Marital status, educational level, and mid-term mortality risk in 5924 patients after transcatheter aortic valve implantation.

Aims: There is scarce knowledge about the association between social factors and mid-term outcome in older patients undergoing transaortic valve implantation (TAVI). Our aim in this study is to explore associations between marital status, educational level, and mortality risk in patients after TAVI. Methods and results: Patients aged ≥65 who underwent TAVI in Sweden during 2014-2020 were identified from the SWEDEHEART registry. Social factors and comorbidities were collected from mandatory national registries. Cox regression models adjusted for baseline comorbidities, age, sex, year of TAVI, social factors, and smoking were used to estimate mortality risk. Median follow-up was 1.9 years (interquartile range: 0.9-3.3). Overall, 5924 patients were included (47.3% women), with a mean age of 82.1 years (standard deviation: 6.1). Of the 1410 (23.8%) deaths during follow-up, 721 (51.2%) were related to cardiovascular causes. Patients with low education (<10 years) had a higher risk of mortality than patients with the highest education level [>12 years; adjusted hazard ratio (aHR): 1.20, 95% confidence interval (CI): 1.03-1.41]. Never being married/cohabiting was associated with an increased risk of mortality in comparison with being married/cohabiting (aHR: 1.32, 95% CI: 1.05-1.65). A separate analysis of men and women showed an increased risk among never-married men (aHR: 1.63, 95% CI: 1.23-2.14) but not among never-married women (aHR: 0.85, 95% CI: 0.56-1.30). Conclusion: Disadvantage in social factors was associated with an increased mortality risk after TAVI in older patients. These findings emphasize the importance of developing strategies to increase health literacy and social support after TAVI in older patients with unfavourable social factors.

Nomophobia (no-mobile-phone phobia) among the undergraduate medical students.

Nomophobia (no-mobile-phone phobia) is the fear and anxiety of being without a mobile phone. This study pioneers the investigation of nomophobia in Afghanistan using the Nomophobia Questionnaire (NMP-Q), addressing a crucial gap in the field. We collected statistical data from 754 undergraduate medical students, comprising men (56.50 %) and women (43.50 %), and analyzed the dimensions of nomophobia. While results revealed that all but two participants were nomophobic, they identified three significant dimensions affecting the level of nomophobia among participants: (a) gender, (b) age, and (c) marital status. The study's contributions are precious, given the peculiarity of Afghan political turmoil, security, and human rights issues, especially for women. For example, the study's data collection was abruptly halted in December 2022 due to the Taliban regime's decision to make it illegal for women to enroll in universities as students. Therefore, while examining the characteristics of nomophobia across societies is imperative, it is also vital to investigate what is true of one society, Afghanistan, at one point in time and space. The study concludes by emphasizing the need to broaden participants' scope in future studies to better understand the prevalence of nomophobia across broader societal contexts and forces.

Combined effect of alcohol consumption patterns and marital status on all-cause mortality among middle- and old-aged people: A longitudinal study from Korea.

PURPOSES: The association between alcohol consumption, health, and mortality is intricate, with marital status being a determinant of drinking behavior. This study investigated the combined effect of alcohol consumption patterns and marital status on mortality in middle-aged and older Korean individuals. METHODS: This prospective longitudinal study used data from the Korean Longitudinal Study of Aging, conducted from 2006 to 2020. The study population comprised individuals who were consuming alcohol around the time of the basic survey and participated in the 1st wave 2006 study. We divided 3,823 drinkers older than 45 into four groups: "normal drinker and married (NM)," "normal drinker and unmarried (NUM)," "excessive drinker and married (EM)," and "excessive drinker and unmarried (EUM)." A Cox proportional hazards regression analysis was performed for survival analysis. RESULTS: The median survival time of the EUM group was 11.9 years. After adjusting for the covariates, the mortality risk among the NUM, EM, and EUM was approximately 1.67 times, 1.33 times, and 3.10 times higher than that among the NM, respectively. CONCLUSIONS: Middle- and old-aged unmarried people with excessive drinking patterns constitute a high-risk group for mortality. Community healthcare providers should focus on characteristics that differ by age, considering family-related factors and assessing alcohol consumption patterns to reduce mortality. Among middle and old-aged people, support for unmarried and excessive drinkers should be strengthened, and consultation on visiting community-based clinics should be promoted to improve firmly established alcohol consumption patterns.

Association between long-term exposure to PM2.5 chemical components and metabolic syndrome in middle-aged and older adults.

Background: Previous studies indicated that exposure to ambient fine particulate matter (PM2.5) could increase the risk of metabolic syndrome (MetS). However, the specific impact of PM2.5 chemical components remains uncertain. Methods: A national cross-sectional study of 12,846 Chinese middle-aged and older adults was conducted. Satellite-based spatiotemporal models were employed to determine the 3-year average PM2.5 components exposure, including sulfates (SO4 2-), nitrates (NO3 -), ammonia (NH4 +), black carbon (BC), and organic matter (OM). Generalized linear models were used to investigate the associations of PM2.5 components with MetS and the components of MetS, and restricted cubic splines curves were used to establish the exposure-response relationships between PM2.5 components with MetS, as well as the components of MetS. Results: MetS risk increased by 35.1, 33.5, 33.6, 31.2, 32.4, and 31.4% for every inter-quartile range rise in PM2.5, SO4 2-, NO3 -, NH4 +, OM and BC, respectively. For MetS components, PM2.5 chemical components were associated with evaluated risks of central obesity, high blood pressure (high-BP), high fasting glucose (high-FBG), and low high-density lipoprotein cholesterol (low-HDL). Conclusion: This study indicated that exposure to PM2.5 components is related to increased risk of MetS and its components, including central obesity, high-BP, high-FBG, and low-HDL. Moreover, we found that the adverse effect of PM2.5 chemical components on MetS was more sensitive to people who were single, divorced, or widowed than married people.

Can family resources and place of residence play a beneficial role in explaining burnout levels in working men?

INTRODUCTION AND OBJECTIVE: The phenomenon of occupational burnout is a common factor affecting employees' health. In a study on occupational burnout it may happen that variables that are not among the main predictors of burnout can noticeably affect burnout and the main independent variables. The aim of this study was to verify hypotheses about the role of demographic variables in explaining levels of stress and burnout, based on the example of men working as firefighters and 112 emergency operators. MATERIAL AND METHODS: A total of 823 men employed as firefighters and 112 emergency number operators were surveyed. The study applied the LINK Occupational Burnout Questionnaire, the PSS-10 Perceived Stress Scale and a demographic questionnaire. It was followed by an analysis of covariance of qualitative variables and quantitative predictors (ANCOVA). RESULTS: The study showed that living in rural areas was associated with lower levels of burnout among the men in the examined group. A similar relationship was detected for marital status, having children and secondary education. The other main variable, the level of perceived stress and age, showed typical associations with occupational burnout. CONCLUSIONS: The search for the causes of occupational burnout should not be narrowed only to stressors related to the demands of the workplace. Demographic variables are important elements of an employee's non-work environment and often a source of personal strengths. However, it should be remembered that the same factor can have both a protective function as well as a source of additional stress.

Longitudinal relationship between loneliness and cognitive function among unmarried older adults in Malaysia: exploring gender disparities.

BACKGROUND: The status of being unmarried is commonly associated with a higher tendency for loneliness and cognitive impairment. However, it has yet to be determined whether there is a link between loneliness and cognitive function among unmarried older people. Therefore, this study used longitudinal data to determine the link between loneliness and cognitive function, and the subjects were unmarried community-dwelling older adults. METHODS: The study follows up a sample of 733 unmarried older adults who were either never married, widowed, divorced or separated, from waves one and two of the 'Neuroprotective Model for Healthy Longevity among Malaysian Older Adults' study. The main statistical analysis used to answer the research question was the PROCESS macro (model 1) for SPSS. RESULTS: The study found that increased loneliness was associated with a decline in cognitive function over a 3-year period. Additionally, gender moderated the link between loneliness and cognitive function, with this association being particularly prominent in older men. CONCLUSIONS: Loneliness among unmarried older people should be given attention as it could lead to deteriorating cognitive function. Notably, older men experience a more substantial impact of loneliness on cognitive function than women. Therefore, special attention should be focused on this population, and more social services should be developed to reduce the incidence of cognitive impairment, improve their quality of life, and promote successful ageing.

Racial discrimination predicts subjective cognitive decline: Perceived relationship support buffers the association.

OBJECTIVES: Recent studies show that chronic exposure to racial discrimination increases the occurrence of subjective cognitive decline (SCD) among Black Americans. Little research, however, has examined potential for protective factors, such as perceived partner support, to buffer these effects. METHODS: This study utilized longitudinal data over a 10-year period from the Family and Community Health Study (FACHS) to examine the associations between experiences of racial discrimination, marital status, partner support, and SCD, measured by the Everyday Cognition (ECog) Scale, among 286 middle-aged Black American women. Regression analysis and internal moderator analyses were employed to analyze the data. RESULTS: About 31% were in married relationships. Thirty-four percent reported cognitive decline, especially in forgetting object locations and dates. Chronic discrimination predicted SCD, and for those in couple relationships, partner support buffered the adverse effects of discrimination, with those in warm and supportive relationships experiencing less SCD than those in relatively unsupportive relationships or not in a relationship. CONCLUSIONS: The study's findings support the idea that racism influences SCD and underscores the importance of supportive couple relationships in promoting resilience. The results also highlight the potential value of culturally relevant family interventions and support strategies to reduce the impact of discrimination-induced stress on cognitive health.

Improving the timeliness of birth registration in Fiji through a financial incentive.

Background: Fiji is a Pacific Island nation with the predominant ethnic groups indigenous Fijians (iTaukei) (62 %) and Fijians of Indian descent (31 %). This study reports on the effect of a Parental Assistance Payment Program (PAPP) tied to on-time birth registration, available in Fiji from August 2018 to July 2020. Methods: Unit record birth registration data (n = 117,829) for children born during 2016-22 were used to calculate mean birth-to-registration intervals and the likelihood of on-time birth registration (within 365 days) before the PAPP (January 2016-July 2018) compared to during the PAPP (August 2018-July 2020), by population disaggregations (sex, ethnicity, age, marital status). Results: During the PAPP, mean birth-to-registration intervals declined sharply by 81 %, from 665 days (95 %CI: 658-671) to 124 days (121-127). The largest declines were among i-Taukei children (803 to 139 days, 83 %) compared to non-iTaukei (283 to 76 days, 73 %); mothers aged 10-19 years (880 to 134 days, 85 %) compared to ≥20 years (653 to 123 days, 81 %); and single mothers (983 to 145 days, 85 %) compared to married mothers (570 to 115 days, 80 %). On-time birth registration increased from 57 % to 93 %, and the adjusted hazard ratio showed children born during the PAPP were 2.3 times more likely (95 %CI: 2.2-2.4) to have their birth registered on-time compared to children born before the PAPP. When the PAPP was discontinued in August 2020, the birth-to-registration interval increased sharply in all population groups. Conclusions: During the two-year period the PAPP was available, it was highly effective at improving the timeliness of birth registration, particularly among iTaukei children, young mothers, and single mothers. After the PAPP was discontinued, the timeliness of birth registration deteriorated sharply. Longer post-PAPP follow-up time (≠5 years) is required to determine whether the timeliness of birth registration has deteriorated to levels similar to those during the pre-PAPP period.

Trends and risk indicators for high fertility among Nigerian female youth aged 15-29 years: A pooled data analysis.

Introduction: Nigeria's age-specific fertility rates are highest among the country's youth population, yet little is known about the factors that influence female youth fertility in Nigeria. This study examined fertility trends and risk factors associated with high fertility among Nigerian female youth aged 15 to 29. Methods: We examined a pooled data from four rounds of the Nigeria Demographic and Health Surveys (conducted in 2003, 2008, 2013, and 2018). Of the data, 62,713 female youth were extracted for this study. Descriptive statistics and multinomial logistic regression were employed. Results: The results show that 21.5 % of the sample had 3 or more children. Between 2003 and 2018, there was a drop of only 28 live births per 1000 women among the youth. Female youth with less than a secondary education were twice as likely to have 1-2 children (adjusted odds ratio [aOR] = 1.54, 95 % confidence interval [CI] = 1.43-1.66) and three times as likely to have 3 or more children (aOR = 3.32, 95 % CI = 3.03-3.64) compared to those with a secondary education or higher. Unmarried female youth were 95 % less likely to have 1-2 children and 98 % less likely to have 3 or more children. Additionally, female youth from the lowest-income families were twice as likely to have 1-2 children (aOR = 2.06, 95 % CI = 1.84-1.84) and four times as likely to have 3 or more children (aOR = 3.50, 95 % CI = 3.03-4.05) compared to those from the highest-income families. Conclusion: To control high fertility, significant improvement in education, employment, ending early marriage, poverty and unfavorable pronatalist cultural norms, are required.

Adverse childhood experiences, marital status and depressive symptoms in later life among the Chinese middle-aged and older adults : the mediating role of marital status.

BACKGROUND: Many studies have shown that adverse childhood experiences (ACEs) lead to adverse social relations in middle-aged and older adults and harm physical and mental health, but few studies have focused on the impact of ACEs on marital status in middle-aged and older adults and the potential influence of marital status between ACEs and depressive symptoms. PURPOSE: This study aimed to analyze the effect of ACEs on marital status and depressive symptoms in the Chinese middle-aged and older adults, and to explore the mediating role of marital status in the association between ACEs and depressive symptoms in middle-aged and older adults. METHOD: This study used the China Health and Retirement Longitudinal Study (CHARLS) 2014 life history survey and 2015 and 2018 follow-up data to analyze, ten ACEs conditions and marital status were collected by questionnaire, using the Center for Epidemiological Studies Depression Scale (CESD-10) 10-item short form to assess depressive symptoms. The association between cumulative ACEs and marital status was assessed by constructing a multinomial logistic regression (MLR) model, as well as a binary logistic regression model to assess the association between ACEs and depressive symptoms. The mediating role of marital status in the association between ACEs and depressive symptoms was also assessed. RESULTS: A total of 10,246 individuals aged 45 years or older were included in the analysis. Compared to individuals who did not experience ACEs, those who experienced two or more ACEs had a higher risk of being unmarried (seperated/divorced/never married) (OR = 1.67, 95% CI=[1.10,2.51]) and a higher risk of depressive symptoms (OR = 1.66, 95% CI=[1.49,1.84]) in middle and old age. Unmarried status partially mediated the association of ACEs with depressive symptoms. CONCLUSION: Chinese middle-aged and older people who experienced two or more ACEs have higher risks of unmarried status and depressive symptoms, and unmarried status partially mediated the ACEs-depressive symptom association. These findings reveal the fact that we need to develop life-cycle public health strategies to reduce exposure to ACEs and society should give more attention to the marital status of older people, thereby reducing the risk of depression among middle-aged and older adults in China.

The role of marital status in gallbladder cancer: a real-world competing risk analysis.

BACKGROUND: The association between marital status and gallbladder cancer (GBC) remains uncertain. This study aimed to verify the relationship between marital status and GBC and construct a prognostic nomogram to predict the impact of marital status on GBC patients. METHOD: GBC patients were divided into married and unmarried groups using data from the Surveillance, Epidemiology, and End Results (SEER) database. We employed competing risk analyses, propensity score matching (PSM), and Kaplan-Meier survival analyses. The relationship between marital status and GBC was then verified, and the predicted nomogram was constructed. RESULTS: A total of 3913 GBC patients were obtained from the SEER database, and an additional 76 GBC patients from Hangzhou Traditional Chinese Medicine Hospital were selected as the external validation group. The competing risk analysis revealed a significant disparity in the 5-year cumulative incidence of cancer-specific death (CSD) between the two cohorts (59.1% vs. 65.2%, p = 0.003). Furthermore, the multivariate competing hazards regression analysis identified a significant association (HR, 1.17; 95% CI, 1.04-1.31; p = 0.007) between marital status and CSD. To assess the 1-, 3-, and 5-year risks of CSD, a comprehensive competing event nomogram was constructed using factors derived from the multivariate analysis. The area under the receiver operating characteristic curve (AUC) values for the 1-, 3-, and 5-year training cohorts were 0.806, 0.785, and 0.776, respectively. In the internal validation cohort, these values were 0.798, 0.790, and 0.790, while the external validation cohort exhibited AUC values of 0.748, 0.835, and 0.883 for the corresponding time intervals. Furthermore, calibration curves demonstrated a commendable level of concordance between the observed and predicted probabilities of CSD. CONCLUSION: Marriage was a protective factor for GBC patients after taking competing risk into consideration. The proposed nomogram demonstrated exceptional predictive power.

Association of marital status with cardiovascular death risk in patients with lung cancer: A population-based study.

Background: To investigate the association of marital status on cardiovascular death risk in lung cancer patients. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) database in the United States from 2011 to 2015 (N = 118,293), the association between marital status and cardiovascular death (CVD) risk in patients with lung cancer was assessed by competing-risks regression models. Results: Unmarried status was associated with increased risk of cardiovascular death in lung cancer patients [hazard ratio (HR)  =  1.398, 95 % confidence interval (CI): 1.268-1.542], which remained significant even after adjusting for potential covariates (HR = 1.407, 95 % CI: 1.276-1.551). Further unmarried subgroups analysis showed that the different unmarried status were associated with increased cardiovascular death risk as follows: single (HR = 1.397, 95 % CI: 1.236-1.1.580), separated (HR = 1.630, 95 % CI: 1.153-2.305), divorced (HR = 1.318, 95 % CI: 1.158-1.500), and widowed (HR = 1.561, 95 % CI: 1.393-1.749). Further subgroup analysis by sex revealed that compared to male lung cancer patients with married, CVD risk was significant increased in their counterparts with widowed (adjusted HR = 1.509, 95 % CI: 1.291-1.764, P<0.001), single (adjusted HR = 1.361, 95 % CI: 1.168-1.585, P<0.001) and divorced (adjusted HR = 1.353, 95 % CI: 1.177-1.555, P<0.001) rather than those with separated. However, similar phenomena was only observed in female lung cancer patients with widowed (adjusted HR = 1.414, 95 % CI: 1.220-1.640, P<0.001) and single (adjusted HR = 1.438, 95 % CI: 1.195-1.730, P<0.001). Conclusion: Unmarried status was associated with increased cardiovascular death risk in patients with lung cancer, which highlighted that more attention and humanistic/supportive care should be offered to unmarried lung cancer patients for improving the prognosis.

Which Social Variables Predict Diabetes Onset? Robust Findings in Two National Surveys.

BACKGROUND AND OBJECTIVES: The role of social factors in diabetes onset has been obscured by wide variation in their conceptualization and operationalization. We apply 3 theoretical frameworks to categorize social relationship variables along several dimensions and identify which dimension(s) are robustly associated with incident diabetes in the older adult population. RESEARCH DESIGN AND METHODS: The National Social Life, Health, and Aging Project (n = 2,365) and the Health and Retirement Study (n =11,824) provided longitudinal data from 57 to 90-year-old respondents over a 4- to 5-year period. Logistic regression models were used to test associations of 15 social variables measured identically in both data sets with diabetes onset measured as respondents' first report of a physician's diagnosis. RESULTS: In both studies, not being married, experiencing strain in a spousal relationship, and feeling lonely were associated with increased risk for diabetes onset at follow-up. Inconsistent or null findings were observed for social support, social activity, network size, number of friends and relatives, living alone, and closeness to network members. DISCUSSION AND IMPLICATIONS: Robust findings in 2 large-scale surveys support the importance of the valence dimension (i.e., positive and negative); specifically, alleviating negative aspects of social life might more effectively reduce risk for diabetes than augmenting positive ones. Findings were not aligned with social variables differing on the subjectivity dimension (i.e., structural, functional, and qualitative aspects of social connections). Future work needs consistent conceptualization and measurement of social factors to correctly identify and categorize risk factors for diabetes onset and other health conditions in older adults.

Predictive factors and symptom severity spectrum in adult schizophrenia: Potential insights for improved management and adequate care.

Schizophrenia is one of the most disabling psychiatric disorders characterized by positive (hallucinations, delusions, formal thinking disorder) and negative symptoms (anhedonia, lack of speech and motivation). The present study aimed to identify the predictive factors of schizophrenia in adults, and potential differences in the environment of origin, sex, levels of occupational stress, intellectual level, marital status and age of onset of the disease depending on the severity of symptoms using analysis of data collected from 120 patients with a diagnosis of schizophrenia. The study was conducted at the 'Prof. Dr. Alexandru Obregia' Clinical Psychiatric Hospital in Bucharest and included adult patients hospitalized between March 2018 and January 2021 diagnosed with schizophrenia and evaluated by general clinical examination, psychiatric, neurological and psychological evaluation. Results revealed that robust predictors of mild and moderate symptoms were affective symptoms, heredo-collateral history of schizophrenia, late onset, the presence of positive and negative symptoms, substance abuse, stress and marital status, unmarried, lower IQ and mental deficiency. For moderate-severe and severe symptoms, predictors were affective symptoms, heredo-collateral history of schizophrenia and affective disorders, substance abuse, stress, borderline IQ and mild mental deficiency. The present results can be used for further development of psychopharmacological management of schizophrenia.

Exploring the impact of maternal marital status on child health: insights from the 2022 Tanzanian Demographic and Health Survey.

The SDG 2.2 targets the end of all forms of malnutrition by 2030. Despite the efforts by the Tanzania government to attain this goal, over 30 percent of children under-five are stunted. This study explored the relationship between maternal marital status and child health outcomes in Tanzania using the Tanzania Demographic and Health Survey data set of 2022. A multiple logistic regression was conducted with the binary outcome variable "Stunted," using predictors such as the mother's age and education level, the child's birth size, birth order, and gender, as well as other household characteristics. The study findings highlight a significant association between maternal marital status and child stuntedness. The mothers in a marriage relationship are 30% less likely to have stunted children (OR=0.70, 95%CI, 0.56-0.86) compared to the mothers outside the marriage relationship. Mothers with primary and secondary education or higher, show a lower likelihood of having stunted children (OR=0.90, 95%CI 0.70-1.17) and (OR=0.68, 95%CI 0.44- 1.03) respectively compared to their uneducated counterparts. In other words, a mother being married or educated reduces the odds of her children being stunted. The probability of child stuntedness reduces as the wealth quintile of the household increases. This study contributes to the understanding of the factors influencing child health outcomes in Tanzania especially the role of marriage.

L'ODD 2.2 vise à mettre fin à toutes les formes de malnutrition d'ici 2030. Malgré les efforts du gouvernement tanzanien pour atteindre cet objectif, plus de 30 % des enfants de moins de cinq ans sont atteints de retard de croissance. Cette étude explore la relation entre le statut matrimonial des mères et les résultats de santé des enfants en Tanzanie en utilisant l'ensemble de données de l'Enquête Démographique et de Santé de Tanzanie de 2022. Une régression logistique multiple a été réalisée avec la variable de résultat binaire "retard de croissance", en utilisant des prédicteurs tels que l'âge et le niveau d'éducation de la mère, la taille à la naissance de l'enfant, l'ordre de naissance, le sexe, ainsi que d'autres caractéristiques du ménage. Les résultats de l'étude mettent en lumière une association significative entre le statut matrimonial des mères et le retard de croissance des enfants. Les mères mariées sont 30 % moins susceptibles d'avoir des enfants atteints de retard de croissance (OR = 0,70, IC à 95 %, 0,56-0,86) par rapport aux mères vivant hors d'une relation matrimoniale. Les mères ayant suivi des études primaires et secondaires ou supérieures présentent une probabilité moindre d'avoir des enfants atteints de retard de croissance (OR = 0,90, IC à 95 %, 0,70-1,17) et (OR = 0,68, IC à 95 %, 0,44-1,03) respectivement, par rapport à leurs homologues non éduquées. En d'autres termes, le fait que la mère soit mariée ou éduquée réduit les chances que ses enfants soient atteints de retard de croissance. La probabilité de retard de croissance infantile diminue à mesure que le quintile de richesse du ménage augmente. Cette étude contribue à la compréhension des facteurs influençant les résultats de santé des enfants en Tanzanie, en particulier le rôle du mariage.

Retirement preparedness: A study of gender, marital status, and motivation factors by using a theory of planned behavior model.

Although working men and women share common retirement concerns, women encounter unique challenges in securing their retirement. These challenges arise from factors such as part-time work, intermittent work histories, and potential wealth disparities. Marital status also exerts a profound influence on retirement decisions. Marital status significantly impacts their financial security as they approach retirement. This study investigates the intricate relationship between gender, marital status, and theory of planned behavior factors that influence retirement planning among older adults. Utilizing data from the 2014 Health and Retirement Study (HRS) and RAND, the research analyzed 2,657 participants aged 50 to 62, all of whom reported full or part-time employment. Also, the research leveraged the theory of planned behavior to examine motivational factors affecting retirement planning. The study's findings highlight the significant association of gender with expected retirement timing, revealing that married women typically anticipate retiring earlier than both unmarried women and men. In addition, older adults who secure retirement resources tend to retire earlier. It is important to develop tailored policies and initiatives to address the specific retirement challenges women face. It is imperative to develop retirement support systems that consider the gender, marital statuses, and retirement resources of older adults, and to give special attention to those who are vulnerable. This study provides valuable insights into the intricate interplay of gender, marital status, retirement motivation factors and retirement planning among older adults.

Impact of life-threatening military incidents during deployments abroad on the relationships between military personnel and their families.

Introduction: The influence of deployments on family relationships has hardly been investigated. Following a recently proposed new research strategy, military personnel with and without deployment-related life-threatening military incidents during deployment were compared. The hypothesis was that partner and family relationships of military personnel who experienced such an event would deteriorate more. Methods: This study included N = 255 military personnel who had a romantic partner (n = 78 of them had children) when deployed to Afghanistan. Of these, n = 68 military personnel experienced a deployment-related critical event during the deployment, n = 187 did not. Partnership quality was assessed using a semi-structured pre- and post-deployment interview. Results: The partner relationships of military personnel who experienced a deployment-related life-threatening military incident during deployment broke up significantly more often. The partner relationships of all military personnel deteriorated significantly, with greater deterioration after deployment in the group who faced such incidents. These results were independent of age, rank or number of previous deployments. In addition, there was a significant deterioration in the relationships between all military personnel and their children with greater deterioration after deployment in the group who faced such incidents. Conclusion: Life-threatening military incidents during a deployment abroad appear to have a considerable influence on the quality and stability of the partner and family relationships of military personnel. These findings can be used to inform the development of specific pre- and post-deployment measures and training.

Marital status and long-term cardiovascular risk in general population-RIFLE project (Italy).

BACKGROUND: The impact of marital status on cardiovascular disease (CVD) remains controversial in the general population. AIM: The present investigation sought to delineate the association between marital status and long-term major non-fatal and fatal CVD, along with all-cause mortality within the scope of the RIFLE project (Risk Factors and Life Expectancy). METHODS: We examined the incidences of CVD, including cerebrovascular accidents and coronary heart disease (CHD), as well as all-cause mortality. In total, 47,167 individuals (46% female, average age 50 ± 9 years) were included in the analysis. Marital status at inception was categorized into married (inclusive of married or cohabitating) versus unmarried cohorts (including widowed, separated, divorced, or single individuals). RESULTS: Compared to their married counterparts, unmarried subjects demonstrated a heightened risk for CVD in both females and males. Throughout a median follow-up span of 7.4 years (interquartile range from 6 to 9 years), married participants, adjusting for standard risk factors, exhibited reduced mortality rates attributed to CHD [hazard ratio (HR) 0.54 (95% confidence interval (CI) 0.33-0.86)) and all causes (HR 0.75 (95% CI 0.62-0.91)] within the aggregate population; this reduction persisted for both CHD-specific [HR 0.39 (95% CI 0.51-0.90)]and all-cause mortality [HR 0.68 (95% CI 0.51-0.90)], independent of traditional risk factors in women. No associations were evident between matrimonial status and any measured outcomes in males. CONCLUSIONS: Within primary care settings, marital status should be considered a potential correlate of long-term CHD and overall mortality risks, especially among women.

The Association between Marital Status and Obesity: A Systematic Review and Meta-Analysis.

BACKGROUND: Obesity was included in the International Classification of Diseases in 1990 as a chronic disease characterized by the excessive accumulation of body fat and a body mass index (BMI) greater than 30 kg/m2. AIM: This systematic review was aimed to examine the role of marital status in determining body mass index and the risk of obesity. METHODS: We performed a systematic literature search using three databases (PubMed (Medline), Embase, and Google Scholar) with the search query. RESULTS: Of the 105 studies included in the systematic review, 76 studies (72%) reported a greater risk of obesity in married individuals compared to unmarried individuals. A meta-analysis of 24 studies included a total population of 369,499 participants: 257,257 married individuals (40,896 of whom had obesity) and 112,242 comparison subjects (single, divorced, or widowed individuals, 15,084 of whom had obesity). Odds ratios for obesity found a significant pooled odds ratio for obesity in married individuals compared with controls (OR 1.70; 95% CI 1.38-2.10). The socioeconomic environment was not the same throughout the period of studies analyzed. The odds of obesity in married individuals during economic crises was greater than during the period between crises: OR 2.56 (95% CI 2.09-3.13) during crises vs. OR 1.55 (95% CI 1.24-1.95) between crises. CONCLUSION: The results of this review confirm the importance of considering marital status in determining the risk of obesity.

The impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation.

Objective: To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis. Methods: We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil. Results: Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 - 3.72, p = 0.0366) than those who underwent breast-conserving surgery. Conclusion: Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973.