The Role of Marriage in the Causal Pathway from Economic Conditions Early in Life to Mortality

This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of early-life conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity and causal effects. Results show that conditions around birth and school ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage on mortality, whereas women suffer during childbearing ages. Having been born under favorable economic conditions reduces female mortality during childbearing ages.death, longevity, recession, life expectancy, lifetimes, marital status, timing of events, selectivity, health

The role of marriage in the causal pathway from economic conditions early in life to mortality

This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of earlylife conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity and causal effects. Results show that conditions around birth and school ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage on mortality, whereas women suffer during childbearing ages. Having been born under favorable economic conditions reduces female mortality during childbearing ages.Death; longevity; recession; life expectancy; lifetimes; marital status; timing of events; selectivity; health

The role of marriage in the causal pathway from economic conditions early in life to mortality

This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of earlylife conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity and causal effects. Results show that conditions around birth and school ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage on mortality, whereas women suffer during childbearing ages. Having been born under favorable economic conditions reduces female mortality during childbearing ages

The role of marriage in the causal pathway from economic conditions early in life to mortality

This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of early-life conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity and causal effects. Results show that conditions around birth and school ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage on mortality, whereas women suffer during childbearing ages. Having been born under favorable economic conditions reduces female mortality during childbearing ages

Impact of an Affimative Action Program in Employment on Child Mortality in India

We evaluate whether a major affirmative action program for a deprived caste in India has affected infant and child mortality rates among the target caste. The program reserves a substantial fraction of public sector jobs for those from the deprived caste and was implemented on September 8, 1993. We use the National Family and Health Survey and we allow mortality rates to depend on family composition, conditions very early in life, current conditions, caste affiliation, and the implementation of the affirmative action program in employment. Results point towards a favorable impact of the policy with a decrease of the child mortality rate for the target group of the program in rural areas - the areas where the child mortality has been highest

Impact of Volunteering on Cognitive Decline of the Elderly

Cognitive decline among the elderly imposes a large welfare and health care cost on the individual as well as society. Little however is known about factors that can mitigate cognitive decline. Using seven waves of the Health and Retirement Study and a fixed effects – instrumental variable methodology, this study estimates the effects of volunteering on old age cognitive decline. Although cognitive decline is an inevitable aspect of aging, our results suggest that volunteering participation significantly forestalls its progress among individuals aged 60 years and older

Insights into neoadjuvant chemotherapy efficacy for stage 1B3 locally advanced cervical cancer: case series

Cervical cancer remains a leading cause of mortality among women worldwide, particularly in developing nations. While radical surgery is the established standard of care for early-stage disease, pelvic relapse post-surgery remains a concern. Neoadjuvant chemotherapy (NACT) preceding radical surgery has emerged as a promising approach, aiming to reduce tumor burden and improve surgical outcomes. We present three cases of stage 1B3 cervical cancer treated with three cycles of NACT repeated three weekly followed by radical hysterectomy. Post-operatively two patients received radiotherapy (External beam radiotherapy and brachytherapy) and one patient got lost to follow-up for 6 months and did not receive post-operative radiotherapy now under observation and regular follow-up. All the patients exhibited significant tumor reduction following chemotherapy, enabling successful surgical intervention. All patients remained in remission post-treatment. NACT showed effectiveness in reducing tumor size and facilitating successful radical surgery in patients with stage 1B3 cervical cancer. Our case series highlights the potential of NACT followed by radical surgery as a promising therapeutic strategy for stage 1B3 cervical cancer. NACT facilitated successful surgical intervention with favourable outcomes. Further research is warranted to elucidate the optimal patient selection criteria and the long-term benefits of this approach in improving survival rates and quality of life for cervical cancer patients

Strategies for managing epithelial ovarian cancer in elderly patients: a comprehensive review

The management of epithelial ovarian cancer in elderly patients presents distinct challenges due to age-related factors and comorbidities. Developing optimal strategies requires a careful balance between treatment efficacy and the potential side effects. This review aims to evaluate current management approaches specifically tailored to elderly patients with epithelial ovarian cancer. It focuses on the effectiveness and safety of various treatments, including surgery, chemotherapy, and targeted therapies, and considers how age-related factors influence treatment decisions and outcomes. Additionally, the review explores the importance of geriatric assessment and supportive care in optimizing treatment for this demographic. The findings suggest that managing epithelial ovarian cancer in elderly patients demands a multifaceted approach that considers both the effectiveness of the treatment and the patient's overall health and quality of life. By recognizing and addressing the unique needs of elderly patients, clinicians can refine treatment strategies, thereby improving outcomes for this vulnerable population. This approach emphasises the importance of individualized care that is responsive to the specific challenges posed by ageing and associated comorbidities, ultimately leading to better health outcomes for elderly patients with epithelial ovarian cancer

Navigating dual challenges-breast cancer and pregnancy: a case report

Pregnancy-associated breast cancer (PABC) is a rare but challenging condition, affecting approximately 1 in 3000 pregnancies. It often presents with symptoms that overlap with common pregnancy changes, leading to delayed diagnosis. PABC is typically more aggressive, with higher rates of hormone receptor negativity and Her2 positivity. The mortality rate for PABC is 50% higher than for non-pregnancy-related breast cancer, making early detection and management crucial for both maternal and fetal outcomes. This case report aims to highlight the management complexities of PABC, emphasizing the importance of early diagnosis, prompt treatment, and coordinated multidisciplinary care to optimize outcomes. A 30-year-old woman, in her first pregnancy, presented with a palpable breast mass, initially believed to be a benign pregnancy-related change. However, further diagnostic evaluation revealed an advanced-stage invasive ductal carcinoma (IDC). Due to the aggressive nature of the tumor, neoadjuvant chemotherapy was promptly initiated. During treatment, the patient experienced spontaneous preterm labor. Despite this complication, both the mother and infant achieved favorable outcomes. The mother responded well to the chemotherapy, and the infant showed no significant complications, highlighting the critical importance of meticulous management in such complex cases. PABC requires prompt clinical evaluation and a multidisciplinary approach to treatment, balancing the needs of both mother and child. Neoadjuvant chemotherapy can be an effective option in managing advanced-stage disease, but careful monitoring is essential. This case underscores the importance of early detection and individualised treatment strategies in optimising outcomes for patients with PABC

Strategies for managing postmenopausal bleeding: a clinician's perspective

Postmenopausal bleeding (PMB) poses a diagnostic challenge due to the varied presentation of endometrial pathologies ranging from benign endometrial atrophy to the possibility of endometrial carcinoma. Although the incidence varies with patient characteristics, it warrants thorough evaluation. Risk factors such as obesity and hormone use should guide assessment. Bleeding may originate from various gynecological and non-gynecological sites, demanding meticulous history-taking and examination. Transvaginal sonography (TVS) is typically the initial step, yet its accuracy in excluding carcinoma remains debated. Invasive procedures like hysteroscopy and endometrial sampling offer higher accuracy but are more intrusive. The optimal diagnostic strategy remains uncertain, necessitating focused research for enhanced accuracy. TVS-guided assessment with an endometrial thickness (ET) threshold of >4 mm prompts evaluation and endometrial sampling. Progestogen therapy mitigates endometrial cancer risk associated with estrogen use, with atypia-hyperplasia necessitating vigilant monitoring and possible hysterectomy. Patient counselling on treatment options is crucial. In summary, PMB warrants a systematic approach integrating imaging, histological assessment, and tailored therapy guided by risk factors, final diagnosis and patient preferences.