On 11th March 2011 a magnitude nine earthquake struck the Tohoku region of Japan. The earthquake resulted in a large tsunami and an accident at the Fukushima Nuclear Power Plant. Previous studies have suggested that demographic indices relating to reproduction and marriage change after such massive disasters (e.g. large earthquakes). The present study investigated whether the number of births, number of marriages and the secondary sex ratio (SSR) changed after the East Japan Earthquake. The monthly number of births (males and females, separately) and marriages in each prefecture in Japan from January 1997 to June 2012 were obtained from the Demographic Survey of Japan. An analysis was performed for three different geographic boundary units: the disaster-stricken area, the non-disaster-stricken area and the whole of Japan. In each unit, the numbers of births and marriages in a given month during the post-disaster period were predicted based on a regression equation estimated by the numbers of births and marriages in that month during the pre-disaster period. The numbers of observed monthly births and marriages during the post-disaster period were compared with the predicted figures. Differences between the observed and predicted numbers were determined by referring to the 95% confidence limits for the predicted mean number. The observed probability of a male birth in a given month during the post-disaster period was compared with a 95% confidence interval of a binominal distribution. In all three boundary units, the number of births was significantly lower than the predicted number by about 3–8% from nine months after the disaster, while the number of marriages in October 2011 was significantly lower than the predicted number by about 25–28%. In October 2011, the SSR in the whole of Japan had decreased from 104.8 (the predicted SSR) to 102.9. The number of births and marriages and the SSR decreased in Japan after the East Japan Earthquake irrespective of locality.

Studies on the causes of maternal mortality in India have focused on institutional deliveries, and the association of socioeconomic and demographic factors with the decline in maternal mortality has not been sufficiently investigated. By using both time series and cross-sectional data, this paper examines the factors associated with the decline in maternal mortality in India. Relative effects estimated by OLS regression analysis reveal that per capita state net domestic product (−1.49611, p<0.05), poverty ratio (0.02426, p<0.05), female literacy rate (−0.05905, p<0.10), infant mortality rate and total fertility rate (0.11755, p<0.05) show statistically significant association with the decline in the maternal mortality ratio in India. The Barro-regression estimate reveals that improvements in economic and demographic conditions such as growth in state income (β=0.35020, p<0.05) and reduction in poverty (β=0.01867, p<0.01) and fertility (β=0.02598, p<0.05) have a greater association with the decline in the maternal mortality ratio in India than institutional deliveries (β=0.00305). The negative β-coefficient (β=−0.69578, p<0.05), showing the effect of the initial maternal mortality ratio on change in maternal mortality ratio in the Barro-regression model, indicates a greater decline in maternal mortality ratio in laggard states compared with advanced states. Overall, comparing the estimates of relative effects, the socioeconomic and demographic factors have a stronger statistically significant association with the maternal mortality ratio than institutional deliveries. Interestingly, the weak association between ‘increase in institutional deliveries' and ‘decline in maternal mortality ratio’ suggests that merely increasing deliveries alone will not help in ensuring maternal survival in India. Quality of services provided by the health facility, birth preparedness and avoiding delay in reaching health facility are also important. Deliveries in health facilities will not necessarily translate into increased survival chances of mothers unless women receive full antenatal care services and delays in reaching health facility are avoided.

Cross-sectional studies in Australia and the Philippines and a longitudinal prospective study in a selected Australian sample of breast-feeding mothers have shown that basal serum prolactin (PRL) concentrations are elevated during 15–21 months of lactational amenorrhoea.

A predictive model of serum PRL levels and return of cyclic ovarian activity during full breast-feeding, partial breast-feeding and weaning has been developed from the results of breast-feeding behaviour and serum PRL, gonadotrophin and oestradiol measurements in 34 mothers breast-feeding on demand for a mean of 67 weeks.

Breast-feeding patterns influence serum PRL levels. Important factors during full breast-feeding are the age of the baby, the longest interval between feeds at night and total 24-hr suckling time, and following the introduction of supplements, the mean interval between feeds, together with the total 24-hr suckling time and the number of solid supplements per day.

The precise mechanisms whereby breast-feeding regulates cyclic ovarian activity remain unknown. Gonadotrophin secretion appears to be quantitatively normal, but qualitative changes, secondary to altered hypothalamic activity, may be the most important factor. A direct inhibitory effect of PRL on ovarian follicular development and steroidogenesis remains possible.

Ovulation with a normal luteal phase is probable for 30% of breast-feeding mothers before the first menses, but is unlikely before 6 months, provided breast-feeding is frequent day and night.

Measurement of serum PRL is a sensitive index of the return of menstruation and fertility during lactation in the population studied.

The aim of this study was to evaluate the sexual attitudes and behaviours of university students. An anonymous questionnaire was administered to 550 final-year university students aged 20–25 years in Izmir, Turkey. Male students opposed premarital sexual intercourse for both genders more than female students did. The frequency of sexual intercourse among male students (61·2%) was higher than that among female students (18·3%). The mean age of first sexual intercourse was lower among male than among female respondents. The rate of condom use at first sexual intercourse was 47·4%. The frequency of having two or more past sexual partners and masturbation was higher among males than females. It was found that there were culture-specific and gender-dependent differences in sexual attitudes and behaviours of the university students. These results may help in the planning of education and health policies in Turkey.

This study aimed to assess the prevalence of and risk factors associated with alcohol abuse among women and men in Moshi in northern Tanzania. Alcohol abuse was measured by a CAGE score of 2–4, versus 0–1 for no alcohol abuse (Ewing, 1984). Crude and adjusted logistic regression models determined odds ratios (OR) and 95% confidence intervals (95% CI) of alcohol abuse by characteristics of, respectively, women with partners (n=1200), women without partners (n=614) and men (n=788) (women’s partners). Prevalence of alcohol abuse was 7·0% (95% CI: 5·6–8·4) among women with partners, 9·3% (95% CI: 7·0–11·6) among women without partners, and more than double among men at 22·8% (95% CI: 19·9–25·8). In general, Christians had higher alcohol abuse than Muslims or other religions, as did Chagga men compared with men of other ethnic groups. Other socio-demographic characteristics, such as education or income, were not significant. Sexual behaviours were significant predictors of alcohol abuse. For example, women without partners who reported more than two partners in the last year had higher alcohol abuse compared with women reporting no partners (OR=8·75; 95% CI: 2·37–32·31), as did men reporting it is ‘OK to hit a partner’ for any reason (OR=1·79; 95% CI: 1·16–2·77) compared with men who did not. HIV-1 infection was not significantly associated with alcohol abuse by women or men. The Christian Church in Moshi should consider raising awareness about the harmful effects of high alcohol use among its adherents. Comprehensive programmes focusing on reducing number of partners and alcohol use, particularly by men, are needed in this community.

In a time series study of the USA from 1933 to 1984, fertility rates were associated with the suicide rates of those aged 15–44. The higher the fertility rate the lower the suicide rate for these age groups, for both whites and non-whites, and for both men and women. The results were seen as supporting Durkheim's theory of suicide.

The aim of this analysis was to examine the effects on stature in two nationally representative samples of Polish 19-year-old conscripts of maternal and paternal education level, and of degree of urbanization, before and after the economic transition of 1990. Data were from two national surveys of 19-year-old Polish conscripts: 27,236 in 1986 and 28,151 in 2001. In addition to taking height measurements, each subject was asked about the socioeconomic background of their families, including paternal and maternal education, and the name of the locality of residence. The net effect of each of these social factors on stature was determined using four-factor analysis of variance. The secular trend towards increased stature of Polish conscripts has slowed down from a rate 2·1 cm per decade across the period 1965–1986 to 1·5 cm per decade between 1986 and 2001. In both cohorts, mean statures increase with increasing size of locality of residence, paternal education and maternal education. The effect of each of these three social factors on conscript height is highly significant in both cohorts. However, the effect of maternal education has increased substantially while that of size of locality of residence and paternal education diminished between 1986 and 2001. These results imply that the influence of parental education on child growth cannot be due solely to a relationship between education and income, but is also perhaps a reflection of household financial management which benefits child health and growth by better educated parents, regardless of level of income. In addition they suggest that, irrespective of whether there are one or two breadwinners in the family, it is the mother, more so than the father, who is principally responsible for the extent to which such management best favours child health and growth. The asymmetry between the importance of maternal as against paternal education for child growth, clearly seen in the 1986 cohort, became more accentuated in 2001, after the abrupt transition from a command to a free-market economy in the early 1990s.

Understanding the level, trend, geographical variations and determinants of use of modern family planning (FP) plays a major role in designing effective interventions leading to increased usage. This study assessed these characteristics of FP use in Nigeria using data from the 2003, 2005 and 2007 National HIV/AIDS and Reproductive Health Survey, a national population-based household survey. A Bayesian geo-additive procedure was used, which provides flexible modelling of non-linear and spatial effects at a highly disaggregated level of states. The findings reveal considerable geographical variation in the use of modern FP in Nigeria, with a distinct north–south divide. Furthermore, a significant trend in the use of modern FP was evident, with an increase between 2003 and 2005 followed by a decline between 2005 and 2007. The effect of respondent's age was non-linear, and use of modern FP was found to differ significantly between never-married and currently/formerly married respondents. Awareness of FP methods and knowledge of where to get/buy FP services/methods were found to be significantly associated with usage. The findings provide policymakers with tools to prioritize the use of scarce resources for implementing FP and reproductive health interventions.

Using data from the 1988 Ghana Demographic and Health Survey, this study examines couples' demographic and socioeconomic characteristics in the context of their attitudes towards family planning, and the impact of these factors on the use of contraceptives. The characteristics of the husbands and their influence on wives' behaviour illustrate the role of intra-household relations between men and women and their effect on fertility-related behaviour in patriarchal African societies.

It is well established that, in general, pregnancies at advanced maternal ages or of advanced birth order are at greater risk of aborting spontaneously. It does not follow that each individual woman, as she proceeds through her reproductive life, becomes steadily more prone to abort. The present paper attempts to analyse evidence on how individual women's abortion probabilities vary during their reproductive lives. Statistical examination of the data suggests that:

1. A spontaneous abortion in a given birth rank is more likely than a live birth in the same rank to be followed by a further pregnancy. Abortion-prone women have more pregnancies than other women.

2. There is no significant overall tendency for spontaneous abortions to appear early or late in sibships even when account is taken of the reproductive compensation reported above.

3. Pathological examination of spontaneously aborted fetuses suggests that more (perhaps many more) than 10% of spontaneous abortions (e.g. those associated with trisomy and maternal isoimmunization) are causally associated with advanced maternal age or birth order.

4. The mean maternal age of spontaneously aborted fetuses which fail to grow in culture is higher than that of fetuses which are successfully cultured.

One would infer:

A. (from suggestions 1 and 2 above) that reproductive compensation (rather than a real birth order effect) is a major reason why abortion rates are higher at higher maternal ages and higher birth ranks;

B. (from suggestions 2 and 3 above) that there must be another group of abortions, roughly equal in number, which are causally associated with low maternal age or early birth order.

Little is known about this second group of reproductive casualties (those associated with low birth order or maternal age), but it is suggested that some have CNS malformations. I have made similar suggestions in regard to stillbirth and neonatal death.

Women's social networks and social power are increasingly seen as important factors modulating their health in sub-Saharan Africa. Polygyny, a common marital structure in many societies, mediates important intra-household relationships by requiring both competition and co-operation among co-wives. Using mixed methods, semi-structured questionnaires were administered to 298 women aged 15–84 living in the Kolondiéba region of rural Mali in 1999, and supplemented by detailed interviews with 40 women. Three categories of outcome were explored: illness experience, therapeutic itinerary and social support received. Quantitative data were analysed using regression analysis and qualitative data using a grounded theory approach. In quantitative analyses, controlling for age and household wealth index, senior wives were less likely to be escorted to a healer by their husbands during illness than were junior wives or monogamous women. Polygynous women were also less likely to obtain a treatment for which there was a monetary fee. Fewer than one-third of polygynous women reported the assistance of a co-wife during illness in any given task. In qualitative analyses, women further related varied mechanisms through which polygyny impacted their health trajectories. These ranged from strongly supportive relationships, to jealousy because of unequal health or fertility, bias in emotional and material support provided by husbands, and accusations of wrong-doing and witchcraft. This study highlights the need for more prospective mixed methods analyses to further clarify the impact of polygyny on women's health-related experiences and behaviours in sub-Saharan Africa.

Mass media play an important role in changing body image. This study aimed to determine the role of media (magazines and television) in body weight concern among university females in five Arab countries. A total sample of 1134 female university students was selected at convenience from universities in five Arab countries: Bahrain, Egypt, Jordan, Oman and Syria. The females' ages ranged from 17 to 32. A pre-tested questionnaire was used to assess the exposure to mass media regarding weight concerns. For the variables on exposure to mass media, girls were divided into two groups: infrequently exposed and frequently exposed. In general, the females who were exposed to mass media had a greater risk of having dieted to lose weight and changing their ideas of a perfect body shape than those who were not exposed or infrequently exposed. The association of exposure to magazines with having dieted to lose weight was only significant among females in Bahrain (p<0.044), Egypt (p<0.001) and Jordan (p<0.001). Exposure to television had a weaker association than exposure to magazines with body weight concerns of females. The association of exposure to television with females' idea of a perfect body shape was only statistically significant in females in Egypt (p<0.019) and Oman (p<0.019). The pressure from mass media on the body weight concern of female university students may lead these women to practise unhealthy weight control diets.

This paper evaluates the influence of breast-feeding on infectious and allergic diseases in infants and children through an analysis of data from a large national sample of US children. It controls for a large number of maternal and child health, demographic, and socioeconomic variables which have been shown to affect feeding patterns, and it includes several aspects of the feeding pattern in addition to breast-feeding. The results suggest that breast-feeding provides some protection against pneumonia and otitis media in the United States while early introduction of formula may have a separate and negative effect.

This study examines fertility decline that is larger than expected on the basis of recorded increases in contraceptive prevalence in Ghana. The primary sources of data are three Demographic and Health Surveys (DHS) conducted in the country in 1988, 1993 and 1998. First, the trend in fertility and contraceptive prevalence in Ghana is considered and compared with the trend that would be expected on the basis of prior research. Next, an attempt is made to uncover the explanation behind this unexpected trend. Measures of the quality of the survey data are looked at, as well as trends in the proximate determinants of fertility: contraceptive use, marriage and sexual activity, postpartum insusceptibility and induced abortion. Finally, evidence is presented that couples adjust their coital frequency in accordance with their fertility preferences, behaviour that would influence fertility rates but would not be captured by conventional measures of the proximate determinants of fertility.

Female- and male-headed households were compared using data from a Demographic and Health Survey conducted in Tanzania in 1996. Chi-squared tests showed that sex of head of household was highly significantly associated with: residence, household size and composition, radio ownership, having enough food to eat, and age and marital status of head of household. An analysis by the logit regression model showed that female-headed households were more likely than male-headed households to be in rural areas, be small, have fewer men, not have radios and not have enough food to eat. The majority of female heads of households were unmarried and older than male heads of households. The implication is that female-headed households are poorer than male-headed households.

Most studies of the association between family structure and risky sexual behaviour among adolescents and young adults have employed a risk perspective which assumes that, compared with other types, two-parent families are protective. Drawing from a positive-oriented approach in this study, it is hypothesized that within each family type some influential factors may mitigate such anticipated deleterious effects of non-intact families and decrease sexual risk-taking. The paper examines specifically the effects of risk and protective factors with an emphasis on family processes associated with resilience, using data from a pooled sample of 1025 females and males aged 12–24 years from Bandjoun (West Cameroon). Findings show that the quality of parent/guardian–youth relationships significantly decreases the odds of risky sexual behaviour by 36%, 65% and 50% in neither-, one- and two-parent families, respectively. For two-parent families only, parental control acts as a significant protective factor; it decreased by 41% the odds of risky sexual behaviour. Programmatically, protective family factors such as parent/guardian–youth interactions need to be promoted to improve the efficiency of reproductive health and HIV interventions in sub-Saharan Africa.

This paper explores the inter-relationships between impairment and disability in a sample of 119 teenagers in relation to their psychological adjustment and quality of social life. Poor psychological adjustment and extreme social isolation are associated not so much with individual functional limitations as with particular configurations of impairments and disabilities. It seems that social handicap is not a direct consequence of any impairment or disability but arises generally from severe functional loss and is shaped by dependency on others, restricted choices, physical barriers and adverse reactions of others.

From statistics on Australian confinements during the period 1944–63 it seems that the following conclusions can legitimately be drawn:

(1) The proportion of multiple births increases with increasing age of mother up to about age 37, turns, and decreases thereafter.

(2) The proportion of multiple births increases with increasing age of father up to about age 34–38 and is fairly constant thereafter.

(3) The variation with age of father, however, only arises because of the high correlation with age of mother which is the determining factor.

(4) The proportion of multiple confinements increases with birth order. This effect holds for all ages of mother except those over 40 where there is no significant variation.

(5) The proportion of multiple confinements decreases from the first year of marriage to the second, then increases steadily to a maximum after about 15 years of marriage and then decreases slightly.

(6) The proportion of binovular twins increases steadily with increasing age of mother up to about age 37, turns, and thereafter decreases steadily.

(7) The proportion of monovular twins increases slightly with increasing age of mother up to about age 37 and is fairly constant thereafter.

(8) From the small amount of data it appears that the proportion of triplets also increases with increasing age of mother.

Season of birth has been shown to correlate with many aspects of somatic and mental disorders, development and social adaptation (so-called ‘birth-date effects’). In a sample of young Swedish men, corresponding roughly to a one-year birth cohort, the results of intelligence tests, psychologists’ ratings of psychological function, school achievement, body height, weight and self-reported health during childhood, were found to be correlated with month of birth, and – more strongly – father’s socioeconomic status. The results were more favourable for men who were born during March–May (the period of highest birth rate), and whose fathers were of higher socioeconomic status, than for those born in November and December (the period of lowest birth rate), and whose fathers were in the lower socioeconomic group. It seems reasonable to conclude, from this study and previously reported findings, that these so-called ‘birth-date effects’ are determined by varying and often interacting biological and psychosocial factors. Among these factors, the light-induced entrainment of circadian and annual rhythms in the fetus and/or infant seems to be of pivotal importance. The organization of children into one-year age classes therefore produces an unfair lack of equality of possibilities.

In South Africa, disability grant allocation has been under review and tensions are evident in government rhetoric stressing welfare provision on the one hand, and encouraging ‘rationalization’ on the other. This ambiguity is traced down to the level of grant negotiations between doctors and ‘clients’ in a psychiatry clinic in Khayelitsha. Here ‘having nerves’ embodies the distress associated with harsh circumstances and is deemed by supplicants as sufficient to secure a grant. The paper illustrates how national discourses influence the presentation and experience of suffering and the way in which doctors mediate diagnoses. The implications of local understandings of ‘health citizenship’ for expectations of the post-apartheid state are explored.