Data on patterns of consanguineous marriage were collected from 5340 families resident in eight cities in the Pakistan province of Punjab. To assess whether social and/or occupational class was interacting with con-sanguinity, information also was obtained on the hereditary qaum to which each family belonged. In the present generation 46·5% of all marriages were contracted at the level of second cousin or closer, with an average coefficient of inbreeding (F) of 0·0286, and the results indicated that in each of the seventeen qaums there was strong preference for marriage to a close biological relative. However, significant differences existed in the distribution of consanguineous marriage by qaum membership, which could interfere with the interpretation of studies into the biological effects of inbreeding.

Maternal mortality persists in low-income settings despite preventability with skilled birth attendance and emergency obstetric care. Poor access limits the effectiveness of life-saving interventions and is typical of maternal health care in low-income settings. This paper examines access to care in obstetric emergencies from the perspectives of service users, using established and contemporary theoretical frameworks of access and a routine health surveillance method. The implications for health planning are also considered. The final caregivers of 104 women who died during pregnancy or childbirth were interviewed in two rural districts in Indonesia using an adapted verbal autopsy. Qualitative analysis revealed social and economic barriers to access and barriers that arose from the health system itself. Health insurance for the poor was highly problematic. For providers, incomplete reimbursements, and low public pay, acted as disincentives to treat the poor. For users, the schemes were poorly socialized and understood, complicated to use and led to lower quality care. Services, staff, transport, equipment and supplies were also generally unavailable or unaffordable. The multiple barriers to access conferred a cumulative disadvantage that culminated in exclusion. This was reflected in expressions of powerlessness and fatalism regarding the deaths. The analysis suggests that conceiving of access as a structurally determined, complex and dynamic process, and as a reciprocally maintained phenomenon of disadvantaged groups, may provide useful explanatory concepts for health planning. Health planning from this perspective may help to avoid perpetuating exclusion on social and economic grounds, by health systems and services, and help foster a sense of control at the micro-level, among peoples' feelings and behaviours regarding their health. Verbal autopsy surveys provide an opportunity to routinely collect information on the exclusory mechanisms of health systems, important information for equitable health planning.

Immigration, immigration policies and education of immigrants alter competence levels. This study analysed their effects using PISA, TIMSS and PIRLS data (1995 to 2012, N=93 nations) for natives' and immigrants' competences, competence gaps and their population proportions. The mean gap is equivalent to 4.71 IQ points. There are large differences across countries in these gaps ranging from around +12 to −10 IQ points. Migrants' proportions grow roughly 4% per decade. The largest immigrant-based ‘brain gains’ are observed for Arabian oil-based economies, and the largest ‘brain losses’ for Central Europe. Regarding causes of native–immigrant gaps, language problems do not seem to explain them. However, English-speaking countries show an advantage. Acculturation within one generation and intermarriage usually reduce native–immigrant gaps (≅1 IQ point). National educational quality reduces gaps, especially school enrolment at a young age, the use of tests and school autonomy. A one standard deviation increase in school quality represents a closing of around 1 IQ point in the native–immigrant gap. A new Greenwich IQ estimation based on UK natives' cognitive ability mean is recommended. An analysis of the first adult OECD study PIAAC revealed that larger proportions of immigrants among adults reduce average competence levels and positive Flynn effects. The effects on economic development and suggestions for immigration and educational policy are discussed.

Based on the authors’ interview survey for 608 randomly selected women of the rural Arab population in the South Ghor district of Jordan, this paper examined the effects of polygyny and consanguinity on high fertility, which was recognized as natural fertility. The prevalence of polygynous and consanguineous marriages was 28·0% and 58·1%, respectively, largely reflecting the population’s traditional marriage customs. The findings highlighted a significantly higher total marital fertility rate (TMFR) in the monogamous wives (10·5) than in the senior polygynous (8·1) and junior polygynous wives (8·6); the TMFR did not significantly differ among the wives of non-consanguineous, first-cousin and second-cousin marriages. The formation of polygynous marriage was decided by the husband, mostly as a result of his senior wife’s infecundity or sub-fecundity, and the age of the husband at marriage to his junior polygynous wife was high in many cases, leading to a decline in this wife’s fecundity.

Childhood excess weight is probably associated with, or reflected in, parental attitudes. The objective of this study was to study the relationships between childhood excess weight and parental attitudes. The study subjects were 53 boys and 56 girls, aged 6–10, regularly attending schools in Porto Alegre, south Brazil, and one of their parents or caregivers. Attitudes of the parents or caregivers were assessed by the Child Feeding Questionnaire (CFD). Weight and height of the children were measured, parents self-reported their weight and height and body mass indexes were calculated for both. The WHO criteria for overweight and obesity were used for the adults. The CDC criteria for overweight and risk for overweight were used for the corresponding children. Boys presented excess weight more often than girls. The parents of children with excess weight showed higher scores for perceived child weight, concern about child weight, restriction and monitoring. In logistic regression, excess weight in children was associated with perceived child weight, restriction and male sex; pressure to eat was negatively associated with excess BMI. In Porto Alegre, south Brazil, excess body weight in children aged 6–10 is associated with parental perceived child weight and concern about it, monitoring and restriction; being a boy increases the odds of being overweight.

Kerala State in India is the most advanced in terms of demographic and epidemiological transition and has the highest proportion of elderly population. The study examines the socio-demographic correlates of health status of elderly persons in Kerala in terms of three components: perceived health status, physical mobility and morbidity level. Overall health status was measured by combining the above three components of health status. Data from the 60th National Sample Survey Organization (NSSO) on Condition and Health Care of the Aged in Kerala in 2004 was used for the study. Significant socio-demographic differentials in health status were noted. While women report less morbidity, perceived well-being and physical mobility was better for men. This anomaly can be explained by variations in the components of socio-demographic factors. The findings call for urgent health care strategies for elderly persons in different socio-demographic groups in transitional Indian states like Kerala.

In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.

Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

Intentional childlessness in Britain has been investigated by means of a postal questionnaire survey of married women who to date had never had a child. These wives were categorized according to their fertility intentions. As a group the wives were well-educated, likely to be employed and to be married to men in professional or managerial occupations, although there were some with husbands in manual occupations. The main reason perceived by the wives for their decision not to have children was the value they placed on the freedom they consequently gained. A majority of the wives felt there were no disadvantages in remaining childless. The remainder who felt that there were disadvantages identified these as: missing the positive features of children; possible loneliness and lack of support in old age; feelings of deviancy; and economic and social discrimination resulting from their childlessness.

The aim of this study was to determine the degree to which socioeconomic status is a risk factor for first birth at age 19 or younger in married women in an urban area of Turkey. The research was a population-based case-control study. The study group comprised all married and pregnant women aged 15–19 (adolescent pregnancies) attending primary care centres (144 subjects). Married women between 20 and 29 years of age, experiencing their first pregnancy (adult pregnancies), were determined as the control group (144 subjects). A questionnaire was completed for each subject during face-to-face interviews. Adolescent pregnancy was more frequent in women from families with a low socioeconomic status, as determined by occupation (class) and income; both were associated with adolescent pregnancy. Multiple logistic regression analysis identified seven factors associated with adolescent pregnancy: exposure to violence within the family prior to marriage; families partially opposed or unopposed to adolescent marriage; secondary school or lower education level; lack of social security; living in houses in which the number of persons per room was over 1; unemployed women; and having sisters with a history of adolescent pregnancy.

A matched group of women who conceived during a 2-month period in 1971 was used to trace some parameters involved in their decision to carry their pregnancies to term or to seek an abortion.

Several specific indices to the decision were considered: whether coitus was anticipated; whether the pregnancy was planned; whether birth control methods were used; and how the pregnancy ended. The effects of age, marital status, religion, reasons for the abortion or carrying the pregnancy to term, and attitude towards a possible delivery were also studied.

It was found that coitus was anticipated by the majority of women, but pregnancy was unplanned for. Two-thirds of the women who did not want to become pregnant were not using a contraceptive method; yet, regardless of whether pregnancy was planned or unplanned, one of three women chose to have an abortion.

Among the most common reasons for women indicating that contraceptive measures were not used were: ‘I didn't want sex to seem planned’ and ‘I thought I was in a safe period’. The decision to have an abortion usually depended upon the woman's marital status, age, religion, and previous use of birth control. Surprisingly, among women who had not planned to become pregnant, the percentage of women choosing abortion was the same from both subgroups of women who used or did not use contraception. It was also surprising that no strong relationship seemed to exist between the type of contraceptive technique used and the decision to have an abortion.

Women who planned ahead to have an abortion if they became pregnant were more often using contraception; thus for these women abortion was not a primary method of family planning but a back-up for failed contraception. Women who had their babies, infrequently considered abortion as an alternative.

It was predicted and found true that women who positively viewed the prospect of having a child chose to carry the pregnancy to term while those who expressed unhappiness at having a baby chose abortion. Unexpectedly, we found the overwhelming majority of women who claimed ‘I would be neither happy nor unhappy to have this baby’ chose to have an abortion. Thus a woman's so-called neutral statement regarding a desire was generally seen not to be neutral.

Our use of a pregnant population of women who conceived at the same time (conception cohort) for the analysis of the decision of whether to have an abortion or carry to term, when abortion is legal, thus seemed to be feasible and practical.

The present study makes use of nationwide individual-level vital registration data on the single live births occurring in Greece in 2006 to explore associations of socio-demographic factors with adverse pregnancy outcomes, using multinomial logistic regression models. The findings indicate that important risk factors associated with low birth weight preterm and intra-uterine growth retarded births (IUGR) include female sex, primiparity, age of mother over 35, illegitimacy and prior history of stillbirths, infant and child deaths. These constitute risk factors for normal weight preterm births as well, though associations with sex and primiparity in this case point to the opposite direction. Residing in large metropolitan areas is related to a greater risk of an IUGR birth. Among Greek women, educational attainment has a protective effect while housewife status is linked to higher chances of an IUGR birth. For immigrant mothers however, the opposite holds. The study also shows that normal weight preterm births form a distinct group.

The long-term high sex ratio at birth (SRB) is a serious issue in China. In this study, changes in SRB were decomposed into variations in SRB by birth order and compositional changes in female births by birth order. With SRB data from China’s surveys and censuses, and SRB data from South Korea’s vital registration and censuses from 1980–2015, the trend and decomposition results in SRB were compared between China and South Korea, and the decomposition results for urban and rural SRBs, and for provinces, are presented. In both China and South Korea the rise in the SRB was driven by a rise in the SRB at all birth orders, which was only partly counteracted by the change in the distribution of births by order. The overall rise in the SRB ended when there was a decline in the SRB at second birth or above in South Korea. In China the total effect of variations in SRB of all birth orders increased more for the rural population than for the urban population before 2000, resulting in a higher total SRB for rural than urban population. After 2000, the total effect of variations in SRB of all birth orders lowered the total SRB for the rural population, whereas the effect of compositional change increased the total SRB, leading to a very slight rise in the total SRB for the rural population. At the province level, there was no spatial autocorrelation for the changes in total SRB by province, the total effect of variations in SRB of all birth orders or the effect of compositional change. The effect of variations in SRB by birth order accounted for the majority of changes in total SRB in most provinces.

A study of urinary schistosomiasis in Umueze-Anam, Anambra State, Nigeria, showed a Schistosoma haematobium infection of 26% (85) among school children with no significant difference by sex except when age as a variable is introduced. Eleven percent (37) of the 333 children were positive for haematuria; all these 37 children lived within 1·0 km of the water sources. Of the 85 infected children, swimming and laundering accounted for 65% and 48% of all water contact activities, for boys and girls respectively. One-third of the 230 adults interviewed believed haematuria to be a venereal disease and 20% thought it was a sign of maturity. Individual perception of causation and seriousness of haematuria differed by level of education and by sex. Less than 2% of the respondents knew that snails transmitted the disease. The effects of social restrictions on the epidemiology of infection is discussed.

The study objective was to analyse the association between food insecurity and the weight and height status of adolescents from a low-income area in the metropolitan region of Rio de Janeiro, Brazil. The population-based cross-sectional survey included 523 adolescents aged 12–18 years, selected by a three-stage cluster sample. Dietary intake was ascertained with a food frequency questionnaire and family food insecurity was assessed with a validated questionnaire. The analysis estimated weighted means of energy and nutrient intakes by families' socioeconomic characteristics and the association between dietary intake with overweight and stunting. The prevalence of mild family food insecurity was 36%, and 24% of the families reported moderate or severe food insecurity. Overweight prevalence was 24%, and the prevalence of stunting was 9%, with no significant differences between sex or age groups. Family food insecurity was associated with unfavourable socioeconomic characteristics, but there was no association between socioeconomic characteristics (including family food insecurity) and overweight or stunting. Moderate or severe family food insecurity was inversely associated with intake of protein and calcium. In addition, stunting was associated with low calcium and iron intake. The co-existence of family food insecurity with overweight and stunting implies a high nutritional risk for adolescents from poor areas of Rio de Janeiro. Nevertheless, the observed absence of a statistical association between family food insecurity and weight status attests to the complexity of this issue.

Inbreeding coefficients were calculated from data on spouse relationships in a sample of 4833 marriages comprising 345 from three Nilotic tribes, 302 from two indigenous Negroid tribes, and 4186 from several Arab and other tribes. The average inbreeding coefficients were 0·0081 to 0·0145 in Nilotic tribes, 0·0251 to 0·0269 in indigenous Negroids, and 0·0286 to 0·0430 in Arab tribes. First cousin unions constituted about half of all the consanguineous marriages and the pattern of first cousin marriages was similar in all three groups. The inbreeding coefficient for the entire sample was 0·0317.

Males traditionally predominate at upper achievement levels. One general view holds that this is due only to various social factors such as the ‘glass ceiling’ and lack of female role models. Another view holds that it occurs partly because of innate ability differences, with more males being at upper ability levels. In the last few decades, women have become more achievement focused and competitive and have gained many more opportunities to achieve. The present study examined one intellectual domain, international chess, to quantify its gender differences in achievement and to see if these have been diminishing with the societal changes. Chess is a good test domain because it is a meritocracy, it has objective performance measures, and longitudinal data of a whole population are available. Performance ratings overall and in the top 10, 50 and 100 players of each sex show large gender differences and little convergence over the past three decades, although a few females have become high achievers. The distribution of performance ratings on the January 2004 list shows a higher male mean and evidence for more male variation, just as with traits such as height. Career patterns of players first on the list between 1985 and 1989 show that top males and females entered the list at about the same age but females tend to play fewer games and have shorter careers. In this domain at least, the male predominance is large and has remained roughly constant despite societal changes.

This paper investigates variations in the strength and structure of familial association in neonatal mortality risks in four populations; Bolivia, Kenya, Peru, and Tanzania. Exploratory analyses of the structure of the familial association are presented for each population. Random effects logistic models are then used to estimate the strength of familial association in neonatal mortality risks using a standard set of control variables. The results suggest that the strength of familial association in neonatal mortality risks is quite similar in these four populations which would be consistent with a biological explanation for the association. However, some differences were found, particularly in the form of the association in Peru, which may suggest at least a small role of other factors.

A quantitative review of the literature on the intellectual achievement of only children indicated that only children were never at a disadvantage in relation to any comparison group; nor were they significantly different from first-born children or children from two-child families. Moreover, only children were at a significant advantage in comparison with later-born children and those from large families. The consistency of these findings across subgroups suggests that interpersonal mechanisms are largely responsible. The strong only-child advantage on tests of verbal ability, together with the overall pattern of findings, implicates parent–child interactions as responsible for the family size and birth order variations in intellectual achievement.

Analysis of the data from the tenth Italian census shows that women born to older fathers tend to marry older men. The correlations between the ages of the father and the husband in various situations were always found to be positive and significant when the age of the woman and her educational level were held constant. Correlation coefficients are higher in rural and economically less developed areas. Behavioural ‘imprinting’ is suggested as a possible explanation.