Marriage Status Research Articles

Prevalence of and factors associated with overweight and obesity in patients with severe mental disorders in Shenzhen: results from the urban Chinese population.

To determine the prevalence of overweight and obesity in patients with severe mental disorders (SMD) and the factors associated with their socio-demographic and disease characteristics in a cross-sectional population-based study. This analysis examined the prevalence of overweight and obesity in 14 868 managed SMD patients in an urban area of Shenzhen city based on data from the health information monitoring system in 2021. Multivariate logistic regression were used to identify the factors associated with the prevalence of overweight and obesity in patients with SMD. China. 14 868 patients with SMD. The prevalence of overweight and obesity in patients with SMD in this study was 32·6 % and 16·1 %, respectively. In multivariate analysis, married status, Shenzhen household registration, management durations of 5-10 years and >10 years, participation in family physician services, taking clozapine or aripiprazole, FPG > 6·1 mmol/l, hypertension, TC ≥ 5·2 mmol/l, TG ≥ 1·7 mmol/l, and more frequent follow-ups in the past year were associated with higher odds of overweight and obesity. Compared to their respective reference categories, living with parents, spouse and children, taking risperidone, aripiprazole, amisulpride and perphenazine, FPG > 6·1 mmol/l, hypertension, TC ≥ 5·2 mmol/l, TG ≥ 1·7 mmol/l, and more frequent follow-ups in the past year were associated with higher odds of obesity. We observed a high prevalence of overweight and obesity in patients with SMD in this study. The findings highlight the need for integrated management of overweight and obesity risk factors among patients with SMD.

Who dominates? Multiple constructions of women's subjective social status and their cohort dynamics in transitional China

The way women construct their subjective social status has garnered significant attention. However, the roles of husbands and fathers in this process have been underexplored, with even less focus on how these roles have evolved across generations. This study aims to answer two important questions against the backdrop: First, which is the most dominant factor in shaping married women's subjective social status, their own objective class or those of their husband or father? Answers to this question reveal the impacts of assortative mating and intergenerational mobility. Second, how does the construction pattern change across birth cohorts? Cohort dynamics help reflect the evolution of gender roles and family values in China. Using pooled data from the Chinese General Social Survey in 2010–2017 and the diagonal reference model, our study finds that Chinese married women previously tended to construct their own social status based on the objective class of their husbands. However, this trend is reversed for younger cohorts. Father's objective class status carries roughly the same weight as women's own, but its impact becomes moderately stronger in younger cohorts. Taken together, the above findings reveal a unique pathway of family modernization in transitional China. Married women, although increasingly independent of their spouses, still remain closely connected with their natal families.

Investigating the relationship between internet addiction, domestic violence, and emotional divorce among married women in Tehran

BackgroundIdentifying the factors affecting emotional divorce due to the negative consequences of this social problem in women can play an important role in preventing its occurrence. Therefore, the present study aimed to investigate the relationship between internet addiction, domestic violence, and emotional divorce among married women in Tehran.MethodsA cross-sectional survey was conducted among married women in Tehran, Iran. Sampling was conducted first through a multi-stage cluster method and then continued using a random method. Tehran was divided into five parts: central, northern, southern, eastern, and western. The sample size was divided by 5, resulting in 80 participants selected from each part. In each part, two regions were selected, and in each region, 40 houses were randomly selected. Researchers visited the selected houses, and the questionnaires were filled out at home by the women. Tools such as Gottman’s Emotional Divorce Test, Young’s Internet Addiction Test, and the Domestic Violence against Women Survey were used to collect data. Descriptive and inferential statistics were used to analyze the data in SPSS (version 24) software.ResultsA total of 400 women participated in the study. 46% of all married women suffered emotional divorce. The analysis of these tests showed that are positive and significant relationships between emotional divorce and internet addiction (r = 0.626, p < 0.0001), emotional divorce and domestic violence (r = 0.632, p < 0.0001), and internet addiction and domestic violence (r = 0.455, p < 0.0001). It was also found that there are significant negative relationships between emotional divorce and both the level of education (r=-0.115, p = 0.021) and employment status (r=-0.512, p < 0.0001). Additionally, there are significant negative relationships between internet addiction and age (r=-0.285, p < 0.0001), duration of marriage (r=-0.237, p < 0.0001) and employment status (r=-0.694, p < 0.0001). Furthermore, it was revealed that there are significant negative relationship between domestic violence and age (r=-0.104, p = 0.037) and level of education (r=-0.156, p = 0.002).ConclusionAlmost half of the married women in this study experienced emotional divorce, internet addiction, and domestic violence. These factors have a direct relationship with emotional divorce. Future studies are needed to understand how internet addiction might be associated with separation, emotional divorce and family problems.

Risk factors for second primary breast cancer by laterality, age, and race and ethnicity.

Epidemiologic studies of risk factors for second primary breast cancer (SBC) have been conducted primarily in non-Hispanic White (NHW) women. A racially- and ethnically-diverse population-based pooled cohort of 9,639 women with first primary stage I-III invasive breast cancer (FBC) was linked with the California Cancer Registry; 618 contralateral SBC (CSBC) and 278 ipsilateral SBC (ISBC), diagnosed >6 months after FBC, were identified. Using Fine and Gray models accounting for competing risks, we assessed associations of CSBC and ISBC risk with FBC clinical characteristics and epidemiologic factors. In younger women (FBC at age <50 years), higher CSBC risk was associated with ER/PR-negative FBC [hazard ratio (HR)=1.68], breast cancer family history (HR = 2.20), and nulliparity (HR = 1.37). In older women (FBC at age ≥50 years), higher risk was associated with breast cancer family history (HR = 1.32), premenopausal status (HR = 1.49), overweight (HR = 1.39), and higher alcohol consumption (HR = 1.34). For ISBC, higher risk was associated with married status (HR = 1.94) in younger women, and overweight (HR = 1.60) among older women. For CSBC, HR estimates were generally similar across racial and ethnic groups. Even after adjustment for these risk factors, compared with NHW women, risk remained elevated for CSBC in younger African American, Asian American, and Hispanic women, and for ISBC in older African American and Hispanic women with ER/PR-positive FBC. Our findings support genetic risk evaluation, enhanced screening, and lifestyle changes in women at higher risk of SBC. Additional risk factors must contribute to the unequal burden of SBC across racial and ethnic groups.

Improvement of quality of life on breast cancer-related lymphedema patients through a postmastectomy care program in Mexico: a prospective study.

To assess whether health-related quality of life (HRQOL) improved through a postmastectomy care program focused on breast cancer-related lymphedema (BCRL) protection/awareness. Postoperative breast cancer patients were enrolled prospectively (February-2018 to September-2019) at Nursing and Obstetrics Faculty, Durango, Mexico. Sociodemographic/clinical characteristics, arm measurements, and HRQOL evaluation with Functional Assessment Cancer Therapy-Breast Cancer were collected at baseline and after six follow-up assessments between six-to-twelve-month postmastectomy. Lymphedema was verified through circometry. Descriptive analysis and McNemar-Bowker test were used to evaluate paired differences in HRQOL. Subgroup analysis was conducted to assess sociodemographic/clinical characteristics of BCRL using Pearson's chi-squared or Fisher exact test along with odds ratios (OR) and 95% confidence intervals (CI). All tests were two-sided with P-values < 0.05 considered statistically significant. One-hundred-two patients developed BCRL (incidence 66.2%, n = 154). All dimensions of HRQOL improved after the postmastectomy care program (P < 0.05). The subgroup analysis indicated that elementary academic degree (OR = 2.40, 95%CI: 1.01-5.69), laborer (OR = 9.85, 95%CI: 3.30-29.3), and total mastectomy (OR = 4.23, 95%CI: 1.20-14.9) were more associated with BCRL (P < 0.05). Conversely, high school academic degree (OR = 0.46, 95%CI: 0.22-0.94), married status (OR = 0.42, 95%CI: 0.21-0.86), housewife (OR = 0.27, 95%CI: 0.12-0.61), professional occupation (OR = 0.10, 95%CI: 0.01-0.64), and having no comorbidities (OR = 0.31, 95%CI: 0.15-0.63) were less associated with BCRL (P < 0.05). Although HRQOL improved through the postmastectomy care program, our findings suggest that lower education, working as a laborer, and total mastectomy may be more associated with BCRL. Continuing research may uncover liabilities among BCRL patients within limited-resources settings.

Legalization of LGBT Marriage: Case Study from Vietnam

LGBT marriage is a legal union between two individuals of the same sex, including lesbian, gay, bisexual, and transgender people. This type of marriage recognizes the equal rights of all people to marry regardless of their sexual orientation or gender identity. In Vietnam, the legal status of LGBT marriage has been the subject of considerable discussion and debate. Although the country has made significant strides in improving the rights of LGBT people, there is still a lack of official legal recognition for same-sex marriage. To date, same-sex marriage has not been explicitly legalized nor fully protected under Vietnamese law. This means that although same-sex marriages are not criminalized, and people have their free will to live together and hold ceremonies, yet these marriages do not hold the same legal status and rights as compared to heterosexual marriages. Vietnam has a strong cultural background and conservative beliefs; these play a crucial role in society in respect to the views within it when it comes to LGBT individuals. Society is becoming more tolerant; however, the LGBT community members are still judged with a high rate of discrimination. Although acceptance still significantly varies between regions and different age groups, public opinion is indeed softening, especially among the young. Due to the legal recognition, LGBT marriages provided them with equal legal rights and responsibilities concerning property, inheritance, adoption, and healthcare, just like heterosexual couples. On the other hand, this also can be regarded as another critical step to social inclusion and the fight against discrimination. This research will discuss the current situation of same-sex marriage in contemporary Vietnam with the aim of completing the picture of the LGBT community. The research study will also interview 22 LGBT individuals and a survey of close to 200 participants.

Psychological distress experienced by pregnant women undergoing antiretroviral treatment: A qualitative study

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The psychological condition of pregnant women with HIV is often a significant barrier to initiating and adhering to antiretroviral therapy (ART). Psychological distress in these women, if left unaddressed, can lead to poor treatment adherence, increasing the risk of mother-to-child transmission of HIV. Managing psychological distress caused by HIV early is crucial for optimizing maternal health outcomes and reducing transmission risks&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Objectives: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;This study aims to explore the psychological distress experienced by pregnant women with HIV undergoing ART and to identify ways to improve treatment adherence and reduce the risk of HIV transmission to their children.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;A qualitative research design with a descriptive phenomenological approach was used. Participants were selected through purposive sampling based on specific inclusion and exclusion criteria. Data were collected from five participants through semi-structured, in-depth interviews. Data analysis was performed using ATLAS.ti software.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Four main themes emerged from the data: psychological factors, sociocultural influences, stressors, and life pressures. The study revealed that pregnant women undergoing ART experience significant anxiety, particularly concerning lifelong medication use and the potential transmission of HIV to their babies.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Conclusions: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Pregnant women undergoing ART are highly vulnerable to anxiety, driven by concerns about their health and the possibility of transmitting HIV to their children. Family support plays a crucial role in helping mothers manage their anxiety, improve ART adherence, and cope with their psychological distress. Additionally, the legal and religious status of marriage was identified as a key factor contributing to stress, further increasing the risk of anxiety and depression among participants.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;

Trends in and Predictors of Patient Pharmacogenomic Test Uptake in a National Healthcare System

Better understanding patient uptake of pharmacogenomic (PGx) testing may inform its implementation and maximize the benefits that such testing can confer. This study examined patient and provider factors associated with PGx test ordering in a national healthcare system where panel-based testing was implemented as part of routine care. We used a retrospective matched cohort design and data from the Veterans Health Administration Corporate Data Warehouse. A conditional logistic model was used to identify factors associated with a PGx order receipt and estimate odds ratios and 95% confidence intervals. The following patient factors predicted receipt of a PGx test order: younger age, married status, rural residence, non-Hispanic Black or Hispanic race/ethnicity, PGx educational mailer receipt, depression diagnosis, allergy to a drug on the panel, prescriptions for drugs on the panel, and specialty care visits (p<0.05). Additionally, patients whose providers were female, younger, a nurse practitioner/physician assistant or pharmacist, or participated in an educational mailer program were more likely to receive an order (p<0.05). This study highlights factors that may facilitate or hinder the widespread and equitable implementation of PGx testing in a large national healthcare system. The information is being used to further refine the program.

Permohonan Itsbat Nikah Untuk Perkawinan Kedua oleh Istri yang Bercerai di Luar Pengadilan Agama (Studi Kasus Padang Pariaman)

Divorces outside the court often occur, resulting in the marriage status remaining valid according to Indonesian positive law. This leads couples who wish to remarry to do so clandestinely and seek marital validation through the religious court. Therefore, the purpose of this research is to understand the process of resolving itsbat nikah petitions for second marriages by wives who divorced outside the court and the legal consequences for the parties from the rejection of itsbat nikah by the religious court. This research employs an empirical juridical method focusing on field realities related to applicable legal aspects. Data analysis is conducted qualitatively to depict the research subjects and objects, with theories developed from the acquired data. The research findings indicate that the itsbat nikah process begins with a petition to the pusbakum, revealing that the couple were single before their secret marriage in 2007. However, during the trial, it was revealed that the wife had legally married in the Office of Religious Affairs (KUA) in 2004 and divorced outside the court in the same year, resulting in the rejection of the itsbat nikah petition. Consequently, the wife's post-divorce iddah maintenance rights are lost, but the child's legal status remains recognized, in accordance with Constitutional Court Decision No. 46/PUU-VII/2010.

The care of non-institutionalized ADL-dependent people in the Orcasitas neighborhood of Madrid (Spain) during the Covid-19 pandemic and its relationship with social inequalities, intergenerational dependency and survival.

Mortality among people with dependency to perform basic activities of daily living (ADL) is higher than that of non-dependent people of the same age. Understanding the evolutionary course and factors involved in non-institutionalized ADL dependency, including the influence of the family structure that supports this population, would contribute to improved health planning. A longitudinal study carried out in the ADL-dependent population of the Orcasitas neighborhood, Madrid (Spain), between June 2020, when the nationwide COVID-19 lockdown ended, and June 2023. A total of 127 patients participated in the study, 78.7% of whom were women and 21.3% were men. Risk analysis was performed via odds ratios (OR) and hazard ratios (HR). Survival analysis was performed using Cox regression. A total of 54.33% of the ADL-dependent persons did not live with their adult children and 45.67% did, being associated living independently with economic capacity and the married marital status but not with the dependency level. In women, being married increased the probability of living independently of their adult children (OR = 12.632; 95% CI = 3.312-48.178). Loss of mobility (OR = 0.398; 95% CI = 0.186-0.853), economic capacity of the dependent (HR = 0.596; 95% CI = 0.459-0.774), and living independently and having better economic capacity (HR = 0.471; 95% CI = 0.234-0.935) were associated with 3-year survival. Those who lived with their adult children had a worse autonomy profile and higher mortality (HR = 1.473; 95% CI = 1.072-2.024). Not being employed, not being married, and not owning a home were significantly associated with being an essential family caregiver. Caregivers were mostly women (OR = 1.794; 95% CI = 1.011-3.182). Among ADL-dependent persons, economic capacity influenced the ability to living independently and affected survival after 3 years. Loss of mobility (wheelchair use) was a predictor of mortality. Social inequalities promote that adult children end up as essential family caregivers. This generates reverse dependency and maintains a vulnerability that is transmitted from generation to generation, perpetuating social and gender inequalities. Dependent parent care in this cohort maintained an archaic pattern in which the eldest daughter cared for her parents. This study made it possible to show that ADL dependence is accompanied by complex interrelationships that must be considered in socio-health planning.

Численность населения Республики Коми: от переписи населения 1897 г. к переписи населения 2021 г.

This article examines the population censuses conducted in the Russian Empire, the USSR and the new Russia; it reveals the peculiarities and methodological apparatus of each population census, presents the main questions of census lists, their comparability with previous censuses, notes new questions and explains their application. Thus, in the 2010 population census, the term “household” was introduced in the question on kinship (property) with other persons living with the respondent; in the question on marriage status, the concepts “officially divorced” and “separated” were differentiated; the levels of education and the presence of a degree were highlighted; the results of population censuses are given according to statistical data for the Komi Republic. The results of the population censuses of 1939 and 1959, which made it possible to assess the scale of forced migration to the Komi region, are separately considered. For each population census, the timing of its conduction and the critical moment are given, it is explained why certain population censuses were carried out not in the “zero” year, as is customary in most countries of the world, but in other years. Particular attention is paid to the 2021 census, it has been postponed for one year due to the COVID-19 pandemic.

Comparison of prognosis between oncocytic thyroid carcinoma and follicular thyroid carcinoma: a population-based propensity score matching analysis.

Oncocytic thyroid carcinoma (OTC) is a rare subtype of thyroid cancer known for its distinctive morphology and high likelihood of recurrence, setting it apart from follicular thyroid carcinoma (FTC). Despite this, there is limited research comparing the clinicopathological characteristics and outcomes of OTC and FTC. We retrospectively searched through the Surveillance, Epidemiology, and End-Results (SEER) database (2004-2015) for histologically diagnosed OTC and FTC patients. Kaplan-Meier analysis, propensity score matching (PSM), univariate Cox proportional risk regression model, and subgroup analysis were employed to investigate the prognostic effect of clinicopathological features and treatment regimens on survival outcomes of OTC and FTC patients. 2329 OTC patients and 5679 FTC patients were included in the study. OTC patients were prone to older age, white race, lymph node metastasis, distal metastasis, extension and multiple primary tumors compared with FTC patients. After using a 1:1 PSM matching ratio, there were no significant differences in demographic and clinicopathological characteristics between the matched groups. Further Cox regression analysis showed that OTC patients had lower overall survival (OS) and cancer-specific survival (CSS) in contrast with FTC patients. Subgroup survival analysis suggested that the OTC patients were related to lower OS in subgroups including those over 55years old, male sex, white ethnicity, extrathyroidal extension, single primary tumor, surgery and without chemotherapy compared with the FTC patients in these subgroups. In addition, the OTC patients were connected with lower CSS in subgroups including male sex, white ethnicity, married status, tumor size is less than 20mm or more than 40mm, N0 stage, localized stage, single primary tumor, surgery, radiotherapy, and without chemotherapy compared with the FTC patients in these subgroups. Meanwhile, the OTC patients had lower CSS compared to FTC patients regardless of age and extrathyroidal extension. The results suggested that OTC patients have unique clinical features and poorer prognoses compared to FTC patients. Surgical resection and radioactive iodine therapy are recommended for OTC patients and FTC patients. It is worth noting that the prognosis of OTC relies largely on the selection of treatment strategies. Therefore, our results highlighted the clinical significance of the early distinguishment and the correct choice of treatment in OTC patients.

Predictors of ICU Surrogates' States of Concurrent Prolonged Grief, Post-Traumatic Stress, and Depression Symptoms.

Scarce research explores factors of concurrent psychologic distress (prolonged grief disorder [PGD], post-traumatic stress disorder [PTSD], and depression). This study models surrogates' longitudinal, heterogenous grief-related reactions and multidimensional risk factors drawing from the integrative framework of predictors for bereavement outcomes (intrapersonal, interpersonal, bereavement-related, and death-circumstance factors), emphasizing clinical modifiability. Prospective cohort study. Medical ICUs of two Taiwanese medical centers. Two hundred eighty-eight family surrogates. None. Factors associated with four previously identified PGD-PTSD-depressive-symptom states (resilient, subthreshold depression-dominant, PGD-dominant, and PGD-PTSD-depression concurrent) were examined by multinomial logistic regression modeling (resilient state as reference). Intrapersonal: Prior use of mood medications correlated with the subthreshold depression-dominant state. Financial hardship and emergency department visits correlated with the PGD-PTSD-depression concurrent state. Higher anxiety symptoms correlated with the three more profound psychologic-distress states (adjusted odds ratio [95% CI] = 1.781 [1.562-2.031] to 2.768 [2.288-3.347]). Interpersonal: Better perceived social support was associated with the subthreshold depression-dominant state. Bereavement-related: Spousal loss correlated with the PGD-dominant state. Death circumstances: Provision of palliative care (8.750 [1.603-47.768]) was associated with the PGD-PTSD-depression concurrent state. Surrogate-perceived quality of patient dying and death as poor-to-uncertain (4.063 [1.531-10.784]) correlated with the subthreshold depression-dominant state, poor-to-uncertain (12.833 [1.231-133.775]), and worst (12.820 [1.806-91.013]) correlated with the PGD-PTSD-depression concurrent state. Modifiable social-worker involvement (0.004 [0.001-0.097]) and a do-not-resuscitate order issued before death (0.177 [0.032-0.978]) were negatively associated with the PGD-PTSD-depression concurrent and the subthreshold depression-dominant state, respectively. Apparent unmodifiable buffering factors included surrogates' higher educational attainment, married status, and longer time since loss. Surrogates' concurrent bereavement distress was positively associated with clinically modifiable factors: poor quality dying and death, higher surrogate anxiety, and palliative care-commonly provided late in the terminal-illness trajectory worldwide. Social-worker involvement and a do-not-resuscitate order appeared to mitigate risk.

The Prevalence of Postpartum Contraception Use among Teenage Mothers at Vajira Hospital, Thailand

OBJECTIVES: To determine the prevalence of postpartum contraception use among teenage mothers and to identify the factors influencing both postpartum contraception use and loss to postpartum follow-up at the Faculty of Medicine Vajira Hospital in Thailand.METHODS: Four hundred and seventy-five participants were randomly selected from 1,060 Thai teenage pregnant that gave birth at the Faculty of Medicine Vajira Hospital between 1 January 2017 and 31 December 2020 and were scheduled postpartum visits. The clinical factors associated with postpartum contraception use and loss to postpartum follow-up were studied using multiple logistic regression analysis.RESULTS: A total of 451 participants remained after excluding criteria. Of these, 212 participants did not follow-up on their postpartum visits, leaving the limitation to summarize the true prevalence of postpartum contraception use of the total population. However, of the 232 participants who visited postpartum follow-ups, the prevalence of contraceptive use was 95.8%. Married status was the only factor associated with higher postpartum contraceptive use (odds ratio (OR) 12.81 [3.38-48.64]). Age 18 years and older (ORadj1.71 [1.16-2.53]), absence of previous contraceptive use (ORadj1.91 [1.29-2.80]), and total antenatal care visits fewer than 8 (ORadj 1.61 [1.07-2.42]) were significantly related with loss to postpartum follow-ups.CONCLUSION: The prevalence of contraceptive use was high among teenage mothers who had follow-up postpartum visits. However, this population also had a high loss rate of postpartum visits. Interventions and close monitoring should be considered to evaluated further for effective adolescent reproductive services.

Association between polypharmacy and 2-year outcomes among Chinese older inpatients: a multi-center cohort study

BackgroundThe escalating global prevalence of polypharmacy presents a growing challenge to public health. In light of this issue, the primary objective of our study was to investigate the status of polypharmacy and its association with clinical outcomes in a large sample of hospitalized older patients aged 65 years and over.MethodsA two-year prospective cohort study was carried out at six tertiary-level hospitals in China. Polypharmacy was defined as the prescription of 5 or more different medications daily, including over-the-counter and non-prescription medications. Baseline polypharmacy, multimorbidity, and other variables were collected when at admission, and 2-year outcomes were recorded by telephone follow-up. We used multivariate logistic regression analysis to examine the associations between polypharmacy and 2-year outcomes.ResultsThe overall response rate was 87.2% and 8713 participants were included in the final analysis. The mean age was 72.40 years (SD = 5.72), and women accounted for 42.2%. The prevalence of polypharmacy among older Chinese inpatients is 23.6%. After adjusting for age, sex, education, marriage status, body mass index, baseline frailty, handgrip strength, cognitive impairment, and the Charlson comorbidity index, polypharmacy is significantly associated with frailty aggravation (OR 1.432, 95% CI 1.258–1.631) and mortality (OR 1.365, 95% CI 1.174–1.592), while inversely associated with readmission (OR 0.870, 95% CI 0.764–0.989). Polypharmacy was associated with a 35.6% increase in the risk of falls (1.356, 95%CI 1.064–1.716). This association weakened after adjustment for multimorbidity to 27.3% (OR 1.273, 95%CI 0.992–1.622).ConclusionsPolypharmacy was prevalent among older inpatients and was a risk factor for 2-year frailty aggravation and mortality. These results highlight the importance of optimizing medication use in older adults to minimize the risks associated with polypharmacy. Further research and implementing strategies are warranted to enhance the quality of care and safety for older individuals exposed to polypharmacy.Trial registrationChinese Clinical Trial Registry, ChiCTR1800017682, registered 09/08/2018.

Queer Economics: Same-Sex Marriage Rate vs. Economics Crisis Expectation

Marriage is not just a promise between two individuals; it serves as a bridge between two families and provides the nurturing ground for many new lives. Research studies have indicated that marriage can enhance the subjective well-being of married individuals[i]. However, beneath the weighty commitments and responsibilities, the dissolution of marriage can increase illness rates and psychological distress among divorced women. [ii]While mainstream society still upholds the social stability brought by marriage and advocates it as an indispensable part of the human lifecycle, people are actively exploring alternative romantic relationships or family models, such as cohabitation. Many individuals engage in cohabitation as a prelude to formal marriage, viewing it as an experimental version of married life, enjoying the everyday romantic relationship without the legal costs and property entanglements. [iii]This article considers cohabitation as an alternative to marriage, which can also be understood as a substitution in consumption when people are deterred from marriage due to the high costs associated with divorce. Therefore, strategies people adopt towards marriage are often influenced by changes in societal patterns and the turbulence in politics and the economy. In comparison to heterosexual couples, the dynamics of marriage are more complex for same-sex couples. Apart from the ethical debates surrounding same-sex marriage, economic models have also demonstrated that same-sex marriage poses significant secular challenges. [iv]For instance, issues like post-marriage healthcare for same-sex couples and the impact of their married status on the labor market are still subjects of debate. However, these issues primarily target the challenges and research pertaining to the identity of being a same-sex individual. Nevertheless, as members of society, same-sex couples also experience the fluctuations brought about by broader social cycles, such as the impact of economic crises. There is relatively limited research in the field on how same-sex couples respond to widespread societal crises, and the strategies employed by same-sex couples during different economic crises can effectively reflect the natural state of this community within society.[v] [i] Janice K Kiecolt-Glaser and Tamara L Newton. (2001). Marriage and Health: His and Hers. American Psychological Association. https://psycnet.apa.org/record/2001-01085-002. [ii] Frederick O Lorenz et al. (2006). The Short-Term and Decade-Long Effects of Divorce on Women’s Midlife Health. American Sociological Association. https://journals.sagepub.com/doi/abs/10.1177/002214650604700202. [iii] Brandon G Wagner, Kate H Choi, and Philip N Cohen. (2020). Decline in Marriage Associated with the COVID-19 Pandemic in the United States. Sage Journals. https://journals.sagepub.com/doi/10.1177/2378023120980328. [iv] DOUGLAS W ALLEN. (2006). An Economic Assessment of Same-Sex Marriage Laws. Semantic scholar. https://www.semanticscholar.org/paper/An-Economic-Assessment-of-Same-Sex-Marriage-Laws-Allen/513a92f3d397ae2b787094294aa465d48053ef53. [v] Malaczewska Paulina and Malaczewski Maciej. (1970, January 1). Marriage, Divorce and Coronavirus—Theoretical Analysis of the Influence of COVID-19 on Family Capital. Economics and Business Review. https://ideas.repec.org/a/vrs/ecobur/v8y2022i3p126-142n7.html.

Factors associated with sleep quality among Afghan healthcare workers.

Sleep is a complex physiological process during which the body and mind enter a period of rest. For a healthy lifestyle, different cohort groups can be affected in different ways. One such cohort is healthcare workers (HCWs)-an unexplored group in Afghanistan. Therefore, the present study examined the association between a range of sociodemographic factors including having night shift work and sleep quality among Afghan HCWs. A cross-sectional survey was administered in January 2023 among HCWs (N = 342) in the Herat province of Afghanistan. The survey examined sleep quality and its association with a range of sociodemographic factors among HCWs. Logistic regression models were used to examine the association of sleep quality with sociodemographic characteristics among HCWs. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among HCWs. A total of 342 HCWs participated in the present study with an age range of 18 to 60 years. The mean age of the participants was 28.90 years (SD ± 8.10). Just over half of the participants were male (50.3%). Of the 342 participants, 58.5% reported poor sleep quality. Being married status, having higher number of children, not being a doctor, having low economic status, working night shifts, and having a traumatic event occur during past month were among the main variables associated with sleep quality among Afghan HCWs. Multiple regression analysis indicated that having high income [negatively] (AOR = 4.132, p = 0.002), working night shifts [positively] (AOR = 0.288, p < 0.001), and having a traumatic event occur during past month [positively] (AOR = 0.504, p = 0.007) were significantly associated with sleep quality. The study suggests the need for Afghan health employers to create a healthy work environment that prioritizes the well-being of their employees by limiting overtime hours, providing rest breaks during long shifts, and ensuring that HCWs have access to necessary resources for coping with work-related stressors. These policies would promote the overall health and well-being of the workforce and would likely lead to better patient care outcomes.

Healthcare workers' perceptions and acceptance for COVID-19 vaccine for their children aged

The coronavirus disease 2019 (COVID-19) vaccination program among adults in India is one of the highly successful vaccination drives globally, but the acceptance of the COVID-19 vaccine among parents for their children is largely unknown. As parents are primary decision-makers for their children, we aimed to assess parents' perceptions and acceptance for COVID-19 vaccination for children in India. To assess parental perceptions and acceptance for COVID-19 vaccination for their children (aged <18 years). A cross-sectional anonymous web-based survey was designed and conducted from November 1 to December 15, 2022. All the healthcare workers of a tertiary care institute in eastern Uttar Pradesh, having a child aged <18 years, constituted the study population and were invited. They were recruited through snowball sampling and were sent the study questionnaire in Google form through email and WhatsApp. Bivariate analysis was performed to determine the predictors of child vaccination acceptance among the parents. A total of 388 healthcare worker parents (HCWPs) having a child <18 years of age completed the survey. The mean age of the parents was 40.28 ± 11.34 years. The majority (96.9%) of them had already received the recommended two doses of the COVID-19 vaccine. Around 91% of the parents agreed that COVID-19 vaccines are important for children's health, whereas 89% agreed that COVID-19 vaccines are effective. A total of 356 (91.7%) parents were willing to vaccinate their children with a COVID-19 vaccine, of which 91.3% intended to do so as soon as possible. The factors significantly associated with the stated willingness for child vaccination among the participants were younger age (P = 0.008), female gender (P = 0000), currently married status (P = 0.00001), urban residence (P = 0.01), lower monthly income (P = 0.03), absence of any chronic illness (P = 0.0003), history of COVID-19 in the child (P = 0.004), and the child being up-to-date with the routine childhood vaccines (P = 0.01). The HCWPs from eastern Uttar Pradesh, India, have a positive attitude and low vaccine hesitancy toward COVID-19 vaccination for children, with around 92% currently willing to vaccinate their children with COVID vaccine. Further longitudinal studies are required to assess the trend of parental acceptance of COVID vaccine.

The Legal Status of Marriage (Merariq) Implementation Within The Indigenous People of Sasak Lombok

This research examines the legal status of merariq marriages within the Sasak traditional community in Lombok. Merarik marriages, governed by customary practices and norms, often conflict with Indonesia's national positive law. This study explores the interaction between Sasak customary law and national law regarding merarik marriages. Using qualitative methods and a case study approach, the researcher conducted in-depth interviews with traditional leaders, legal practitioners, and community members to gain a comprehensive understanding of the issue. The findings reveal a discrepancy between national legal provisions and customary practices, creating challenges in legal recognition and enforcement. The study suggests that harmonization between customary and positive law is necessary to ensure fair recognition of customary practices and the protection of individual rights. This research aims to enhance understanding of the legal dynamics within Indigenous communities and support the development of policies that are inclusive and responsive to cultural diversity.

Construction of a novel predictive model for hope level in patients with primary liver cancer from a positive psychology perspective

This study aimed to investigate the current hope levels in patients with primary liver cancer by analyzing the risk indicators of hope levels, constructing and validating a novel hope score-based predictive model. A total of 206 patients with primary liver cancer admitted to the hepato-pancreato-biliary surgery department of a tertiary hospital from October 2020 to June 2021 were included. The Herth Hope Index was utilized to assess hope levels, and based on the questionnaire results, the patients were categorized into low-hope (≤ 30 points) and high-hope (> 30 points) groups. Single-factor analysis and logistic multivariate regression analysis were conducted to explore the factors influencing hope levels in patients with primary liver cancer. A nomogram was plotted, and a risk prediction model for hope levels in these patients was developed. The predictive performance of the nomogram model was evaluated using calibration plots, the Hosmer–Lemeshow test, and other relevant assessments. Total of 206 patients participated in the questionnaire survey, with 82 patients (39.81%) categorized as belonging to the low-hope group. The results of the single-factor analysis showed statistically significant differences (all P < 0.05) in marriage status, education level, residence, occupation, family monthly income, reason for hospitalization or outpatient visit, pressure caused by the disease on the family, history of cirrhosis, and level of social support between the two groups. These variables were subsequently included in the logistic multivariate regression model. The results of the regression analysis indicated that marriage status, residence, family monthly income, and level of social support were independent risk factors. These four influencing factors were transformed into a visual predictive model, which yielded an area under the ROC curve of 0.931 (95% CI 0.899–0.963) and demonstrated model significance (Hosmer–Lemeshow test: χ2 = 4.008, P = 0.856, P > 0.05). The observed and expected values generated by the Hosmer–Lemeshow test were plotted as a scatter plot with a fitted linear trend, showing good consistency between the predictive model and actual risk. The constructed predictive model developed in this study exhibited good predictive capability for assessing the hope levels of patients with primary liver cancer. This model can assist clinical staff in rapidly identifying the psychological risk of low hope levels in patients, thereby providing valuable insights for the timely implementation of proactive management measures.