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Biomedical subjects

J Knodel

Publications and source records attributed to J Knodel.

At least 19 recordsLinked to original sources
PubMed2001

Older people and AIDS: quantitative evidence of the impact in Thailand.

Discussions of the AIDS epidemic rarely consider the impact on older people except as infected persons. Virtually no systematic quantitative assessments exist of the involvement of parents or other older generation relatives in the living and caretaking arrangements of persons with AIDS in either the West or the developing world. We assess the extent of such types of involvement in Thailand, a country where substantial proportions of elderly parents depend on adult children for support and where co-residence with an adult child is common. Interviews with local key informants in the public health system in rural and urban communities provided quantitative information on a total of 963 adult cases who either had died of AIDS or were currently symptomatic. The results indicate that a substantial proportion of persons with AIDS move back to their communities of origin at some stage of the illness. Two-thirds of the adults who died of an AIDS-related disease either lived with or adjacent to a parent by the terminal stage of illness and a parent, usually the mother, acted as a main caregiver for about half. For 70%, either a parent or other older generation relative provided at least some care. The vast majority of the parents were aged 50 or more and many were aged 60 or older. This extent of older generation involvement appears to be far greater than in Western countries such as the US. We interpret the difference as reflecting the contrasting epidemiological and socio-cultural situations in Thailand and the West. The fact that older people in Thailand, and probably many other developing countries, are extensively impacted by the AIDS epidemic through their involvement with their infected adult children has important implications for public health programs that address caretaker education and social and economic support.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Can prostitutes marry? Thai attitudes toward female sex workers.

This study explores popular attitudes towards female sex workers in Thailand by examining the general public's perceptions of a prostitute's ability to marry based on focus group data. The tentative conclusion emerging from our findings that the general public believes sex workers can marry is that a relative lack of severe or lasting social stigma is an important part of a Thai context that facilitates recruitment into prostitution and permits it to persist on a widespread scale. We interpret this conclusion in terms of the broader value system in Thai society. Although our findings are implicitly comparative in nature, a lack of comparable information from other countries on how those who provide commercial sex are viewed by the general population prevents a more definitive conclusion. There is an obvious need for research on this topic as well as on how sex workers view themselves, and how this translates into actual behavior. Data set used: focus group transcripts from the project "The influence of primary female partners and male peers on male extramarital sexual behavior in Thailand".

Adult↗
PubMed1998

In the company of friends: peer influence on Thai male extramarital sex.

We explore some of the key social dynamics underlying patterns of male extramarital heterosexual behavior in Thailand. We analyze transcripts of focus group discussions and focused individual interviews conducted during 1993 and 1994 with married men and women living in both urban and rural areas of central Thailand. We discern several pathways of peer influence on extramarital commercial sex patronage that are common across our sites and interpret these peer effects in light of contemporary theories of social influence and sexual behavior.

Alcohol Drinking↗
PubMed1998

Family size and children's education in Vietnam.

Data from the nationally representative 1994 Inter-Censal Demographic Survey are used to examine the association between family size and children's schooling in Vietnam. The data provide information on several education measures for all children over age 10, including children no longer residing in the household. Although a clear inverse bivariate association between family size and children's school attendance and educational attainment is evident, multivariate analysis controlling for urban/rural residence, region, parents' education, household wealth, and child's age, reveals that much of this association, especially that predicting educational attainment, is attributable to these other influences. Moreover, much of the effect that remains after statistical adjustment for the other influences is seen mainly at the largest family sizes. We consider the implications of these findings for current population policy in Vietnam and the possible features of the Vietnamese context that might account for the modest association.

Adolescent↗
PubMed1991

Birth spacing and infant mortality: evidence for eighteenth and nineteenth century German villages.

Data from an historical population in which fertility control was minimal and modern health services were mostly unavailable are used to show that there appears to have been a strong association between previous birth interval length and infant mortality, especially when the previous child survived. Although only imperfect proxies for breast-feeding practices and other potentially confounding factors are available for this population, the results suggest that the association between previous interval length and infant mortality in this population is not solely, or primarily, a function of differences in breast-feeding behaviour or socioeconomic status. Other factors, e.g. maternal depletion or sibling competition, are more likely to explain the observed association.

Birth Intervals↗
PubMed1991

Family size and children's education in Thailand: evidence from a national sample.

Analysis of a large, nationally representative survey shows that family size exerts a substantial negative influence on the probability that a child will attend secondary school in Thailand. The primary mechanism underlying this effect is most likely the dilution of familial resources available per child associated with larger numbers of children. The extent and the level of schooling at which this effect operates vary with the household level of wealth and with rural or urban residence. Because fertility decline is leading to a major increase in the proportion of children who come from small families, falling birth rates contribute to increasing educational attainment in Thailand.

Adolescent↗
PubMed1987

Starting, stopping, and spacing during the early stages of fertility transition: the experience of German village populations in the 18th and 19th centuries.

Examination of the reproductive histories of a sample of German married couples during the 18th and 19th centuries provides insights into behavioral changes involved in the shift from natural fertility to deliberate marital fertility control. A simple accounting scheme is used to assess the relative contributions of starting, spacing, and stopping to changes in family size during the initial phases of the fertility transition. The results suggest that in rural Germany, attempts to terminate childbearing prior to the end of the reproductive span were far more important in initiating the onset of fertility transition than efforts to deliberately prolong intervals between births or changes in the timing of the start of childbearing.

Adult↗
PubMed1984

Effects of birth rank, maternal age, birth interval, and sibship size on infant and child mortality: evidence from 18th and 19th century reproductive histories.

There has been long-standing interest in the effects of maternal age, birth rank, and birth spacing on infant and child mortality. Contradictory inferences about the role of these factors have arisen on occasion because of the absence of adequate controls, the use of cross-sectional or incomplete reproductive histories, and inattention to the effect of family size goals and birth limitation practices. This study analyzes completed reproductive histories for German village populations in the 18th and 19th centuries, a period when deliberate fertility control was largely absent. Our results confirm previous studies of the association of infant mortality with maternal age, although in the present data these differentials are largely limited to neonatal mortality. They also confirm the importance of birth interval as a factor in infant mortality. Sibship size is positively related to infant mortality even when birth rank is controlled. However, once sibship size is controlled, there are no systematic differences in infant and child mortality by birth order. The mechanisms relating sibship size and mortality are explored.

Adult↗
PubMed1979

From natural fertility to family limitation: the onset of fertility transition in a sample of German villages.

Utilizing data from a sample of German village genealogies, it is possible to document the changes in reproductive patterns on the family level that started to take place in Germany during the nineteenth century and formed the basis for the secular decline in fertility which eventually encompassed the entire country. One striking finding from this study was the substantial diversity among the small sample of villages in terms of the timing of the emergence of family limitation. While couples in all villages who married during the last half of the eighteenth century appeared to be characterized predominantly by natural fertility the emergence of family limitation began as early as the turn of the nineteenth century in some places and as late as the end of the nineteenth century in others. Occupational differentials with respect to family limitation were also examined. There is little evidence that changes in birth spacing played an important part in the initial phase of the fertility trnsition. Rather, the underlying process appears to involve a change from fertility patterns that were characterized by the absence of parity-dependent control to one in which attempts to terminate childbearing in response to the number of children already born becomes widespread.

Age Factors↗
PubMed1977

Breast-feeding and population growth.

Abandonment of breast-feeding in parts of the world where contraception is not in common use may mean both higher birthrates and, especially among the poor, higher infant death rates. In this article estimates of the magnitude of these effects are made.

Amenorrhea↗
PubMed1977

Response reliability in a longitudinal survey in Thailand.

The two rounds of the National Longitudinal Study in Thailand provide a useful opportunity to explore response reliability in a large-scale social and demographic survey in a developing country. The results indicate that nonrandom reliability at the individual level ranged from quite high (for several straightforward, facual questions) to quite low (for most attitudinal questions). There was considerable distributional stability, however, even for many of the variables with low individual-level reliability. In terms of its response reliability, the Thai study compares reasonably well with several leading US fertility surveys. However, in both countries response reliability at the individual level for attitudinal questions is distressingly low. This clearly should be a matter of major concern for social scientists using survey results.

Demography↗
PubMed1977

The impact of breast feeding patterns on the biometric analysis of infant mortality.

A major assumption of the biometric analysis of infant mortality as developed by Bourgeois-Pichat is that the age structure of infant deaths after the first month of life is virtually constant across time and cultures. Reanalysis of results from studies which compare the mortality of infants according to the type of feeding indicated that the relationship between mortality and age within the first year of life followed different patterns for breast fed and artificially fed infants. Historical data for populations with different breast feeding customs reveal similar differences in the age pattern of infant mortality. In populations where breast feeding was uncommon or of very short duration, infant mortality rises particularly steeply during the early months of the first year of life. The age structure of infant mortality in less developed countries where breast feeding is decreasing rapidly may bsimilarly affected. When substantial deviations from the linear relationship are evident, particular caution is required in applying the biometric technique, since in such situations the estimated endogenous mortality is very much affected by the particular set of data points within the first year of life which are chosen for the basis of the estimates.

Age Factors↗