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A comparison of ever-married and never-married women with anorexia nervosa or bulimia nervosa.

OBJECTIVE: The results of the scant research on anorexia nervosa and marriage suggest that married anorexics may exhibit more severely disordered eating. However, past research has not controlled for the greater age of married versus unmarried anorexics, and very little research has been conducted on marriage and women with bulimia nervosa. We investigated differences in disordered eating and clinical traits between ever-married and never-married women with anorexia nervosa or bulimia nervosa and statistically controlled for age. METHOD: Adult women ages 20-45, who were assessed in an outpatient eating disorders clinic and diagnosed with anorexia nervosa (n = 91) or bulimia nervosa (n = 223), completed several measures of disordered eating and related traits at the point of initial evaluation. RESULTS: In simple comparisons, ever-married women differed from their never-married peers with regard to several indices of symptom history and severity. However, after controlling for age, ever-married women differed only with regard to an earlier onset of menarche and, for women with bulimia nervosa, an earlier onset of sexual intercourse. DISCUSSION: Results are discussed with regard to possible explanation and directions for future research.

Adult↗

Factors affecting ever-married men's contraceptive knowledge and use in Nigeria.

African men play important roles in the decisions about family life, including fertility and family planning. However, fertility and family planning research and programmes have ignored their roles in the past, focusing only on women's behaviours. Since the 1994 International Conference on Population and Development (ICPD), interest in men's involvement in reproductive health has increased. Unfortunately, data on their knowledge and use of contraception are generally scanty. This paper examines knowledge and use of contraception among ever-married men in Nigeria. A total of 1451 ever-married men aged 18-55 were interviewed in Imo and Ondo States, Nigeria. The findings reveal that men's level of contraceptive knowledge is high in the study areas. About 90% knew at least one method of family planning. Furthermore, the level of contraceptive use among married men is such that men could participate in family planning activities if there were adequate programmes to involve them. Men in the sample areas were found not only to support their spouses' use of contraceptives, but were actually using condoms to delay or prevent pregnancy. Age, education, place of residence, number of living children and being counselled for family planning were identified as key factors determining contraceptive knowledge and use among married men in the study areas. To ensure increased participation of men in family planning, programmes must be designed to educate them on the need for family size limitation and involve them in service delivery, even if only to their male counterparts.

Adult↗

Community based study of reproductive tract infections among ever married women of reproductive age in a rural area of Haryana, India.

A community based study was carried out to estimate the load of reproductive tract infections (RTIs) among ever married rural women aged 15-44 years and utilisation of a mobile village based treatment facility by them, during 1997. Complete household survey was done in 10 randomly selected villages of Mahindergarh district in Haryana, India. A total of 2325 women were interviewed by auxiliary nurse midwives and were invited for medical examination in a health camp set-up in their village. Sixty-one percent (1415/2325) women reported symptoms of RTIs. Only 35% (812/2325) had their per-speculum examination done. Out of those examined, 32% (263/812) had vaginitis, 21% (175/812) had cervicits, and 19% (156/812) had pelvic inflammatory disease. Vaginal smear of those having discharge revealed that 48% (231/476) had bacterial vaginosis, 0.8% (4/476) had fungal infection 9% (44/496) had trichomonal infection and none was found to be having gonococcal infection. Tests for chlamydial infection could not be performed as the cost was not affordable. Eighty-nine percent of women who reported symptoms of RTIs had not consulted anyone for their problem prior to our village based camp. Only 42% symptomatic and 24% asymptomatics availed the services even in the village based camps. Study revealed high load of reproductive tract infections and low utilisation of treatment facility. In-depth studies are required to understand for high RTI morbidity load and low treatment seeking rate so as to design an appropriate RTI control programme.

Adolescent↗

Induced abortion and effecting factors of ever married women in the Southeast Anatolian Project Region, Turkey: a cross sectional study.

BACKGROUND: Nearly 10% of the population of Turkey lives in the Southeast Anatolian Project (SEAP) region. The population growth rate and the rate of unintended pregnancies are high and family planning services are insufficient in this region. Lifetime induced abortion rate is also high in this region. Public health problems of the SEAP region were investigated in the "SEAP Public Health Project" in 2001 and 2002. As it is one of the most important health problems of the women living in this region; induced abortion was also investigated in this project. METHODS: An optimumsample size representing the rural and urban area of the region (n = 1150) was chosen by the State Institute of Statistics by a sampling method proportional to size. 1126 of the area's 1150 houses have been visited and data about induced abortions have been obtained by applying a questionnaire to 1491 ever married women who live in the region. RESULTS: It has been found that 9.0% of these women who had at least one pregnancy in their life had at least one induced abortion. The lifetime induced abortion per 100 pregnancies was found to be 2.45. The primary reason given for induced abortions was "wanting no more children" (64.6%). Lifetime induced abortions were 5.3 times greater with women using a family planning method than women not using family planning methods. Lifetime induced abortions were 4.1 times greater with unemployed women than working women. Most of the women have used private doctors in order to have an induced abortion. Although 32.29% have not yet begun to use a contraceptive method after their last induced abortion, 43.75% of the women have since started to use an effective contraceptive method. 23.96% of them have begun to use an ineffective contraceptive method. CONCLUSIONS: Induced abortion is still an important problem at the SEAP region. The results of the study remind us that unemployed women and women who have more than four children is our target group in the campaign against induced abortions. Most of the women use private doctors in order to have an induced abortion. Thus, priority must be given to educate private gynecologists with respect to induced abortion. After induced abortions, a qualified family planning consultant can be given to women and they can be secured to use a suitable contraceptive method.

Abortion, Induced↗

Determinants of unintended childbearing among ever-married women in the United States: 1973-1988.

A downward trend in unwanted childbearing has reversed among large segments of the population, according to data from the 1988 National Survey of Family Growth. The proportion of births in the previous five years that were unwanted at conception fell from 14 percent in 1973 to eight percent in 1982, but increased to 10 percent in 1988. Between the 1982 and 1988 surveys, increases were most pronounced among women with less than a high school education and among women living below the federal poverty level. Differences between black women and white women in levels of unwanted childbearing, which were converging prior to 1982, have since grown considerably, particularly among the poor and the less educated.

Adolescent↗

Perceived gynecological morbidity among young ever-married women living in squatter settlements of Karachi, Pakistan.

BACKGROUND: Community-based information on obstetric and gynecological morbidity in developing countries is meager and nearly non-existent in Pakistan. OBJECTIVES: To estimate the prevalence of specific gynecological morbidities and investigate the predictors of pelvic inflammatory disease. METHODS: Users [404] and non-users [313] of modern contraceptives were identified from eight squatter settlements of Karachi, Pakistan and detailed information on basic demographics, contraceptive use, female mobility, decision-making and gynecological morbidities were elicited. RESULTS: The perceived prevalence of menstrual disorders were 45.3%, uterine prolapse 19.1%, pelvic inflammatory disease 12.8% and urinary tract infection 5.4%. The magnitude of gynecological morbidity was high with about 55% of women reporting at least one gynecological morbidity though fewer [20%] reported at least two gynecological morbidities. Significant predictors of pelvic inflammatory disease were intrauterine contraceptive device users (OR = 3.1; 95% CI 1.7-5.6), age < or = 20 years (OR = 2.3; 95% CI 1.1-4.8) and urban life style (OR = 2.1; 95% CI 1.0-4.6). CONCLUSION: There is an immense burden of reproductive ill-health and a significant association between ever users of intrauterine contraceptive device and pelvic inflammatory disease. We therefore suggest improvement in the quality of reproductive health services generally, but specifically for family planning services.

Adolescent↗

Herpes simplex 2 risk among women in a polygynous setting in rural West Africa.

OBJECTIVES: To determine risk factors for herpes simplex 2 (HSV2) infection in women in a polygynous rural Gambian population. METHODS: Data from women who participated in a cross-sectional survey of reproductive health were matched to their own and, for women who had been or were married (ever-married), their spouses' data collected in a cross-sectional survey of fertility interests, including information on marital histories. RESULTS: Data were available on 150 never-married and 525 ever-married women. HSV2 prevalence was 16% amongst never-married women and 36% amongst ever-married women. For ever-married women, their own personal characteristics (age, ethnicity and genital cutting status) and events from their husbands' marriage history were important determinants of HSV2 infection. Women whose husbands married for the first time over age 35 were at greater risk than women whose husbands married by age 24 [odds ratio (OR) 2.72, 95% confidence interval (CI) 1.20-6.10]. Women whose husband reported interest in a new marriage were more likely to be HSV2 positive (OR 1.91, 95% CI 1.18-3.09). Women whose husbands were currently monogamous but had had previous marriages (OR 2.76, 95% CI 1.30-5.88) and women in currently polygynous marriages (OR 2.88, 95% CI 1.66-5.01) were three times as likely to be HSV2 positive as women who were their husband's only wife ever. CONCLUSION: Much transmission of HSV2 in this setting occurs within marriage where opportunity for personal protection is limited. High levels of transmission within marriage may undermine the impact of sexual behaviour change programmes aiming to reduce HSV2 and HIV incidence and complicate their evaluation.

Adolescent↗

Living arrangements and well-being of the elderly.

The usefulness of household composition in characterizing the functional status of the elderly was examined in a random sample of 1,598 noninstitutionalized urban persons aged 65 years and older. Subjects were interviewed twice, one year apart. Five areas of well-being were assessed, including: physical and mental health, social and economic functioning, and ability to perform daily tasks. Living arrangements were categorized as follows: living alone, never married; living alone, ever married; living with spouse; living with spouse and children; living with children, but without spouse; and living with others, not spouse or children. Profiles for those living with children but without spouses and those living with spouses provided the most extreme contrasts. Persons living alone and never married consistently had better outcomes than those living alone but ever married. After one year, changes in living arrangements were most likely to occur for those living with spouse/children and those living with others. For the elderly, "Who lives with you?", is an important question.

Activities of Daily Living↗

Census-derived estimates of fertility by duration since first marriage in the Republic of Korea.

This paper estimates ever-married birth rates by age and duration since first marriage and ever-married total fertility rates for the Republic of Korea, derived by applying an extension of the own-children method of fertility estimation to the 1975 and 1980 censuses. Since each census provides annual estimates for the 15-year period previous to enumeration, there is a ten-year period of overlapping estimates that facilitates checks for consistency and accuracy. Comparisons are also made with estimates derived from the 1974 Korea National Fertility Survey, which was part of the World Fertility Survey. The method works well, except in its application to the 1975 Census where the evidence suggests considerable misreporting of age at first marriage because of the way the question was asked and coded. Results confirm that ever-married fertility fell substantially in Korea between 1961 and 1980, with a temporary resurgence in the late 1960s and early 1970s. Ever-married fertility rose at younger ages and shorter durations and fell at older ages and longer durations. Ever-married fertility differentials by urban-rural residence and by education were usually in the expected direction, with urban fertility generally lower than rural fertility and the fertility of those with more education usually lower than the fertility of those with less education. Differential ever-married fertility by urban-rural residence and education declined over the estimation period.

Adolescent↗

Child support awards: differentials and trends by race and marital status.

This study has analyzed data from combined 1979 and 1982 April supplements to the Current Population Survey to study differences in the award of child support by race and marital status. The following findings emerge from this study: The percentage of women with children present from an absent father who are awarded child support varies greatly by race and marital status. Among all women, nonblacks are more than twice as likely as blacks to have a child support award, and the ever-married are almost six times as likely as the never-married to have an award. Among the ever-married, currently separated women are approximately half as likely as the ever-divorced to have secured an award. The lower probability of child support awards among blacks can be attributed in part to their disproportionate membership in marital status groups with lower award probabilities. Blacks are four and one-half times as likely as nonblacks to be among the never-married and almost twice as likely to be among the currently separated. Racial differences in award probabilities exist within all marital status groups except the never-married. Among the currently separated, blacks are one-third less likely than nonblacks to have an award. Among the ever-divorced, blacks are almost one-fourth less likely than nonblacks to have an award. Among the never-married, unlike the ever-married, virtually no statistically significant socioeconomic characteristics appear to distinguish mothers who have a child support award from those who do not. Among all women, 50 to 60 percent of the gross racial differential in award rates can be explained by observed differences in such economic and demographic characteristics as marital status, educational attainment, age, place of residence, and number of children. Among the ever-married, 50 percent of the gross racial difference can be explained by these factors. Among the ever-married, the likelihood of being awarded child support at marital disruption has increased over time, but this upward trend has been different for blacks and nonblacks. Among nonblacks, the proportion of women obtaining a child support award increased 1.3 percent per year between 1960 and 1975 and then declined 0.4 percent per year since then. Among blacks, the proportion increased 0.8 percent per year between 1960 and 1975 and then accelerated to 1.6 percent per year since then.(ABSTRACT TRUNCATED AT 400 WORDS)

Black or African American↗

The relationship of marital status to survival from melanoma.

As an indirect test of the hypothesis that prior pregnancy has a favorable influence on prognosis in melanoma, the relation of marital status to survival among melanoma patients was examined in data gathered by the Connecticut Tumor Registry, 1935--1973. Compared to women who had never been married, ever-married women with the disease had a slightly increased survival rate, but the difference was not statistically significant. If a difference between parous and nulliparous women in survival from melanoma truly exists, it is probably a small one, and could be due to differences in characteristics other than childbearing.

Adult↗

A twin study of the association of post-traumatic stress disorder and combat exposure with long-term socioeconomic status in Vietnam veterans.

This study examines the association between post-traumatic stress disorder (PTSD) and combat exposure with the socioeconomic status of 2210 male monozygotic veteran twin pairs in 1987. In the unadjusted analysis on individuals, modest correlations indicated that those with PTSD were more likely to have been divorced, and less likely to be currently employed or to achieve high status in income, education or occupation. In the crude analysis of veterans not suffering from PTSD, there were small positive correlations between combat level experienced and the likelihood of ever being married, ever being divorced, and the number of years employed at the current job. However, when we examined identical twins discordant for PTSD, and adjusted for pre-military and military service factors, only unemployment remained significant. Likewise, in combat-discordant twins, no significant effects on the socioeconomic indicators were seen. We conclude that PTSD and combat experience in Southeast Asia have not had a major impact on the socioeconomic status of veterans.

Adaptation, Psychological↗

Total and occupationally active life expectancies in relation to social class and marital status in men classified as healthy at 20 in Finland.

STUDY OBJECTIVE: To study differences in total life expectancy and in occupationally active life expectancy in relation to social class and marital status in men classified as healthy as young adults. DESIGN: Historical cohort study. SETTING: Finland. PARTICIPANTS: Altogether 1662 men classified as completely healthy at the time of induction to military service (mean birth year 1923), who had been selected as referents for a study of former athletes. Mean follow up time was 46 years. MEASUREMENTS: Vital status was determined by follow up through local parish data up to 1990. Mortality data were obtained from the Cause of Death bureau of the Central Statistical Office of Finland. Occurrence of work disability was assessed from nationwide disability pension register data. Mean total life expectancy and mean occupationally active life expectancy (end points disability pension or death before age 65 years) were estimated. Social class was based on the major lifetime occupation, while marital status was classified as "never married" or "ever married" at the end of follow up. MAIN RESULTS: Mean total life expectancy was highest among executives and managers (73.2 (95% confidence interval (CI): 70.3, 76.1) years), next highest in clerical (white collar) workers (72.0 (70.0, 74.1) years), and lowest in unskilled blue collar workers (63.65 (61.1, 66.2) years). Skilled workers and farmers were intermediate. For the occupationally active life expectancy estimates, a similar gradient was observed: highest for executives (61.9 (60.7, 63.1) years) and lowest for the unskilled (52.2 (50.2, 54.2) years). The ratio of occupationally active life expectancy to total life expectancy was highest for executives (85%) and lowest for farmers (81%) and unskilled workers (82%). CONCLUSIONS: The social class gradient known to exist for mortality is also present for occupational disability. Social class and marital status differences in mortality are already evident in early adulthood and continue into old age. Those with the highest life expectancy also have the largest proportion of their life span free of occupationally incapacitating disability.

Adult↗

Nuptiality pattern in Saudi Arabia.

The data of this work are based on the 'Saudi Maternal and Child Health Survey' conducted in 1991. This was a nationwide house to house field survey. The study included 6294 ever-married Saudi female in the childbearing age who represent the target population. They were randomly selected from both urban and rural settings of the five geographical areas of Saudi Arabia. The mean current age of the sample of ever-married women was 31 years and the mean age at first marriage was 17 and 16 years for urban and rural females, respectively. Education was associated with upward shift of the age at first marriage. About 20 per cent of the sampled ever-married Saudi females got married before their 15th birthday and 83 per cent before reaching 20 years of age. These percentages are even higher in rural than urban settings. The overall percentage of women who were currently married at the time of the survey was 96 per cent. The divorced and widowed women of childbearing age were 2 and 3 per cent, respectively, of the total. Husband's educational level had positive impact on the frequency of divorce. The latter was highest among women married to illiterate husbands with a dose response pattern. Comparison has been made with the situation 4 years ago. An increase in literacy rates among Saudi ever-married women and their husbands was observed, however, a significant (P < 0.05) difference still exists between female and male literacy rates (38 and 71 per cent, respectively). The events of early marriage, before the age of 15 years, became less frequent. There is an overall decline in teenage marriages which explains a large part of the recent changes observed in nuptiality and pattern of birth in Saudi Arabia.

Adolescent↗

Marriage in the survivors of childhood cancer: a preliminary description from the Childhood Cancer Survivor Study.

BACKGROUND: The goal of this paper is to provide a preliminary description of the marital status for a large number of childhood cancer survivors participating in the Childhood Cancer Survivor Study (CCSS). PROCEDURE: This report includes children and adolescents (< 21 years of age) diagnosed with cancer between 1970 and 1986 at 25 oncology centers in the United States and Canada who survived at least 5 years from diagnosis. Self-reported data from 10,425 survivors are used in this preliminary descriptive summary. The proportion of survivors ever married and divorced/separated is compared to the U.S. population according to age-specific groups. The median age of the survivor population at diagnosis was 7 years and 26 years at the time martial status was ascertained. Excluded from this assessment are children < 15 years of age at the time of study, those whose martial status was unknown, and those married prior to diagnosis. Data for marital status of the U.S. population, as tabulated in the Bureau of Census 1995 Update, is used as a general comparison to the survivor population. RESULTS: Overall, 32% of the survivors reported being married or living as married, 6% being divorced or separated, 0% being widowed, and 62% having never been married. In general, compared to the U.S. population, survivors were less likely to have ever married, particularly females and whites, but, once married, were less likely to divorce/separate, again particularly females and whites. Black survivors were generally found to be more likely to have married, with males and blacks more likely to divorce/separate once married. Comparison of childhood tumor types suggested that survivors of CNS tumors, particularly males, were less likely to have ever married and more likely to divorce/separate compared to those with other cancer diagnoses and the general U.S. population. CONCLUSIONS: This interim evaluation of the CCSS cohort provided preliminary data describing a suggested decreased likelihood of marriage, which may be influenced by gender and/or race. These patterns must be confirmed within the entire CCSS cohort and comparisons made with an appropriate sibling comparison group before making final conclusions.

Adolescent↗