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Article ; Online: Utility of the Actiwatch Spectrum Plus for detecting the outdoor environment and physical activity in children.

Shneor, Einat / Gordon-Shaag, Ariela / Doron, Ravid / Benoit, Julia S / Ostrin, Lisa A

2023 Volume 17, Issue 1, Page(s) 100483

Abstract: Purpose: To describe the performance of the Actiwatch Spectrum Plus (Philips, Respironics) for determining real world indoor and outdoor environments and physical activity in children.: Methods: Children wore the device while performing 10 different ... ...

Abstract	Purpose: To describe the performance of the Actiwatch Spectrum Plus (Philips, Respironics) for determining real world indoor and outdoor environments and physical activity in children. Methods: Children wore the device while performing 10 different activities, ranging from sedentary to vigorous physical-activity, and under different indoor and outdoor conditions. Repeated measures ANOVA was implemented via mixed effects modeling to determine illuminance (lux) and physical activity (counts per 15 s, CP15) across conditions. Receiver operator characteristics (ROC) analysis assessed the accuracy to detect indoor versus outdoor settings. Results: Illuminance was found to be statistically different across indoor (793 ± 348 lux) and outdoor (4,413 ± 518 lux) conditions (P<.0001), with excellent diagnostic accuracy to detect indoor versus outdoor settings (Area under the ROC Curve, AUC 0.94); 1088 lux was identified as the optimal threshold for outdoor illuminance (sensitivity: 93.0%; specificity: 85.0%). Using published activity ranges, we found that when children were sitting, 94% of the physical-activity readings were classified as sedentary or light. When children were walking, 88% of readings were classified as light, and when children were running, 77% of readings were classified as moderate or vigorous. Conclusion: The Actiwatch Spectrum Plus performed well during real world activities in children, showing excellent diagnostic accuracy at 1088 lux as a threshold to detect indoor versus outdoor environments and in categorizing physical activity.
MeSH term(s)	Child ; Humans ; Light ; Exercise
Language	English
Publishing date	2023-10-03
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2443288-X
ISSN	1989-1342 ; 1888-4296
ISSN (online)	1989-1342
ISSN	1888-4296
DOI	10.1016/j.optom.2023.100483
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Article ; Online: Objective quantification of viewing behaviours during printed and electronic tasks in emmetropic and myopic ultra-Orthodox Jewish men.

Doron, Ravid / Gordon-Shaag, Ariela / Shneor, Einat / Goldstein, Ayelet / Ostrin, Lisa A

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

2023 Volume 43, Issue 3, Page(s) 337–346

Abstract: Purpose: Ultra-Orthodox Jewish men are known to have a high prevalence of myopia, which may be due to intense near-work from an early age. This study objectively assessed near-viewing behaviours in ultra-Orthodox and non-ultra-Orthodox men in Israel for ...

Abstract	Purpose: Ultra-Orthodox Jewish men are known to have a high prevalence of myopia, which may be due to intense near-work from an early age. This study objectively assessed near-viewing behaviours in ultra-Orthodox and non-ultra-Orthodox men in Israel for different tasks. Methods: Ultra-Orthodox (n = 30) and non-ultra-Orthodox (n = 38) men aged 18-33 years participated. Autorefraction, visual acuity, height and Harmon distance were measured. An objective range-finding sensor was mounted on their spectacles while they performed four 10-min tasks in a randomised order: (1) reading printed material, (2) writing printed material, (3) passive electronic and (4) active electronic tasks. Near-viewing distance and the number of viewing breaks were calculated for each task. Statistical analyses included Student t-tests and the Mann-Whitney test between groups and repeated measures ANOVA or Friedman between tasks. Results: For all tasks combined, a significantly shorter viewing distance was observed for the ultra-Orthodox group (36.2 ± 7.0 cm) than for the non-ultra-Orthodox group (39.6 ± 6.7 cm, p < 0.05). Viewing distances for the passive reading and electronic tasks were shorter for the ultra-Orthodox group (36.9 ± 7.7 cm vs. 41.3 ± 8.1 cm, p < 0.03 and 39.0 ± 10.1 vs. 43.9 ± 9.3, p < 0.05, respectively). Viewing distances were significantly different between all four tasks, with writing having the closest distance. No correlation was found between working distance and spherical equivalent or Harmon distance. However, a significant correlation was found in the ultra-Orthodox group between working distance and height for each task (p < 0.04, R < 0.42 for all). There was no difference in the number of viewing breaks between the groups. Conclusion: When reading a book and viewing an iPad, ultra-Orthodox men demonstrated a closer objective working distance than non-ultra-Orthodox men. This shorter viewing distance may contribute to the high prevalence and degree of myopia in this population.
MeSH term(s)	Male ; Humans ; Jews ; Myopia/therapy ; Refraction, Ocular ; Visual Acuity ; Israel/epidemiology
Language	English
Publishing date	2023-01-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604564-9
ISSN	1475-1313 ; 0275-5408
ISSN (online)	1475-1313
ISSN	0275-5408
DOI	10.1111/opo.13092
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Article ; Online: The number of optometrists is inversely correlated with blindness in OECD countries.

Shneor, Einat / Isaacson, Michal / Gordon-Shaag, Ariela

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

2020 Volume 41, Issue 1, Page(s) 198–201

MeSH term(s)	Blindness/diagnosis ; Blindness/epidemiology ; Blindness/etiology ; Humans ; Ophthalmologists ; Ophthalmology ; Optometrists ; Optometry ; Organisation for Economic Co-Operation and Development
Language	English
Publishing date	2020-10-16
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	604564-9
ISSN	1475-1313 ; 0275-5408
ISSN (online)	1475-1313
ISSN	0275-5408
DOI	10.1111/opo.12746
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Article: The epidemiology and treatment of conjunctivitis at Urgent Care Centres in Israel.

Gordon-Shaag, Ariela / Zimmerman, Deena Rachel / Shneor, Einat

Clinical ophthalmology (Auckland, N.Z.)

2019 Volume 13, Page(s) 771–779

Abstract: Purpose: ...

Abstract	Purpose:
Language	English
Publishing date	2019-05-02
Publishing country	New Zealand
Document type	Journal Article
ISSN	1177-5467
ISSN	1177-5467
DOI	10.2147/OPTH.S202362
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Article ; Online: The prevalence of refractive errors in college students in Israel.

Shneor, Einat / Doron, Ravid / Ostrin, Lisa A / Gordon-Shaag, Ariela

Journal of optometry

2021 Volume 15, Issue 4, Page(s) 284–292

Abstract: Purpose: To determine the prevalence of refractive errors in Jewish and Arab college students in Israel and associations with ethnicity and sex.: Methods: In this retrospective cross-sectional study, first-year college students underwent non- ... ...

Abstract	Purpose: To determine the prevalence of refractive errors in Jewish and Arab college students in Israel and associations with ethnicity and sex. Methods: In this retrospective cross-sectional study, first-year college students underwent non-cycloplegic autorefraction and answered a questionnaire to assess age, sex, and self-identified ethnicity. Spherical equivalent refractive error (SER) was calculated, and the prevalence of hyperopia (>+0.50 Diopter, D), emmetropia (>-0.50 to +0.50 D), myopia (≤-0.50D, low ≤-0.50 to >-3.0D, moderate <-3.0 to >-6.0D, high ≤-6.0D), and astigmatism (>0.50D) were determined. Groups were compared using Chi-square or Fisher test. Univariate and multivariate analyses were conducted to identify factors associated with refractive errors. Results: Participants (n = 807) had a mean age of 22.1 ± 2.6 years (range: 17-30 years) and SER of -1.7 ± 2.2D (range: -13.3 to +5.7D). The prevalence and 95% confidence internal of myopia was 66.3% (63.0-69.6). Jewish students had a higher prevalence than Arab students for myopia (69.2% vs 60.3%), moderate (18.5% vs 12.2%) and high myopia (5.9% vs 1.9%) and astigmatism (51.4% vs 43.9%, p<0.05 for all), but not low myopia or hyperopia. Females had a higher prevalence of myopia than males (68.1% vs 58.7%, p<0.03). Jewish ethnicity was associated with myopia (OR=1.48, p = 0.01) and moderate myopia (OR=1.72, p = 0.01), and studying optometry was associated with moderate myopia (OR=1.63, p = 0.02). Sex and age were not associated with myopia. Conclusion: Myopia prevalence in Israeli college students is high, showing associations with Jewish, but not Arab, ethnicity, suggesting that ethnic factors may play a role in the refractive differences between Arabs and Jews.
MeSH term(s)	Adult ; Astigmatism/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Hyperopia ; Israel/epidemiology ; Male ; Myopia/epidemiology ; Prevalence ; Refractive Errors/epidemiology ; Retrospective Studies ; Students ; Young Adult
Language	English
Publishing date	2021-12-28
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2443288-X
ISSN	1989-1342 ; 1888-4296
ISSN (online)	1989-1342
ISSN	1888-4296
DOI	10.1016/j.optom.2021.09.001
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Article ; Online: A Novel method of enhancing students' involvement in reflective writing.

Rajhans, Vidyut / Eichler, Rachel / Sztrigler Cohen, Orit / Gordon-Shaag, Ariela

The clinical teacher

2020 Volume 18, Issue 2, Page(s) 174–179

MeSH term(s)	Humans ; Students, Medical ; Writing
Language	English
Publishing date	2020-11-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2151518-9
ISSN	1743-498X ; 1743-4971
ISSN (online)	1743-498X
ISSN	1743-4971
DOI	10.1111/tct.13303
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Article ; Online: Baseline characteristics in the Israel refraction, environment, and devices (iREAD) study.

Shneor, Einat / Ostrin, Lisa A / Doron, Ravid / Benoit, Julia S / Levine, Jonathan / Davidson, Kevin / Gordon-Shaag, Ariela

Scientific reports

2023 Volume 13, Issue 1, Page(s) 2855

Abstract: The purpose of this study is to present baseline data from a longitudinal study assessing behavioral factors in three groups of boys in Israel with varying myopia prevalence. Ultra-Orthodox (N = 57), religious (N = 67), and secular (N = 44) Jewish boys ( ... ...

Abstract	The purpose of this study is to present baseline data from a longitudinal study assessing behavioral factors in three groups of boys in Israel with varying myopia prevalence. Ultra-Orthodox (N = 57), religious (N = 67), and secular (N = 44) Jewish boys (age 8.6 ± 1.4 years) underwent cycloplegic autorefraction and axial-length measurement. Time-outdoors and physical-activity were assessed objectively using an Actiwatch. Ocular history, educational factors, and near-work were assessed with a questionnaire. Group effects were tested and mixed effects logistic and linear regression were used to evaluate behaviors and their relationship to myopia. The prevalence of myopia (≤ - 0.50D) varied by group (ultra-Orthodox: 46%, religious: 25%, secular: 20%, P < 0.021). Refraction was more myopic in the ultra-Orthodox group (P = 0.001). Ultra-Orthodox boys learned to read at a younger age (P < 0.001), spent more hours in school (P < 0.001), spent less time using electronic devices (P < 0.001), and on weekdays, spent less time outdoors (P = 0.02). Increased hours in school (OR 1.70) and near-work (OR 1.22), increased the odds of myopia. Being ultra-Orthodox (P < 0.05) and increased near-work (P = 0.007) were associated with a more negative refraction. Several factors were associated with the prevalence and degree of myopia in young boys in Israel, including being ultra-Orthodox, learning to read at a younger age, and spending more hours in school.
MeSH term(s)	Male ; Humans ; Child ; Israel/epidemiology ; Longitudinal Studies ; Vision Tests ; Refraction, Ocular ; Myopia/epidemiology
Language	English
Publishing date	2023-02-17
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-29563-3
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Article ; Online: The prevalence of corneal abnormalities in first-degree relatives of patients with keratoconus: a prospective case-control study.

Shneor, Einat / Frucht-Pery, Joseph / Granit, Edna / Gordon-Shaag, Ariela

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

2020 Volume 40, Issue 4, Page(s) 442–451

Abstract: Purpose: Although there is a high prevalence of keratoconus in the Middle East including Israel, limited data is available describing first-degree relatives of patients with sporadic keratoconus (KC) using Scheimpflug imaging. The purpose of this study ... ...

Abstract	Purpose: Although there is a high prevalence of keratoconus in the Middle East including Israel, limited data is available describing first-degree relatives of patients with sporadic keratoconus (KC) using Scheimpflug imaging. The purpose of this study is to accurately phenotype first-degree relatives of patients with sporadic KC in Israel using corneal tomography, which may help determine the genetic aetiology of KC. Methods: First-degree relatives (N = 56) of 16 KC probands participated in this prospective case-control study. Healthy controls (N = 96) were from a previous study. Autorefraction, visual acuity, slit lamp biomicroscopy, retinoscopy, subjective refraction and Scheimpflug imaging (CSO Sirius Topographer) of keratoconus patients and their first-degree relatives were evaluated. The worse eye was used for KC and KC suspects. The main outcome measure was prevalence of abnormal corneal topography and tomography parameters, which was compared between first-degree relatives vs controls. p values < 0.05 were considered significant. Results: KC (N = 2) or KC suspect (N = 8) was diagnosed in 18% (95% CI 8-28%) of the first-degree relatives. At least one abnormal corneal parameter was evident in 34% of first-degree relatives, while this was significantly lower for controls (14%, χ Conclusions and relevance: Eye care practitioners should consider first-degree relatives of patients with KC at moderate risk for the disease and/or corneal abnormalities.
MeSH term(s)	Adolescent ; Adult ; Case-Control Studies ; Child ; Cornea/diagnostic imaging ; Corneal Topography/methods ; Family ; Female ; Humans ; Israel/epidemiology ; Keratoconus/diagnosis ; Keratoconus/epidemiology ; Keratoconus/genetics ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Visual Acuity ; Young Adult
Language	English
Publishing date	2020-07-20
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604564-9
ISSN	1475-1313 ; 0275-5408
ISSN (online)	1475-1313
ISSN	0275-5408
DOI	10.1111/opo.12706
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Article ; Online: Environmental and Behavioral Factors with Refractive Error in Israeli Boys.

Gordon-Shaag, Ariela / Shneor, Einat / Doron, Ravid / Levine, Jonathan / Ostrin, Lisa A

Optometry and vision science : official publication of the American Academy of Optometry

2021 Volume 98, Issue 8, Page(s) 959–970

Abstract: Significance: Evidence supporting the contributions of near work in myopia is equivocal. Findings from this pilot study suggest that a high prevalence of myopia in ultra-Orthodox boys may be attributed to intense near work at school and learning to read ...

Abstract	Significance: Evidence supporting the contributions of near work in myopia is equivocal. Findings from this pilot study suggest that a high prevalence of myopia in ultra-Orthodox boys may be attributed to intense near work at school and learning to read in preschool at an early age. Purpose: This study aimed to assess factors that may influence myopia in three groups of Jewish boys with different educational demands. Methods: Healthy ultra-Orthodox, religious, and secular Jewish boys (n = 36) aged 8 to 12 years participated. Refractive status, education, time spent reading and writing, and electronic device use were assessed using a questionnaire, and time outdoors and physical activity were assessed objectively using an Actiwatch. Data were analyzed with χ2 and Kruskal-Wallis tests with Bonferroni post hoc comparisons. Results: Ultra-Orthodox (n = 14) and religious (n = 13) children had greater myopia prevalence compared with secular children (n = 9; P = .01), despite no differences in parental myopia. Actigraph data showed that there were no differences in activity (P = .52) or time spent outdoors (P = .48) between groups. Ultra-Orthodox children learned to read at a younger age and spent more hours at school (P < .001 for both). All groups engaged in a similar amount of near work while not in school (P = .52). However, ultra-Orthodox boys had less electronic device use than did religious (P = .007) and secular children (P < .001). Conclusions: This pilot study demonstrates that ultra-Orthodox, religious, and secular children have distinct educational demands but similar time outdoors, physical activity, and near work while not in school. The findings suggest that near work at school and/or learning to read in preschool at an early age may contribute to previously reported differences in refractive error between groups. However, conclusions should be confirmed in a larger sample size.
MeSH term(s)	Child ; Humans ; Jews ; Judaism ; Male ; Myopia/epidemiology ; Pilot Projects ; Vision Tests
Language	English
Publishing date	2021-08-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1001706-9
ISSN	1538-9235 ; 1040-5488
ISSN (online)	1538-9235
ISSN	1040-5488
DOI	10.1097/OPX.0000000000001755
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Article ; Online: Adherence to referrals from preschool vision screening and identification of barriers for non-adherence in Israel.

Gordon-Shaag, Ariela / Ben-Eli, Hadas / Sztrigler Cohen, Orit / Toledano, Monique / Benyamin, Aviya / Stein-Zamir, Chen

Clinical & experimental optometry

2022 Volume 106, Issue 2, Page(s) 202–210

Abstract: Clinical relevance: Preschool vision screening is essential for the early detection and treatment of eye and vision problems.: Background: The rate of parental adherence to referrals for comprehensive examination was assessed and factors and ... ...

Abstract	Clinical relevance: Preschool vision screening is essential for the early detection and treatment of eye and vision problems. Background: The rate of parental adherence to referrals for comprehensive examination was assessed and factors and potential barriers associated with adherence were identified. Methods: In a prospective cohort study design, parents were offered to bring their 3-6 year old aged children to free-of-charge vision screening tests at community-based Mother Child Health Centers. Children with abnormal findings were referred to an ophthalmologist examination. Parents were interviewed three to six months after the referral to evaluate adherence and barriers. Barriers were organised into a conceptual framework of parental predisposing and health system factors. Adherence and barriers were assessed by sex, age, ethnic group and socio-economic-status. Results: Altogether 1283 children (mean age 4.5 ± 0.6 years, 47.8% girls) were screened in the Jerusalem district, Israel. The ethnic groups, Jewish (ultra-Orthodox 51.4%, secular/religious 33.2%) and Arab (15.4%), were similar by age and sex, but not by socio-economic status. The overall referral rate was 23.0% (N = 295). Referral rate was not associated with demographic factors. Overall, 54.3% (N = 160) of parents adhered to the referral to bring the child for a full eye examination. Adherence did not differ with sex, ethnicity or socio-economic-status. Parents of 5-6-year-old children were significantly more likely to adhere than parents of younger children. Of parents who did not adhere, 79.3% were attributed to predisposing factors, 16.3% to system factors and 4.4% to other reasons. Conclusions: Only half the parents proceeded with the recommended full eye examination. Parents of older children were more likely to adhere to referral. In contrast with vaccinations provided by Mother Child Health Centers, adherence to vision screening did not vary based on ethnicity or socio-economic factors. Since most barriers were associated with predisposing factors of parents, interventions to improve adherence should include parental education.
MeSH term(s)	Child ; Female ; Child, Preschool ; Humans ; Adolescent ; Middle Aged ; Aged ; Male ; Vision Screening ; Israel ; Prospective Studies ; Ethnicity ; Referral and Consultation
Language	English
Publishing date	2022-08-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	639275-1
ISSN	1444-0938 ; 0816-4622
ISSN (online)	1444-0938
ISSN	0816-4622
DOI	10.1080/08164622.2022.2107891
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