Modelling population movement into the Scottish highlands and islands from the remainder of Britain, 1990-1991

"In this analysis, data are used from the 1991 Census Special Migration Statistics to model the migration flows into the Scottish highlands and islands, from the remainder of Britain, between 1990 and 1991. A Poisson regression approach is used to identify the origins of unusually large flows into this broad destination area, and to introduce origin-based explanatory variables which help to explain the factors influencing these flows. The flows into this area which originate in Scotland are contrasted with those which originate in England and Wales and the findings suggest that middle class in-migration from southern England continues to be a significant element of population change in this remote rural destination."

Does antenatal care make a difference to safe delivery? A study in urban Uttar Pradesh, India

Evidence to support that antenatal screenings and interventions are effective in reducing maternal mortality has been scanty and studies have presented contradictory findings. In addition, antenatal care utilization is poorly characterized in studies. As an exposure under investigation, antenatal care should be well defined. However, measures typically only account for the frequency and timing of visits and not for care content. We introduce a new measure for antenatal care utilization, comprised of 20 input components covering care content and visit frequency. Weights for each component reflect its relative importance to better maternal and child health, and were derived from a survey of international researchers. This composite measure for antenatal care utilization was studied in a probability sample of 300 low to middle income women who had given birth within the last three years in Varanasi, Uttar Pradesh, India. Results showed that demarcating women's antenatal care status based on a simple indicator--two or more visits versus less--masked a large amount of variation in care received. Logistic regression analyses were conducted to examine the effect of antenatal care utilization on the likelihood of using safe delivery care, a factor known to decrease maternal mortality. After controlling for relevant socio-demographic and maternity history factors, women with a relatively high level of care (at the 75th percentile of the score) had an estimated odds of using trained assistance at delivery that was almost four times higher than women with a low level of care (at the 25th percentile of the score) (OR = 3.97, 95% CI = 1.96, 8.10). Similar results were obtained for women delivering in a health facility versus at home. This strong positive association between level of care obtained during pregnancy and the use of safe delivery care may help explain why antenatal care could also be associated with reduced maternal mortality.

Psychological adjustment of Yoruba adolescents as influenced by family type: a research note

This research examines the influence of family type on the psychological adjustment of Yoruba adolescents. Using a sample of 116 adolescents, 69 males and 47 females, with mean age of 17.8 years of age (S.D. = 1.72), the results reveal that male adolescents from monogamous families experience better psychological adjustment than their polygynous counterparts, whereas no such difference exists in the levels of psychological adjustment of female adolescents from both family types. These findings suggest that (i) sex-role prescription influences psychological adjustment of adolescents in Yoruba societies, and (ii) female children enjoy more protective upbringing in polygynous families than their male counterparts.

Seroepidemiology of cytomegalovirus infection among children between the ages of 4 and 12 years in Taiwan

To determine risk factors responsible for primary cytomegalovirus (CMV) infection in Taiwan, samples of blood for antibody to CMV were obtained from 362 children aged 4 to 12 years: 58% were found to be positive for anti-CMV IgG antibody. Logistic regression analysis showed that seropositivity correlated with age, method of delivery, duration of breast feeding, and younger age of mother. Neither socioeconomic status nor crowded living conditions showed significant correlation with CMV seropositivity. Primary CMV infection in Taiwan appears to be less related to socioeconomic status shown in western countries, and, since the majority of pregnant women were seropositive in Taiwan, two of the major sources of primary CMV transmission are infected breast milk and the infected genital tract.

The incidence of unplanned and unwanted pregnancies among live births from health visitor records

A survey of health visitor records has indicated that approximately one-third of pregnancies resulting in live births are unplanned. The data further revealed an association between planning of pregnancies and socio-demographic variables and use of preventive health care for infants.

Knowledge and attitude towards breast feeding among adolescent girls

Majority of the urban adolescent girl students (n = 76) from middle socioeconomic group correctly reported that breast milk is the best food for infants (95%), and it has protective antibodies (98%). However, most of them (92%) had incorrect knowledge about the role of diet in breast milk secretion and continuation of breastfeeding while mother is suffering from tuberculosis (92%), malaria (84%).

Validity of questionnaire information on frequency of coitus

A total of 91 women provided reproductive histories, including usual frequency of coitus, at their enrollment into prospective studies conducted by the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, in 1984-1986. Those data were compared with coital data recorded during study participation. Overall, women reported a significantly higher frequency of coitus on the interviewer-administered questionnaire than they recorded daily, by an average of 0.8 episodes per week. The size of this difference did not vary significantly for subgroups of women defined by demographic and other covariates. Excluding days of menses from the prospective records reduced the difference by 25%. The authors attribute the overestimate on the questionnaire to a tendency to report a coital frequency that might exist in the absence of travel, illness, and other transient factors that are likely to decrease frequency. This nondifferential information bias is unlikely to produce misleading comparisons or erroneous associations in epidemiologic studies of reproduction.

[Demographic trends: birth spacing]

Two studies to measure children spacing in western metropolitan Santiago are compared. The first (1984-85) surveyed a sample of 687 mothers and the second 1,000. Deliveries took place at San Juan de Dios and Félix Bulnes hospitals (both state-finance) which provide medical care for medium and low income groups. Long spacing (5 years or more) accounted for the highest proportion of non-first born children (33.8% in 1984-85 with a significant increase to 40.1% in 1988) while short spacing (under 2 years) accounted for 19.2% in 1984-85 and 21.8% in 1988 (not significant). Mean birth weights were over 3,200 g in every spacing group. Despite the low illiteracy rate, predominant urban origin and having at least one child born before, high proportions of children were conceived despite the use of contraceptive measures (19.7% in 1984-85 and 22.5% in 1988). This contraceptive failure was less frequent among children born after longer spacings.

Working status and stress of middle class women of Calcutta

In India an increase in female employment outside the home has occurred during the last few decades, especially in urban areas. A working woman may face difficulties in attempting to fulfil the demands of both worlds, at home and outside, while a housewife may feel tired and irritated with her household chores and financial dependence. All these may cause stress for these groups of women. The present study compares a group of working mothers with their non-working counterparts with respect to: (a) stress level, measured in terms of their anxiety score; and (b) certain general indicators of health including a broad measure of stress. The results show that anxiety and health scores of the two groups of women are similar. Further, the health score and anxiety score seem to be correlated, more clearly among the working mothers.

Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation

After validation of test-weighing procedures milk volumes produced by 13 multiparous Caucasian women were followed longitudinally through the first year of lactation. All practiced exclusive breast-feeding for at least 5 mo. Milk transfer to the infant was low on days 1 and 2 and increased rapidly to 498 +/- 129 g/d (means +/- SD) on day 5 and then more slowly to 753 +/- 89 g/d during months 3-5. There was a characteristic milk volume for each mother-infant pair that was significantly related neither to milk yield on days 4-6 nor to birth weight. It was, however, strongly related to infant weight at 1 mo, suggesting that infant and/or maternal factors coming into play during the first month of life are strong determinants of subsequent milk transfer to the infant.

Use-effectiveness of the ovulation method initiated during postpartum breastfeeding

Between April 1981 to March 1984, 419 urban middle class postpartum women entered the Natural Family Planning (NFP) program of the Pontificia Universidad Catolica de Chile. This NFP program teaches the Ovulation Method (Billings). Only 1.9% of the women did not learn how to recognize the mucus pattern of fertility awareness. The sample of 378 women who were practicing the method to avoid a pregnancy completed 4,935 months of use of the OM. The cumulative life table unplanned pregnancy rate at the 12th postpartum month was 11.1 +/- 1.9 and the Pearl Rate was 12.1 per 100 woman-years. The Pearl Rate calculation of method-related failure was only 2.1 pregnancies per 100 woman-years. The breastfeeding group showed a significantly lower rate of unplanned pregnancies than the nonbreastfeeding group and there was no significant increase in unplanned pregnancy at the time of menstruation among previously amenorrheic women as compared to later intervals. The protection against unplanned pregnancy shown in this study should be viewed as the combination of two factors: breastfeeding and the Ovulation Method (OM) of NFP.

Nursing practices and lactation amenorrhoea

The study examines the effects of nursing practices on the duration of lactation in middle-class American women. Thirty-two nursing mothers were followed for 2 years post-partum, data being collected at eight home visits by interview and by nursing records kept by the mothers. Those women who nursed frequently (>8/day) during exclusive breastfeeding remained amenorrhoeic longer than infrequent nursers, introduced supplements later and did not resume menses as promptly thereafter. They continued an hour or more of night nursing during supplemented nursing. Duration of exclusive nursing and night nursing after supplementation were the major influences on duration of amenorrhoea. Mothers' age, weight-for-height, and nursing frequency before supplementation showed no significant effect but night nursing after supplementation was a major factor in post-supplementation duration of amenorrhoea. Those women who both supplemented later and maintained an hour of night nursing after supplementing remained amenorrhoeic for 6–10 months longer than those who supplemented early and/or reduced subsequent night nursing.

Social and environmental factors influencing contraceptive use among black adolescents

In 1979 survey among sexually active unmarried black adolescents from Chicago found that 28 percent of the young women and 18 percent of the young men used a contraceptive at first intercourse. Statistically significant differences in such contraceptive use among teenage women were found for three social and environmental characteristics: social class, parents' marital status and neighborhood quality. Thus, 41 percent of the young women from the highest social class used contraceptives at first intercourse, but only 17 percent of those from the lowest class did so. The proportions were 35 percent for young women from neighborhoods of high socioeconomic status and 17 percent for those from ghetto neighborhoods. Thirty-six percent of teenage women whose parents had intact marriages as of the adolescent's 11th birthday used contraceptives at first intercourse, compared with 23 percent of those from single-parent and divorced families. Among males, social class was the only one of these three characteristics that was statistically significant; 32 percent of adolescents from the highest class and 11 percent from the lowest practiced contraception at first intercourse. For teenagers of both sexes, career aspirations were of marginal statistical significance in the practice of contraception. Thirty-six percent of young women with high aspirations used contraceptives at first intercourse and 19 percent of those with low aspirations did so. Only four percent of the young men with low career aspirations used contraceptives, compared with 25 percent of those with high aspirations. Number of siblings, parental supervision of dating and having a sister who had become a teenage mother showed no association with contraceptive use.(ABSTRACT TRUNCATED AT 250 WORDS)

Episodes of illness in breast-fed and bottle-fed infants in Jerusalem

In a prospective study on breast-feeding in Jerusalem, 274 middle-class Jewish women were interviewed about their breast-feeding practices, and symptoms and signs of disease, episodes of illness and hospitalization of the infant. Women of a higher education level breast-fed more often and for a longer period than did women with less education. Infants exclusively breast-fed had significantly fewer symptoms of disease than did those not breast-fed or partially breast-fed. The odds ratios for cough, respiratory difficulty, and diarrhea by breast-feeding practice were 3.66, 2.14 and 2.72 (P = 0.04). Significant differences in the number of illness episodes were found between breast-fed and bottle-fed infants at 20 weeks; infants exclusively breast-fed had the least number of illness episodes. A positive association was found between number of illness episodes and duration of breast-feeding. Infants who were breast-fed for 20 weeks had the least number of illness episodes; 52% of them had no episode compared with only 15% who were not breast-fed. Comparison of the numbers of illness episodes among non-breast-fed infants of mothers with low and high education levels indicated that the infants of better educated mothers had a significantly lower percentage of illness episodes (P less than 0.05). Even infants of a middle-class and well-educated population benefit from the breast-feeding practice and its protective effect, more so if they are exclusively breast-fed and for a longer period.

Economic development: the middle class and international migration in the Dominican Republic

"The Dominican Republic is classified as one of a group of Latin American and Caribbean countries whose international migratory flows appear to be primarily composed of the urban middle class, rather than the rural poor. It is argued that Dominican middle class international migration has emerged as a partial solution to a political economic crisis that was dramatized by the April Revolution of 1965 and deepened through the 1970s with the failure of industrialization strategies to generate significant changes in the class structure."