Showing papers in "Journal of Biosocial Science in 2016"

Prevalence of child marriage among Bangladeshi women and trend of change over time.

Abstract: Many Bangladeshi women marry early, and many marry before the legal age of 18 years. This practice has been associated with a higher risk of health and medical morbidities, and also early pregnancy with higher pre- and postnatal complications. The aim of this study was to determine the prevalence, and factors associated with, child marriage among Bangladeshi women using multiple binary logistic regression analysis of data from the BDHS-2011. Further analysis on the trend of age at first marriage was performed with additional data sets from previous surveys. The mean and median of ages at first marriage of Bangladeshi women in 2011 were 15.69±2.97 and 15.00 years, respectively. A remarkably high percentage (78.2%) married before the age of 18; of these, 5.5% married at a very early age (before 13 years of age). Binary logistic regression analysis demonstrated that uneducated women were more likely to be married early (p<0.001) than those with secondary and higher education. Child marriage was especially pronounced among women with uneducated husbands, Muslims, those with poor economic backgrounds and those living in rural areas. Further analysis including data from previous BDHS surveys showed that child marriage among Bangladeshi women had a decreasing trend from 1993-94 to 2011. These results show that child marriage was very common in Bangladesh, and closely associated with low level of education and low economic status. The decreasing trend in child marriage indicates an improvement over the past two decades but more effort is needed to further reduce and eventually eliminate the practice.

Social, historical and cultural dimensions of tuberculosis.

Abstract: Tuberculosis (TB) researchers and clinicians, by virtue of the social disease they study, are drawn into an engagement with ways of understanding illness that extend beyond the strictly biomedical model. Primers on social science concepts directly relevant to TB, however, are lacking. The particularities of TB disease mean that certain social science concepts are more relevant than others. Concepts such as structural violence can seem complicated and off-putting. Other concepts, such as gender, can seem so familiar that they are left relatively unexplored. An intimate familiarity with the social dimensions of disease is valuable, particularly for infectious diseases, because the social model is an important complement to the biomedical model. This review article offers an important introduction to a selection of concepts directly relevant to TB from health sociology, medical anthropology and social cognitive theory. The article has pedagogical utility and also serves as a useful refresher for those researchers already engaged in this genre of work. The conceptual tools of health sociology, medical anthropology and social cognitive theory offer insightful ways to examine the social, historical and cultural dimensions of public health. By recognizing cultural experience as a central force shaping human interactions with the world, TB researchers and clinicians develop a more nuanced consideration of how health, illness and medical treatment are understood, interpreted and confronted.

The prevalence of consanguineous marriages and affecting factors in turkey: a national survey.

Abstract: This study was carried out by the Turkish Republic Ministry of Health to determine the prevalence of consanguineous marriage and its correlates with socio-demographic and obstetric risk factors in women in Turkey. The cross-sectional, national-level study was carried out from October to December 2013. The study population was composed of women between the ages of 15 and 65 years living in Turkey. The sample size was calculated as 9290 houses within Turkey's 81 provinces so as to improve the Turkish rural-urban expectations by means of systematic stack sampling according to the Turkish Statistical Institute's address-based vital statistics system. The target sample size was 6364, but only eligible 4913 women, who had been married, were included in the study. The consanguineous marriage frequency in the sample was found to be 18.5%, and of these 57.8% were first cousin marriages. Women living in an extended family and whose education level and first marriage ages were low, and whose perceived economic status was poor, had higher frequencies of consanguineous marriage (p<0.001). Consanguineous marriage frequencies were higher (p<0.001) for women who had spontaneous abortions and stillbirths or who had given birth to infants with a congenital abnormality. In this context, it is important to develop national policies and strategies to prevent consanguineous marriages in Turkey.

The cognitive competences of immigrant and native students across the world: An analysis of gaps, possible causes and impact

Abstract: 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.

Regional variations in child marriage in bangladesh.

Abstract: This study aimed to investigate the regional variations in the prevalence of child marriage in Bangladesh with a view to providing recommendations for division-specific policy interventions. Data from the 2011 Bangladesh Demographic and Health Survey were analysed using multivariate logistic regression. Substantial regional variations in child marriage were found in Bangladesh. Rangpur and Khulna had more than four times higher odds of child marriage than Sylhet (4.57 and 4.11 times, respectively). Barisal and Rajshahi had more than three times higher odds of child marriage than Sylhet (3.70 and 3.48 times, respectively). Chittagong and Dhaka had about two times odds of child marriage than Sylhet (1.98 and 2.67 times, respectively), even after controlling for selected socio-demographic, economic and cultural characteristics. Respondent's education, employment status, husband's education and wealth index were inversely associated with the prevalence of child marriage. The policy implications of these findings are discussed in the context of Bangladesh.

Community co-designed schistosomiasis control interventions for school-aged children in zanzibar

Abstract: Top-down biomedical interventions to control schistosomiasis in sub-Saharan Africa have had limited success, primarily because they fail to engage with the social, political, economic and ecological contexts in which they are delivered. Despite the call to foster community engagement and to adapt interventions to local circumstances, programmes have rarely embraced such an approach. This article outlines a community co-designed process, based upon Human-Centered Design, to demonstrate how this approach works in practice. It is based on initial work undertaken by social science researchers, public health practitioners and community members from the Zanzibar Islands, Tanzania, between November 2011 and December 2013. During the process, 32 community members participated in a qualitative and quantitative data-driven workshop where they interpreted data on local infections from S. haematobium and co-designed interventions with the assistance of a facilitator trained in the social sciences. These interventions included the implementation of novel school-based education and training, the identification of relevant safe play activities and events at local schools, the installation of community-designed urinals for boys and girls and the installation of community-designed laundry-washing platforms to reduce exposure to cercariae-contaminated fresh water. It is suggested that the a community co-designed process, drawing from Human-Centered Design principles and techniques, enables the development of more sustainable and effective interventions for the control of schistosomiasis.

Neglected tropical diseases in biosocial perspective

Abstract: The term 'neglected tropical diseases' (NTDs) points to the need for a biosocial perspective. Although 'diseases' are widely understood as biological phenomena, 'neglect' is inherently social. Social priorities, social relations and social behaviour profoundly influence the design, implementation and evaluation of control programmes. Yet, these dimensions of neglect are, themselves, neglected. Instead, emphasis is being placed on preventive chemotherapy - a technical, context-free approach which relies almost entirely on the mass distribution of drugs, at regular intervals, to populations living in endemic areas. This article reflects on the processes which have enabled an NTD 'brand' identity to emerge, and it comments on a disquieting disengagement with some of the more critical insights about the consequences of mass drug administration. Building on the work of biosocial scholars studying other aspects of health and disease, a more adequate, evidence-based approach is delineated. Developing such an approach is an iterative process, requiring on-going engagement with both biological and social insights as they emerge. Considerable theoretical, methodological and political challenges lie ahead, but it is essential they are overcome, if the sustainable control of NTDs is to become a reality.

Iq and socioeconomic development across regions of the uk.

Abstract: Cross-regional correlations between average IQ and socioeconomic development have been documented in many different countries. This paper presents new IQ estimates for the twelve regions of the UK. These are weakly correlated (r=0.24) with the regional IQs assembled by Lynn (1979). Assuming the two sets of estimates are accurate and comparable, this finding suggests that the relative IQs of different UK regions have changed since the 1950s, most likely due to differentials in the magnitude of the Flynn effect, the selectivity of external migration, the selectivity of internal migration or the strength of the relationship between IQ and fertility. The paper provides evidence for the validity of the regional IQs by showing that IQ estimates for UK nations (England, Scotland, Wales and Northern Ireland) derived from the same data are strongly correlated with national PISA scores (r=0.99). It finds that regional IQ is positively related to income, longevity and technological accomplishment; and is negatively related to poverty, deprivation and unemployment. A general factor of socioeconomic development is correlated with regional IQ at r=0.72.

Effect of individual and community factors on maternal health care service use in india: a multilevel approach

Abstract: This study aimed to assess empirically the influence of individual and community (neighbourhood) factors on the use of maternal health care services in India through three outcomes: utilization of full antenatal care (ANC) services, safe delivery and utilization of postnatal care services. Data were from the third round of the National Family Health Survey (2005-06). The study sample constituted ever-married women aged 15-49 from 29 Indian states. Multilevel logistic regression analysis was performed for the three outcomes of interest accounting for individual- and community-level factors associated with the use of maternal health care services. A substantial amount of variation was observed at the community level. About 45%, 51% and 62% of the total variance in the use of full ANC, safe delivery and postnatal care, respectively, could be attributed to differences across the community. There was significant variation in the use of maternal health care services at the individual level, with socioeconomic status and mother's education being the most prominent factors associated with the use of maternal health care services. At the community level, urban residence and poverty concentration were found to be significantly associated with maternal health care service use. The results suggest that an increased focus on community-level interventions could lead to an increase in the utilization of maternal health care services in India.

Community members' perceptions of mass drug administration for control of lymphatic filariasis in rural and urban tanzania.

Abstract: Lymphatic filariasis is one of several neglected tropical diseases with severely disabling and stigmatizing manifestations that are referred to as ‘neglected diseases of poverty’. It is a mosquito-borne disease found endemically and exclusively in low-income contexts where, concomitantly, general public health care is often deeply troubled and fails to meet the basic health needs of impoverished populations. This presents particular challenges for the implementation of mass drug administration (MDA), which currently is the principal means of control and eventual elimination. Several MDA programmes face the dilemma that they are unable to attain and maintain the required drug coverage across target groups. In recognition of this, a qualitative study was conducted in the Morogoro and Lindi regions of Tanzania to gain an understanding of community experiences with, and perceptions of, the MDA campaign implemented in 2011 by the National Lymphatic Filariasis Elimination Programme. The study revealed a wide variation of perceptions and experiences regarding the aim, rationale and justification of MDA. There were positive sentiments about the usefulness of the drugs, but many study participants were sceptical about the manner in which MDA is implemented. People were particularly disappointed with the limited attempts by implementers to share information and mobilize residents. In addition, negative sentiments towards MDA for lymphatic filariasis reflected a general feeling of desertion and marginalization by the health care system and political authorities. However, the results suggest that if the communities are brought on board with genuine respect for their integrity and informed self-determination, there is scope for major improvements in community support for MDA-based control activities.

Zoonotic encounters at the slaughterhouse: pathways and possibilities for the control of cystic echinococcosis in northern morocco

Abstract: 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.

Rumours riots and the rejection of mass drug administration for the treatment of Schistosomiasis in Morogoro Tanzania.

Abstract: In 2008 in Morogoro region Tanzania mass drug administration (MDA) to school-aged children to treat two neglected tropical diseases (NTDs) -urinary schistosomiasis and soil-transmitted helminths -was suspended by the Ministry of Health and Social Welfare after riots broke out in schools where drugs were being administered. This article discusses why this biomedical intervention was so vehemently rejected including an eyewitness account. As the protest spread to the village where I was conducting fieldwork villagers accused me of bringing medicine into the village with which to ‘poison’ the children and it was necessary for me to leave immediately under the protection of the Tanzanian police. The article examines the considerable differences between biomedical and local understandings of one of these diseases urinary schistosomiasis. Such a disjuncture was fuelled further by the apparent rapidity of rolling out MDA and subsequent failures in communication between programme staff and local people. Rumours of child fatalities as well as children’s fainting episodes and illnesses following treatment brought about considerable conjecture both locally and nationally that the drugs had been either faulty counterfeit hitherto untested on humans or part of a covert sterilization campaign. The compelling arguments by advocates of MDA for the treatment of NTDs rest on the assumption that people suffering from these diseases will be willing to swallow the medicine. However as this article documents this is not always the case. For treatment of NTDs to be successful it is not enough for programmes to focus on economic and biomedical aspects of treatment rolling out ‘one size fits all’ programmes in resource-poor settings. It is imperative to develop a biosocial approach: to consider the local social biological historical economic and political contexts in which these programmes are taking place and in which the intended recipients of treatment live their lives. If this is not done the world’s poor will continue to be neglected.

Deworming delusions? mass drug administration in east african schools.

Abstract: 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 association between menstrual cycle characteristics and perceived body image: a cross-sectional survey of polish female adolescents.

Abstract: The increasing prevalence of negative body perceptions among adolescent girls and the tendency towards wishing to be thinner have become a cultural norm in Western culture. Adolescent girls are particularly vulnerable to developing a negative body image due to physical and sexual changes occurring during puberty. This study aimed to evaluate the association between different measures of body image perceptions and different phases of the menstrual cycle after controlling for weight status and other potential confounders in Polish adolescent girls aged 12-18 years. Three-hundred and thirty participants of a cross-sectional survey conducted in 2009, normally cycling and with no eating disorders, completed a background questionnaire and the Stunkard Figure Rating Scale, and their anthropometric measurements were collected. The dependent outcome variables were measures of body image (actual body image, ideal body image and ideal-self discrepancy) and dichotomous body image perception (satisfied versus dissatisfied) adjusted for other predictor factors: socio-demographic variables, menstrual history and cycle phases, and weight status. One-way ANOVA indicated that weight status, age at menarche and menstrual cycle phase were associated with actual body image and rate of ideal-self discrepancy. Ideal body image was associated with weight status and menstrual cycle phase. General logistic regression models were constructed to evaluate associations of body dissatisfaction and all potential predictor variables. The final selected model of the multiple logistic regression analysis using the backward elimination procedure revealed that adjusted for other factors, negative body image was significantly associated with different phases of the menstrual cycle (p trend=0.033) and increasing body weight status (p trend=0.0007). The likelihood of body dissatisfaction was greatest during the premenstrual phase of the menstrual cycle (OR=2.38; 95% CI 1.06, 5.32) and among girls in obesity class I (OR=8.04; 95% CI 2.37, 27.26). The study confirmed the association between body image dissatisfaction in adolescent girls and different phases of the menstrual cycle after controlling for weight status. The issue of negative body self-image is not only of cognitive, but also of practical value as understanding better the factors contributing to the formation of a negative body image may be instrumental in developing preventive health programmes targeted at young people.

Utilization of maternal health services among internal migrants in mumbai, india.

Abstract: This study aimed to understand access to maternal health care and the factors shaping it amongst poor migrants in Mumbai, India. A cross-sectional mixed methods approach was used. It included multistage cluster sampling and face-to-face interviews, through structured interview schedules, of 234 migrant women who had delivered in the two years previous to the date they were interviewed. Qualitative in-depth interviews of migrant women, health care providers and health officials were also conducted to understand community and provider perspectives. The results showed that access to antenatal care was poor among migrants with less than a third of them receiving basic antenatal care and a quarter delivering at home. Multivariate analysis highlighted that amongst migrant women those who stayed in Mumbai during pregnancy and delivery had better access to maternal health care than those who went back to their home towns. Poor maternal health care was also due to weaker demand for health care as a result of the lack of felt-need among migrants due to socio-cultural factors and lack of social support for, and knowledge of, health facilities in the city. Supply-side factors such as inadequate health infrastructure at primary and secondary levels, lack of specific strategies to improve access to health care for migrants and cumbersome administrative procedures that exclude migrants from certain government programmes all need to be addressed. Migrants should be integral to the urban development process and policies should aim at preventing their exclusion from basic amenities and their entitlements as citizens.

Ethnicity and income impact on bmi and stature of school children living in urban southern mexico.

Abstract: 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.

Health education and the control of urogenital schistosomiasis: assessing the impact of the juma na kichocho comic-strip medical booklet in zanzibar.

Abstract: 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.

Gender-related factors influencing women's health seeking for tuberculosis care in ebonyi state, nigeria

Abstract: This is a qualitative, descriptive study to explore gender-related factors that influence health seeking for tuberculosis (TB) care by women in Ebonyi State, Nigeria In-depth interviews based on interview guides were conducted with participants selected through purposive sampling in communities in the state The results show that gender relations prohibit women from seeking care for symptoms of TB and other diseases outside their community without their husbands' approval Gender norms on intra-household resource ownership and control divest women of the power to allocate money for health care seeking Yet, the same norms place the burden of spending on health care for minor illnesses on women, and such repeated, out-of-pocket expenditures on health care at the village level make it difficult for women to save money for use for health care seeking for major illnesses such as TB, which, even if subsidized, still involves hidden costs such as transport fare The opening hours of TB clinics do not favour their use by most women as they are open when women are usually engaged in income-generating activities Attending the clinics may therefore entail opportunity costs for many women People with chronic, infectious diseases such as TB and HIV are generally stigmatized and avoided Women suffer more stigma and discrimination than men Stigma and discrimination make women reluctant to seek care for TB until the disease is advanced Policies and programmes aimed at increasing women's access to TB services should not only take these gender norms that disempower women into explicit consideration but also include interventions to address them The programmes should integrate flexible opening hours for TB treatment units, including introduction of evening consultation for women Interventions should also integrate anti-stigma strategies led by the community members themselves

Neighbourhood poverty, perceived discrimination and central adiposity in the usa: independent associations in a repeated measures analysis.

Abstract: This study examines the independent effects of neighbourhood context (i.e. neighbourhood poverty) and exposure to perceived discrimination in shaping risk of obesity over time. Weighted three-level hierarchical linear regression models for a continuous outcome were used to assess the independent effects of neighbourhood poverty and perceived discrimination on obesity over time in a sample of 157 non-Hispanic Black, non-Hispanic White and Hispanic adults in Detroit, USA, in 2002/2003 and 2007/2008. Independent associations were found between neighbourhood poverty and perceived discrimination with central adiposity over time. Residents of neighbourhoods with high concentrations of poverty were more likely to show increases in central adiposity compared with those in neighbourhoods with lower concentrations of poverty. In models adjusted for BMI, neighbourhood poverty at baseline was associated with a greater change in central adiposity among participants who lived in neighbourhoods in the second (B=3.79, p=0.025) and third (B=3.73, p=0.024) poverty quartiles, compared with those in the lowest poverty neighbourhoods. The results from models that included both neighbourhood poverty and perceived discrimination showed that both were associated with increased risk of increased central adiposity over time. Residents of neighbourhoods in the second (B=9.58, p<0.001), third (B=8.25, p=0.004) and fourth (B=7.66, p=0.030) quartiles of poverty were more likely to show greater increases in central adiposity over time, compared with those in the lowest poverty quartile, with mean discrimination at baseline independently and positively associated with increases in central adiposity over time (B=2.36, p=0.020). The results suggest that neighbourhood poverty and perceived discrimination are independently associated with a heightened risk of increase in central adiposity over time. Efforts to address persistent disparities in central adiposity in the USA should include strategies to reduce high concentrations of neighbourhood poverty as well as discrimination.

Changes in marriage patterns among the arab community in israel over a 60-year period.

Abstract: The aim of this study was to determine the prevalence and trends of various types of consanguineous marriage among the Arab community in Israel over a long time period (1948-2007) by religion and educational level. Data were collected by face-to-face interview of 3173 Arab couples living in Israel in 2007 and 2008. The trend in consanguineous marriages was found to decrease significantly over successive time periods, from 42.5% to 30.9% (p=0.001), and the prevalence of first-cousin and closer marriages decreased, from 23% to 12.7%. Consanguinity was found to be significantly related to religion (p=0.001) and wife's level of education (p=0.028).

Effect of nativity and duration of residence on chronic health conditions among asian immigrants in australia: a longitudinal investigation.

Abstract: This study examined the effect of Asian nativity and duration of residence in Australia on the odds of reporting a chronic health condition (cancer, respiratory problems, cardiovascular disease (CVD) and diabetes mellitus). Data were from waves 3, 7 and 9 of the Household Income and Labour Dynamics in Australia (HILDA) longitudinal survey, and multi-level group-mean-centred logistic regression models were used for the analysis. After covariate adjustment, Asian immigrants were less likely to report cancer and respiratory problem compared with native-born Australians. While there was no significant difference in reporting CVD, they were more likely to report diabetes than native-born people. Asian immigrants maintained their health advantage with respect to cancer regardless of duration of residence. However, after 20 years of stay, Asian immigrants lost their earlier advantage and were not significantly different from native-born people in terms of reporting a respiratory problem. In contrast, Asian immigrants were not measurably different from native-born Australians in reporting diabetes if their length of stay in Australia was less than 20 years, but became disadvantaged after staying for 20 years or longer. There was no measurable difference in the odds of reporting CVD between Asian immigrants and native-born Australians for any duration of residence. On the whole this study found that health advantage, existence of healthy immigrant effect and subsequent erosion of it with increasing duration of residence among Asian immigrants depends upon the chronic health condition.

Consanguinity and inbreeding coefficient in tribal pashtuns inhabiting the turbulent and war-affected territory of bajaur agency, north-west pakistan.

Abstract: The north-western populations of Pakistan in the Federally Administered Tribal Areas (FATA) adjoining the Pakistan-Afghanistan border are an amalgamation of native and migrated Pashtun tribes. These tribal populations are in transition due to war conditions and geo-political turmoil on both sides of the border since the Soviet invasion in 1979. Bio-demographic and epidemiological data for these tribes are scarce. A prospective cross-sectional sample of 967 males was selected from a representative Pashtun population of Bajaur Agency, and information obtained on bio-demographic variables and marital union types. Analysis of these data revealed that consanguinity was 22.34% and the inbreeding coefficient F was calculated to be 0.0134. The inbreeding coefficient was observed to be higher in subjects who were illiterate, had unskilled jobs and who belonged to younger age categories, extended families and the Tarkalani tribe. Further analyses with respect to temporal variables like subject's age, year of marriage and age at marriage revealed that after a transition in marital union types in the early 80s, there has been a declining trend in the rate of consanguineous unions. Further, consanguineous unions in the parental generation were only 5%, but parental marriage types were predictors of subjects' marital union types. The data further establish that, contrary to a general notion about a high consanguinity rate in Pakistan, consanguineous unions are not common in Bajaur Agency and first cousin marriage is not the preferred type. Furthermore, this research shows that there is a great regional variation in the pattern of consanguinity in Pakistan that needs to be documented in order to draw a more comprehensive picture of the inbreeding coefficient in the country.

Attitudes towards and practice of sexuality among university students in lebanon

Abstract: 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.

Factors influencing mistimed and unwanted pregnancies among nepali women.

Abstract: This paper assesses the factors influencing mistimed and unwanted pregnancies in Nepal separately using data from the 2011 Nepal Demographic and Health Survey. Women who had given birth within the five years before the survey were interviewed about the intendedness of their last pregnancy. The data were analysed with a chi-squared test, followed by multiple logistic regression analysis. Among the total 5391 participants, 11.29% and 13.13% reported their last pregnancy as mistimed and unwanted respectively. Logistic regression analysis showed that women from the hill region were more likely to report mistimed pregnancy, while women from the Western and Far-Western development regions were less likely to report mistimed pregnancy. Education status was positively correlated with the reporting of mistimed pregnancy. Women involved in agriculture, with full autonomy on household decision, with some exposure to mass media, belonging to higher age group and having third or higher parity were less likely to report mistimed pregnancy. Similarly, women from the Western development region had relatively higher odds of reporting unwanted pregnancy. Women with husbands involved in a paid job had lower odds of unwanted pregnancy. Women's autonomy was also positively correlated with unwanted pregnancy. Women with the intention to use contraceptive had lower odds of unwanted pregnancy. Interventions targeting the factors identified by this study could be useful in reduction of mistimed and unwanted pregnancies among Nepali women.

Sex differences in digit ratio (2d:4d) among military and civil cohorts at a military academy in wrocław, poland.

Abstract: The ratio of second-to-fourth digit length (2D:4D), which is generally higher in women compared with men, is a putative marker of prenatal testosterone (PT) exposure. Lower 2D:4D is linked with greater physical ability and strength, better sporting performance and a propensity towards jobs demanding greater physical ability. The objectives of this paper were to examine the sexual dimorphism in 2D:4D in both hands 1and compare this dimorphism in the students of military and civil courses at the General Kuściuszko Military Academy of Land Forces in Wroclaw. The cross-sectional study compared 59 female and 118 male students from the military courses and 53 females and 64 male students from the civil courses. Besides calculating 2D:4D (2D/4D) for each hand, height and weight were also recorded. Physical fitness and endurance were assessed using Eurofit tests. Handgrip strength was measured using a standardized isometric dynamometer. In almost all physical tests, students in the military cohort showed highly significant greater physical ability and strength (e.g. handgrip strength) when compared with the civil cohort. Male participants had a significantly lower 2D:4D than females for each hand, as well as for the average value for both hands. The sexual dimorphism was, however, a little more pronounced in the right hand than in the left. Both sex and course type were significant predictors of 2D:4D. There were significant interactions between sex and the student type. Among females, but not in males, the military cohort had a significantly lower, i.e. more 'masculine', 2D:4D for the left hand and right hand and average for both hands (t=3.290, p<0.001) than the civil cohort. This was not the case in males. However, the sex difference in 2D:4D was only significant among the civil students, and not among the military cadets. In conclusion, higher PT exposure, as represented by a lower 2D:4D, among the Polish females might be an indicator of relatively increased physical ability and motivation to choose professions that require higher strength and endurance.

Consanguinity, genetics and definitions of kinship in the uk pakistani population.

Abstract: Consanguineous marriage is a controversial topic in many Western societies, with attention mainly focused on the health of immigrant communities from Asia and Africa. In the UK consanguinity is especially prevalent in the Pakistani community, which now numbers over 1.1 million. Less attention has been paid to the influence of hereditary population stratification within Pakistani communities, in particular biraderi (literally brotherhood) membership, which denotes male lineages that largely govern marriage partner choice and hence the transmission of disease genes. The various roles played by biraderi and their relationship to other socio-occupational and kinship terms, such as caste, quom and zat, are often overlooked in health-based studies. The interchangeable use of these different kinship terms without rigorous definition can create identity uncertainty and hinders inter-study comparisons. Where feasible, standardization of terminology would be both desirable and beneficial, with biraderi the preferred default term to identify specific social and genetic relationships within the Pakistani diaspora.

Impaired fertility and perceived difficulties conceiving in Ghana:measurement problems and prospects

Abstract: What is the most appropriate measure of impaired fertility for understanding its social consequences in sub-Saharan Africa? The dearth of subjective measures in surveys in the region has prevented comparisons of subjective and objective measures. Perceived difficulties conceiving may have a greater impact than objective measures for social outcomes such as divorce, stigmatization and distress. This study compares 12- (clinical) and 24- (epidemiological) month measures from biomedicine and 5- and 7-year measures from demography with a subjective measure of impaired fertility using correlations, random effects models and test-retest models to assess relationships between measures, their association with sociodemographic characteristics and the stability of measures across time. Secondary panel data (1998-2004) from 1350 Ghanaian women aged 15-49 of all marital statuses are used. Longer waiting times to identification of impaired fertility required by demographic measures result in more stable measures, but perceived difficulties conceiving are most closely aligned with clinical infertility (r=0.61; p<0.05). Epidemiological infertility is also closely aligned with the subjective measure. A large proportion of those identified as having impaired fertility based purely on waiting times are successful contraceptors. Where subjective measures are not available, epidemiological (24-month) measures may be most appropriate for studies of the social consequences of impaired fertility. Accounting for contraceptive use is important in order to avoid false positives. Future research should consider a variety of measures of perceived difficulties conceiving and self-identified infertility to assess which is most valid; in order to accomplish this, it is imperative that subjective measures of infertility be included in social surveys in sub-Saharan Africa.

Low prevalence of intestinal schistosomiasis among fisherfolk living along the river nile in north-western uganda: a biosocial investigation.

Abstract: Mass drug administration has been less successful as a technique for controlling intestinal schistosomiasis (S. mansoni) than anticipated. In Uganda, the mass distribution of praziquantel has been provided to populations at risk of infection since the early 2000s, but prevalence mostly remains high. This is the case, for example, at locations in north-western and south-eastern Uganda. However, there is a remarkable exception. Among Madi fishing populations and their immediate neighbours, living close to the border with South Sudan, the rate of infection has dropped dramatically. A parasitological survey carried out at twelve fishing sites in 2013 identified only three cases of S. mansoni among 383 adults tested. This article asks: why is the prevalence of S. mansoni so low among fisherfolk in northern Uganda? Taking a biosocial approach, it suggests that the mass distribution of drugs, free of charge, has had an impact. However, the low prevalence of infection cannot be attributed to this alone. Other important factors may also have contributed to the decline in infection. These include changing fishing livelihoods, local attitudes to public health interventions, access to water and sanitation facilities, hygiene practices and the use of anti-malarial treatments. Above all, the article highlights the importance of investigating both social and biological dimensions of infection simultaneously, and of recognizing the local complexities of sustainably treating this debilitating parasitic disease.

THE CORRELATION BETWEEN g LOADINGS AND HERITABILITY IN RUSSIA.

Abstract: The study focused on the extent to which the general factor of intelligence g and heritability coefficients of the subtests of an IQ battery correlate. Modest to strong positive correlations were found in five studies from Western countries and six studies from a Japanese meta-analysis. The results for Russian twins were compared with those of the Western and Japanese studies. Data from 402 twins aged 13 and 296 twins aged 16 showed correlations of r=-0.45 and r=-0.60, respectively. It is concluded that the two data points are clearly not in line with established findings. It may be that the link between g loadings and heritabilities is more complex than previously thought.

Factors associated with hiv voluntary disclosure to one's steady sexual partner in mali: results from a community-based study.

Abstract: Despite the widespread dissemination of HIV information through public awareness campaigns in Mali, disclosing seropositivity to one's steady sexual partner (SSP) remains difficult for people living with HIV (PLHIV). Disclosure is a public health concern with serious implications and is also strongly linked to the quality of life of PLHIV. This study aimed to analyse factors associated with voluntary HIV disclosure to one's SSP, using a community-based cross-sectional study on 300 adult PLHIV in contact with a Malian community-based organization working in the field of AIDS response. A 125-item questionnaire was administered by trained personnel to study participants between May and October 2011. Analysis was restricted to the 219 participants who both reported having a SSP and answered to the question on disclosure to their SSP. A weighted multivariate logistic regression was used to determine variables independently associated with disclosure. In total, 161 participants (73%) reported HIV disclosure to their SSP. Having children (odds ratio [95% confidence interval]: 4.52 [1.84-11.12]), being accompanied to the survey site (3.66 [1.00-13.33]), knowing others who had publicly declared their seropositivity (3.12 [1.59-6.12]), having higher self-esteem (1.55 [1.09-2.19]) and using means other than anti-retroviral treatment to treat HIV (0.33 [0.11-1.00]) were independently associated with disclosure. This study identified several factors that should be considered for the design of interventions aimed at facilitating disclosure if/when desired in this cultural context.