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Level dependent signal flow in the light pupil reflex. II. Phase velocity of responses to sinusoidal light stimuli.

Pupillary responses to sinusoidal light stimuli were measured over a range of light levels and frequencies. The phase lag and equivalent time delay of these responses were reduced in an approximately log-linear fashion with increasing mean light level (slope = -60 ms/log unit). The magnitude of this level dependence is reduced at higher frequencies, and at higher light levels. This nonlinear level dependent signal flow (LDSF) effect is shown to be essentially independent of target distance (accommodative stimulus) which influences pupil size, and of pupil size itself. Thus most of the level dependence probably resides in the afferent path of the light-pupil reflex arc, before the accommodation signal joins the light signal in the Edinger-West-phal nucleus. A systems model is presented to the LDSF effect described here and in the companion papers (Myers and Stark 1993a, b). When parameters of the model are adjusted to fit pupillary responses to transient light stimuli over a range of light levels, the model simulates reduced phase lag in response to increased mean light level, and the reduction in this LDSF effect with increased mean light level or increasing stimulus frequency without further changes in parameters. This latter reduction explains the relatively small level dependence seen in latency data (-34 ms/log unit). These data will be shown (Myers and Stark 1990b) to be commensurate with reduction in pupil cycle time (increased frequency of oscillation) observed in high gain oscillation experiments as mean brightness increases.(ABSTRACT TRUNCATED AT 250 WORDS)

Accommodation, Ocular↗

Teaching nuns' perceptions of white and black pupils as a function of authoritarianism and other factors.

A sample of 283 teching nuns described the White Pupil, the Black Pupil, and the Ideal Pupil on an adjective description form. A Prejudice score was computed by subtracting the Ideal minus Black differences summed across 52 items from the Ideal minus White differences. Analyses based on 269 subjects revealed that neither age nor amount of prior contact with minorities predicted level of prejiduce. However, high and low-F-scale scorers differed significantly on the Prejudice score and on selected pupil perception factors. Implications in regard to training programs on racial attitudes were discussed.

Black or African American↗

Modelling autonomous oscillations in the human pupil light reflex using non-linear delay-differential equations.

Neurophysiological and anatomical observations are used to derive a non-linear delay-differential equation for the pupil light reflex with negative feedback. As the gain or the time delay in the reflex is increased, a supercritical Hopf bifurcation occurs from a stable fixed point to a stable limit cycle oscillation in pupil area. A Hopf bifurcation analysis is used to determine the conditions for instability and the period and amplitude of these oscillations. The more complex waveforms typical of the occurrence of higher order bifurcations were not seen in numerical simulations of the model. This model provides a general framework to study the different types of dynamical behaviors which can be produced by the pupil light reflex, e.g. edge-light pupil cycling.

Feedback↗

An investigation of the correlation between abnormal patterns of ocular microtremor and an abnormal pupil reflex in neurological patients.

Twenty-two patients and 7 normal subjects at the Burdenko Institute of Neurosurgery, Moscow, have taken part in an investigation in which the direct light reflex to a brief flash, and the high-frequency microtremor of the eyes, have been recorded. The direct pupil reflex recordings obtained with a flash of 20 msec duration and 100 lux intensity at the plane of the pupil were registered from the right eye of each patient. Ocular microtremor recordings were obtained simultaneously from both eyes of 20 of the patients. A set of criteria of abnormality of ocular microtremor, as judged by visual examination of the records, is proposed by the authors. Abnormality of the pupil reflex is assessed in terms of the amplitude, latent period, and time course of the contraction and relaxation phases of the reflex. A strong correlation has been found between the occurrence of an abnormal ocular tremor record and an abnormal pupil reflex. On the basis of this correlation, the authors propose that ocular tremor recordings may be used in diagnosis as sensitive indicators of brain-stem dysfunction.

Brain Diseases↗

The vestibulo-ocular reflex in pupils at a Dutch school for the hearing impaired; findings relating to acquired causes.

The vestibulo-ocular reflex was evaluated with caloric tests and velocity step (VS) tests in 121 pupils at a school for the hearing-impaired. Vestibular impairment was found in a total of 50 pupils (41%). It was found in 17 out of the 33 (52%) pupils with acquired causes of hearing impairment and significantly more often in pupils with a pure tone hearing threshold of more than 90 dB than in those with a lower threshold. In the group with prenatal causes, 5 out of 8 rubella cases showed vestibular impairment. Four of these cases had impaired VS responses and normal caloric responses. The high proportion of vestibular impairment in the group with postnatal causes was due to 5 cases with meningitis, all of whom showed caloric weakness. Kernicterus was significantly associated with vestibular hyperreactivity (5 cases out of 7), presumably due to a central dysfunction.

Adolescent↗

School nurses and health education for pupils with and without intellectual handicaps: a study conducted in Japan and Sweden.

The purpose of this study is to report the results from a questionnaire that was given to about 600 school nurses working in schools which have pupils with and without intellectual handicaps in Japan and Sweden, concerning their opinions on health education including sex and interpersonal relationships. The study was conducted during the spring 1987 in Sweden and during the autumn 1987 in Japan. The main results from this study concern differences between Japanese and Swedish school nurses when answering certain questions. These questions, for instance, concerned the nurses' working situation and their health education for pupils with and without intellectual handicaps. Of all the Japanese school nurses 27%, compared to 90% of the Swedish school nurses, taught about health including sex and interpersonal relationships in regular classes. Of school nurses having pupils with intellectual handicaps, only 1% of the Japanese school nurses, compared to 47% of the Swedish school nurses, taught their pupils these subjects. These differences merely seemed to be related to the educational system, including its curriculum, reflecting the general policy held within each country.

Attitude of Health Personnel↗

Is the learning curve for laparoscopic fundoplication determined by the teacher or the pupil?

BACKGROUND: For all surgical procedures, a surgeons' learning curve can be anticipated during which complication rates are increased. The aims of this study were to evaluate individual learning curves for a group of surgeons performing laparoscopic fundoplication and to evaluate if the Procedicus MIST-simulator (Mentice Inc., Göteborg, Sweden) accurately predicts surgical performance. METHODS: Twelve Nordic centers participated, each contributing with a "master" and a "pupil" surgeon. The pupils were tested in the simulator and thereafter performed their first 20 supervised operations. All procedures were videotaped and evaluated by 3 independent reviewers. RESULTS: A significant decrease in operative time (P <0.001) and a trend (P = 0.12) toward improved score were seen during the series. The master significantly affected the pupil's score (P =0.0137). The simulator-test showed no correlation with the operative score. CONCLUSIONS: Individual learning curves varied, and the teacher was shown to be the most important factor influencing the pupil's performance score. The correlation between assessed performance and patient outcome will be further investigated.

Computer Simulation↗

Is inter-school variation in smoking uptake and cessation due to differences in pupil composition? A cohort study.

The aims of this study were to determine if inter-school variation in smoking prevalence was due to differences in pupil composition or other school-level factors. A cohort of 13-14-year-olds (n = 7147) from 52 schools was followed-up 1 year later. Random effects logistic regression was used to examine school variation in smoking uptake and cessation, with and without adjustment for pupil composition. Inter-school variation in smoking prevalence is not caused by differences in pupil composition but is due to differences in the onset of smoking arising because of unmeasured school contextual or collective factors operating on pupils' decisions.

Adolescent↗

Targeting pupils at risk of occupational asthma.

A cross-sectional study was carried out in pupils attending the last training year from three school sections with high risks of occupational asthma (hairdressing, wood's profession, bakery) and in two groups with lower risks (butcher, salesmen). The analysis concerns a representative sample of 533 pupils in the French-speaking Community of Belgium. Among them, 62.0% in high risk professions of occupational asthma (OA) are conscious of occupational risks related to their work, as were 52.1% of those in professions less at risk (P < 0.05). The difference is also significant when asthma is mentioned as a health problem: 12.6% of the bakers and 14.1% of the hairdressers declared having suffered from asthma and 21.4% of the bakers and 26.7% of the hairdressers reckoned having had wheezing in their chest over the last 12 months. These results report preliminary signs of asthma in pupils before entering in their active life with risk of OA. Primary prevention should include information and redirecting pupils at risk of developing or increasing the disease in their working environment.

Adolescent↗

Calcium homeostasis in photoreceptor cells of Drosophila mutants inaC and trp studied with the pupil mechanism.

The light-driven pupil mechanism, consisting of an assembly of mobile pigment granules inside the photoreceptor cells, has been investigated by in vivo reflection microspectrophotometry in wild type (WT) Drosophila and in the photoreceptor mutants inaC and trp. The pupillary response of a dark-adapted WT eye to a step in light is a monophasic reflectance increase reaching a plateau after ca. 15-s light adaptation. This reflectance change is due to photoreceptor pigment granules that accumulate near the tips of the rhabdomeres under light adaptation and that are withdrawn towards the periphery in the dark (Franceschini & Kirschfeld, 1976). The step response of the pupil mechanism of inaC is triphasic. Strikingly, the reflectance level at light onset is distinctly higher than that in WT, due to a partly aggregated state of the photoreceptor pigment granules near the rhabdomere tips that persists in the dark-adapted state, in line with direct calcium measurements of Peretz et al. (1994b). The step response of the pupil mechanism of inaC is slightly elevated compared to that of WT. The step response in trp is a transient, biphasic reflectance change, approximating a log normal function. This function is also a good approximation of the pulse response in WT and inaC. The intensity range of pupillary sensitivity is about 4 log unit. The range of inaC compared to that of WT is slightly (approximately 0.5 log unit) shifted towards lower intensities, but that in trp is strongly shifted to higher intensities (approximately 2.5 log unit). The results can be interpreted with the present knowledge of the primary steps in fly phototransduction and the hypothesis that the local intracellular calcium concentration determines the position of the pigment granules, and hence are in line with the notion that the pupil can be used as a qualitative Ca2+ probe.

Animals↗

Supporting pupils in mainstream school with an illness or disability: young people's views.

To date, little research has focused directly on health-related support in school for children with a chronic illness or physical disability, yet these children are known to be at increased risk for psychosocial and academic problems. In addition, few studies have sought the views of pupils directly: those which have report a wide range of problems with school life. The increasing numbers of children surviving and managing their health conditions, together with UK policy for inclusive education, means that a growing proportion of pupils in mainstream schools require understanding of their special health needs and may need service support from education and health professionals. This paper presents findings from semistructured interviews with 33 mainstream secondary school pupils with a variety of illnesses and disabilities on the impact of their health condition on school life. Results show that young people valued school and were actively managing the effects of their condition, but needed support from others. Informal support was most frequently cited, including parents--particularly mothers--teachers and close friends. The main difficulties were implications of school absence, exclusion from school life, teachers' reactions to the illness or disability, and peer relationships. The discussion focuses on ways in which health professionals can play a part in supporting pupils both directly and indirectly, through helping others in school understand the condition and its impact on school life.

Attitude↗

Evidence for increased internal exposure to lower chlorinated polychlorinated biphenyls (PCB) in pupils attending a contaminated school.

External and internal exposure to six WHO-indicator congeners of polychlorinated biphenyls (PCB 28, 52, 101, 138, 153, 180) as well as subjective health complaints of a group of 377 pupils attending a PCB-contaminated school were compared with a control group of 218 pupils attending a non-contaminated school. Indoor air of the contaminated school revealed total PCB concentrations (sum of six indicator congeners times 5) ranging between 690 and 20,800 ng/m3 (median 2044 ng/m3). The lower chlorinated congeners PCB 28, 52, 101 were the prevailing contaminants (median 33, 293, and 66 ng/m3). Using improved analytical procedures at least one of the lower chlorinated congeners could be detected in 95% of the blood samples of pupils attending the contaminated school. Median concentrations for PCB 28, 52, 101, and for the sum of lower chlorinated congeners were 6, 9, 5, and 22 ng/l blood plasma, respectively, whereas the corresponding values in the control group were all < 1 ng/l. In contrast, no significant differences were found for the higher chlorinated congeners (PCB 138, 153, 180) which were detected in 1-2 orders of magnitude higher concentrations in both groups. Due to the dietary intake of these congeners similar total PCB levels were found (95th percentile 1070 and 1010 ng/l plasma in participants of the contaminated and control school). Using the Giessen Subjective Complaint List for Children and Adolescents no statistically significant differences in health complaints were observed between both groups of children. It is concluded that exposure of pupils to PCB in indoor air of the contaminated school caused increased blood concentrations of lower chlorinated congeners. Compared to background levels the detected excess body burden was very low indicating no additional health risk. Exposure was not associated to any specific subjective complaints.

Adolescent↗

Prevalence of self-reported hand dermatosis in upper secondary school pupils.

The purpose of the present study was to estimate the prevalence of self-reported hand dermatosis among upper secondary school pupils. All pupils in grades 1 and 3 from the four upper secondary schools in Växjö, southern Sweden, were invited to participate in the study. A previously validated questionnaire was used. Of the 2609 invited pupils, 2572 (98.6%) responded to the questionnaire. The point prevalence of self-reported hand dermatosis was 4.2% (95% CI, 3.4-4.9%) with no significant differences between gender and grades. The overall one-year prevalence of self-reported hand dermatosis was 10.0% (95% CI, 8.8-11.1%), i.e. the corresponding figures for males were 7.3% (95% CI, 5.9-8.8%) and for females 12.5% (95% CI, 10.6-14.6%). There were significant gender differences in grade 1 (p < 0.001) and in grade 3 (p < 0.05). Males and females from the hotel and restaurant course had the highest one-year prevalence in grade 3. It is concluded that the high point and one-year prevalence of hand dermatosis among upper secondary school pupils merits long-term prospective study in order to address the question of which aetiological or trigger factors are most important in the development of hand dermatosis in a population.

Child↗

Pupil dilation as a measure of processing load in simultaneous interpretation and other language tasks.

The present study tested whether the pupillary response can be applied to study the variation in processing load during simultaneous interpretation. In Experiment 1, the global processing load in simultaneous interpretation as reflected in the average pupil size was compared to that in two other language tasks, listening to and repeating back an auditorily presented text. Experiment 1 showed clear differences between the experimental tasks. In Experiment 2, the task effect was replicated using single words as stimuli. Experiment 2 showed that momentary variations in processing load during a lexical translation task are reflected in pupil size. Words that were chosen to be more difficult to translate induced higher levels of pupil dilation than did easily translatable words. Moreover, repeating back words in a non-native language was accompanied by increased pupil dilations, in comparison to repetition in the subject's native language. In sum, the study lends good support to the use of the pupillary response as an indicator of processing load.

Adult↗

Ifs, maybes and butts: factors influencing staff enforcement of pupil smoking restrictions.

Levels of pupil smoking are reported to be associated with the extent to which school staff consistently enforce smoking restrictions. Little is known, however, about factors which might motivate or discourage staff from doing so. Following analysis of interviews conducted with 27 members of school personnel purposively selected from two Scottish secondary schools serving relatively deprived communities, this paper identifies various issues that hinder staff intervention when confronted with pupil smoking. Both schools had no-smoking policies. In each, staff assumed or understood that smoking within the buildings was forbidden, yet were unsure about how far the bans extended. While the risk of fire in the school buildings prompted staff to intervene when smoking was witnessed indoors, where this risk was absent, decisions were largely context dependent or motivated by personal and professional values. Concerns about staff-pupil relationships, attention to pupils' wider welfare, lack of authority and staff levels of discomfort were salient issues inhibiting intervention. Implications for smoking policies and their enforcement are discussed. The concept of the Health Promoting School is considered in the light of the findings and inherent tensions highlighted.

Adolescent↗

School differences in pupil smoking: a consequence of a trade-off between health and education agendas?

Current policy documents stress that raising standards in education and health are inextricably linked, with schools identified as well placed to advance both agendas. This paper considers these assumptions in the light of data derived from 27 staff interviews conducted in two secondary schools. These schools served relatively disadvantaged communities, but differed in their pupil smoking rates with one school being 'high-smoking', the other 'low-smoking'. It explores whether this difference reflects the differential emphasis placed by each school on education or health. Analysis reveals that the 'low-smoking' school subscribes to holistic values and operates according to a child-centred bottom-up philosophy offering a differentiated programme of pupil support contingent on needs. In contrast, the 'high-smoking' school maintains a narrow focus on educational outcomes, and its high expectations are viewed as running counter to those held by pupils and parents. The contrasting school philosophies bring different unintended consequences. The holistic focus of the low-smoking school is associated with tempered educational expectations, thus conflicting with recommendations in education policies. The singular education focus of the high-smoking school leaves little room for a health agenda, and can overlook and disenfranchise the educationally disinclined. The school systems' impact on pupil engagement may explain their different smoking rates.

Adolescent↗

Health behaviour and sense of coherence among pupils aged 14-15.

AIM: The overall aim of the study was to investigate if there was a relationship between health behaviour and sense of coherence (SOC) in pupils aged 14-15. A specific aim was to investigate if socioeconomic areas and sex could be related to health behaviour and SOC of these pupils. METHOD: A cross-sectional study was conducted in a sample of pupils in grade eight selected from primary schools in Stockholm city with regard to socioeconomic area. The final sample of the study was 383: 196 girls and 187 boys. Two questionnaires, the Health Profile Scale measuring health behaviour and the Sense of Coherence Scale were used to collect data. RESULTS: Of the total group, girls had a significantly lower SOC mean score compared to boys. There were differences in health behaviour related to both SOC and sex. In comparison with boys, the girls showed a lower SOC in several health behaviours, e.g. breakfast, dinner, alcohol and bed-going habits. The pupils in the high socioeconomic area showed a low SOC score in several health behaviours. CONCLUSION: The findings in this study were that girls aged 14-15 had a lower SOC mean score compared to boys. The girls showed a lower SOC score related to several health behaviours. There were no significant differences in the SOC mean scores between the two socioeconomic areas.

Adaptation, Psychological↗

Issues in comparing the speechreading abilities of hearing-impaired and hearing 15 to 16 year-old pupils.

The speechreading skills of 57 hearing-impaired 15 to 16-year-olds were compared with a sample of 30 hearing pupils in the same school year. Previous comparative studies have included a complete population of hearing-impaired pupils or have been confined to those who are severely-profoundly deaf. In the present study only pupils who had sufficient verbal memory to be able to repeat up to six words in a sentence were included. The test stimuli consisted of two word lists, one from the AB isophonemic word lists and the other from the New Manchester Picture Test together with a sentence list from the Manchester Speechreading (Lipreading) Test. The hearing-impaired pupils were placed full time in mainstream units for the hearing impaired and special schools for the hearing impaired. The sample also contained a small group of five who were placed in schools for children with moderate learning difficulties. The hearing-impaired group scored significantly better than the hearing group in all of the lists. Intelligence factors assessed by the Raven's Standard Progressive Matrices were not a major influence except for the MLD group. The superiority of the hearing-impaired sample is attributed to a greater need for speechreading and the practice derived from it. Evidence from this study supports the view that sufficient development in memory for spoken language needs to occur for a child to maximise speechreading skills.

Adolescent↗