published_or_final_version / Medicine / Master / Doctor of Medicine

<p> How a professional football player will adjust to retirement can be difficult to predict. Personality traits could play a role in retirement satisfaction and narcissistic personality traits, which can assist an individual during his playing career, may in fact hinder his ability to adjust to life after football. Using the Narcissistic Personality Inventory and the Retirement Satisfaction Inventory, this study aimed to identify features of narcissism that may correlate with satisfaction and dissatisfaction in retirement among former NFL players. </p><p> Results from this study found significant positive correlations between both authoritativeness and satisfaction with life in retirement, and self-sufficiency and satisfaction with life in retirement. Results also indicated a significant negative relationship between narcissism and total playing years accrued in the NFL, suggesting that those who sustained longer playing careers before retirement had lower levels of narcissism. Lastly, results from this study showed higher satisfaction with retirement the longer an individual had been away from the league, suggesting the retirement process, which has been chronicled as challenging during the first few years, may likely become more manageable as time goes on.</p>

The decision to relocate or to age in place can be a difficult one, mitigated by a variety of influencing factors such as finances, physical abilities, as well as social and instrumental support from family and others. This study focuses on the stresses of residential relocation to independent and assisted living facilities among older women living in Lexington, Kentucky. Participation entailed three semi-structured interviews as well as saliva and blood sampling over a period of 6 months, beginning within one month of the move. Measures of cortisol were used as indicators of stress reactivity. Distinct patterns of cortisol response have been identified, with those who indicated the relocation was the result of health issues or anticipated health issues showing the greatest degree of physiological stress reactivity. The majority of women reveal satisfactory psychosocial adjustment, with women indicating the move was facilitated by need for caring for ailing family showing the least amount of facility integration. Significant life events appear to be related to social integration, stress reactivity, and perceptions of facility life over the course of the first six months in residence. These results have implications for facility managers with regard to facilitation of new and prospective resident acclimation and possible interventions aimed at reducing adaptation time among those on waitlists for such facilities.

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In chapter one, the existing literature on ovarian ageing and fertility is reviewed. In it I (a) discuss the natural history and the potential causes of ovarian ageing (b) assess available tests of ovarian ageing and their limitations (c) discus the trends in the age of first childbirth, its causes and health service consequences. In chapter two, I explore women’s awareness of issues associated with delayed childbearing, including their social and medical implications and the limitations of available treatment. In chapter three, I surveyed IVF clinics throughout the United Kingdom, to determine (1) proportion of women aged 40 or more in each clinic (2) attitudes of clinicians towards older women and (3) clinicians’ views on an upper age limit for IVF. In chapter four, I investigated trends in the age at which women present to general infertility clinics (a step prior to IVF) in Grampian region. Women were grouped according to their age at first presentation to the infertility clinic (&lt;30, 30-34, 35-39 and ≥40 years). I tested the hypothesis that women of advanced reproductive age have a different diagnostic profile than younger women (&lt;30 years). In particular older women are more likely to be diagnosed with unexplained sub-fertility, probably due to ovarian ageing. This hypothesis was tested based on routinely collected data from a single secondary care centre. In chapter five, a systematic review of currently available dynamic tests of ovarian reserve assesses their power to predict fertility outcomes. In chapter six, I calculated the costs of achieving a live birth in different age groups (< 30, 30-34, 35-39 and ≥40 years) following IVF. In chapter seven, I summarize the results of the studies reported in this thesis and consider how they have improved our understanding of various aspects of delayed childbearing.

<p> There are many variables that influence how successfully someone can move through the aging process while maintaining high levels of health, physical and psychological. In the present study, we examined how self-perceptions of aging&mdash;or the way in which someone might view their own aging process in a more positive or negative manner&mdash;influenced such healthy aging outcomes. More specifically, it was hypothesized that if we could get people to hold a more positive view of the aging process, it would make them more likely to work towards maintaining or improving their own levels of psychological well-being. In order to test this idea, older adult participants were recruited and placed into treatment or control groups. The treatment groups received a brief, psychoeducational intervention in the form of a presentation, discussing healthy aging, the importance of holding a positive view of aging, and ways to improve mental health in old age. The findings of this study indicated that the intervention did not significantly help to improve positive perceptions of aging compared to the control group, nor to increase their levels of engagement in psychologically healthy behaviors. However, there were many limitations to this study that may have been confounding, many of which would be easily changeable if the study were to be replicated in the future. Therefore, further research is merited on these topics, as they may provide much needed information about how to help senior citizens stay psychologically healthy.</p>

This thesis examines the Navy Limited Duty Officer and Chief Warrant Officer programs to determine the differences in characteristics. Descriptive statistics, correlation analysis was developed for year groups 1990 through 2005 to analyze the differences in background characteristics and military characteristics of both programs. The study used a logistic regression analysis to examine the predictors of background and military characteristics of Limited Duty Officers and Chief Warrant Officers. The results of the study revealed the background characteristics age, education, race and ethnicity groups were significantly different between the Limited Duty Officer and Chief Warrant Officer Communities. The military characteristics rank, length of service and Armed Forces Qualification Test were significant among Limited Duty Officers and Chief Warrant Officers. This study explains the results and provides recommendations to the Bureau of Naval Personnel and future research.

We examined age-related differences in figure-ground perception by exploring the effect of age on Convexity Context Effects (CCE; Peterson & Salvagio, 2008). Experiment 1, using Peterson and Salvagio's procedure and black and white stimuli consisting of 2 to 8 alternating concave and convex regions, established that older adults exhibited reduced CCEs compared to younger adults. Experiments 2 and 3 demonstrated that this age difference was found at various stimulus durations and sizes. Experiment 4 compared CCEs obtained with achromatic stimuli, in which the alternating convex and concave regions were each all black or all white, and chromatic stimuli in which the concave regions were homogeneous in color but the convex regions varied in color. We found that the difference between CCEs measured with achromatic and colored stimuli was larger in older than in younger adults. Our results are consistent with the hypothesis that the senescent visual system is less able to resolve the competition among various perceptual interpretations of the figure-ground relations among stimulus regions.

In the present set of experiments, we investigated the effects of age and COMT genotypes on traditional measures of executive functions, e.g., Wisconsin Card Sorting Test (WCST; Hart et al., 1988), a battery of executive functions based on the 3 factor model (shifting, updating, inhibition) described by Miyake et al. (2000) and developed at the University of Arizona (Alexander et al., 2012), and two fMRI tasks of executive functions (shifting, updating). The results of experiment 1 showed that COMT influenced performance on several traditional measures of executive functions, with Met homozygotes outperforming Val homozygotes. However, on the WCST we did not observe less perseverative errors in Met carriers as reported previously (Barnett, Jones, Robbins, & Muller, 2007; Bruder et al., 2005; Malhotra et al., 2002; Nagel et al., 2008). According to Miyake et al. (2000), however, such tasks as the WCST may actually involve multiple executive processes, making it difficult to tease apart the different types of executive functions being measured. Furthermore, COMT may be sensitive to some aspects of executive functions and not others. To this end, in experiment 2 we investigated associations between COMT and measures of executive functions from each of the 3 domains described in Miyake et al. (2000). According to the models proposed by Bilder et al. (2004) and Cools and D’Esposito (2011), the Val allele promotes cognitive flexibility, while the Met allele promotes cognitive stability. Contrary to what we expected, Met homozygotes actually performed better than Met/Val heterozygotes but no better than Val homozygotes on one measure of updating (flexibility). Upon closer examination of the processes involved in the updating task, however, the results may not necessarily be contradictory as the task may have required greater stability than previously thought. In the fMRI experiment, although behavioral performance was largely similar between age groups and COMT genotypes on the fMRI tasks, we observed differences in activation such that younger adults and Met homozygotes showed higher levels of activation relative to older adults and Val carriers, respectively. Our results suggest that these higher levels of activation may have been relied upon to maintain similar levels of performance. Additionally, across the 3 experiments the effects of COMT indicate that an overall Met advantage cannot be assumed. Rather, the benefits of one allele compared to the other should be investigated in terms of the specific cognitive processes involved in the task at hand. Thus, it is important for future studies to continue characterizing the unity and diversity of executive functions and investigate factors that may influence these patterns behaviorally and neurally, such as age and genetics.