Biomedical subjects

Tay K McNamara

Publications and source records attributed to Tay K McNamara.

9 recordsLinked to original sources

PubMed2006

Estimates of prenatal abstinence from alcohol: a matter of perspective.

Abstinence from alcohol has been recommended for both pregnant and pre-conceptional women. The purpose of this study is to compare self and partner reports of abstinence from alcohol in a sample of 253 pregnant women who were T-ACE (Tolerance, Annoy, Cut-down, Eye-opener) alcohol screen positive. Dyads' reports of the women's abstinence from alcohol before, during, and after pregnancy were compared. Based on their own self-report, less than 20% of the pregnant women were abstinent in their first trimester and about half were abstinent for the rest of their pregnancy. Partners significantly over-estimated the women's abstinence from alcohol at all points except in the post-partum period when the dyad had the highest rate of agreement (85.4%). Reasons for the discrepancies in the self and partner reports of prenatal abstinence, and how partners might influence such behavior remain speculative, but identify areas for future research and prevention.

Adult↗

PubMed2006

Brief intervention for prenatal alcohol use: the role of drinking goal selection.

The behavioral problems and cognitive deficits resulting from even small amounts of prenatal alcohol exposure can be significant and enduring but completely preventable. The purpose of this study was to examine the impact of a prenatal drinking goal selected during a brief intervention for 115 pregnant women and their partners on subsequent consumption. Higher proportions of women having their first pregnancy chose abstinence as a goal over drinking reduction. Goal selection was highly predictive of subsequent drinking behavior. Interestingly, the participants who were abstinent at enrollment and who chose to remain abstinent had the highest rates of abstinence. In contrast, the women who chose cutting down on drinking were the least likely to drink less subsequently, despite recognizing more situations putting them at risk for drinking and identifying more alternatives to consumption. We conclude that goal choice in behavioral self-management of alcohol use by pregnant women is critical.

Adult↗

PubMed2006

Alcohol use by pregnant women: partners, knowledge, and other predictors.

OBJECTIVE: The impact of a couple's knowledge about healthy pregnancy habits involving alcohol and substance use was assessed in the context of other factors previously identified to predict prenatal alcohol consumption in a sample of 254 pregnant women and their male partners. METHOD: Couples were asked to assess independently a series of statements (true or false) describing the consequences of prenatal substance exposure, while also providing information about their own drinking. RESULTS: Although the couples demonstrated good knowledge of healthy habits during pregnancy, they did not agree when the element of chance was considered. Median household income was more highly predictive of a pregnant woman's knowledge score than her partner's score. In turn, the subject's knowledge of healthy pregnancy habits as manifested in the assessment score had only a weak relationship with prenatal alcohol consumption. Previous alcohol use by the pregnant woman was the strongest predictor of prenatal alcohol use. CONCLUSIONS: Because previous alcohol consumption use by the pregnant woman was the strongest predictor of prenatal alcohol use, the importance of its accurate identification is emphasized. Although pending further investigation, knowledge about healthy pregnancy behaviors may exert greater impact if it is shared by a pregnant woman and her partner.

Adult↗

PubMed2005

Risk during pregnancy--self-report versus medical record.

OBJECTIVE: This study was undertaken to compare the frequencies with which physicians and patients report medical and behavioral risk factors during pregnancy, with particular attention to identification of women at risk for prenatal alcohol use. STUDY DESIGN: The sample included 278 women, drawn from a randomized trial of T-ACE (alcohol screening questionnaire) positive pregnant women receiving obstetric care. Medical records and participants' self-reports were available for comparison. RESULTS: Physicians identified only 10.8% of women recognized as at risk for alcohol consumption by the T-ACE screening measure. In contrast, the physicians' records were more inclusive for medical risk factors than the participant's self-reports. Physicians were significantly more likely to correctly identify nonwhite participants as being at risk for prenatal alcohol use (odds ratio = 3.59, P = .026), compared with their white counterparts. CONCLUSION: Self-report on the T-ACE questionnaire is more effective than medical records in identifying women at risk for prenatal alcohol use.

Adult↗

PubMed2005

Brief intervention for prenatal alcohol use: a randomized trial.

OBJECTIVE: To test the effectiveness of a brief intervention in the reduction of prenatal alcohol consumption by women when a partner is included. METHODS: Randomized trial of a single session brief intervention given by the study nurse or principal investigator for 304 pregnant women and their partners. The women had positive T-ACE (Tolerance, Annoyed, Cut down, Eye-opener, an alcohol screening test) results and were at risk for alcohol consumption while pregnant. All completed initial diagnostic and postpartum interviews. RESULTS: Fewer than 20% of participants (median 11.5 weeks of gestation) were abstinent at study enrollment, averaging more than 1.5 drinks per episode. Nearly 30% had 2 or more drinks at a time while pregnant. Prenatal alcohol use declined in both the treatment and control groups after study enrollment, based on a 95% follow-up rate. Factors associated with increased prenatal alcohol use after randomization included more years of education, extent of previous alcohol consumption, and temptation to drink in social situations. Brief interventions for prenatal alcohol reduced subsequent consumption most significantly for the women with the highest consumption initially (regression coefficient, b = -0.163, standard error (b) = 0.063, P < .01). Moreover, the effects of the brief intervention were significantly enhanced when a partner participated (b = -0.932, standard error (b) = 0.468), P < .05). CONCLUSION: Pregnant women with the highest levels of alcohol use reduced their drinking most after a brief intervention that included their partners. Recommendations include consistent screening for prenatal alcohol use followed by diagnostic assessment when indicated, and if confirmed by other studies, a patient-partner brief intervention for the heaviest drinkers.

Adult↗

PubMed2004

Race, gender, and the retirement decisions of people ages 60 to 80: prospects for age integration in employment.

UNLABELLED: Demographic projections have prompted concerns about the potential economic burden of an aging population. This article, drawing on the 1998 Health and Retirement Study, explores ways in which race, gender, and age moderate the effects of various factors on labor force participation among people ages 60 to 80. Key findings center on health, education, and non-wage income. First, the effect of low non-wage income is weaker at older ages due to higher levels of functional disability. Second, the effect of low education is stronger for women, who perceive their chances of finding employment as low. Third, the effect of health is weaker for blacks, as they are less likely to find steady employment regardless of health. POLICY IMPLICATIONS: Employer flexibility in number of hours worked might make sense for workers close to retirement age, while job search and training programs might be preferable for workers past the typical retirement age.

Age Distribution↗

PubMedDate not supplied

Problem drinking in women evaluated for infertility.

Clinicians may wish to use the T-ACE, a screening instrument for prenatal risk drinking, for their infertile patients. Twenty-eight T-ACE negative and 23 T-ACE positive women presenting to an academic infertility clinic completed two interviews about their drinking. The 23 T-ACE positive participants were also randomized to receive a brief intervention. The T-ACE distinguished between heavier and lighter patterns of alcohol use in this sample. Moreover, it appeared that although the average quantity of alcohol consumed per drinking day was unchanged, the overall mean percentage of days drinking declined significantly from the time of enrollment to follow-up in all groups.

Adult↗

PubMedDate not supplied

Social support and prenatal alcohol use.

BACKGROUND: Lack of social support during pregnancy may be associated with the prenatal use of alcohol. The purpose of this study is to evaluate the degree, predictors, and consequences of social support in a cohort of 200 pregnant women who scored 2 or more on the T-ACE, a 4-item screening questionnaire for prenatal drinking. METHODS: The pregnant women completed the Maternal Social Support Index (MSSI). Their partners completed the same measure, which was modified to reflect their status as the biological fathers. RESULTS: Despite having similar overall MSSI scores, there was only slight to fair agreement on the level of support received by the pregnant women for most daily tasks when their responses were compared with their partners. Predictors of increased maternal social support included the woman's being married and having more education and a more prestigious job than her partner. Social support was not predictive of either subsequent prenatal alcohol use or newborn birth weight. CONCLUSIONS: Regardless of social support, previous, prepregnancy, and early pregnancy drinking were the most predictive factors for subsequent prenatal alcohol consumption in this sample, underscoring the importance of screening pregnant women for drinking.

Adult↗

PubMedDate not supplied

Psychosocial function after hematopoietic stem cell transplantation.

The authors report on a prospective cohort study of patients with chronic myelogenous leukemia undergoing allogeneic hematopoietic stem cell transplantation. The purpose was to evaluate the progression of quality of life and mood, as well as patterns of alcohol consumption, a behavior with potential adverse health consequences. Of the 84 subjects who completed serial measures and other interviews at admission for hematopoietic stem cell transplantation and 6-month follow-up, 75 provided data 12 months later The main findings of this study were that quality of life improves, measures of depressive symptoms decline, and patients drink less alcohol overall. Time was the most important variable accounting for these changes.

Activities of Daily Living↗