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A 10-year-old child with status asthmaticus, hypercapnia and a unilateral dilated pupil.

This article reports the case of a 10-year-old child with an exacerbation of asthma requiring mechanical ventilation. His immediate course was complicated by significantly elevated arterial CO(2) tensions and a unilateral dilated pupil. A computed tomography scan of his brain failed to demonstrate any evidence of intracranial hypertension or cerebral edema, and he went on to make an uncomplicated recovery, with no evidence of neurological sequelae. The most likely diagnosis appeared to be local contamination with ipratropium when he was receiving frequent nebulizers prior to mechanical ventilation. Similar cases reported in the literature are reviewed, with a discussion of clinical management, implications of permissive hypercapnia and neurological complications in ventilating asthmatic patients and the importance of safe drug handling by staff members.

Albuterol↗

Swedish upper secondary school pupils' sense of coherence, coping resources and aggressiveness in relation to educational track and performance.

The health of an individual depends on how well he or she can handle various stressors in his or her environment. One vulnerable period occurs during the transition from child to adult. The overall aim of this research project was to determine whether differences in the ability to deal with stress are related to various health indicators, aggression, and school marks during primary and upper secondary school. Data were collected class-wise and 253 Swedish upper secondary school pupils participated. Three well-established questionnaires [Sense of Coherence (SOC), Coping Resources Inventory (CRI) and Aggression Questionnaire (AQ)] were used. In addition, blood pressure, teacher evaluation and school marks were collected. Some demographic data such as gender, age and type of study programme were also collected. Both SOC and Coping Resources Inventory correlated significantly positively with many of the primary and upper secondary marks, while the AQ had significantly negative correlations with the mark. Females obtained higher values than males in Coping Resources Inventory, but lower in SOC and AQ.

Adaptation, Psychological↗

Positive correlation between initial pupil diameter and amplitude of miotic response to pilocarpine in rabbits and to carbachol in man.

A linear correlation between amplitude of miotic response and initial pupil diameter has been demonstrated in rabbits using various concentrations of pilocarpine HC1. The same correlation was found when published results in humans using carbachol were examined and it is likely that the correlation also applies to pilocarpine in humans. No such correlation was observed with physostigmine.

Animals↗

Preventive dental health in adolescents: short and long term pupil response to trials of an integrated curriculum package.

A controlled evaluation of a 3-week teacher mediated dental health education curriculum package was undertaken in 35 English secondary schools in three Area Health Authorities. 4500 13-14-year-old adolescents were involved. The package emphasized self-care potential and combined a scientifically accurate message with educational and behavioural science concepts. Evaluation was at the levels of process and outcome using changes in oral hygiene recorded on a random sample (n = 1491) by two trained examiners; self-complete pre/posttest questionnaires, pupil worksheets and home experiment diaries. Behavioural, cognitive and affective outcomes are reported. Significant improvements in oral hygiene status were recorded at the conclusion of the programme along with large gains in knowledge and positive changes in attitude. Long term follow-up oral hygiene examinations in six schools (n = 145) conducted in conjunction with a reinforcement programme, indicated a maintenance of the initial improvements in five schools. Further significant improvements were measured after the reinforcement programme.

Adolescent↗

Pre-employment screening for contact dermatitis among the pupils of a metal industry school.

79 male pupils of a metal industry school were investigated, none of whom had yet been occupationally exposed to metals or to cutting oils. In 1 or 2 years, depending on their grade and age, they would all be employees in the metal industry. Each was patch tested with nickel sulfate 5% pet., cobalt chloride 1% pet., and potassium dichromate 0.5% pet., and 28 had a positive reaction to 1 or more of the metals tested. This finding indicates the necessity not only for pre-employment patch testing in industries where contact dermatitis is likely to occur, but that patch testing should be done even earlier in school children, before they decide to enter certain occupations.

Adolescent↗

Hip pain in adolescents: results of a cross-sectional study in German pupils and a review of the literature.

AIM: To determine the prevalence of hip pain (HP) in adolescents in East Germany and to evaluate the potential factors associated with HP. DESIGN: Cross-sectional epidemiological study of a total of 2368 pupils (1137 males, 1231 females; age 14.5+/-0.65, range 13-18 y). Demographic data and information on sports activity and consumption of soft legal drugs were obtained using a questionnaire. Physical examination was carried out by school doctors. Odds ratio (OR [95% confidence interval]) was calculated for common factors associated with HP. RESULTS: The prevalence of adolescents suffering from HP was 6.5% (n=151). Pain episodes were reported as occasional in 3.0%. A total of 69 subjects (2.9%) suffered from permanent pain during physical activity. Permanent pain when at rest was reported in 0.5% (n=12). Female subjects, students attending high school, smoking adolescents and adolescents with a consumption of alcoholic beverages had a significantly higher prevalence of HP. HP was associated with a significantly higher prevalence of low back pain and knee pain. The prevalence of pathological findings of the hip was 2.5% (n=60). Factors significantly associated with HP were: female gender (1.9-fold), attending high school (2.1-fold) and consumption of tobacco (1.6-fold). CONCLUSIONS: HP in adolescents seems to be mostly caused by functional disorders. There is a possible association between HP and psychological stress or consumption of legal drugs. Prophylactic measures are necessary in this age group in future.

Adolescent↗

Positive factors associated with promoting health in low-risk and high-risk populations of 15- and 16-year-old pupils in Oslo, Norway.

AIM: To explore possible risk-reducing factors associated with the incidence of common illnesses and use of healthcare services among adolescents. METHODS: Cross-sectional questionnaire study conducted in all Oslo schools among all 15- and 16-y-olds in 2000 and 2001. The adolescent population was divided into a low-risk (LR) and a high-risk (HR) group, and into quartiles, based on a sum score of different negative life experiences. The groups were compared with respect to potential risk-reducing factors. RESULTS: 88% of the 8316 pupils filled in the questionnaires. The difference between the LR and HR groups was largest for the possible risk-reducing factor "my family values my opinion" (LR group = 92%; HR group = 82%), and "I manage to solve serious problems myself" (LR = 91%; HR = 86%). The family valuing the adolescents' opinions was the risk-reducing factor most often associated with lower incidences of illness and healthcare utilization. Among the adolescents at highest risk, less depression was strongly related to positive relationships with friends, boys: odds ratio = 0.1 (CI 95%: 0.0-0.7); and girls: 0.2 (0.1-0.5). Adolescents reporting that they managed their own problems had about half the risk of depression. CONCLUSION: Good relations with family and friends, and a feeling of managing one's own life, are significantly related to lower rates of illness, in particular depression, and less healthcare-seeking behaviour. The risk-reducing effects increase with increasing risk. Healthcare workers therefore need to pay more attention to HR patients.

Adolescent↗

Ophthalmological findings in pupils of a primary school with particular reference to reading difficulties.

200 good readers and 41 poor readers selected from 718 pupils in a primary school, grade 1-6 were examined in respect of stereopsis, visual acuity, phorias, tropias, fusional breakpoint, fusional amplitude and objective refraction. No statistical difference was found between the 2 reader groups, and the need for optical aid was of the same order. 80 of the 241 children had unnecessary glasses, and many of those who needed spectacles were improperly aided.

Age Factors↗

Twenty-year follow-up of pupils in a special class for the mentally retarded: a study of a complete school community.

Long-term individual follow-up of a class of 18 mildly mentally retarded pupils and of a larger group of their contemporaries--at three and at 20 years after primary school--raises questions about theories and assumptions that serve as a basis for educational and health policies affecting such students. The particular importance of interdisciplinary education and cooperation among professionals serving this population is stressed.

Adult↗

Sex-related patterns of worry in secondary school pupils.

This investigation sought data concerning sex differences in the worry patterns of children. The sample comprised 182 comprehensive school pupils, 91 boys and 91 girls, between the ages of 12 years 1 month and 13 years 7 months. The Simon-Ward Worry Survey (1976) was administered in order to ascertain the frequency and intensity of worry experienced in the following areas; family, school, economic, social, personal adequacy, health, imagination and animals. Both in the frequency and intensity of worry girls scored higher than boys in the areas of family, social and imagination, but no significant differences occurred for personal adequacy, health, animal or economic factors. For both sexes the category order, from highest to lowest, was the same--family, social, school, imagination, personal adequacy, health, economic and animals.

Adolescent↗

Monitoring changing attitudes towards Christianity among secondary school pupils between 1974 and 1986.

The Francis scale of attitude towards Christianity Form ASC4B was administered to the whole pupil population in years one through five of two co-educational comprehensive schools in 1974. The study was replicated at four-yearly intervals in 1978, 1982 and 1986. The results confirm the finding that attitudes towards Christianity decline throughout the years of compulsory secondary schooling and also establish that there has been a significant and progressive decline in attitude scores throughout this age range during the 12-year period between 1974 and 1986.

Adolescent↗

The examination attainments of secondary school pupils who abuse solvents.

A sample of 105 adolescents who had abused solvents and an equal number of controls matched for school, school year and sex were identified by means of a two-stage screening procedure involving (a) administration of a self-completed questionnaire to approximately 5,000 third, fourth and fifth year pupils in 16 secondary schools, and (b) individually conducted interviews. These two groups were followed up at the end of their final year of compulsory education when details of their fifth year public examination entries and results were obtained from their schools. The examination attainments of the solvent abusers were generally lower than those of the controls. They were more likely to leave school at Easter of their fifth year and a much higher proportion of them were not entered for any examinations. Those who were entered for exams were less likely to pass at O level and, regardless of the type of exam, much less likely to obtain higher examination grades. Poor examination attainments among the solvent abusers were associated with adverse domestic circumstances, frequent self-reported behaviour problems and low scores on educational tests administered at the time of transfer from primary to secondary school. After controlling for these factors, the difference between groups in examination attainments was no longer statistically significant.

Absenteeism↗

Teacher's perception of primary schoolchildren's undesirable behaviors: the effect of teaching experience, pupil's age, sex and ability stream.

Using a self-administered questionnaire, the attitudes of 844 Maltese primary school teachers towards 16 selected undesirable behaviours were surveyed. Results indicated that pupils' age is a significant moderator of half of the behaviours; these are perceived to be significantly more serious by teachers in the second three years of the primary school than by their colleagues in the first three years. Significant boy-girl differences in the seriousness of behaviour were revealed in most of the behaviours as rated by teachers in both the first and in the second years. In addition, length of teaching experience was found to be a significant moderator of the perceived seriousness of some of the behaviours: the less experienced, when compared with the more experienced, judged these behaviours as being more serious. Ability stream did not have any significant effects on the teachers' attitudes towards the undesirable behaviours.

Aptitude↗

Changes in control beliefs in Portuguese primary school pupils as a consequence of the employment of self-assessment strategies.

Previous findings suggest that a move towards internality in control beliefs is positively associated with academic success. The present study set out to explore the extent to which the use of self-assessment techniques by Portuguese primary school children is positively associated with increased internality, and to establish whether the presence of these techniques together with enhanced internality correlate with improved academic (mathematical) performance. A sample of Portuguese primary school teachers was coached in how to teach self-assessment techniques to their children, and these children were then monitored by the researchers over an eight-month period. Results on the Control, Agency and Means-End Interview Questionnaire (Skinner, Chapman & Baltes, 1988a, 1988b) indicated that at the end of the experimental period the children showed significantly less dependence upon external sources of control (perceived externality), and upon luck and unknown control as explanations for school academic events when compared to a matched control group of children who were not using pupil self-assessment. In addition, the children regularly using self-assessment strategies significantly increased their relative internality over the period concerned, and showed significant improvements in academic performance (as measured by mathematics scores) relative to the control group.

Achievement↗

Counting and cardinality in English nursery pupils.

This study examines the development of counting and cardinality in a structured sample of 60 English 3 1/2-4 1/2 year-olds attending local education authority nursery classes in socially mixed areas of Portsmouth. Children were given two types of task: counting sets of animals, and giving specified numbers of items from a pile. Three measures of cardinal understanding were used: spontaneous repetition of the last word on completion of a counting trial, repetition of the last word in reply to a question, and use of counting vs. grabbing when asked to give a specific number of items from a heap. In line with research on other populations the results indicate a pronounced developmental discrepancy between procedural and conceptual knowledge of counting, but cardinality appears to develop six months later in this population than in other populations studied. There were marked individual differences, however. Proficiency with object counting was found to be necessary, but not sufficient, for cardinal understanding. Children rarely repeated final count words spontaneously. Last word repetition in response to a verbal prompt depended on the nature of the prompt. Contrary to previous research, the present results indicate that last word repetition elicited by the prompt 'how many?' is not merely a conventional reply but generally implies an understanding of cardinality. The findings also indicate that an understanding of cardinality emerges relatively suddenly, consistent with the discovery or construction of a principle. Whether nursery pupils treat counting simply as a conventional routine without cardinal significance appears to depend on the situation as well as on their understanding of cardinality. The findings are discussed in relation to Karmiloff-Smith's Representational Redescription model.

Analysis of Variance↗

Assessment of pupillary light reflex latency and darkness adapted pupil size in control subjects and in diabetic patients with and without cardiovascular autonomic neuropathy.

Increased pupillary light reflex latencies were found more often than a reduced darkness pupil size in diabetic patients with and without abnormal cardiovascular reflexes. This finding suggests that parasympathetic pupillary dysfunction precedes sympathetic pupillary denervation in diabetic autonomic neuropathy.

Adolescent↗

Pupil-sparing oculomotor palsy caused by fusiform arteriosclerotic aneurysm of the basilar artery--a case report.

Paresis of the oculomotor nerve is a very rare complication of an unruptured arteriosclerotic fusiform aneurysm of the basilar artery. A handful of cases are described in the world literature. A fifty-four-year-old man with a history of hypertension and diabetes mellitus presented with painless partial oculomotor palsy of sudden onset. A cerebral angiogram demonstrated a tortuous fusiform deformity of the basilar artery and the origin of the posterior cerebral arteries, indicative of an arteriosclerotic aneurysmal dilation. A sudden onset of a pupil-sparing ophthalmoplegia is the typical history of a microvascular infarct of the third nerve, whereas pupillary sparing in aneurysmal oculomotor paresis is a very rare event. Special emphasis has been placed on the pupillary size as a guide for the indication of arteriography. The many exceptions to this rule suggest that cerebral arteriography may be indicated more often than generally believed.

Basilar Artery↗

Neuropsychological intervention in dyslexia: two studies on British pupils.

The theoretical context of this research is developmental neuropsychology--in particular, the educational implications for the classification of and intervention in specific developmental dyslexia (SDD). Controlled and validated research can help identify optimal teaching methods for groups and individuals. Within this framework, neuropsychological theory can be explored as a medium for improving intervention for pupils with SDD. Neuropsychological stimulation cannot change the macro aspects of the brain but can change its "finetuning" and its response to written text. Within the psycho-neurological approaches, Bakker (1979, 1990, 1998) developed both a diagnostic procedure and empirically investigated intervention procedures. The theory rests on the Balance Model of learning to read, in which differential hemisphere involvement is implicated in beginning and advanced reading. Intervention can take place via hemisphere-specific stimulation using visual or tactile stimulation or hemisphere-alluding stimulation using modified text. Two investigations are presented, one experimental and another clinical. The results support the validity of dyslexia subtyping and the effectiveness of the treatment methods.

Adolescent↗