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1.
BMC Public Health ; 24(1): 1494, 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38835026

ABSTRACT

BACKGROUND: Unintended pregnancies and abortions among unmarried adolescents in Nigeria are outcomes of the interplay of multifaceted factors. Abortion, a global public health and social issue, impacts both developed and developing countries. This scoping review explored the literature and mapped the risk factors for unintended pregnancies and abortions among unmarried female adolescents in Nigeria. METHODS: A scoping literature search was conducted across databases, including PubMed, Science Direct, Web of Science, EBSCOhost, JSTOR, African Index Medicus, and Scopus. Inclusion criteria encompassed peer-reviewed articles and reports in English, focusing on unmarried female adolescents. The range of interest included the past incidents of having sex, unintended pregnancies, contraceptive use, and abortions among this demographic. Studies categorized as grey literature were excluded to ensure the reliability and validity of the synthesized information. RESULTS: A total of 560 articles, 553 identified through databases and 7 through hand search, were subjected to a comprehensive full-text review, resulting in the inclusion of 22 studies that met the criteria for the final review. The scoping review shed light on the past incidents of having sex, unintended pregnancies, contraceptive use, and abortions among unmarried adolescents in Nigeria. The range of incidence for having sex varied from 57.2% to 82.7%, with the prevalence of unintended pregnancies ranging from 23.4% to 92.7%. Contraceptive use was notably low, with 21.5% reporting low usage, contributing to the high incidence of abortions, ranging from 20.2% to 51.0%. Factors influencing unintended pregnancies included a lack of awareness of modern contraceptives and limited access to sexual and reproductive health information. For induced abortions, factors such as the impact on educational career, childbearing outside wedlock and fear of expulsion from school were identified. CONCLUSION: This scoping review, through a systematic examination of existing literature, contributes to a more robust understanding of the factors influencing unintended pregnancies and abortions among unmarried adolescents in Nigeria. The findings inform future research directions and guide the development of targeted interventions to improve reproductive health outcomes for this vulnerable population.


Subject(s)
Abortion, Induced , Pregnancy, Unplanned , Adolescent , Female , Humans , Pregnancy , Young Adult , Abortion, Induced/statistics & numerical data , Contraception Behavior/statistics & numerical data , Nigeria , Pregnancy in Adolescence/statistics & numerical data , Risk Factors , Sexual Behavior/statistics & numerical data , Single Person/statistics & numerical data
2.
Harefuah ; 163(6): 372-375, 2024 Jun.
Article in Hebrew | MEDLINE | ID: mdl-38884291

ABSTRACT

INTRODUCTION: Sperm banks have shifted from assisting heterosexual couples with male infertility to primarily serving single women and female couples through medical services, reflecting advances in fertility treatments and societal changes. AIMS: Evaluate demographic changes among single women who have applied for sperm donation during 30 years in the State of Israel. METHODS: This retrospective cohort study includes 4265 single women who received sperm donation between January 1992 and December 2021, at a tertiary medical center. We divided the follow-up period into 6 groups of 5 years each. A comparison was made of the demographic characteristics of single women applying for sperm donation in different periods according to: 1) age at the beginning of the treatment; 2) ethnic origin - 7 ethnic groups. RESULTS: The average age of single women who received sperm donation was 38.2±4.4 years. The average age of patients decreased from 39.58 years in 1997-1992 to 38.08 years in 2017-2021 (p-value<0.05). Ashkenazic Jews (38.4%) and Sephardic Jews (37.7%) were the most common ethnic origins among single women, with Arab women comprising only 0.2%. Single Jewish women of Ashkenazi descent seek sperm donation treatment almost a year earlier than their Sephardic counterparts (Arab countries and North Africa). CONCLUSIONS: Single Israeli women opting for early sperm donation carries significant clinical, social, and economic implications. Women from conservative social backgrounds appear to be less inclined to seek sperm donation as single individuals or tend to delay this option until a later age, in contrast to women from liberal backgrounds.


Subject(s)
Jews , Humans , Israel , Retrospective Studies , Adult , Male , Female , Jews/statistics & numerical data , Age Factors , Arabs/statistics & numerical data , Ethnicity/statistics & numerical data , Single Person/statistics & numerical data , Tissue Donors/statistics & numerical data , Spermatozoa , Sperm Banks/statistics & numerical data
3.
Reprod Health ; 18(1): 6, 2021 Jan 06.
Article in English | MEDLINE | ID: mdl-33407604

ABSTRACT

PURPOSE: Adolescents 360 (A360) is an initiative being rolled out across Nigeria with the aim of increasing voluntary modern contraception use among women aged 15 to 19 years. Using evaluation study baseline data, we identified sexuality, fertility and contraceptive use characteristics of young unmarried girls in South Western Nigeria. METHODS: A cross-sectional baseline survey of unmarried girls aged 15 to 19 years was conducted in Ogun state, Nigeria in August 2017. A clustered sampling design was used. We identified determinants of modern contraceptive use in this subpopulation using logistic regression. RESULTS: Of 12,024 women interviewed, 15.3% reported sexual intercourse in the past year. The majority of respondents (79.6%, 9525/11,967) had heard of contraception. 45.3% of sexually active respondents were using a modern contraceptive method. Of those using any method of contraception, male condoms (50.3%) were the most widely used modern method followed by the emergency contraceptive pill (16.7%). Following adjustment for socio-demographic characteristics, there was evidence that the use of modern contraception was positively associated with having never given birth, living in an urban area, current enrolment in education, high level of education, high socioeconomic status, exposure to information about contraception, perceived social support for contraception, and self-efficacy for contraception. CONCLUSIONS: In South Western Nigeria, unmarried sexually active adolescent girls have relatively low levels of modern contraceptive use. Programmes should aim to increase access to modern contraception and to increase social support and acceptability of contraceptive use.


Subject(s)
Contraception Behavior/statistics & numerical data , Contraception , Contraceptive Agents/therapeutic use , Family Planning Services , Single Person/psychology , Adolescent , Adult , Child , Contraception Behavior/ethnology , Contraceptive Agents/adverse effects , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Nigeria , Pregnancy , Pregnancy in Adolescence , Single Person/statistics & numerical data , Surveys and Questionnaires , Young Adult
4.
Reprod Biomed Online ; 41(6): 1007-1014, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33046376

ABSTRACT

RESEARCH QUESTION: What is the cumulative live birth rate (LBR) following donor intrauterine insemination (IUI-D) treatment in a large, retrospective, single-centre cohort of single women, same-sex couples and heterosexual patients? DESIGN: Outcomes from 8922 treatments performed in 3333 consecutive women (45% single, 43% from same-sex and 12% from heterosexual couples) were analysed in a 13-year retrospective study from a private, HFEA-regulated UK centre between January 2004 and December 2016. RESULTS: A total of 795 live births resulted in an overall delivery rate of 8.9% per cycle, including 24 (3%) twins. Age-specific crude and expected cumulative LBR calculated in four age groups (<35, 35-37, 38-39 and 40-42 years) were 29, 23, 21, 12% and 66, 49, 54, 28%, respectively. A plateau was reached after six cycles, beyond which there were few additional live births. There was no significant difference in cumulative LBR between single women and same-sex couples. In a multivariate analysis, female age (adjusted odds ratio [aOR] 0.92; 95% confidence interval [CI] 0.90-0.93; P < 0.0001), previous live birth following IUI-D (aOR 2.15; 95% CI 1.69-2.73; P < 0.0001) and mild stimulation (aOR 1.27; 95% CI 1.09-1.48; P = 0.02) had a significant effect on outcome, but relationship status or cycle rank did not. CONCLUSIONS: These results indicate there is little benefit performing more than six cycles of IUI-D in all women up to 40 years old, including those from same-sex relationships, while only three attempts seem reasonable in those aged 40-42 years. These results do not reflect current clinical guidelines in the UK. The authors found that consecutive IUI cycles, especially with mild stimulation, were an efficient treatment in all indications.


Subject(s)
Birth Rate , Heterosexuality/statistics & numerical data , Homosexuality, Female/statistics & numerical data , Insemination , Single Person/statistics & numerical data , Adult , Female , Humans , Infant, Newborn , Infertility, Male/epidemiology , Infertility, Male/therapy , Male , Pregnancy , Pregnancy Outcome/epidemiology , Retrospective Studies , Tissue Donors/statistics & numerical data , United Kingdom/epidemiology
5.
Am J Geriatr Psychiatry ; 28(1): 33-44, 2020 01.
Article in English | MEDLINE | ID: mdl-31522861

ABSTRACT

OBJECTIVE: This study aims to explore whether low mood is related to an increased dementia risk in two cohorts of older adults of different generations, and whether marital status and living situation modify this association. METHODS: Participants (≥70 years), free from dementia and living at home, were identified from two population-based studies: the Kungsholmen Project (KP; n = 1,197) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; n = 1,402). Low mood was obtained by self-report (KP and SNAC-K) at baseline in 1987-89 (KP) and 2001-04 (SNAC-K). Incident dementia cases were ascertained over 9 years, using the same diagnostic procedures and comparable criteria for the two cohorts (DSM-III-R in KP and DSM-IV-TR in SNAC-K). Hazard ratios (HR) were derived from Cox proportional hazards models. RESULTS: Those having low mood at baseline were at higher risk of dementia in both cohorts combined (HR: 1.2, 95% confidence interval (CI): 1.0-1.4) than those without low mood. However, an increased risk was detected only in those who did not have a partner (HR: 1.5, 95% CI: 1.2-1.9), or lived alone (HR: 1.5, 95% CI: 1.2-1.9), but not among those who had a partner or lived with someone (HR: 0.8, 95% CI: 0.5-1.2). CONCLUSION: Marital status and living situation have the potential to buffer the detrimental effects of low mood on dementia onset. Thus, specific attention from health care should target individuals having low mood and who do not have a partner or live alone.


Subject(s)
Affect , Affective Symptoms/epidemiology , Dementia/epidemiology , Marital Status/statistics & numerical data , Residence Characteristics/statistics & numerical data , Aged , Aged, 80 and over , Female , Health Surveys , Humans , Longitudinal Studies , Male , Risk , Single Person/statistics & numerical data , Sweden/epidemiology
6.
Scand J Rheumatol ; 49(3): 221-224, 2020 May.
Article in English | MEDLINE | ID: mdl-32162563

ABSTRACT

Objectives: To evaluate the influence of low socioeconomic status (SES) on mortality among patients with granulomatosis with polyangiitis (GPA).Methods: Using nationwide registers, we established a cohort of 827 patients diagnosed with GPA in the public hospital system of Denmark. For each patient, information regarding educational level, civil status, employment status, and comorbidities at time of GPA diagnosis was collected. We used Cox regression analyses to calculate hazard ratios (HRs) adjusted for age, gender, calendar period of GPA diagnosis, and Charlson Comorbidity Index score for preceding illnesses as a measure of relative risk of death. We assessed the risk of death associated with three measures of low SES: basic schooling only, civil status as single, and being unemployed or recipient of disability pension.Results: The median age of patients at GPA diagnosis was 61 (interquartile range 51-69) years, and 508 were 18-64 years old. During a total of 4337 person-years, 237 patients died. Among patients aged 18-64 years at GPA diagnosis, all three measures of low SES were identified as risk factors for death [basic schooling only: HR = 2.04, 95% confidence interval (CI) 1.30-3.19; civil status as single: HR = 1.95, 95% CI 1.24-3.05; being unemployed or recipient of disability pension: HR = 2.96, 95% CI 1.72-5.08]. The association between low SES and mortality was less pronounced among patients aged ≥ 65 years.Conclusions: Our observations indicate that low SES is associated with increased mortality in GPA, especially among patients of working age.


Subject(s)
Educational Status , Granulomatosis with Polyangiitis/epidemiology , Mortality , Single Person/statistics & numerical data , Social Class , Unemployment/statistics & numerical data , Adolescent , Adult , Aged , Cause of Death , Cohort Studies , Comorbidity , Denmark/epidemiology , Employment/statistics & numerical data , Female , Granulomatosis with Polyangiitis/mortality , Granulomatosis with Polyangiitis/therapy , Humans , Kaplan-Meier Estimate , Male , Marital Status/statistics & numerical data , Middle Aged , Pensions , Proportional Hazards Models , Risk Factors , Young Adult
7.
AIDS Behav ; 24(3): 791-801, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31429030

ABSTRACT

In China, the serious involuntary bachelorhood due to sex ratio imbalance in decades is expected to dramatically increase the spread of HIV through heterosexual contact. However, the higher HIV transmission risk and its correlates among never married men in rural China are not well understood. This study explored whether and how bachelorhood and migration increased the HIV transmission risk through commercial sex. By combining two cross-sectional survey data from never married men in rural areas and male migrants (including both married and unmarried men) in urban areas, a total of 1030 participants who were never married and age 28 and above or married male migrants were included in this study. The results show that both bachelorhood and migration put the never married male migrants at particularly higher HIV transmission risk by increasing both the possibility of engaging in commercial sex, and the frequency and inconsistency of condom use in commercial sex. Selection bias into marriage and neighborhood characteristics associated with exposure to commercial sexual risk may partly explain why male migrants that never married had a higher commercial sex related risk than that of married male migrants and never married non-migrant males.


Subject(s)
HIV Infections/psychology , Marital Status , Rural Population/statistics & numerical data , Sex Work/statistics & numerical data , Sexual Behavior/statistics & numerical data , Single Person/psychology , Transients and Migrants , Urban Population/statistics & numerical data , Adolescent , Adult , China/epidemiology , Cross-Sectional Studies , Emigration and Immigration , Female , HIV Infections/epidemiology , HIV Infections/transmission , Humans , Male , Marriage , Middle Aged , Sexual Behavior/psychology , Single Person/statistics & numerical data , Young Adult
8.
Int J Gynecol Cancer ; 30(5): 583-589, 2020 05.
Article in English | MEDLINE | ID: mdl-32184269

ABSTRACT

OBJECTIVES: Vulvar squamous cell carcinoma is a rare malignancy and lymph node involvement is the most significant prognostic factor. We aimed to evaluate the association between partnership status and mortality from vulvar squamous cell carcinoma, cancer stage at the time of presentation, and the decision for sentinel lymph node biopsy. METHODS: The US National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database was queried and different parameters were evaluated relative to partnership status. A total of 4851 patients with vulvar squamous cell carcinoma, >18 years of age, who presented between January 2010 to December 2015, were analyzed. Kaplan-Meier and Cox regression analyses were used to assess survival and hazard ratio. Multinomial regression analysis and χ2 were utilized to evaluate odd ratios and significance of variables. RESULTS: Most patients were unpartnered (58.5%), including never married (17.7%), divorced (13.8%), or widowed (27%). Partnered patients were mostly Caucasian (88.4%), insured (74%), and presented with stage I disease (57.2%), compared with unpartnered patients (79.1%), (61.7%), and (51.7%), respectively (p<0.01). The mean survival time (months) in partnered patients was longer, compared with unpartnered (p<0.001), and the difference between both groups increased from 9 months at stage I to 24 months at stage IV, which remained independently significant after adjusting the different variables. Cox regression showed that partnered patients had a lower hazard ratio than unpartnered patients (p<0.01). Mortality from vulvar squamous cell carcinoma increased with age at diagnosis, no surgery, and unemployment (p<0.01). Unpartnered patients were the least likely to undergo sentinel lymph node biopsy in early stages, compared with partnered (p<0.01). Univariate Cox regression analysis showed that not performing sentinel lymph node biopsy almost doubled the hazard ratio of vulvar squamous cell carcinoma (p<0.01). CONCLUSIONS: Partnership status should be considered when counseling patients for vulvar squamous cell carcinoma therapy and when recommending screening and follow-up to optimize patient care.


Subject(s)
Carcinoma, Squamous Cell/pathology , Marital Status/statistics & numerical data , Sentinel Lymph Node Biopsy/statistics & numerical data , Vulvar Neoplasms/pathology , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/mortality , Decision Making , Divorce/statistics & numerical data , Female , Humans , Middle Aged , Proportional Hazards Models , SEER Program , Single Person/statistics & numerical data , Spouses/statistics & numerical data , United States/epidemiology , Vulvar Neoplasms/mortality , Widowhood/statistics & numerical data
9.
J Biosoc Sci ; 52(1): 78-96, 2020 01.
Article in English | MEDLINE | ID: mdl-31169109

ABSTRACT

From an evolutionary perspective, childlessness may be considered a failure, as it implies that there will be no direct transmission of one's genetic material to later generations. It is also a pressing social issue, because in many contemporary advanced societies, levels of childlessness have increased, and particularly so among men. The absence of a partner is naturally a fundamental determinant of childlessness. Empirical evidence on how childlessness relates to individuals' partnership histories is nevertheless limited. This issue was analysed with Finnish population register data, which allow the complete cohabitation and marriage histories of individuals from age 18 years to be observed. For women and men born between 1969 and 1971, logistic regression models were estimated for childlessness at age 40 by partnership histories in terms of various stages in the process of union formation and dissolution, and accounting for several socioeconomic variables. A strong link between union histories and childlessness was found, with short partnership spells raising the risk of not becoming a parent. Later age when leaving the parental home raised female childlessness, while a short first-union duration related more strongly to male childlessness. These findings may be considered as providing insights into how specific life-history strategies affect reproductive outcomes, and highlight the need to develop new approaches to understand this feature of social inequality.


Subject(s)
Marriage/statistics & numerical data , Parents , Registries/statistics & numerical data , Single Person/statistics & numerical data , Adult , Female , Fertility , Finland , Humans , Logistic Models , Longitudinal Studies , Male
10.
Demography ; 56(2): 427-450, 2019 04.
Article in English | MEDLINE | ID: mdl-30834488

ABSTRACT

The rapid growth in cohabitation over the past quarter-century necessitates studies of changes in the stability and outcomes of cohabitation. We utilized data from the 1988 National Survey of Family Growth (NSFG) and the most recent NSFG data from 2011-2013 to examine the outcomes of two comparable cohorts of first premarital cohabiting women (1983-1988 and 2006-2013). Our results showed that cohabitations formed between 2006 and 2013 lasted longer-18 months, on average-than those formed in the mid-1980s, which lasted for an average of 12 months. We found that the lengthening of cohabitation over time cuts across sociodemographic characteristics-race/ethnicity, education, and motherhood status-and resulted mostly from the declining rate of transitioning to marriage. We found some support for the diverging destinies perspective in that disparities in the outcomes of cohabitation by education and by cohabiting birth have widened over time. Our analyses showed that changes in the outcomes of first premarital cohabiting unions over the past three decades were not due to compositional shifts in cohabitors. These results demonstrate the evolving dynamics of cohabitation over a 30-year window.


Subject(s)
Residence Characteristics/statistics & numerical data , Single Person/statistics & numerical data , Adolescent , Adult , Ethnicity/statistics & numerical data , Family Characteristics , Female , Humans , Illegitimacy , Male , Marriage/statistics & numerical data , Pregnancy , Surveys and Questionnaires , United States , Young Adult
11.
Heart Vessels ; 34(8): 1288-1296, 2019 Aug.
Article in English | MEDLINE | ID: mdl-30806777

ABSTRACT

Because living alone is associated with an increased risk of type 2 diabetes mellitus in men but not women, living alone may be a risk factor of cardiovascular events after acute myocardial infarction (AMI) in diabetic men. The aim of the present study was to investigate the association between living alone and mid-term clinical outcomes after AMI in diabetic men. We conducted a single center, retrospecitve study. The primary endpoint was the major adverse cardiovascular events (MACE) defined as the composite of all cause death, AMI, and target vessel revascularization. A total of 253 AMI men with diabetes mellitus were included from our hospital records, and divided into the living together group (n = 203) and the living alone group (n = 50). Median follow-up duration was 239 days (Q1: 94 days, Q3: 451 days). A total of 66 MACE was observed during the study period, and Kaplan-Meier curves were constructed to compare the MACE. The MACE was more frequently observed in the living alone group than the living together group (P = 0.041). Multivariate Cox regression analysis revealed that the living alone group was significantly associated with the MACE (Odds ratio: 1.770, 95% confidence interval 1.018-3.077, P = 0.043) after known clinical risk factors. In conclusion, living alone was significantly associated with the mid-term MACE after AMI in diabetic men. It may be important to provide multiple interventions including lifestyle guidance as well as sufficient acute medical care for such high-risk patients.


Subject(s)
Cardiovascular Diseases/etiology , Diabetes Mellitus, Type 2/complications , Myocardial Infarction/complications , Single Person/statistics & numerical data , Social Isolation , Aged , Aged, 80 and over , Cardiovascular Diseases/mortality , Cause of Death , Humans , Japan/epidemiology , Kaplan-Meier Estimate , Male , Middle Aged , Multivariate Analysis , Prognosis , Residence Characteristics/statistics & numerical data , Retrospective Studies , Risk Factors
12.
Eur J Cancer Care (Engl) ; 28(3): e13094, 2019 May.
Article in English | MEDLINE | ID: mdl-31090179

ABSTRACT

BACKGROUND: Oncologists may be particularly at risk of burnout. This systematic literature review and meta-analysis explores the prevalence of burnout and associated factors in oncologists. METHODS: The authors assessed 26 studies that utilised the Maslach Burnout Inventory (MBI) tool to measure burnout. Pooled prevalence rates were calculated via meta-analysis (MetaXL) using random effects models. RESULTS: Approximately 5,768 oncologists provided burnout data. A significant number experience burnout as highlighted by the pooled prevalence rates for MBI subscales of: emotional exhaustion at 32%; depersonalisation at 24%; and low personal accomplishment at 37%. Eighteen of the studies reported factors found to be significantly associated with high levels of burnout in oncology physicians. These were grouped into demographic differences, individual factors and work factors. CONCLUSION: Burnout was found to affect a significant proportion of oncologists. Burnout was associated with being single, being younger in age, reduced psychological well-being, difficulties outside of work, workplace demands and workplace stress. Burnout has considerable implications for oncology physicians and patient safety. Further insight into individual factors, and factors associated with lower burnout would be beneficial.


Subject(s)
Burnout, Professional/epidemiology , Oncologists/statistics & numerical data , Age Factors , Burnout, Professional/psychology , Humans , Marital Status/statistics & numerical data , Mental Health/statistics & numerical data , Occupational Stress/epidemiology , Occupational Stress/psychology , Oncologists/psychology , Prevalence , Risk Factors , Single Person/statistics & numerical data
13.
Eur J Contracept Reprod Health Care ; 24(1): 54-60, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30656978

ABSTRACT

OBJECTIVE: Premarital sexual practices and contraceptive prevalence rate (CPR) among unmarried women in China remain unclear. We conducted a systematic review and meta-analysis to estimate CPR and analyse contraceptive methods used by unmarried women between 1982 and 2017. METHODS: Wanfang, The China National Knowledge Infrastructure Database, MEDLINE, PubMed and Web of Science were systematically searched. Data on CPR and use of major contraceptive methods were extracted and pooled using a DerSimonian-Laird random effects model. RESULTS: Of 188 articles retrieved from five databases, 22 studies met our inclusion criteria. Overall CPR based on a random effects meta-analysis was 32.2% (95% confidence interval [CI] 24.7%, 39.8%). Pooled rates of contraceptive use were 61.4% (95% CI 47.9%, 74.9%) for condoms, 25.9% (95% CI 14.5%, 37.4%) for pills, 19.8% (95% CI 8.9%, 30.8%) for the rhythm method and 25.4% (95% CI 14.2%, 36.7%) for the withdrawal method. CONCLUSIONS: The sexual and reproductive health situation of unmarried women in China seems to have improved little since the 1990s. Our findings may help to optimise reproductive health care programmes and thereby reduce the alarming rates of unplanned pregnancies and abortions among unmarried women in China.


Subject(s)
Contraception Behavior/trends , Contraception/trends , Sexual Behavior/statistics & numerical data , Single Person/statistics & numerical data , Adolescent , Adult , China/epidemiology , Databases, Factual , Female , Humans , Pregnancy , Young Adult
14.
J Neurol Neurosurg Psychiatry ; 89(3): 231-238, 2018 03.
Article in English | MEDLINE | ID: mdl-29183957

ABSTRACT

BACKGROUND: Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a systematic review and meta-analysis of studies of the association between marital status and the risk of developing dementia. METHODS: We searched medical databases and contacted experts in the field for relevant studies reporting the relationship, adjusted for age and sex, between marital status and dementia. We rated methodological quality and conducted random-effects meta-analyses to summarise relative risks of being widowed, divorced or lifelong single, compared with being married. Secondary stratified analyses with meta-regression examined the impact of clinical and social context and study methodology on findings. RESULTS: We included 15 studies with 812 047 participants. Compared with those who are married, lifelong single (relative risk=1.42 (95% CI 1.07 to 1.90)) and widowed (1.20 (1.02 to 1.41)) people have elevated risk of dementia. We did not find an association in divorced people.Further analyses showed that less education partially confounds the risk in widowhood and worse physical health the elevated risk in lifelong single people. Compared with studies that used clinical registers for ascertaining dementia diagnoses, those which clinically examined all participants found higher risk for being unmarried. CONCLUSIONS: Being married is associated with reduced risk of dementia than widowed and lifelong single people, who are also underdiagnosed in routine clinical practice. Dementia prevention in unmarried people should focus on education and physical health and should consider the possible effect of social engagement as a modifiable risk factor.


Subject(s)
Dementia/epidemiology , Divorce/statistics & numerical data , Marriage/statistics & numerical data , Single Person/statistics & numerical data , Widowhood/statistics & numerical data , Confounding Factors, Epidemiologic , Educational Status , Humans , Marital Status/statistics & numerical data , Observational Studies as Topic , Protective Factors , Risk Factors
15.
Demography ; 55(3): 849-875, 2018 06.
Article in English | MEDLINE | ID: mdl-29693225

ABSTRACT

Drawing on data from the American Community Survey, we compare patterns of assortative mating in first marriages, remarriages, and mixed-order marriages. We identify a number of ascribed and achieved characteristics that are viewed as resources available for exchange, both as complements and substitutes. We apply conditional logit models to show how patterns of assortative mating among never-married and previously married persons are subject to local marriage market opportunities and constraints. The results reveal that previously married individuals "cast a wider net": spousal pairings are more heterogamous among remarriages than among first marriages. Marital heterogamy, however, is reflected in systematic evidence of trade-offs showing that marriage order (i.e., status of being never-married) is a valued trait for exchange. Never-married persons are better positioned than previously married persons to marry more attractive marital partners, variously measured (e.g., highly educated partners). Previously married persons-especially women-are disadvantaged in the marriage market, facing demographic shortages of potential partners to marry. Marriage market constraints take demographic expression in low remarriage rates and in heterogamous patterns of mate selection in which previously married partners often substitute other valued characteristics in marriage with never-married persons.


Subject(s)
Marriage/statistics & numerical data , Adult , Age Factors , Family Characteristics , Female , Humans , Male , Population Dynamics , Sex Factors , Single Person/statistics & numerical data , Socioeconomic Factors
16.
BMC Womens Health ; 18(1): 181, 2018 11 09.
Article in English | MEDLINE | ID: mdl-30413203

ABSTRACT

BACKGROUND: Individuals with high sexual compulsivity are preoccupied with their sexual desire to such an extent that it interferes with their normal daily life and can inhibit self-control. Previous studies have found a close association between sexual compulsivity and condomless sex among different populations; however, no studies have investigated this among unmarried female migrant workers in China. This study aimed to validate the Sexual Compulsivity Scale (SCS) for appropriate use and examine the association between sexual compulsivity and condomless sex in this target population. METHODS: In 2015, we recruited 1325 unmarried female migrant workers in Shanghai, China. Information about sociodemographics, sexual compulsivity, and condomless sex were collected using a structured questionnaire. Exploratory factor analysis and reliability analysis were performed to validate the Chinese version of the SCS. Multiple logistic regression analyses were used to examine the association between sexual compulsivity and condomless sex. RESULTS: The prevalence of condomless sex in the previous 6 months was 66.8% among all participants. The SCS was proven internally consistent for the overall scale (Cronbach's α = 0.89), and two factors, Social Disruptiveness (Cronbach's α = 0.87) and Perceived Self-Control (Cronbach's α = 0.84), were extracted. With mean total score of 18.25 (standard deviation = 4.94) after adjusting for significant sociodemographic factors, the SCS total scores (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI] = 1.02-1.07) and two subscale scores (AOR = 1.07, 95% CI = 1.02-1.13; AOR = 1.06, 95% CI = 1.02-1.10) were all related to inconsistent condom use with partners in the previous 6 months. CONCLUSIONS: The Chinese version of the SCS was found to be well adaptable for use among unmarried Chinese female migrant workers and a potential predictor for condomless sex. In addition to safe sex interventions, counselling on managing sexually compulsivity should also be provided in this population.


Subject(s)
Asian People/psychology , Compulsive Behavior/psychology , Safe Sex/psychology , Sexual Behavior/psychology , Sexual Partners/psychology , Single Person/psychology , Transients and Migrants/psychology , Adolescent , Adult , Asian People/statistics & numerical data , China , Cross-Sectional Studies , Factor Analysis, Statistical , Female , Humans , Odds Ratio , Reproducibility of Results , Safe Sex/statistics & numerical data , Sexual Behavior/statistics & numerical data , Single Person/statistics & numerical data , Surveys and Questionnaires , Transients and Migrants/statistics & numerical data , Young Adult
17.
J Nerv Ment Dis ; 206(3): 160-168, 2018 03.
Article in English | MEDLINE | ID: mdl-28837427

ABSTRACT

Suicide is one of the leading causes of death among medical students, second to car accidents. We investigated the prevalence and predictors of suicidal ideation (SI) among medical students in Brazil. This is a cross-sectional study with 475 medical students of a public university. The research protocol included data on sociodemographics and academic life, and structured instruments to assess social support and psychopathological symptoms, including the Beck Depression Inventory (BDI). The outcome was evaluated using the BDI suicide item. Bivariate analyses were followed by logistic regression. SI was present in 34 participants (7.2%). In the logistic regression, SI remained associated with living alone, thoughts of abandoning the course, moderate or severe depressive symptoms, and probable obsessive-compulsive disorder. SI is frequent among medical students and can be identified with a simple screening question. Special attention should be given to students living alone, with thoughts of abandoning the course, and relevant depressive or obsessive-compulsive symptoms.


Subject(s)
Students, Medical/psychology , Suicidal Ideation , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Marital Status , Prevalence , Psychiatric Status Rating Scales , Risk Factors , Single Person/psychology , Single Person/statistics & numerical data , Students, Medical/statistics & numerical data , Young Adult
18.
BMC Public Health ; 18(1): 625, 2018 05 15.
Article in English | MEDLINE | ID: mdl-29764402

ABSTRACT

BACKGROUND: Despite reports of mental health issues, suicidality has not been closely examined among the migrant population. The association between induced abortion and suicidal ideation is unknown among unmarried female migrant workers of reproductive age in China. This study aims to examine induced abortion and suicidality among the Chinese migrant population. METHODS: We recruited 5115 unmarried female migrant workers during 2015 to 2016 from Shanghai, Beijing and Guangzhou, and collected demographic, psychosocial, reproductive and mental health information using structured questionnaires. We used logistic regression models to examine the association between lifetime induced abortion and suicidal ideation during the past year among the subjects. RESULTS: Overall, 8.2% of the subjects had suicidal ideation during the past year, and 15.5% of the subjects experienced induced abortion. Induced abortion was associated with nearly twice the odds of having past-year suicidal ideation (Odds ratio, OR = 1.89; 95% confidence interval, CI: 1.46, 2.44) after adjusting for age, education, years in the working place, tobacco use, alcohol consumption, daily internet use, attitude towards premarital pregnancy, multiple induced abortion, self-esteem, loneliness, depression, and anxiety disorders. The association was stronger in those aged > 25 (OR = 3.37, 95% CI = 2.16, 5.28), with > 5 years of stay in the working place (OR = 2.98, 95% CI = 2.02, 4.39), the non-anxiety group (OR = 2.28, 95% CI = 1.74, 3.00), and the non-depression group (OR = 2.94, 95% CI = 2.08, 4.15). CONCLUSIONS: Induced abortion was associated with increased odds for suicidal ideation among the unmarried female migrant workers in urban cities in China. More attention should be paid to the mental health of the population.


Subject(s)
Abortion, Induced/statistics & numerical data , Single Person/psychology , Suicidal Ideation , Transients and Migrants/psychology , Adolescent , Adult , Beijing/epidemiology , China/epidemiology , Cities , Cross-Sectional Studies , Female , Humans , Pregnancy , Risk Factors , Single Person/statistics & numerical data , Surveys and Questionnaires , Transients and Migrants/statistics & numerical data , Young Adult
19.
Appetite ; 126: 43-53, 2018 07 01.
Article in English | MEDLINE | ID: mdl-29522791

ABSTRACT

The purpose of this article is to map the data currently available on the subject of eating practices and food environments in small (i.e. one- and two-person) households. Specifically, the enquiry is focused on commensality; the act of eating together. Research dates from the late 1980s, however, there are few recent publications on this subject. Searching Ovid MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, ProQuest and Google Scholar, 2949 papers were found, but only 457 discussed any element of the research questions. These were further distilled to a count of 117, by abstract reading to 53 at which point, quality, location and study focus eliminated a further 34 articles leaving 19 articles. After full reading, it was clear that only seven of these focused on the research question in detail and these are marked as four-star articles by bold text. The 19 articles are analysed for quality and their aspects of relevance to the central research question is discussed.


Subject(s)
Family Characteristics , Feeding Behavior , Australia , Environment , Food/statistics & numerical data , Humans , Single Person/statistics & numerical data , United Kingdom , United States
20.
J Biosoc Sci ; 50(2): 161-177, 2018 03.
Article in English | MEDLINE | ID: mdl-28382871

ABSTRACT

This study aimed to contribute to the evidence on the timing of sexual debut in young people in sub-Saharan African countries. Data were extracted from 34 nationally representative surveys conducted in the region between 2006 and 2014. The study sample comprised unmarried women (n=167,932) and men (n=76,900) aged 15-24 years. Descriptive techniques and Cox proportional regression models were used to estimate the timing of sexual debut, and Kaplan-Meier hazard curves were used to describe the patterns of sexual debut in each country by sex. For the countries studied, sexual debut for both women and men occurred between the ages of 15 and 18 years, with median ages of 16 for women and 17 for men. Overall, education and household wealth provided significant protection against early sexual debut among women, but the reverse was found among men for wealth. Women in rural areas, in female-headed households and in Central, South and West Africa reported higher hazards of early commencement of sexual activity than their counterparts in urban, male-headed households and East Africa. However, the impact of these variables on male sexual debut did not follow a consistent pattern. Varied timing, as well as country-specific risk factors associated with sexual debut for young women and men across sub-Saharan Africa, were identified. Sexual health programmes and interventions for young people may require different approaches for young women and men.


Subject(s)
Coitus , Single Person/statistics & numerical data , Adolescent , Adult , Africa South of the Sahara , Age Factors , Educational Status , Female , Humans , Kaplan-Meier Estimate , Male , Proportional Hazards Models , Social Class , Surveys and Questionnaires , Young Adult
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