Perisaccadic gamma modulation in Parkinson disease patients and healthy subjects.

We quantified the anterior-posterior distribution of the gamma modulation index (GMI), an index of perisaccadic phasic modulation of the gamma (35-45 Hz) range electroencephalogram (EEG), in healthy human subjects and Parkinson disease (PD) patients. The EEG was recorded over the frontal, parietal, temporal and occipital sites in 11 idiopathic PD patients (age 50-70 years, four females), 4 age matched healthy volunteers (1 female) and 17 young healthy controls (age 21-30 years, four females) Eye movements were recorded with EOG and ISCAN camera. Subjects executed saccades to a mark at right and back to fixation point and vice versa. The saccades directed away from center/fixation (centrifugal CF) were analyzed. Two minutes of EEG were obtained from each subject for the two possible saccade types (centrifugal rightwards and leftwards at 15 degrees). Each perisaccadic EEG segment was analyzed using continuous wavelet transform for quantifying the power and time course of gamma EEG ranges for each saccade type. A three way ANOVA was used for statistical analysis. Perisaccadic GMI (peak intrasaccadic power divided by mean power) in healthy subjects was higher over the contralateral hemisphere to the saccade direction, for both centrifugal saccades at anterior, posterior and occipital recording sites. Contrary to the healthy subject GMI remained near one in PD, i.e., there was no evidence of intrasaccadic gamma power increase in PD patients.

Analysis of compliance, morbidities and outcome in neurodevelopmental follow-up visits in urban African-American infants at environmental risk.

The objectives of this study were to determine compliance rate in a uniform, urban African-American patient population at environmental risk for adverse neurodevelopmental outcome and to define risk factors for non-compliance with neurodevelopmental follow-up. A retrospective chart review was performed which included 481 infants with birth weight (BW) of 495-4195 g and gestational ages (GAs) between 23 and 42 weeks born at our hospital. Statistical analysis was performed using the Jonckheere-Terpstra test for ordinal variables. For 2 × 2 tables, χ 2 test and Fisher's exact test (P < 0.05) were used. To determine significant predictive variables, data were analyzed by multiple logistic regression with one independent variable at a time. Infants compliant with follow-up had significantly more morbidities in the very low BW category (⩽1500 g) than infants with larger BW. The highest compliance rate (70%) was found among the smallest and most immature (GA ⩽28 weeks) infants. Based on this finding, we postulate that the number of infants with severe disability is not likely to be underestimated. The significantly more frequent developmental anomalies found in the largest BW (⩽2500 g) category raises significant concern, though findings in this subset of infants may not be representative of the whole population. There was no significant difference between the compliant and non-compliant groups regarding socio-economic status. Severe or multiple morbidities and prolonged hospital stay may provide parents with greater opportunity to learn and understand about the infant's condition which may lead to greater compliance.

Keeping it together: stigma, response, and perception of risk in relationships between drug injectors and crack smokers, and other community residents.

Sexual relations between drug injectors (IDUs) and crack smokers (CS), and non-drug users are a major means of HIV spread to the broader population. However there is little literature describing community processes that regulate sexual and social partnerships among these groups. We describe these relationships in Bushwick, a low-income, mainly Latino neighbourhood in Brooklyn, NY. In this community, IDU and CS are heavily stigmatized, both by non-users and by some users. Known IDU/CS may find it harder to start and maintain social and sexual relationships, and to get jobs or support. Partially as a result of this stigma, IDU/CS attempt to 'keep it together' and hide either their drug use or its extent from other residents. Nevertheless, other residents believe, sometimes falsely, that they can distinguish users from nonusers. We describe some potential negative consequences of these beliefs and interactions, including their effects on risk for HIV and other sexually transmitted diseases.

Consistent condom use among drug-using youth in a high HIV-risk neighbourhood.

The objectives of this study were to determine predictors of consistent condom use in heterosexual relationships of young adults who use hard drugs in a neighbourhood with widespread drug-use-connected HIV. We interviewed 196 18-24 year olds who injected drugs or used heroin, cocaine or crack in the prior year and lived in the Bushwick neighbourhood of New York City. Interviews covered sociodemographics, substance use and sexual networks. The unit of analysis is the relationship; the dependent variable measures consistent condom use over the prior 30 days in a given relationship. Consistent condom use was reported in 26% of 377 non-commercial relationships and in all of 22 commercial relationships. Using multiple logistic regression, consistent condom use in non-commercial relationships was more likely in relationships that are not 'very close'; for men (but not women) with peers whose norms are more favourable to condom use; and for subjects who had concurrent sex partners in the last 12 months. In conclusion, we found that: (1) the lack of relationship between the peer norms of drug-using women and their condom use suggests they may have little control over condom use in their relationships-programmes should attempt to empower young women drug users and to develop ways for their peers to influence the men in their lives; (2) epidemiologically, the positive association of concurrency to consistent condom use suggests that condom use may be restricting HIV spread through the community-the presence of consistent condom use in all of the commercial sexual relationships also may restrict HIV spread; (3) prevention efforts should attempt to change peer cultures as a way to develop self-sustaining risk reduction. These changes should include changes in gender roles and power relations.

Stigmatized drug use, sexual partner concurrency, and other sex risk network and behavior characteristics of 18- to 24-year-old youth in a high-risk neighborhood.

BACKGROUND: Sex risks and drug use are related. This relation in youth is described. GOAL: To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. STUDY DESIGN: In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs. RESULTS: Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. CONCLUSIONS: Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk.

Prevalence and correlates of anal sex with men among young adult women in an inner city minority neighborhood.

In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespread injection of drugs and HIV, 14% reported unprotected anal sex with men in the past year. Independent significant predictors were illegal drug use, having a main partner who takes the lead in deciding what to do during sex, and less self-deception. Having ever had anal sex was associated with having ever been infected with hepatitis B.

Consistent condom use in the heterosexual relationships of young adults who live in a high-HIV-risk neighbourhood and do not use "hard drugs".

This study was set up to determine the predictors of condom use in the heterosexual non-commercial sexual relationships of young adults who neither inject drugs nor use cocaine, heroin or crack, in a neighbourhood with widespread drug-use-connected HIV. The analytic sample is 279 young adults, aged 18-24, who have never injected drugs and who have not used heroin, cocaine or crack in the last year. They were recruited in the Bushwick neighbourhood of New York City, July 1997 to September 1999. A face-to-face interview included items about their sociodemographic background, substance use and sexual networks. Sexual relationship and self-reported consistent (100%) condom use over the prior year with the partner in a given relationship was examined. Subjects had 337 heterosexual non-commercial relationships. Consistent condom use was reported in 32% of these relationships. In multiple logistic regression, consistent condom use was more likely in relationships that are not 'very close' (odds ratio = 3.92; 95% confidence interval = 2.08, 7.52); in the relationships of subjects whose peer norms support condom use (OR = 1.94; 95% CI = 1.43, 2.69), who are not problem drinkers (OR = 8.70; 95% CI = 2.22, 58.8), and (perhaps as a result of measurement issues) who are men (OR = 1.95; 95% CI = 1.04, 3.68). In conclusion, consistent condom use remains uncommon among youth in this high-risk neighbourhood. It is thus important to keep HIV from entering the sexual networks of youth in communities like this through programmes aimed at drug injectors and their sexual partners. Programmes to increase condom use among young adults should focus on strengthening norms that promote safer sex to protect oneself and others. In addition, assistance should be provided to youth who are problem drinkers.

Drug use, HIV-related risk behaviors and dropout status of new admissions and re-admissions to methadone treatment.

New entrants to methadone maintenance treatment programs (MMTP) have been reported to have different drug use patterns than re-admissions. This study assesses differences between 211 re-admissions and 128 new admissions to a NYC MMTP. Those new to MMTP were found to be less likely to have ever injected drugs, have used more types of drugs, and used heroin at higher frequencies in the 30 days prior to admission. Within the first three months of treatment, new admissions dropped out at a higher rate than the re-admissions (31% vs. 20%, p < 0.05). The most frequent reasons for dropout, for both groups, included "lost to contact" and incarceration. Further research on strategies to address polydrug use of MMTP admissions is needed. Efforts to identify concerns of new admissions early in treatment, and programs to continue drug treatment services to incarcerated clients, are indicated.

What kinds of leaders are entering optometry schools?

The purpose of this study was to determine the parameters of leadership of students entering one optometry school, assess the relation between personality types and leadership during optometry school, and forecast potential for leadership beyond school. Personality inventories of 269 students entering University of Houston College of Optometry (UHCO) from 1988 through 1990 were analyzed for personality type according to Gough's two-vector system (V1 = extroversion/introversion; V2 = norm-favoring/norm-doubting) which results in four types or life styles: Alpha, Beta, Gamma, and Delta. Although some sex and ethnic differences were found, most (71%) optometry students were Alphas (extroverted/norm-favoring), accepted leaders who strive to maintain and advance consensual values. Alphas achieved well in classroom and clinic and were student leaders. A lesser number (10%), mostly women, were Gammas; extroverted but norm-questioning, Gammas can provide creative and progressive leadership. Remaining types were Betas (15%) and Deltas (4%), both introverted types who avoid leadership positions. In sum, traditional and, to a lesser degree, innovative leadership potential appears strong among optometry students; they should serve the profession well.

Predicting the academic performance of Asian, black, and Hispanic optometry students.

As optometry schools receive increasing numbers of Asian, Black, and Hispanic applications, it is appropriate for us to ask whether minority students differ in meaningful ways from nonminority students in measures used in admissions, and whether these variables have differential validity in predicting their achievement in optometry school. This study compares Asian, Black, Hispanic, and nonminority students at entry to the University of Houston College of Optometry (UHCO) from 1981 through 1986 and tests the validity of admissions indices to predict optometry grades, academic dropout, and high-level achievement for these ethnic groups. Although preoptometry grade point average (GPA) was the best predictor of optometry grades for all students, measures of verbal ability were additional predictors for Asian students and, for Black and Hispanic students, ability in study/reading and math were predictors. In addition, personality inventory measures and ratings of the competitiveness of the undergraduate institution were important in differentiating minority academic dropouts from retained students. Suggestions are made for optometry college programs which will enhance the probability of success for minority students.

Surveying optometry school alumni: a multifaceted approach.

Surveying alumni of a college of optometry provides vital information on the effectiveness of academic and clinical programs which prepare students for the practice of optometry and for advancement of the profession. This University of Houston College of Optometry (UHCO) alumni study took a multifaceted approach, asking graduates of recent years--1984, 1985, 1986--to evaluate program areas and to tell how they practiced in the first years out. Although most young optometrists worked for someone else in the year after graduation, within 2 years, two-thirds of men and women were self-employed and located primarily in urban/suburban areas. A striking finding was the difference in type of practice entered by women and men: women far more often entered solo practice or, if employed, worked for a health maintenance organization (HMO), while men more often entered partnerships or worked for another optometrist. And, women reported much lower incomes than men regardless of type of practice. These differences merit attention, as does the familiar finding that alumni, although satisfied with their optometric training overall, rated their training in practice management most inadequate.

Women optometry students: how qualified?

This study compares the academic and personal qualifications of women and men entering the University of Houston College of Optometry (UHCO) over a 6-year period, as well as the performance of these women and men throughout 4 years of optometry school. As predicted, women, as a group, presented somewhat higher grade point averages (GPA's) upon application to optometry, whereas men presented higher scores on science, especially physics, and math sections of the Optometry College Admission Test (OCAT). Women also scored significantly higher on an inventory of positive personality traits generally associated with achievement in higher education. Despite these differences, women and men performed at essentially equivalent levels throughout optometry school, both in the classroom and in the clinic. Women were under-represented as dropouts and over-represented as summa cum laude graduates; men received more clinical performance awards. In terms of personality traits, women were more similar to their male peers and female medical students than to college women in general. Strong motivation to achieve, independence, self-confidence, interpersonal skillfulness, and a sensitivity to others--traits generally associated with leadership--typified optometry students, especially women. These findings suggest that the increasing numbers of women graduates will bring to the profession young optometrists who are well qualified, not only to practice optometry, but also to fill positions of leadership in the profession.

Academic dropout or academic success: a model for prediction.

Why do some students who qualify for admission to optometry school become academic dropouts while others succeed? This question was addressed in a study which compared the admission records of 21 academic dropouts from three classes at the University of Houston College of Optometry (UHCO) with 269 retained students. Academic dropouts were found to have significantly lower preoptometry grades, lower Optometry College Admission Test (OCAT) scores, attended less competitive (i.e., less selective) undergraduate institutions, scored lower on the California Psychological Inventory (CPI), and were older than retained students. When these differentiating admission variables, excepting age, were applied to a new entering class, prediction of subsequent academic dismissal or serious academic difficulty was highly accurate. However, it was found that such prediction must take into account not only areas of weakness, i.e., academic and psychological factors which place a student at risk, but also areas of strength which give the student an advantage. For all students, regardless of age, sex, or ethnic origin, it was the ratio of "advantage" factors to "risk" factors which gave the most valid prediction of academic success or failure.

Predicting optometry school grades from intellectual and nonintellectual admission variables.

Intellectual achievement, assessed over time by grades in preprofessional courses and standardized by scores on the Optometry College Admission Test (OCAT), is typically used to judge an applicant's potential for academic achievement in optometry school. In this study both intellectual and nonintellectual admission variables were tested as predictors of optometry grade point average (GPA). GPA at the end of two years was strongly and efficiently predicted by the following combination of intellectual and nonintellectual variables: preoptometry GPA, scores on the physics section of the OCAT, and a score based on the applicant's California Psychological Inventory (CPI) profile. The multiple correlation coefficient between this three-variable combination and GPA was 0.66; cross-validated r = 0.56. Scores on the quantitative section of the OCAT were the best single predictor of first year grades; when preoptometry GPA scores on the physics section of the OCAT and the personality inventory score were added, a predictive validity coefficient of 0.61 was obtained. It is concluded that the prediction of grades in optometry school, and indeed all professional schools, will derive from these three factors: preprofessional grades, standardized achievement test scores, and a quantitative measure of personal traits which relate to academic achievement. Whereas the exact weighting of each variable in a predictive equation depends upon the individual school, maximum predictive validity will be based on these three factors.

Personality test measures in optometry school admissions.

Predicting clinical competence among optometry students from data obtainable at the time of admissions is the focus of this study. Preoptometry grades, Optometry College Admission Test (OCAT) scores, and applicant scores on a standardized personality inventory were tested as predictors of faculty ratings of student performance in optometry clinics. Students' clinical performance was best predicted by certain personality dimensions, objectively measured by the California Psychological Inventory (CPI). Preoptometry grades and OCAT scores, although significantly correlated with optometry grades, were generally poor predictors of clinical performance. For men, achievement drive, self-confidence, and tolerance and for women, self-confidence, assertiveness, and interpersonal effectiveness were the personal qualities most highly correlated with instructors' ratings of performance. The study demonstrates that these personal qualities, as well as the degree to which an applicant presents a "good impression," can be objectively assessed at the time of application to optometry school.

A personality profile of "Gold Retinoscope" winners: 1961-1975.

Fifteen Gold Retinoscope winners, each judged the most outstanding student in his/her graduating class of the School of Optometry, University of California at Berkeley, were compared with samples of optometry students, Academy Fellows, and non-Academy optometrists. Although most Gold Retinoscope winners had entered optometry school with low to average grades, their grades and clinical performance in optometry school were outstanding. When compared with other optometry students and optometrists in practice, these outstanding students were distinguished by greater self-confidence, initiative, and motivation to achieve. It is suggested that these personality traits were important contributors to their superior achievement.

Predictors of rural practice location.

Attitudes toward the urban environment and place of origin were found to be the best predictors of an optometrist's practice location. When urbanism attitude and origin were scaled and placed in an equation to predict practice location, identification of an optometrist's practice location as rural or urban was highly accurate. Most important, scores on the equation were predictive of optometry students' future practice location. A single cutoff point on the equation correctly identified 79 percent of students who entered a rural or isolated small city practice and 81 percent of those who entered urban practice. The findings imply that optometry students most likely to enter rural practice can be objectively identified early in their training. If certain factors affecting choice of practice location are common to all health professions, the predictive equation presented here may be useful in the selection of students for rural practice in medicine.

The rural optometrist: who and why?

A first step toward the goal of better optometric manpower distribution is the identification of variables associated with the optometrist's choice of practice location. This study focuses on the optometrist who chooses a rural practice location and on ways in which the rural optometrist differs from the non-rural optometrist. One hundred sixty optometrists practicing in rural locations in ten states answered questions about their background, mode of optometric practice, attitude toward the environment, interests, and personality traits. Rural optometrists were found to differ from other optometrists in their rural origin, their strong liking for the people and life style of the rural community, and their interest in outdoor pursuits. Community recognition as a health professional, rapid practice growth, professional independence, and the opportunity for community leadership were seen by the rural optometrist as major advantages of rural optometric practice.