Biochemical and palaeopathological investigations on weaning and infant mortality in the early Middle Ages

Weaning age of the children of the early medieval population at Wenigumstadt (Ldkr. Aschaffenburg, southern Germany, 500-700 AD) was estimated by stable nitrogen isotope analysis of bone collagen. The onset of weaning was by one year of age, when solid vegetal food subsequently replaced breast milk. In total, the change from mother's milk to solid adult food took about three years, the infants being fully weaned at this age. While the growing infant was sufficiently supported in utero and during the first months of life, the weanling's diet was insufficient for further growth and development. Starting with about 18 months of age, more and more symptoms of malnutrition are detectable on the skeletal remains, and the peak of both morbidity and mortality is reached at four years of age. Especially unspecific stress markers like Harris' lines and enamel hypoplasia clearly indicate the infants' risk of falling ill or die between three and four years of age. Malnutrition weakens the immune response, therefore the majority of inflammations detectable on the skeleton are found among the inadequately nourished children. The assumption that weaning is responsible for pathological skeletal lesions and early death in history is thus supported by archaeometry.     

Causes of infant mortality in the Middle Ages revealed by chemical and palaeopathological analyses of skeletal remains

In most prehistoric and historic populations, mortality of small infants is very high. Causes of death are mainly discussed in analogy to the situation in modern preindustrial societies. The children are at high risk to fall ill or even die especially in times of weaning. Trace element analysis of the skeletal remains of small infants excavated in Schleswig (northern Germany, 11th/12th century AD) led to the estimation of weaning age as well as to the reconstruction of a stepwise substitution of mothers' milk by other food items. Subsequent palaeopathological analysis confirmed high mortality in this age-group. Thus, causes of death of small infants in a medieval town can be outlined.     

Sleepwalking, Violence and Desire in the Middle Ages

This study discusses the phenomenon of medieval sleepwalking as a disorder of body and soul. In the thirteenth and early fourteenth centuries, medical and natural philosophical writers began to identify the category of the sleepwalker with unusual precision: the most common example of the disorder involved an aristocrat who rose, armed himself, and mounted his horse, all the while imagining that he was fighting enemies or hunting deer. Explanations for this extraordinary behaviour involved the physiology of sleep and the functioning of the brain. In particular, theorists believed that the imagination, a storehouse of images located towards the front of the brain, took control because reason and sensation had been disabled during sleep. As a consequence, daytime fears and traumas could come to the fore for some sleepers, causing them to act and react in their sleep in ways they could not, or were not willing to do, in their waking, rational state. As such, medieval medical writers viewed sleepwalking as a dangerous, disordered state which called into question the Aristotelian divide between waking and sleeping as well as the categories of reason, sensation and voluntary motion.     

A case of acromegaly in the Middle Ages

A case of acromegaly in a male individual aged about 30 years, who lived in the area of Central Balkans in the 14th or 15th century will be described here. This individual is from an archeological site named Przine near Gacko, Bosnia and Herzegovina. The diagnosis is based on pathological changes of the skull and the postcranial skeleton. By radiological analysis it could be observed that the Sella turcica does not show any change. Furthermore, the individual under study is not conspicuous by giant growth. This case of acromegaly is the oldest one found in the Balkan area.     

Observations on recent increase in mortality from asthma.

The mortality attributed to asthma has increased annually in England and Wales from 1960 to 1965. The increase is more pronounced at ages 5 to 34 years than at older ages and is most pronounced at ages 10 to 14 years. In this last age group the mortality increased nearly eight times in seven years, and in 1966 asthma accounted for 7% of all deaths. No comparable increase has been observed in any other country, but smaller increases at ages 10 to 19 years have been observed in Australasia, Japan, western Europe, and the United States. There is no evidence to suggest that there has been any change in diagnostic habits, certification of deaths, or methods of classification which could account for the increase in Great Britain, and it is concluded that the increase is real. General practitioners'' records provide no evidence of an increase in prevalence and it seems probable that there has been an increase in case fatality. No environmental hazards are known which could have increased the severity of the disease, and the possibility has to be considered that the increase may be due to new methods of treatment. Corticosteroids have been used increasingly since 1952, and in Great Britain the use of pressurized aerosols containing sympathomimetics has increased rapidly since 1960.     

Infant and child mortality in rural Egypt.

This research examines determinants of infant and child mortality in rural Egypt, primarily the effects of household economic status and the availability of health services. Certain features of the health service environment affect survival in the neonatal period. In early childhood, survival chances improve markedly as income increases and if the household depends almost exclusively on employment income. In infancy and in early childhood, mortality is strongly associated with region of residence and maternal demographic characteristics, and is weakly associated with parental schooling.     

Determinants of child mortality in south-west Uganda.

Anthropometric and sociodemographic variables were taken from 4320 children in a baseline survey carried out in March-April 1988 in the district of Mbarara, south-west Uganda. After 12 months a follow-up survey assessed the mortality of the children during the preceding year. Lack of ownership of cattle, recent arrival in the village, using candles for lighting, being of birth order higher than 5 and having a father with less than 8 years of schooling were significantly associated with child mortality. The addition of mid-upper arm circumference significantly improved the logistic model of socioeconomic variables and mortality and did not diminish the predictive power of socioeconomic variables in relation to increased mortality. This suggests that nutritional status and specific socioeconomic factors are both, independently, important predictors of child mortality.     

Tulips: An Ornamental Crop in the Andalusian Middle Ages

Tulips: An Ornamental Crop in the Andalusian Middle Ages. The authors are working on the project “Crop Flora of al-Andalus,” which aims to recover the crop diversity of the Middle Ages in western Europe during the Islamic period. The documental sources of this study are all the agricultural treatises written in this territory and culture between the 10th and 14th centuries. Al-Andalus was the territory occupied by Islam between the 8th and 15th centuries, varying over time on varying regions on the Iberian Peninsula. In this period, a genuine agricultural revolution took place, as well as the incorporation into the Western world of many Eastern agricultural species. When we focused on the study of ornamental species used in gardens, courtyards, and houses, tulips could be identified in several texts, the main one being the ‘Umda, a botanical work written at the end of the 11th century or beginning of the 12th, probably by the agronomist Abu l-Jayr. Tulips are mentioned in this text 500 years before the first known references to their introduction into Europe, traditionally asserted to be from the Ottoman Empire to Holland via Austria, always in the 16th century. Thus the route of these ornamental bulbs in their passage from East to West must be modified.     

Infant and child mortality in Bangladesh

Socioeconomic differences and trends in infant and child mortality in Bangladesh are examined using data from the 1975 World Fertility Survey and 1979 Contraceptive Prevalence Survery. There is evidence of some recent decline in infant mortality and child mortality. Logit analysis of infant and child mortality indicates that sociodemographic variables such as mother's education, recent period, or higher birth orders, has significant independent effects upon the reduction of infant and child mortality. Other variables such as fetal loss, father's education, or land ownership had no consistent significant effect. On the other hand the effect of urban residence on infant and child mortality was positive after the control of sociodemographic variables. Mere concentration on the supply of modern medical services may bring limited returns unless they are reinforced by appropriate social changes, in particular those affecting the socioeconomic status of women. Educated mothers are likely to belong to higher income households, have better knowledge of how to care for children, and can bring more resources to the care of a sick child.     

Birth spacing and child mortality in a Caribbean population.

Ten independent variables were used to predict death before the first birthday for 4411 births that took place from 1878 to 1976 to 978 women of native ancestry on the island of St. Barthélemy. Significant predictors of death include the death of the mother within a year, the birth year, multiple birth, whether the preceding child also died before 1 year of age, and whether the next child was conceived before the index child was 1 year old. Unlike most prior studies, birth-spacing variables were only weakly related to death in the first year. The relative absence of contraceptive techniques to control birth spacing in the study population and the use of vital records rather than survey data distinguish this project from others and may account at least partly for the unusual findings.     

Observations on the history of Dutch physical stature from the late-Middle Ages to the present

In the late-Middle Ages and at the onset of the early modern period, the Dutch population was taller than in the first half of the 19th century. This inference is partially based on skeletal evidence, mainly collected by the Dutch physical anthropologist George Maat and his co-workers. A spectacular increase in Dutch heights began in the second half of the 19th century and accelerated in the second half of the 20th century. At the end of the 20th century, the Dutch became tallest in the world.     

Realities for change in child health care: existing patterns and future possibilities.

In assessing some of the existing patterns and future possibilities in child health care it was found that the continuing large social class differences in morbidity and mortality may be attributed to continued poverty, both of income and therefore of diet, and also to environmental deprivation. The absence of safe places for children to play, for example, is related to the high accident rates experienced by children. Doctors admit to awareness of these social and environmental causes of unnecessary morbidity and mortality among children but have failed to address the causes directly. While the causes are outside the immediate professional provenance of doctors, it is argued that, aware as they are of this aetiology, they have a moral and professional responsibility to act collectively as a pressure group urging improvements on the relevant authorities (as they have done in the case of smoking and clean air, for example).     

Housing quality and child mortality in the rural Philippines

Factors influencing child survival to age 5 are investigated for a rural sample in lloilo Province, Philippines. Considered are construction materials in walls, doors, windows, and floors and the typpes of toilet facilities. 707 women were asked how many children they had borne alive; the sexes and dates of each live birth; whether each child was still living; and if not at what age the child had died. This study focused retrospectively on mortality among 2359 children born between 1960 and 1973. About 4.9% had died before age 5. This is 1/2 of what was observed nationally for rural children in the 1978 fertility survey. Health conditions in rural Iloilo Province may have been more favorable than in other rural parts of the nation. Income generated from shipping, lumbering, and fish culture may have also contributed to the lower rate of child mortality observed in this sample. The sex ratio of the children was 102, well within the range regarded as typical. A logit regression was employed. Of the 207 girls with low demographic risk and worse quality housing, 249 were estimated to survive to age 5 and 18 to die before age 5. Sex was not an important factor in child mortality. Boys and girls had about equal chances of surviving. A social-demographic risk factor commonly linked with infant mortality is breast feeding. Breastfed infants from a number of developing countries have had lower rates of infant mortality. A slightly larger % of nonbreastfed children (96.9%) survived to age 5 than did breastfed children. Living in a poorly constructed dwelling reduced the odds of a child's survival. Estimates from the Brass method showed that the expected probability of children dying before age 5 was .073 and .035, representing life expectancies at birth of 63.4 and 69.9 years.     

Parental education and child mortality in Burundi

This paper examines the relationship between parental education and child mortality in Burundi using data collected in the 1987 Demographic and Health Survey. Proportional hazards models are estimated to examine this relationship, while holding constant other known child mortality determinants. Parental education proves to be a key factor in explaining differences in child mortality, the effect of maternal education being particularly strong compared to paternal education.     

Infant mortality and child health in Brazil

Child health is a central issue in the public policy agenda of developing countries. Several policies aimed at improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have triggered a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high compared to international standards. Moreover, there is considerable imbalance across Brazilian municipalities suggesting that various policies should be adopted. We investigate the determinants of infant mortality at the municipal level and provide an analysis of the factors affecting child health at the individual level. To analyze the mortality rate, we estimate static and dynamic panel data models using four censuses covering the period from 1970 to 2000. The demand for child health, on the other hand, is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results obtained indicate that a rise in sanitation, education and per capita income contributed to the decline of infant mortality in Brazil, with stronger impacts in the long run than in the short run. The fixed effects associated with county characteristics explain the observed dispersion in child mortality rates. The results from the decision model are confirmed by the findings of the mortality model: education, sanitation and poverty are the most important causes of poor child health in Brazil.