Men's participation in perinatal care (PNC) is a promising strategy for improving maternal health. This study aimed to assess the educational needs of men for their participation in PNC. This is a qualitative research study using focus group discussions. These were performed with eight groups of men and women in selected hospitals of Shahid Beheshti Medical Science University, Iran. Data were analysed using qualitative content analysis methodology. The majority of participants gave the ‘emotional support of women’ as the most appropriate form of men's participation in PNC, and the ‘long working hours of men’ as the main barrier. The majority would prefer men's education to be about ‘emotional support’, ‘physiological changes’ and ‘signs of risks’ during pregnancy. The participants emphasized the need to consider couples' requirements when selecting the place, time and duration of education.

This study describes Finnish university students' knowledge and attitudes towards HIV and AIDS, homosexuality and sexual risk behaviour. Finnish-speaking students were randomly selected from all registered students at two universities in Finland (N=9715, n=950). The data were collected by using a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire on sexual risk behaviour developed by Held and Chng. The total response rate was 35% (n=333). The data were analysed using quantitative statistical methods. Normally distributed data were analysed by t-test and one-way ANOVA, with Bonferroni corrections. Non-normally distributed data were analysed using the Mann-Whitney U-test and Kruskal-Wallis test, followed by a post-hoc test. The majority of students were familiar with HIV and AIDS, including its mode of transmission. However, there were still some misconceptions concerning HIV and AIDS. The oldest students and women had a more positive attitude towards people living with HIV and AIDS (PLWHA). Of patients with HIV or AIDS, intravenous drug users were perceived most negatively. Male students had more homophobic attitudes. Students who reported that religion had an important role in their lives had significantly stricter attitudes towards sexual risk behaviour. Students' knowledge correlated positively with general attitudes towards HIV and AIDS. Knowledge about HIV and AIDS will lead to more positive attitudes towards HIV and AIDS as a disease, towards those infected as well as homosexual people. There is a need to focus on preventive health care and sexual health promotion by educating young people and changing their attitudes towards sexual risk behaviour.

Using retrospective data from the Urban Integration Survey conducted in 2001 in Nairobi, Kenya, on a sample of 955 women and men aged 25–54, this paper compares factors influencing entry into union formation for men and women. The analysis uses event history methods, specifically Cox Proportional Hazards regression, stratified by age cohort and run separately by sex. The results indicate that delay in union formation is more pronounced for women than for men. Cohabitation without formal marriage is the prominent form of union, especially among the younger generation, and appears to have increased. For men, the timing of union is more dependent upon human capital acquisition than on cultural factors. These findings show that the marriage search model, which was first applied in Western countries, can also hold in cities of developing countries. Nonetheless, neither the search model nor the integration or the independence models apply to women's union formation, which very few exogenous factors can explain.

A majority of Zambian children live in impoverished communities that lack safe water and proper sanitation, exposing them to urogenital and intestinal helminths. Efforts to mitigate this plight have been implemented through mass drug administration aimed at deworming school-age and under-five children against schistosomiasis and soil-transmitted helminths. However, the disease status of adults living in the same communities as the treated children remains unknown. The aim of this study was to describe the potential contribution of infected adult populations to the transmission of these infections in southern Zambia. A cross-sectional study was conducted in April and May 2013 as part of baseline survey for a larger study in Mazabuka and Siavonga Districts. Stool and urine samples of 2829 adults from five catchment areas were collected and processed using Kato-Katz and urine filtration methods, respectively. Adults from Siavonga had a 13.9% combined prevalence of Schistosoma haematobium and S. mansoni, and 12.1% combined prevalence of Ascaris lumbricoides and hookworm. There was no S. mansoni in Mazabuka, and only a 5.3% prevalence of S. haematobium and 7.4% combined prevalence of A. lumbricoides and hookworm. Additionally, no Trichuris trichiura infections were observed in the two districts. Despite most of these infections being categorized as light intensity, heavy infection intensities were also found for all four parasite species. If this infected adult population is left untreated, the possibility of it acting as a reservoir of infections and ultimately transmitting the infections to treated children remains. Therefore, there is need to consider alternative treatment strategies that incorporate adults, thereby reducing the risk of contaminating the environment and perpetuating transmission to children.

The combined effects of decreased fertility and mortality coupled with increasing survivorship across most ages have been upsetting the levels and age patterns of morbidity and mortality in India. This study examined data from the National Sample Survey (NSS) and Sample Registration System (SRS) of India. The results reveal marked structural changes in the age patterns of morbidity and mortality. The analysis also tested whether morbidity contours are being compressed or expanded, connecting it with the ongoing processes of demographic and epidemiological transition. The Sullivan (1971) method was used to estimate the health ratio over three time periods to ascertain the expansion of morbidity. The results reveal an exceptional rise in the prevalence rate of chronic non-communicable diseases in ages 60 and above. The proportion of unhealthy years of the total life expectancy has increased more than before for all older age groups. Overall, the results confirm that an expansion of morbidity is in progress, with a heavier and cumulated concentration of morbidity in older ages. The expansion of morbidity hypothesis is validated for major categories of population: rural, urban, male and female. Older females bear a much heavier burden of chronic non-communicable diseases and are vulnerable to a higher proportion of unhealthy years. The age-structural shifts in morbidity and mortality signal the steady progress of epidemiological transition in India.

This paper assesses women's awareness of the liberalization of abortion law and their knowledge of a place for obtaining abortion services in Nepal. The data are from the 2011 Nepal Demographic and Health Survey. The results are compared with data from a similar survey conducted in 2006. Variations in the two measures among several population sub-groups are analysed by performing logistic regression. Among women aged 15–44, 38.7% (CI: 37.8, 39.6) were aware of the legal status of abortion and 59.8% (CI: 58.9, 60.7) knew of a place to have an abortion. The percentages of both measures varied considerably by various population sub-groups. Over a 5-year period, knowledge of the legality of abortion increased by 6.4 percentage points, and awareness of service delivery sites increased by 3.3 percentage points. The increases in both measures were, however, largely limited to higher wealth quintiles and those with higher educational attainment. The results suggest the need to intensify efforts to educate women in Nepal, particularly the most disadvantaged women, about abortion law, including the conditions under which abortion is permitted, and where to access safe abortion services.

Malnutrition among children is prevalent in almost all the states in India. This study assesses the extent and causes of malnutrition in two eastern Indian states with similar climates, namely West Bengal and Assam, using data from the National Family Health Survey 1998–99 (NFHS-2). The three indices of malnutrition taken for analysis are weight-for-height (WHZ), height-for-age (HAZ) and weight-for-age (WAZ). These are assumed to depend on birth order, preceding birth interval, parent’s educational status, working status of the mother, mother’s age at delivery of the children, source of drinking water, toilet facilities and standard of living of the household. Logistic regression was carried out separately for each of the three indices on the explanatory variables for both the states. It was found that not all variables are equally important in determining whether a baby is underweight, or suffering from acute or chronic malnutrition. Also, the importance of variables is not the same in the two states. It was observed that the coefficients associated with the variables in determining weight-for-height are not significant compared with those for weight-for-age and height-for-age.

This study traces the biosocial dynamics of Echinococcus granulosus – a zoonotic tapeworm spread between dogs, livestock and people – at slaughterhouses in Morocco. One of the most important parasitic zoonoses worldwide, this neglected cestode is responsible for a debilitating, potentially life-threatening, human disease and significant livestock production losses. Transmission can be interrupted, among other ways, by restricting dogs from eating cyst-infected livestock viscera. Recent epidemiological studies in Sidi Kacem province, northern Morocco, found that government-operated slaughterhouses were ‘hotspots’ for hydatid cysts in livestock and infection in dogs. An ethnographic approach was used to compliment these studies, exploring ‘how’ and ‘why’ cysts were being openly discarded. All seven visited slaughterhouses had low levels of hygiene, oversight and infrastructure. This was described locally as perpetuating a sense of ‘chaos’ that normalized (un)hygienic practices and justified the ignoring of state rules and regulations. However deference to ‘poor’ infrastructure, both physically and symbolically, served to under-emphasize local institutional logics, which were mediated by prevailing risk perceptions, economic practices and local socio-political norms. These included inter-departmental government relationships, the motivation of veterinary technicians, the political lobbying of butchers and market-based mitigation strategies. The study shows the importance of understanding E. granulosus from a biosocial perspective, and the need for more long-term, participatory and integrated ‘One Health’ approaches for neglected zoonotic diseases.

In a prospective study in Matlab, a rural area in Bangladesh, the relationship between a variety of covariates and childhood mortality was examined. Economic status of household, education of mother, sex of the children, health intervention programmes, age of mother, and live birth order of the children were identified as having a statistically significant impact on child survival when the effect of age was controlled. The effects of sex of the children, health programmes, age of mother, and birth order were found to be dependent on the age of the children, but the effect of mother's education was dependent on sex of the children.

Excess weight is becoming widespread in Spain due to changes in nutritional habits and lifestyles. Previous studies on this issue have focused on specific Spanish regions, subpopulations or relatively short time spans. This study analysed sex, age and cohort trends in the prevalence of adult overweight and obesity over the last two decades by applying a demographic methodology. Data came from the Spanish National Health Surveys that were held between 1987 and 2006. The respondent's demographic characteristics and self-reported height and weight were aggregated to a single dataset in order to analyse changes in weight and BMI by age and sex, over time and within and between quasi birth-cohorts. After correcting for sample bias and coding errors a total sample of about 100,000 subjects aged 20–79 was obtained. The results show that between 1987 and 2006 adult males and females increased their average weight by 8.2% and 2.8%, respectively. While among younger adults this is partly explained by height increases, prevalence in excess weight increased among 50- to 79-year-old males. Persons of the same 10-year age group but of a more recent 10-year quasi birth-cohort had a BMI that was 0.2–0.8 points higher. BMI increases were lower for women and mainly affected 60–79 year olds. In fact, even decreases were observed for 40- to 49 and 50- to 59-year-old women. Potential explanatory factors are discussed.

Endeavours to control urogenital schistosomiasis on Unguja Island (Zanzibar) have focused on school-aged children. To assess the impact of an associated health education campaign, the supervised use of the comic-strip medical booklet Juma na Kichocho by Class V pupils attending eighteen primary schools was investigated. A validated knowledge and attitudes questionnaire was completed at baseline and repeated one year later following the regular use of the booklet during the calendar year. A scoring system (ranging from 0.0 to 5.0) measured children’s understandings of schistosomiasis and malaria, with the latter being a neutral comparator against specific changes for schistosomiasis. In 2006, the average score from 751 children (328 boys and 423 girls) was 2.39 for schistosomiasis and 3.03 for malaria. One year later, the score was 2.43 for schistosomiasis and 2.70 for malaria from 779 children (351 boys and 428 girls). As might be expected, knowledge and attitudes scores for schistosomiasis increased (+0.05), but not as much as originally hoped, while the score for malaria decreased (−0.33). According to a Kolmogorov–Smirnov test, neither change was statistically significant. Analysis also revealed that 75% of school children misunderstood the importance of reinfection after treatment with praziquantel. These results are disappointing. They demonstrate that it is mistaken to assume that knowledge conveyed in child-friendly booklets will necessarily be interpreted, and acted upon, in the way intended. If long-term sustained behavioural change is to be achieved, health education materials need to engage more closely with local understandings and responses to urogenital schistosomiasis. This, in turn, needs to be part of the development of a more holistic, biosocial approach to the control of schistosomiasis.

Factor analytic studies in Africa are compared with other cross-cultural investigations into the structure of abilities in different ethnic groups. Similarities and differences are noted; and environmental influences on the acquisition of skills are also summarized. A correlational study of wrong answers to a battery of thirty marker tests given to a group of predominantly Mashona students indicates that efficiency skills of numerical facility and memory remain at the first order of factor extraction, reasoning abilities emerge in second-order analysis, while perceptual styles are present in the third-order level. This study is used to hypothesize, in thecontext of African systems of thought, the existence of a primary thought mode that asserts itself in conditions involving repeated errors.

Despite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy.

The aim of this study was to examine the positive relationship between religiosity and fertility from the perspective of perceived consequences of parenthood. Previous studies in Germany have found that highly religious people ascribe higher benefits and lower costs to having children. Furthermore, the impact of costs and benefits on fertility is less pronounced among the highly religious. This study tested these mechanisms for fertility intentions and in the context of Poland – a country with a low fertility rate and high religiosity in comparison to other European countries. A sample of 4892 men and women of childbearing age from the second wave of the Polish version of the Generations and Gender Survey conducted in 2014/2015 was used. First, the extent to which perceived costs and benefits mediate the impact of religiosity on fertility intentions was analysed. Second, whether religiosity moderates the impact of perceived costs and benefits on fertility intentions was investigated. The results show that part of the positive effect of religiosity on fertility intentions can be explained by more-religious people seeing higher benefits of having children. Furthermore, but only in the case of women, religiosity moderates the impact of perceived costs on fertility intentions, suggesting that the effect of perceived costs decreases with increasing religiosity.

Child mortality (the mortality of children less than five years old) declined considerably in the developing world in the 1990s, but infant mortality declined less. The reductions in neonatal mortality were not impressive and, as a consequence, there is an increasing percentage of infant deaths in the neonatal period. Any further reduction in child mortality, therefore, requires an understanding of the determinants of neonatal mortality. 209,628 birth and 2581 neonatal death records for the 1998 birth cohort from the city of São Paulo, Brazil, were probabilistically matched. Data were from SINASC and SIM, Information Systems on Live Births and Deaths of Brazil. Logistic regression was used to find the association between neonatal mortality and the following risk factors: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. Infants of older mothers were less likely to die in the neonatal period. Caesarean delivery was not found to be associated with neonatal mortality. Low birth weight, pre-term birth and low Apgar scores were associated with neonatal death. Having a mother who lives in the highest developed community decreased the odds of neonatal death, suggesting that factors not measured in this study are behind such association. This result may also indicate that other factors over and above biological and more proximate factors could affect neonatal death.

Evidence from eleven samples indicates that the mean IQ of third world immigrants in the Netherlands is lower than the Dutch mean by approximately one standard deviation for Surinamese and Antillians, and by approximately one and a half standard deviations for Turks and Moroccans. Since IQ tests provide the best prediction of success in school and organizations, it could be that the immigrants’ lower mean IQ is an important factor in their low status on the Dutch labour market. The IQs of second-generation immigrants are rising.

Responses of 44 vasectomized voluntarily childless men and 51 vasectomized fathers were compared on the California Psychological Inventory, the Bowerman Scale of Marital Satisfaction and a questionnaire. The childless felt negatively stereotyped, but there were no differences between the parents and childless on marital satisfaction, reported childhood happiness or level of psychological adjustment. There were differences in modes of adjustment, with the childless seemingly less tied to tradition, more inclined to experiment and showing more capacity for independent thought than the parents. The findings suggested that childlessness may be a viable, healthy lifestyle, not determined by or associated with personal or social pathology.

The success of the Community-Directed Treatment (ComDT) approach in the control of onchocerciasis and filariasis has caught the attention of other disease control programmes. In this study the ComDT approach was implemented and compared with the school-based approach for control of schistosomiasis and soil-transmitted helminthiasis among school-age children in Lushoto District, Tanzania. This was a qualitative study, consisting of in-depth interviews with village leaders, community drug distributors (CDDs) and schoolteachers, as well as focus group discussions with separate groups of mothers and fathers to assess the perceptions and experiences of the villagers on the implementation of the two approaches. It was found that the villagers accepted the ComDT approach and took the responsibility of selecting the CDDs, organizing and implementing their own method of distributing drugs to the school-age children in their villages. The ComDT approach was well received and was successfully implemented in the villages. Although the villagers pointed out the limitation in reaching the non-enrolled children in the school-based approach, they also expressed satisfaction with this approach. This study suggests that the ComDT approach is well accepted and can be implemented effectively to ensure better coverage of especially non-enrolled school-age children.

Turkey has high levels of infant mortality and consanguineous marriages. It has had a high level of infant mortality for its economic level for many years. Over recent decades, although adult mortality rates have not been very different from those of other countries with similar socioeconomic structures, its life expectancy at birth has remained low due to its high infant mortality rate. This has been called the Turkish Puzzle. According to the Turkey Family Structure and Population Issues Survey, 27% of women had a consanguineous marriage in 1968. Subsequent Turkish Demographic and Health Surveys (TDHSs) found the rate of consanguineous marriages to be stagnated at 22–24%, with a resistance to reduction. According to the TDHS-2008, 24% of women had a consanguineous marriage. Numerous studies in various countries of the world have indicated that consanguineous marriages, particularly of first-degree, have the effect of increasing infant mortality. The main aim of this study was to assess the causal impact of consanguineous, particularly first-degree consanguineous, marriages on infant mortality, controlling for individual, cultural, bio-demographic and environmental factors. Data were merged from four Turkish DHS data sets (1993, 1998, 2003 and 2008). Multivariate analysis revealed that first-degree consanguineous marriages have increased infant mortality by 45% in Turkey: 57% in urban areas and 39% in rural areas. The results indicate that there is a causal relationship between consanguineous marriages and infant mortality. This finding should be taken into account when planning policies to reduce infant mortality in Turkey, and in other countries with high rates of consanguineous marriage and infant mortality.

Do males and females differ in general intelligence? Lynn (1994, 1998) and I (Mackintosh, 1996) agree that the answer to this question must depend on the answer to two prior questions: what is the definition of general intelligence, and what tests best measure it? Our disagreement arises partly from different answers to these prior questions, but also from differences in our reading of some not wholly consistent evidence. What answers might one give to these prior questions? They are not independent, for a possible (severely operational) definition of general intelligence is that it is a person's score on one particular IQ test battery. Let us start with that simple possibility.