinical Relevance: The findings provide greater information on the level of refractive errors in Vietnam, which could assist clinicians and relevant stakeholders to identify high-risk groups and prioritise interventions and preventative measures, contributing to more efficient eye care and cost-effective strategies. Background/Aims: Vietnam, a developing country in Southeast Asia, has shown an increase in myopia progression in recent years. However, the prevalence of refractive errors across the country is unclear. The aim of this study was to estimate the pooled prevalence of different refractions in children across Vietnam, and to explore differences between rural and urban areas, and male and female children. Methods: A systematic literature search was performed to capture all studies up to April 2024, using online databases including Medline, Web of Science, Scopus, and CINAHL. This was carried out independently by two researchers, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO ID: CRD42024524780). The quality assessment of included studies was conducted using the Joanna Briggs Institute Prevalence Critical Appraisal Tool checklist. Meta-analysis was performed to estimate pooled refractive error prevalence, with robustness evaluated using 95% confidence intervals and sensitivity analyses. Results: 15 school-based studies were identified (children n = 32,211), of which 6 qualified for meta-analysis inclusion (n = 15,825). The pooled refractive error, myopia, and hyperopia prevalences were calculated respectively as 37.60% [95%CI: 27.78–47.43], 28.83% [95%CI: 19.24–38.42], and 0.41% [95%CI: 0.24–0.59] with high heterogeneities of 99%, p<0.01. Refractive error prevalence was greater in urban locations, and female children. Conclusions: This systematic review and meta-analysis of refractive error prevalence in Vietnamese school children indicates a significant presence of refractive error, especially myopia. However, the large interval ranges suggest that further research using a standardised protocol is required to achieve more accurate estimates.Publication Factors affecting the lifetime cost of myopia and the impact of active myopia treatments in Europe(2025-10)PURPOSE: There are an increasing number of effective myopia control options available; however, their financial impacts are unclear. We estimated lifetime costs of myopia under 5 scenarios in France and the United Kingdom (UK): traditional myopia management (single vision correction), low-dose atropine, anti-myopia spectacles, anti-myopia soft contact lenses, and orthokeratology. DESIGN: Model-based cost estimate. METHODS: Each modeled scenario began with an 8-year-old child presenting with −0.75 DS. Natural progression data were used to determine the likelihood of possible refractive outcomes for children predicted to be at risk for faster and slower myopia progression until adulthood followed by an assumed exponential decay to zero progression by age 25 years. Societal care costs (direct and indirect) were collected from published sources, key informants, and informal surveys. Predicted progression rates for those at risk for slower and faster progression, costs, protocols, and risks were used to estimate and compare lifetime cost of myopia and its associated complications under each scenario. All future costs were discounted by 3% per year for sensitivity analysis. The main outcome measures were the lifetime cost of myopia, and cost ratio (myopia control cost divided by traditional care cost). RESULTS: Estimated lifetime cost of myopia using a traditional approach was US$32,492/US$22,606 for those predicted to experience faster/slower myopia progression in France, and US$48,170/US$29,664 in the UK. For those at risk for faster progression in France and the UK, cost ratios for the myopia control options ranged from 0.60 to 0.81, and 0.50 to 0.69, respectively. For those at risk for slower progression in France and the UK, the cost ratios ranged from 0.81 to 1.10, and 0.73 to 1.00, respectively. Female individuals incurred higher lifetime costs due to higher contact lens wear rates, prevalence of vision impairment, and longer life expectancy. CONCLUSIONS: Investment in myopia control during childhood in Europe likely reduces the total lifetime cost of myopia compared to traditional care via reduced refractive progression, need for complex lenses, and risk of pathology and vision loss. Children predicted to experience faster myopia progression derive the greatest economic advantage from myopia control.Publication Frequency and causes of visual impairment in people attending outreach clinics in Zambia(2025)Clinical relevance: Preventable visual impairment and blindness represent significant global public health challenges. Expanding access to high-volume eye care services in underserved areas may reduce visual impairment and blindness. Background: Visual impairment negatively impacts quality of life, education, and employability, but is often treatable with management following a basic eye examination. Access to basic eyecare in Zambia is limited. Vision Action, a UK-based nongovernmental organisation, facilitates eyecare services in Zambia to reduce rectifiable visual impairment by supporting government outreach clinics in underserved communities. This study examines the frequency of presenting visual impairment, uncorrected refractive error, and ocular pathology among outreach clinic attendees in Zambia. Methods: A retrospective analysis of outreach clinic records between 2012 and 2015 was performed. The available data include patient demographics, presenting symptoms, presenting level of vision, and classification of any ocular pathology present. Levels of visual impairment were categorised according to the World Health Organization's classification for blindness and visual impairment. Results: Data from 5809 patients were collected (58.5% female, mean age = 41.9 years, SD = 20.7 years). Presenting vision, in the better eye, was classified as ‘moderate visual impairment’ in 14.2% (n = 766), ‘severe visual impairment’ in 0.3% (n = 15) and ‘blind’ in 4.3% (n = 234) of individuals. Uncorrected refractive error was responsible for 62.4% and 57.0% of blindness and severe visual impairment, respectively. Cataract, corneal scarring, and glaucoma were the most common non-refractive ocular pathologies associated with visual impairment. Conclusion: Uncorrected refractive error is the leading cause of blindness and visual impairment in patients presenting to outreach clinics in Zambia and is particularly significant in a predominantly working-age population. Outreach clinics are an effective method of detecting and treating correctable visual impairment in this population. However, there is a need to expand and enhance primary eyecare services to reduce the burden of visual impairment, through management of uncorrected refractive error.Publication Taking a partnership approach to embed physical activity in local policy and practice: a Bradford District case study(2025-01)Background: Supportive policy is an important component of a whole-systems approach to increasing physical activity and reducing inequalities. There is a growing body of literature surrounding the design and effectiveness of national policy approaches to physical activity, but evidence related to local-level approaches is lacking. The aim of this study was to examine ‘what works’, and identify factors underpinning change, focused on work to embed physical activity in local policy and practice in Bradford, UK. Methods: A mixed-methods case study approach involved collecting data from cross-sectoral stakeholders directly or indirectly engaged in the physical activity agenda in Bradford over a period of three years (2021–2024). Data collection included focus groups, semi-structured interviews, researcher observations of key workshops and meetings, and surveys at two time-points (December 2021 and January 2024). Qualitative data were analysed using reflexive thematic analysis. Quantitative data were analysed using descriptive and inferential statistics. Results: Four themes were identified which embody conditions that appear to be critical for working towards physical activity being embedded in local policy & practice within the Bradford District. These included: collaboration and sector integration, co-productive working, governance and leadership, and cultivating a learning culture. The process of co-producing a district-wide strategy for physical activity was key to facilitating shared ownership of the physical activity agenda across different levels of the system, and for supporting and maintaining cross-sectoral collaboration. On average, survey respondents connected with four more local organisations in relation to the physical activity agenda in January 2024 than in December 2021. Conclusion: Taking a partnership approach, and fostering a culture of evidence-informed decision making, is key to embedding physical activity into policy and practice at a local level. Investing time to understand the aims and values of each partner, and potential synergies and tensions between them, can support the development of a positive and productive collaboration and, subsequently, more effective whole-system delivery and population-level increases in physical activity.