Linda Bourque

To evaluate factors related to the quality of vision after LASIK. Survey study. One hundred consecutive patients. LASIK with a 6.0-mm elliptical ablation pattern without transition zone to treat mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent [MSE], -4.79 +/- 1.33 diopters [D]; range, -2.88 to -9.25 D). The second eye was treated 1 month after the first. Completed questionnaires assessing night vision problems (glare, haze, and halo symptoms) before surgery and at 1, 3, and 6 months after surgery in 97, 75, 81, and 66 subjects, respectively. Mesopic pupil size and preoperative and postoperative variables were analyzed with questionnaire data using an analysis of variance (ANOVA) and multivariate regression analysis. Patients with large mesopic pupils had significantly more reports of glare, haze, and halo than did those with smaller pupils in the treated eye at 1 month after surgery (P=0.02, P=0.03, and P=0.02, respectively ANOVA) and of glare at 3 months (P=0.05). Significant predictors of symptoms at 6 months, identified through multivariate regression analysis, included preoperative MSE (for glare and haze), preoperative contrast acuity (glare), postoperative uncorrected visual acuity (UCVA; haze), and residual cylinder (haze). Together, these factors accounted for only 19% of the overall variability in glare and 37% of the variability in haze responses. No relationship between pupils and symptoms was noted at 6 months after surgery in either the ANOVA or regression analysis group. Patients with large pupils had more quality of vision symptoms in the early postoperative period, but no correlation was observed 6 months after surgery. Factors related to long-term symptoms include the level of treatment (preoperative myopia), preoperative contrast acuity, postoperative UCVA, and residual cylinder. Most of the variability in visual quality could not be explained by preoperative or clinical outcome measures, including pupil size.

Suicide is one of the three leading causes of death among adolescents. More importantly, the rate of suicide is on the increase among both male and female adolescents (Tischler, McKenry, & Morgan, 1981). Data from the United States show that approximately 25,000 persons commit suicide each year (Coleman, 1976), and almost one-fifth of these are in the 15 to 24 year age group (Hendin, 1975). More disturbing is that a large number of adolescent suicides go unreported and that up to 50% of all these unreported suicides are categorized as "accidents" (Toolan, 1964). Utilizing suicide data collected in Sacramento County, California between 1925 and 1979, we analyzed suicides among persons aged 10 to 24 to determine if there are sociodemographic factors or presuicide behaviors which discriminate between male and female suicides, suicides of different ages, or explain the increase in suicide rates, and to compare adolescent suicide rates in Sacramento County with national findings.

Long-term trends in suicides among females were investigated using data from Sacramento County, California. Of the 3,741 cases, 3,398 were Caucasian and 952 (25.4 percent) were females. These analyses focus on 837 Caucasian and Hispanic females. Female suicide rates in Sacramento County have increased gradually since 1925 with a corresponding decline in the male/female sex ratio. The suicide data suggest that a minimum of three types of female suicides can be identified and that the incidence of each type varies with the age of the women. Indicators that help in identifying cases and in tentatively describing an etiology include marital status, employment status and occupation, physical ill health, familial loss or disruption, and psychiatric symptoms.

Long-term trends in suicides among females were investigated using data from Sacramento County, California. Of the 3,741 cases, 3,398 were Caucasian and 952 (25.4 percent) were females. These analyses focus on 837 Caucasian and Hispanic females. Female suicide rates in Sacramento County have increased gradually since 1925 with a corresponding decline in the male/female sex ratio. The suicide data suggest that a minimum of three types of female suicides can be identified and that the incidence of each type varies with the age of the women. Indicators that help in identifying cases and in tentatively describing an etiology include marital status, employment status and occupation, physical ill health, familial loss or disruption, and psychiatric symptoms.

Development of an earthquake early warning capability and pilot project were objectives of TriNet, a 5-year (1997-2001) FEMA-funded project to develop a state-of-the-art digital seismic network in southern California. In parallel with research to assemble a protocol for rapid analysis of earthquake data and transmission of a signal by TriNet scientists and engineers, the public policy, communication and educational issues

The demographic, life-style, and self-reported health characteristics of a convenience sample of 207 male and 70 female, non-Hispanic White, heavy marijuana users in Los Angeles County were compared with those of more representative county and national samples. Consistent with other researchers' findings, heavy marijuana users were found to differ significantly in living arrangements, job stability, and income. Heavy marijuana users did not differ in completed education, self-reported physical health, or use of alcohol and cigarettes. Heavy marijuana users were less likely to be married than nonusers, but reported the same number of close friends with whom they interacted more frequently than same-aged comparison groups. Our findings suggest that heavy marijuana users are not homogeneous, and that female users differ significantly from male users.

To evaluate factors related to the quality of vision after LASIK. Survey study. One hundred consecutive patients. LASIK with a 6.0-mm elliptical ablation pattern without transition zone to treat mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent [MSE], -4.79 +/- 1.33 diopters [D]; range, -2.88 to -9.25 D). The second eye was treated 1 month after the first. Completed questionnaires assessing night vision problems (glare, haze, and halo symptoms) before surgery and at 1, 3, and 6 months after surgery in 97, 75, 81, and 66 subjects, respectively. Mesopic pupil size and preoperative and postoperative variables were analyzed with questionnaire data using an analysis of variance (ANOVA) and multivariate regression analysis. Patients with large mesopic pupils had significantly more reports of glare, haze, and halo than did those with smaller pupils in the treated eye at 1 month after surgery (P=0.02, P=0.03, and P=0.02, respectively ANOVA) and of glare at 3 months (P=0.05). Significant predictors of symptoms at 6 months, identified through multivariate regression analysis, included preoperative MSE (for glare and haze), preoperative contrast acuity (glare), postoperative uncorrected visual acuity (UCVA; haze), and residual cylinder (haze). Together, these factors accounted for only 19% of the overall variability in glare and 37% of the variability in haze responses. No relationship between pupils and symptoms was noted at 6 months after surgery in either the ANOVA or regression analysis group. Patients with large pupils had more quality of vision symptoms in the early postoperative period, but no correlation was observed 6 months after surgery. Factors related to long-term symptoms include the level of treatment (preoperative myopia), preoperative contrast acuity, postoperative UCVA, and residual cylinder. Most of the variability in visual quality could not be explained by preoperative or clinical outcome measures, including pupil size.

Selected patients who complained of fluctuating visual acuity in the Prospective Evaluation of Radial Keratotomy (PERK) Study were examined before 8:00 a.m. and after 7:00 p.m. on the same day to determine diurnal change in uncorrected visual acuity, best corrected visual acuity, manifest refractive error, average central keratometric power, and intraocular pressure. Sixty-three operated eyes were examined at three months, while 46 operated and 40 unoperated contralateral eyes were examined at one year after radial keratotomy. One year after surgery, 42% of the operated eyes had an increase in minus power of the manifest refraction of 0.50 to 1.25 diopters, 26% of the eyes changed their uncorrected visual acuity by 2 to 4 Snellen lines, and 35% of the operated eyes showed central steepening of the cornea by 0.50 to 1.25 diopters. These changes in the operated eyes at one year were similar to the changes at three months. Minimal diurnal changes occurred in the unoperated eyes at one year. Only 11% of the unoperated eyes changed their manifest refraction by 0.50 to 1.00 diopters, none changed their uncorrected visual acuity by 2 to 4 Snellen lines, and only one of the unoperated eyes changed its central keratometric power by 0.50 diopters. This study documents that many patients who experience diurnal fluctuation of vision have steepening of the cornea and an increase in the minus power of their refraction during the day.

Telephone interviews utilizing random digit dialing were conducted in Los Angeles County to assess the public's knowledge of differences between ophthalmologists and optometrists and to determine factors predictive of knowledge status. Knowledge status was determined by performance on a questionnaire specifically designed for this study. Using multiple logistic regression analysis for simultaneous evaluation of potentially predictive factors, higher education, history of prior eye examination as an adult, and history of prior or present contact lens or spectacle wear were associated with scoring as knowledgeable. Predicted probabilities of being knowledgeable and not knowledgeable were presented for all combinations of these predictive variables. Such information may be helpful in guiding public education campaigns regarding eye care.

This study assesses schools' experiences with, and preparedness for, emergencies and disasters. Data are collected by mail survey from 157 public schools in California. The majority of schools have experienced emergencies in recent years. Although respondents generally feel their school is well prepared for future emergencies, limitations are identified in their disaster plans, availability of emergency supplies, training, and interagency

The National Eye Institute Prospective Evaluation of Radial Keratotomy (PERK) Study is a multicenter clinical trial for the evaluation of radial keratotomy. This article describes the questionnaire data collected on PERK patients and compares them with a similar group of myopic persons studied during the Rand Health Insurance Experiment (heretofore referred to as the Rand study). The PERK patients are young, white myopes who dislike being dependent on corrective lenses but perceive themselves to be more visually impaired than do comparable Rand study myopes. Most female subjects and a plurality of the male subjects have tried contact lenses and quit wearing them mainly because use of the lenses was inconvenient or bothersome. There is no evidence that patients are psychologically or socially deviant. Both male and female subjects expressed a fear of being without vision and cited impatience with the lenses as their major motivation for wanting surgery.

We studied satisfaction with the results of radial keratotomy one year after surgery on one eye as reported by 354 patients in the Prospective Evaluation of Radial Keratotomy (PERK) Study. We measured satisfaction using an index based on ten questions that were part of a longer psychometric questionnaire. Patients were generally satisfied with the results of radial keratotomy-48% were very satisfied, 42% were moderately satisfied, and 10% were dissatisfied. A lot of trouble with fluctuating vision was reported by 12% of patients before surgery and by 34% one year after surgery; 17% reported a lot of trouble with glare both before surgery and one year after surgery. The three major factors that influenced satisfaction were uncorrected visual acuity, residual refractive error, and subjective daily fluctuation in vision. A multiple regression equation that incorporated these three variables, glare, and patient sex was able to predict only 46% of the variance in patient satisfaction.