RESUMO
In this study, we provide empirical evidence in support of intergenerational effects of women's marriage age on girl-specific child education outcomes using a nationally representative household survey of 24,809 households from Pakistan. Our key findings are four-fold: First, we find that mother's age at marriage has no girl-specific impact on the education of children of school going age in terms of school enrolment, type of school (public/private) or education expenditure. However, there is a positive effect of delaying mother's marriage on girls in terms of relative grade progression and primary school attainment, implying that late-marrying mothers are more likely to transfer their human capital advantages/disadvantages to the daughters. Second, the impact does not depend on whether the child is firstborn or later-order, youngest child or with no siblings. Sex of the previous child does not affect the relationship either. Third, the beneficial impact of mother's marriage age on girls' education is visible only in the cohort of women who got married in 2000 or later. Fourth, father's marriage age is significantly associated with an increase in daughters' school enrolment and primary completion. The impact of smaller spousal age difference is also positive. These findings are robust to the use of empirical strategies and specifications that address potential endogeneity, collider bias, recall bias, sample selection and confounding factors. These findings suggest that delay in women's marriage is helping to narrow down gender disparities in education. The findings underscore the need to promote social and behavioural changes that encourage later marriages.
RESUMO
Background@#Psoriasis imposes a significant treatment burden on patients, particularly impacting well-being and quality of life (QoL). The psychosocial impact of psoriasis treatments remains unexplored in most patient populations. @*Objective@#To assess the impact of adalimumab on health-related QoL (HRQoL) in Korean patients with psoriasis. @*Methods@#This 24-week, multicenter, observational study, assessed HRQoL in Korean patients treated with adalimumab in a real-world setting. Patient-reported outcomes (PROs) including European Quality of Life-5 Dimension scale (EQ-5D), EQ-5D VAS, SF-36, and DLQI were evaluated at week 16 and 24, versus baseline. Patient satisfaction was assessed using TSQM. @*Results@#Among 97 enrolled patients, 77 were assessed for treatment effectiveness. Most patients were male (52, 67.5%) and mean age was 45.4 years. Median baseline body surface area and Psoriasis Area and Severity Index (PASI) scores were 15.00 (range 4.00~80.00) and 12.40 (range 2.70~39.40), respectively. Statistically significant improvements in all PROs were observed between baseline and week 24. Mean EQ-5D score improved from 0.88 (standard deviation [SD], 0.14) at baseline to 0.91 (SD, 0.17) at week 24 (p=0.0067). The number of patients with changes in PASI 75, 90, or 100 from baseline to week 16 and 24 were 65 (84.4%), 17 (22.1%), and 1 (1.3%); and 64 (83.1%), 21 (27.3%), and 2 (2.6%), respectively. Overall treatment satisfaction was reported, including effectiveness and convenience. No unexpected safety findings were noted. @*Conclusion@#Adalimumab improved QoL and was well-tolerated in Korean patients with moderate to severe psoriasis, as demonstrated in a real-world setting. Clinical trial registration number (clinicaltrials.gov: NCT03099083).
RESUMO
An aspect of the Covid-19 pandemic that merits attention is its effects on marriage and childbirth. Although the direct fertility effects of people getting the virus may be minor, the impact of delayed marriages due to the first preventive lockdown, such as that imposed in Pakistan from March 14 to May 8 2020, and the closure of marriage halls that lasted till September 14 may be non-negligible. These demographic consequences are of particular import to developing countries such as Pakistan where birth rates remain high, marriage is nearly universal, and almost all child-bearing takes place within marriage. Based on historic marriage patterns, we estimate that the delay in nuptiality during the first wave of the coronavirus outbreak may affect about half of the marriages that were to take place during the year. In Pakistan, childbearing begins soon after marriage, and about 37% of Pakistani married women give birth to their first child within twelve months of marriage. A sizeable number out of these, around 400,000 annual births that occur within twelve months of the marriage, may consequently be delayed. Postponement of marriages due to the accompanying difficult economic situation and employment precariousness will accentuate this fertility effect. The net fertility impact of the Covid-19 outbreak will ultimately depend not only on the delay in marriages but also on the reproductive behavior of existing couples.
