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Kathryn Graham

Publications and source records attributed to Kathryn Graham.

At least 19 recordsLinked to original sources
PubMed2007

Does the association between alcohol consumption and depression depend on how they are measured?

BACKGROUND: Inconsistent findings regarding the relationship between alcohol consumption and depression, including whether the relationship is J-shaped or U-shaped, may be at least partly due to the types of measures used for both alcohol consumption and depression. METHODS: We conducted a general population survey using random digit dialing (RDD) and computer-assisted telephone interviewing (CATI) with 6,009 males and 8,054 females aged 18 to 76 years. The survey included 4 types of alcohol measures (frequency, usual and maximum quantity per occasion, volume, and heavy episodic drinking) covering both the past week and the past year, and 2 types of depression measures (meeting DSM criteria for a clinical diagnosis of major depression, recent depressed affect). RESULTS: The overall relationship between depression and alcohol consumption did not vary by gender or type of depression measure but did vary significantly by type of alcohol measure, with the strongest relationship found for heavy episodic drinking and high quantity per occasion. There were also significant gender interactions with both depression and alcohol measures, with females showing a stronger relationship than males when depression was measured as meeting the criteria for major depression and when alcohol consumption was measured as quantity per occasion or heavy episodic drinking. There was some evidence of a J-shaped relationship, that is, greater depression among abstainers compared with those who usually drank 1 drink and never drank as much as 5 drinks for both former drinkers and lifetime abstainers when depression was measured as recent symptoms of depression but the J shape was found only for former drinkers when depression was measured as meeting the criteria for major depression and did not reach statistical significance in some analyses. CONCLUSIONS: The results of the present study suggest that measurement and gender are key issues in interpreting findings on the relationship between alcohol and depression. First, depression is primarily related to drinking larger quantities per occasion, less related to volume, and unrelated to drinking frequency, and this effect is stronger for women than for men. Second, the overall relationship between depression and alcohol consumption is stronger for women than for men only when depression is measured as meeting a clinical diagnosis of major depression and not when measured as recent depressed affect. Finally, while there was some evidence that former drinkers had slightly higher rates of major depression and higher scores on recent depressed affect compared with light drinkers, there was no evidence that light drinking was protective for major depression when compared with lifetime abstainers, although light drinkers did report fewer recent symptoms of depressed affect.

Adolescent↗
PubMed2006

Gender and the assessment of at-risk drinking: evidence from the GENACIS Canada (2004-2005) telephone survey version of the AUDIT.

The alcohol use disorders identification test (AUDIT) is widely used in general population surveys as a method of determining prevalence of hazardous drinking. However, its interpretation has been questioned particularly regarding the unequal contribution of the items to the total score, specifically, that the drinking frequency item contributes disproportionately to the score and may lead to inappropriate identification of some drinkers as hazardous drinkers. To explore these issues further as well as possible gender differences in the applicability of the AUDIT, we conducted analyses using a modified version of the AUDIT (AUDIT(M)) as part of a general population survey that used random digit dialing and computer-assisted telephone interviewing. Item and factor analyses were performed separately for men and women, and the impacts of excluding the frequency of drinking item in the measurement of mean scores, percentages and types of problems for men and women were examined. We found that the AUDIT(M) items loaded onto three distinct dimensions for both men and women: frequency of drinking; usual quantity and frequency of heavy-episodic drinking; problem consequences from drinking. In addition, we found that excluding the frequency question may give a more meaningful estimate of the percent of drinkers actually at risk of experiencing problems from drinking for both men and women. Finally, although our analyses identified only minor gender differences in the structure of the AUDIT and good sensitivity for identifying problem drinkers among both men and women, significant gender differences in the types of problems experienced suggest that use and interpretation of the AUDIT should routinely take gender into consideration.

Alcohol Drinking↗
PubMed2006

Lymphovascular invasion is associated with poor survival in gastric cancer: an application of gene-expression and tissue array techniques.

OBJECTIVES: To examine a population-based cohort for the association between clinicopathologic predictors of survival and immunohistochemical markers (IHC), and to assess changes in gene expression that are associated with lymphovascular invasion (LVI). SUMMARY BACKGROUND DATA: LVI has been associated with poor survival and aggressive tumor behavior. The molecular changes responsible for the behavior of gastric cancer have yet to be determined. Characterization of IHC markers and gene expression profiles may identify molecular alterations governing tumor behavior. METHODS: : Clinicopathologic and survival data of 114 patients were reviewed. Archival specimens were used to construct a multitumor tissue array that was subjected to IHC of selected protein targets. Correlation of IHC with tumor thickness (T status), LVI and prognosis was studied. Microarray analysis of fresh gastric cancer tissue was conducted to examine the gene expression profile with respect to LVI. RESULTS: In a multivariate analysis, nodal status (N), metastasis (M), and LVI were independent predictors of survival. LVI was associated with a 5-year survival of 13.9% versus 55.9% in patients in whom it was absent. LVI correlated with advancing T status (P = 0.001) and N status (P < 0.001). IHC staining of cyclooxygenase-2 (COX-2) correlated with T status, tumor grade, lymph node positivity, and IHC staining of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9). Microarray analyses suggested differential expression of oligophrenin-1 (OPHN1) and ribophorin-II (RPNII) with respect to LVI. CONCLUSION: LVI was an independent predictor of survival in gastric cancer. Expression of COX-2 may facilitate tumor invasion through MMP-2 and MMP-9 activation. OPHN1 and RPN II appeared to be differentially expressed in gastric cancers exhibiting LVI. The reported function of OPHN1 and RPN II makes these gene products promising candidates for future studies involving LVI in gastric cancer.

Adenocarcinoma↗
PubMed2006

Measuring alcohol consumption--should the 'graduated frequency' approach become the norm in survey research?

AIMS: To analyse whether recommendations for the graduated frequency (GF) approach to measure alcohol consumption are justified in a multi-cultural comparative study. DESIGN: Representative surveys, conducted between 1995 and 2003, of 10 countries participating in the GENACIS project (Gender, Alcohol and Culture: an International Study). MEASUREMENTS: Usual quantity, usual frequency and mean consumption per day measured with three instruments: GF, generic quantity-frequency (QF) and beverage-specific quantity-frequency (QFBS). FINDINGS: The GF did not consistently yield higher volumes and quantities across all countries compared with the generic QF, while the QFBS resulted in higher quantities and higher volumes compared with the GF (in all but one country) and the QF. Frequencies were mostly higher on the GF compared with the QF and QFBS but there was also evidence of over-reporting of frequencies with the GF. Results for the GF suggested that it was implemented improperly in at least three of the 10 countries. CONCLUSION: The GF does not appear to be appropriate for cross-cultural research. It results in over-reporting of frequencies and appears to be too complex to be administered correctly in many countries. The best measure for these purposes appeared to be the QFBS particularly because it captures more effectively the variability of different alcoholic beverages with different ethanol contents and consumption with different vessel sizes.

Adult↗
PubMed2006

Bad nights or bad bars? Multi-level analysis of environmental predictors of aggression in late-night large-capacity bars and clubs.

AIMS: To clarify environmental predictors of bar-room aggression by differentiating relationships due to nightly variations versus across bar variations, frequency versus severity of aggression and patron versus staff aggression. DESIGN, SETTING AND PARTICIPANTS: Male-female pairs of researcher-observers conducted 1334 observations in 118 large capacity (> 300) bars and clubs in Toronto, Canada. MEASUREMENTS: Observers independently rated aspects of the environment (e.g. crowding) at every visit and wrote detailed narratives of each incident of aggression that occurred. Measures of severity of aggression for the visit were calculated by aggregating ratings for each person in aggressive incidents. FINDINGS: Although bivariate analyses confirmed the significance of most environmental predictors of aggression identified in previous research, multivariate analyses identified the following key visit-level predictors (controlling for bar-level relationships): rowdiness/permissive environment and people hanging around after closing predicted both frequency and severity of aggression; sexual activity, contact and competition and people with two or more drinks at closing predicted frequency but not severity of aggression; lack of staff monitoring predicted more severe patron aggression, while having more and better coordinated staff predicted more severe staff aggression. Intoxication of patrons was significantly associated with more frequent and severe patron aggression at the bar level (but not at the visit level) in the multivariate analyses and negatively associated with severity of staff aggression at the visit level. CONCLUSIONS: The results demonstrate clearly the importance of the immediate environment (not just the type of bar or characteristics of usual patrons) and the importance of specific environmental factors, including staff behaviour, in predicting both frequency and severity of aggression.

Aggression↗
PubMed2006

Harm, intent, and the nature of aggressive behavior: measuring naturally occurring aggression in barroom settings.

The research goals were to use the constructs of harm and intent to quantify the severity of aggression in the real-world setting of the bar/club, to describe the range of aggressive behaviors and their relationship to harm and intent, and to examine gender differences in the form and severity of aggression. Systematic observations were conducted by trained observers on 1,334 nights in 118 bars/clubs. Observers documented a range of aggressive acts by 1,754 patrons in 1,052 incidents, with many forms of aggression occurring at more than one harm and intent level. Women used different forms of aggression, inflicted less harm, and were more likely to have defensive intent compared with men. Implications of the findings for research and measurement of aggression and applications to preventing aggression and violence are discussed.

Aggression↗
PubMed2006

To what extent is intoxication associated with aggression in bars? A multilevel analysis.

OBJECTIVE: The purpose of this study was to assess the relationship between level of intoxication and the frequency and severity of aggression at the person, incident, visit, and bar level for aggressive incidents observed in bars or clubs. METHOD: Hierarchical Linear Modeling (HLM) analysis of 1025 incidents of aggression documented by trained observers during 1334 nights of observation in 118 bars and clubs in Toronto, Canada, was conducted. RESULTS: Both level of intoxication of the crowd during the visit as well as mean level of intoxication at the bar level significantly predicted frequency of aggression. There was a positive association between level of intoxication and severity of aggression at both the incident and person level except for the highest level of intoxication at the person level, where severity of aggression was less than for moderate intoxication. A person-incident level interaction between intoxication and severity of aggression was also found. CONCLUSIONS: These results suggest that prevention efforts should focus on both identifying bars that typically have more intoxicated patrons and reducing the intoxication levels of patrons across bars generally. The results also showed a strong positive relationship between level of intoxication and severity of aggression (except at the highest levels), indicating that intoxication increases risk in terms of both frequency and severity of aggression. The significant interaction between person- and visit-level intoxication suggests that greater attention needs to be paid to group dynamics in alcohol-related aggression.

Aggression↗
PubMed2005

Do predisposing and family background characteristics modify or confound the relationship between drinking frequency and alcohol-related aggression? A study of late adolescent and young adult drinkers.

The present study examined whether predisposing and family background characteristics confounded (common cause/general deviance theory) or modified (conditional/interactive theory) the association between drinking frequency and alcohol-related aggression. A secondary analysis of the US National Longitudinal Survey of Youth was conducted using a composite sample of drinkers, ages 17 to 21, from the 1994, 1996, and 1998 Young Adult surveys (n=602). No evidence of confounding of the relationship between drinking frequency and alcohol-related aggression was found. In addition, predisposing characteristics did not modify the association between drinking frequency and alcohol-related aggression. However, family background variables (mother's education and any poverty) were important explanatory variables for alcohol-related aggression among males, whereas recent aggression (fights at school or work) was an important predictor for females. Overall, lack of support for the conditional/interactive and common cause theories of the alcohol and aggression relationship suggests that alcohol has an independent explanatory role in alcohol-related aggression. In addition, the gender differences found in the present study highlight the need for more gender-focussed research on predictors of alcohol-related aggression, especially among adolescents and young adults.

Adolescent↗
PubMed2005

Drinking patterns, drinking contexts and alcohol-related aggression among late adolescent and young adult drinkers.

AIMS: The main objectives of this study were to determine: (1) the relative roles of heavy episodic drinking (HED), drinking frequency and drinking volume in explaining alcohol-related aggression and (2) whether drinking context variables (i.e. usual drinking locations, typical drinking companions and extent of peer drinking) confound or modify the relationship between HED and alcohol-related aggression or whether they predict alcohol-related aggression independently. DESIGN: A secondary analysis of the US National Longitudinal Survey of Youth was conducted. Alcohol-related aggression (denoted fights after drinking) was measured based on self-reports of arguments or fights that occurred during or after drinking in the previous 12 months. PARTICIPANTS: A composite sample of drinkers, ages 17-21, from the 1994, 1996 and 1998 Young Adult surveys (n = 738) was used. FINDINGS: Frequency of drinking and drinking volume largely confounded the association between HED and fights after drinking. Usually drinking in public locations away from home versus private locations was found to be significantly associated with a greater likelihood of fights after drinking among females. Among males, usual drinking location modified the relationship between drinking frequency and alcohol-related aggression, with the greatest risk of aggression for males who drank frequently and usually drank in public locations away from home. CONCLUSIONS: Programs designed to reduce drinking frequency in this population and to increase the safety of drinking locations in public places away from home may prove to be beneficial in reducing alcohol-related aggression.

Adolescent↗
PubMed2005

Guardians and handlers: the role of bar staff in preventing and managing aggression.

AIMS: To identify good and bad behaviors by bar staff in aggressive incidents, the extent these behaviors apparently reflect aggressive intent, and the association of aggressive staff behavior with level of aggression by patrons. DESIGN, SETTING AND PARTICIPANTS: Data on staff behavior in incidents of aggression were collected by 148 trained observers in bars and clubs on Friday and Saturday night between midnight and 2 a.m. in Toronto, Canada. Behaviors of 809 staff involved in 417 incidents at 74 different bars/clubs were analysed using descriptive statistics and three-level hierarchical linear modeling (HLM) analyses. MEASUREMENTS: Observers' ratings of 28 staff behaviors were used to construct two scales that measured escalating/aggressive aspects of staff behavior. Apparent intent level for bar staff was dichotomized into (1) no aggressive intent versus (2) probable or definite aggressive intent. Five levels of patron aggression were defined: no aggression, non-physical, minor physical, moderate physical and severe physical. FINDINGS: The most common aggressive behaviors of staff were identified. Staff were most aggressive when patrons were either non-aggressive or highly aggressive and staff were least aggressive when patrons exhibited non-physical aggression or minor physical aggression. Taking apparent intent into consideration decreased staff aggression scores for incidents in which patrons were highly aggressive indicating that some aggression by staff in these instances had non-aggressive intent (e.g. to prevent injury); however, apparent intent had little effect on staff aggression scores in incidents with non-aggressive patrons. CONCLUSION: Although there is potential for staff to act as guardians or handlers, they often themselves became offenders when they responded to barroom problems. The practical implications are different for staff aggression with nonaggressive patrons versus with aggressive patrons.

Aggression↗
PubMed2004

Problems with the graduated frequency approach to measuring alcohol consumption: results from a pilot study in Toronto, Canada.

AIMS: To evaluate advantages and disadvantages of the graduated frequency (GF) approach, which asks about the frequency of alcohol consumption at mutually exclusive quantity levels (i.e. 12 or more drinks, at least eight drinks but less than 12, etc.). METHODS: Telephone survey of 464 adults aged 18 and older in Toronto, Canada, using random digit dialing and computer-assisted telephone interviewing. RESULTS: Respondents reported higher frequency and volume of drinking on the GF compared to overall and beverage-specific quantity-frequency type measures; however, at least 16% of GF responses included double counting on their frequency estimates using the GF. When these cases were excluded or corrected, differences between the GF and quantity-frequency measures mostly disappeared. The GF was superior to quantity-frequency measures for identifying heavy episodic drinkers. However, the GF had little advantage over the weekly recall method except for identifying very infrequent (i.e. less often than twice a month) heavy drinkers. CONCLUSIONS: Because the GF has a high rate of response errors in terms of measuring frequency of alcohol consumption, other combinations of measures, including alternate measures of heavy episodic drinking should be considered.

Adolescent↗
PubMed2004

The effect of the Safer Bars programme on physical aggression in bars: results of a randomized controlled trial.

The purpose of this study was to evaluate the effectiveness of Safer Bars, an intervention to reduce aggression in bars. A total of 734 pre - post-intervention observations were conducted by trained observers on Friday and Saturday nights between midnight and 2 a.m. in 18 large capacity ( > 300) Toronto bars and clubs assigned randomly to receive the intervention (69% participation rate of the 26 assigned) and 12 control bars. As part of the intervention, owners/managers completed the risk assessment workbook to identify ways of reducing environmental risks, and 373 staff and owners/managers (84% participation rate) attended a 3-hour training session focused on preventing escalation of aggression, working as a team and resolving problem situations safely. The main outcome measures were rates of severe aggression (e.g. punching, kicking) and moderate physical aggression (e.g. shoving, grappling). Hierarchical linear modelling (HLM) comparing pre - post aggression for intervention versus control bars indicated a significant effect of the intervention in reducing severe and moderate aggression. This effect was moderated by turnover of managers and door/security staff with higher post-intervention aggression associated with higher turnover in the intervention bars. The findings indicate the potential for a stand-alone relatively brief intervention to reduce severe and moderate physical aggression in bars.

Aggression↗