Differences in weekday versus weekend drinking among nonstudent emerging adults.
ABSTRACT: In the current investigation, we sought to examine "day-of-the-week" drinking of an at-risk sample of nonstudent emerging adults and whether specific factors are associated with differential drinking patterns. Our study aims were to (a) identify differences in weekday versus weekend drinking, and (b) examine specific expectancies (i.e., sociability, tension reduction) and demographic factors (e.g., age, sex) relating to weekend versus weekday drinking after controlling for harmful drinking and holiday drinking. Participants were heavy-drinking noncollege attenders recruited from the community (N = 238; 63.4% men, 35.7% women; M age = 21.92 years). They reported daily drinking for the previous 30 days and completed measures of harmful drinking, alcohol expectancies, and demographic information. Results showed that more drinks were consumed on the weekends (i.e., Thursday to Saturday) than weekdays, with 63% of drinks consumed on weekends. Multilevel modeling analyses indicated that weekday drinking was associated with tension-reduction expectancies, social expectancies, sex, and age. Weekend-drinking increases were related to social expectancies, but not tension-reduction expectancies. Our final model indicated that, after controlling for the effect of holiday drinking, the within-person weekday-weekend distinction explained 18% of the total variance. In general, our findings highlight the importance of alcohol expectancies and drinking contexts in understanding the drinking behaviors of nonstudents. The differential role of tension-reduction and social-facilitation expectancies on drinking throughout the week imply that different cognitive pathways are involved in weekday versus weekend drinking, and both types of expected alcohol effects should be targets of risk-reduction efforts with nonstudent drinkers.
Project description:The current study tested and identified risk and protective pathways from alcohol expectancies to weekday and weekend consumption to problematic consequences. Adult alcohol users (N?=?395) completed measures of alcohol expectancies, daily consumption habits during a typical week, and alcohol-related problems. Confirmatory factor analysis supported the five-factor structure of positive expectancy, negative expectancy, weekday drinking, weekend drinking, and alcohol problems. The structural equation model specifying general positive and negative expectancy to weekday and weekend use to alcohol problems exhibited satisfactory fit indices. Specifically, positive expectancy contributed to greater weekend drinking, but negative expectancy prompted greater weekday drinking. Furthermore, lower positive expectancy, higher negative expectancy, higher weekday drinking, and higher weekend drinking each uniquely explained greater alcohol problems. The structural equation model involving the seven specific expectancies to weekday and weekend use to alcohol problems produced high fit indices. Specifically, higher risk and aggression, higher self-perception, and lower cognitive and behavioral impairment expectancies uniquely predicted weekday drinking. In contrast, higher sociability, higher liquid courage, higher risk and aggression, and lower cognitive impairment expectancies explained weekend drinking. The predictive model premised on specific alcohol expectancies as distinct constructs exhibited higher fit indices and more nuanced insights regarding risk and protective pathways for prevention than the model involving general positive versus negative expectancy constructs. Findings underscore that different types of self-fulfilling alcohol expectancy beliefs distinctively explain weekday versus weekend intake and problems.
Project description:Personality and expectancies are relevant psychological factors for the development of adolescent alcohol use and misuse. The present study examined their direct, mediated and moderated effects on different drinking behaviors in adolescence. Personality domains of the five-factor model, positive and negative alcohol expectancies (AEs), alcohol use during the week and the weekend, and alcohol-related problems were assessed in a sample of 361 adolescents. Different personality dimensions were directly associated with specific alcohol outcomes: Extraversion, low Conscientiousness and low Openness were associated with weekend alcohol use; low Agreeableness was related to weekday use; whereas low Agreeableness, low Conscientiousness and Extraversion were associated with alcohol-related problems. In addition, positive AEs mediated the relationship between Extraversion and alcohol use, whereas both positive and negative expectancies mediated the association between Neuroticism and alcohol consumption and alcohol-related problems. Finally, both types of expectancies interacted with Extraversion to predict alcohol problems. Our results highlight the importance of examining the complex interplay of comprehensive personality models and AEs to gain a better understanding of the development of different alcohol use and misuse patterns in adolescence.
Project description:BACKGROUND:Understanding patterns of antiretroviral adherence and its predictors is important for designing tailored interventions. Alcohol use is associated with non-adherence. This study aimed to evaluate: (1) if there was a difference in weekday compared with weekend adherence in HIV-infected individuals from low and middle income countries (LMIC), and (2) whether binge drinking was associated with this difference. METHODS:Data from a randomized trial conducted at 9 sites in 8 LMIC were analyzed. Microelectronic monitors were used to measure adherence. Differences between weekday and weekend adherence in each quarter (successive 12-week periods) were compared using Wilcoxon signed rank tests and predictors of adherence, including baseline binge drinking, were evaluated using Generalized Estimating Equations. RESULTS:Data from 255 participants were analyzed: 49.8% were male, median age was 37 years and 28.6% enrolled in Haiti. At study entry, only 2.7% reported illicit substance use, but 22.3% reported binge drinking at least once in the 30 days prior to enrollment. Adherence was higher on weekdays than weekends (median percent doses taken: 96.0% vs 94.4%; 93.7% vs 91.7%; 92.6% vs 89.7% and 93.7% vs 89.7% in quarters 1-4 respectively, all p<0.001). Binge drinking at baseline and time on study were both associated with greater differences between weekday and weekend adherence. CONCLUSIONS:Adherence was worse on weekends compared to weekdays: difference was small at treatment initiation, increased over time and was associated with binge drinking. Screening and new interventions to address binge drinking, a potentially modifiable behavior, may improve adherence in HIV-infected individuals in LMIC.
Project description:Self-medication theory (SMT) posits that individuals exposed to trauma and resulting posttraumatic stress symptoms (PTSD) are at risk for heavy drinking and associated negative consequences. Close peer alcohol use is also a powerful predictor of alcohol involvement in college, particularly influencing those with greater negative affect. As individuals with PTSD may rely on peers for support, peer drinking behaviors are possibly putting them at further risk for greater alcohol use and resulting consequences. To test self-medication processes, the present study examined the relationship between weekday PTSD symptoms, weekend alcohol behavior, and the influence of both emotionally supportive peer and other friend drinking behavior by investigating: (a) whether weekday PTSD symptoms predicted subsequent weekend alcohol use and consequences; and (b) whether the relationship between weekday PTSD symptoms and weekend alcohol behavior was moderated by various drinking behaviors of one's peers. Trauma-exposed heavy-drinking college students (N = 128) completed a baseline assessment and 30 daily, Web-based assessments of alcohol use and related consequences, PTSD symptoms, and peer alcohol behavior. Results directly testing SMT were not supported. However, friend alcohol behavior moderated the relationship between weekday PTSD and weekend alcohol behavior. Findings highlight the importance of peer drinking as both a buffer and risk factor for problematic drinking and provide useful information for interventions aimed at high-risk drinkers. (PsycINFO Database Record
Project description:<h4>Objective</h4>Our study aimed to compare the mortality risk among patients admitted to internal medicine departments during official consecutive holidays (using Chinese New Year holidays as an indicator) with that of weekend and weekday admissions.<h4>Design</h4>Nationwide population-based cohort study.<h4>Setting</h4>Taiwan's National Health Insurance Research Database.<h4>Patients</h4>Patients admitted to internal medicine departments in acute care hospitals during January and February each year between 2001 and 2013 were identified. Admissions were categorised as: Chinese New Year holiday (n=10?779), weekend (n=35?870) or weekday admissions (n=143?529).<h4>Outcome measures</h4>ORs for in-hospital mortality and 30-day mortality were calculated using multivariate logistic regression with adjustment for confounders.<h4>Results</h4>Both in-hospital and 30-day mortality were significantly higher for patients admitted during the Chinese New Year holidays and on weekends compared with those admitted on weekdays. Chinese New Year holiday admissions had a 38% and 40% increased risk of in-hospital (OR=1.38, 95% CI 1.27 to 1.50, p<0.001) and 30-day (OR=1.40, 95%?CI 1.31 to 1.50, p<0.001) mortality, respectively, compared with weekday admissions. Weekend admissions had a 17% and 19% increased risk of in-hospital (OR=1.17, 95%?CI 1.10 to 1.23, p<0.001) and 30-day (OR=1.19, 95%?CI 1.14 to 1.24, p<0.001) mortality, respectively, compared with weekday admissions. Analyses stratified by principal diagnosis revealed that the increase in in-hospital mortality risk was highest for patients admitted on Chinese New Year holidays with a diagnosis of ischaemic heart disease (OR=3.43, 95%?CI 2.46 to 4.80, p<0.001).<h4>Conclusions</h4>The mortality risk was highest for patients admitted during Chinese New Year holidays, followed by weekend admissions, and then weekday admissions. Further studies are necessary to identify the underlying causes and develop strategies to improve outcomes for patients admitted during official consecutive holidays.
Project description:Background Hospital staffing is usually reduced on weekends, potentially impacting inpatient care and postdischarge coordination of care for patients with acute decompensated heart failure (ADHF). However, investigations of in-hospital mortality on the weekend versus weekday, and post-hospital outcomes of weekend versus weekday discharge are scarce. Methods and Results Hospitalizations for ADHF were sampled by stratified design from 4 US areas by the Community Surveillance component of the ARIC (Atherosclerosis Risk in Communities) study. ADHF was classified by a standardized computer algorithm and physician review of the medical records. Discharges or deaths on Saturday, Sunday, or national holidays were considered to occur on the "weekend." In-hospital mortality was compared between hospitalizations ending on a weekend versus weekday. Post-hospital (28-day) mortality was compared among patients discharged alive on a weekend versus weekday. From 2005 to 2014, 39 699 weighted ADHF hospitalizations were identified (19% terminating on a weekend). Demographics, comorbidities, length of stay, and guideline-directed therapies were similar for patients with hospitalizations ending on a weekend versus weekday. In-hospital death doubled on the weekend compared with weekday (12% versus 6%) and was not attenuated by adjustment for potential confounders (odds ratio, 2.37; 95% CI, 1.93-2.91). There was no association between weekend discharge and 28-day mortality among patients discharged alive. Conclusions The risk of in-hospital death among patients admitted with ADHF appears to be doubled on the weekends when hospital staffing is usually reduced. However, among patients discharged alive, hospital discharge on a weekend is not adversely associated with mortality.
Project description:Background and purpose - The term "weekend effect" describes differences in outcomes between patients treated at weekends compared with weekdays. We investigated whether there is a weekend effect for the risk of reoperation and mortality after hip fracture surgery at Norwegian hospitals.Patients and methods - We included data from 76,410 hip fractures in patients 60 years and older reported to the Norwegian Hip Fracture Register (NHFR) between 2005 and 2017. Cox survival analyses with adjustments for age, sex, ASA class, type of fracture, operating method, and waiting time from fracture to surgery were used to calculate the risk of reoperation and death after surgeries performed at weekends compared with surgeries performed on weekdays.Results - The mean age for all patients was 82 years, and 71% were female. 73% of fractures occurred on weekdays (Monday to Friday) and 27% during weekends (Saturday and Sunday). 71% of fractures were operated on a weekday and 29% at a weekend. Slightly increased mortality was observed during the 2 first months after weekend admission with hip fracture (HR 1.08; 95% CI 1.03-1.14). This did not continue in subsequent months, but the initial effect of weekend presentation was still apparent at 1-year follow-up. Further, there was no difference in mortality between patients who were operated at a weekend and patients operated on a weekday. Neither were there any differences in the risk of reoperation between weekday and weekend when comparing day of fracture or day of surgery.Interpretation - Patients who suffered a hip fracture during a weekend had slightly increased mortality in the first 2 months postoperatively. Whether the surgery was done on weekdays or at weekends did not affect mortality or the risk of reoperation.
Project description:Background:Patients with atrial fibrillation-flutter (AF) admitted on the weekends were initially reported to have poor outcomes. The primary purpose of this study is to re-evaluate the outcomes for weekend versus weekday AF hospitalization using the 2014 Nationwide Inpatient Sample (NIS). Methods:Included hospitalizations were aged above 18 years. The hospitalizations with AF were identified using the international classification of diseases 9 (ICD-9) codes (427.31, 427.32). In-hospital mortality, length of stay (LOS), other co-morbidities, cardioversion procedures, and time to cardioversion were recorded. All analysis was performed using SAS 9.4 statistical software (Cary, North Carolina). Results:A total of 453,505 hospitalizations with atrial fibrillation and flutter as primary discharge diagnosis were identified. Among the total hospitalizations with a primary diagnosis of AF, 20.3% were admitted on the weekend. Among the weekend hospitalizations, 0.19% died in hospital compared to 0.74% among those admitted during the week. After adjusting for patient characteristics, hospital characteristics and disease severity, the adjusted odds for in-hospital mortality were not significantly different for weekend vs. weekday hospitalizations (OR = 0.91, 95% CI [0.77-1.11]; p = 0.33). The weekend admissions were associated with significantly lower odds of cardioversion procedures (OR = 0.72, 95% CI [0.69-0.76], P < 0.0001), lower cost of hospitalization (USD 8265.8 on weekends vs. USD 8966.5 on the weekdays, P < 0.001), slightly lower rate of anticoagulation (17.09% on the weekends vs. 18.73% on the weekdays. P < 0.0001), and slightly increased time to cardioversion (1.94 days on the weekend vs. 1.73 days on weekdays, P < 0.0005). The mean length of hospital stay (LOS) was statistically not different in both groups: (3.49 days ± 3.70 (SD) in the weekend group vs. 3.47 days ± 3.50 (SD) in the weekday group, P = 0.42). Discussion:The weekend AF hospitalizations did not have a clinically significant difference in mortality and LOS compared to those admitted on a weekday. However, the use of cardioversion procedures and cost of hospitalization was significantly lower on the weekends.
Project description:BACKGROUND:Healthcare interventions on weekends have been associated with increased mortality and adverse clinical outcomes, but these findings are inconsistent. We hypothesized that patients admitted to hospital on weekends who have surgery have an increased risk of death compared with patients who are admitted and have surgery on weekdays. METHODS AND FINDINGS:This matched cohort study included 318,202 adult patients from Ontario health administrative and demographic databases, admitted to acute care hospitals from 1 January 2005 to 31 December 2015. A total of 159,101 patients who were admitted on weekends and underwent noncardiac surgery were classified by day of surgery (weekend versus weekday) and matched 1:1 to patients who both were admitted and had surgery on a weekday (Tuesday to Thursday); matching was based on age (in years), anesthesia basic unit value for the surgical procedure, median neighborhood household income quintile, resource utilization band (a ranking system of overall morbidity), rurality of home location, year of admission, and urgency of admission. Of weekend admissions, 16.2% (25,872) were elective and 53.9% (85,744) had surgery on the weekend of admission. The primary outcome was all-cause mortality within 30 days of the date of hospital admission. The 30-day all-cause mortality for patients admitted on weekends who had noncardiac surgery was 2.6% (4,211/159,101) versus 2.5% (3,901/159,101) for those who were admitted and had surgery on weekdays (adjusted odds ratio [OR] 1.05; 95% CI 1.00 to 1.11; P = 0.03). However, there was significant heterogeneity in the increased odds of death according to the urgency of admission and when surgery was performed (weekend versus weekday). For urgent admissions on weekends (n = 133,229), there was no significant increase in odds of mortality when surgery was performed on the weekend (adjusted OR 1.02; 95% CI 0.95 to 1.09; P = 0.7) or on a subsequent weekday (adjusted OR 1.05; 95% CI 0.98 to 1.12; P = 0.2) compared to urgent admissions on weekdays. Elective admissions on weekends (n = 25,782) had increased risk of death both when surgery was performed on the weekend (adjusted OR 3.30; 95% CI 1.98 to 5.49; P < 0.001) and when surgery was performed on a subsequent weekday (adjusted OR 2.70; 95% CI 1.81 to 4.03; P < 0.001). The main limitations of this study were the lack of data regarding reason for admission and cause of increased time interval from admission to surgery for some cases, the small number of deaths in some subgroups (i.e., elective surgery), and the possibility of residual unmeasured confounding from increased illness severity for weekend admissions. CONCLUSIONS:When patients have surgery during their hospitalization, admission on weekends in Ontario, Canada, was associated with a small but significant proportional increase in 30-day all-cause mortality, but there was significant heterogeneity in outcomes depending on the urgency of admission and when surgery was performed. An increased risk of death was found only for elective admissions on weekends; whether this is a function of patient-level factors or represents a true weekend effect needs to be further elucidated. These findings have potential implications for resource allocation in hospitals and the redistribution of elective surgery to weekends.
Project description:The present study tested the role of FKBP5 binding protein 5 (FKBP5) genetic variation in an internalizing pathway from child maltreatment to emerging adult problem drinking among a sample of African American youth (N = 280) followed prospectively from ages 11 to 20. Specifically, whether childhood internalizing symptoms and emerging adult tension reduction alcohol expectancies sequentially mediate the effect of child maltreatment on emerging adult problem drinking and whether FKBP5 moderates these associations were investigated. The results indicate that individuals with at least one copy of the FKBP5 CATT haplotype (minor alleles) are more vulnerable to traversing the hypothesized internalizing pathway of risk than individuals without this genotypic profile. Taken together our findings highlight the importance of FKBP5 genetic variation in the context of early adversity; support the role of two prospective sequential mediators of an internalizing pathway to problematic drinking, namely, childhood internalizing symptoms and emerging adult tension reduction alcohol expectancies; and identify a subgroup of maltreated children most susceptible to progressing along this less common pathway of risk.