Love in the time of cholera. Cholera epidemics and changes in the marriage market in nineteenth-century Poznań

BackgroundSaudi Arabia has undergone substantial development in the recent past with concomitant changes in living conditions, and economic and general health status that have affected the age at menarche in Saudi women. We evaluated the current age at menarche and reproductive events among Saudi women.Subjects and MethodsAge, age at menarche, age at marriage, age of first pregnancy, number of children, and number of abortions were collected for Saudi women attending King Khalid University Hospital (KKUH) over a 3-month period in 2002.ResultsFor 989 Saudi women, the mean age at menarche was 13.05 years. There was a decrease in the age of menarche over the past 20 years, an increase in the age of marriage, age of first pregnancy, and a decrease in the number of children and abortions. Compared with data from two decades, the age at menarche decreased significantly from 13.22 to 13.05 years.ConclusionThe decrease in the age of menarche among Saudi women indicates better socioeconomic status and improvements in health.

BackgroundThis study investigated the impact of getting older than the mean marriage age on mental disorders and suicidality among never-married people.MethodsWe performed an epidemiological survey, a nationwide study of mental disorders, in 2016. In this study, a multi-stage cluster sampling was adopted. The Korean version of the Composite International Diagnostic Interview was conducted with 5,102 respondents aged 18 years or above. The associations between never-married status, mental disorders, and suicidality were explored according to whether the mean age of first marriage (men = 32.8 years; women = 30.1 years) had passed.ResultsNever-married status over the mean marriage age was associated with agoraphobia, obsessive–compulsive disorder, mood disorders, and major depressive disorder after adjusting for sociodemographic factors. Respondents with never-married status above the mean marriage age were associated with suicide attempts (adjusted odds ratio [aOR], 3.21; 95% confidence interval [CI], 1.36–7.60) after controlling for sociodemographic factors and lifetime prevalence of mental disorders, while respondents with never-married status under the mean marriage age were not. Moreover, in respondents with never-married status, getting older than the mean marriage age was associated with suicidal ideations (aOR, 1.49; 95% CI, 1.04–2.15) and suicide attempts (aOR, 3.38; 95% CI, 1.46–7.84) after controlling for sociodemographic factors and lifetime prevalence of mental disorders.ConclusionNever-married status above the mean first marriage age was associated with mental disorders and suicidality. These findings suggest the need for a national strategy to develop an environment where people with never-married status do not suffer even if their marriage is delayed.

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Background and Aim: Abnormal uterine bleeding (AUB) has a major social, psychological, and economic impact on women aged 18–45 years, in the most productive stage of their life. This study was done to assess the impact of menstrual and obstetric patterns, cardiometabolic risk factors, and metabolic syndrome on women of reproductive age with AUB. Materials and Methods: Our hospital-based case–control study had 61 participants, of which 31 were cases and 30 were age-matched controls. They were compared on their age, age of menarche and marriage, number and type of deliveries, contraceptives used, cardiometabolic risk factors like body mass index, waist-hip ratio, waist-height ratio, fasting blood sugar (FBS), total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), and having metabolic syndrome. Results: The majority of the cases were 36–45 years of age. The mean age of marriage was significantly less but the parity was more ≥2 in cases when compared to controls. FBS, TC, triglycerides, LDL, and HDL in cases were significantly more than controls. A 33.3% of cases had metabolic syndrome. Women with metabolic syndrome were 15 times more likely to develop AUB, as compared to normal women. Conclusion: Age of menarche did not influence but lower age of marriage and increased number of pregnancies had a profound effect on the occurrence of AUB. Metabolic syndrome is significantly associated and could be a potential fellow traveler in women with AUB.

Reviewed by: Jewish Marriage and Divorce in Imperial Russia David Shneer Jewish Marriage and Divorce in Imperial Russia, by ChaeRan Y. Freeze. Hanover, NH: Brandeis University Press, 2002. 399 pp. $65.00 (c); $29.95 (p). If today conservatives lament the high divorce rate of Americans in 2002, what would they have thought of Jews living in tsarist Russia, who divorced at rates higher than today’s American rates? ChaeRan Freeze, assistant professor of Near Eastern Studies at Brandeis University, uncovers these seemingly shocking statistics in her brilliantly researched book, Jewish Marriage and Divorce in Imperial Russia, and shows how Russian Jewish marriage and divorce operated and changed throughout the nineteenth century. Freeze concludes that patterns of Jewish marriage and divorce in Russia [End Page 153] counter previous understandings about how marriage, divorce, and the family had changed over time. Most scholars of the family suggest that divorce rates increased during the nineteenth century as modernization, mobility, education, and new expec tations about conjugal life changed each partner’s, but especially women’s, expectations about what to expect from marriage. In theory, people came together for love rather than to please the parents, and the economics of the family changed, making divorce a financial possibility for more people. But Freeze argues that “the Jews showed the contrary tendency with modernization: from astronomically high divorce rates in the early nineteenth century, they demonstrated a striking tendency to reduce, not increase, the divorce rate” (p. 146, emphasis in original). In what might be Freeze’s most startling statistic, in 1845, the province of Vilna registered more divorces than marriages, the only time Freeze found such a statistic in her research. Freeze allows that her research sample, which was by definition limited to those locales whose documents were preserved, might not be able to be generalized. But she does her best to provide a cross- section of Russian Jewish society by bringing in material from a variety of places such as Vilna, an urban city in the North, and Korostyshev, a small predominantly hasidic shtetl in the Ukranian south. Unlike their Orthodox Christian neighbors and unlike Jews in other parts of Europe, Russian Jews had no hang-ups about dissolving unions. Much of Freeze’s book focuses on the messy details of couples coming together, and more important for Freeze, dissolving their marriages. In the early nineteenth century, Jews married at a young age for a variety of reasons—procreation in the face of high mortality rates, avoiding the tsarist draft, and the maintenance of parental control over their children. In 1851, the mean age of marriage was 19.5 for women and 23.4 for men, although average marrying age varied depending on geography, class, and degree of urbanization. Freeze also describes what were called “panic marriages,” when families married their children off at a very young age to create stability in times of crisis. She shows that those involved in the marriage business often fanned fears of instability to increase the rate of panic marriages and boost business But the age of Jewish marriage increased through the second half of the century so that by 1900, the Jewish age of marriage in Vilna was 23.2 for women, 26.3 for men, the highest marrying age of any religious group in the Russian Empire. In her examination of the reasons for the age increase, Freeze brings social, cultural, and political history together. She shows that Jews married at an older age not just because women had a larger voice in negotiating families; not just because the Russian state was taking a greater interest in families; and not just because child mortality rates were dropping, but because of all of these factors. And the complexities of marriage fore shadowed the even more complicated cultural phenomenon of Jewish divorce, which is central to Freeze’s story. For Russia’s Jews divorce was a legal, more than a spiritual, issue. The rituals surrounding divorce were as technical and legalistic as the rituals for marriage. [End Page 154] Documents exchanged hands, courts examined the grounds for divorce to determine their legitimacy, witnesses gave testimony, property was divided, and custody of the children was determined. The...

For as in those days before the flood they were eating and drinking, marrying and giving in marriage, until the day when Noah entered the ark, and they did not know until the flood came and swept them all away, so will be the coming of the Son of man. Matthew 24: 38-39 In the course of the nineteenth century, cholera came to be defined as a disease caused by a comma-shaped bacillus that often spreads through fecal contamination of drinking water. Symptoms of the disease include copious vomiting and diarrhea which frequently lead to death from severe dehydration. The history of cholera epidemics in Europe and the Americas has been shaped by this understanding of how the disease spread and the story of how it came to be controlled. As R. J. Morris noted in his history of the 1832 cholera epidemic in Britain,Historians of disease and public health tend to concentrate on the prehistory of our own modes of thought and action, the miasma-contagion disputes, the problems of administration and finance and the campaign to gain political support for reform.1 It makes sense that the provision of urban sanitation, the development of scientific understanding, and the triumph of the germ theory have been among the most important themes in the historical literature on nineteenth-century epidemics, but it is also true that many historians have recognized that for those who faced those deadly epidemics of cholera, hygiene meant more than cleanliness and the absence of microscopic pathogens. Germs, after all, would not be discovered for decades after the first cholera epidemics arrived in the West. In the nineteenth century, hygiene connected good health and cleanliness with virtue and morality. Cholera was not just an epidemic; it was a moral plague.2 Cholera epidemics stimulated debate not only about public issues but about proper behavior in private life as well. Whether the disease was caused by an environmental condition or by a microscopic organism, a crucial question awaited an answer: why did some die while others were spared? Why did not all those exposed to the miasma or to the germs succumb to the disease? Each potential explanation left open the question of predisposition to disease, the notion of contributing causes that might be subject to personal control. Most people were not concerned with grand theories of etiology: with effluvia, miasmas, or microscopic animals. They wanted to know what they could do to avoid a disgusting disease and a rapid and painful death. Morality and mundane activities were common concerns for those awaiting the first cholera epidemics. For many people, the time of cholera was a time to face death, to ponder their lives, and to examine their mundane activities; or, at least, to have these questioned for them by the literate class. Early publications on cholera prophylaxis are rife with social prejudice and condemnations of the lifestyles of the poor and infamous. After a brief review of how the worldly pleasures of eating, drinking, and sexual activity were thought to be related to the possibility of death from cholera in Canada, Mexico, and the United States, we can turn our attention from these recommendations to the behavioral patterns connecting marriage and religion to cholera epidemics in Catholic populations in Mexico City and Montreal in the early 1830's. As the epidemic approached, food and drink were carefully scrutinized and categorized; some of each were thought to increase the risk of sudden death from cholera. Advice on eating and drinking was consistent in each of the three countries, as were the political efforts to limit sale of disreputable foods and to prohibit or limit drinking. Given the consensus that common foods might provoke attacks of cholera, officials of the Catholic Church frequently were willing to set aside the traditional rules of ritual abstinence in the time of cholera. Special dispensations to consume meat on what otherwise would have been meatless holy days were granted in several cities. …

Because of bias of unknown sign and extent introduced by age misreporting when calculating the singulate mean age of marriage in the usual manner, Van de Walle has suggested a fairly robust estimator based on stable population structure. Unfortunately not much is known about the properties of this estimator. Various demographers have argued informally that it indeed estimates the SMAM; others feel that it instead estimates the mean age of marriage in a cohort, the mean age of marriage in the stable population, or the singulate median age of marriage. In this paper the properties of this estimator are examined. Further, extensions of the Van de Walle estimator based on regression are shown to be significantly superior to the estimator alone.

A Theory of Marriage: Part II

Introduction:Spatial segregation of social classes is often accompanied by social segregation. This means that patterns of social behavior also change in proportion to class spatial segregation. Accordingly, people from different classes living in separate areas are expected to have different patterns of behavior. The main purpose of the present study is to compare the marriage patterns of women in the high and low-class regions of Hamadan province. Marriage patterns include age patterns, dating patterns, the prevalence of consanguineous marriages, intra-ethnic marriages, and differences in the marriage criteria. Materials and Methods:The research method was survey and a researcher-made questionnaire was used to collect the data. The statistical population of the study included married women living in high and low-class regions of Hamadan province. According to the latest population and housing census, their number is 198124 cases. The sample size was calculated based on Cochran’s formula and equaled 325 people. The sampling method in this study was stratified sampling.The reliability of the questions related to marriage criteria by removing three inconsistent variables was equal to 0.711. The face validity of this research was based on expert judgement (two students of social research and sociology and two professors of sociology).Based on some theoretical viewpoints such as Bourdieu’s theory of distinction, Gidden’s theory, and relational theories of space, a theoretical model was created and some variables were identified. The formulated hypotheses of the study were:The age pattern of marriage is different for women in the high and low-class parts of Hamadan province.The way of acquaintance in the marriage of women is different.The pattern of kinship marriage is different among women in the high and low-class parts of Hamadan province.The pattern of ethnic marriage is different among women in the high and low-class parts of Hamadan province.The importance of marriage criteria is different for women in the high and low-class parts of Hamadan province.The age pattern of the marriage of married women in the high and low-class parts of Hamadan province is related to their ethnicity.The standards of marriage for married women in the high and low-class parts of Hamadan province are related to their ethnicity. Discussion of Results and Conclusions:According to the data obtained, the highest percentage of marriage age belonged to the age group of 16 to 25 years. The average age of marriage was 18-20 years in the low-class regions of the city and 25.5 years in the high-class regions. The results of the t-test showed that there was a significant difference between the mean age of marriage between members of the high and low-class parts of the city. Statistical data showed that there was no statistically significant difference between high and low women in Hamadan province in terms of family relationship with the husband. The chi-square test was used to examine the relationship between couples’ ethnic compatibility and residential areas. The test result was significant. This difference was large in the low-class parts of the city and the proportion of adaptation to ethnic non-conformity was 75 to 25 percent. Women living in the low-class parts of the city assigned more importance to the appearance criteria in marriage than women in the high-class parts. However, regarding the economic criteria, the people of high-class parts of the city assigned more importance to this issue. This showed that the economic view of the issue of marriage was more prevalent among women in this region. Accordingly, spatial and class differences were symmetrical. In other words, the high-classes paid more attention to economic criteria while the low-classes paid more attention to the appearance criteria in marriage.The findings of this study showed that some social dimensions of marriage were affected by the place where the person was economically and socially different from others. For example, the age of marriage in the low-class parts of the city was less than the high ones. This showed that there was a difference in attitude in the views of the high and low-class peoples of Hamadan province in terms of the suitable marriage time. The premarital relationship was not different between these two regions with different class structures and seemed to follow a similar and general pattern, not dependent on the region. The premarital relationship was possibly influenced by the currents of modernity and globalization and the like. People living in the low-class parts of the city were more in line with the couples’ patterns of kinship and ethnicity.

Expecting a family is an important component and a great goal for better quality of life for most of adults with β-thalassemia major. The aim of the present study was to examine the marital status of adults with β-thalassemia major. This cross-sectional study examined the marital status of patients with transfusion-dependent β-thalassemia aged over 15years. Patients' demographic characteristics including age, gender, marital status, duration of marriage, divorce, having or not having children and spouse's health status were recorded. Information about the disease including cardiac and endocrine complications, ferritin level, splenectomy and viral hepatitis were also recorded. Of 228 patients with transfusion-dependent β-thalassemia major aged over 15years who were treated at this medical center, 32 (14%) were married. The mean age of married patients was 25.18±4.74years. Among the married patients, 8 (25%) were females and 24 (75%) patients were males. The mean age of marriage was 22.76±4.16years. The minimum and maximum marriage age was 15 and 33years, respectively. The median duration of marriage was one year with the range from 3months to 11years. Only 8 (25%) patients (one female and seven males) had children. Therapeutic advances have led to significantly increased survival and improved quality of life and fertility of patients with β-thalassemia major. According to the results, 14% of patients over 15years were married which was slightly higher as compared with other similar studies.

In contrast to the setting of Love in the Time of Cholera by Gabriel Garcia Marquez, we live in a time when no one should have to contract or die of cholera. Nonetheless, ≈100,000 persons in Africa contracted cholera in 2011 alone, and >2,500 died in what Mintz and Guerrant have referred to as an “unconscionable tragedy” (1). In Africa in the Time of Cholera, Echenberg chronicles how, within a century, cholera has been transformed from an imported scourge to an African disease. Echenberg sets the stage with a concise historical overview, depicting the eventual triumph over cholera in most of the world as a technological conquest over the original technological advances that created pandemic cholera. The first part of the book, devoted to the first 6 pandemics, is a lucid account of cholera in Africa before the 1950s. It includes some lesser known facets of cholera history, such as James Christie’s excellent mid-19th century epidemiologic work in Zanzibar and the political consequences of that period’s cholera outbreaks in Tunisia. The second part, which covers the current and 7th cholera pandemic, begins with an overview of medical advances that have yielded today’s intervention tools. The section unfortunately includes a smattering of scientific inaccuracies, mostly related to the cell biology of Vibrio cholerae, in an otherwise well-researched and accessible book. Drawing from biomedical as well as historical sources, Echenberg demonstrates how the failure to provide clean water and sanitation to most of Africa’s inhabitants has led to explosive human and financial costs from cholera. He sketches portraits of these failures in countries with different histories and governance problems, illustrating infrastructural setbacks that have enabled cholera to erupt in present day Angola, South Africa, Senegal, and Zimbabwe. The book highlights the success of oral rehydration therapy for cholera case management, and the futility of antimicrobial drug strategies because of drug resistance. Echenberg touches on the potential for vaccines, with appropriate caution, emphasizing that vaccination is no substitute for plumbing. Unfortunately, vaccines are often presented in a manner that entangles their weaknesses with those of antimicrobial drugs, underplaying the potential advantages that vaccines may have over drugs in dealing with outbreaks once they occur. It has taken cholera experts decades to advocate for vaccine use in high risk settings, culminating in World Health Assembly resolution WHA64.15 in May 2011, which urges that all states “give consideration to the administration of vaccines, where appropriate, in conjunction with other recommended prevention and control methods and not as a substitute for such methods.” The most compelling arguments for vaccine use in conjunction with preventive interventions were published just as the book was being completed (2), and it is unfortunate that they were not included in this otherwise commendable analysis of intervention possibilities. However, Echenberg is to be commended for the strength of the key message of the book: that lack of potable water and sanitation, the factors that eliminated cholera from much of the world, is the principal reason why today’s cholera crisis (excluding complex emergencies, perhaps typified by the ongoing epidemic in Haiti) is largely African. The story of cholera in Africa is long overdue and timely. In his usual engaging and accessible style, Echenberg has written another book that infectious disease experts should read for historical and social perspectives on the diseases they investigate and treat.

The period between 1966 and 1996 was a period of great change for society in Australia. Two particular aspects of that change have been highlighted in this study. It will examine the changing patterns of attendance at religious services and religious affiliation over this time period. In particular it examines the connection of attendance and belief patterns, which have changed during this period, with particular reference to Christian religious groups. By examining data from each of the Censuses in the period between 1966 and 1996 it was possible to note three fundamental changes in the patterns of religious affiliation. The first was the movement away from patterns of Christian affiliation to no religious affiliation. The second was the shift of migration patterns which drew substantially from Europe in the period prior to 1971 to a pattern with higher levels of migration from Asia and Oceania. The third saw a decline in Christian affiliation among the 15-24 age group. After analysing this affiliation data a weekly average religious attendance measure was composed to compare data from each of the social science surveys. This made it possible to examine generational trends by age and sex which resulted from changing patterns of affiliation, immigration, stability of residence and marital status Also a case study of the Canberra parishes in the Catholic Archdiocese of Canberra and Goulburn was undertaken to examine the particular impact that these changes had on a particular religious grouping. In studying these indicators it is believed that the change in patterns of Australian religious attendance and affiliation while influenced by life course events has also been substantially affected by issues of generational change. These changes

Obesity rates have been rising over the past decade. As more people become obese, the social stigma of obesity may be reduced. Marriage has typically been used as a positive signal to employers. If obese individuals possess other characteristics that are valued in the labour market they may no longer face a wage penalty for their physical appearance. This paper investigates the relationship between marital status, body mass index (BMI), and wages by estimating a double selection model that controls for selection into the labour and marriage markets using waves 14 and 16 (2004 and 2006) of the British Household Panel Survey. Results suggest that unobserved characteristics related to marriage and labour market participation are causing an upward bias on the BMI coefficients. The BMI coefficient is positive and significant for married men only in the double selection model. The findings provide evidence that unobserved characteristics related to success in the marriage and labour market may influence the relationship between BMI and wages.

Marriage has a prominent place in criminological theory and research as one institution that has the potential to genuinely foster desistance from a criminal career. Mass imprisonment policies in the United States and elsewhere, therefore, pose a potential threat of increased crime if they impede the ability of ex-prisoners to reintegrate into society by stigmatizing them and limiting their chances in the marriage market. We use a long-term study of a conviction cohort in The Netherlands to ascertain the effect that first-time imprisonment has on the likelihood of marriage and divorce. The results suggest that the effect of imprisonment on the likelihood of marriage (among unmarried offenders) is largely a selection artifact, although there is very weak evidence for a short-lived impact that does not persist past the first year post-release. This is interpreted as a residual incapacitation effect. On the other hand, the results strongly suggest that the experience of incarceration leads to a substantially higher divorce risk among offenders who are married when they enter prison.

Objective: To evaluate the characteristics of men who support their partners in getting the HPV vaccine. Material And Methods: All married women (< 26 years) who were admitted to the gynecology outpatient clinic and their husbands were evaluated for participation in the study. Patients’ and all characteristics of male partners were recorded. All male participants answered a survey form including ten statements about HPV and HPV vaccination. Male participants were divided into two groups according to their support or lack of support for HPV vaccination of their wife. Results: In total, 92 men supported HPV vaccination for their partners and 144 men opposed HPV vaccination (support rate: 39%). The mean marriage age, education status and monthly income were significantly higher in favor of men who support HPV vaccination for their wives. The rate of those who stated they were religious was significantly higher in the anti-vaccine group. Safety concerns about vaccine (27.8%), cost of vaccine (26.4%) and belief about HPV vaccine effectiveness (26.4%) were most common reasons for opposing HPV vaccination. Multivariate regression analysis revealed marriage age ≥25 years, education level of high school and university, higher monthly income and not self-identification as religious increased the HPV vaccine support rate. Conclusion: The present study found that men with higher marriage age, higher educational level, higher monthly income, and higher score on the HPV survey were significantly more supportive of their spouses getting the HPV vaccination. In contrast, men who identified themselves as religious had significantly less support for their wife being vaccinated. Keywords: vaccine, immunity, genital wart, human papilloma virus, cervical cancer