Is marital status a risk predictor for alcohol use problems? Part 4

EXPLANATORY variables: MARITAL (categorical), AGE (quantitative)

RESPONSE variables:

ABUSE (secondary variable; grouped candidates as YES or NO based on number of daily drinks; so I converted a quantitative variable into categorical variable).

alcohol abuse/dependence variables ALCABDEP12DX and DEPENDENCE (secondary variable based on dependence symptoms)

I will be creating

 

usage

USAGE GRAPHS

MARITAL AND USAGE

 

UNIVARIATE GRAPH FOR ALCOHOL ABUSE: UNIVARIATE GRAPH

Alcohol abuse: a unimodal graph where 80% participants abuse alcohol, 12% use alcohol in high amounts and safe drinking is found in less than 10% population. The graph is skewed to the left, greatly.

 

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BIVARIATE bar chart for MARITAL (categorical) vs USAGE (categorical)

Marital status:

1 married.

2 living together as if married

3. widowed

4. divorced

5. seperated

6. never married

 

 

In the bar graph below, the highest alcohol abuse listed is for widowed participants (coded 3; n=67). The graph is unimodal and less skewed.

Living together as though married abuse alcohol very less often (coded as 2; n=32). The other groups including the divorced, abuse alcohol more frequently (n~40)

bivariate marital vs usage bar graph code

bivariate marital vs usage bar graph

Is marital status a risk predictor for alcohol use problems? Part 3

Independent variables: MARITAL

Dependent variables:

Alcohol overuse variables S2AQ8B (male only) and S2AQ9 (female only).

alcohol abuse/dependence variables ALCABDEP12DX and DEPENDENCE (secondary variable based on dependence symptoms)

S2AQ8B : >5+ drinks, as this variable includes both male and female I will exclude female candidates and missing data to retain only male candidates.

 

  1. Coding in valid data and recoding variables: coded ‘never drinkers’ for S2AQ8B as 100. The data shows that 1850 participants in  table 1 were by default detected as missing data, actually they never drank alcoholic drink in past 12 months.

program

  1. Collapse response categories of a age variable into 10 groups: collapsed age response into age group. <10, 11-20, 21-30… so on. % frequency distribution is not even, so I collapsed the values based on age groups with 10 years interval. There is no data for age interval 30 to 90, so the table does not include those columns.

Table 1:

grouping response categories

  1. Creating secondary variables:

()The code book lists 11 variables that are actually alcohol dependence symptoms. I aggregated in the yes responses (coded as 1) to find out how many participants had at least 1 alcohol dependence symptoms. As below, I created a secondary variable DEPENDENCE which is a result of 11 different questions S2BQ1A9A to S2BQ1A9K (as I mentioned in first assignment. blog Table 3).

Table 3: Alcohol dependence variables:

S2BQ1A2 ever had to drink more to get the effect wanted
S2BQ1A4 ever increase drinking because amount formerly consumed no longer gave desired effect
S2BQ1A6 more than once try unsuccessfully to stop or cut down on drinking
S2BQ1A9B ever shake when effects of alcohol were wearing off
S2BQ1A9C ever feel anxious or nervous when effects of alcohol were wearing off
S2BQ1A9D ever have nausea when effects of alcohol were wearing off
S2BQ1A9E ever feel unusually restless when effects of alcohol were wearing off
S2BQ1A9F ever sweat or heart beat fast when effects of alcohol were wearing off
S2BQ1A9G ever see, feel, hear things when effects of alcohol were wearing off
S2BQ1A9H ever have fits or seizures when effects of alcohol were wearing off
S2BQ1A9I ever have very bad headaches when effects of alcohol were wearing off
S2BQ1B9J withdrawal symptoms in last 12 months caused significant distress or impairment in social, occupational or other important areas
S2BQ1C9K withdrawal symptoms before 12 months ago caused significant distress or impairment in social, occupational or other important areas

With this I now know that there were 2007 of 5401 (37.15%) divorced participants who had at least 1 alcohol dependence symptoms, that is pretty alarming!! The missing data includes divorced who never drank and those who don’t have alcohol dependence.

sec variable program.PNG

Table 2:

secondary variables

The proc print step confirms that the system worked efficiently in grouping all the variables based on the logic.

Is marital status a risk predictor for alcohol use problems? Part 2

In my last blog, I shared my research question. Here on, we shall find answers to it.

I worked out the major variables to study. I chose to stick to people divorced and number of previous marriages. For alcohol use variables, i chose to interpret largest number of drinks, how frequently they had 5+ drinks (males) or 4+ drinks (females) in a year.

Since, the alcohol consumption recommendations are different for male and female, I took the variable SEX also into consideration.

So, totally you will find 6 variables in study so there will be 6 frequency table generated.

Firstly, I have restricted my sample data by divorcees only IF MARITAL=4;). So, my sample size reduced from 43093 to 5331, meaning there were 5331 divorcees in the NESARC data.

My program is as below:

My program

I have created frequency tables for 6 variables. As mentioned before, Marital has only 1 category: divorcees. I created logic for other 4 variables to rule out unknown category out of the frequency table.

Let us see the frequency tables for each variables:

Frequency table for marital sex and number of marriages.PNG

Of the 5331 divorcees, 2058 are males (code 1) and 3273 are females (code 2). To my surprise, I found a divorcee who has married 12 times for now, I am sure I am not judging. 1136 participants married twice and 296  participants married thrice. That is quite a data.

Now let us see alcohol consumption frequency tables. In the table below, we see 3084 (88%) participants drinking up to 4 drinks a day. Remaining 22% of the participants drank more than that, which is definitely not safe drinking. Roughly 2% of the population is extremely alcoholic based on cut off ‘more than 9 drinks a day’. We do not have data for 1837 participants, cumulative frequency confirms the data is only from 3494 participants.

number of drinks per day since a year.PNG

In the table below, we will see how frequently do people have 5+ drinks per day. Remember, this data includes both male and female participants. 70% of the divorced population never consumed so much in the past year (code 11)! 1.97% and 1.63% consumed 5+ drinks every day (code 1) and nearly everyday (code 2), respectively.

The code book mentions, 356 people consumed this amount every day of which 69 people are divorcees as per the frequency table below. So let me calculate the overall percentage- so, 19% (n=69) of the 5+ drinkers are divorcees.

frequency of more than 5 drinks a day

The table below is the female only table. Of the total 3273 female participants in the study, we have data from a total of 1977 females only. We have been missing data regularly from 1837 participants, but as per my calculation 3273-1977 = 1296 participants data are missing. In the table below, 3354 participant data is missing I believe the system is not excluding male missing data from here. If you a reviewer find an answer to this mystery, let me know in your comments.

Coming to interpret the data, 0.76% and 0.40% of the female population consumes 4+ drinks in a day and nearly every day, respectively.

frequency of more than 4 drinks a day

 

See you till next week!!!

 

 

 

 

 

 

 

Is marital status a risk predictor for alcohol use problems? Part 1

Research question:

Is alcohol dependence associated with marital status? (discussion below after the review)

 

Literature review:

Marital status is a major psychosocial predictor of alcohol problems. It becomes one of the critical point of consideration in alcohol rehabilitation and relapse prevention programs.[1] In never married and separated individuals, significant increase in heavy drinking was observed with adverse alcohol-related health consequences occurring immediately around divorce.[2] In the same study, it was observed that heavy drinking declined with ageing from 23 to 33 years (21.4-13.0% in men, 6.4-3.4% in women).

On the contrary, in a Kenyan study[3]  marital status did not significantly influence the alcohol abuse in patients who attended comprehensive care centre, Kenyatta  National Hospital. However, the major risk factors found in this study were depressive disorders and gender. Males were more susceptible to alcohol abuse when compared to females.

In the Collaborative Study of the Genetics of Alcoholism (COGA), both marital status and GABRA-2 gene were independently related to alcohol problems. There were significant correlations observed between; marital status and alcohol dependence, GABRA-2 and alcohol dependence, marital status and, GABRA-2 and interaction between marital status and GABRA-2 on alcohol dependence.[4]

I would like to study exact correlation between marital status and alcohol abuse/dependence using large US population sample. Going with promising results from COGA, I hypothesize that marital status can significantly influence alcohol consumption.

The U.S. National Epidemiological Survey on Alcohol and Related Conditions (NESARC) is a survey designed to determine the magnitude of alcohol use and psychiatric disorders in the U.S. population.[5] Using the data set made available from NESARC, I have selected all the variables that relate to marital status (9 variables) and alcohol dependence (31 variables) along with age and gender information.

Search terms used: “martital status” and “alcohol dependence”

Method:

The correlation should be significant enough for rejecting the null hypothesis or accepting the alternate hypothesis.

Null hypothesis: Marital status does not influence alcohol dependence.

Alternate hypothesis: Marital status influences quantity, frequency and dependence of alcohol consumption.

I have taken into account all the variables that can possibly help me in understanding the correlation.

Firstly, I will look for divorcees, widow/ers and compare them to married individuals based on their alcohol consumption pattern.

Next, I will focus on number of unsuccessful marriages for the separated individuals and additional responsibilities (single parenting children) to study and compare their alcohol use behaviour against married individuals.

In both the cases, unmarried individuals will act as a control for alcohol use pattern. drinking more than 4 (for women) and 5 (for men) at once is considered excessive.

Main variables:

Alcohol abuse: Marital status ‘MARITAL’ vs how often drank 5+ drinks of any alcohol in last 12 months ‘S2AQ8E’ and 4+women only ‘S2AQ9’

Alcohol dependence: Marital status ‘MARITAL’ vs ever had to drink more to get the effect wanted ‘S2BQ1A2’ and secondary variable created by grouping all variables listed in table 3.

I will use SAS programming for the study.

Please follow my blog to find the evidences on the course and results once the study is complete.

Table 1: Marital parameters:

IDNUM unique ID number
AGE age in years
SEX sex
MARITAL current marital staus
S1Q3B number of marriages
S1Q4A age at first marriage
S1Q4B how first marriage ended
S1Q4C age when stopped living with first spouse
S1Q4D age when married current spouse
S1Q5A number of children ever had, including, adoptive, step and foster children
S1Q5B age when first child born/started living together
S1Q5C age when last child born/started living together

Alcohol consumption variables: 

Table 2: Alcohol abuse variables:

S2AQ1  drank at least 1 alcoholic drink in life
S2AQ2 drank at least 12 alcoholic drinks in last 12 months
S2AQ3 drank at least 1 alcoholic drink in last 12 months
S2AQ8A how often drink any alcohol in last 12 months
S2AQ8B  number of drinks of any alcohol usually consumer on days when drank alcohol in last 12 months
S2AQ8C largest number of drinks of any alcohol consumed on days when drank alcohol in last 12 months
S2AQ8D how often drank largest number of drinks of any alcohol in last 12 months
S2AQ8E how often drank 5+ drinks of any alcohol in last 12 months
S2AQ9 how often drank 4+ drinks of any alcohol in last 12 months (women only)
S2AQ10 how often drank enough to feel intoxicated in last 12 months
S2AQ11 how many drinks can hold without feeling intoxicated
S2AQ14 number of years drank same as in last 12 months
S2AQ20 duration (years) of period of heaviest drinking
S2AQ21A how often drank any alcohol during period of heaviest drinking
S2AQ21B number of drinks of any alcohol usually consumed on days when drank alcohol during period of heaviest drinking
S2AQ21C largest number of drinks of any alcohol consumed on days when drank alcohol during period of heaviest drinking
S2AQ21D how often drank largest number of drinks of any alcohol during period of heaviest drinking
S2AQ23 main type of alcohol consumed during period of heaviest drinking

Table 3: Alcohol dependence variables:

S2BQ1A2 ever had to drink more to get the effect wanted
S2BQ1A4 ever increase drinking because amount formerly consumed no longer gave desired effect
S2BQ1A6 more than once try unsuccessfully to stop or cut down on drinking
S2BQ1A9B ever shake when effects of alcohol were wearing off
S2BQ1A9C ever feel anxious or nervous when effects of alcohol were wearing off
S2BQ1A9D ever have nausea when effects of alcohol were wearing off
S2BQ1A9E ever feel unusually restless when effects of alcohol were wearing off
S2BQ1A9F ever sweat or heart beat fast when effects of alcohol were wearing off
S2BQ1A9G ever see, feel, hear things when effects of alcohol were wearing off
S2BQ1A9H ever have fits or seizures when effects of alcohol were wearing off
S2BQ1A9I ever have very bad headaches when effects of alcohol were wearing off
S2BQ1B9J withdrawal symptoms in last 12 months caused significant distress or impairment in social, occupational or other important areas
S2BQ1C9K withdrawal symptoms before 12 months ago caused significant distress or impairment in social, occupational or other important areas

References:

[1] http://www.ingentaconnect.com/contentone/ben/cdar/2016/00000009/00000001/art00002

[2] http://www.ncbi.nlm.nih.gov/pubmed/10790900

[3] http://erepository.uonbi.ac.ke/handle/11295/93939?show=full

[4] http://www.jsad.com/doi/abs/10.15288/jsa.2006.67.185

[5] https://clinicaltrials.gov/ct2/show/NCT01273220

Abs your goal:

Abs abs abs!!! They are the exciting mantra for you to be noticed and revered. Many of us in the aim of getting perfectly sculpted abs hit the gym and do all sorts of crunches. Getting 6 pack abs is a costly affair that requires enormous time, dedication and physical exertion. But there is something that is hindering your progress. Blindly doing the crunches every other time can be a devastatingly surprising to end up with zero abs.

Are you on your path?

So, what is it that is holding you from those most coveted 6 pack abs. Number one, the fat in the abdomen. Your favourite ice creams and French fries have resulted in heavy fat deposition in the abdominal region. Therefore, even if you developed such strong muscles, the abs is easily imperceptible behind this mesh of fat. Number two, the crunches you do are not effective in sculpting the 6 pack abs for you. There has to be some changes made in your training so that you look perfect in just a few days.

If not turn towards the right path:

So, as soon as you hit the gym, the first aim should be to burn the excess fat. Once you have gotten rid of fatty tissues, you have to concentrate on the hardcore exercise in designing the 6 pack abs. Here are a few important exercises that will surely help you in the journey of getting that abs. With proper diet, even a 1 or 2 hours of work out should be sufficient to help reach your goal. Be a champ by helping yourself with body building diet and little effort to shape a body of your dreams.

Plank: Performing 2 to 3 sets of planks with 30 to 60 seconds hold time will ensure perfect exercise for the entire core. You can raise the level of the work out by widening the feet and reaching there with your hands without tilting the hips.

Side plank: This exercise will help you to reduce the weakness in general and improve the balance. It is important to maintain the shoulder, hip and ankle in the same line keeping the chin off the chest. You can make it even more difficult by raising the top leg higher in the plane parallel to the floor.

Bicycle crunch: Doing 20 to 30 reps of 2 to 3 sets will ensure 190 percent larger activity than the regular crunch. The main motto is to completely extend a leg at a time and bring the shoulder to touch the opposite knee so there is a little contraction.

Reverse crunch: Doing reverse crunch is by placing the hands below the butts and brining the knees close to the chest with full concentration on pelvis.

Vertical chair knee raise: This crunch is the ultimate as it is comparable to 200 percent more results to that of normal crunch. Maintaining the shoulders and back in a perfect posture, knees have to be raised till the waistline. You can make it even harder by raising the straight leg at once or alternatively.

Surviving Asthma

When the season is back and you are prone to allergy, that is a very bad situation you are in. Especially as asthmatic patient you have to be very careful not to encounter an asthma attack. It is really hard to struggle for air and feel like you are going to die. Asthma has indeed victimized people- both children and adults worldwide. Surviving asthma is a real challenge.

Asthma is a life threatening disease. Small allergens like dust, pollens, specific chemical can trigger asthma in these patients. Even the pets can transmit allergens through their hairs. It is always better to know the asthma conditions so create a pattern of triggers that result in an attack. This will eventually help you to avoid them and start breathing well.

Though there is no complete cure for asthma, there are many medicines available that helps the patients prevent an attack and/or cope with the attack. Choosing the right medication and inhalers by talking to your doctor will help a lot. Know your medication before you start taking it. The side effects, contraindications, when and how to take. When you are prescribed to use an asthma inhaler or a pump, the trick to get is right is inhale deeply in the lungs by holding your breath for a few seconds. This will give time for the drug to get diffused in the lungs before you exhale slowly.

Have you heard of AsthmaSense? If not it is a new app that is built for the asthmatics that will help the patient to record the symptoms, use of medications, a reminder to take pills or inhaler and what’s more a rescue option in case of emergency. This app is available on apple app stores where you can download it on to your iPad or iPhones.

Awareness is the best medicine to successfully tackle the disease. When you are fully aware and have accept it already, life becomes simple and comfortable. Here are a few tips that shall keep asthma attack at bay.

  • Asthma patients out of fear breathe too much and too fast that cause chronic hyperventilation. So if the patient starts breathing slow and deep, the risk of an attack can be reduced. Usually attacks occur as a result of anxiety and panic. When you are tensed, just breath into a paper bag for a minute can bring the carbon dioxide levels in blood back to normalcy.
  • Purse-lipped breathing can reduce the symptoms of asthma. Discuss with the therapist before trying it yourself. Also learn it from him as to how to stand, sit or breathe as small and abrupt body movements can be triggers of asthma.
  • Quit smoking, Smoking is considered to be the high risk factor for not only asthma but COPD. Whatsoever, smoking is also responsible for lung cancer and serious of heart issues that reduce the life expectancy of the patient.
  • Make your surroundings friendlier. Keep all the things you want near you. Take the support of your friends and family. In case your friend has common cold or contagious diseases, smartly avoid them.

Learn your autistic child

Autism: Know your child better

Autism is a disorder that inflicts humans in young age. The juvenile patients may not be able to comprehend the disease and it becomes a tough challenge for an adult too. So, understanding autism is the first medicine for leading the patient towards an independent and productive lifestyle ahead.

Autism is a condition that precipitates differently in every child and needs special care from the parent, caregiver and teacher that is child oriented. Knowing your child better will help you to understand the situation and adapt to it.

Innocence:

The child doesn’t know why the disease, why me, what is happening, how do I deal with it, and what am I capable of. An adult can give them an idea and support them to overcome their weakness. www.helpyourautisticchildblog.com

Communicates, but differently:

Autism may not allow the child to talk fluently and at times they do not get the proper words to express themselves. So, a care taker may look for body language, agitation and other signs. The child is trying hard to memorize what is to be spoken from books, conversations heard and television- echolalia. www.growingyourbaby.com

Sensitivity:

Autism leaves the child very sensitive to sights, smells, tastes, sounds and touches. Loud music, noise of a mixer grinder or a small coffee grinder, smell of a fish, fluorescent or pulsating high intensity lights or swirling fans may be highly disturbing for the child. www.autismlearningfelt.com

Poor comprehension:

The child is able to hear but is not successful in grasping the instructions and applying it in the class. Teaching becomes difficult, but giving special attention and directing the child in simpler language can make all the difference. www.nj.com

Visualization helps:

Sometimes the words or phrases may be replaced with actions. A visual support can help the child getting all the blocks of the information. www.myaspergerschild.com

Good thinking skills:

The child has no problem with thinking. It is just that the instructions are not communicated in simple language. Instead of telling your baby “its pouring cats and dogs”, convey the message in simple words – it is raining. Do not use idioms, metaphors, sarcasm, allusions, nuances or puns on the child. health.more4kids.info

Sociable:

They are young and sociable, and they will be interested to mingle with other children and neighborhood. Teaching them the body languages, facial expressions and emotions will give them a good foundation to be more responsive and interactive. www.smh.com.au

 

How do I lead my autistic child?

Weight the abilities:

The child may fail to do a task but that does not mean he can’t do anything at all. Patient observation to identify the strengths and step wise guidance and encouragement will help the child try something new. www.brightmindsinstitute.com

Meltdowns:

Child is elusive about meltdowns. Try and figure out what could be the reason, food allergies, sensitivities, improper sleep and stomach problems. When you get the pattern of cause and effect, the problem is half solved. Avoiding them in future can in turn avoid meltdowns and blow-ups. psychcentral.com

Unconditional care and love:

Children need unconditional support, care and love. This might be very difficult, but the mantra is patience with less expectation. The child totally relies on you, what he/she can become in future is decided on what foundation you provide them. As a guide and caregiver you can improve the quality of living for the autistic child. www.autism-programs.com