Happiness as an unmet reality in Pakistan: discourses of divorced and separated individuals

Background: Chronic stress is associated with cardiovascular disease (CVD) in part through neural mechanisms that potentiate inflammation. Disrupted social connections are associated with higher chronic stress. As such, we hypothesized that: 1) previously married (divorced, separated) individuals have higher major adverse cardiovascular event (MACE) risk compared to married individuals and 2) that greater activation of stress-related neural-immune mechanisms contributes to this relationship. Methods: Participants (N=75,638) enrolled in the Mass General Brigham Biobank were studied. Marital status and MACE were identified using survey data and ICD-10 codes, respectively. A subset (N=1,121) underwent clinical 18F-FDG-PET imaging, enabling assessment of stress-related neural activity as the ratio of the amygdala to prefrontal cortex activity (AmygAc). Clinical high-sensitivity C-reactive protein (hs-CRP) levels were assessed in another subset of the cohort (N=10,358). Linear and Cox regression and mediation analyses were used. Results: Among participants (median age 62 years; 53% female), 2,978 subjects developed MACE after Biobank enrollment. Previously married (vs. currently married) individuals had greater MACE risk (HR 1.33 [95% CI: 1.20,1.57], p=<0.001, Figure 1A) , higher AmygAc (B=0.23 [95% CI: 0.06-0.40], p=0.009) and higher hs-CRP (B=0.19 [95% CI: 0.13-0.25], p=<0.001). MACE risk remained significant after adjustment for key confounders (Table 1), and both the AmygAc and CRP were higher among divorced or separated individuals (Figure 1B and 1C). Moreover, increased AmygAc and hs-CRP associated with increased MACE risk (HR=1.24 [1.14-1.36], p=<0.001 and 1.13 [1.09-1.16], p=<0.001, respectively), and both AmygAc and hs-CRP mediated the relationship between marital status and MACE (p<0.05). Conclusions: Our findings suggest that divorced and separated individuals are at an increased risk for MACE. This relationship appears to be driven in part by stress-related neural-immune mechanisms.

Happiness as an unmet reality in Pakistan: discourses of divorced and separated individuals

BackgroundDepression is one of the most common mental disorders in Western countries and is related to increased morbidity and mortality from medical conditions and decreased quality of life. The sociodemographic factors of age, gender, marital status, education, immigrant status, and income have consistently been identified as important factors in explaining the variability in depression prevalence rates. This study evaluates the relationship between depression and these sociodemographic factors in the province of Ontario in Canada using the Canadian Community Health Survey, Cycle 1.2 (CCHS-1.2) dataset.MethodsThe CCHS-1.2 survey classified depression into lifetime depression and 12-month depression. The data were collected based on unequal sampling probabilities to ensure adequate representation of young persons (15 to 24) and seniors (65 and over). The sampling weights were used to estimate the prevalence of depression in each subgroup of the population. The multiple logistic regression technique was used to estimate the odds ratio of depression for each sociodemographic factor.ResultsThe odds ratio of depression for men compared with women is about 0.60. The lowest and highest rates of depression are seen among people living with their married partners and divorced individuals, respectively. Prevalence of depression among people who live with common-law partners is similar to rates of depression among separated and divorced individuals. The lowest and highest rates of depression based on the level of education is seen among individuals with less than secondary school and those with "other post-secondary" education, respectively. Prevalence of 12-month and lifetime depression among individuals who were born in Canada is higher compared to Canadian residents who immigrated to Canada irrespective of gender. There is an inverse relation between income and the prevalence of depression (p < 0.0001).ConclusionThe patterns uncovered in this dataset are consistent with previously reported prevalence rates for Canada and other Western countries. The negative relation between age and depression after adjusting for some sociodemographic factors is consistent with some previous findings and contrasts with some older findings that the relation between age and depression is U-shaped. The rate of depression among individuals living common-law is similar to that of separated and divorced individuals, not married individuals, with whom they are most often grouped in other studies.

Previous studies have described the increase in depressive symptoms in divorced and separated individuals. However, the factors associated with depression have been little explored in this particular context. The aim of the present study was to assess the degree to which difficulties in emotional regulation are associated with depressive symptomatology in divorced and separated individuals. A sample of 1189 Chilean individuals, separated or divorced, completed self-reported measures of difficulties in emotional regulation and depression. The results obtained allow us to conclude that difficulties in emotional regulation, over other individual factors, such as early risk situations or circumstances of separation, are associated with higher rates of depression in men and women, explaining 41% of the variance of the depressive symptomatology. Emotional regulation difficulties are associated with greater depressive symptomatology in divorced/separated individuals. We discuss the clinical implications of these results, as well as future lines of research.

Panel Count Data Analysis of Determinants of Cigarette Smoking: Evidence from British Household Panel Survey, 2001-2009

Against the backdrop of demographic change and the pluralisation of living arrangements, the article focuses on repartnering after widowhood, divorce and separation in older age in Germany. While theoretically framing repartnering as a lifecourse transition, the question arises of how later-life relationships form in relation to gender- and ageing-specific as well as structural and processual dimensions. Since previous research indicates that there are gender-specific patterns when repartnering in older age which differ from repartnering in middle age, the article explicitly accounts for gendered ageing and attitudes towards ageing. Using data from the German Ageing Survey (1996–2017), longitudinal hybrid panel regressions are modelled for 3,653 respondents, 11,628 observations and 179 new relationships. I propose to understand within-effects as processual and between-effects as structural dimensions of repartnering. The results for the structural dimensions show that the likelihood of repartnering is higher for men and for individuals with more negative attitudes towards ageing. The results for the processual dimensions show how repartnering becomes less likely the older one gets and the more positive one's attitudes towards ageing become. The interaction term for gender and ageing shows that ageing has a stronger influence on the likelihood to repartner for women than for men. Additionally, the findings reveal a difference between forms of singlehood: in the short term, repartnering is less likely for divorced or separated individuals than for widowed individuals, whereas the opposite effect shows in the long term. In sensitising the lifecourse perspective with gender- and ageing-specific concepts and analytically separating processual and structural dimensions, this article demonstrates the importance of gendered ageing and of the linkage between relationship transitions. Applying hybrid panel models to lifecourse transitions in older age reveals the processual dynamic and structural embeddedness of repartnering in older age.

Joint association of physical activity and dietary quality with advanced cardiovascular-kidney-metabolic syndrome in older adults: A population-based study.

Introduction\nThe prevalence of smoking is determined by three major parameters: initiation, cessation, and relapse. Various wider health determinants influence these parameters. Existing literature has mostly focused on investigating determinants of smoking initiation and cessation, whereas studies investigating smoking relapse in-depth are scarce.\n \n Aim \n \nThis analysis aims to estimate the prevalence of cigarette smoking relapse and determine its predictors in a representative sample of adult former smokers in the United States.\n\nMethods\nThis quantitative research project analysed secondary data retrieved from the Tobacco Use Supplement-Current Population Survey (TUS-CPS) 2010-11 cohort with a total sample size of 3,621 participants. Smoking relapse was defined as picking up smoking in 2011 after reporting smoking abstinence in 2010. The prevalence of relapse over the 12-month follow-up period was estimated in different subgroups. Multivariate logistic regression models were applied to determine associations between smoking relapse and a broad spectrum of sociodemographic and environmental factors.\n\nResults\nA total of 184 former smokers reported smoking relapse by 2011 (weighted prevalence: 6.8%. 95%CI: 5.7%-8.1%). Prevalence and odds of relapse were higher among young people compared to the oldest age group (65-years and above). Former smokers living in smoke-free homes had 60% lower odds of relapse compared with those living in homes that allowed smoking inside (aOR:0.40; 95%CI: 0.25-0.64). Regarding race/ethnicity, only Hispanics had significantly higher odds of relapse compared to whites (non-Hispanics). Odds of relapse were higher among never-married, widowed, divorced and separated couples compared to the married group. Continuous smoking cessation for 6-months or more significantly decreased odds of relapse among the study sample.\n\nConclusions\nWider health determinants influenced prevalence of smoking relapse among US adults; individual as well as lifestyle characteristics were associated with relapse, highlighting the need for designing targeted interventions to prevent it.

Long-acting injectable (LAI)-PrEP provides better protection against HIV compared to oral PrEP, which requires taking a daily pill. Our study aimed to assess knowledge about oral and LAI-PrEP and identify factors associated with willingness to use LAI-PrEP among key populations (KPs) in Uganda. We conducted a cross-sectional study at the Most at Risk Populations Initiative (MARPI) clinic between November and December 2021. Participants were recruited through convenience sampling and interviewed using a structured questionnaire by trained interviewers. Participants were categorised into three groups based on their oral PrEP use: those who had not yet initiated PrEP, those who had discontinued oral PrEP, and those currently on oral PrEP. Modified Poisson regression analysis was performed to determine factors associated with the participants' willingness to use LAI-PrEP. Data was analysed using STATA 14 software. Of the 234 participants, 135 (57.7%) were female, 82.5% knew about LAI-PrEP, and 65.8% were willing to use it. The mean age was 28.7 years (standard deviation [SD] 5.8). Willingness to use LAI-PrEP was less likely among divorced, widowed, or separated individuals than singles (i.e., people with no prior marital experience and neither in a romantic relationship) (adjusted prevalence ratio [aPR] 0.65, 95% CI: 0.43-0.98). Relative to current oral PrEP users, willingness to use LAI-PrEP was similar among those who discontinued oral PrEP (aPR 1.39, 95% CI: 0.92-2.11) and those who had not yet initiated PrEP but were at risk for HIV (aPR 1.26, 95% CI: 0.83-1.89). This cross-sectional analysis of diverse members of KPs in Uganda revealed that the willingness to use LAI-PrEP was lower among individuals who were divorced, separated, or widowed compared to those who were single. Future studies should investigate effective methods for promoting the uptake of long-acting PrEP formulations among populations at high risk of HIV acquisition.

ObjectivesThis research project aims at estimating the prevalence of cigarette smoking relapse and determining its predictors among adult former smokers in the USA.SettingThis research analysed secondary data retrieved from the...

Introduction Intimate relationships may impact insomnia symptoms. In particular, marriage may serve as a protective factor against the development of insomnia, particularly for men. However, little research has studied how relationship quality may contribute to insomnia, particularly in military populations where social support may be particularly important. Therefore, this study will examine the associations between indices of relationship quality and insomnia in a sample of Army Soldiers. Methods Data were acquired from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS; N=21,449; mean age= 28.6; 88.24% male). Participants completed a survey that included questions about insomnia symptoms and their social networks. Items assessed marital status, duration of marriage, frequency of disagreements, and relationship quality and happiness. Chi-squared analyses were used to examine the associations between probable insomnia from the past 30 days and relationship items. Results Approximately 38.2% of this sample experienced past month insomnia symptoms. Insomnia was more prevalent in divorced or separated individuals. Among partnered individuals, Soldiers who reported that they talked more about ending the relationship and had more disagreements with their partners were more likely to have insomnia symptoms. Conversely, those reporting that their relationships were going well or satisfied in their relationship were more likely to not have insomnia. Conclusion In this sample of Soldiers, marriage only served as a protective factor when individuals had a positive outlook in their relationship. These results also suggest that healthier relationships are generally associated with better sleep. These findings underline the importance of relationship quality and its effects on insomnia. Support (if any) This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan-http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981. CJS’s time was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Mental Illness Research and Treatment. KEM’s time was supported by the U.S Department of Veterans Affairs, Veterans Health Administration (Clinical Science Research and Development Service – IK2 CX001874).

Background.Long-acting injectable (LAI)-PrEP provides better protection against HIV compared to oral PrEP, which requires taking a daily pill. Our study aimed to assess knowledge about oral and LAI-PrEP and identify factors associated with willingness to use LAI-PrEP among key populations (KP) in Uganda.Methods.We conducted a cross-sectional study at the Most at Risk Populations Initiative (MARPI) clinic between November and December 2021. Participants were recruited through convenience sampling and interviewed using a structured questionnaire by trained interviewers. Participants were categorised into three groups based on their oral PrEP use: those who had not yet initiated PrEP, those who had discontinued oral PrEP, and those currently on oral PrEP. Modified Poisson regression analysis was performed to determine factors associated with the participant’s willingness to use LAI-PrEP. Data was analysed using STATA 14 software.Results.Of the 234 participants, 135 (56.7%) were female, 82.5% knew about LAI-PrEP, and 67.5% were willing to use it. The mean age was 28.7 years (standard deviation [SD] 5.8). Willingness to use LAI-PrEP was less likely among divorced, widowed, or separated individuals than those in relationships (adjusted prevalence ratio [aPR] 0.65, 95% CI: 0.43–0.98). Relative to current oral PrEP users, willingness to use LAI-PrEP was similar among those who discontinued oral PrEP (aPR 1.39, 95% CI: 0.92–2.11) and those who had not yet initiated PrEP but were at risk for HIV (aPR 1.26, 95% CI: 0.83–1.89).Conclusions.In this cross-sectional analysis of diverse members of key populations in Uganda, previous or non-use of oral PrEP was not associated with willingness to use LAI-PrEP relative to current users. Future studies should investigate effective methods for promoting the uptake of long-acting PrEP formulations among populations at high risk of HIV acquisition.

The study uses 15 waves of the British Household Panel Survey and the General Health Questionnaire to investigate changes in mental distress over several years surrounding transitions both into and out of marital partnerships (marriages and cohabitations) using fixed effects models. Entering marital partnerships is associated with reduced distress in separated or divorced individuals but not with those not previously married. Partnership dissolution is associated with very high levels of distress, but most people experience levels of distress a few years after leaving a partnership similar to that of a few years before leaving. These results vary, however, between married and cohabiting individuals, between fathers and mothers, and between age and gender groups.

Critical life events, such as partner loss, in the second half of life pose a significant threat to well-being. Divorce and bereavement have negative consequences for mental and physical health, identity, social relationships and financial adequacy, among others, which can lead to loss of resources and trigger vulnerability. The LIVES “Intimate Partner Loss Study” investigates adaptation to these critical life events in later life, that is also challenged by age-related changes. Specifically, the focus of this study lied on the investigation of patterns of adaptation and their characteristics, considering different types of resources (e.g., intimate partner, personality traits), personal growth, and accumulation and persistence of disadvantage (e.g., critical life events across the life course). It is a prospective longitudinal study (3 waves of data collection) that was conducted in the French and German-speaking parts of Switzerland from 2012 to 2016. The sample consisted of 963 separated or divorced individuals, 563 widow(er)s, and 1279 continuously married individuals (more than 15 years), who served as a reference group. Results highlighted the different adaptation patterns to later life divorce and bereavement regarding timing, coping mechanisms, and resilience, and furthermore identified individuals who became more vulnerable after the critical partner loss events. Implications for research and practice are discussed.

The relationship between major depression and marital disruption is bidirectional