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The influence of parental occupation and the pupils' educational level on lifestyle behaviors among adolescents in Belgium.

PURPOSE: To analyze the associations of lifestyle behaviors with educational level and social background based on parental occupation in adolescence. METHODS: Data from secondary school pupils participating in the Belgian (Flemish) Health Behavior in School-aged Children (HBSC) survey of the year 2002 (N = 12,490) were analyzed. Multiple logistic regressions adjusting for age and gender were used to assess the effects of parental occupation and pupil educational level on the selected lifestyle behaviors. RESULTS: Pupils of lower educational level reported less healthy food habits, less teeth brushing, less seatbelt use, more TV watching, more smoking, more drunkenness, more use of hashish, and more lifetime use of Ecstasy. Pupils of parents with lower socioeconomic status (SES) (based on the occupation of the head of the household) reported less healthy food habits, less teeth brushing, more TV watching, and less seatbelt use. Daily smoking and the lifetime use of Ecstasy varied among pupils of different parental occupation, although the effect disappeared when the pupils' educational level was introduced into the models. Regular drunkenness and regular use of hashish did not vary among pupils of different SES backgrounds. However, after controlling for educational level, an effect of parental occupation on regular hashish use became visible, with a higher percentage of regular users among the pupils of higher parental occupation. CONCLUSION: A lower educational level is associated with higher prevalence of indicators of an unhealthy lifestyle. The results are less straightforward for the relationship between SES and lifestyle behaviors.

Adolescent↗

Phacoemulsification in eyes with a small pupil.

PURPOSE: To evaluate the intraoperative difficulties and long-term outcome of phacoemulsification through a small pupil using minimal iris manipulation. SETTINGS: Iladevi Cataract & IOL Research Centre, Ahmedabad, India. METHODS: This prospective study included 30 consecutive eyes with a maximally dilated pupil size of 4.0 mm or smaller. Except synechiolysis and occasional pupil retraction with a chopper, no iris manipulation was performed. The phacoemulsification technique included creation of deep central space, use of a low aspiration flow rate with appropriate vacuum, and step-by-step chop in situ and lateral separation of the nucleus. Patients were examined 1 day, 1 week, 1 and 3 months, and 1 year postoperatively. Specular microscopy was performed at 1 month and 1 year. RESULTS: Fourteen eyes had chronic iritis, 12 had glaucoma surgery, 2 had pseudoexfoliation, and 2 had a rigid pupil. Mean follow-up was 13.6 months. Eighteen eyes (60%) had hard cataract. Mean preoperative pupil size was 2.80 mm +/- 0.75 (SD). Mean pupil size before the capsulorhexis was initiated was 4.42 +/- 0.58 mm. The iris was bruised in 10 eyes during cortex removal. Trace amounts of cortex were left in 4 cases. Two eyes had increased intraocular pressure in the early postoperative period. Six patients had a minimal amount of retained viscoelastic material (pseudofibrin), and 2 patients developed a sterile hypopyon. Sixteen eyes had cell deposits on the IOL surface and 12 eyes, fine uveal pigments. In 2 eyes with previous glaucoma surgery and in all eyes with iritis except 2, posterior synechias reformed. CONCLUSIONS: Successful phacoemulsification was done with minimal or no pupil-widening maneuvers, restoring the preoperative pupil configuration.

Adult↗

Swedish and English secondary school pupils' attitudes towards, and conceptions of, bullying: concurrent links with bully/victim involvement.

Thirteen and fifteen year old Swedish and English secondary school pupils (n = 210) completed a questionnaire designed to measure attitudes towards, and conceptions of, bullying. The older participants also provided peer nominations of classmates thought to be bullies and victims. Significant differences between pupils from the two countries, between younger and older pupils, and between girls and boys emerged on a number of these variables. For example, a significantly larger percentage of English pupils than Swedish pupils indicated that name calling is bullying, whereas the reverse was true for leaving somebody out. These results suggest that findings concerning incidence of, and beliefs about, bullying may not generalise from one group of pupils to another. Overall, participants tended to express anti-bullying attitudes. The present results also add to the small but growing set of findings which suggest that pupils' attitudes concerning bullying and their actual involvement in bullying are associated concurrently. Attitudes were found to significantly predict involvement in bullying even after the variance shared with participants' sex had been controlled. Specifically, those pupils that expressed the weakest anti-bullying attitudes were found to be most often nominated by peers as a bully. The implications of these results for anti-bullying interventions were discussed.

Adolescent↗

Caries prevalence and periodontal treatment needs in public and private school pupils in Jordan.

A total of 886 pupils aged 15-16 years selected from 20 public and 10 private schools in northern Jordan were investigated for frequency of toothbrushing and sweet consumption, dental caries and periodontal treatment needs. A questionnaire and clinical examination were used utilising decayed-missing-filled teeth (DMFT) code and the Community Periodontal Index of Treatment Needs (CPITN), respectively. Results revealed that 35.5 per cent of public and 57.1 per cent of private school pupils reported to brush their teeth regularly while the majority of them frequently consumed sweets. There were slight differences in caries experience amongst public and private school pupils, as measured by DMFT (4.74: 4.95). While bleeding and calculus scores were prevalent in pupils of both types of schools, they were slightly higher in pupils of public schools than those in private schools. Both shallow and deep pathological pockets were found in fewer numbers (6.09 per cent) in pupils in public schools only. Oral hygiene instruction and scaling were the predominant periodontal treatment needs in both types of schools. However, the treatment needed by pupils in public schools was higher than those in private schools. Complex treatment was rarely needed by public school pupils only.

Adolescent↗

A photometric study of the effect of pupil dilatation on Nd:YAG laser iridotomy area.

A photometric study of the effect of pupil dilatation on Nd:YAG laser iridotomy area was performed in 21 eyes of 21 patients. The iridotomy area was 0.075 (0.055) mm-2 (mean (SD)) before pupil dilatation and 0.073 (0.070) mm-2 after pupil dilatation (t test NS). Iridotomy area after pupil dilatation correlated with iridotomy area before pupil dilatation (r = 0.815, p < 0.01) but did not significantly correlate with measures of iridotomy shape or position, or with changed iris area following pupil dilatation. Two iridotomies became reduced to less than 20% of their initial area following pupil dilatation. Our findings suggest that the only effective method of avoiding development of unacceptably small iridotomy area after pupil dilatation is to create a sufficiently large iridotomy at the time of initial laser surgery.

Acute Disease↗

Ability grouping in secondary schools: effects on pupils' self-concepts.

BACKGROUND: Current pressure on secondary schools to increase ability grouping has raised concerns about the impact of setting on pupils' self-concepts. Evidence from previous research is conflicting. A multidimensional measure and multilevel modelling promise to clarify the effects. AIMS: This paper aims to examine the effects of structured ability grouping on year 9 pupils' self-concepts. SAMPLES: The sample comprises over 3000 year 9 pupils (aged 13-14 years) in 45 mixed secondary comprehensive schools in England. The schools represent three levels of ability grouping in the lower school (years 7 to 9). METHODS: Pupils responded to a multidimensional self-concept scale measuring academic and general facets of the self-concept. Measures of attainment were collected in English, mathematics and science. Multilevel modelling was used to examine the effect of the type of school on the general facets of the pupils' self-concept and the effects of setting in each curriculum subject on the academic facets of the self-concept. RESULTS: Pupils' general self-concept was higher in the group of schools with moderate levels of setting. The degree of setting in mathematics and science had no effect on the corresponding academic self-concepts but setting in English tended to lower the self-concepts of the higher attaining pupils and raise the self-concepts of lower attaining pupils. Gender differences were consistent with previous research, with boys having significantly higher self-concept scores than girls, except in English. These findings indicate that the degree of stratification in schools can have an impact on adolescents' self-esteem and views of themselves in school.

Achievement↗

Peer-assessed behavioural characteristics and sociometric rejection: differences between pupils who have moderate learning difficulties and their mainstream peers.

BACKGROUND: The outcomes of social inclusion and skills training programmes for pupils with special educational needs have been mixed. Programmes are generally based on research with mainstream samples yet it has been suggested that the social skills important for sociometric acceptance may be different for children who have special educational needs. AIMS: The study aims to compare peer-assessed behavioural characteristics associated with sociometric status for included children who have moderate learning difficulties and their mainstream classmates. SAMPLE: Mainstream classmates (N=867) of all the children ascertained as having Moderate Learning Difficulties (MLD) and included in mainstream middle schools (8-12 years) in one English county. Subgroups of rejected mainstream (n=38) and pupils with MLD (n=32) were further investigated. METHOD: Discriminant function analysis was carried out with peer assessment items as predictors of sociometric status group membership in the mainstream sample and contrasted with previously reported data from pupils with MLD in the same classes. Cluster analysis was used to identify behavioural subtypes within the rejected groups drawn from each sample. For pupils with MLD subtypes were validated using teacher assessments of social behaviour. RESULTS: Systematic differences were identified across different analyses between the peer-assessed behavioural characteristics associated with rejected sociometric status for pupils with MLD and for mainstream pupils. CONCLUSIONS: The appropriateness of generic social skills training programmes for promoting the social inclusion of pupils with MLD should be questioned and consideration given to rejected pupil subtypes.

Child↗

Pupils' evaluation and generation of evidence and explanation in argumentation.

BACKGROUND: Studies on argument have found that participants tend to prefer explanations to evidence. This apparent bias toward explanation has been qualified recently by research that has found it to diminish with the availability of evidence. AIM: This study examines the use of explanation versus evidence in the context of argumentation with reference to the goals of particular argument situations. SAMPLE: Seventy-nine eighth-grade pupils at a regular, urban middle school. METHOD: The pupils read argumentation scenarios, each having the stated goal of either explaining or proving a claim. The pupils rated the degree to which each of two provided assertions (one a theoretical explanation, and the other evidence-based) helped achieve the goal of the argument. On a second task, the pupils chose which of the two assertions should be more effective in achieving the argument goal. On the third task, the pupils generated either an explanation or evidence for each of the argumentation scenarios. RESULTS: Pupils demonstrated sensitivity to the relative epistemic strength of explanation and evidence. They rated explanations as more advantageous in achieving the explanation goal, and evidence as more advantageous in achieving the proof goal. Conversely, however, when asked to generate or recall an explanation or evidence, pupils produced more explanations than evidence independent of the argumentation goal. CONCLUSIONS: The study refines the definition of argumentation context to include specific goals. Pupils were sensitive to the context of the argumentation situation (e.g.goals, availability of evidence). However, they appeared to have a disposition toward explanation when asked to produce an explanation or evidence-based justification.

Adolescent↗

Comparison of threshold visual perimetry and objective pupil perimetry in clinical patients.

OBJECTIVES: In an attempt to measure the visual field objectively, we have performed pupil perimetry, by which the pupil light reflex is monitored in response to perimetric light stimuli. The purpose of this study was to ascertain whether pupil perimetry reveals defects similar to those revealed by standard threshold perimetry in patients with various diseases. MATERIAL AND METHODS: An infrared pupillometer was linked to an automated perimeter to record, at each perimetric location, 76 pupil contractions, which were comparable to the test locations of the Humphrey Field Analyzer (HFA 30-2 program; Humphrey, San Leandro, CA). One hundred eighteen patients with various diseases were investigated. RESULTS: Ninety-one patients (77.1%) maintained a pupil area large enough (more than 10 mm2 in area) to respond adequately to focal light stimuli throughout the test. The correlation between the pupil field and the threshold visual field was subjectively judged to be good in most cases. However, pupil perimetry showed less damage than that seen in threshold perimetry in six of nine patients who had Leber's hereditary optic neuropathy (LHON). CONCLUSIONS: Pupil perimetry is a good method for measuring the visual field objectively and has potential for clinical use in most of the cases.

Adult↗

[Phacoemulsification through a small pupil].

OBJECTIVE: To discuss the surgical techniques and attention points in phacoemulsification through a small pupil. METHOD: Eighty three cataracts of 77 patients were emulsified by using non-cut pupil dilation, cystotome or diathermic high-frequency capsulorrhexis. RESULTS: The 66 cataracts of 83 eyes were emulsified by means of the above method. After the surgery, all the pupils were recovered to normal size (2 to 3 mm), and none of them were damaged. In 17 eyes, the procedure was performed after separation of synechia and excision of the organized membranes; after the surgery, a round pupil was obtained in 15 cases and an irregular pupil in 2 cases. The visual acuity at postoperative 1 month was >or= 0.5 in 46 eyes (55.4%) and corrected >or= 0.5 in 71 eyes (85.5%). CONCLUSION: After phacoemulsification through a small pupil by non-cut pupil dilation method, the pupil can be recovered to normal and no unfavorable reaction is seen.

Adult↗

Pupil block glaucoma from traumatic vitreous prolapse in a patient with posterior chamber lens implantation.

BACKGROUND: Angle closure secondary to pupil block is an entity known to occur in aphakic and pseudophakic patients. In aphakic patients, typically the cause of the pupil block is vitreous prolapse (aphakic pupil block). In pseudophakic patients, the typical cause of the pupil block is an anterior chamber lens implant, often in the absence of an iridectomy (pseudophakic pupil block). Rarely, a hybrid of these two conditions can occur, in which vitreous prolapse causes a pupil block in a pseudophakic patient with a posterior chamber lens implant. METHODS: The case presented is that of an elderly pseudophakic man with a posterior chamber lens implant who experienced ocular trauma, and who subsequently also experienced a ruptured posterior capsule with resultant vitreous prolapse and pupil block angle closure. Key diagnostic features are presented, as well as patient-specific management for this uncommon condition. CONCLUSIONS: While diagnosis and management of acute primary angle closure are well-known and reported, acute secondary angle closure is not as well reported. It is imperative to understand the mechanism of angle closure, as this properly delineates the management plan. Use of management plans appropriate to acute primary angle closure with pupil block (the use of miotics) could potentially have disastrous consequences in cases of secondary angle closure from vitreous prolapse.

Aged↗

Automated pupil perimetry in amblyopia: generalized depression in the involved eye.

OBJECTIVE: This study was designed to determine whether the relative afferent pupillary defects observed commonly in amblyopic eyes are associated with a uniform depression of the pupillary light reflex throughout the visual field or solely by a focal decrease in pupillary response near fixation. DESIGN: The authors used pupil perimetry to evaluate the contraction amplitude of the pupil in response to focal light stimuli at 76 points throughout the 30 degrees field in each eye of 28 patients with amblyopia. The "pupil fields" were recorded using a computerized infrared pupillograph linked to a Humphrey Field Analyzer, so that the pupil contraction could be recorded in response to perimetric light stimuli. PARTICIPANTS: Nine patients had strabismic amblyopia, ten had anisometropia, six had a combination of anisometropia and strabismus, and three had deprivation amblyopia due to monocular congenital cataract. MAIN OUTCOME MEASURES: Mean pupillary contraction amplitude for the entire field and focal amplitudes at each tested location were compared. Mixed-model analysis of variance was used to assess effects of perimetry location, type of amblyopia, and interaction effects. RESULTS: The overall average of all the pupil contractions throughout the 30 degrees field was less for the amblyopic eye compared with that of the fellow eye. This decrease in focal pupil response for amblyopic eyes was present in each type of amblyopia and was greatest for deprivation amblyopia. The contraction amplitude was depressed diffusely throughout the pupil field and showed neither focal deficits nor a selective depression about fixation. CONCLUSION: Amblyopia produces a global depression of focal pupillary responses across the entire 30 degrees field.

Adult↗

Buspirone, but not sumatriptan, induces miosis in humans: relevance for a serotoninergic pupil control.

BACKGROUND AND OBJECTIVE: Drugs that act on the serotoninergic system have been shown to influence the pupil size. However, the 5-hydroxytryptamine (5-HT) receptor type or subtype that affects pupil diameter has not been defined in humans. With a placebo-controlled, double-blind randomized design, we investigated in healthy volunteers the effect on pupil size of buspirone and sumatriptan, which mainly act on 5-HT1A- and the 5-HT1-like receptors, respectively. METHODS: The pupil area was measured by means of a videopupillometer before and after a single oral administration of placebo or of three different doses of active drugs. Heart rate and arterial blood pressure were recorded after pupil area measurement. RESULTS: Buspirone (5, 10, and 20 mg) caused a dose-dependent miosis. Sumatriptan (50, 100, and 200 mg) did not affect the pupil size. Twenty milligrams of buspirone reduced the mydriasis induced by pretreatment with homatropine eyedrops. A 20 mg dose of buspirone reduced blood pressure without change in heart rate, whereas buspirone, at doses lower than 20 mg, and sumatriptan did not affect heart rate and blood pressure. CONCLUSIONS: This study suggests that buspirone, but not sumatriptan, the selective agonist of 5-HT1-like receptors, causes miosis in humans by activation of 5-HT1A receptors, possibly located in the central nervous system where they inhibit iris sympathetic pathways. Measurement of pupil size seems to provide a valuable and sensitive index of 5-HT1A receptor function in humans.

Administration, Oral↗

Accommodative microfluctuations and pupil diameter.

The nominally steady-state accommodation response exhibits temporal variations which can be characterized by two dominant regions of activity; a low frequency component (LFC < 0.6 Hz) and a high frequency component (1.0 < or = HFC < or = 2.1 Hz). There is no consensus as to the relative contribution made by each of the frequency components of the microfluctuations to the control of steady-state accommodation. We investigate the effect of variations in artificial pupil diameter (0.5, 1, 2, 3, 4 and 5 mm pupils) on the microfluctuations of accommodation, while three young emmetropic subjects view, monocularly, a photopic high contrast Maltese cross target placed at a dioptric distance equal to their open-loop accommodation level. Average power spectra were calculated for five accommodation signals, each of 10 sec duration, collected for each viewing condition at a sampling rate of 102.4 Hz using a continuously recording infrared objective optometer. For artificial pupil diameters < or = 2 mm the power of the LFC was found to increase as a function of reducing pupil diameter, while for artificial pupil diameters > 2 mm the LFC was found to be relatively constant. No systematic change in the HFC with varying artificial pupil diameter was observed. Changes in the root-mean-square (r.m.s.) value of the fluctuations with varying pupil diameter were significant (one-way ANOVA, F = 8.507, P = 0.0001, d.f. = 89) and showed a similar form to the changes in the LFC.(ABSTRACT TRUNCATED AT 250 WORDS)

Accommodation, Ocular↗

Pupil decentration and iris tilting detected by Orbscan: anatomic variations among healthy subjects and influence on outcomes of laser refractive surgeries.

PURPOSE: To investigate the anatomic variations of entrance pupil decentration and tilting angle of the iris in healthy subjects and the influence of these factors on the outcome of laser in situ keratomileusis (LASIK). SETTING: Minamiaoyama Eye Clinic, Tokyo, Japan. METHODS: The degree of pupil decentration and tilting angle of the iris in 2280 eyes of 1144 myopic patients without abnormal findings by ophthalmologic examination were assessed using Orbscan. Of these, 901 eyes of 467 patients had LASIK. Multiple analysis of variance (ANOVA) was used to determine risk factors for reduction of postoperative best spectacle-corrected visual acuity (BSCVA) considering patient age, refractive power, tilting angle of the iris, pupil decentration, and corneal power. RESULTS: The mean pupil decentration in all eyes was 0.19 mm +/- 0.11 (SD) (range 0 to 0.9 mm); tilting angle of the iris was 4.06 +/- 1.41 degrees (range 0.19 to 12.69 degrees). By multiple ANOVA, refractive power, pupil decentration, and tilting angle of the iris were significant for the reduction of BSCVA. CONCLUSIONS: Some eyes with pupil decentration or tilting angle of the iris could not be detected under typical ophthalmologic examination but only with topographic examination. Attention should be paid to eyes with large pupil decentration and tilting angle of the iris because these may be risk factors for reduction of postoperative BSCVA during corneal refractive surgeries.

Adult↗

Influence of pupil and optical zone diameter on higher-order aberrations after wavefront-guided myopic LASIK.

PURPOSE: To investigate the influence of pupil and optical zone (OZ) diameter on higher-order aberrations (HOAs) after myopic wavefront-guided laser in situ keratomileusis (LASIK). METHODS: Twenty-seven myopic eyes of 19 patients were included. The mean preoperative spherical equivalent was -6.86 diopters (D) +/- 1.24 (SD) (range -4.25 to -9.5 D); the mean planned OZ diameter was 6.26 +/- 0.45 mm (range 5.7 to 7.1 mm). All patients had uneventful wavefront-guided LASIK (Zyoptix version 3.1, Bausch & Lomb) and an uncomplicated follow-up of 12 months. Wavefront measurements were performed with a Hartmann-Shack sensor in maximum mydriasis preoperatively and 12 months after LASIK. Wavefront errors were computed for pupil diameters (PDs) of 3.0, 3.5, 4.0, 5.0, 6.0, and 7.0 mm for the individual OZ diameter and for the individual mydriatic PD (7.93 +/- 0.46 mm). The impact of the relationship between pupil diameter and OZ diameter (fractional clearance [FC]) on HOA was described and quantified using curvilinear regression with a 4th-order polynomial fit. RESULTS: There was a reproducible relationship between FC and the amount of induced HOA. The change in HOA root mean square and primary spherical aberration (Z(4)0) was significantly correlated with FC. If the OZ was 16.5% larger than the pupil (FC = 1.17), only half the amount of HOA was expected to be induced than if the OZ equaled the pupil. In contrast, an OZ that was 9% smaller than the pupil (FC = 0.91) resulted in an HOA induction 50% higher than at FC = 1. CONCLUSION: The OZ zone to pupil ratio (fractional clearance) had a significant impact on HOA induction after wavefront-guided LASIK.

Adult↗

Assessment of pupil size under different light intensities using the Procyon pupillometer.

PURPOSE: To study the relationship between pupil size and light intensity using the Procyon pupillometer. SETTING: University based clinic. METHODS: In this retrospective study, 20 consecutive patients had pupil size assessment with the Procyon pupillometer under 3 different light conditions--4, 0.4, and 0.04 lux. Correlation was established using the log unit of the light intensity and pupil size. RESULTS: The correlation coefficient for the association between pupil size and log unit of light intensity in all eyes was significant (P<.001). The mean correlation coefficient for the association between pupil size and log unit of light intensity in all patients was 0.968 +/- 0.089 (SD) in the right eye and 0.970 +/- 0.031 in the left eye. CONCLUSION: The linear relationship between the pupil size and the log unit of the light intensity showed a tight correlation in all cases. These results can be useful in the comparing pupil size with pupillometers that work under different light conditions.

Adult↗

Pupillary functions after cataract surgery using flexible iris retractor in patients with small pupil.

PURPOSE: To quantitatively assess pupillary functions after small pupil cataract surgery using the flexible iris retractor. METHODS: Subjects were 11 patients (12 eyes) with small pupils who underwent phacoemulsification and intraocular lens implantation. Pupils were enlarged using the flexible iris retractor intraoperatively, and postoperative iriscorder data were compared with the data of 20 normal controls who underwent standard phacoemulsification and intraocular lens implantation. RESULTS: Although pupillary area before light stimulus did not differ between the groups, contraction rate after light stimulus was significantly lower in the small pupil group than in the normal controls. The velocity of contraction and dilation was also significantly slower in the small pupil group. Wider pupillary stretching during surgery resulted in deteriorated pupillary functions after surgery. Eyes of patients on long-term miotic therapy with pilocarpine showed poorer pupillary reaction postoperatively. CONCLUSION: Inappropriate use of the flexible iris retractor causes an atonic, chronically enlarged postoperative pupil. To avoid postoperative pupillary complications, miotic pupils should not be stretched to larger than a 5.0 x 5.0 mm square.

Aged↗