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Pupil dilatation does affect some aspects of daytime driving performance.

AIMS: To examine the effects of pupil dilatation on driving performance and determine whether this was related to changes in standard measures of visual function. METHODS: The driving and vision performance of 16 young, visually normal participants was measured with both normal and dilated pupils. Pupils were dilated with 1% tropicamide. Driving performance was measured under daytime conditions on a closed road circuit that was free of other vehicles and has been used in previous studies of driving performance. Measures included road sign detection and recognition, hazard detection and avoidance, gap perception and negotiation, driving reaction times and time to complete the circuit. Visual performance measures included high contrast visual acuity, Pelli-Robson letter contrast sensitivity, and glare sensitivity. RESULTS: Pupil dilatation significantly (p<0.05) decreased the ability of participants to recognise low contrast hazards and avoid them, decreased their visual acuity and contrast sensitivity and increased glare sensitivity. The decreases in vision performance were not, however, significantly related to the decrement in driving performance. CONCLUSION: Pupil dilatation can impair selected aspects of driving and vision performance and patients should be cautioned about these possible effects.

Adult↗

Parents' and pupils' causal attributions for difficult classroom behaviour.

BACKGROUND: Studies of causal attributions for difficult pupil behaviour in schools have tended to focus on the perspectives of teachers. AIMS: The present study examines the causal attributions made by parents for difficult behaviour in classrooms. It reveals the structure of these attributions and serves as a direct comparison to a previous study of pupils' attributions (Miller, Ferguson, & Byrne, 2000) and, more indirectly, with the teacher studies. SAMPLE: The participants were 144 parents (106 mothers and 38 fathers) whose children all attended the same inner city school. METHOD: A questionnaire was constructed following three initial small group interviews with parents to identify the wide range of factors they viewed as potential causes of difficult classroom behaviour. This was then administered to all the parents of children attending the same inner-city primary school. RESULTS: Factor analysis indicated that parents' attributions for misbehaviour were best represented by three factors: (1) 'fairness of teachers' actions', (2) 'pupil vulnerability to peer influences and adverse family circumstances', and (3) 'differentiation of classroom demands and expectations'. While there were no differences between parents in terms of gender or ethnicity, they did see the first two factors as more significant contributors to pupil misbehaviour than the third. CONCLUSION: There is both agreement and conflict between parents' attributions and those made by pupils and by teachers. The implementation of policy initiatives, such as home-school agreements and Pastoral Support Programmes, risk exacerbating tensions and difficulties if these differences in attributions are not acknowledged and acted upon.

Child↗

Influence of the National Curriculum for Physical Education on inner-city teachers' behaviours associated with pupils' psychosocial development.

This study examined the quality of instruction provided by a sample of teachers working in a depressed urban setting and within the confines of the National Curriculum for Physical Education in terms of use of behaviours related to pupils' psychosocial development. Subjects were 18 specialist physical education teachers working in seven mixed-sex secondary schools in one large city in southeastern England. Two lessons of each teacher's choice, in which they taught any activity to pupils in Years 7, 8, or 9, were videotaped during the summer term of 1996. Lessons were coded with the Coaching Behavior Assessment System, an observational procedure designed to record the rate at which teachers use behaviours positively and negatively associated with pupils' psychosocial development. Descriptive statistics indicated that teachers used behaviours linked with pupils' positive psychosocial development much more frequently than they used behaviours associated with pupils' negative psychosocial development. A comparison of the data collected at these seven urban schools with those collected previously in a rural setting (Curtner-Smith, Kerr, & Hencken, 1995) suggested that, in general, British physical education teachers' behaviours are similar across the locations.

Adolescent↗

Causes of childhood blindness in east Africa: results in 491 pupils attending 17 schools for the blind in Malawi, Kenya and Uganda.

Pupils attending 12 schools for the blind in Malawi, 3 schools in Kenya and 2 schools in Uganda were examined to determine the causes of severe visual impairment or blindness (visual acuity in the better eye of less than 6/60). A total of 491 pupils aged 3-22 years was examined. Visual acuity was measured in each eye using a Snellen E chart. The anatomical site of abnormality and underlying cause of visual loss were determined by clinical examination for each eye, and for the child. Information was recorded on a standard reporting form (the WHO/PBL Eye Examination Record for Children with Blindness and Low Vision). Data were analysed for those aged less than 16 years using a database which accompanies the form. Preventable and treatable causes were identified. 260 pupils aged 5-20 years were examined in Malawi, 163 pupils aged 3-19 years were examined in Kenya and 68 pupils aged 6-22 years were examined in Uganda. Of the 491 students included in the study 309 (62.9%) were blind (BL) and 69 (14.1%) were severely visually impaired (SVI). 244 were aged less than 16 years and had SVI/BL. In these 244 children 35.2% of visual loss was due to corneal pathology, 13.5% was due to cataract and 14.8% to diseases of the retina. Corneal pathology, attributed to vitamin A deficiency and measles infection in the majority, was responsible for proportionally more SVI/BL in students in Malawi than in Uganda or Kenya.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Socio-demographic factors of pupils who use tobacco in randomly-selected primary schools in Nairobi province, Kenya.

OBJECTIVE: To report the prevalence and socio-economic correlates of tobacco use among primary school pupils in Nairobi, Kenya. DESIGN: Cross-sectional school-based survey. SETTING: Ten primary schools in Nairobi, Kenya. SUBJECTS: A questionnaire was administered to 1198 primary school pupils aged 12 to 17 years and 1130 (response rate 94.3%) students responded under supervision in the classroom. RESULTS: A total of 31% (95% CI 27.5-34.5) had experimented with smoking, 9% (95% CI 7.1-11.5) with smokeless tobacco and 55% (95% CI 50.7-59.6) reported having friends who smoked. The rates of lifetime smoking were statistically significantly higher in urban than in suburban students (33% versus 25%, p<0.05), whereas a higher proportion of suburban residents reported lifetime use of smokeless tobacco (8 % versus 12 %, p<0.05). Among urban as well as suburban students, 15 years and above were significantly more likely than their counterparts aged 14 years and below to report lifetime smoking, lifetime use of smokeless tobacco, fathers' use of tobacco, and friend's tobacco use. The adjusted odds ratios, OR, and 95% confidence intervals, 95% CI, for students ever smoking were 2.2 (95% CI 1.3-1.8), 2.4 (95 % CI 1.6-3.7), 1.8 (95 % CI 1.1-3.2 and 2.6 (95 % CI 1.7-4.1) for place of residence, gender, age and friend's use of tobacco. CONCLUSION: Generally, the proportions of primary pupils using different forms of tobacco were low in Nairobi province, although the proportion of pupils who had smoked at least once in their lifetime amounted to 31%. Since primary school pupils live in an environment that makes them susceptible to smoking, preventive programmes should be introduced to avoid the development of nicotine addiction and regular smoking.

Adolescent↗

Spontaneous fluctuations of human pupil reflect central autonomic rhythms.

Aim of this study is to assess whether and to what extent LF and HF rhythms contribute to spontaneous pupil diameter fluctuations at rest and during sympathetic activation by Head-Up Tilt Test 70 degrees. ECG, Finapres and Respiration data from 10 normal subjects were recorded simultaneously to spontaneous pupil diameter fluctuations (SPDF). The respiratory rhythm and the LF component were clearly detected in all the SPDF series. The cross-spectrum analysis gave significant results (> 0.5) in HF band. During tilt, a reduction in the total variability with a relative increase of the LF component was observed in HR, BP and SPDF signals. The multivariate analysis of the SPDF and of the cardiovascular variability series allows new insights into the physiology of pupil neural control. The effect of tilting on SPDF spectra and the physiological background of the pupil control are consistent with the hypothesis that pupil fluctuations reflect a generalized increase of the sympathetic tone.

Adult↗

Sleep problems among pupils in Benghazi, Libya.

OBJECTIVE: To find the prevalence of sleep problems among pupils, its possible causes and associated behaviors. METHODS: This study was carried out during 3-24 February 1996. We randomly selected a sample of (277) 5th graders (181 boys and 96 girls), from 3 public primary schools in 3 different socio-economic areas in Benghazi, Libya. We interviewed the pupils and the teachers by a pretested questionnaire concerning sleep, school achievement and other behaviors. Those pupils who sleep after 10:00 pm, or those having bad sleep characters, or both, twice or more a week in the last month, were considered suffering from sleep problems. According to their performance in the first semester in both Arabic and Mathematics, pupils were classified in to 3 groups (>70% in both the good group, 50-70% in both subjects or in one provided that the other was above 70% the average group, <50% in one or both subjects the poorly achieving group). RESULTS: This study shows high prevalence of sleep problems among pupils (28.9%), especially in a high-density area, with non-significant gender difference. Associated behaviors are bad school achievement, sleepiness and mood fluctuation. CONCLUSION: Parental ignorance, unawareness and bad child rearing and follow-up are evident, and considered to be the main cause of these problems, that needs intensive education towards better sleep hygiene.

Child↗

An epidemiological perspective of substance use among high school pupils in rural KwaZulu-Natal.

OBJECTIVES: To investigate prevalence and the factors influencing substance use among rural high school pupils in KwaZulu-Natal in order to develop and implement intervention programmes. DESIGN: Cross-sectional study. SETTING: Twenty-eight high schools in southern KwaZulu-Natal. SUBJECTS: One thousand three hundred and eighteen grade 10 pupils. OUTCOME MEASURES: An anonymous self-reporting questionnaire was used to investigate the use of alcohol, tobacco (cigarettes), cannabis and solvents. RESULTS: Of the male scholars, 52.9% (95% confidence interval (CI): 45.4-60.3) reported ever using alcohol, 16.9% (CI: 11.5-24.0) reported using cannabis, and 13.1% (CI: 7.2-22.5) had smoked more than one cigarette daily. Among male pupils 45.5% (CI: 38.6-52.6) had inhaled benzine and 34.6% (CI: 28.0-41.8), thinners; 7.4% (CI: 3.4-15.2) had used cocaine and 4.1% (CI: 1.0-10.6), crack. Female pupils reported significantly less use of alcohol (25.5%, CI: 17.6-35.3), cannabis (2.3%, CI: 1.3-4.1), cigarettes (more than one daily) (2.0%, CI: 1.0-4.1), and inhalation of benzine (18.8%, CI: 13.8-25.2) and thinners (10.8%, CI: 7.2-16). Logistical regression indicated that the odds of smoking cigarettes increased significantly (p < 0.0005) with use of the other substances. CONCLUSION: The results of this study confirm the prevalence of multi-substance use among pupils at the majority of rural high schools in this district and the need for targeted interventions to reduce/prevent this.

Adolescent↗

Baseline survey of oral health of primary and secondary school pupils in Uganda.

BACKGROUND: Among the issues that determine the performance of a child at school is health. In recognition of this, the Uganda government has embarked on a school health program for the success of universal primary education. Although dental health is an important component of school health there is little information on it. OBJECTIVE: This study aimed at collecting information on dental health of pupils in school for evaluation and planning. DESIGN: A cross-sectional study using a multistage cluster sampling technique was used to select 685 children attending schools in 5 districts. Children were clinically examined for common illnesses/conditions. The oral examinations were done using simplified versions of Decayed, Missing, and Filled teeth (DMFT) index and Community Periodontal Index (CPI). Oral examinations also assessed presence of fluorosis. RESULTS: The pupils attending school were aged from 5 to 22 years. Sixty six percent (456) were found to be caries free with a group DMFT of 0.7. The D-component (decay) accounted for approximately 70% of the cases. Fifty nine percent of the pupils were found to have a healthy periodontium. Sixteen percent of the pupils were found to have some degree of fluorosis of whom the majority were from the highland districts of Kabale and Mbale. Urban school pupils were more likely to have caries (OR 1,69; 95% CI 1.21-2.37) than the rural. CONCLUSION: There is an upward trend in the caries prevalence when compared to studies done earlier. This study revealed a need to develop preventive programs alongside improvement of dental health services.

Adolescent↗

Effect of xylitol candies on plaque and gingival indices in physically disabled school pupils.

OBJECTIVE: To evaluate the effectiveness of xylitol candies on plaque and gingival index scores on physically disabled school pupils in Kuwait. METHODOLOGY: Altogether 145 school pupils (105 in the xylitol group and 40 in the control group), with ages ranging from 10 to 27 years (mean age = 14.7 +/- 3.1 years), participated in this 18-month intervention program. The school health nurses distributed xylitol candies to the pupils three times during the school day. Plaque was scored according to the Silness and Löe Plaque Index, and gingivitis according to the Löe and Silness Gingival Index. RESULTS: The mean Plaque Index score decreased from 1.73 to 1.14 (p < 0.001), and the mean Gingival Index score from 1.74 to 1.16 (p < 0.001) in the study group. Significant differences were found between the xylitol and the control groups in the reduction of Plaque (p = 0.037) and Gingival Index scores (p = 0.008). There was high correlation between the individual Plaque and Gingival Index scores at baseline (r = 0.93) and at the final examinations (r = 0.95). CONCLUSION: Consuming xylitol candies three times during school days seemed to reduce both the Plaque and Gingival Index scores. This school-based delivery system offered a practical way to distribute and use xylitol candies among these disabled pupils. The regular use of xylitol candies may, therefore, support oral hygiene routines in disabled pupils.

Adolescent↗

Impact of lead exposure on health status and scholastic achievement of school pupils in Alexandria.

Lead exposure among children is a serious health problem affecting virtually every system in their bodies. Affection of their cognitive function with its implication of poor school performance, is one of the serious outcomes of such exposure. In an attempt to arrive to an adequate knowledge about the impact of lead exposure on the health status and scholastic achievement in school age, a cross sectional study was carried out on 250 primary school pupils aged from 8 to 10 years in Wassat region in Alexandria. The concentration, visual and hearing acuity and the cognitive function. Moreover, laboratory investigation of blood lead level of the pupils was carried out. Their final scholastic achievement at the end of the year were recorded. The results indicated that the mean blood lead level among the studied pupils was 17.36 +/- 10.67 microg/dl, more than one third of the sample (36.00%) were highly exposed to lead with blood level of 20 microg/dl and more. A significant negative correlation was found between blood lead level and the 50th percentile of weight for height (r = -0.4488), haemoglobin concentration (r = -0.6133) and IQ scores (r = -0.8150) of the pupils. While a significant positive correlation was observed with the functional visual and hearing loss (r = 0.1390 and 0.2189 respectively). Moreover, the multiple regression analysis determined that age, blood lead level, crowding index, IQ score and number of missed school days were the significant contributing variables to the final scholastic achievement of the pupils from all the studied factors.

Age Factors↗

[A case of unruptured anterior temporal artery aneurysm showing pupil-sparing oculomotor palsy].

The authors report a case of unruptured anterior temporal artery aneurysm showing pupil-sparing oculomotor palsy. The patient was a 55-year-old male with the complaints of left blepharoptosis and diplopia. He had a history of tuberculous meningitis 9 years previously, and since then he suffered from paraparesis of lower extremities and bladder and bowel disturbance. Neurological examination on admission revealed left blepharoptosis and disturbance of medial and vertical movement of the left eye ball, but the pupils were isocoric with normal light reaction. Carotid angiography demonstrated that the left internal carotid artery was tortuous toward the medial side in the C2 portion, and the saccular aneurysm was present in the anterior temporal artery 3 mm distal from the middle cerebral artery. At operation it was revealed that the aneurysm which had a diameter of 17 mm located in the proximal portion of the anterior temporal artery, and compressed the dorsal aspect of the oculomotor nerve. A month after operation the left oculomotor palsy disappeared. There had been no report of the case of unruptured middle cerebral artery aneurysm causing oculomotor palsy. Pupil-sparing oculomotor palsy is characteristic of diabetic oculomotor palsy, and rare cases showing pupil-sparing oculomotor palsy are caused almost by aneurysms of the internal carotid-posterior communicating artery junction. Anatomical study revealed that the parasympathetic fibers which go to the pupil constrictor muscle were in the dorsomedial aspect of the oculomotor nerve in the subarachnoid portion.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Angiography↗

[Extra-capsular cataract extraction and intraocular lens implantation in cases with cataract and a small pupil with synechiae].

OBJECTIVE: To introduce a new surgical technique for cataract with a small synechia pupil and evaluate its effects. METHODS: 43 eyes of 40 patients were operated on and followed up for 3-30 months. Surgical procedures included iridectomy, separating the posterior synechiae, straight cutting of upper iris and making 3 little cuts at inferior pupillary margin, extracapsular cataract extraction, intraocular lens implantation, and at last suturing the iris cuts to form a round pupil. RESULTS: Postoperatively, all 43 eyes had 3-4 mm basically round pupil and 42 eyes (97.7%) had improved vision. Of the 32 eyes followed up for more than three months, 22 eyes (68.8%) obtained visual acuities 0.5 or better, 10 eyes (31.2%) had visual acuities worse than 0.4 which were attributed to posterior segment abnormalities. Intraoperatively, no posterior capsular rupture was seen, and postoperatively, no severe complications were found. CONCLUSION: The results suggest that patients with cataract and a small synechia pupil obtain improved vision and round pupil without unacceptable risk by means of the surgical technique mentioned in this paper.

Adolescent↗

Pupils' experiences of the annual health dialogue with the school health nurse.

This study describes and analyses the health dialogue on the basis of the pupils' experience and the association with background factors such as age, sex, geographical areas, family and social class. The theoretical framework is based on empowerment and health promotion, and on Kolb's theory of experiential learning. The study, conducted in 1991, is the Danish contribution to the WHO collaborative study 'Health Behaviour in School Children'. A nationwide random sample of pupils aged 11, 13 and 15 (n = 1860) answered a standardized questionnaire about perceived health, health behaviour, social situation and the health dialogue with the school health nurse. Among the pupils, 68% had participated in the annual health dialogue at the time of the survey (three quarters of the way through the school year). The youngest pupils, and the girls, often participated in groups and reported the greatest number of topics discussed. The health dialogue most frequently comprised 11-20 topics. Most topics discussed were related to health promotion, 31%-60% were related to prevention of illness and symptoms and the rest were related to psychosocial issues. Girls more often reported discussing personal relationships and boys more often discussed action-related topics. Pupils from lower social classes more frequently reported topics related to prevention of illness and symptoms and psychosocial issues. The discussions are the first step in a learning process as a Concrete Experience (CE).

Adolescent↗

Small incision single-suture-loop pupilloplasty for postoperative atonic pupil.

In this small incision technique to correct postoperative atonic pupil in the aphakic or pseudophakic eye, the pupil is sutured and constricted with a 10-0 polypropylene loop through 3 1.0 mm stab incisions. The surgery is easier to perform than previous methods, appears safe and reproducible, and requires little special equipment. Although the pupil's shape may become slightly irregular, its size is fairly easy to regulate. This new method should be useful in correcting postoperative atonic pupil, and the small incision technique will likely minimize surgical trauma and induced astigmatism.

Anesthesia, Local↗

Normal pupil size and anisocoria in newborn infants.

The incidence of anisocoria in the newborn period is not well described. Additionally, the normal range of infant pupil size is not well defined. Eight-eight healthy newborns were evaluated. Pupil size and color were obtained from photographs. The mean (+/- SD) pupil size was 3.8 +/- 0.8 mm. There was no statistical difference between right and left eyes. A statistically significant difference in pupil size was found between blue and brown eyes. The incidence of anisocoria was found to be 21%. No difference was greater than 1.0 mm. The incidence of anisocoria was no different on the basis of eye color.

Anisocoria↗

Pupil sparing in oculomotor palsy: a brief review.

The clinical dictum that pupil sparing in oculomotor nerve palsy predicts an extraaxial ischemic lesion while pupil involvement predicts an extraaxial compressive lesion has some important exceptions. Two case reports and a review of the literature disclose that pupil sparing occurs in a small proportion of intraaxial and compressive subarachnoid oculomotor nerve lesions and in a large proportion of compressive cavernous sinus oculomotor nerve lesions. Careful examination is also necessary to separate examples of apparent pupil sparing in cases of aberrant regeneration and in some instances of cavernous sinus compression.

Adult↗

Orientation of slit pupil and visual streak in the eye of the cat.

The orientation of the visual streak of the cat's retina was compared to that of the long axis of the slit pupil in the same eye. In five paralyzed, anesthetized cats, the retinal projection to the superior colliculus was mapped with electrophysiological techniques. The orientation of the visual streak was estimated from the projection in visual space of the collicular region of high magnification which corresponds to the central projection of the streak. The angle by which the streak was tilted from absolute horizontal was always within one or two degree of the angle by which the pupil axis was tilted from absolute vertical. This relationship was confirmed in three of the animals in which small retinal lesions were placed a known distance from the histologically determined axis of the streak. From the visual coordinates of these lesions, an independent estimate of the streak's orientation was obtained. In each case, the tilt of streak axis from horizontal differed by no more than 0.5 degrees from the tilt of the pupil axis from vertical. The results support the hypothesis that planes containing the long axis of the cat's slit pupil are perpendicular to planes containing the long axis of the visual streak of the same eye.

Animals↗