In the course of this century man's control over his natural environment and its effects has vastly increased. As a result, death rates from many illnesses caused by environmental factors have fallen markedly. This is very evident in the field of infant mortality. In 1906–10, of every 1000 babies born alive in this country, 117 died before their first birthday. By 1971–75 this figure had dropped to less than 17.

Despite years of health and medical advancement, children still suffer from infectious diseases that are vaccine preventable. India reacted in 1978 by launching the Expanded Programme on Immunization in an attempt to reduce the incidence of vaccine-preventable diseases (VPDs). Although the nation has made remarkable progress over the years, there is significant variation in immunization coverage across different socioeconomic strata. This study attempted to identify the determinants of wealth-based inequality in child immunization using a new, modified method. The present study was based on 11,001 eligible ever-married women aged 15–49 and their children aged 12–23 months. Data were from the third District Level Household and Facility Survey (DLHS-3) of India, 2007–08. Using an approximation of Erreyger’s decomposition technique, the study identified unequal access to antenatal care as the main factor associated with inequality in immunization coverage in India.

The aim of this study is to analyse the impact of maternal age at first birth on low birth weight, preterm birth and low Apgar scores at one minute and at five minutes among live births delivered to primiparous Brazilian women in the city of São Paulo. Analyses were based on 73,820 birth records from the 1998 birth cohort. Logistic regression was used to assess the association between maternal age and each outcome variable, controlling for the following risk factors: delivery mode, plurality, sex, maternal education, number of prior losses, prenatal care, race, parity and community development. Maternal ages below 20 and above 30 years were significantly associated with the risks of low birth weight and preterm birth, but no association was found between maternal ages and Apgar score, with the exception that ages 15–19 reduced the odds of a low one-minute score. Even though this result seems to be inconsistent, low birth weight, preterm birth and low Apgar scores measure different dimensions of newborn well-being, and the association of each measure with maternal age is expected to diverge.

Age at menarche is associated with anthropometry in adolescence. Recently, there has been growing support for the hypothesis that timing of menarche may be set early in life but modified by changes in body size and composition in childhood. To evaluate this, a cohort of 255 girls aged <5 years recruited in 1988 were followed up in 2001 in Matlab, Bangladesh. The analysis was based on nutritional status as assessed by anthropometry and recalled age at menarche. Data were examined using lifetable techniques and the Cox regression model. The association between nutritional status indicators and age at menarche was examined in a multivariate model adjusting for potential confounding variables. Censored cases were accounted for. The median age at menarche was 15·1 years. After controlling for early-life predictors (birth size, childhood underweight, childhood stunting) it appeared that adolescent stunting stood out as the most important determinant of age at menarche. Adolescent stunting still resonates from the effect of stunting in early childhood (OR respectively 2·63 (p<0·01 CI: 1·32–5·24) and 8·47 (p<0·001 CI: 3·79–18·93) for moderately and severely stunted under-fives as compared with the reference category). Birth size was not a significant predictor of age at menarche. It is concluded that age at menarche is strongly influenced by nutritional status in adolescence, notably the level of stunting, which is in turn highly dependent on the level of stunting in early childhood. A ‘late’ menarche due to stunting may be detrimental for reproductive health in case of early childbearing because of the association between height and pelvic size.

Factors contributing to India’s vulnerability to the AIDS epidemic include pervasive poverty, low levels of education and high gender stratification. This study uses data collected in the 1998–99 National Family Health Survey-2 (NFHS-2) to investigate the relationship between aspects of women’s autonomy and four measures of HIV-related knowledge and behaviour – awareness and knowledge of HIV/AIDS, condom awareness and condom use – in three culturally contrasting states in India: Kerala (n=2884), Karnataka (n=4357) and Uttar Pradesh (n=8981). The NFHS-2 is a nationally representative survey of India, with a sampling scheme that was designed such that each state sample can be generalized back to represent ever-married women aged 15–49 living in the state. Kerala scores highest in the four health outcome measures, followed by Karnataka and then Uttar Pradesh, but condom use is lowest in Karnataka. Kerala also leads in the four dimensions of autonomy examined and in socio-demographic status, followed again by Karnataka and Uttar Pradesh. Despite these observed differences, in all three states, women with greater autonomy as measured by this study were more likely to be knowledgeable about AIDS and condoms and to use condoms, after controlling for socio-demographic factors. These results concur with other studies focusing on women’s autonomy and health outcomes around the world, and point to the importance of incorporating a gender-based approach to AIDS prevention programmes in India.

This study uses data from the 1992–93 National Family Health Survey to assess trends in consanguinity in the South Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. In Kerala, the frequency of consanguineous marriages is very low and one type of preferred marriage of the Dravidian marriage system – uncle–niece marriage – is conspicuously absent. In the other states of South India, consanguinity and the coefficient of inbreeding are high. While no change in consanguinity is observed during the past three to four decades in Karnataka, a definite decline is observed in Andhra Pradesh and Tamil Nadu. Due to recent changes in the demographic and social situation in these states, this decline in consanguinity is likely to continue.

A longitudinal study of the growth of a cohort of 229 infants born in a rural area in Jamaica and followed to their 4th birthdays is described, and this paper reports analyses of the anthropometric measurements.

Moderate impairment of growth affected the majority of children and was most marked between the ages of 3 and 15 months. Severe impairment occurred in boys more often than girls and in this comm unity was rarely attributable to disease.

The concept of weight faltering has been investigated in some detail; failure to gain weight for a period of 6 months occurred in almost half the children but was not, by itself, a useful prognostic index of malnutrition; it occurred commonly in children of above average weight whose subsequent growth was normal.

The provision of intensive care at specially appointed child welfare clinics did not completely prevent the development of serious malnutrition.

The genetic structure of Sicily was analysed through the distribution of surnames of 758,793 users registered in the Italian Telephone Company, corresponding to 371 communes of the island. Estimates of the coefficient of consanguinity due to random isonymy, of Fisher's a, an indicator of abundance of surnames, and of Karlin–McGregor's v, an indicator of immigration rates, were obtained for each commune. Four different estimates of genetic distance between all possible pairs of communes within each province were also obtained, and their relationship with geographic distance was studied. The logarithmic transformation of Lasker's coefficient of relationship showed correlations with the log of geographic distance which range between −0·78 and −0·40; the strongest, for the province of Catania, was attributed to the presence of Mount Etna, and the weakest, for Palermo, to the high population density of this province.

A prospective study of 113 children in rural Bhutan registered their morbidity and weight and their mothers' subsequent pregnancies, monthly for 32 months during the children's first 3 years of life. Children whose mothers had a subsequent birth interval of 18–30 months had an incidence of diarrhoea during the subsequent pregnancy 50% higher than their matched cohort whose mothers did not become pregnant (p=0·02). The relative risk for diarrhoea calculated from pooled child months was 1·51. Children whose mothers became pregnant also tended to have a higher incidence of skin infections.

Children, whose mothers were pregnant when they terminated breastfeeding, experienced an increased incidence of diarrhoea around weaning (p=0·01). Children weaned at the same age from non-pregnant mothers did not show increased morbidity.

This study, for the first time, relates observations of children's morbidity directly in time to the occurrence of the mother's subsequent pregnancy, and provides evidence of a causal relationship between a moderately short subsequent birth interval and a concurrent increase in morbidity for the study child.

Recent debates about deworming school-aged children in East Africa have been described as the ‘Worm Wars’. The stakes are high. Deworming has become one of the top priorities in the fight against infectious diseases. Staff at the World Health Organization, the Gates Foundation and the World Bank (among other institutions) have endorsed the approach, and school-based treatments are a key component of large-scale mass drug administration programmes. Drawing on field research in Uganda and Tanzania, and engaging with both biological and social evidence, this article shows that assertions about the effects of school-based deworming are over-optimistic. The results of a much-cited study on deworming Kenyan school children, which has been used to promote the intervention, are flawed, and a systematic review of randomized controlled trials demonstrates that deworming is unlikely to improve overall public health. Also, confusions arise by applying the term deworming to a variety of very different helminth infections and to different treatment regimes, while local-level research in schools reveals that drug coverage usually falls below target levels. In most places where data exist, infection levels remain disappointingly high. Without indefinite free deworming, any declines in endemicity are likely to be reversed. Moreover, there are social problems arising from mass drug administration that have generally been ignored. Notably, there are serious ethical and practical issues arising from the widespread practice of giving tablets to children without actively consulting parents. There is no doubt that curative therapy for children infected with debilitating parasitic infections is appropriate, but overly positive evaluations of indiscriminate deworming are counter-productive.

The names we use for our own species represent general attitudes, many of which were adumbrated by the Greeks. Linnaeus called us Homo sapiens, or thinking man, and his image may be represented by Athene, the goddess of wisdom and my favourite deity. Equally justified is Homo faber, man the maker, represented by Vulcan or Hephaistos. Another aspect of man has been given confusing prominence recently; for man the warrior I have had to invent a name, Homo pugnax—Mars or Ares. Homo ludens has also been proposed (Huizinga, 1970); his counterpart was perhaps Hermes.

While the macro-level association between poverty and child malnutrition is well-established, the concept of ‘poverty’ and its operationalization in terms of measures of socioeconomic status shed little or no light on the mechanisms through which malnutrition is created and/or prevented. This paper investigates a woman’s social power, one such mechanism that may mediate the impact of poverty on childhood nutrition. This micro-level factor is examined using survey data on 402 children 5 years of age and younger and their 261 Fulbe mothers in rural Mali. A conceptual model of social power is developed and used to test the hypothesis that a mother’s social power can predict her child’s nutritional status.

This study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005–2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15–24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.

The present study investigates the socioeconomic risk factors of anaemia among women belonging to eastern Indian states. An attempt has been made to find out differences in anaemia related to social class and place of residence, and age and marital status. It was hypothesized that rural women would have a higher prevalence of anaemia compared with their urban counterparts, particularly among the poorest social strata, and that ever-married women would be at elevated risk of anaemia compared with never-married women, particularly in the adolescent age group. Using data from National Family Health Survey-3, 2005–6, a nationally representative cross-sectional survey that provided information on anaemia level among 19,695 women of this region, the present study found that the prevalence of anaemia was high among all women cutting across social class, location and other attributes. In all 47.9% were mildly anaemic (10.0–11.9.9 g/dl), 16.1% were moderately anaemic (7.0–9.9 g/dl) and 1.6% were severely anaemic (<7.0 g/dl). Protective factors include frequent consumption of pulses, milk and milk products, fruits and fish, educational attainment, mass media exposure and high socioeconomic status. Urban poor women and adolescent ever-married women had very high odds of being anaemic. New programme strategies are needed, particularly those that improve iron storage and enhance the overall nutritional status of women throughout the life-cycle.

Obesity affects quality of life and increases the risk of morbidity and mortality. Mexico, a middle-income country, has a high prevalence of overweight and obesity among urban children. Merida is the most populated and growing city in southern Mexico with a mixed Mayan and non-Maya population. Local urbanization and access to industrialized foods have impacted the eating habits and physical activity of children, increasing the risk of overweight and obesity. This study aimed to contribute to the existing literature on the global prevalence of overweight and obesity and examined the association of parental income, ethnicity and nutritional status with body mass index (BMI) and height in primary school children in Merida. The heights and weights of 3243 children aged 6–12 from sixteen randomly selected schools in the city were collected between April and December 2012. Multinomial logistic regression models were used to examine differences in the prevalence of BMI and height categories (based on WHO reference values) by ethnicity and income levels. Of the total students, 1648 (50.9%) were overweight or obese. Stunting was found in 227 children (7%), while 755 (23.3%) were defined as having short stature. Combined stunting and overweight/obesity was found in 301 students (9.3%) and twelve (0.4%) were classified as stunted and of low weight. Having two Mayan surnames was inversely associated with having adequate height (OR=0.69, p<0.05) and the presence of two Maya surnames in children increased the odds of short stature and stunting. Children from lower income families had twice the odds of being stunted and obese. Overweight, obesity and short stature were frequent among the studied children. A significant proportion of Meridan children could face an increased risk of developing cardiovascular disease and its associated negative economic and social outcomes unless healthier habits are adopted. Action is needed to reduce the prevalence of obesity among southern Mexican families of all ethnic groups, particularly those of lower income.

Duration of postpartum amenorrhoea (PPA) was compared among women who breast-fed For ≥ 6 months (breast-feeding group) Or ≤ 3 Months (formula-feeding group) and was found to be significantly shorter among the latter. associations between maternal factors and duration of PPA were examined. within the formula-feeding group, the only variable associated with duration of PPA was duration of breast-feeding. among breast-feeding mothers who resumed menstruation after 3 months postpartum, duration of PPA was positively associated with parity and negatively associated with maternal body mass index (bmi) at 3 months postpartum. Among breastfeeding mothers who resumed menstruation after 6 months, duration of PPA was positively associated with parity, pregnancy weight gain, number of night feeds and milk volume at 6 months, and negatively associated with maternal age and bmi at 6 months postpartum. These results indicate that maternal anthropometric status is related to duration of PPA, even in a relatively well-nourished population of lactating women.

The incidence of family breakdown and stress has been examined in an unselected group of 92 South Wales families, each containing a patient suffering from Huntington's chorea, and related to the onset and duration of the disease, age of the patient, and behavioural symptoms shown. The frequency of actual and attempted suicide is analysed and the effects of the disorder on the primary care agent for the patient discussed. Some of the effects on children and the needs of the families for support and practical help are outlined. It is concluded that family support is an essential factor in any programme aimed at the long-term alleviation and prevention of Huntington's chorea.

The genetic structure and its recent evolution in a small isolated village in the French Pyrenees, Arthez-d'Asson, have been characterized by calculating the probabilities of origin of genes and inbreeding values at every generation since the 17th century.

Arthez-d'Asson appears to be one of the most inbred populations in France, with an inbreeding coefficient of approximately 0·5%. This is due first to genetical and cultural isolation, and secondly to migration out of the village towards towns at the turn of the century. The valley of Ouzom, in which Arthez-d'Asson lies, constitutes a hierarchical population and some cultural and genetical turnover is drawing back to the valley genes which have been absent for some generations.

Results are reported for mean IQs on the WAIS-R in Sudan in 1987 and 2007. There was a gain of 4·05 Full Scale IQ points over the 20-year period, representing a gain of 2·05 IQ points a decade. The Verbal IQ showed a loss of 1·65 IQ points, while the Performance IQ showed a gain of 7·2 IQ points. These results are broadly consistent with those in economically developed countries in showing that mean IQ on the WAIS-R has increased in Sudan, and the Performance IQ has increased more than the Verbal IQ.

Sibling relations are by nature ambivalent with high levels of both altruistic helping and competition. Higher relatedness is often assumed to reduce the occurrence of conflicts between siblings, but evidence of this has been scarce and mixed. Siblings typically compete over resources and parental attention, and parental constellations vary with sibship types. Since full-siblings compete over the same two biological parents, while half-siblings have only one shared biological parent and often a higher number of parents overall, it is hypothesized that conflicts are more common between full- than half-siblings. This study tested this assumption using the British Millennium Cohort Study (n=7527 children at age 11). Conflicts were measured as children’s reports of how much siblings picked on and hurt each other. Households with full-siblings only, maternal half-siblings only, and both full- and maternal half-siblings were compared. The results show that children who were living with only their full-siblings were more likely to experience sibling conflicts compared with children living with their maternal half-siblings only. This was the case also after controlling for several potentially confounding variables. The results suggest that differential access to parental resources of available biological and step-parents may explain the higher amount of sibling conflict between full- compared with maternal half-siblings.