Divorced Status Research Articles

Factors Associated with Chlamydia Infection among Female Sex Workers in West Jakarta: Analysis of the 2018-2019 Integrated Biological and Behavioral Survey

Background: Chlamydia is one of the most common sexually transmitted infections globally. Female sex workers (FSW), especially in urban areas, face a higher risk of infection due to their risky work environment and lifestyle. Jakarta is a city that has cosmopolitan and urban characteristics with an active sex industry. This research was conducted to determine the factors associated with the incidence of chlamydia infection among FSWs in West Jakarta.Methods: The research was conducted using a cross-sectional design by analyzing data from the 2018-2019 Integrated Biological and Behavioral Survey (IBBS). The data were analyzed using univariate and bivariate analysis with the chi-square test. Prevalence ratio (PR) was used as the measure of association.Results: Of the 283 FSWs involved in the study, the positivity rate of chlamydia infection in West Jakarta reached 42.8%. Significant risk factors for chlamydia infection among FSWs in West Jakarta include younger age, divorced status, recently becoming a sex worker, and having ≥ 5 customers per week.Conclusion: The high rate of chlamydia infection among FSWs in West Jakarta highlights the need to increase outreach to FSWs in order to educate them about STIs and encourage them to perform regular screenings, especially for young FSWs.

The Dynamics of Divorce in Indonesian Muslim Families

The development of divorce cases from year to year is very dynamic. Divorce occurs not only because of problems in the family but also because divorce is attached to the husband and wife, who are left behind due to death. Likewise, the judge's decision can affect the determination of divorce status. If the judge is unwilling or does not decide on the divorce, the marriage is not declared divorced. Therefore, divorce is defined as the breakup of the marital relationship with the judge's decision or the request of one of the parties. This article aims to find out the dynamics of divorce development in Indonesia. This research is library-based qualitative with a descriptive, critical, analytical approach and an interdisciplinary perspective, combining philosophical, psychological, sociological, juridical, and comparative methods. The results show that divorce and marriage exist in the world. In the jewish religion, divorce is permitted. In the catholic faith, divorce is prohibited, while in protestantism, it is allowed on the grounds of adultery. In islam, the majority of islamic jurists allow it and some islamic jurists ban divorce. Meanwhile, in indonesia, divorce is permitted by a court decision. Some regions with the most divorce cases are West Java, East Java, Central Java, North Sumatra, DKI Jakarta, Banten, South Sulawesi, And Riau. The factors that cause divorce are spouse conflicts, economy, leaving one party, domestic violence, drunkenness, gambling, neglect, one of them being imprisoned, adultery, polygamy, forced marriage, and disputes that lead to divorce. Efforts to prevent divorce include premarital education, family money management training, strengthening the basis of personality, family mediation, and rehabilitative assistance for divorced couples.

PENETAPAN AHLI WARIS DALAM TINJAUAN YURIDIS NORMATIF

This study focused on disparities between decisions made by first-instance and appeal courts in handling the same case. Failure to register marriages and divorces leads to legal division of property and inheritance shares. First-instance judges prioritize legal certainty of marriage/divorce certificates and their legal implications. However, appeal courts lean towards sociological facts, disregarding the evidential value of authentic marriage certificates. Furthermore, their decisions conflict with the Marriage Registration Act, which mandates valid divorces to be confirmed by court-issued certificates. This study was normative research using case, legal, and conceptual approaches. The legal material was decision number 651/Pdt.G/2020/PA.Tgr and number 54/Pdt.G/2021/PTA.Smd, as well as legal provisions in the law of evidence. Based on these legal materials, legal analysis was conducted using deductive and inductive methods to strengthen the analysis of legal reasoning results of different judges hearing the same case. This study found that: firstly, the High Court of Religion in Samarinda's decision to disregard the divorce certificate did not uphold legal certainty, as certificates hold significant weight in inheritance cases, serving as conclusive evidence. Hence, there was ambiguity regarding the divorce status of Kasmawati binti Talle and Tajang bin Abu Bagenda in case number 54/Pdt.G/2021/PTA.Smd due to the absence of fully evidential documentation. Secondly, the legal ramifications of an unregistered divorce render it invalid and necessitate annulment, binding the wife to her former husband, a principle supported by Imam As-Syafi'i in Islamic jurisprudence, aligned with other scholarly opinions.

Sociodemographic and Lifestyle Risk Factors Associated with Fragility Hip Fractures: A Systematic Review and Meta-Analysis

Hip fractures inflict heightened morbidity and mortality upon older adults. Although previous studies have explored the impact of individual demographic factors on hip fracture risk, a comprehensive review can help reconcile disparities among these factors. This meta-analysis encompassed 69 studies involving 976,677 participants and 99,298 cases of hip fractures. We found that age ≥ 85 (OR = 1.75), BMI < 18.5 (OR 1.72), female sex (OR = 1.23), history of falls (OR = 1.88), previous fractures (OR = 3.16), menopause (OR 7.21), history of maternal hip fractures (OR = 1.61), single and unmarried status (OR = 1.70), divorced status (OR 1.38), residing in a residential care facility (OR = 5.30), and living alone (OR = 1.47) were significantly associated with an increased incidence of hip fracture. Conversely, BMI ranging from 25 to 30 (OR = 0.59), BMI > 30 (OR = 0.38), parity (OR = 0.79), non-Caucasian descent (overall OR = 0.4, Asian OR 0.36, Black OR = 0.39, and Hispanic OR = 0.45), and rural residence (OR = 0.95) were significantly associated with a diminished risk of hip fracture. Hip fracture patients exhibited significantly lower weight and BMI than the non-fracture group, while their age was significantly higher. However, age at menopause and height did not significantly differ between the two groups.

Newly Diagnosed Mental Health Disorders in Patients With Breast Cancer Receiving Radiation Therapy

ObjectivesPatients with a mental health disorder (MHD) have higher age-adjusted mortality compared to the general population. Few reports investigate factors contributing to MHD among breast cancer patients receiving radiotherapy. Here, we report the incidence of acquired MHD after the diagnosis of breast cancer and treatment with radiotherapy. MethodsUtilizing a single-institution, prospectively maintained database, we analyzed patients with breast cancer treated with radiotherapy between 2012 and 2017. We cross-referenced these patients with newly acquired ICD-10 MHD codes within 3 years post-breast cancer diagnosis. The study included baseline NCCN distress tool scores and area deprivation index (ADI). Univariate (UVA) and multivariable (MVA) Cox regression analyses were conducted to evaluate factors impacting new MHD onset. ResultsOf the 967 included patients, 318 (33%) developed an MHD after their breast cancer diagnosis, which were predominately anxiety (45.1%) and depression (20.1%) related, with a median (IQR) time to diagnosis of 30 (24–33) months. UVA showed lymph node-positive disease, receipt of chemotherapy, receipt of a mastectomy, high comorbidity index, divorced status, retired status, and fourth-quartile ADI as significant predictors. On MVA, only receipt of chemotherapy (HR=1.70, p=0.014) and divorced status (HR=2.04, p=0.009) remained significant. Fourth-quartile ADI, retired status, and high comorbidity index showed trends towards significance (HR=1.78, p=0.065; HR=1.46, p=0.094; HR=1.41, p=0.059, respectively). On MVA examining the effects of the radiotherapy type on MHD, whole breast with regional nodal irradiation (WBI+RNI) (HR=2.31, p=0.015) and post-mastectomy radiotherapy (PMRT) (HR=1.88, p=0.024) were both strong predictors of MHD development. Additionally, an NCCN distress tool score of >3 was also predictive of MHD onset. ConclusionIn this cohort, one in three patients with localized breast cancer developed a new MHD, predominantly related to anxiety and depression. MHD risk was higher among divorced patients, those receiving chemotherapy, and patients receiving PMRT or WBI+RNI. These findings highlight the importance of future studies and targeted interventions to support this vulnerable population.

Kepastian Hukum dalam Proses Perceraian Talak di Hadapan dan Melalui Izin Mahkamah Negara Bagian dan Wilayah Persekutuan Malaysia

Divorce that occurs outside and without permission from the court raises many legal problems, from the validity of the divorce to the non-fulfillment of the rights and obligations of husband and wife after divorce. Malaysia is a country consisting of states and an alliance area which in its Islamic family law rules regulates divorce before the court to ensure legal certainty. This paper discusses the procedures for the divorce of Malaysian citizens that must be carried out before the Malaysian Court and the rules for registering talak for divorces that have already occurred not in front of and without the permission of the Malaysian Court. The regulations for imposing divorce outside the Malaysian Court also include penalties (punishment) for violators. This paper uses a juridical-philosophical approach to explain the procedure for divorce before the court and the rules related to the registration of divorce that have been carried out outside and without the truth of the court to create legal certainty. This research is a qualitative type of literature research. The conclusion of this paper shows that the rules related to divorce before the Malaysian Court indicate legal certainty because in the process the judge examines the validity of the lafadz talak that the husband has imposed to ensure the validity of the legal status of divorce in Sharia and the state administratively, as well as the fulfillment of the rights and obligations of husband and wife after divorce.

Burn-out among practitioners managing abdominal surgical emergencies in Senegal

IntroductionSurgery represents a distinct medical specialization that necessitates direct interaction with patients and the ability to manage complications. Burn-out is defined as a syndrome arising from persistent workplace stress that has not been effectively addressed. The objective of this work was to assess the prevalence and factors associated with burn-out among practitioners managing abdominal surgical emergencies in Senegal. A descriptive and analytical cross-sectional study was conducted; the study included healthcare professionals (general practitioners, general surgeons, anesthesiologists, nurses) involved in the management of surgical emergencies across all hospitals in Senegal. A standardized assessment of perceived stress was conducted using the Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion, depersonalization, and personal accomplishment. A multiple linear regression model was used to estimate the determinants of burn-out on the three subscales. A total of 186 observations were included in the study, for a response rate of 90.7%. The majority of participants were from the capital region of Dakar (44. 6%). There were 46 women (24. 7%) and 140 men (75. 3%). The mean age was 34 years 9 ±6.7 years, with a range of 24–59 years. The majority of participants were married (71%), followed by single individuals (26. 3%), divorced (2. 2%), and widowed (0. 5%). The majority of participants were physicians (80. 6%), followed by nurses (19. 4%). The most common medical specializations were general surgery (58.7%), anesthesia and resuscitation (22. 7%), and general medicine (18. 7%). Additionally, 46% of participants were in training (residency program). The predominant motivations included passion for the profession (75.3%), patient satisfaction (69. 9%), stimulating challenges (21%), and salary considerations (11. 8%). The overall prevalence of high burn-out (at least in one dimension) was 46.2%. A multiple linear regression model showed that the risk factors contributing to high burn-out were divorce status, being in training, and being motivated by stimulating challenges, salary considerations or passion for the profession. The protective factors were a positive perception of one's salary, a favorable physical work environment, and high-quality training. This study revealed an alarming prevalence of burn-out among surgical teams dealing with abdominal emergencies in Senegal. These findings call for immediate action to ensure the well-being of surgical teams and, by extension, the quality of healthcare delivery.

Determination of the Factors Affecting Divorce in Türkiye According to Gender: A Research with TUIK Data

This study aims to determine the factors affecting the divorces of men and women in Türkiye and the effects of these factors on the probability of divorce. For this purpose, the survey data of 24200 people, 55% women and 45% men were used in the Family Structure Research carried out by TUIK in 2016. In the research, Pearson’s chi-square analysis was performed first to determine the factors affecting the divorces of individuals. Then, logit and probit regression analyses were applied to the variables found to be significant. As a result of the analysis, it was determined that some of the sociodemographic and socioeconomic variables significantly affect individuals' divorce status.

Stressors and coping mechanisms of divorced women

Background/Aim: The high divorce rate in Indonesia has an impact on the number of divorced women. In Indonesia, women with divorced status are still stigmatised, whereas the stigma and perception of divorced women in the community are still skewed. The formation of a negative stigma from the community makes women who experience divorce face many problems that can increase stress and make women psychologically disturbed. To overcome the conflict experienced, individuals have a coping mechanism as a way to defend themselves against changes that occur both within themselves and from outside themselves. The purpose of this study was to explore the sources of stress and coping mechanisms for stress in divorced women in Cirebon Regency, West Java, Indonesia. Methods: This research was qualitative research with a phenomenological approach. The research participants amounted to 8 women with a divorce status of less than 2 months who experienced mild and moderate stress in dealing with the new status of divorce in Cirebon Regency. The selection of research participants used a convenience sampling technique. Data collection methods using in-depth interview techniques and administering questionnaires perceived stress scale (PSS) to determine a person's level of psychological stress. Data analysis in this study used the Colaizzi method. This study identified two themes, namely the sources of stress of divorced women and coping mechanisms for stress built in divorced women. Results: Sources of stress included social status, negative stigma from society, the process of raising children without a husband, economic factors , fear of facing life in the future and relationships with ex-husbands and their families. These various stresses did not prevent divorced women from continuing their life process. This was because of the coping mechanisms made by divorced women so that the stress they experience did not harm their lives. These coping mechanisms included self-management, enjoying the process, diverting problems, telling other people about problems , strengthening spirituality and self-reflection. Conclusion: Divorced women struggle with numerous stressors. It is necessary to strengthen positive coping mechanisms and to overcome stigmas and prejudices in society towards divorced women.

Prevalence of ADHD and factors for parent's participation in the care of children with ADHD, Yasothon, Thailand.

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder commonly observed in children. Parents' participation in the care (PPC) of children with ADHD (C-ADHD) is especially important to promote support care and treatment. We estimated the prevalence of C-ADHD and identified the factors for the PPC of C-ADHD. A cross-sectional analytic study was conducted on parents and grade-one students in five primary schools, Muang district, Yasothon, Thailand. The study was conducted from March to June 2022. Data were collected using the screening test of SNAP-IV Thai version and by interviewing child psychiatrists and parents. Descriptive statistics were used to summarize the demographic data and prevalence of C-ADHD. Unconditional multiple logistic regression was used to identify predictive statistical model for the PPC of C-ADHD. Four hundred sixty-four students were screened by SNAP-IV, of which 30 students were confirmed as ADHD (6.5% [95% confidence interval [CI]: 4.4-9.1]), with 9.1% boys and 3.6% girls. Four factors associated with the PPC of C-ADHD significantly including male (ORadj: 2.5, 95% CI: 1.4-4.4), single divorce status (ORadj: 2.1, 95% CI: 1.1-4.2), income more than 15,000 baht (ORadj: 3.1, 95% CI: 1.8-5.1), and attitude level during middle-high (ORadj: 8.4, 95% CI: 5.0-14.2). Predictive factors of four variables can be used to implement the policy to improve the healthcare system, prevention, and PPC of C-ADHD.

Depression in Working Professionals – A Systematic Review of the Literature

Introduction: Workplace depression is a debilitating public health issue with far-reaching impacts on employees, employers, and organizations. Depression among working professionals is on the rise, and is a direct and indirect threat to the overall health and well-being of the employees, the productivity of the organizations, and the economic progress of the nations as a whole. This systematic review synthesizes evidence from the existing literature regarding workplace depression and the factors implicated in the development of depression in this population. Methods: The author conducted a search on electronic research databases including PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar, without language restrictions. The studies published within the last 20 years were screened based on the title and abstract. The data extraction of the eligible studies included measures of mental health symptoms, screening (If included), work-related adverse outcomes, work-related satisfaction outcomes, quality of life, help- seeking behavior, risk factors, protective factors, and non-work-related factors. The health risk factors or health- related behaviors associated with workplace depression include overweight or obesity, daily tobacco or cigarette smoking, sleep duration, alcohol consumption, low physical activity, diagnosis of diabetes mellitus, diagnosis of other chronic conditions, and overall poor health status. Results: The development of depression in working professionals is a complex and multifaceted interplay of personal, work-related, and health risk factors of varying degrees. The personal risk factors comprise age, gender, having a partner at home, being a family caregiver, diagnosis of a chronic illness, having children at home, history of recurrent depression, low education level, widowed or divorced status, and history of diabetes mellitus. The workplace factors include role conflict, procedural injustice, .....

COVID-19 vaccine hesitancy in Egypt: a cross-sectional study.

Coronavirus disease 2019 (COVID-19) vaccine hesitancy is a major problem. This study aimed to determine the factors associated with COVID-19 vaccine acceptance. A cross-sectional survey-based study was conducted on a sample of the Egyptian population using an online survey distributed through social media platforms, including Facebook, WhatsApp, and LinkedIn. The questionnaire was composed of five parts: part I describing the research questionnaire and its aim, part II assessing the demographic data, part III assessing knowledge and attitude towards COVID-19 infection, and part IV and V evaluating knowledge regarding COVID-19 vaccines, factors affecting vaccine acceptance and participants' attitude toward vaccination. Regression models were used to assess factors associated with vaccine acceptability. A total of 24376 responses were included in the statistical analysis. Females represented more than two-thirds of the study sample (70.5%,) and 18-24 years was the most commonly reported age group. Around one-third of the sample were healthcare professionals (HCPs). Only 14.3% of the participants received or registered to receive the vaccine, while 47% refused to be vaccinated. Regression analysis revealed that male gender, secondary education, older age, married or divorced status, presence of comorbidities, and higher level of knowledge regarding the vaccine were significantly associated with high vaccine acceptance. The most important vaccine attributes influencing vaccine selection in the current work were efficacy and safety. Vaccine hesitancy is currently a major challenge. Governments should design educational campaigns that provide trusted data related to vaccine efficacy and safety to encourage vaccination and enhance awareness.

Social Dynamics on the Increasing Divorce of Malay Communities during COVID-19 in Sambas West Kalimantan, Indonesia Perspective of Islamic Family Law

The purpose of this study is to find out the causes and provide alternative solutions to the increase in divorce of the Malay community in Sambas Regency, West Kalimantan. The emergence of Covid-19 at the beginning of 2019 as a very scary and deadly virus for mankind in this world. One of them is Indonesia, which has been greatly affected by Covid-19, both from the family economy side and from the family resilience side. One of the cases that occurred in Sambas Regency was that in 2021 there was an increase in divorce during the Covid-19 pandemic, resulting in a change in status. This type of research is a type of qualitative research that prioritizes field studies with a normative juridical approach. The focus in this research is what causes the increasing divorce status of the Malay community during the Covid-19 period in Sambas Regency? And what are the alternative solutions to reduce the high divorce rate during the Covid-19 period in Sambas Regency. The findings of this study are the increase in divorce in Sambas Regency, the existence of conflicts in the families of married couples which results in divorce the main cause of problems in life or family economic resilience, communication in the family is tenuous and marriage. immaturity is caused by being too young to start a household. The alternative solution provided by this study is that husband and wife must communicate actively without prioritizing 2E, namely emotion and egoism to avoid conflict, synergistic active intervention from religious leaders, government, KUA, BBKN and families, to conduct socialization in order to create good relationships for newly married couple or husband and wife who have been married for a long time

Learning from Their Daughters: Family Exposure to Gender Disparity and Female Representation in Male-Led Ventures

We build on recent studies on daughter-to-father influence to explore how male founders’ fatherhood of daughters impacts female representation in their ventures. We find that, conditional on the total number of children, fathering an additional daughter versus a son is associated with a 4% (11%) increase in female director (employee) representation. This daughter-to-father effect gradually matures as daughters grow up and socialize in schools and workplaces, and it increases as daughters age, suggesting that male founders vicariously learn from their daughters about the constraints women face throughout the daughters’ life cycles. Heterogeneity analyses (regarding founder cohort, divorce status, and social class), combined with qualitative evidence, further substantiate the plausibility of vicarious learning as a potential yet understudied mechanism underlying daughter effects. In addition, daughter effects on employee recruitment are concentrated in microbusinesses (number of employees is ≤10) where the founder is close in decision authority to all employees. These findings add important nuances to our understanding of daughter effects in organizational contexts and extend theory of gender homophily in organizations. This paper was accepted by Olav Sorenson, organizations. Funding: K. Wennberg acknowledges funding from the Swedish Royal Academy of Letter. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4727 .

Factors Influencing Suicidal Ideation According to the Deprivation Indices of Different Regions in Korea.

This study examined how deprivation differed by region and the effect those differences had on suicidal ideation among the local population. Data collected over 10 years (2012-2021) in the Korea Welfare Panel Study were organized into 3 categories: metropolitan, city, and rural. A panel analysis was conducted on the impact of deprivation indices, socio-demographic characteristics, and life satisfaction on suicidal ideation in each category. Income, divorce status, family relationship satisfaction, and medical deprivation had a significant impact on suicidal ideation in metropolitan areas, whereas these variables did not have significant effects in rural areas. In other words, income, family, and medical support were more impactful in city areas. Although the deprivation index was higher in rural areas than in city areas due to an aging population and reduced income levels, the mental health of rural residents was found to be generally better than that of city residents. The possibility that this is related to the strength of relationships within the respective communities should be considered in light of recent discussions on relational welfare.

Statistical analysis of divorce status and causes in the Russian Federation

The article presents the results of a statistical analysis of the breeding rate in Russia. The annual data characterizing the number of divorces in 2000−2021 are considered, unstable dynamics is noted, which is generally characterized by a tendency of their decline. The dynamics of the indicator according to short-term data has showed the presence of seasonal fluctuations, seasonality indices have been calculated, a seasonal wave graph has been constructed. Based on the analysis of sociological research data, the reasons for divorces have been identified. On the basis of statistical data, the indicators that have statistical links with the general coefficient of divorce are identified and have an impact on it. These variables have been grouped by individual characteristics, the following groups of factors are formed: demographic factors; income and employment; housing conditions; public health; digital environment. With the help of correlation and regression analysis, linear models have been built for individual groups of factors, and a generalised model. By comprehensively influencing the indicators included in the model, it is possible to adjust the values of the total dilution coefficient for the future. Based on cluster analysis, regions with high, medium and low breeding rates have been identified. The results of the study can be useful to state bodies in the framework of their practical activities.

QUALITY OF LIFE AND ITS DETERMINANTS AMONG ELDERLY WHO LIVING WITH CHRONIC NON-COMMUNICABLE DISEASE

Background: Chronic diseases include non-communicable diseases have been a health burden globally particularly for older people. Since the ageing population is being increased during few decades. The incidence of non-communicable diseases among older people also increased, and continues to rise as alongside the growth of aging. There many studies identified that chronic disease affect the health-related quality of life among older people. Purposes: This study aims to identify the quality of life and its determinant among older people who living with chronic non-communicable disease. Methods: This study applied a cross section survey design. The study participants are elderly who visit primary health care, and older people who have a chronic disease. The study conducted in two primary health care facilities, in Makassar. Results: there are 41 participants who involve in this study. Predominantly participants were late older in group of age (48.8%), female (75.6%), have secondary level in education (41.5%), currently employ (85.4%), divorce status (58.5), have hypertension history range from 1-5 years (73.2%), and have complications (58.5%). The complication of disease shows significant impact on the quality of life (p<0.05, p=0.022). Since the sample size was small this may affect the study results. Conducting research in large sample and add some characteristics are needed in order to improve the evidence. Keywords: Quality of life, Elder people, Non communicable disease

Global prevalence estimates of poststroke fatigue: A systematic review and meta-analysis.

Poststroke fatigue (PSF) is a common complication after stroke. However, information on the global prevalence of PSF and how this varies geographically and by population is lacking. Our aim was to examine the global prevalence of PSF and identify sources of heterogeneity in the published literature. Four medical databases (PubMed, EMBASE, PsycINFO, and Cochrane Database of Systematic Reviews) were searched from their inception to 28 February 2022. The Joanna Briggs Institute Critical Appraisal Instrument for studies reporting prevalence data (JBI) was used to assess the risk of bias (ROB) of the included studies. The primary outcome was the prevalence of PSF determined using a random-effects model. Subgroup analysis and meta-regression models were used to define the source of heterogeneity. In all, 66 studies with 11,697 patients were included in this meta-analysis. The overall quality of the included studies was medium. The global pooled prevalence of PSF in stroke survivors was 46.79% (95% confidence interval (CI), 43.41-50.18%). The prevalence estimates of PSF based on the Fatigue Severity Scale (FSS), Multidimensional Fatigue Inventory-20 (MFI-20), and Fatigue Assessment Scale (FAS) were 47.44% (95% CI, 43.20-51.67%), 51.69% (95% CI, 44.54-58.83%), and 36.13% (95% CI, 23.07-49.18%), respectively. Prevalence rates of PSF were higher in females (53.19%; 95% CI, 46.46-59.92%), in hemorrhagic stroke (57.54%; 95% CI, 40.55-74.53%), in those with a college degree or higher (53.18%; 95% CI, 42.82-63.54%), and in those with unmarried or divorced status (59.78%; 95% CI, 44.72-74.83%). The prevalence of PSF in stroke survivors is high, affecting almost half of all stroke sufferers. PSF rates were higher with female gender, being unmarried or divorced, having a higher educational level, and being hemorrhagic compared to ischemic stroke. PROSPERO (CRD42021269441).

Opioid Use Among Medicare Beneficiaries With Knee Osteoarthritis: Prevalence and Correlates of Chronic Use.

To determine the prevalence of chronic and occasional opioid use and identify risk factors of opioid use among persons with knee osteoarthritis (OA). We used the Medicare Current Beneficiary Survey to select a knee OA cohort. We obtained data on demographics characteristics, marital status, comorbidities, insurance, and prescription medication coverage from survey data and linked Medicare claims. We included all prescribed medication records classified as opioid under the First Databank therapeutic antiarthritics or analgesics categories. We stratified individuals with knee OA into 3 opioid use groups: 1) nonusers (0 prescriptions/year), 2) occasional users (1-5 prescriptions/year), and 3) chronic users (6+ prescriptions/year). We built multivariable logistic regression models using a generalized estimating equation to determine correlates of chronic opioid use. Among 3,549 Medicare beneficiaries with knee OA and a mean ± SD age of 78 ± 7 years, 68% were female, 9% were chronic users, and 21% used opioids occasionally. Multivariable analysis showed that non-Hispanic ethnicity (odds ratio [OR] 4.8, 95% confidence interval [95% CI] 2.2-10.2), divorced status (vs. married; OR 2.3, 95% CI 1.5-3.5), Medicaid eligibility (OR 1.9, 95% CI 1.3-2.7), depression (OR 1.9, 95% CI 1.5-2.5), chronic obstructive pulmonary disease (OR 1.9, 95% CI 1.4-2.5), and inability to walk without assistive devices (vs. no difficulty walking; OR 2.4, 95% CI 1.5-3.7) were independently associated with chronic opioid use. A total of 9% of persons with knee OA use opioids chronically. Efforts to find nonopioid regimens for treating knee OA pain should be tailored to patients at high risk for chronic use.

Life events as predictors of unsustainable working life trajectories from a life course perspective

Abstract Background The association between family-related life events (e.g., getting married or having children) and unsustainable working life in terms of unemployment, sickness absence and disability pension (SA/DP) are rarely studied from a life-course perspective although having public health importance. We investigated trajectories of unsustainable working life, and the associations between change in family-related life events and unsustainable working life trajectories by controlling for familial factors. Methods This is a prospective cohort study of 37,867 Swedish twins aged between 20-40 years on 31st December 1994. Data on trajectories of annual unemployment, SA/DP, and a combined measure of unsustainable working life months was collected from the Swedish national registers. The trajectories over a 23-year period were analysed by group-based trajectory modelling. Associations of change in family-related life events with trajectory groups in the whole sample were estimated by multinomial logistic regression and in discordant twin pairs (n = 4,647 pairs) with conditional models. Results Most participants had no or low levels of unemployment, SA/DP or combined unsustainable working life during 1994-2016. Individuals who were stably married or changed from being single living without children to married living with children had a decreased risk of unsustainable working life compared to individuals with stable family-related life events. The risk of unsustainable working life months over time was higher among individuals who changed from married to single status regardless of having children (range of HRs:1.31-4.44). Conclusions Family-related life events such as maintaining the relationship or getting married and having children decreases the risk of unsustainable working life while divorce is a risk factor for unsustainable working life. From a public health perspective, actions to support family formation or life would consequently promote a sustainable working life. Key messages • Unsustainable working life was less likely among married and among those who changed from single living without children to married with children compared to those with stable family life events. • Individuals who changed from being married to divorced status had an increased risk of unsustainable working life over time and therefore being potentially an important group for public health.