It has long been known that mild mental retardation (meaning that associated with an IQ in the 50–69 range) shows a strong tendency to run in families and that there is a much increased recurrence risk if either a parent or a sib has mental retardation. For example, Reed & Reed (1965) found that, having had one retarded child, the chance of a further retarded child was 6% if both parents and their sibs were ‘normal’, 13% if both parents were normal but one had a retarded sib, 20% if one parent was retarded, and 42% if both were retarded. A somewhat similar gradient was found in the more recent study by Bundey, Thake & Todd (1989). The appreciation that mild mental retardation was so strongly familial had led Lewis (1933) some years earlier to refer to it as ’subcultural‘ (meaning that it was a normal variation), in order to differentiate it from severe mental retardation, which was viewed as ‘pathological’. Penrose (1938, 1963) made the same classificatory distinction and the utility of a two-group approach became generally accepted (Burack, 1990).

Seasonal variation in human natality is examined over a period of several decades for an isolated Inuit settlement in the central Canadian Arctic. The results substantiate earlier reports of the existence of a birth season in the first half of the year. The 2-decade period coinciding with the gradual concentration of the regional population into the settlement experienced a temporary disruption of this traditional rhythmic pattern. Family planning has been introduced in the modern period, yet birth seasonality is even more pronounced than during previous decades. Both planned and unplanned births occur predominantly in the first half of the year, indicating the paramount importance of behavioural and social responses to extreme seasonal variation.

This note categorizes the evidence for the hypothesis that mammalian offspring sex ratios (proportions male) are causally related to the hormone levels of both parents around the time of conception. Most of the evidence may be acknowledged to be correlational and observational. As such it might be suspected of having been selected; or of having been subject to other forms of bias or confounding; or, at any rate, of being inadequate as a firm basis for causal inference. However, there are other types of evidence that are not vulnerable to these types of criticism. These are from the following sources: (1) previously neglected data from Nazi Germany and Soviet Russia; (2) fulfilled predictions; (3) genetics; and (4) a network of logically (mathematically) related propositions, for some of which there is overwhelming empirical evidence. It is suggested that this variety of evidence confers greater overall credibility on the hypothesis than would be the case if all the evidence were of the same observational/correlational status. This observational/correlational evidence is tabulated to illustrate its consistency.

Defined as the co-occurrence of more than two chronic conditions, multi-morbidity has been described as a significant health care problem: a trend linked to a rise in non-communicable disease and an ageing population. Evidence on the experiences of living with multi-morbidity in middle-income countries (MICs) is limited. In high-income countries (HICs), multi-morbidity has a complex impact on health outcomes, including functional status, disability and quality of life, complexity of health care and burden of treatment. Previous evidence also shows that multi-morbidity is consistently higher amongst women. This study aimed to explore the perceptions and experiences of women living with multi-morbidity in the Greater Accra Region, Ghana: to understand the complexity of their health needs due to multi-morbidity, and to document how the health system has responded. Guided by the Cumulative Complexity Model, and using stratified purposive sampling, 20 in-depth interviews were conducted between May and September 2015 across three polyclinics in the Greater Accra Region. The data were analysed using the six phases of Thematic Analysis. Overall four themes emerged: 1) the influences on patients’ health experience; 2) seeking care and the responsiveness of the health care system; 3) how patients manage health care demands; and 4) outcomes due to health. Spirituality and the stigmatization caused by specific conditions, such as HIV, impacted their overall health experience. Women depended on the care and treatment provided through the health care system despite inconsistent coverage and a lack of choice thereof, although their experiences varied by chronic condition. Women depended on their family and community to offset the financial burden of treatment costs, which was exacerbated by having many conditions. The implications are that integrated health and social support, such as streamlining procedures and professional training on managing complexity, would benefit and reduce the burden of multi-morbidity experienced by women with multi-morbidity in Ghana.

One of the major goals of health programmes in the developing world is to improve maternal and child health. Two important steps towards achieving this goal are the promotion of birth spacing and the promotion of breast-feeding. Since birth spacing requires some type of fertility control measures, modern contraceptive programmes are becoming an integral part of maternal and child health programmes. The next logical question would then appear to be, ‘What are the appropriate contraceptives, particularly among the modern methods, for use during lactation ?’

In this paper, longitudinal data from northern Ghana is used to assess the effects of encouragement to use family planning that men receive from their personal network partners on the adoption of modern contraception by their wives. The study tests a conceptual model that, in addition to the effect of men’s network encouragement, incorporates the effect of encouragement to use family planning that women receive from their respective network partners and the effect of spousal communication on reproductive matters and approval of family planning. Results show that encouragement received by men from their social networks significantly increases the likelihood of subsequent contraceptive use by their wives but this effect operates primarily by galvanizing spousal communication on reproductive matters. The effect of encouragement received by women from their respective network partners is largely independent from the effect of male network encouragement but it influences contraceptive adoption both directly and through spousal communication.

From an economic perspective that understood it as a spillover of development, migration is now also the subject of socioeconomic investigation incorporating the problems of assimilation, relative deprivation and isolation. The corollary is an increased emphasis on economic and social understanding of migration and its consequences. This entails studying migration or migrants in terms of factors beyond income. Health outcome is important among these non-income factors but at the same time remains less studied. Although there have been a few influential studies on health issues as linked to migration status, the issue of malnutrition in this context continues to be under-researched. This paper explores, theoretically and empirically, migration status and malnutrition in Mumbai in India. An econometric analysis of Demographic and Health Survey data gives insight into the dynamics of child and maternal undernutrition as mediated by migration status in Mumbai.

In a medical practice in which artificial insemination has been carried out for over 40 years, 40% of women inseminated with donor semen (AID), and 21% inseminated with homologous semen (AIH) gave birth to children. Up to December 1975, 399 pregnancies were achieved using fresh donor semen and nineteen with deep-frozen semen. There was no apparent increase in the incidence of birth anomalies in children conceived with frozen semen, nor was there a significant increase in the incidence of still-births, ectopic pregnancy or miscarriage when compared to the rate in the normal population. Eight conceptions were achieved using deep-frozen semen stored for 6 months or longer, and one pregnancy was achieved with a specimen frozen for 3 years. Good cryosurvial was observed in semen frozen for up to 6·7 years. The development of many of the children was followed, and it was concluded that the great majority of marriages into which AID children were born, were undoubtedly enriched and psychological and sociological problems were few. The whole field still awaits the implementation of recommendations concerning the legal status of children born as a result of AID.

Afghanistan has made remarkable progress in reducing maternal mortality over the past few decades, and male participation in their pregnant partner’s reproductive health care is crucial for further improvement. This study aimed to examine whether male attendance at antenatal care (ANC) with their pregnant partners might be beneficially associated with the degree of utilization of reproductive health care by the pregnant partners. Data for 2660 couples (women aged 16–49 years) were taken from the 2015 Afghanistan Demographic and Health Survey (AfDHS). Bivariate and multivariate logistic regression models were employed to explore the association between male attendance at ANC with their pregnant partners and reproductive health care utilization outcomes, including adequate utilization (four or more visits) of ANC services, ANC visits during the first trimester (up to 12 weeks) of pregnancy, rate of blood and urine testing during pregnancy, rate of institutional delivery and utilization of postnatal check-up services. The results indicated that the rate of male attendance at ANC with their pregnant partners was 69.4%. After controlling for covariates, pregnant partners who were accompanied to ANC by their male partners were more likely to adequately utilize ANC services (AOR=1.42; 95% CI: 1.18–1.71), commence ANC visits even during the first trimester (AOR=1.21; 95% CI: 1.03–1.42), give birth at a health facility (AOR=1.23; 95% CI: 1.03–1.47) and present themselves for postnatal check-ups (AOR=1.24; 95% CI: 1.04–1.47) than those who were not accompanied by them. The study demonstrated that participation of male partners in ANC was positively associated with their pregnant partners’ utilization of reproductive health care services in Afghanistan. The findings suggest that, to improve maternal and child health outcomes in the country, it would be worthwhile implementing interventions to encourage male partners to become more engaged in the ANC of their pregnant partners.

Obesity indicators are useful clinical tools in the measurement of obesity, but it is important for clinicians to appropriately interpret their values in individuals with different ethnicities. Future research is needed to identify optimal cut-offs that can predict the occurrence of cardio-metabolic comorbidities in individuals of different ethnic descent. Assessment of more recently developed indicators like the Edmonton Obesity Staging System and visceral adipose tissue are able to appropriately identify metabolically at-risk individuals.

Birth order and family size have been studied in a representative sample (10,000) of the adult population of Great Britain. This was done to test theoretical predictions about the ways in which the birth-order distribution in a population sample will be biased by secular changes in family size. The principal predictions were that, in a sample born during a period when family size was decreasing, the distribution of birth ranks in the larger families would be biased towards an over-representation of later born subjects (i.e. those lower in birth order), while in smaller families there would be an under-representation of later born. In a sample born during a period when family size was increasing, the reverse effects would occur. It was also predicted that among subjects from large families there would be an excess of females; and that the extent of the bias due to decrease in family size would be greatest in the unskilled and least in the highly skilled social classes.

The findings confirmed these predictions. The sample also showed an un-predicted excess of subjects in the middle ranks of families. It is suggested that the hypothesis of birth rate bias may be used for predicting the type of birth-order distribution to be expected in a sample of any population.

Analyses of height variation using the 1970 UK national cohort study (12,508 children at age 10 and 5470 at age 16) found clear evidence that children of higher socioeconomic status (as measured by social class, crowding, tenure, type of accommodation, income and receipt of government financial assistance) were on average taller than children of lower socioeconomic status but there was little or no difference in average stature between children living in urban or rural areas. Significant differences in height remained for most of the variables after removing the effects of father’s social class suggesting that reliance on social class per se to explain height variation is inadvisable.

This paper evaluates exposure to mass media family planning (FP) messages among the Garo, an indigenous community in Bangladesh. A sample of 223 currently married Garo women were selected purposively from two districts where most of the Garo population live. The analysis demonstrated that television was the most significant form of mass media to disseminate FP messages among the recipients – more so than radio and newspapers. About 80·6% of the respondents had heard of FP messages through television, while for the radio and newspapers the percentages were 55·3% and 22·7% respectively. The contraceptive prevalence rate is much higher (79·5%) in the study area than the national level (55·8%). A linear logistic regression model was employed to identify the confluence of different demographic and socioeconomic characteristics on mass media FP messages. Regarding exposure to FP messages, four independent variables out of six had significant effects on the exposure to FP messages through any one of the types of media, i.e. radio, television and newspapers. These independent variables were age, level of education, occupation and number of children.

Data on the fertility of mothers and daughters in 10,931 mother–daughter pairs were obtained from family reconstitution studies based on English parish registers between the sixteenth and nineteenth centuries. These data indicate that there is no association between the fecundity of daughters and that of their mothers.

This paper examines the role of observed contextual factors like topography, development and literacy on severe malnutrition among social groups in rural Maharashtra based on the Reproductive and Child Health District Level Household Survey (RCH-DLHS) Round II (2002–04) data. Multilevel modelling techniques were applied in order to examine the district-wise variations in severe malnutrition associated with the characteristics of the places (contextual effects), as the relationships with the type of people (compositional effects) have already been well established. The results show that developmental aspects such as road connectivity, community literacy, toilet facilities and household standard of living contribute positively to the status of severe malnutrition. Also, the scheduled tribe, aboriginal underprivileged group are more at risk of severe malnourishment due to a lack of proper development, poor awareness about maintaining and enhancing the nutritional value of food and lack of hygiene and sanitation as compared with the scheduled castes, another aboriginal group.

The influence of parental age at birth, and parity, was studied in a series of 48 dyslexic boys. It was concluded that both increased paternal and maternal age contributes to a greater incidence of the condition. The similarity to the age distributions of chromosomal aberrations and some mutation defects suggests some genetic implication. The findings thus favour a biological rather than environmental element in the aetiology.

Using the nationally representative sample of about 15,000 Add Health respondents in Wave III, the hypothesis is tested that masculinity–femininity in adolescence is correlated with sexual orientation 5 years later and 6 years later: that is, that for adolescent males in 1995 and again in 1996, more feminine males have a higher probability of self-identifying as homosexuals in 2001–02. It is predicted that for adolescent females in 1995 and 1996, more masculine females have a higher probability of self-identifying as homosexuals in 2001–02. Masculinity–femininity is measured by the classical method used by Terman & Miles. For both time periods, the hypothesis was strongly confirmed for males: the more feminine males had several times the probability of being attracted to same-sex partners, several times the probability of having same-sex partners, and several times the probability of self-identifying as homosexuals, compared with more masculine males. For females, no relationship was found at either time period between masculinity and sex of preference. The biological mechanism underlying homosexuality may be different for males and females.

Aiming to further explore possible underlying causes of the recent remarkable stagnation and relative decline in American heights, this paper describes the result of analysis of the commercial US Sizing Survey (2002). Heights are correlated positively with income and education among both white males and females while Body Mass Index (BMI) is correlated negatively among females, as in other samples. In contrast to much of the literature, this paper considers geographic correlates of height such as local poverty rate, median income and population density at the zip code level of resolution. After adjusting for confounding factors that influence height such as income and education, population density is found to be strongly and negatively correlated with height among white men, but less so among white women. The effect on BMIs less convincing. Other ethnic groups are not analysed in detail because of the small number of observations available. Local economic conditions as measured by median income, unemployment and poverty rate do not have a strong correlation with height or BMI after adjusting for individual income and education.

The role of religion in contraceptive use is an issue of significant debate. This study employed the 1990 and 2008 Nigeria Demographic and Health Survey data to examine differences and similarities in the influence of religious affiliation on non-use of modern contraceptives in Nigeria over the last two decades. The results suggest that a significant increase has occurred in the level of awareness of modern contraceptives in Nigeria over the last two decades, but that non-use remains very high. Religion could not independently predict non-use of modern contraceptives in 1990. Women of Islam and Traditional religions were more likely to have never used or not to be using modern contraceptives compared with Catholics and Protestants in 2008 (p<0.05). This can be explained by their poorer socioeconomic status relative to Catholics and Protestants. Therefore, improving women's socioeconomic status is an imperative in the promotion of modern contraception in Nigeria. Education and employment are critical in this regard and adherents of Islam and Traditional religions require special attention.

In order to evaluate the mental health aspects of voluntary sterilization for family planning purposes, WHO initiated in 1978 a multi-centre prospective controlled study. A total of 926 healthy women with at least two living children, who requested sterilization (interval, post-partum or post-abortion), and 924 controls using other methods of contraception, were selected for a prospective investigation which included pre-operative and post-operative (6 weeks, 6 months, and 1 year) standardized assessment of mental state and a range of variables related to physical health and psychosexual functioning. Although pre-operatively a high proportion of subjects in both index and control groups reported minor non-specific psychiatric symptoms the percentage of women meeting defined criteria of psychiatric disorder was low to moderate (less than 15%) in all centres except Cali (26%). In all centres the pre-operative rates of psychiatric disorder were somewhat higher in the sterilization groups than in the control groups, and in two centres (Cali and Chandigarh) this difference was statistically significant. Thus, the data indicate that women choosing sterilization for birth control tend to show pre-operatively more psychiatric disturbance than their control counterparts who opt for other methods of contraception.