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1. How International Higher Education Graduates Contribute to Their Home Country: An Example from Government Scholarship Recipients in Kazakhstan

Author

Jonbekova, Dilrabo, Serkova, Yevgeniya, Mazbulova, Zhanar, Jumakulov, Zakir, and Ruby, Alan

Abstract

Many countries offer government scholarships for international higher education and expect the recipients to contribute to national development. While there are many benefits from these scholarship programmes, they have been criticized as expensive. We examine the perceived contribution of Kazakhstan's two government scholarship alumni to the development of the nation. Drawing on Kirkpatrick's model of evaluation, we explore the influence of government scholarships on Bolashak and Nazarbayev University alumni and their contribution at organizational and societal levels. Our findings show that both groups of alumni play important roles in developing local talent and contributing to the improvement of systems, practices, and policies within their workplaces and to wider socio-economic changes. Alumni are fostering social developments bringing attention to issues of environmental protection and political engagement. However, our findings also illustrate that underdeveloped industries, limited job opportunities in some fields, low salaries, bureaucratic management culture, and resistance to change limit alumni contributions. We argue that the problem is at the system level and that the national economy is lagging in human capital development. Our findings emphasize the critical importance of developing the economy in tandem with education and human capital development to reap greater benefits from the knowledge of international education graduates.

Published
2023
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2. The Mobility of Education Policy in the 21st Century: Lessons from Other Fields

Author

Ruby, Alan and Li, Aisi

Abstract

This paper seeks to connect the work on policy mobility in education and that in other fields through a review of literature. Drawing on material from political science, international relations, geography, and economic and social development, it discusses different forms of policy mobility like traveling policies, policy borrowing, and silent borrowing. It concludes that policy transfer is a more dynamic process than the bounded cyclical and linear models often used in education policy debates.

Published
2020

3. LONG-TERM USE OF ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Author

Begaj, Tedi, Jeong, Daeun, Park, Jong G., Runner, Margaret M., Capone, Antonio, Jr, Dass, A. Bawa, Drenser, Kimberly A., Faia, Lisa J., Farley, Nathan D., Garretson, Bruce R., Hassan, Tarek S., Mahmoud, Tamer H., Margherio, Alan, Raphaelian, Paul V., Randhawa, Sandeep, Ruby, Alan J., Sneed, Scott, Rao, Prethy, Wolfe, Jeremy D., and Williams, George A.

Published
2024
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4. Surgical Management of Full-Thickness Macular Holes in Macular Telangiectasia Type 2: A Global Multicenter Study

Author

Park, Jong G., Adrean, Sean D., Begaj, Tedi, Capone, Antonio, Jr, Charles, Steve, Chen, San-Ni, Chou, Hung-Da, Cohen, Michael N., Corona, Stephanie Trejo, Faia, Lisa J., Garg, Sunir J., Garretson, Bruce R., Gregori, Ninel Z., Haller, Julia A., Houghton, Odette Margit, Hsu, Jason, Jo, Jaehyuck, Kaiser, Richard S., Lai, Chi-Chun, Mahgoub, Mohamed Moghazy, Mansoor, Mahsaw, Matoba, Ryo, Morizane, Yuki, Nehemy, Marcio B., Raphaelian, Paul V., Regillo, Carl D., Ruby, Alan J., Runner, Margaret M., Sneed, Scott R., Sohn, Elliott H., Spirn, Marc J., Vander, James F., Wakabayashi, Taku, Wolfe, Jeremy D., Wykoff, Charles C., Yonekawa, Yoshihiro, Yoon, Young Hee, and Mahmoud, Tamer H.

Published
2024
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5. Implementing Educational Reform: Cases and Challenges. Cambridge Education Research

Author

McLaughlin, Colleen, Ruby, Alan, McLaughlin, Colleen, and Ruby, Alan

Abstract

There is constant pressure on governments and policy makers to raise the standard of education, and to develop appropriate curriculum and pedagogies for students. It is no easy task. This book presents eight specific case studies of education reform implementation which capture how the design and implementation choices of policy makers are shaped by national and historical contexts. They offer real examples of the choices and constraints faced by policymakers and practitioners. The cases are a mix of nationally and locally mandated reforms with five examples from nations where the state initiated and guided reforms. The concluding synthesis chapter highlights commonalities and differences across the cases and disparate responses to shared concerns. Providing a breadth of real-world research, it will assist policy makers, practitioners and other stakeholders interested in system change. (1) Contains eight case studies of national reform and other major types of reform; (2) Situates policies and actions in national and historical contexts, and identifies the choices and constraints faced by policymakers and practitioner; and (3) Cases are written by people closely involved in the design, implementation or evaluation of aspects of the reforms.

Published
2021

6. Prediction for 2-Year Vision Outcomes Using Early Morphologic and Functional Responses in the Comparison of Age-related Macular Degeneration Treatments Trials

Author

Williams, David F., Beardsley, Sara, Bennett, Steven, Cantrill, Herbert, Chan-Tram, Carmen, Cheshier, Holly, Damato, Kathyrn, Davies, John, Dev, Sundeep, Enloe, Julianne, Follano, Gennaro, Gilbert, Peggy, Johnson, Jill, Jones, Tori, Mayleben, Lisa, Mittra, Robert, Moos, Martha, Neist, Ryan, Oestreich, Neal, Quiram, Polly, Ramsay, Robert, Ryan, Edwin, Schindeldecker, Stephanie, Snater, John, Steele, Trenise, Selders, Dwight, Tonsfeldt, Jessica, Valardi, Shelly, Fish, Gary Edd, Aguado, Hank A., Arceneaux, Sally, Arnwine, Jean, Bell, Kim, Bell, Tina, Boleman, Bob, Bradley, Patricia, Callanan, David, Coors, Lori, Creighton, Jodi, Crew, Timothy, Cummings, Kimberly, Dock, Christopher, Duignan, Karen, Fuller, Dwain, Gray, Keith, Hendrix, Betsy, Hesse, Nicholas, Jaramillo, Diana, Jost, Bradley, Lash, Sandy, Lonsdale, Laura, Mackens, Michael, Mutz, Karin, Potts, Michael, Sanchez, Brenda, Snyder, William, Solley, Wayne, Tarter, Carrie, Wang, Robert, Williams, Patrick, Perkins, Stephen L., Anderson, Nicholas, Arnold, Ann, Blais, Paul, Googe, Joseph, Higdon, Tina T., Hunt, Cecile, Johnson, Mary, Miller, James, Moore, Misty, Morris, Charity K., Morris, Christopher, Oelrich, Sarah, Oliver, Kristina, Seitz, Vicky, Whetstone, Jerry, Doft, Bernard H., Bedel, Jay, Bergren, Robert, Borthwick, Ann, Conrad, Paul, Fec, Amanda, Fulwylie, Christina, Ingram, Willia, Latham, Shawnique, Lester, Gina, Liu, Judy, Lobes, Louis, Lucko, Nicole M., Mechling, Holly, Merlotti, Lori, McBroom, Keith, Olsen, Karl, Puskas, Danielle, Rath, Pamela, Schmucker, Maria, Schueckler, Lynn, Schultz, Christina, Shultz, Heather, Steinberg, David, Vyas, Avni, Whale, Kim, Yeckel, Kimberly, Orth, David H., Arredondo, Linda S., Brown, Susan, Ciscato, Barbara J., Civantos, Joseph M., Figliulo, Celeste, Hasan, Sohail, Kosinski, Belinda, Muir, Dan, Nelson, Kiersten, Packo, Kirk, Pollack, John S., Rezaei, Kourous, Shelton, Gina, Townsend-Patrick, Shannya, Walsh, Marian, McDonald, H. Richard, Ansari, Nina, Bye, Amanda, Fu, Arthur D., Grout, Sean, Indermill, Chad, Johnson, Robert N., Jumper, J. Michael, Linares, Silvia, Lujan, Brandon J., Munden, Ames, Persons, Meredith, Rodriguez, Rosa, Rose, Jennifer M., Teske, Brandi, Urias, Yesmin, Young, Stephen, Dreyer, Richard F., Daniel, Howard, Connaughton, Michele, Handelman, Irvin, Hobbs, Stephen, Hoerner, Christine, Hudson, Dawn, Kopfer, Marcia, Lee, Michael, Lemley, Craig, Logan, Joe, Ma, Colin, Mallet, Christophe, Milliron, Amanda, Peters, Mark, Wohlsein, Harry, Pearlman, Joel A., Andrews, Margo, Bartlett, Melissa, Carlson, Nanette, Cox, Emily, Equi, Robert, Gonzalez, Marta, Griffin, Sophia, Hogue, Fran, Kennedy, Lance, Kryuchkov, Lana, Lopez, Carmen, Lopez, Danny, Luevano, Bertha, McKenna, Erin, Patel, Arun, Reed, Brian, Secor, Nyla, Sison, Iris R., Tsai, Tony, Varghis, Nina, Waller, Brooke, Wendel, Robert, Yebra, Reina, Roth, Daniel B., Deinzer, Jane, Fine, Howard, Green, Flory, Green, Stuart, Keyser, Bruce, Leff, Steven, Leviton, Amy, Martir, Amy, Mosenthine, Kristin, Muscle, Starr, Okoren, Linda, Parker, Sandy, Prenner, Jonathan, Price, Nancy, Rogers, Deana, Rosas, Linda, Schlosser, Alex, Studenko, Loretta, Tantum, Thea, Wheatley, Harold, Trese, Michael T., Aaberg, Thomas, Bezaire, Denis, Bridges, Craig, Bryant, Doug, Capone, Antonio, Coleman, Michelle, Consolo, Christina, Cook, Cindy, DuLong, Candice, Garretson, Bruce, Grooten, Tracy, Hammersley, Julie, Hassan, Tarek, Jessick, Heather, Jones, Nanette, Kinsman, Crystal, Krumlauf, Jennifer, Lewis, Sandy, Locke, Heather, Margherio, Alan, Markus, Debra, Marsh, Tanya, Neal, Serena, Noffke, Amy, Oh, Kean, Pence, Clarence, Preston, Lisa, Raphaelian, Paul, Regan, Virginia R., Roberts, Peter, Ruby, Alan, Sarrafizadeh, Ramin, Scherf, Marissa, Scott, Sarita, Sneed, Scott, Staples, Lisa, Terry, Brad, Trese, Matthew T., Videtich, Joan, Williams, George, Zajechowski, Mary, Joseph, Daniel P., Blinder, Kevin, Boyd, Lynda, Buckley, Sarah, Crow, Meaghan, Dinatale, Amanda, Engelbrecht, Nicholas, Forke, Bridget, Gabel, Dana, Grand, Gilbert, Grillion-Cerone, Jennifer, Holekamp, Nancy, Kelly, Charlotte, Nobel, Ginny, Pepple, Kelly, Raeber, Matt, Rao, P. Kumar, Ressel, Tammy, Schremp, Steven, Sgorlon, Merrilee, Shears, Shantia, Thomas, Matthew, Timma, Cathy, Vaughn, Annette, Walters, Carolyn, Weeks, Rhonda, Wehmeier, Jarrod, Wright, Tim, Berinstein, Daniel M., Ayyad, Aida, Barazi, Mohammed K., Bickhart, Erica, Brady, Tracey, Byank, Lisa, Cronise, Alysia, Denny, Vanessa, Dunn, Courtney, Flory, Michael, Frantz, Robert, Garfinkel, Richard A., Gilbert, William, Lai, Michael M., Melamud, Alexander, Newgen, Janine, Newton, Shamekia, Oliver, Debbie, Osman, Michael, Sanders, Reginald, von Fricken, Manfred, Dugel, Pravin, Arenas, Sandra, Balea, Gabe, Bartoli, Dayna, Bucci, John, Cornelius, Jennifer A., Dickens, Scheleen, Doherty, Don, Dunlap, Heather, Goldenberg, David, Jamal, Karim, Jimenez, Norma, Kavanagh, Nicole, Kunimoto, Derek, Martin, John, Miner, Jessica, Mobley, Sarah, Park, Donald, Quinlan, Edward, Sipperley, Jack, Slagle, Carol, Smith, Danielle, Yafchak, Miguelina, Yager, Rohana, Flaxel, Christina J., Bailey, Steven, Francis, Peter, Howell, Chris, Hwang, Thomas, Ira, Shirley, Klein, Michael, Lauer, Andreas, Liesegang, Teresa, Lundquist, Ann, Nolte, Sarah, Nolte, Susan K., Pickell, Scott, Pope, Susan, Rossi, Joseph, Schain, Mitchell, Steinkamp, Peter, Toomey, Maureen D., Vahrenwald, Debora, West, Kelly, Hubbard, Baker, Andelman, Stacey, Bergstrom, Chris, Brower, Judy, Cribbs, Blaine, Curtis, Linda, Dobbs, Jannah, DuBois, Lindreth, Gaultney, Jessica, Gibbs, Deborah, Jordan, Debora, Leef, Donna, Martin, Daniel F., Myles, Robert, Olsen, Timothy, Schwent, Bryan, Srivastava, Sunil, Waldron, Rhonda, Antoszyk, Andrew N., Balasubramaniam, Uma, Brooks, Danielle, Brown, Justin, Browning, David, Clark, Loraine, Ennis, Sarah, Held, Susannah, Helms, Jennifer V., Herby, Jenna, Karow, Angie, Leotaud, Pearl, Massimino, Caterina, McClain, Donna, McOwen, Michael, Mindel, Jennifer, Pereira, Candace, Pierce, Rachel, Powers, Michele, Price, Angela, Rohrer, Jason, Sanders, Jason, Avery, Robert L., Avery, Kelly, Basefsky, Jessica, Beckner, Liz, Castellarin, Alessandro, Couvillion, Stephen, Giust, Jack, Giust, Matthew, Nasir, Maan, Pieramici, Dante, Rabena, Melvin, Risard, Sarah, See, Robert, Smith, Jerry, Wan, Lisha, Bakri, Sophie J., Abu-Yaghi, Nakhleh, Barkmeier, Andrew, Berg, Karin, Burrington, Jean, Edwards, Albert, Goddard, Shannon, Howard, Shannon, Iezzi, Raymond, Lewison, Denise, Link, Thomas, McCannel, Colin A., Overend, Joan, Pach, John, Ruszczyk, Margaret, Shultz, Ryan, Stephan, Cindy, Vogen, Diane, Bradford, Reagan H., Jr., Bergman, Vanessa, Burris, Russ, Butt, Amanda, Daniels, Beth, Dwiggins, Connie, Fransen, Stephen, Guerrero, Tiffany, Haivala, Darin, Harris, Amy, Icks, Sonny, Kingsley, Ronald, Redden, Lena, Richmond, Rob, Ross, Brittany, White, Kammerin, Youngberg, Misty, Topping, Trexler M., Bennett, Steve, Chong, Sandy, Ciotti, Mary, Cleary, Tina, Corey, Emily, Donovan, Dennis, Frederick, Albert, Freese, Lesley, Graham, Margaret, Gud, Natalya, Howard, Taneika, Jones, Mike, Morley, Michael, Moses, Katie, Stone, Jen, Ty, Robin, Wiegand, Torsten, Williams, Lindsey, Winder, Beth, Awh, Carl C., Amonette, Michelle, Arrindell, Everton, Beck, Dena, Busbee, Brandon, Dilback, Amy, Downs, Sara, Guidry, Allison, Gutow, Gary, Hardin, Jackey, Hines, Sarah, Hutchins, Emily, LaCivita, Kim, Lester, Ashley, Malott, Larry, McCain, MaryAnn, Miracle, Jayme, Moffat, Kenneth, Palazzotta, Lacy, Robinson, Kelly, Sonkin, Peter, Travis, Alecia, Wallace, Roy Trent, Winters, Kelly J., Wray, Julia, Harris, April E., Bunnell, Mari, Crooks, Katrina, Fitzgerald, Rebecca, Javid, Cameron, Kew, Corin, Kill, Erica, Kline, Patricia, Kreienkamp, Janet, Martinez, Maricruz, Moore, Roy Ann, Saavedra, Egbert, Taylor, LuAnne, Walsh, Mark, Wilson, Larry, Ciulla, Thomas A., Coyle, Ellen, Harrington, Tonya, Harris, Charlotte, Hood, Cindi, Kerr, Ingrid, Maturi, Raj, Moore, Dawn, Morrow, Stephanie, Savage, Jennifer, Sink, Bethany, Steele, Tom, Thukral, Neelam, Wilburn, Janet, Walker, Joseph P., Banks, Jennifer, Ciampaglia, Debbie, Dyshanowitz, Danielle, Frederick, Jennifer, Ghuman, A. Tom, Grodin, Richard, Kiesel, Cheryl, Knips, Eileen, McCue, Jonathan, Ortiz, Maria, Peters, Crystal, Raskauskas, Paul, Schoeman, Etienne, Sharma, Ashish, Wing, Glenn, Youngblood, Rebecca, Chandra, Suresh R., Altaweel, Michael, Blodi, Barbara, Burke, Kathryn, Dietzman, Kristine A., Gottlieb, Justin, Knutson, Gene, Krolnik, Denise, Nork, T. Michael, Olson, Shelly, Peterson, John, Reed, Sandra, Soderling, Barbara, Somers, Guy, Stevens, Thomas, Wealti, Angela, Bearelly, Srilaxmi, Branchaud, Brenda, Bryant, Joyce W., Crowell, Sara, Fekrat, Sharon, Gammage, Merritt, Harrison, Cheala, Jones, Sarah, McClain, Noreen, McCuen, Brooks, Mruthyunjaya, Prithvi, Queen, Jeanne, Sarin, Neeru, Skalak, Cindy, Skelly, Marriner, Suner, Ivan, Tomany, Ronnie, Welch, Lauren, Park, Susanna S., Cassidy, Allison, Chandra, Karishma, Good, Idalew, Imson, Katrina, Sashi, Kaur, Metzler, Helen, Morse, Lawrence, Redenbo, Ellen, Salvador, Marisa, Telander, David, Thomas, Mark, Wallace, Cindy, Barr, Charles C., Battcher, Amanda, Bottorff, Michelle, Chasteen, Mary, Clark, Kelly, Denning, Diane, Schoen, Debra, Schultz, Amy, Tempel, Evie, Wheeler, Lisa, Whittington, Greg K., Stone, Thomas W., Blevins, Todd, Buck, Michelle, Cruz, Lynn, Heath, Wanda, Holcomb, Diana, Isernhagen, Rick, Kidd, Terri, Kitchens, John, Sears, Cathy, Slade, Ed, Van Arsdall, Jeanne, VanHoose, Brenda, Wolfe, Jenny, Wood, William, Zilis, John, Crooks, Carol, Disney, Larry, Liu, Mimi, Petty, Stephen, Sall, Sandra, Folk, James C., Aly, Tracy, Brotherton, Abby, Critser, Douglas, Hinz, Connie J., Karakas, Stefani, Kirschner, Valerie, Lester, Cheyanne, Montague, Cindy, Russell, Stephen, Stockman, Heather, Taylor, Barbara, Verdick, Randy, Walshire, Jean, Thompson, John T., Connell, Barbara, Constantine, Maryanth, Davis, John L., Jr., Gwen Holsapple, Hunter, Lisa, Lenane, C. Nicki, Mitchell, Robin, Russel, Leslie, Sjaarda, Raymond, Brown, David M., Benz, Matthew, Burns, Llewellyn, Carranza, JoLene G., Fish, Richard, Goates, Debra, Hay, Shayla, Jeffers, Theresa, Kegley, Eric, Kubecka, Dallas, McGilvra, Stacy, Richter, Beau, Sneed, Veronica, Stoever, Cary, Tellez, Isabell, Wong, Tien, Kim, Ivana, Andreoli, Christopher, Barresi, Leslie, Brett, Sarah, Callahan, Charlene, Capaccioli, Karen, Carli, William, Coppola, Matthew, Emmanuel, Nicholas, Evans, Claudia, Fagan, Anna, Grillo, Marcia, Head, John, Kieser, Troy, Lee, Elaine, Lord, Ursula, Miretsky, Edward, Palitsch, Kate, Petrin, Todd, Reader, Liz, Reznichenko, Svetlana, Robertson, Mary, Smith, Justin, Vavvas, Demetrios, Wells, John, Cahill, Cassie, Clark, W. Lloyd, Henry, Kayla, Johnson, David, Miller, Peggy, Oliver, LaDetrick, Spivey, Robbin, Swinford, Tiffany, Taylor, Mallie, Lambert, Michael, Chase, Kris, Fredrickson, Debbie, Khawly, Joseph, Lazarte, Valerie, Lowd, Donald, Miller, Pam, Willis, Arthur, Ferrone, Philip J., Almonte, Miguel, Arnott, Rachel, Aviles, Ingrid, Carbon, Sheri, Chitjian, Michael, DAmore, Kristen, Elliott, Christin, Fastenberg, David, Golub, Barry, Graham, Kenneth, Lavorna, AnnMarie, Murphy, Laura, Palomo, Amanda, Puglisi, Christina, Rhee, David, Romero, Juan, Rosenblatt, Brett, Salcedo, Glenda, Schlameuss, Marianne, Shakin, Eric, Sookhai, Vasanti, Kaiser, Richard, Affel, Elizabeth, Brown, Gary, Centinaro, Christina, Fine, Deborah, Fineman, Mitchell, Formoso, Michele, Garg, Sunir, Grande, Lisa, Herbert, Carolyn, Ho, Allen, Hsu, Jason, Jay, Maryann, Lavetsky, Lisa, Liebenbaum, Elaine, Maguire, Joseph, Monsonego, Julia, O’Connor, Lucia, Pierce, Lisa, Regillo, Carl, Rosario, Maria, Spirn, Marc, Vander, James, Walsh, Jennifer, Davidorf, Frederick H., Barnett, Amanda, Chang, Susie, Christoforidis, John, Elliott, Joy, Justice, Heather, Letson, Alan, McKinney, Kathryne, Perry, Jeri, Salerno, Jill A., Savage, Scott, Shelley, Stephen, Singerman, Lawrence J., Coney, Joseph, DuBois, John, DuBois, Kimberly, Greanoff, Gregg, Himmelman, Dianne, Ilc, Mary, McNamara, Elizabeth, Novak, Michael, Pendergast, Scott, Rath, Susan, Smith-Brewer, Sheila, Tanner, Vivian, Weiss, Diane E., Zegarra, Hernando, Halperin, Lawrence, Aramayo, Patricia, Dhalla, Mandeep, Fernandez, Brian, Fernandez, Cindy, Lopez, Jaclyn, Lopez, Monica, Mariano, Jamie, Murphy, Kellie, Sherley, Clifford, Veksler, Rita, Rahhal, Firas, Babikian, Razmig, Boyer, David, Hami, Sepideh, Kessinger, Jeff, Kurokouchi, Janet, Mukarram, Saba, Pachman, Sarah, Protacio, Eric, Sierra, Julio, Tabandeh, Homayoun, Zamboni, Adam, Elman, Michael, Belz, Jennifer, Butcher, Tammy, Cain, Theresa, Coffey, Teresa, Firestone, Dena, Gore, Nancy, Singletary, Pamela, Sotirakos, Peter, Starr, JoAnn, Meredith, Travis A., Barnhart, Cassandra J., Cantrell, Debra, Esquejo-Leon, RonaLyn, Houghton, Odette, Kaur, Harpreet, NDure, Fatoumatta, Glatzer, Ronald, Joffe, Leonard, Schindler, Reid, Xue, Katie, Hua, Peiying, Maguire, Maureen G., Daniel, Ebenezer, Jaffe, Glenn J., Grunwald, Juan E., and Ying, Gui-shuang

Published
2023
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7. Employment of International Education Graduates: Issues of Economy and Resistance to Change

Author

Jonbekova, Dilrabo, Kim, Tatyana, Kerimkulova, Sulushash, Ruby, Alan, and Sparks, Jason

Abstract

The use of international scholarship programmes is part of a long-standing approach to human capital development in many developing and middle-income countries that finance studies at universities abroad and locally. Yet, many scholarship alumni struggle to thrive in their home country and encounter numerous difficulties in their transition to the job market. This paper examines the employment experiences of Kazakhstan's government scholarship alumni in science, technology, engineering and mathematics fields and identifies the challenges they encounter navigating the labour market. Our analysis of 45 interviews demonstrated that although alumni hold a positional advantage in the job market and many succeed, there are also many alumni whose employability and career success are impeded by an intersection of socioeconomic and cultural factors, intergenerational clashes and scholarship programme regulations. The implications for scholarship programmes and government policy goals are discussed.

Published
2021
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8. Toward a Science of Failure Analysis: A Narrative Review

Author

Allen-Platt, Claire, Gerstner, Clara-Christina, Boruch, Robert, and Ruby, Alan

Abstract

When a researcher tests an educational program, product, or policy in a randomized controlled trial and detects a significant effect on an outcome, the intervention is usually classified as something that "works." When expected effects are not found, there is seldom an orderly and transparent analysis of plausible reasons why. Accumulating and learning from possible failure mechanisms is not standard practice in education research, and it is not common to design interventions with causes of failure in mind. This chapter develops Boruch and Ruby's proposition that the education sciences would benefit from a systematic approach to the study of failure. We review and taxonomize recent reports of large-scale randomized controlled trials in K-12 schooling that yielded at least one null or negative major outcome, including the nature of the event and reasons (if provided) for why it occurred. Our purpose is to introduce a broad framework for thinking about educational interventions that do not produce expected effects and seed a cumulative knowledge base on when, how, and why interventions do not reach expectations. The reasons why an individual intervention fails to elicit an outcome are not straightforward, but themes emerge when researchers' reports are synthesized.

Published
2021
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9. Natural History of Drusenoid Pigment Epithelial Detachment Associated with Age-Related Macular Degeneration Age-Related Eye Disease Study 2 Report No. 17

Author

Yu, Jeannette J, Agrón, Elvira, Clemons, Traci E, Domalpally, Amitha, van Asten, Freekje, Keenan, Tiarnan D, Cukras, Catherine, Chew, Emily Y, Ferris, Frederick L, SanGiovanni, John Paul, Clemons, Traci, Lindblad, Anne, Lindblad, Robert, Shah, Nilay, Sperduto, Robert, McBee, Wendy, Gensler, Gary, Harrington, Molly, Henning, Alice, Jones, Katrina, Thotapally, Kumar, Tull, Diana, Watson, Valerie, Williams, Kayla, Gentry, Christina, Kaufman, Francine, Morrison, Chris, Saverino, Elizabeth, Schenning, Sherrie, Blodi, Barbara, Danis, Ronald P, Davis, Matthew, Glander, Kathy, Guilfoil, Gregory, Hubbard, Larry D, Johnson, Kristine, Klein, Ronald, Nardi, Barbara, Neider, Michael, Robinson, Nancy, Rosensteel, Eileen, Wabers, Hugh, Zhang, Grace, Ruby, Alan J, Capone, Antonio, Dass, Bawa, Drenser, Kimberly, Garretson, Bruce R, Hassan, Tarek S, Trese, Michael, Williams, George A, Wolfe, Jeremy, Bell, Tina, Zajechowski, Mary, Bezaire, Dennis, McIver, Fran, Medina, Anthony, Pagett, Jackie, Smith, Stephanie Hatch, Swartz, Lynn, Treuter, Tom, Antoszyk, Andrew, Brown, Justin, Browning, David J, Holland, Walter, Karow, Angella, Stalford, Kelly, Price, Angela, Ennis, Sarah, Fredenberg, Sherry, Herby, Jenna, Balasubramaniam, Uma, Clark, Loraine, McClain, Donna, McOwen, Michael, Watson, Lynn, Klein, Michael, Bailey, Steven T, Hwang, Thomas J, Lauer, Andreas, Stout, J Timothy, McCollum, Patty, Johnson, Milt, Rice, Patrick B, Kim, Ivana, Loewenstein, John, Miller, Joan, Sobrin, Lucia, Young, Lucy, Sullivan, Jacqueline, Houlihan, Patricia, Merry, Linda, Lane, Ann Marie, Bator, Ursula Lord, Evans, Claudia, Brett, Sarah, and Callahan, Charleen

Subjects
Prevention, Clinical Research, Neurodegenerative, Clinical Trials and Supportive Activities, Eye Disease and Disorders of Vision, Macular Degeneration, Aging, Genetics, Eye, Aged, Aged, 80 and over, Disease Progression, Female, Follow-Up Studies, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Prospective Studies, Proteins, Retinal Detachment, Retinal Drusen, Retinal Pigment Epithelium, Retrospective Studies, Time Factors, Visual Acuity, Age-Related Eye Disease Study 2 Research Group, Clinical Sciences, Opthalmology and Optometry, Public Health and Health Services, Ophthalmology & Optometry
Abstract

PurposeTo investigate the natural history and genetic associations of drusenoid pigment epithelial detachment (DPED) associated with age-related macular degeneration (AMD).DesignRetrospective analysis of a prospective cohort study.ParticipantsOf the 4203 Age-Related Eye Disease Study 2 (AREDS2) participants, 391 eyes (325 participants) had DPED without late AMD at the time of DPED detection. Genetic analyses included 120 white AREDS2 participants and 145 Age-Related Eye Disease Study (AREDS) participants with DPED.MethodsBaseline and annual stereoscopic fundus photographs were graded centrally to detect DPED, a well-defined yellow elevated mound of confluent drusen ≥433 μm in diameter, and to evaluate progression rates to late AMD: geographic atrophy (GA) and neovascular (NV)-AMD. Five single nucleotide polymorphisms (CFH [rs10611670], C3 [rs2230199], CFI [rs10033900], C2/CFB [rs114254831], ARMS2 [rs10490924]) and genetic risk score (GRS) group were investigated for association with DPED development. Kaplan-Meier analyses and multivariable proportional hazard regressions were performed.Main outcome measuresProgression rates to late AMD and decrease of ≥3 lines in visual acuity (VA) from the time of DPED detection; association of rate of DPED development with genotype.ResultsMean (standard deviation [SD]) follow-up time from DPED detection was 4.7 (0.9) years. DPED was associated with increased risk of progression to late AMD (hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.98-2.82; P < 0.001); 67% of eyes progressed to late AMD 5 years after DPED detection. Drusenoid pigment epithelial detachment was associated with increased risk of ≥3 lines of VA loss (HR, 3.08; CI, 2.41-3.93; P < 0.001) with 46% of eyes experiencing vision loss at 5 years (with or without progression to late AMD). ARMS2 risk alleles (1 vs. 0: HR, 2.72, CI, 1.58-4.70; 2 vs. 0: HR, 3.16, CI, 1.60-6.21, P < 0.001) and increasing GRS group (4 vs. 1) (HR, 12.17, CI, 3.66-40.45, P < 0.001) were significantly associated with DPED development in AREDS. There were no significant genetic results in AREDS2.ConclusionsThis study replicates the results of previous natural history studies of eyes with DPED including the high rates of progression to late AMD and vision loss (regardless of progression to late AMD). The genetic associations are consistent with genes associated with AMD progression.

Published
2019

10. Progression of Geographic Atrophy in Age-related Macular Degeneration AREDS2 Report Number 16

Author

Keenan, Tiarnan D, Agrón, Elvira, Domalpally, Amitha, Clemons, Traci E, van Asten, Freekje, Wong, Wai T, Danis, Ronald G, Sadda, SriniVas, Rosenfeld, Philip J, Klein, Michael L, Ratnapriya, Rinki, Swaroop, Anand, Ferris, Frederick L, Chew, Emily Y, SanGiovanni, John Paul, Clemons, Traci, Lindblad, Anne, Lindblad, Robert, Shah, Nilay, Sperduto, Robert, McBee, Wendy, Gensler, Gary, Harrington, Molly, Henning, Alice, Jones, Katrina, Thotapally, Kumar, Tull, Diana, Watson, Valerie, Williams, Kayla, Gentry, Christina, Kaufman, Francine, Morrison, Chris, Saverino, Elizabeth, Schenning, Sherrie, Blodi, Barbara, Danis, Ronald P, Davis, Matthew, Glander, Kathy, Guilfoil, Gregory, Hubbard, Larry D, Johnson, Kristine, Klein, Ronald, Nardi, Barbara, Neider, Michael, Robinson, Nancy, Rosensteel, Eileen, Wabers, Hugh, Zhang, Grace, Ruby, Alan J, Capone, Antonio, Dass, Bawa, Drenser, Kimberly, Garretson, Bruce R, Hassan, Tarek S, Trese, Michael, Williams, George A, Wolfe, Jeremy, Bell, Tina, Zajechowski, Mary, Bezaire, Dennis, McIver, Fran, Medina, Anthony, Pagett, Jackie, Smith, Stephanie Hatch, Swartz, Lynn, Treuter, Tom, Antoszyk, Andrew, Brown, Justin, Browning, David J, Holland, Walter, Karow, Angella, Stalford, Kelly, Price, Angela, Ennis, Sarah, Fredenberg, Sherry, Herby, Jenna, Balasubramaniam, Uma, Clark, Loraine, McClain, Donna, McOwen, Michael, Watson, Lynn, Klein, Michael, Bailey, Steven T, Hwang, Thomas J, Lauer, Andreas, Stout, J Timothy, McCollum, Patty, Johnson, Milt, Rice, Patrick B, Kim, Ivana, Loewenstein, John, Miller, Joan, Sobrin, Lucia, Young, Lucy, Sullivan, Jacqueline, and Houlihan, Patricia

Subjects
Prevention, Genetics, Neurodegenerative, Aging, Eye Disease and Disorders of Vision, Macular Degeneration, Eye, Aged, Aged, 80 and over, Disease Progression, Docosahexaenoic Acids, Drug Therapy, Combination, Eicosapentaenoic Acid, Female, Geographic Atrophy, Humans, Lutein, Male, Middle Aged, Photography, Prospective Studies, Visual Acuity, Zeaxanthins, AREDS2 Research Group, Clinical Sciences, Opthalmology and Optometry, Public Health and Health Services, Ophthalmology & Optometry
Abstract

PurposeTo analyze the prevalence, incidence, and clinical characteristics of eyes with geographic atrophy (GA) in age-related macular degeneration (AMD), including clinical and genetic factors affecting enlargement.DesignProspective cohort study within a controlled clinical trial.ParticipantsAge-Related Eye Disease Study 2 (AREDS2) participants, aged 50-85 years.MethodsBaseline and annual stereoscopic color fundus photographs were evaluated for GA presence and area. Analyses included GA prevalence and incidence rates, Kaplan-Meier rates, mixed-model regression, and multivariable analysis of the square root of GA, area adjusted for covariates, including clinical/imaging characteristics and genotype.Main outcome measures(1) Presence or development of GA; (2) change in the square root of GA area over time.ResultsAt baseline, 517 eyes (6.2%) of 411 participants (9.8%) had pre-existing GA (without neovascular AMD), with the following characteristics: 33% central, 67% noncentral; and the following configurations: 36% small, 26% solid/unifocal, 24% multifocal, 9% horseshoe/ring, and 6% indeterminate. Of the remaining 6530 eyes at risk, 1099 eyes (17.3%) of 883 participants developed incident GA without prior neovascular disease during mean follow-up of 4.4 years. The Kaplan-Meier rate of incident GA was 19% of eyes at 5 years. In eyes with incident GA, 4-year risk of subsequent neovascular AMD was 29%. In eyes with incident noncentral GA, 4-year risk of central involvement was 57%. GA enlargement rate (following square root transformation) was similar in eyes with pre-existing GA (0.29 mm/year; 95% confidence interval 0.27-0.30) and incident GA (0.28 mm/year; 0.27-0.30). In the combined group, GA enlargement was significantly faster with noncentrality, multifocality, intermediate baseline size, and bilateral GA (P < 0.0001 for interaction in each case) but not with AREDS2 treatment assignment (P = 0.33) or smoking status (P = 0.05). Enlargement was significantly faster with ARMS2 risk (P < 0.0001), C3 non-risk (P = 0.0002), and APOE non-risk (P = 0.001) genotypes.ConclusionsAnalyses of AREDS2 data on natural history of GA provide representative data on GA evolution and enlargement. GA enlargement, which was influenced by lesion features, was relentless, resulting in rapid central vision loss. The genetic variants associated with faster enlargement were partially distinct from those associated with risk of incident GA. These findings are relevant to further investigations of GA pathogenesis and clinical trial planning.

Published
2018

11. Are There Metrics for MOOCs from Social Media?

Author

Ruby, Alan, Perna, Laura, Boruch, Robert, and Wang, Nicole

Abstract

Since "the year of the MOOC" in 2012, the effectiveness of massive open online courses (MOOCs) has been widely debated. Some argue that MOOCs are not an effective mode of instructional delivery because of low completion rates. In the interest of developing alternative indicators of performance this study draws from recent efforts to measure engagement in social media, as well as from research on indicators of student engagement in traditional college courses. Using data from 16 Coursera MOOCs offered by the University of Pennsylvania we calculate standardized access rates for lectures and assessments. While these indicators have clear limitations as measures of educational progress they offer a different, more nuanced understanding of the level and nature of users' engagement with a MOOC. This paper shows that a very small share of users takes up available opportunities to access course content but notes that the standardized access rates compare favorably with those for social media sites and with response rates to large-scale direct mail marketing programs. For MOOC providers and platform managers, indicators like the ones developed in this study may be a useful first step in monitoring the extent to which different types and combinations of activities may be providing better opportunities for learning.

Published
2015

17. Raising Research Productivity in a Post-Soviet Higher Education System:A Case from Central Asia

Author

Kuzhabekova, Aliya and Ruby, Alan

Abstract

To raise university research productivity, the government of Kazakhstan introduced a requirement for university faculty members to publish in journals with a nonzero impact factor in order to qualify for promotion. A survey of faculty members at six universities was conducted to explore their response to the policy. The results suggest that a promotion-linked publication requirement may lift faculty research productivity if it is accompanied by support structures and if universities have control over the promotion process.

Published
2018
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18. Characterization of Epiretinal Proliferation in Full-Thickness Macular Holes and Effects on Surgical Outcomes

Author

Lee Kim, Esther, Weiner, Adam J., Ung, Cindy, Roh, Miin, Wang, Jay, Lee, Ivan J., Huang, Natalie T., Stem, Maxwell, Dahrouj, Mohammad, Eliott, Dean, Vavvas, Demetrios G., Young, Lucy H.Y., Williams, George A., Garretson, Bruce R., Kim, Ivana K., Hassan, Tarek S., Mukai, Shizuo, Ruby, Alan J., Faia, Lisa J., Capone, Antonio, Jr., Comander, Jason, Kim, Leo A., Wu, David M., Drenser, Kimberly A., Woodward, Maria A., Wolfe, Jeremy D., and Yonekawa, Yoshihiro

Published
2019
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19. Predictors of Endophthalmitis after Intravitreal Injection: A Multivariable Analysis Based on Injection Protocol and Povidone Iodine Strength

Author

Stem, Maxwell S., Rao, Prethy, Lee, Ivan J., Woodward, Maria A., Faia, Lisa J., Wolfe, Jeremy D., Capone, Antonio, Jr., Covert, Douglas, Dass, A. Bawa, Drenser, Kimberly A., Garretson, Bruce R., Hassan, Tarek S., Margherio, Alan, Oh, Kean T., Raephaelian, Paul V., Randhawa, Sandeep, Sneed, Scott, Trese, Michael T., Yedavally, Sunita, Williams, George A., and Ruby, Alan J.

Published
2019
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20. Long Term Use of Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration

Author

Begaj, Tedi, primary, Jeong, Daeun, additional, Park, Jong G., additional, Runner, Margaret M., additional, Capone, Antonio, additional, Dass, A. Bawa, additional, Drenser, Kimberly A., additional, Faia, Lisa J., additional, Farley, Nathan D., additional, Garretson, Bruce. R., additional, Hassan, Tarek S., additional, Mahmoud, Tamer H., additional, Margherio, Alan, additional, Raphaelian, Paul V., additional, Randhawa, Sandeep, additional, Ruby, Alan J., additional, Sneed, Scott, additional, Rao, Prethy, additional, Wolfe, Jeremy D., additional, and Williams, George A., additional

Published
2023
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21. Surgical Management of Full Thickness Macular Holes in Macular Telangiectasia Type 2.A Global Multicenter Study

Author

Park, Jong G., primary, Adrean, Sean D., additional, Begaj, Tedi, additional, Capone, Antonio, additional, Charles, Steve, additional, Chen, San-Ni, additional, Chou, Hung-Da, additional, Cohen, Michael N., additional, Corona, Stephanie Trejo, additional, Faia, Lisa J., additional, Garg, Sunir J., additional, Garretson, Bruce R., additional, Gregori, Ninel Z., additional, Haller, Julia A., additional, Houghton, Odette Margit, additional, Hsu, Jason, additional, Jo, Jaehyuck, additional, Kaiser, Richard S., additional, Lai, Chi-Chun, additional, Mahgoub, Mohamed Moghazy, additional, Mansoor, Mahsaw, additional, Matoba, Ryo, additional, Morizane, Yuki, additional, Nehemy, Marcio B., additional, Raphaelian, Paul V., additional, Regillo, Carl D., additional, Ruby, Alan J., additional, Runner, Margaret M., additional, Sneed, Scott R., additional, Sohn, Elliott H., additional, Spirn, Marc J., additional, Vander, James F., additional, Wakabayashi, Taku, additional, Wolfe, Jeremy D., additional, Wykoff, Charles C., additional, Yonekawa, Yoshihiro, additional, Yoon, Young Hee, additional, and Mahmoud, Tamer H., additional

Published
2023
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22. Clinical Outcomes And Treatment Course of Eyes with Neovascular Age-Related Macular Degeneration Following the Development of Endophthalmitis

Author

Koulisis, Nicole, Moysidis, Stavros N., Govindaraju, Viren K., Dersch, Anne Merrylees, Capone, Antonio, Jr, Covert, Douglas J., Dadgostar, Hajir, Dass, A. Bawa, Drenser, Kimberly A., Engstrom, Robert E., Jr, Faia, Lisa J., Garretson, Bruce R., Guerami, Amir H., Hanscom, Thomas A., Mahmoud, Tamer H., Margherio, Alan R., Oh, Kean T., Randhawa, Sandeep, Raphaelian, Paul V., Rhoades, William R., Ruby, Alan J., Sanfilippo, Christian J., Sneed, Scott R., Trese, Michael T., Wolfe, Jeremy D., Williams, George A., Yedavally, Sunita, and Hassan, Tarek S.

Published
2020
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24. Moving through MOOCs: Understanding the Progression of Users in Massive Open Online Courses

Author

Perna, Laura W., Ruby, Alan, Boruch, Robert F., Wang, Nicole, Scull, Janie, Ahmad, Seher, and Evans, Chad

Abstract

This paper reports on the progress of users through 16 Coursera courses taught by University of Pennsylvania faculty for the first time between June 2012 and July 2013. Using descriptive analyses, this study advances knowledge by considering two definitions of massive open online course (MOOC) users (registrants and starters), comparing two approaches to measuring student progress through a MOOC course (sequential versus user driven), and examining several measures of MOOC outcomes and milestones. The patterns of user progression found in this study may not describe current or future patterns given the continued evolution of MOOCs. Nonetheless, the findings provide a baseline for future studies.

Published
2014
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25. Reply to Wiebe et al.

Author

Boruch, Robert F., Rovine, Michael J., Perna, Laura W., and Ruby, Alan

Published
2015

26. Reshaping the University in an Era of Globalization

Author

Ruby, Alan

Abstract

Globalization affects every aspect of higher education through increased demand, diversified student bodies, a growing private sector, and a variety of delivery mechanisms. But universities should not see themselves as passive victims of globalization. As creators and disseminators of knowledge, universities shape globalization just as much as they are shaped by it.

Published
2005

28. Indicators on Enrollment, Educational Career Paths and School Leavers at Different Stages of the Educational System: Existing Instruments, Methodological Problems, Reasons and Prospects for International Cooperation.

Author

Ruby, Alan and Simons, Fran

Abstract

This paper discusses the three phases of the recent and future work of the Network groups--Network 1--of the OECD/CERI International Indicators Project. Essentially, Network 1's responsibility is to develop and test "participation" indicators on enrollments, educational career paths, and school leavers at different stages of the member countries' educational systems for the ultimate purposes of improving retention in secondary and higher education, enhancing student completion of programs that fit the requisites of the high technology job market, ensuring equality of educational outcomes, and informing governments regarding the educational policy and management of vocational instruction. Specifically, Network 1 offered preliminary assessments of the policy areas where participation indicators have been or could be of assistance; reviewed the education systems and the data collections of each country; and developed indicator definitions and research methodologies for the indicators. The paper concludes that the Network's overriding interest is to develop participation indicators that are relevant to policy interests and that have sufficient reliability and depth so that they can be used, with confidence, to inform policy decisions. This common interest makes a strong statement about the social and economic pressures on governments around the world to improve their educational systems in terms of access, outcomes, and effectiveness. (JAM)

Published
1989

34. Secondary Analyses of the Effects of Lutein/Zeaxanthin on Age-Related Macular Degeneration Progression: AREDS2 Report No. 3

Author

Chew, Emily Y., Clemons, Traci E., SanGiovanni, John Paul, Danis, Ronald P., Ferris, Frederick L., III, Elman, Michael J., Antoszyk, Andrew N., Ruby, Alan J., Orth, David, Bressler, Susan B., Fish, Gary E., Hubbard, George Baker, Klein, Michael L., Chandra, Suresh R., Blodi, Barbara A., Domalpally, Amitha, Friberg, Thomas, Wong, Wai T., Rosenfeld, Philip J., Agrón, Elvira, Toth, Cynthia A., Bernstein, Paul S., and Sperduto, Robert D.

Published
2014
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35. PERIPHERAL RETINAL ANGIOGRAPHIC FINDINGS IN MACULAR TELANGIECTASIS TYPE 2

Author

Moysidis, Stavros N., primary, Koulisis, Nicole, additional, Rao, Prethy, additional, Govindaraju, Viren K., additional, Gamsky, Samuel, additional, Mahmoud, Tamer H., additional, Randhawa, Sandeep, additional, Faia, Lisa J., additional, Wolfe, Jeremy D., additional, Drenser, Kimberly A., additional, Ruby, Alan J., additional, Garretson, Bruce R., additional, Hassan, Tarek S., additional, Williams, George A., additional, Trese, Michael T., additional, and Capone, Antonio, additional

Published
2021
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37. Lutein/Zeaxanthin for the Treatment of Age-Related Cataract: AREDS2 Randomized Trial Report No. 4

Author

Chew, Emily Y., SanGiovanni, John Paul, Ferris, Frederick L., III, Wong, Wai T., Agron, Elvira, Clemons, Traci E., Sperduto, Robert, Danis, Ronald, Chandra, Suresh R., Blodi, Barbara A., Domalpally, Amitha, Elman, Michael J., Antoszyk, Andrew N., Ruby, Alan J., Orth, David, Bressler, Susan B., Fish, Gary E., Hubbard, George B., Klein, Michael L., Friberg, Thomas R., Rosenfeld, Philip J., Toth, Cynthia A., and Bernstein, Paul

Published
2013
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39. New twist on an old concept: master planned communities show off at the Cliffs in the Western Carolinas

Author

Ruby, Alan S.

Subjects
Planned communities -- Planning, Planned communities -- Economic aspects, Recreation areas -- Planning, Recreation areas -- Economic aspects, Company business planning, Business, Real estate industry
Abstract

The evolution of the recreational master planned community is examined by studying the Cliffs Communities of the Western Carolinas. The Cliffs Communities is focused on wellness and is positioned to take advantage of a small boom in housing.

Published
2010

41. Erratum to: Predictors of Post-Injection Endophthalmitis: A Multivariable Analysis Based on Injection Protocol and Povidone Iodine Strength

Author

Stem, Maxwell S., Rao, Prethy, Lee, Ivan J., Woodward, Maria A., Faia, Lisa J., Wolfe, Jeremy D., Capone, Antonio, Covert, Douglas, Dass, A. Bawa, Drenser, Kimberly A., Garretson, Bruce R., Hassan, Tarek S., Margherio, Alan, Oh, Kean T., Raephaelian, Paul V., Randhawa, Sandeep, Sneed, Scott, Trese, Michael T., Yedavally, Sunita, Williams, George A., and Ruby, Alan J.

Subjects
Article
Published
2019

44. Predictors of Endophthalmitis after Intravitreal Injection: A Multivariable Analysis Based on Injection Protocol and Povidone Iodine Strength

Author

Stem, Maxwell S., Rao, Prethy, Lee, Ivan J., Woodward, Maria A., Faia, Lisa J., Wolfe, Jeremy D., Capone, Antonio, Covert, Douglas, Dass, A. Bawa, Drenser, Kimberly A., Garretson, Bruce R., Hassan, Tarek S., Margherio, Alan, Oh, Kean T., Raephaelian, Paul V., Randhawa, Sandeep, Sneed, Scott, Trese, Michael T., Yedavally, Sunita, Williams, George A., and Ruby, Alan J.

Subjects
Adult, Male, Vascular Endothelial Growth Factor A, Endophthalmitis, Incidence, Angiogenesis Inhibitors, Middle Aged, Article, Eye Infections, Bacterial, Bevacizumab, Retinal Diseases, Risk Factors, Ranibizumab, Intravitreal Injections, Humans, Female, Povidone-Iodine, Retrospective Studies
Abstract

PURPOSE: To determine the incidence of endophthalmitis following anti-vascular endothelial growth factor (VEGF) therapy at our institution and to identify potential risk factors for post-injection endophthalmitis DESIGN: Retrospective, single center cohort study PARTICIPANTS: All patients who received an intravitreal injection of an anti-VEGF medication between January 1, 2014 and March 31, 2017. METHODS: Current Procedural Terminology and International Classification of Diseases billing codes were used to identify instances of anti-VEGF administration and cases of endophthalmitis. Medical records and injection technique were carefully reviewed in each case. Multivariable logistic regression analysis was performed in a stepwise fashion to determine independent predictors of endophthalmitis based on injection protocol. MAIN OUTCOME MEASURES: Incidence of post-injection endophthalmitis and odds of endophthalmitis by injection technique with 95% confidence intervals (CI). RESULTS: A total of 154,198 anti-VEGF injections were performed during the time period of interest, resulting in 58 cases of endophthalmitis (0.038%, 1:2,659). After adjustment for confounders, both 2% lidocaine jelly (OR = 11.28, 95% CI: 3.39 – 37.46, p < 0.001) and 0.5% Tetravisc (OR = 3.95, 95% CI: 1.15 – 13.50, p = 0.03) use were independent risk factors for post-injection endophthalmitis. Lid speculum use, povidone iodine strength (5% vs. 10%), injection location (superior or inferior), conjunctival displacement, use of provider gloves, employment of a strict no-talking policy, use of subconjunctival lidocaine, and topical antibiotic use were not statistically significant predictors of post-injection endophthalmitis. There was no difference in endophthalmitis rate among the anti-VEGF agents (bevacizumab, ranbizumab 0.3 mg, ranibizumab 0.5 mg, and aflibercept). CONCLUSION: The incidence of endophthalmitis after anti-VEGF injections is low. Use of lidocaine jelly or Tetravisc may increase the risk of post-injection endophthalmitis.

Published
2018

45. Reply

Author

Stem, Maxwell S., primary, Rao, Prethy, additional, Williams, George A., additional, and Ruby, Alan J., additional

Published
2019
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