Gender with marital status, cultural differences, and vulnerability to hypertension: Findings from the national survey for noncommunicable disease risk factors and mental health using WHO STEPS in Bhutan.

Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1,909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan- 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23-1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12-1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20-1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06-1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan.

Changes in relationship status following bariatric surgery.

BACKGROUND AND OBJECTIVE: Bariatric surgery is a major event associated with psychological changes such as improvements in self-esteem, increased autonomy, and better self-value. Such changes could affect the patient's interpersonal relationships; however, little is known about the impact of bariatric surgery on changes in relationship status. In this paper, we aim to test the hypothesis that bariatric surgery is associated with changes in interpersonal relationships such as becoming single for those who were in a relationship or entering a relationship among those who were single before surgery. METHODS: This register-based cohort study consisted of 12,493 patients undergoing bariatric surgery (95% gastric bypass) from 2005 to 2013 and a reference group of 15,101 individuals with obesity between the age of 18-63 with a body mass index between 32 and 60 kg/m2. Transitions between married, divorced, widowed, never-married single, and living with a partner without being married were analyzed by Poisson regression. Additionally, the outcome was dichotomized, and transitions between being single and being in a relationship were also analyzed. All analyses were weighted using inverse probability of treatment weighting based on propensity scores. RESULTS: The overall incidence rate ratio (IRR) of changing status from being single to in a relationship was 2.03 (95% CI: 1.18-2.28), and the overall IRR of changing status from being in a relationship to single was 1.66 (95% CI: 1.50-1.83). CONCLUSION: Bariatric surgery is associated with a higher chance of finding a partner among single individuals, and a higher risk of separating from a partner among individuals in a relationship.

Divorce or Separation Following Postpartum Psychiatric Episodes: A Population-Based Cohort Study.

Objective: Psychiatric disorders are an established risk factor for divorce or separation. Despite the fact that 10%-15% of new mothers experience postpartum psychiatric episodes (PPEs), no previous studies have investigated the effects of PPEs on the probability of divorce in these new families. Therefore, this study aimed to investigate and quantify the probability of subsequent divorce/separation among women with either mild/moderate or severe PPE compared to mothers without PPE.Methods: This cohort study based on the national Danish registers included all cohabitating, primiparous women without previous psychiatric history who gave birth from 1996 through 2014. At 6 months postpartum, each woman's PPE status was evaluated and categorized as follows: (1) mild/moderate PPE (prescription of psychotropic medication-Anatomical Therapeutic Chemical Classification codes N03-N07), (2) severe PPE (psychiatric inpatient or outpatient treatment-International Classification of Disease, 10th Edition codes F00-F99, excluding codes for organic mental disorders, substance abuse, and mental retardation), and (3) no PPE (reference group). Subsequently, the status of cohabitation was assessed a maximum of 5 times (every January 1).Results: A total of 266,771 new mothers were included; 4,442 had a first mild/moderate PPE and 1,141 had a first severe PPE within 6 months postpartum. Compared to mothers without PPE, women with mild/moderate PPE had a significantly higher probability of later divorce (adjusted hazard ratio [HR] = 1.23; 95% CI, 1.15-1.31); for women with severe PPE, the probability was even greater (adjusted HR = 1.64; 95% CI, 1.45-1.85).Conclusions: Women experiencing their first-ever PPE following childbirth have a higher probability of divorce in the years following their diagnosis than mothers without PPE. Further, this study showed a dose-response relationship between the severity of PPE and the probability of divorce.

Prevalence of adverse childhood experiences among individuals aged 45 to 85 years: a cross-sectional analysis of the Canadian Longitudinal Study on Aging.

BACKGROUND: Population-level prevalence estimates for a broad range of adverse childhood experiences (ACEs), which are known to affect health across the lifespan, are currently unavailable in Canada. The purpose of this study was to estimate the prevalence of individual ACEs by sociodemographic factors among middle-aged and older adults. METHODS: Data for this cross-sectional analysis were obtained from the first follow-up (2015-2018) of the Canadian Longitudinal Study on Aging (baseline recruitment from 2011 to 2015). Participants included individuals aged 45-85 years and residing in the community in the 10 Canadian provinces. Exposure to ACEs was assessed using a retrospective, self-report questionnaire. Logistic regression was used to obtain the adjusted prevalence estimates of ACEs within groups formed by the sociodemographic characteristics and each variable was adjusted for all other sociodemographic variables. RESULTS: Of the 44 817 participants in the first follow-up, 61.6% (weighted) reported exposure to at least 1 ACE. Exposure to physical abuse (weighted prevalence of 25.7%), intimate partner violence (22.4%) and emotional abuse (21.8%) were the most prevalent types of ACEs. Individuals younger than 65 years (born in 1950-1969), with no postsecondary education or education below a bachelor's degree, or with annual household income less than $20 000 reported greater exposure to ACEs. Reporting for many ACEs was higher among women and those of nonheterosexual orientation. Overall, British Columbia, Alberta, Manitoba, Ontario and Quebec reported relatively higher prevalence for several examined categories of ACEs. INTERPRETATION: Adverse childhood experiences were highly prevalent across all demographic groups with substantial heterogeneity in the distribution among the middle and older age population. The high prevalence of ACEs and their potential negative consequences on health and well-being emphasize the need to develop and promote trauma-informed care to assist individuals affected by ACEs.

Consanguineous marriage and its relevance to divorce, polygyny and survival of marriage: evidence from a population-based analysis in Jordan.

BACKGROUND: Consanguinity has been extensively studied in the context of its negative health outcomes for offspring and socio-demographic factors, but little evidence-based research has been done on its potential social benefits. AIM: To examine the association between consanguineous marriage and the risk of divorce or separation, polygyny, and survival of marriage in Jordan. SUBJECTS AND METHODS: Data were obtained from the 2018 Jordan Population and Family Health Survey, covering a nationally representative sample of ever-married women of reproductive age. Descriptive statistics, multiple logistic regression, and survival analysis techniques were used for data analysis. RESULTS: The prevalence of consanguineous marriage was found to be 27.5% in Jordan in 2018, while the prevalences of polygyny and divorced/separated rates were 4.4% and 4.7%, respectively. Both consanguineous and polygyny rates showed declining trends, but divorce/separation rate showed an increasing trend. Compared to non-consanguineous marriages, the risk of divorce/separation and polygyny were found to be lower among women with consanguineous marriage, while the survival of marriages was found to be higher for consanguineous marriages than for non-consanguineous marriages. CONCLUSIONS: Findings revealed that consanguinity has some social benefits as it plays protective roles against divorce or separation, polygyny and enhances the survival of marriages.

Parental divorce, Interparental conflict, and Parent-child relationships in Spanish young adults / Divorcio parental, conflicto interparental y relaciones parento-filiales en adultos jóvenes españoles

The main aim of this study was to analyze the associations between parental divorce and interparental conflict with father child and mother-child relationship quality, in a Spanish young adult sample. The moderating effect of adult child's gender was also analyzed. Using a sample of 1,078 Spanish young adults, our results suggested that interparental conflict was more strongly associated with lower mother-child and father-child relationship quality, and that parental divorce was more strongly associated with father-child relationship quality than with mother-child relationship quality. In addition, adult child's gender only moderated the effect of parental divorce on father-child relationship quality, such that women from divorced families score lower on father-child relationship quality than women from non-divorced families. Findings add to the existing literature and promote a better comprehension of the complex associations between parental divorce and conflict with parent-child relationship quality in an understudied cultural context

El principal objetivo de este estudio fue analizar las asociaciones entre el divorcio parental y el conflicto interparental con la calidad de las relaciones paterno-filiales y materno-filiales, en una muestra española de 1078 adultos jóvenes. También se analizó la función moderadora del género de estos adultos jóvenes. Nuestros resultados sugirieron que el conflicto interparental se asocia con relaciones paterno-filiales y materno-filiales de menor calidad, mientras que el divorcio parental se asocia de forma más negativa con la calidad de la relación con el padre que con la madre. Además, el género de los hijos adultos únicamente moderó la asociación entre el divorcio parental y la calidad de las relaciones paterno-filiales, de manera que las mujeres de familias divorciadas obtienen puntuaciones más bajas en la calidad de la relación paterno-filial que las mujeres de familias no divorciadas. Los resultados aportan mayor información a la literatura empírica existente y promueven una mejor comprensión de las asociaciones complejas existentes entre el divorcio y conflicto parental con la calidad de las relaciones parento-filiales, en un contexto cultural donde hay escasa investigación sobre el tema

The Cumulative and Differential Relation of Adverse Childhood Experiences and Substance Use During Emerging Adulthood.

Adverse childhood experiences (ACEs) have far-reaching effects on a wide range of health outcomes in adulthood, however, less is known about their consequences in emerging adulthood or in a geographically distinct sample. We examined the cumulative and individual relation of ACEs and two risky behaviors: alcohol and illegal drugs consumed by 490 Spanish emerging adults (mean age = 18.9). Participants answered the ACEs questionnaire, and two items about alcohol and illegal drugs consumption. Results showed that the overall experience of suffering different ACEs was a significant predictor of drug but not of alcohol consumption. Moreover, ACEs subtypes presented differential effects on substance use. Whereas some increased the likelihood of either drug or alcohol use, others reduced it. This study supports the importance of examining specific adverse experiences rather than only using an overall measure and provides some counterintuitive results that may be linked to resilient mechanisms.

Association Between Paternal Separation During Early Childhood and Pubertal Timing Among Girls Using Longitudinal Birth Cohort in Japan.

Introduction: Previous studies have shown that paternal absence leads to earlier pubertal timing among girls in high-income countries. Despite the low divorce rate in Japan, paternal separation is commonly seen due to a unique corporation system, tanshin funin, where employees relocate with their spouses and children. We examined paternal separation, including paternal absence (due to divorce or paternal death) and paternal tanshin funin, during early childhood as a predictor of earlier girl's pubertal development, assessed as age at peak height velocity (PHV). Methods: This study examined 15 214 girls from a longitudinal survey conducted in Japan from 2001 to 2016 by the Ministry of Health, Labor and Welfare. Paternal separation was determined by the occurrence through annual surveys conducted at ages 0.5 to 4.5 years. Outcome was defined as age at PHV between ages 6 to 15 years. We conducted linear regression, adjusted for potential confounders and other covariates. Results: Continuous father cohabitation was seen in 88.7% of households, while paternal separation was experienced 1-2, 3-4 and 5 times (always) among 7.4%, 2.8% and 1.1% of households, respectively. Girls who confronted continuous paternal separation (5 times) experienced 0.42 years earlier [95% confidence interval (CI): -0.75, -0.10] age at PHV compared to their peers who always lived with their fathers. Conclusion: Girls who experienced paternal separation throughout ages 0.5 to 4.5 years experienced PHV earlier.

The Economic Consequences of Gray Divorce for Women and Men.

OBJECTIVES: Gray divorce, which describes divorce among persons aged 50 and older, is increasingly common reflecting the doubling of the gray divorce rate since 1990. Yet, surprisingly little is known about the consequences of gray divorce and in particular how women and men fare economically during the aftermath. METHOD: Using longitudinal data from the 2004-2014 Health and Retirement Study, we estimated hybrid fixed/random-effects models comparing women's and men's economic well-being prior to, during, and following gray divorce and subsequent repartnering. RESULTS: Women experienced a 45% decline in their standard of living (measured by an income-to-needs ratio), whereas men's dropped by just 21%. These declines persisted over time for men, and only reversed for women following repartnering, which essentially offset women's losses associated with gray divorce. No gender gap emerged for changes in wealth following divorce with both women and men experiencing roughly a 50% drop. Similarly, repartnering was ameliorative only for women's wealth. DISCUSSION: Gray divorce is often financially devastating, especially for women. Although repartnering seems to reverse most of the economic costs of gray divorce for women, few form new co-residential unions after divorce. This study offers a cautionary tale about the financial aftermath of gray divorce, which is likely to contribute to growing economic disadvantage among older adults.

The development of communication behavior over the newlywed years.

Communication behavior occupies a fundamental role in basic and applied relationship science, yet we know very little about how this important process develops over time, and how the natural developmental process is linked with relationship outcomes. The present study aims to examine the development of naturally occurring trajectories of couple communication behavior across three domains, examined concurrently; positive affect, negative affect, and effective problem solving. A large sample of newlywed couples recruited from low-income neighborhoods (N = 431) completed observational discussion tasks at 4 time points, spanning 2.5 years, and provided data on marital status 4.5 years into marriage. Results from multivariate group-based trajectory modeling indicate that three groups of couples can be distinguished, with the best communicators demonstrating high levels of positivity and effectiveness and low levels of negativity, the worst communicators demonstrating low levels of positivity and effectiveness and high levels of negativity, and the middle group demonstrating low levels of all three dimensions. Trajectory group membership was significantly associated with demographic and relationship characteristics, such that the best communicators had more adaptive relationship characteristics and less demographic risk. Wives' trajectory group membership was significantly associated with divorce rates such that the best communicators had the lowest divorce rate (9%), and the worst communicators had the highest divorce rate (22%). Overall, communication behavior is quite consistent over time, indicating that early interaction dynamics tend to be enduring and predictive of relationship outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

[Parental Separation - Is the Accumulation with Other Adverse Childhood Experiences the Main Burden? Analysis of a Representative Sample of the German Population]. / Trennung der Eltern ­ Liegt die Hauptbelastung in der Kumulation mit anderen Kindheitsbelastungen? Untersuchung einer repräsentativen Stichprobe der deutschen Bevölkerung.

INTRODUCTION: Adverse childhood experiences (ACEs) tend to co-occur. The more forms of childhood adverse are experienced, the higher are the psychological and physical impairments in adulthood. The present study therefore examines the extent to which the experience of parental separation is related to the risk of other forms of ACEs and the extent to which the accumulation of ACEs is related to impairment in adulthood. METHODS: A cross-sectional analysis of a representative sample of the German population from the age of 18 onwards was performed (N=2466; mean age=49.5 years (18-93); f: 1368 (55.5%); m: 1098 (44.5%)). The demographic data were assessed by interview, the remaining data were collected by questionnaires. Current depressive and anxiety symptoms self-perceived somatic health and life quality were assessed, while ACEs were assessed retrospectively by the Adverse Childhood Experiences (ACE)-Questionnaire. RESULTS: Child maltreatment and mental illness of household members, substance abuse of household members, incarceration of household members and violence against the mother were more frequent when participants reported separation of parents. Parental separation was not associated with an increased rate of psychological impairment and, in women, physical impairment when no other forms of ACEs were present. CONCLUSION: Children and adolescents whose parents have separated more often experience other forms of ACEs than their peers. It seems to be this accumulation of ACEs that is associated with impairments in adulthood.

Family factors predicting self-rated health during early adolescence.

BACKGROUND: Health impairments in adolescents associated with divorce and loss of parental contact are frequently reported. However, other family factors more likely to promote health are less researched. We examined the impact of several family factors on self-rated health (SRH). METHODS: A longitudinal cohort study of 1225 students in high school aged 11 and 13 years in 2011. The students were surveyed at onset and after 2 years with SRH as the outcome measure. We adjusted for sex, age and self-rated socioeconomic status in temporal causal analyses, and adjusted for SRH at onset in residual change analyses, applying an ordinal logistic method. Adjusted analyses with each factor and multivariable models with backward exclusion were performed. We reported the predictive associations with odds ratios and 95% confidence limits. RESULTS: The most decisive factors predicting future positive SRH were linked to confidence in communicating with both parents about bothersome issues, and the experience of parental support with school work. Furthermore, the experience of opinions being taken seriously in the family and the absence of excessive parental expectations predicted SRH positively after 2 years. Divorce had a modest impact on SRH and was mediated by the other factors. Only the absence of contact with fathers moderated the effect that divorce experience had on SRH. We ascertained the causal relationships through residual change analyses. CONCLUSIONS: As SRH in adolescence has an impact on later health and is amendable, it is important, from a public health perspective, to preserve and improve relationships and confidence between children and both parents.

Factors associated with divorce from first union among women in Ethiopia: Further analysis of the 2016 Ethiopia demographic and health survey data.

BACKGROUND: Globally, divorce is a common phenomenon in couples' marital life. As a result, many divorced couples and their children face several social, economic, and health problems after dissolution. There is little information on the magnitude and determinants of divorce in developing countries including Ethiopia. Therefore, this study aimed to estimate the prevalence of divorce from the first union and its predictors among reproductive-age women in Ethiopia. METHODS: We used the 2016 Ethiopia demographic and health survey data for this analysis. The survey was a community-based cross-sectional study conducted from January 18 to June 27, 2016. The survey employed a two-stage stratified cluster sampling technique. A total of 11,646 ever-married women were included in the analysis. Bivariate and multivariable logistics regression was done to identify the determinants of divorce from the first marriage. A p-value < 0.05 was used to declare statistical significance. RESULTS: About 25% (95%CI: 23.4% - 26.6%) ever-married women were divorced from their first marital relationship. Women who were married at age < 15 years (AOR = 1.34; 95%CI: 1.07-1.68), urban women (AOR = 1.69; 95%CI: 1.22-2.35), women who did not attend formal education (AOR = 4.36; 95%CI: 3.14-6.05), women who were employed (AOR = 1.51; 95%CI: 1.31-1.73), and being childless (AOR = 1.34; 95%CI: 1.07-1.69) had higher odds of experiencing a divorce. Similarly, women who experienced partner violence, women with no house ownership, and women in the Amhara region had higher odds of divorce from their first marital union. Conversely, women in Oromia, SNNPR, the metropolis, and the pastoral regions had lower odds of divorce from their first marital union. CONCLUSION: Divorce from the first marriage is high in Ethiopia. Preventing early marriage and partner violence and promoting girls' education would reduce the divorce rate in Ethiopia.

Household Composition and Gender Differences in Parental Time Investments.

Recent research has documented the relatively poor performance of boys, especially those from single-mother households, on a number of outcomes. Differences in noncognitive skills are often cited as a main contributing factor. However, we still know little about the underlying mechanisms driving differences in noncognitive skills and other outcomes. This article provides empirical evidence that parental time investments, defined as the amount of time that parents spend participating in activities with their child, change differentially by child gender following a transition from a two-parent to single-mother household. Boys experience larger investment reductions following the change in household structure, which may help facilitate previously documented gender gaps in noncognitive skills for those in single-mother households. Boys lose an estimated additional 3.8 hours per week in fathers' time investments, nearly 30% of average weekly paternal investments across the sample. The difference is increasing with age, concentrated in leisure and entertainment activities, with little to no evidence that mothers increase investments in boys relative to girls after such transitions.

Trends in Adverse Childhood Experiences (ACEs) in the United States.

BACKGROUND: It is important for those called upon to discuss major social determinants of health such as adverse childhood experiences (ACEs) to have accurate knowledge about generational trends in their prevalence. OBJECTIVE: To review available trend data on major forms of ACEs. METHODS: A search of academic data bases was conducted by combining the term "trend" with a variety of terms referring to childhood adversities. RESULTS: Available trend data on ACEs from the 20th century show multi-decade declines in parental death, parental illness, sibling death, and poverty, but multi-decade increases in parental divorce, parental drug abuse and parental incarceration. More recent trend data on ACEs for the first fifteen to eighteen years of the 21st century show declines in parental illness, sibling death, exposure to domestic violence, childhood poverty, parental divorce, serious childhood illness, physical abuse, sexual abuse, physical and emotional bullying and exposure to community violence. Two 21st century ACE increases were for parental alcohol and drug abuse. Overall, there appear to have been more historical and recent improvements in ACEs than deteriorations. But the US still lags conspicuously behind other developed countries on many of these indicators. CONCLUSION: Awareness of improvements, as well as persistent challenges, are important to motivate policy makers and practitioners and to prompt them to recognize the feasibility of success in the prevention of ACEs.

Association between parental separation and addictions in adolescents: results of a National Lebanese Study.

BACKGROUND: Since divorce rates are on the rise in Lebanon (an increase of 101% between 2006 and 2017) and since previous international studies have shown a relationship between divorced parents and adolescents' addiction to smoking, alcohol, and the internet, assessing the background of the Lebanese situation was deemed necessary. The study objective was to investigate the association between the divorce of parents and smoking, alcohol, and internet addiction among a representative sample of Lebanese adolescents. METHODS: This study was a cross-sectional, conducted between January and May 2019 using a proportionate random sample of schools from all Lebanese Mohafazat. Out of 2000 questionnaires distributed; 1810 (90.5%) were completed and collected back. RESULTS: The mean age was 15.42 ± 1.14 years, with 53.3% females and 74.1% smokers. In addition, 11.9% [95% CI 0.104-0.134] of the adolescents had separated/divorced parents. Divorce in parents was significantly associated with higher alcohol use disorder (Beta = 8.035), higher cigarette dependence (Beta = 2.767) and a higher waterpipe dependence (Beta = 5.263) in adolescents. However, divorce in parents was not associated with internet addiction in adolescents. CONCLUSION: Parental divorce is correlated to higher alcohol and smoking, but not internet addiction among adolescents. Children whose parents are divorced should be subject to continuous follow-up by their parents and by a psychiatrist/psychologist in order not to develop an addiction that could potentially harm them.

Depression, anxiety and associated factors among housemaids working in Addis Ababa Ethiopia.

BACKGROUND: Housemaids are part of women with low socioeconomic status and most of them are migrant from rural to central part of Ethiopia, less educated, either with poor, separated, single or divorced family and/or dead parents. Housemaid may experience problems like depression and anxiety more than other groups of women. Therefore, the aim of this study was to assess the magnitude and determinants of those problems among housemaids. OBJECTIVE: To assess the magnitude and determinants of depression & anxiety among housemaids in Addis Ababa; Ethiopia; 2018. METHODS: Community based cross-sectional study was conducted from May 1 to August 30, 2018 among housemaids working in Addis Ababa, Ethiopia. Multistage sampling technique was applied with a total of 826 samples. Quantitative data was employed by using structured questionnaires. The collected data was coded, entered in to Epi-Info version 7 and analyzed by using SPSS version 20. Descriptive, analytical statistical procedures; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was declared at p value < 0.05. RESULTS: This study enrolled 862 participants with response rate 99.5%, 99.5% refers to the number of people who actually completed the interview. The result showed prevalence of depression and anxiety among housemaids 27.5% and 32.3% respectively. Among all participants 44.6% (95% CI= 41.0 - 47.9) have mild, 18.5% (95% CI= 15.7 - 21.2) have moderate and 6.1% (95% CI= 4.5 - 7.8) have severe form of comorbid anxiety with depression. Depression (44.9%) and anxiety (41.9%) found more prevalent among the age group 16 to 20. In this study history of parental divorce, participant's divorce, physical violence and sexual violence are positively associated. Other factors; being less educated and living with relatives; were associated negatively. CONCLUSION: The prevalence of Depression and Anxiety is found high among housemaid; its prevalence is more among age group 16 to 20 than other age groups. Violence, participant's divorce, history of parental divorce and contraceptive use has positively associated with depression and anxiety.

Marital status, living arrangements, and mortality in middle and older age in Europe.

OBJECTIVES: We study the role of marital status and living arrangements in mortality among a 50+ population living in Europe by gender and welfare states. METHODS: Using data from waves 4, 5, and 6 of the Survey of Health Age and Retirement in Europe (n = 54,171), we implemented Cox proportional hazard models by gender and age groups (50-64 and 65-84). We estimated pooled models and separated models for two regions representing different welfare states (South-East and North-West). RESULTS: Among people aged 50-64, nonpartnered individuals (except never-married women) showed a higher mortality risk as compared with those partnered. Among the older population (65-84), divorce was associated with higher mortality among men, but not among women, and living with someone other than a partner was associated with higher mortality risk as compared to those partnered. In the South-East region living with a partner at ages 50-64 was associated with lower mortality. CONCLUSIONS: Partnership and residential status are complementary for understanding the role of family dimensions in mortality. The presence of a partner is mortality protective, especially among 50-64-year-old men in South-East Europe.

Forming and ending marital or cohabiting relationships in a Danish population-based cohort of individuals with neurofibromatosis 1.

Individuals with neurofibromatosis 1 (NF1) may have problems in managing the transition between childhood and adulthood, such as forming a relationship or finding a partner. We aimed to determine the association between NF1 and forming and ending marital or cohabiting relationships by comparing a large Danish population of adults with NF1 with population comparisons. In this population-based cohort study, we compared a population of Danish adults who were hospitalized for or with complications to prior diagnosed NF1 (n = 787) with population comparisons matched on gender and birth year (n = 7787) through nationwide registries with annually updated information on marriage and cohabitation. Discrete-time survival models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the formation and termination of relationships, with adjustment for birth year, gender, and somatic and psychiatric comorbidities at entry. Individuals with NF1 were significantly less likely to form a relationship (HR = 0.65; 95% CI: 0.58-0.73), with the lowest association for individuals ≥33 years (HR 0.40; 95% CI: 0.25-0.63) and the highest for those aged 18-20 years (HR 0.82; 95% CI: 0.70-0.96). No significant difference was found for ending relationships (HR 1.00; 95% CI: 0.86-1.16). In conclusion, individuals who were hospitalized for NF1 are less likely to engage in marital or cohabiting relationships than population comparisons and are older when they form their first relationship. Once a relationship has been established, however, couples with a NF1-individual are not at greater risk of ending the relationship.

Cooperation after divorce: an RCT study of the effects of a digital intervention platform on self-perceived stress / La cooperación después del divorcio: un estudio RCT sobre los efectos en el estrés percibido de una intervención basada en una plataforma digital

Divorce has long been considered one of the most pervading stressful life events and has consistently been associated with high stress levels and subsequent poorer mental- and physical health. This study evaluates the effectiveness of the Cooperation after Divorce (CAD) online intervention on perceived stress immediately following divorce. The study's design was a one-year longitudinal randomized controlled trial including an intervention group (n = 1,031) and a no-treatment control group (n = 825) with four assessments of perceived stress levels (at baseline and 3, 6 and 12-months post-divorce). The CAD intervention consists of a 17-module online platform designed to support divorcees and their children post-divorce. Data analyses consisted of linear mixed effect modeling and means comparisons. The study found that the intervention significantly accelerated the reduction of perceived stress among recently divorced adults when compared with controls. Further, after one year, stress levels in the intervention group were reduced to normed national stress levels while the mean stress level in the control group remained substantially higher. The results suggest that online interventions may offer long-term public health benefits in reducing stress among newly divorced individuals and speak to potential implications related to the services provided for people undergoing divorce

El divorcio se ha considerado como uno de los eventos estresantes de la vida más persistentes y se ha asociado repetidamente con altos niveles de estrés y el deterioro de la salud mental y física. Este estudio evalúa la eficacia de la intervención online Cooperación Después del Divorcio (CAD) en el estrés percibido inmediatamente después de su ocurrencia. El diseño del estudio fue un ensayo controlado aleatorio longitudinal de un año que incluyó un grupo de intervención (n = 1,031) y otro de control sin tratamiento (n = 825) con cuatro evaluaciones del nivel de estrés percibido (línea base y 3, 6 y 12 meses después del divorcio). La intervención CAD consiste en una plataforma online de 17 módulos diseñada para apoyar a los divorciados y sus hijos después del divorcio. Los análisis de datos consistieron en modelos lineales de efectos mixtos y comparación de medias. El estudio encontró que la intervención aceleró significativamente la reducción del estrés percibido entre los adultos recientemente divorciados en comparación con el grupo control. Además, después de un año, el nivel de estrés en el grupo de intervención se redujo al nivel de estrés nacional normativo, mientras que el nivel de estrés promedio en el grupo control permaneció sustancialmente más alto. Los resultados sugieren que las intervenciones online pueden ofrecer ventajas para la salud pública a largo plazo para reducir el estrés entre las personas recién divorciadas y pueden tener implicaciones para los servicios que se prestan a las personas que se encuentran en un proceso de divorcio