Census data were used to investigate the influences of socioeconomic and environmental variables on child mortality rates in southern Brazil. By multivariate logistic regression analysis the effects of correlated factors were distinguished, after adjustment for maternal age and parity. Low family income and, to a lesser degree, low employment status of the head of the family were associated with high child mortality levels. Place of residence, education of the mother and of the head of the family, availability of piped water in the home, access to a toilet and type of housing were all associated with childhood mortality variation, even after allowing for the effects of income and employment. The contributions of the source of the water supply and type of sanitation facilities, however, were less clear and tended to become unimportant after controlling for the socioeconomic variables. There was also no apparent advantage in being covered by government health insurance.

The association between breast-feeding patterns and resumption of menses post-partum was examined in a longitudinal study initiated in March 1976 in Bangladesh. Information on suckling patterns and menstrual status was collected on 148 breast-feeding women who were still amenorrhoeic at 17–25 months post-partum at the beginning of the study. Suckling was measured during an 8-hr period once a month for up to 19 months of follow-up.

A high frequency of suckling was found, even at this late post-partum duration. Total suckling time and the number of suckling episodes declined with the age of the child but the mean duration of each episode did not change. The fact that regression analyses did not show a correlation between suckling patterns and return of menses post-partum may be related to the large individual variations in suckling patterns and in the duration of amenorrhoea in this population, and the need to study suckling patterns for longer than 8 hr per day.

The variables maternal age, paternal age, and birth order are studied for possible effects on the human secondary sex ratio. Several multivariate models are applied to a set of over 1·4 million births to assess the effects of these three highly correlated variables. Also investigated is the polynomial regression model used by Novitski & Kimball (1958) in their approach to the same problem. Analysis of the present data shows a weak and negative association between sex ratio and birth order and the suggestion of a similar association with paternal age.

Bangladesh society is profoundly gender stratified, and yet male roles in reproductive health processes have not been rigorously investigated. This study examines the association between men’s reproductive health knowledge, attitude and behaviour and their wives’ subsequent reproductive behaviour using longitudinal data from the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A total of 4969 matched husband-and-wife data from a 1998 survey and women’s contraceptive use history data following this survey are used. Results show a significant association between husbands’ fertility preferences and current use of any family planning method. When wives’ background characteristics, and husbands’ background and socioeconomic characteristics are controlled for, the predicted probability of using a method of contraception among non-educated wives whose husbands want more children is 0·49 compared with 0·64 for those whose husbands do not want more children. However, the net effect of husbands’ preference for additional children diminishes as wives’ level of education increases. Among wives who had completed high school, the predicted probability of using a method of contraception is 0·70 for those whose husbands want more children compared with 0·69 for those whose husbands do not want more children.

There is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father's education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder–Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor.

This paper models the proximate determinants of children born to over 13,000 Ethiopian women and of the women’s stated preferences for additional births using the data from the Ethiopian Demographic and Health Survey 2000. Empirical models for the number of children born to women were estimated using Poisson and ordinal regressions. The results show the importance of variables such as maternal education for smaller family size, and that variables reflecting desired family size are strong predictors of the numbers of children born to women. Secondly, binary logistic models for dichotomous variables for women not wanting more children and if getting pregnant would be a ‘big problem’ showed non-linear effects of the surviving and ‘ideal’ number of children. Moreover, the results indicated a desire on the part of women to limit family size, especially as the number of surviving children increased. Probit models were estimated to address potential endogeneity of certain variables. Overall, the results indicated that counselling couples about small family size and increasing the utilization of health care services can lower fertility in Ethiopia.

Trends in multiple birth rates are thought to have been substantially affected by subfertility treatments in the last 25 years, but there are few quantitative assessments of this. This paper examines trends in twin and higher multiple birth rates separately in Scotland, England and Wales and compares their course with corresponding multiple birth rates in the Oxford Record Linkage Study area, where the proportions following subfertility treatment are documented. National data on prescriptions for subfertility treatments reinforce the view that they have had a major effect on the trends, and currently perhaps 60% of triplet and higher order births and 15% of twins follow their use in Britain.

Sexuality is still a taboo in Middle Eastern countries, and Lebanon is no exception. This study’s objective was to evaluate attitudes towards sexuality and its practice among university students in Lebanon and assess their respective correlates. The cross-sectional study was carried out among students selected from seventeen universities across Lebanon. The participants received a self-administered standardized questionnaire that assessed their attitudes towards sexuality. It included questions on socio-demographic factors, risk-taking, risky behaviours and sexuality-related questions. Among 3384 students, 2700 (79.8%) answered the questions on sexuality. Around 15% had engaged in sexual activity, while 20% were regularly sexually active. Among males, 34.8% had never had sexual activity, 29.9% had tried it and 35.3% were regularly sexually active. Among females the results were respectively 85.1%, 5.3% and 9.6% (p<0.001). Only 36% regularly used condoms during their relationships. A liberal attitude towards sex, male sex, motives for risky behaviours, current cigarette smoking and problematic alcohol consumption were associated with sexual activity. Realizing that risky behaviours are dangerous, health concerns related to sexual relationships and a liberal attitude towards sex were associated with regular condom use. However, being bothered by condoms and female sex were inversely associated with condom use. Finally, participants who had motives for, and those who felt excited about risky behaviours, and those reporting current cigarette and waterpipe smoking and problematic alcohol consumption (β=0.600; p=0.002) embraced a more liberal attitude towards sex. Conversely, females (β=−7.58; p<0.001) and individuals who considered risky behaviours as dangerous reported an unfavourable attitude towards sexuality. A substantial proportion of Lebanese university students have regular sexual activity, but a low percentage use condoms for protection. Interventions are required among males in particular in view of these attitude and behavioural changes towards sexuality.

Findings are reported on 100 couples who had requested donor insemination as a means of circumventing male infertility. Twelve couples dropped out, but the remainder were graded for personal acceptability. Forty-six couples were recommended with only minor reservations if any, 40 were seen as unsatisfactory in varying degree, and two were rejected owing to gross marital and sexual problems. In one couple, early marital breakdown after childbirth occurred.

A strong sense of mutual commitment may be the norm in such couples but exchange of affection between partners, as measured by the Ryle marital patterns test, was less vivid than in an earlier study of childless couples waiting to adopt. The infertile husband may be in particular need of emotional support from his wife, and a careful appraisal of the marriage seems warranted before treatment.

Reported age at first coitus was shown to be associated with incidence and degree of infertility. Infertility patients reported later first coital ages than gynaecological patients in a sample of 792 women seen in a major infertility service. Among the infertility patients, those who had never conceived presented a later first coital age than those who had previously conceived. Routine gynaecological patients reported the youngest first coital age of the groups studied.

This paper reports the findings of longitudinal studies of married primigravidae resident in Aberdeen city:

(1) All 1026 primigravidae delivered in 1949 were followed up 5 years later.

(2) A 1-in-6 random sample of primigravidae delivered 1950–53 (330 women) were studied intensively and followed up at 5 and 10 years.

The findings are biased in favour of families of manual workers because more upper social class families left Aberdeen.

Many primigravidae had no definite ideas on family size but they made up their minds or changed their preferences (sometimes to accommodate to reality) as they gained experience of marriage and motherhood. Most women wanted 2 or 3 children and none wanted more than 4 children.

There were striking differentials in fertility at both 5 and 10 years. Women who were under 20 years of age when they had their first baby, those who conceived prenuptially, and those married to a semi-skilled or unskilled manual worker had the largest families at both 5 and 10 years. At 5 years, although on average such women were having intercourse more frequently, they were the least likely to have been regular users of contraceptives.

Two-thirds of all pregnancies which occurred in the first 5 years were ‘unintended’. Only 15% of couples had used contraceptives regularly from marriage and a further 20% became regular users in the 5 years following the birth of their first child. At the end of the first 5 years, 10% of women already had more children ‘than they felt able to manage without excessive strain’. The number increased in the following years but was modified partly by delegation of responsibility for a few children to other women but more especially by the liberal policy to sterilization pursued in Aberdeen. The repetition of the disadvantages in the childhood environment of the largest families is illustrated. It is argued that ‘the pill’, which was not available to the women in the studies reported, may reduce the number of ‘unintended‘ pregnancies in future, but that sterilization may remain the most satisfactory measure of family limitation in a small group of women whose way of life is not conducive to forward planning and sustained rational behaviour.

During the past year, data have been published on the offspring sex ratios of people diagnosed with toxoplasmosis, hepatitis B, and pre- and post-menopausal breast cancer. It is shown here how these offspring sex ratios constitute further support for the hypothesis that mammalian (including human) parental hormone concentrations around the time of conception partially control the sexes of the resulting infants. If this interpretation were correct, then hormonal treatments might be considered for some or all of these conditions. It is intended that anyone who has read the present note and my two previous papers (James, 1996, 2004) should be aware of all the data relating to the hypothesis.

The author's theory that among adults men have a higher mean IQ than women has been critized by Mackintosh. His criticisms are examined and found wanting. New evidence is adduced that men obtain higher means than women on Raven's Progressive Matrices.

Analysis of British National Child Development Study data corroborates the long held views that first born children tend to get more medical surveillance than those of later birth order, and that there is a direct relationship between achieved family size and social status.

This report is based on the findings of an epidemiological study of 29,468 rural, semi-rural and urban inhabitants of the Agra region of Uttar Pradesh. The survey was made in order to find out the prevalence of severe mental disorders and associated conditions in an Indian community. The sampling was purposive and areas selected were contiguous. Census methods were used. All inhabitants were investigated by a team consisting of a psychologist, a statistician, social workers and psychiatrists. After reconnaissance and initial contact by home visits, suspected cases were detected by a searching inquiry and the information so obtained was carefully documented. These cases were subjected to psychiatric examination and abnormal ones identified. Consultation with another psychiatrist was necessary to make a final diagnosis.

The lifetime prevalence rate of schizophrenia was 2·2 per thousand, about the same frequency as found in other parts of the world. The maximum number of cases occurred in males between the ages of 15 and 24 and in females between the ages of 35 and 44. Single people, that is, never married, widowed, divorced or separated suffered significantly much more from the disease than bachelors and married people. A significant relationship was found between schizophrenia and castes in Vaish and Brahmin males as compared with others. The highest rate of schizophrenia was found among people in unremunerative status. Intoxicants were used more by schizophrenics than by normal people. Caste group indulgents had their own preferences in drug use, cannabis indulgence being highest among Brahmins. No association of schizophrenia with residence, educational status or sex was found.

The question of youth sexual behaviour has been widely debated, with researchers such as Berhan and Berhan (2015) arguing that young adults aged 15–24 are more likely to engage in risky behaviours. However, research has not adequately addressed the issue of positive sexual behaviours, in particular among young people in sub-Saharan Africa. Adapting the compensatory model of risk and resiliency theory, this study examined the determinants of positive sexual behaviours among youth in sub-Saharan Africa. Using recent data from Demographic and Health Surveys of sixteen countries representative of each African region (East, West, Southern and Central), it was hypothesized that positive sexual behaviours of youth (condom use at last sex and single sexual partnership) would be most strengthened by protective factors at the individual and family levels, and that these behaviours would differ by region due to regional variation in socio-cultural practices. Delayed age at sexual debut (first sex after the age of 15) was found to be the strongest protective factor for positive sexual behaviours among males and females in sub-Saharan Africa. Certain socioeconomic variables were found to be positively associated with positive sexual behaviours and the associations differed by gender.

It has been widely observed that socioeconomic status (SES) is associated with frequency of cardiovascular disease. Both men and women of low socioeconomic position have increased risk of cardiovascular disease morbidity and premature death. In this study the relationship between SES in childhood, and health status at the age of 50 years was examined. Socioeconomic status in childhood was measured using objective (father’s educational level and number of children in the family) and subjective (self-assessed SES in childhood declared in early adulthood) indicators. Data from the Wrocław Growth Study were completed when subjects were 50 years old, and information concerning health status was added. The results indicated that the objective, universally used measures of SES in childhood such as father’s educational level and size of family did not show any essential relationships with health outcomes in adulthood, both for men and women. By contrast, retrospective, self-assessed SES (as better, average or worse as compared with peers) in childhood was significantly associated with the appearance of cardiovascular disease among women aged 50 years. Women who at the beginning of their adult life declared better socioeconomic condition in childhood were significantly healthier at the age of 50 years (OR=3·43; p=0·02). Moreover, this appeared to be independent of BMI, SES and life-style in adulthood. For men, retrospective self-assessed SES showed no relation to health status at the age of 50 years. The gender differences in the relationships between self-assessed SES in childhood and health status in adulthood are explained by possible selective premature mortality among men from lower childhood SES and/or sex differences in cognitive abilities.

At the end of the 4th week of the Hilary Term 1977, 1006 male and 1009 female undergraduates at Oxford University were sent a questionnaire enquiring about their sexual behaviour and contraceptive practice. Of the 862 women and 634 men who replied, 512 women (59%) and 332 men (52%) had experienced sexual intercourse, 396 women and 191 men in the 4-week period preceding receipt of the questionnaire. No contraception had been used by 27% of the women on the first occasion that they had had intercourse; during the 4-week period preceding receipt of the questionnaire 10% of sexually active women had had intercourse on one or more occasions without using a contraceptive. The use of contraception increased with the frequency of intercourse and the stability of the relationship. Thirty-one women had been pregnant in the past; none was known to be pregnant at the time of the survey, although sixteen suspected that they might be. Ninety per cent of the students approved of the free distribution of a booklet on contraception and related matters to all undergraduates.

This paper interrogates the routine and unproblematic use of terms such as ‘self-medication’ in biomedical and anthropological discourse. A typical depiction of the social factors that explain the practice of ‘self-medication’ in India is to put together the supply side factors (such as protection offered by the government for the production of generic drugs, especially in the small scale sector, and expansion of the number of drug store outlets), with the increasing demand for allopathic drugs. The paper provides an ethnographic account of the intricate connections between households and biomedical practitioners in urban neighbourhoods in Delhi. It breaks away from the conventional opposition drawn between the practices of physicians and the beliefs of their patients, and suggests that what constitutes the medical environments of these neighbourhoods is the product of medical practices, household economies and concepts of disease. Thus pharmaceutical use is determined as much by practices of dispensation and by how practitioners understand what constitutes therapy as by household understanding of the normal and the pathological. This paper uses both quantitative data and narrative interviews to provide an in-depth understanding of the circulation of pharmaceuticals within the life worlds of the urban poor.

The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women’s decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women’s household wealth, education, antenatal care and community’s wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.