Was Cinderella just a fairy tale? Survival differences between stepchildren and their half-siblings.

The death of a parent, particularly the mother, is linked to a suite of negative outcomes across the life-course. Compounding concerns for child outcomes are expectations of poor treatment by step-parents after parental remarriage. Indeed, folk tales of step-parental abuse abound cross-culturally and are embedded into stories taught to children. To understand why child outcomes might be sensitive to levels of relatedness within the household, evolutionary-oriented research targets patterning in parental expenditure in ways predicted to maximize inclusive fitness. In particular, parents are expected to prioritize investments in their biological children. However, stepfamilies are only formed after children experience multiple unfortunate events (e.g. parental loss, poverty), blurring causal interpretations between step-parental presence and stepchild outcomes. Moreover, stepchildren have been shown to be integral to household functioning, caring for their half-siblings and stabilizing relationships. These results challenge narrow views of adaptive behaviour; specifically, that step-parents, unlike biological parents, do no stand to reap fitness benefits from the care that they provide to their stepchildren. To evaluate these critiques, we analyse the survival outcomes of stepchildren. We include over 400 000 individuals from across a natural fertility period (1847-1940) in the United States state of Utah and examine the consequences of parental loss and step-parental introduction. Our analyses yield three key results: (i) exposure to maternal loss in childhood is associated with elevated mortality risk, (ii) parental remarriage does not increase the risk of mortality among stepchildren compared to non-stepchildren who too had lost a parent, and (iii) stepchildren enjoy higher survival than their half-siblings within the same family. Ultimately, this work contributes to the increasingly recognized importance of cooperative relationships among non-kin for childcare and household functioning. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Investigating pathways linking women's status and empowerment to skilled attendance at birth in Tanzania: A structural equation modeling approach.

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa where use of a skilled birth attendant (SBA) at delivery has remained low. Despite the recognized importance of women's empowerment as a key determinant of maternal and newborn health, evidence from sub-Saharan Africa is more limited. Using data from the 2010 Tanzania Demographic and Health Survey (n = 4,340), this study employs a robust method-structural equation modeling (SEM)-to investigate the complex and multidimensional pathways through which women's empowerment affects SBA use. The results show that women's education and household decision-making are positively associated with SBA use. However, not all empowerment dimensions have similar effects. Attitudes towards sex negotiation and violence as well as early marriage are not significant factors in Tanzania. Mediation analysis also confirms the indirect effect of education on SBA use only through household decision-making. The findings underscore the utility of structural equation modeling when examining complex and multidimensional constructs, such as empowerment, and demonstrate potential causal inference to better inform policy and programmatic recommendations.

Skills-Building Programs to Reduce Child Marriage in Bangladesh: A Randomized Controlled Trial.

PURPOSE: Child marriage is the norm in Bangladesh, leading to lifelong negative consequences. Evidence on sustainable child marriage programs is scant. Our study aimed to evaluate the impact of three community-based skills-building programs to delay child marriage among adolescent girls in rural Bangladesh. METHODS: The study used a cluster randomized controlled trial design with four arms-ARM1 offered educational support, ARM2 promoted gender rights awareness, ARM3 offered livelihoods training, and ARM4 was a control area. All adolescent girls were offered 144 hours of skills training in village centers over 18 months. Among 11,609 baseline survey respondents, 91% were successfully included in the endline analysis. Program impact was assessed using discrete time hazard models. RESULTS: The program reduced child marriages (<18) significantly in all arms relative to control-(adjusted hazard ratio [AHR]: .75; 95% confidence interval [CI]: .60-.92) for the education arm, (AHR: .72; 95% CI: .59-.88) for the gender arm, and (AHR: .70; 95% CI: .56-.87) for the livelihoods arm. Program participants were younger and more likely to be in school and faced lower risk of marriage relative to nonparticipants. In the gender and livelihoods arm, nonparticipants had lower risk of child marriage relative to the control group significant at the 10% level. CONCLUSIONS: The study demonstrates it is possible to reduce the prevalence of child marriage in a relatively short period of time by working with communities to implement holistic programs to build skills among girls. The program had similarly large impact and did not depend on the type of skills offered.

Child Brides, Forced Marriage, and Partner Violence in America: Tip of an Iceberg Revealed.

Forced marriage is a violation of human rights and thwarts personal safety and well-being. Child brides are at higher risk of intimate partner violence (IPV) and often are unable to effectively negotiate safe sex, leaving them vulnerable to sexually transmitted infections, including human immunodeficiency virus, and early pregnancy. The prevalence of forced marriage and child marriage in the United States is unknown. The intersection of forced marriage and child marriage and IPV is equally unknown. When 277 mothers who reported IPV to shelter or justice services were asked about a forced marriage attempt, frequency and severity of IPV, mental health status, and behavioral functioning of their child, 47 (17%) reported a forced marriage attempt with 45% of the women younger than 18 years of age at the time of the attempt. Among the 47 women, 11 (23%) reported death threats, 20 (43%) reported marriage to the person, and 28 (60%) reported a pregnancy. Women younger than 18 years reported more threats of isolation and economic deprivation associated with the attempt as well as pressure from parents to marry. Regardless of age, women experiencing a forced marriage attempt reported more intimate partner sexual abuse, somatization, and behavior problems for their children. Forced marriage attempts occurred to one in six women (17%) reporting IPV and are associated with worse functioning for mother and child. The frequent occurrence and associated effect of forced marriage attempts to maternal child functioning indicates routine assessment for a forced marriage attempt as part of comprehensive care for women reporting IPV.

Culture and demography: from reluctant bedfellows to committed partners.

Demography and culture have had a long but ambivalent relationship. Cultural influences are widely recognized as important for demographic outcomes but are often "backgrounded" in demographic research. I argue that progress toward a more successful integration is feasible and suggest a network model of culture as a potential tool. The network model bridges both traditional (holistic and institutional) and contemporary (tool kit) models of culture used in the social sciences and offers a simple vocabulary for a diverse set of cultural concepts, such as attitudes, beliefs, and norms, as well as quantitative measures of how culture is organized. The proposed model conceptualizes culture as a nested network of meanings represented by schemas that range in complexity from simple concepts to multifaceted cultural models. I illustrate the potential value of a model using accounts of the cultural changes underpinning the transformation of marriage in the United States and point to developments in the social, cognitive, and computational sciences that could facilitate the application of the model in empirical demographic research.

Padrões de nupcialidade na economia cafeeira de São Paulo (1860-1930) / Marriage patterns in São Paulo coffee economy (1860-1930) / /Patrones de nupcialidad en la economía cafetera de Sao Paulo (1860-1930)

O objetivo deste trabalho é apresentar e discutir as pautas matrimoniais vigentes em um município típico da economia cafeeira paulista, entre 1860 e 1930, tomando tal variável como indicador do vigor da identidade étnica e do grau de assimilação dos estrangeiros na sociedade local. São Carlos foi fundado em 1857 e conformou-se, a partir da penúltima década do século XIX, como um município bastante representativo da economia cafeeira que se desenvolveu no Estado. De fato, com uma mão de obra inicialmente composta por escravos negros, a partir dos anos 1880 o município passou a receber expressivas levas de imigrantes europeus - italianos, portugueses, espanhóis e outros numericamente menos significativos - para trabalhar nas plantações de café, a ponto de, em 1894, ter recebido o maior contingente de imigrantes de todo o interior paulista. A partir de uma análise dos 15.011 registros paroquiais de casamento observados no período, o trabalho discute a evolução das preferências matrimoniais desses diversos grupos que, ao lado de brasileiros brancos e negros, conformaram uma população estimada em 60 mil indivíduos em 1930. Os dados analisados indicam que a origem nacional atuou como condicionante muito significativo das opções matrimoniais efetivamente concretizadas até pelo menos final dos anos 1920. Assim, as evidências colhidas apontam que pelo menos as primeiras duas gerações de indivíduos de origem imigrante, que viveram em São Carlos até a Grande Depressão do final da década de 1920, mostraram-se bastante resistentes ao processo de assimilação, pelo menos sob o ângulo das pautas matrimoniais.

This paper discusses marriage patterns in a representative city in the state of São Paulo during the coffee economy of 1860-1930. It takes these patterns as indicators of the strength of ethnic identities and of the assimilation of European immigrants in the local society. The city of São Carlos was founded in 1857 and by the late 19th century, it can be seen as fairly typical of the coffee economy that developed in the state of São Paulo. In fact, with a workforce initially composed of African slaves, from the 1880s the city began to receive significant waves of European immigrants - Italians, Portuguese, Spanish and other less numerically significant - for work on coffee plantations, to the point that, in the year of 1894, it received the highest number of immigrants in all of the state, except for the capital. From an analysis of 15,011 parish registers of marriage observed in the period, this paper discusses the evolution of marriage preferences among diverse groups that, alongside black and white Brazilians, conformed an estimated population of 60,000 individuals in 1930. The data analyzed indicate that national origin served as very significant determinant of marital options effectively implemented until at least the late 1920s. Thus, the evidence gathered indicates that at least the first two generations of persons of immigrant origins, living in São Carlos until the Great Depression in the late 1920s, were quite resistant to the process of assimilation, at least in regards to marriage patterns.

El objetivo de este trabajo es presentar y discutir las pautas matrimoniales vigentes en un municipio típico de la economía cafetera paulista, entre 1860 y 1930, tomando tal variable como un indicador del vigor de la identidad étnica y del grado de asimilación de los extranjeros en la sociedad local. San Carlos fue fundado en 1857 y se convirtió, a partir de la penúltima década del siglo XIX, en un municipio bastante representativo de la economía cafetera que se desarrolló en el estado de Sao Paulo. De hecho, con una mano de obra inicialmente compuesta por esclavos negros, a partir del año 1880 y en adelante, el municipio pasó a recibir ingentes masas de inmigrantes europeos - italianos, portugueses, españoles y otros numéricamente menos significativos- para trabajar en las plantaciones de café, hasta el punto de que, en 1894, había recibido el mayor contingente de inmigrantes de todo el interior del estado de Sao Paulo. A partir de un análisis de los 15.011 registros parroquiales de matrimonio observados en el período, el trabajo discute la evolución de las preferencias matrimoniales de esos diversos grupos que, junto a los brasileños blancos y negros, conformaron una población estimada en 60 mil individuos en 1930. Los datos analizados indican que el origen nacional actuó como un condicionante muy significativo en las opciones matrimoniales, efectivamente consumadas en matrimonios, hasta por lo menos final de los años veinte del siglo pasado. Así pues, las evidencias recogidas apuntan a que por lo menos las primeras dos generaciones de individuos de origen inmigrante, que vivieron en San Carlos hasta la Gran Depresión del final de la década de 1920, se mostraron bastante resistentes al proceso de asimilación, por lo menos bajo el ángulo de las pautas matrimoniales.

Improvement of maternal Aboriginality in NSW birth data.

BACKGROUND: The Indigenous population of Australia was estimated as 2.5% and under-reported. The aim of this study is to improve statistical ascertainment of Aboriginal women giving birth in New South Wales. METHODS: This study was based on linked birth data from the Midwives Data Collection (MDC) and the Registry of Births Deaths and Marriages (RBDM) of New South Wales (NSW). Data linkage was performed by the Centre for Health Record Linkage (CHeReL) for births in NSW for the period January 2001 to December 2005. The accuracy of maternal Aboriginal status in the MDC and RBDM was assessed by consistency, sensitivity and specificity. A new statistical variable, ASV, or Aboriginal Statistical Variable, was constructed based on Indigenous identification in both datasets. The ASV was assessed by comparing numbers and percentages of births to Aboriginal mothers with the estimates by capture-recapture analysis. RESULTS: Maternal Aboriginal status was under-ascertained in both the MDC and RBDM. The ASV significantly increased ascertainment of Aboriginal women giving birth and decreased the number of missing cases. The proportion of births to Aboriginal mothers in the non-registered birth group was significantly higher than in the registered group. CONCLUSIONS: Linking birth data collections is a feasible method to improve the statistical ascertainment of Aboriginal women giving birth in NSW. This has ramifications for the ascertainment of babies of Aboriginal mothers and the targeting of appropriate services in pregnancy and early childhood.

Reconstructing the history of marriage strategies in Indo-European-speaking societies: monogamy and polygyny.

Explanations for the emergence of monogamous marriage have focused on the cross-cultural distribution of marriage strategies, thus failing to account for their history. In this paper I reconstruct the pattern of change in marriage strategies in the history of societies speaking Indo-European languages, using cross-cultural data in the systematic and explicitly historical framework afforded by the phylogenetic comparative approach. The analysis provides evidence in support of Proto-Indo-European monogamy, and that this pattern may have extended back to Proto-Indo-Hittite. These reconstructions push the origin of monogamous marriage into prehistory, well beyond the earliest instances documented in the historical record; this, in turn, challenges notions that the cross-cultural distribution of monogamous marriage reflects features of social organization typically associated with Eurasian societies, and with "societal complexity" and "modernization" more generally. I discuss implications of these findings in the context of the archaeological and genetic evidence on prehistoric social organization.

Reconstructing the history of marriage and residence strategies in Indo-European-speaking societies.

This file provides additional information on the data and methods used in Fortunato (2011a, b), and discussion of the results of the fossilization of nodes Proto-Indo-Hittite (PIH) and Proto-Indo-European (PIE) for marriage and residence strategies.

Improving marital quality in women with medical illness: integration of evidence-based programs into clinical practice.

Good marital quality (MQ) is associated with better outcomes in many medical illnesses, especially for women. However, improved outcome is only apparent when MQ is measured across a range of marital functioning and when it is statistically described as either good or poor functioning. This article describes the biological processes that have been shown to underlie this relationship and reviews the influence of MQ on patient outcomes in cardiovascular disease. Studies of interventions to improve MQ vary in level of sophistication, depending on the skill of the provider. This article describes successful evidence-based interventions and the skill sets associated with those interventions. In daily clinical practice, psychiatrists can assess MQ by using the Global Assessment of Relational Functioning (GARF) scale and by asking questions about several dimensions of functioning. Understanding how to apply findings from family research concerning outcomes of medical illness is especially important for psychiatrists who practice psychosomatic medicine. This article outlines how such findings can be applied in clinical practice.

Marital satisfaction, sexual problems, and the possible difficulties on sex therapy in traditional Islamic culture.

We plan to investigate the level of marital satisfaction, the prevalence of sexual problems, and related issues in couples who were referred to an outpatient clinic of psychiatry for their sexual problems. All were living according to traditional Islamic culture. Twenty-five (80.64%) of the couples attended the clinic for not being able to have any sexual intercourse. Overall, 25.8% of the women, and 3.2% of the men had been married without their consent; those marriages were arranged and mediated by matchmakers. Vaginismus (58.06%) was the most common diagnosis among women and premature ejaculation (38.70%) among men. We found that marital satisfaction was affected by the mode of marriage.

Age and sex suicide rates in the Eastern Mediterranean Region based on global burden of disease estimates for 2000.

Suicide was estimated to be the 25th leading cause of death in the WHO Eastern Mediterranean Region in the year 2000. Using data from the WHO global burden of disease project, estimated rates of suicidal deaths were plotted for different sex and age groups. Overall rates of suicide were higher in females than males in age groups 5-14 and 15-29 years. The peak age for suicides among females was 15-29 years (8.6 per 100,000) and for males 60+ years (100,000). As a proportion of all deaths due to injury, suicides were substantially higher in females than males. Females in high-income countries had the lowest rates of suicide in all age groups and males in high-income countries had a lower rate than males in low- and middle-income countries.

[Medical-social aspects pregnancy, labor and puerperium in patients the solitary mother home in Karwowo near Szczecin]. / Medyczno-spoleczne aspekty przebiegu ciazy, porodu i pologu u pacjentek--pensjonariuszek domu samotnej matki w Karwowie kolo Szczecina.

PURPOSE: Solitary maternity is a significant problem of modern times requiring socio-economic and psychological, as well as perinatological studies. The twentieth anniversary of the Maternity Home managed by the Benedictine Samaritan Sisters motivated the present study. MATERIAL AND METHODS: Hospital discharge summaries of 429 women (group DSM) who lived at the Maternity Home between 26 July 1983 and 26 February 2002 were analyzed. This documentation was supplemented with hospital data on 177 women who gave birth at two Szczecin hospitals and on 13 who left the Home before delivery. RESULTS: Residents of the Home came from all regions of Poland and from urban and rural societies. They were between 14 and 43 years of age (mean 22.6 +/- 5.7). 87.4% of them were single and 63.7% were primipara. 50.4% of them failed to complete primary education while 3.4% had university-level education. 6% were mentally and/or psychologically handicapped and 42.7% had no profession. The major causes of admission into the Home were: desire to hide the pregnancy, family conflicts, homelessness, difficult material situation, mental or physical disability, violence or alcoholism in the family. The control group comprised 400 women (group K) who gave birth at the Department of Obstetrics and Perinatology, Pomeranian Medical University in Szczecin. 51.5% of them were primipara. The mean age in this group was 27.4 +/- 5.4 (17-44). 71.3% were married. The Majority had secondary (41.9%) or university (32.5%) education. Most of them worked as artisans, teachers or economists. Neurological or psychiatric diseases dominated in group DSM but otherwise no severe disease at all could be disclosed. Satisfactory prenatal care was provided to 33.1% of DSM patients and to 78% of group K. No prenatal care was provided to 9.5% of DSM patients and to 1.7% of group K. EPH gestosis was more often observed in DSM patients and imminent abortion, premature birth, PROM, urinary tract infection, and anaemia were more frequent in controls. More DSM patients had no treatment during pregnancy than controls. The use of tocolytics was significantly more frequent in DSM patients. Antibiotics and drugs accelerating maturation of the respiratory system were applied with similar frequency in both groups. Frequency of immature and mature births was similar in both groups. 84.2% of DSM patients and 68.8% of controls had natural delivery. Cesarian section was twice more frequent in group K. Immediate indications dominated in both groups (74.1% in DSM; 57.4% in K). No medication was used during delivery in 30% of patients. DSM patients more often required strong analgesics. Antibiotics and agents increasing uterine tension more often were used in K patients. Deliveries in both groups were usually without complications. Female genital tract injury was more frequent in DSM patients (20.9% in DSM; 14.8% in K). Delivery duration was similar in both groups, but the second part of delivery was longer in K primipara. Mean neonatal weight in the 1000-2500 g range was similar in both groups but was significantly higher in controls for 2501-4000 g neonates. The difference for newborns weighing more than 4000 g was not significant. There were no neonates weighing less than 1000 g. The clinical condition of newborns measured with the Apgar scale was worse in the DSM group after the 1st min, as well as after the 3rd and 5th min and the difference in each case was significant. Puerperium was usually uncomplicated. However, urinary tract infection was more frequent in DSM patients and anaemia was more frequent in controls. The duration of hospitalisation was similar in both groups (mean = 6 days). 120 of 177 DSM mothers left hospital together with their children, as compared to 99.3% in the control group. 87 children of mothers from the Maternity Home were offered for adoption. CONCLUSION: By studying unwed maternity it was observed that a holistic approach is the only way to disclose all the problems which are often unusually complex and concealed but which determine the normal development of an individual in the society. Analysis of the factors involved may help in attaining goals that serve the good of the society.

[An epidemiological study on domestic violence in Hunan, China].

OBJECTIVE: To investigate the prevalence of domestic violence (DV) in Hunan. METHODS: Using a multi-stage sampling strategy, 9451 households involving 32 720 persons in urban, rural and industrial areas in Hunan, China were studied. Multiform clue investigation and face-to-face interviews were combined to investigate the prevalence of DV. RESULTS: A lifetime prevalence of DV was reported by 1533 households (16.2%). A total of 1098 households (11.6%) reported at least one incident of DV in the previous year. Both lifetime and 12-month prevalence of DV varied significantly by geographic setting (P < 0.01). The lifetime prevalence abuse rates were: spousal 10.2%, child abuse 7.8%, and elder 1.5%. With regard to household structure, the lifetime prevalence of DV was highest among those remarried families (21.0%), followed by married couples with one child and extended families with several generations living together (20.1% and 20.0%, respectively). The highest rate of spousal abuse was found among remarried families (14.7%), while child and elder abuse was most prevalent among extended families (12.4% and 4.1%, respectively). CONCLUSIONS: The findings suggested that although the prevalence of DV in Hunan was modest compared to Western countries, it remained a serious public health problem affecting over 1 in 10 households. Furthermore, the prevalence of various types of DV varied by geographic setting and family structure, suggesting that diverse geographic setting and family constellations carried different risk and protective features.

[Treatment of adult patients with epilepsy in the children's hospital].

During one year from November 2002 to October 2003, 810 patients with epilepsy were examined in Shiga Medical Center for Children, and 186 patients (23%) were over 18 years old. Among them, 162 adult patients (male; 52%, female; 48%) were regularly examined at the outpatient-clinic. Seizures persisted in 56% of these adult patients. Over 80% of the patients were classified as symptomatic epilepsy. Seventy-eight percent of the cases were combined with physical or mental disability. Six percent of the patients had psychological disorders and 11% of the patients had internal diseases. Fifteen percent of the patients had jobs, 4% were married, and 8% had driver's licenses. Seventy percent of the patients were not independent because of their handicap. In our children's hospital, adult patients with epilepsy are increasing, and a countermeasure is necessary. It is important to join networks between regional adult hospitals and clinics. On the other hand, pediatric neurologists must study psychological and internal diseases, management of women with epilepsy, and employment and driving in patients with epilepsy.

The American Cancer Society Cancer Prevention Study II Nutrition Cohort: rationale, study design, and baseline characteristics.

BACKGROUND: Large-scale, prospective cohort studies have played a critical role in discovering factors that contribute to variability in cancer risk in human populations. Epidemiologists and volunteers at the American Cancer Society (ACS) were among the first to establish such cohorts, beginning in the early 1950s and continuing through the present, and these ACS cohorts have made landmark contributions in many areas of epidemiologic research. METHODS AND RESULTS: The Cancer Prevention Study II Nutrition Cohort was established in 1992 and was designed to investigate the relation between diet and other lifestyle factors and exposures and the risk of cancer, mortality, and survival. The cohort includes over 84,000 men and 97,000 women who completed a mailed questionnaire in 1992. New questionnaires are sent to surviving cohort members every other year to update exposure information and to ascertain new occurrences of cancer; a 90% response rate was achieved for follow-up questionnaires in 1997 and 1999. Reported cancers are verified through medical records, registry linkage, or death certificates. The cohort is followed actively for all cases of incident cancer and for all causes of death. Through a collaborative effort among ACS national and division staff, volunteers, and the American College of Surgeons, blood samples were collected from a subgroup of 40,000 cohort members and are in storage at a central repository for future investigation of dietary, hormonal, genetic, and other factors and cancer risk. Collection of DNA samples from buccal cells in an additional 50,000 cohort members is underway currently and will be completed in 2002. CONCLUSIONS: This new cohort of both men and women promises to be particularly valuable for the study of cancer occurrence, mortality, and survival as they relate to obesity and weight change, physical activity at various points in life, vitamin supplement use, exogenous hormone use, other medications (such as aspirin and nonsteroidal anti-inflammatory drugs) and cancer screening modalities.

Infertility: a sociological analysis of problems of infertility among women in a rural community in Nigeria.

This study highlighted the problems of infertility among-women in Ilora rural community. The result revealed that in spite of high fertility rate and high rate of pregnancy wastage, 8.7% out of the 400 women studied were found to be infertile. It is interesting to note that in a strictly polygamous environment, almost half of the women suffering from infertility were found to be the only wife of their respective husbands. The African concept as to the solution to the problems was also discussed, and highlighted in relation to awareness of possible hospital treatment of their conditions.

Risk factors for surgery for prostatic hypertrophy.

The purpose of this case-control study was to evaluate potential risk factors for prostatic hypertrophy. The cases were 910 residents of Rhode Island who had a partial or total prostatectomy that was not related to cancer in the years 1985-1987. The controls were 2,003 members of the source population who were selected from a list of holders of Rhode Island driver's licenses or a roster of older Americans compiled by the Health Care Financing Administration. Cases and controls were interviewed by telephone. The risk of prostatic hypertrophy was elevated in Jewish men compared with Protestants and Catholics and in blacks compared with whites. Risk was reduced in ever-married compared with never-married men, in men who had left school at age 16 years or more compared with those who had left earlier, and in relatively tall or relatively heavy men. Coffee drinking and cigarette smoking were inversely but only weakly related to prostatic hypertrophy. There was a relatively strong, although irregular, inverse relation of beer drinking to prostatic hypertrophy. The associations of spirits and wine consumption with prostatic hypertrophy were weak.