1
|
Fitzpatrick ME, Burrows SG, Yonker JA. An Exploratory Study of Engineering Graduate Student Persistence: Self-Efficacy and Contextual Influences. Journal of Career Development 2022. [DOI: 10.1177/08948453221123789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Women and U.S. racial/ethnic minority students are underrepresented in engineering graduate education and engineering practice. Demographic homogeneity in engineering research teams can negatively affect individuals, innovation, and research outcomes. Thus, it is important to explore factors that influence student intentions to complete engineering degrees, particularly for groups historically underrepresented in engineering. Social Cognitive Career Theory guided the development of new items to evaluate self-efficacy, feeling welcome and included, relationship with principal investigator, and research group environment. Results with 295 engineering graduate students found that female sex, engineering self-efficacy, and feeling welcome and included were independently positively associated with commitment to complete an engineering degree. Feeling welcome and included operated 30% through self-efficacy and 70% directly. The effects of female sex were unmediated by self-efficacy. Results suggest that proximal and distal contextual factors may operate independently from self-efficacy to influence retention in graduate engineering programs.
Collapse
Affiliation(s)
| | - Stephanie G. Burrows
- Department of Educational Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - James A. Yonker
- Division of Diversity, Equity, and Educational Achievement, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
2
|
Lor M, Yu Z, Chen W, Xiong Y, Yonker JA, Brown R, Krahn DD. Refugee-related trauma patterns and mental health symptoms across three generations of Hmong Americans. J Trauma Stress 2022; 35:1087-1098. [PMID: 35201638 PMCID: PMC9355917 DOI: 10.1002/jts.22813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/01/2022] [Accepted: 01/13/2022] [Indexed: 11/11/2022]
Abstract
Hmong adults who are Vietnam War refugees have been exposed to refugee-related trauma, but little is known about associations between patterns of trauma exposure and mental health outcomes in Hmong adults. We examined patterns of trauma exposure and mental health symptoms (i.e., somatization, depression, anxiety, and probable posttraumatic stress disorder [PTSD]) in three generations of Hmong adults (N = 219). Trauma exposure and probable PTSD were measured using the Harvard Trauma Questionnaire-Hmong Version. Somatization, depression, and anxiety symptoms were measured using the Brief Symptom Inventory. Latent class analysis (LCA) and auxiliary analysis of sociodemographic characteristics and mental health symptoms were performed. The best-fitting LCA model described three distinct classes: complex and pervasive trauma (60.3%), combat situation and deprivation trauma (26.0%), and low exposure to refugee-related trauma (13.7%). Participants in the complex and pervasive trauma class were the oldest, had the shortest U.S. residency, were the least proficient in English, and reported the most severe mental health symptoms; those in the combat situation and deprivation trauma class were the youngest, moderately proficient in English, and reported moderate mental health symptoms; and those in the low exposure to refugee-related trauma class were the most proficient in English, had the longest U.S. residency, and reported the least severe mental health symptoms. Our findings call for surveillance and a trauma-informed approach for Hmong elders with limited English proficiency, who have a high risk of experiencing accumulative effects of refugee-related trauma and are susceptible to poor mental health outcomes.
Collapse
Affiliation(s)
- Maichou Lor
- University of Wisconsin–Madison, Wisconsin, USA
| | - Zhiyuan Yu
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Wenyi Chen
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Yee Xiong
- University of Wisconsin–Madison, Wisconsin, USA
| | | | - Roger Brown
- University of Wisconsin–Madison, Wisconsin, USA
| | | |
Collapse
|
3
|
Gonzales TK, Yonker JA, Chang V, Roan CL, Herd P, Atwood CS. Myocardial infarction in the Wisconsin Longitudinal Study: the interaction among environmental, health, social, behavioural and genetic factors. BMJ Open 2017; 7:e011529. [PMID: 28115328 PMCID: PMC5278299 DOI: 10.1136/bmjopen-2016-011529] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES This study examined how environmental, health, social, behavioural and genetic factors interact to contribute to myocardial infarction (MI) risk. DESIGN Survey data collected by Wisconsin Longitudinal Study (WLS), USA, from 1957 to 2011, including 235 environmental, health, social and behavioural factors, and 77 single- nucleotide polymorphisms were analysed for association with MI. To identify associations with MI we utilized recursive partitioning and random forest prior to logistic regression and chi-squared analyses. PARTICIPANTS 6198 WLS participants (2938 men; 3260 women) who (1) had a MI before 72 years and (2) had a MI between 65 and 72 years. RESULTS In men, stroke (LR OR: 5.01, 95% CI 3.36 to 7.48), high cholesterol (3.29, 2.59 to 4.18), diabetes (3.24, 2.53 to 4.15) and high blood pressure (2.39, 1.92 to 2.96) were significantly associated with MI up to 72 years of age. For those with high cholesterol, the interaction of smoking and lower alcohol consumption increased prevalence from 23% to 41%, with exposure to dangerous working conditions, a factor not previously linked with MI, further increasing prevalence to 50%. Conversely, MI was reported in <2.5% of men with normal cholesterol and no history of diabetes or depression. Only stroke (4.08, 2.17 to 7.65) and diabetes (2.71, 1.81 to 4.04) by 65 remained significantly associated with MI for men after age 65. For women, diabetes (5.62, 4.08 to 7.75), high blood pressure (3.21, 2.34 to 4.39), high cholesterol (2.03, 1.38 to 3.00) and dissatisfaction with their financial situation (4.00, 1.94 to 8.27) were significantly associated with MI up to 72 years of age. Conversely, often engaging in physical activity alone (0.53, 0.32 to 0.89) or with others (0.34, 0.21 to 0.57) was associated with the largest reduction in odds of MI. Being non-diabetic with normal blood pressure and engaging in physical activity often lowered prevalence of MI to 0.2%. Only diabetes by 65 (4.25, 2.50 to 7.24) and being exposed to dangerous work conditions at 54 (2.24, 1.36 to 3.69) remained significantly associated with MI for women after age 65, while still menstruating at 54 (0.46, 0.23 to 0.91) was associated with reduced odds of MI. CONCLUSIONS Together these results indicate important differences in factors associated with MI between the sexes, that combinations of factors greatly influence the likelihood of MI, that MI-associated factors change and associations weaken after 65 years of age in both sexes, and that the limited genotypes assessed were secondary to environmental, health, social and behavioral factors.
Collapse
Affiliation(s)
- Tina K Gonzales
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - James A Yonker
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Vicky Chang
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Carol L Roan
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Pamela Herd
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
- La Follete School of Public Affairs, University of Wisconsin, Madison, Wisconsin, USA
| | - Craig S Atwood
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
- Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, Wisconsin, USA
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| |
Collapse
|
4
|
Abstract
Americans experience higher mortality than their peers in other high-income countries for most of the life course, but recent work has shown that at the oldest ages they experience a mortality advantage- a phenomenon we call the "US mortality crossover." In this paper we document the crossover and time trends thereof. We find that the age of crossover increases linearly by about 0.5 years per year, a pattern of changes that, to our knowledge, has not been identified before. We then interrogate several potential explanations for a steadily increasing crossover age. While none is completely satisfactory, we rule out differential age misstatement, selection, and access to and quality of health care. We find that the most plausible explanations involve the deleterious effects of differential smoking and obesity but we are unable to adjudicate more precisely if either of these independently or in combination explain the phenomenon.
Collapse
|
5
|
Roetker NS, Page CD, Yonker JA, Chang V, Roan CL, Herd P, Hauser TS, Hauser RM, Atwood CS. Assessment of genetic and nongenetic interactions for the prediction of depressive symptomatology: an analysis of the Wisconsin Longitudinal Study using machine learning algorithms. Am J Public Health 2013; 103 Suppl 1:S136-44. [PMID: 23927508 DOI: 10.2105/ajph.2012.301141] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined depression within a multidimensional framework consisting of genetic, environmental, and sociobehavioral factors and, using machine learning algorithms, explored interactions among these factors that might better explain the etiology of depressive symptoms. METHODS We measured current depressive symptoms using the Center for Epidemiologic Studies Depression Scale (n = 6378 participants in the Wisconsin Longitudinal Study). Genetic factors were 78 single nucleotide polymorphisms (SNPs); environmental factors-13 stressful life events (SLEs), plus a composite proportion of SLEs index; and sociobehavioral factors-18 personality, intelligence, and other health or behavioral measures. We performed traditional SNP associations via logistic regression likelihood ratio testing and explored interactions with support vector machines and Bayesian networks. RESULTS After correction for multiple testing, we found no significant single genotypic associations with depressive symptoms. Machine learning algorithms showed no evidence of interactions. Naïve Bayes produced the best models in both subsets and included only environmental and sociobehavioral factors. CONCLUSIONS We found no single or interactive associations with genetic factors and depressive symptoms. Various environmental and sociobehavioral factors were more predictive of depressive symptoms, yet their impacts were independent of one another. A genome-wide analysis of genetic alterations using machine learning methodologies will provide a framework for identifying genetic-environmental-sociobehavioral interactions in depressive symptoms.
Collapse
Affiliation(s)
- Nicholas S Roetker
- Nicholas S. Roetker, James A. Yonker, Vicky Chang, Carol L. Roan, Pamela Herd, Taissa S. Hauser, and Robert M. Hauser are with the Department of Sociology, University of Wisconsin-Madison. Pamela Herd is also with La Follete School of Public Affairs, University of Wisconsin-Madison. C. David Page is with the Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison. Craig S. Atwood is with the Geriatric Research, Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, and the Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Yonker JA, Chang V, Roetker NS, Hauser TS, Hauser RM, Atwood CS. Hypothalamic-pituitary-gonadal axis homeostasis predicts longevity. Age (Dordr) 2013; 35:129-38. [PMID: 22139381 PMCID: PMC3543732 DOI: 10.1007/s11357-011-9342-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 11/07/2011] [Indexed: 05/29/2023]
Abstract
The reproductive-cell cycle theory of aging posits that reproductive hormone changes associated with menopause and andropause drive senescence via altered cell cycle signaling. Using data from the Wisconsin Longitudinal Study (n = 5,034), we analyzed the relationship between longevity and menopause, including other factors that impact "ovarian lifespan" such as births, oophorectomy, and hormone replacement therapy. We found that later onset of menopause was associated with lower mortality, with and without adjusting for additional factors (years of education, smoking status, body mass index, and marital status). Each year of delayed menopause resulted in a 2.9% reduction in mortality; after including a number of additional controls, the effect was attenuated modestly but remained statistically significant (2.6% reduction in mortality). We also found that no other reproductive parameters assessed added to the prediction of longevity, suggesting that reproductive factors shown to affect longevity elsewhere may be mediated by age of menopause. Thus, surgical and natural menopause at age 40, for example, resulted in identical survival probabilities. These results support the maintenance of the hypothalamic-pituitary-gonadal axis in homeostasis in prolonging human longevity, which provides a coherent framework for understanding the relationship between reproduction and longevity.
Collapse
Affiliation(s)
- James A. Yonker
- />Department of Sociology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography and Ecology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography of Health and Aging, University of Wisconsin—Madison, Madison, WI USA
| | - Vicky Chang
- />Department of Sociology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography and Ecology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography of Health and Aging, University of Wisconsin—Madison, Madison, WI USA
| | - Nicholas S. Roetker
- />Department of Sociology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography and Ecology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography of Health and Aging, University of Wisconsin—Madison, Madison, WI USA
| | - Taissa S. Hauser
- />Department of Sociology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography and Ecology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography of Health and Aging, University of Wisconsin—Madison, Madison, WI USA
| | - Robert M. Hauser
- />Department of Sociology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography and Ecology, University of Wisconsin—Madison, Madison, WI USA
- />Center for Demography of Health and Aging, University of Wisconsin—Madison, Madison, WI USA
| | - Craig S. Atwood
- />Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, WI USA
- />Department of Medicine, University of Wisconsin—Madison School of Medicine and Public Health, Madison, WI USA
- />School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, WA Australia
- />Wm S. Middleton Memorial VA (GRECC 11G), University of Wisconsin—Madison Medical School, 2500 Overlook Terrace, Madison, WI 53705 USA
| |
Collapse
|
7
|
Roetker NS, Yonker JA, Lee C, Chang V, Basson JJ, Roan CL, Hauser TS, Hauser RM, Atwood CS. Multigene interactions and the prediction of depression in the Wisconsin Longitudinal Study. BMJ Open 2012; 2:bmjopen-2012-000944. [PMID: 22761283 PMCID: PMC3391375 DOI: 10.1136/bmjopen-2012-000944] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Single genetic loci offer little predictive power for the identification of depression. This study examined whether an analysis of gene-gene (G × G) interactions of 78 single nucleotide polymorphisms (SNPs) in genes associated with depression and age-related diseases would identify significant interactions with increased predictive power for depression. DESIGN A retrospective cohort study. SETTING A survey of participants in the Wisconsin Longitudinal Study. PARTICIPANTS A total of 4811 persons (2464 women and 2347 men) who provided saliva for genotyping; the group comes from a randomly selected sample of Wisconsin high school graduates from the class of 1957 as well as a randomly selected sibling, almost all of whom are non-Hispanic white. PRIMARY OUTCOME MEASURE Depression as determine by the Composite International Diagnostic Interview-Short-Form. RESULTS Using a classification tree approach (recursive partitioning (RP)), the authors identified a number of candidate G × G interactions associated with depression. The primary SNP splits revealed by RP (ANKK1 rs1800497 (also known as DRD2 Taq1A) in men and DRD2 rs224592 in women) were found to be significant as single factors by logistic regression (LR) after controlling for multiple testing (p=0.001 for both). Without considering interaction effects, only one of the five subsequent RP splits reached nominal significance in LR (FTO rs1421085 in women, p=0.008). However, after controlling for G × G interactions by running LR on RP-specific subsets, every split became significant and grew larger in magnitude (OR (before) → (after): men: GNRH1 novel SNP: (1.43 → 1.57); women: APOC3 rs2854116: (1.28 → 1.55), ACVR2B rs3749386: (1.11 → 2.17), FTO rs1421085: (1.32 → 1.65), IL6 rs1800795: (1.12 → 1.85)). CONCLUSIONS The results suggest that examining G × G interactions improves the identification of genetic associations predictive of depression. 4 of the SNPs identified in these interactions were located in two pathways well known to impact depression: neurotransmitter (ANKK1 and DRD2) and neuroendocrine (GNRH1 and ACVR2B) signalling. This study demonstrates the utility of RP analysis as an efficient and powerful exploratory analysis technique for uncovering genetic and molecular pathway interactions associated with disease aetiology.
Collapse
Affiliation(s)
- Nicholas S Roetker
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - James A Yonker
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Chee Lee
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Vicky Chang
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Jacob J Basson
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Carol L Roan
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Taissa S Hauser
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Robert M Hauser
- Department of Sociology, University of Wisconsin, Madison, Wisconsin, USA
| | - Craig S Atwood
- Geriatric Research, Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
8
|
Kramer BJ, Kavanaugh M, Trentham-Dietz A, Walsh M, Yonker JA. Complicated grief symptoms in caregivers of persons with lung cancer: the role of family conflict, intrapsychic strains, and hospice utilization. Omega (Westport) 2011; 62:201-20. [PMID: 21495532 PMCID: PMC3265356 DOI: 10.2190/om.62.3.a] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Guided by a stress process conceptual model, this study examines social and psychological determinants of complicated grief symptoms focusing on family conflict, intrapsychic strains, and the potential moderating effect of care quality and hospice utilization. Relying on data from 152 spouse and adult child lung cancer caregiver survey respondents, drawn from an ancillary study of the Assessment of Cancer CarE and SatiSfaction (ACCESS) in Wisconsin, hierarchical multiple regression analysis was used to examine determinants of complicated grief. After controlling for contextual factors and time since death, complicated grief symptoms were higher among caregivers with less education, among families with lower prior conflict but higher conflict at the end-of-life, who had family members who had difficulty accepting the illness, and who were caring for patients with greater fear of death. Additionally, hospice utilization moderated the effect of fear of death on complicated grief. Findings suggest that family conflict, intrapsychic strains, and hospice utilization may help to explain the variability found in complicated grief symptoms among bereaved caregivers. Implications for enhancing complicated grief assessment tools and preventative interventions across the continuum of cancer care are highlighted.
Collapse
Affiliation(s)
- Betty J Kramer
- University of Wisconsin-Madison, School of Social Work, Madison, WI 53706, USA.
| | | | | | | | | |
Collapse
|
9
|
Kramer BJ, Yonker JA. Perceived success in addressing end-of-life care needs of low-income elders and their families: what has family conflict got to do with it? J Pain Symptom Manage 2011; 41:35-48. [PMID: 20832980 DOI: 10.1016/j.jpainsymman.2010.04.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 04/18/2010] [Accepted: 04/20/2010] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to examine the predictors of perceived success in addressing the end-of-life care needs of low-income older adults and their family members. Perceived success is defined as the clinician's subjective assessment of the extent to which end-of-life care needs of the patient and family have been met by the interdisciplinary team. The results are drawn from a larger longitudinal multimethod case study designed to understand how end-of-life care is provided to a diverse group of frail elders in an innovative, fully "integrated," managed care program. Data were generated from 120 social work surveys detailing care experiences and outcomes particular to 120 elder deaths. Significant predictors of perceived success for addressing patient needs included patient care needs (β=0.17, P≤0.05), race (β=0.19, P≤0.05), patient preferences elicited (β=0.29, P≤0.01) and honored (β=0.20, P≤0.05), and family conflict (β=-0.24, P≤0.01). Significant predictors of perceived success for addressing family needs included family care needs (β=0.30, P≤0.001), team and administrative resources (β=0.19, P≤0.01), patient preferences honored (β=0.16, P≤0.05), quality of relationship with patient (β=0.27, P≤0.001) and family (β=0.23, P≤0.01), and family conflict (β=-0.31, P≤0.001). This study provides preliminary evidence of differential correlates and predictors of perceived success for addressing patient and family needs, highlighting the detrimental influence of family conflict. Future research is needed to better understand the kinds of assessment and intervention protocols that might prevent or ameliorate conflict and enhance structures and process-of-care variables to facilitate more successful outcomes.
Collapse
Affiliation(s)
- Betty J Kramer
- School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - James A Yonker
- Department of Sociology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
10
|
Molander RC, Yonker JA, Krahn DD. Age-related changes in drinking patterns from mid- to older age: results from the Wisconsin longitudinal study. Alcohol Clin Exp Res 2010; 34:1182-92. [PMID: 20477774 DOI: 10.1111/j.1530-0277.2010.01195.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Drinking has generally been shown to decline with age in older adults. However, results vary depending on the measure of alcohol consumption used and the study population. The goals of this study were to (i) describe changes in drinking in a current cohort of older adults using a variety of measures of drinking and (ii) examine a number of different possible predictors of change. METHODS This is a longitudinal study of a community-based sample surveyed at 2 time points, ages 53 and 64 years. We estimated a series of logistic regressions to predict change and stability in drinking categories of nondrinking, moderate drinking, and heavy drinking. Linear regressions were used to predict change in past-month drinking days, past-month average drinks per drinking day, and past-month total drinks. RESULTS From age 53 to 64, average drinks per drinking day and heavy drinking decreased. Frequency of drinking increased for men and women, and total drinks per month increased for men. The most consistent predictors of drinking changes were gender, health, and education. Other factors predicted drinking change but were not consistent across drinking measures including: adolescent IQ, income, lifetime history of alcohol-related problems, religious service attendance, depression, debt, and changes in employment. CONCLUSIONS Heavy drinking decreases with age, but we may see more frequent moderate drinking with current and upcoming cohorts of older adults. Components of quantity and frequency of drinking change differently. Composite measures of total alcohol consumption may not be adequate for describing relevant changes in drinking over time. A number of factors predicted patterns of change in drinking and warrant further exploration.
Collapse
Affiliation(s)
- Rachel C Molander
- Department of Psychiatry, University of Wisconsin-Madison Medical School, USA.
| | | | | |
Collapse
|
11
|
Kramer BJ, Kavanaugh M, Trentham-Dietz A, Walsh M, Yonker JA. Predictors of family conflict at the end of life: the experience of spouses and adult children of persons with lung cancer. Gerontologist 2010; 50:215-25. [PMID: 19671660 PMCID: PMC2904531 DOI: 10.1093/geront/gnp121] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Accepted: 07/13/2009] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Guided by an explanatory matrix of family conflict at the end of life, the purpose of this article was to examine the correlates and predictors of family conflict reported by 155 spouses and adult children of persons with lung cancer. DESIGN AND METHODS A cross-sectional statewide survey of family members of persons who died from lung cancer was conducted as part of the larger study on the Assessment of Cancer CarE and SatiSfaction in Wisconsin. RESULTS Significant bivariate correlations were found between family conflict and family context variables (i.e., a history of conflict, younger respondent age, race, and specified end-of-life care wishes of the patient), conditions (i.e., greater physical and psychological clinical care needs of the patient), and contributing factors (i.e., communication constraints and family asserting control). In the multivariate model, significant predictors of family conflict included prior family conflict, race, communication constraints, and family members asserting control; the model explained 72% of the variance in conflict. IMPLICATIONS Implications for routine assessment and screening to identify families at risk and recommendations for the development and testing of interventions to facilitate shared decision making and enhance open communication among at-risk families are highlighted.
Collapse
Affiliation(s)
- Betty J Kramer
- MSSW, School of Social Work, University of Wisconsin-Madison, 1350 University Avenue, Madison, WI 53706-1510, USA.
| | | | | | | | | |
Collapse
|