DOCSLIB.ORG

An Intellectual Odyssey

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
An Intellectual Odyssey "Malnutrition": An Intellectual Odyssey David Seckler When President Young asked me to "malnutrition". Under one criterion proper address this meeting of the Western Agricul- nutrition is defined as sufficient intake of tural Economics Association on my work in nutrients to reach the full genetic growth nutrition policy I gladly accepted for I have potential of the individual defined by various been spending most of my time talking to anthropometric and nutritional standards. nutritionists about these problems and Malnutrition then becomes abnormally low perhaps not enough time talking to my fellow size and/or consumption. Under the second agricultural economists. I say this not only criterion, malnutrition is defined in terms of because of the obvious connection between certain clinical signs of nutritional inadequa- nutrition, food policy and agriculture but cy and/or indices of functional impairment, because of a discovery, in my opinion, of such as the inability to work productively. considerable consequence. This discovery is Proper nutrition then presumably becomes that the concept of "malnutrition" cannot be the absence of these clinical-functional signs comprehended except in terms of the eco- of malnutrition. The problem is that most of nomic theory of optimality. the people who are not "properly nourished" In order to understand what I mean by this under the first criterion are also not "mal- statement it is first necessary to understand nourished" under the second criterion! "malnutrition" is an extremely ambiguous There exists a considerable "grey area", word. The Random House Dictionary, for consisting of perhaps as much as 80% or more example, defines "malnutrition" as "lack of of the conventionally estimated world of proper nutrition." Since "proper nutrition" is malnutrition, who are neither "properly not defined, one must simply assume that it nourished" nor "malnourished". They are is "lack of malnutrition". As Ford observes, simply "Small but Healthy" people who have "The term 'malnutrition' has been in use for a very attaind an optimum size with respect to their long time and appears to be self-explanatory but environment. even the briefest perusal of the vast literature on In the course of the following discussion I nutrition raises grave doubt about that. There is no would like to describe how I arrived at this has the same signifi- way of knowing if the word - my "Intellectual Odyssey," as I cance in all parts of the world or if its interpreta- conclusion tion lies, like beauty, in the eyes of the behol- have called it. I have chosen this mode of der ..... Anything less scientific than this chaotic presentation primarily because it appears to inexactitude would be difficult to imagine." me to present the most convenient format for The problem is that there are two quite reducing a rather lengthy research effort to a different criteria of "proper nutrition" and short discussion; but also, because I am interested in the philosophy of science, and I David Seckler is Professor in the Department of Eco- have personally found the process of"conjec- nomics at Colorado State University on assignment to ture and refutation", as Karl R. Popper Ford Foundation in New Delhi, India. describes it, over these past three years one of the most exciting intellectual episodes of Appreciation is expressed to P. V. Sukhatme and Shel- don Margen for their gracious help and encouragement my life. Thus I will speak some of my in this odyssey although they are not, of course, personal experience and to those who think responsible for any of the views expressed here. this has no place in academe I can do no 219 December 1980 Western Journal of Agricultural Economics better than cite our colleague William Foltz still in this most fascinating field of nutrition. who once said in introducing his remarks on a I estimated that a representative house- paper he was about to review, "Gentlemen, I hold of Indian agricultural laborers consisting apologize for citing my personal experience of 5.33 people would generate about 776 days - but, Gentlemen, it is the only experience of work per year under full employment I have had." [Seckler]. In order to meet their energy requirements at this level of work they would require about 4,245,000 kcal. per year - or, Nutritional "Requirements" at 3,150 kcal. per kg. of wheat, about 1,350 My interest in nutrition began in the kg. of wheat per year. The poor Indian summer of 1977 when I was in India on a household spends about 60% of its income on short-term consulting assignment to the Cen- foodgrains, 20% on other food items, and tral Soil and Water Research Conservation 20% on non-food necessities such as clothing, and Training Institute, Dehra Dun. The shelter and fuel. Thus to meet all necessities or assignment, I thought, was quite simple: to it must earn about 2,000 kg. of wheat the do economic evaluations of various projects equivalent per year. At full employment, of the Institute in rather remote and isolated daily minimum foodgrain wage would be 2.6 areas of India, particularly in the "hill areas" kg. Assuming men earn 20% more than would of the Himalayas. women, the minimum male wage rate The specific problem I encountered was be 2.9 kg. of foodgrain. I later found that this to that in the highly underemployed and pover- estimate corresponds remarkably close ty stricken area of the hills - and, I later Clarke and Haswell's survey of agricultural economies. They found, generally throughout India - people wage rates in subsistence that, would not work for less than about Rs.5 (or observed, "... the strange fact... times and places for which we 60¢) per day. I thought it peculiar that people throughout all appeared to be willing to starve rather than have information, the rural laborer, however less than work for this, under Indian conditions, not poor, will not do a day's work for inconsiderable wage. The fact of this wage three kilograms grain equivalent." floor was of course of considerable impor- It is difficult to convert this minimum tance to my evaluations because while it is foodgrain wage to monetary terms without conventionally assumed that the shadow detailed knowledge of local diets and costs of price of labor under conditions of unemploy- foodgrains and other necessities. However, ment is zero, or near zero, this fact seemed to following Dandekar and Rath's estimates for me to indicate that there was a real cost of rural India 1969-1970 and adjusting for infla- labor keeping this wage floor in place. Let tion to 1977 I found that the Rs.5 figure was me say at the outset that I do not believe that perhaps as close as one could conceivably "culture" or "work-leisure" preferences are get. I concluded that the energy-work con- very relevant in this domain of abject pover- nection is indeed decisive in setting such ty. Something more fundamental, I suspect- floors as I had observed. ed, was going on. The one snag in this conclusion was that It is clear that the physical energy expend- the Rs.5 figure was based on the assumption ed in physical work must be provided by the of a fully employed household. If unemploy- physical energy provided by food. Thus there ment existed in the extent of 20%, with only must be a fundamental connection between 600 days of work per year, the minimum earnings, which are used mainly to purchase daily wage would have to be about Rs.5.8 or food, and the energy requirements of the 16% more than the observed floor (the rela- work required to obtain earnings. I thought I tion is non-liner due to savings of calories and would spend a few days working this little other necessities in unemployment).l For problem out and here I am, three years later, reasons explained below, I later discovered 220 Seckler Malnutrition that I had overestimated kcal. requirements cle must soon end because the laborer "gets and thus, the Rs.5 figure was probably about sick". The body throws out a complex variety right with 20% unemployment. of defensive mechanisms: slowness, drow- From this point I naturally became inter- siness, lethargy, stumbling, and fainting ested in the mechanism through which this (quite a common sight in Indian fields)- apparently universal minimum foodgrain which causes the laborer to be dismissed. As wage would be established. The classical more of the laboring class is disabled by low theory of the subsistence wage immediately wages a labor shortage develops and wages comes to mind. But this theory is a long-run are restored to their energy equilibrium theory depending on the regulation of the level. Of course there is nothing above aggregate supply curve for labor through equilibrium in this model to stimulate a attrition of children and, while obviously true higher wage because once the laborer can as a long-run phenomena, it did not appear to purchase enough energy to do the work, the me to be adequate for the essentially short- marginal product of the energy-wage is zero. run, nearly day-to-day equilibrium which I This analysis seems to me to be perfectly seemed to detect in the case even of the satisfactory but it depends on one crucially individual household. important and, I find, entrancing assump- The answer to this problem is quite specif- tion. This assumption is that the wage- ic and direct in the nutritional literature. In earners in a household love their dependents the classic starvation studies of Keyes, there to the extent that they will, in a sense, is shown a very clear production function "irrationally" share their scarce food supplies between energy intake and work ability and with their dependents in proportion to their work performance.
Load more

Recommended publications
  • Abstracts from the 9Th Biennial Scientific Meeting of The
    International Journal of Pediatric Endocrinology 2017, 2017(Suppl 1):15 DOI 10.1186/s13633-017-0054-x MEETING ABSTRACTS Open Access Abstracts from the 9th Biennial Scientific Meeting of the Asia Pacific Paediatric Endocrine Society (APPES) and the 50th Annual Meeting of the Japanese Society for Pediatric Endocrinology (JSPE) Tokyo, Japan. 17-20 November 2016 Published: 28 Dec 2017 PS1 Heritable forms of primary bone fragility in children typically lead to Fat fate and disease - from science to global policy a clinical diagnosis of either osteogenesis imperfecta (OI) or juvenile Peter Gluckman osteoporosis (JO). OI is usually caused by dominant mutations affect- Office of Chief Science Advsor to the Prime Minister ing one of the two genes that code for two collagen type I, but a re- International Journal of Pediatric Endocrinology 2017, 2017(Suppl 1):PS1 cessive form of OI is present in 5-10% of individuals with a clinical diagnosis of OI. Most of the involved genes code for proteins that Attempts to deal with the obesity epidemic based solely on adult be- play a role in the processing of collagen type I protein (BMP1, havioural change have been rather disappointing. Indeed the evidence CREB3L1, CRTAP, LEPRE1, P4HB, PPIB, FKBP10, PLOD2, SERPINF1, that biological, developmental and contextual factors are operating SERPINH1, SEC24D, SPARC, from the earliest stages in development and indeed across generations TMEM38B), or interfere with osteoblast function (SP7, WNT1). Specific is compelling. The marked individual differences in the sensitivity to the phenotypes are caused by mutations in SERPINF1 (recessive OI type obesogenic environment need to be understood at both the individual VI), P4HB (Cole-Carpenter syndrome) and SEC24D (‘Cole-Carpenter and population level.
    [Show full text]
  • Random Coefficient Repeated Measures Models
    (Entry for Encyclopaedia of Biostatistics, Armitage, P., & Colton,T. (Eds.), 1998, Wiley.) Random coefficient repeated measures models by Harvey Goldstein Institute of Education London, WC1H 0AL [email protected] Introduction This section is concerned with modelling data where measurements of one or more attributes are repeated on the same set of individuals over time. Typical applications are to the modelling of anthropometric growth of children or animals. The model specification will be developed for the case where a single continuous measurement is made on several occasions for a sample. This will then be extended to consider the case of multiple measurements at each time point and mention will be made of extensions to latent variable models and to discrete response data. To begin with we look at the simple, restricted, data structure where there are a fixed number of measurement occasions and each individual has a measurement at each occasion. Multivariate models Consider the data matrix of responses Individual Occasion 1 Occasion 2 Occasion 3 Occasion 4 1 y11 y21 y31 y41 2 y12 y22 y32 y42 3 y13 y23 y33 y43 The first subscript refers to occasion and the second to individual. We assume multivariate normality and so for the response vector we have initially YN~(,)µ Σ (1) This constitutes a null model and in general we will wish to include further variables, notably age or time. Suppose we wish to express the response, say a weight measurement, as a linear function of time (t) measured at each occasion. We may then write =+β β +ε ytij01 j j ij ij (2) where we allow the intercept and average growth rate to vary across individuals.
    [Show full text]
  • Environmental Pollution in Urban Environments and Human Biology
    7 Aug 2003 8:27 AR AR196-AN32-06.tex AR196-AN32-06.sgm LaTeX2e(2002/01/18) P1: IKH 10.1146/annurev.anthro.32.061002.093218 Annu. Rev. Anthropol. 2003. 32:111–34 doi: 10.1146/annurev.anthro.32.061002.093218 Copyright c 2003 by Annual Reviews. All rights reserved First published online as a Review in Advance on June 4, 2003 ENVIRONMENTAL POLLUTION IN URBAN ENVIRONMENTS AND HUMAN BIOLOGY Lawrence M. Schell and Melinda Denham Department of Anthropology, University at Albany, State University of New York, 1400 Washington Ave., Albany, New York, 12222; email: [email protected], [email protected] Key Words growth, lead, noise, stress, urbanism ■ Abstract The biocultural approach of anthropologists is well suited to understand the interrelationship of urbanism and human biology. Urbanism is a social construction that has continuously changed and presented novel adaptive challenges to its residents. Urban living today involves several biological challenges, of which one is pollution. Using three different types of pollutants as examples, air pollution, lead, and noise, the impact of pollution on human biology (mortality, morbidity, reproduction, and develop- ment) can be seen. Chronic exposure to low levels of these pollutants has a small impact on the individual, but so many people are exposed to pollution that the effect species- wide is substantial. Also, disproportionate pollutant exposure by socioeconomically disadvantaged groups exacerbates risk of poor health and well being. URBANISM AND HUMAN BIOLOGY Urban growth began slowly several thousand years ago and has accelerated tremen- dously over the past 300 years. By 2006, half of the world’s population will be living in urban places (United Nations 1998).
    [Show full text]
  • The Psychological Burden of Short Stature
    European Journal of Endocrinology (2004) 151 S29–S33 ISSN 0804-4643 The psychological burden of short stature: evidence against Linda D Voss and David E Sandberg1,2 Department of Endocrinology and Metabolism, Peninsula Medical School, Plymouth, UK, 1Departments of Psychiatry and Pediatrics, University of Buffalo, The State University of New York and 2the Women and Children’s Hospital of Buffalo, Buffalo, New York, USA (Correspondence should be addressed to L D Voss, EarlyBird Research Centre, Child Health, Level 12, Derriford Hospital, Plymouth PL6 8DH, UK; Email: [email protected]) Abstract Short stature, per se, is clearly not a disease, but is commonly perceived to be associated with social and psychological disadvantage. The assumption, widely held by pediatricians that short children are likely to be significantly affected by their stature, has been founded largely on older, poorly designed clinic-based studies and laboratory investigations of beliefs about the association between stature and individual characteristics. In contrast, data from more recent and better designed clinic- and commu- nity-based studies show that, in terms of psychosocial functioning, individuals with short stature are largely indistinguishable from their peers, whether in childhood, adolescence or adulthood. Parents and children alike should be reassured by these findings. In the absence of clear pathology, physical or psychological, GH therapy for the short but otherwise normal child raises ethical concerns about so-called ‘cosmetic endocrinology’. European Journal of Endocrinology 151 S29–S33 Introduction that SS constitutes a psychosocial burden (8). This belief is widespread. In a recent survey, 56% of phys- Short stature (SS) may result from an idiopathic icians felt that height impaired emotional well-being deficiency in growth hormone (GH) or be a feature of in children below the 3rd centile (9).
    [Show full text]
  • Absolute Or Relative Measures of Height and Weight&Quest
    European Journal of Clinical Nutrition (2015) 69, 647–648 © 2015 Macmillan Publishers Limited All rights reserved 0954-3007/15 www.nature.com/ejcn EDITORIAL Absolute or relative measures of height and weight? An Editorial European Journal of Clinical Nutrition (2015) 69, 647–648; interpret all individual growth data in the light of one international doi:10.1038/ejcn.2015.70 growth standard? Indian newborns are light and short5 when compared with WHO standards. We are used to explain anthropometric birth data In this volume, Spiegler and coworkers present their work on very from India by unfavourable maternal conditions. But also Indian low-birth weight infants (VLBW), they analysed at what age infants born to modern upper class women are shorter and lighter parents start complementary food in these infants, they deter- than WHO standards, and do not reflect maternal wealth and mined risk factors for early introduction of complementary food caste (Table 1). and they analysed whether the age at introduction of comple- Khadilkar and Khadilkar6 state: ‘The disadvantage of using mentary food influences height or weight at two years of age. The charts such as these (WHO charts) is that they are likely to over study is an important contribution to infant nutrition. But there is diagnose underweight and stunting in a large number of more to the study: the study was performed at the crossroads apparently normal children in the developing countries such as between nutrition and auxology. India’. Not only wealthy Indian children are shorter and lighter Studying nutrition and nutritional intervention on growth than these standards.
    [Show full text]
  • UCLA Electronic Theses and Dissertations
    UCLA UCLA Electronic Theses and Dissertations Title Growing Taller, yet Falling Short: Policy, Health, and Living Standards in Brazil, 1850-1950. Permalink https://escholarship.org/uc/item/7nn3b9g6 Author Franken, Daniel W. Publication Date 2016 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California UNIVERSITY OF CALIFORNIA Los Angeles Growing Taller, yet Falling Short: Policy, Health, and Living Standards in Brazil, 1850-1950 A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in History by Daniel William Franken 2016 ! © Copyright by Daniel William Franken 2016 ABSTRACT OF THE DISSERTATION Growing Taller, yet Falling Short: Policy, Health, and Living Standards in Brazil, 1850-1950 by Daniel William Franken Doctor of Philosophy in History University of California, Los Angeles, 2016 Professor William R. Summerhill, Chair The emergence of regional inequities and the genesis of modern economic growth in Brazil have remained shrouded by a dearth of historical evidence. Although quantitative scholars have revealed the efficacy of the First Republic (1889-1930) in fomenting economic progress, the extent to which Brazil’s early economic growth fostered improvements in health remains unclear. My dissertation fills this void in scholarship by relying on hitherto untapped archival sources with data on human stature—a reliable metric for health and nutritional status. Heights offer an excellent source of knowledge regarding human development for Brazil in the 1850-1950 period—an era of deep social, political, and economic transformations. My analysis centers heavily on a large (n≈17,000), geographically- comprehensive series compiled from military inscription files, supplemented by an ancillary dataset drawn from passport records (n≈6,000).
    [Show full text]
  • Barry M. Popkin, Phd W
    Barry M. Popkin, PhD W. R. Kenan Jr. Distinguished Professor Department of Nutrition Gillings School of Global Public Health The University of North Carolina at Chapel Hill Home address: 104 Mill Run Dr. Chapel Hill, NC 27514-3134 Office Address: Carolina Population Center Campus Box 8120 137 E. Franklin St. Chapel Hill, NC 27516-3997 Phone: (919) 962-6139 Fax: (919) 966-9159/919-445-0740 Email: [email protected] Website: www.nutrans.org EDUCATION Ph.D., Cornell University, Agricultural Economics (1973-1974) M.S., University of Wisconsin, Economics (1968-1969) Other graduate work, University of Pennsylvania (1967-1968) B.S., University of Wisconsin, Honors in Economics (1962-1965, 1966-1967) Other undergraduate work, University of New Delhi (1965-1966) FIELDS OF INTEREST Program and policy research to arrest and prevent excessive energy imbalance and diabetes; The nutrition transition: patterns and Determinants of Dietary Trends and body composition trends (United States and many low- and middle-income countries); Obesity dynamics and their environmental causes; Dietary and physical activity patterns, trends and determinants; The creation of large-scale program and policy initiatives to address nutrition-related noncommunicable diseases. CURRENT POSITION Distinguished Professor, Department of Nutrition Fellow, Carolina Population Center Director, The Nutrition Transition Research Program Rev. January 2017 Adjunct Professor, Department of Economics Member, UNC Lineberger Comprehensive Cancer Center Editorial Board, PLOS Medicine, Economics and Human Biology, Appetite, Risk Management and Healthcare Policy, The Lancet Diabetes & Endocrinology, Lifestyle Medicine - Research, Prevention & Treatment of Noncommunicable Diseases SELECTED HONORS AND AWARDS (2016) World Obesity Federation Population Science & Public Health Award (2015) Chinese government’s first award for significant foreign contributions to Chinese Nutrition (2015) Conrad A.
    [Show full text]
  • Handbook of Behavior, Food and Nutrition Wwwwwwwwwwwwwww Victor R
    Handbook of Behavior, Food and Nutrition wwwwwwwwwwwwwww Victor R. Preedy x Ronald Ross Watson Colin R. Martin Editors Handbook of Behavior, Food and Nutrition Editors Prof. Victor R. Preedy Prof. Ronald Ross Watson King’s College London University of Arizona Department Nutrition & Dietetics Health Sciences Center 150 Stamford St. Department of Health Promotion Sciences London SE1 9NH 1295 N. Martin Ave. UK Tucson, AZ 85724-5155 USA Prof. Colin R. Martin University of the West of Scotland Ayr Campus KA8 0SR Ayr UK ISBN 978-0-387-92270-6 e-ISBN 978-0-387-92271-3 DOI 10.1007/978-0-387-92271-3 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011921927 © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made.
    [Show full text]
  • Astronomy and Astrophysics
    Academic and Professional Catalogue Academic and Professional Academic and Professional Publishing Catalogue New books and Journals ➤ See page 70 ➤ See page 77 ➤ See page 143 New books and Journals July 2004 – February 2005 2004 – February July New books and Journals ➤ See page 25 ➤ See page 2 ➤ See page 35 Cover image ➤ See page 61 ➤ See page 5 ➤ See page 71 Cambridge University Press The Edinburgh Building www.cambridge.org JULY 2004 – FEBRUARY 2005 Cambridge CB2 2RU, UK April 2004 2004/5 Highlights Customer Services Cambridge University Press Booksellers Bookshop For order processing and customer service, please contact: Cambridge University Press Bookshop UK International occupies the historic site of 1 Trinity Catherine Atkins Phone + 44 (0)1223 325566 Monica Stassen Phone + 44 (0)1223 325577 Street, Cambridge CB2 1SZ, where Fax + 44 (0)1223 325959 Fax + 44 (0)1223 325151 the complete range of titles is on sale. Email [email protected] Email [email protected] Bookshop Manager: Cathy Ashbee Libraries and Individuals Phone + 44 (0)1223 333333 Please order from your bookseller. In case of difficulty, contact Linda Hine Fax + 44 (0)1223 332954 Tel + 44 (0)1223 326050 Fax + 44 (0)1223 326111 Email [email protected] Email [email protected] ➤ Your telephone call may be monitored for training purposes. See page 137 Account-holding booksellers can order online at www.cambridge.org/booksellers ➤ See page 17 ➤ See page 74 Cambridge University Press Around the World ➤ See page 70 Cambridge University Press has offices, representatives and distributors in some 60 countries around the world; our publications are available through bookshops in virtually every country.
    [Show full text]
  • Prevention of Obesity on Primary Secondary And
    PREVENTION OF OBESITY ON PRIMARY, SECONDARY AND TERTIARY LEVELS OF CHILDREN' S HEALTH CARE Martin Bigec PditiiPediatrician Pediatric department, University Clinical Center Maribor XIV. Congress ISGA 2017, Buenos Aires, Argentina Slovenia XIV. Congress ISGA, Buenos Aires, Argentina Maribor is the second largest city in Slovenia area:147,5 km2 Waether: 20 0C, Wind SW at 11 km/h 35% humidity; 270 m altitude XIV. Congress ISGA, Buenos Aires, Argentina The hospital employs approximately 2800 staff members, 450 of whom are UNIVERSITY ppyhysicians and 1300 healthcare workers. MEDICAL The hospital is a 1266-bed facility. Approximately 60,000 patients are treated CENTER annually. More than 390,000 outpatients are treated at 270 different outpatient MARIBOR clinics. XIV. Congress ISGA, Buenos Aires, Argentina Obesity Obesity and complications of obesity in children and adolescents are one of the most important public health problems of the Republic of Slovenia. The National Institute of Public Health formed a Working Group where experts from various fields played an important role in the problem (doctors- pediatricians from all levels of treatment, nutritionists, psychologists, kinesiologists, IT professionals). A common denominator of the measures envisaged is that the healthcare system necessarily needs a digitized platform for the implementation of a successful preventive programs (1). 1. Working group National Institute of Public Health. Prevention of obesity and a healthy lifestyle of children and youth in Sloven ia. In the press. XIV. Congress ISGA, Buenos Aires, Argentina Obesity II PlllParallel to thesetting up of a digit a l pltflatform, it is also necessary to estblihtablish and adequately support (financially and HR) for multidisciplinary teams, which will treat children and adolescents with obesity and complications at the primary and secondary levels equally, and implement preventive programs of a healthy lifestyle.
    [Show full text]
  • Early- Life Adversity and Neurological Disease
    REVIEWS Early- life adversity and neurological disease: age- old questions and novel answers Annabel K. Short 1,2 and Tallie Z. Baram 1,2,3* Abstract | Neurological illnesses, including cognitive impairment, memory decline and dementia, affect over 50 million people worldwide, imposing a substantial burden on individuals and society. These disorders arise from a combination of genetic, environmental and experiential factors, with the latter two factors having the greatest impact during sensitive periods in development. In this Review , we focus on the contribution of adverse early-life experiences to aberrant brain maturation, which might underlie vulnerability to cognitive brain disorders. Specifically , we draw on recent robust discoveries from diverse disciplines, encompassing human studies and experimental models. These discoveries suggest that early-life adversity , especially in the perinatal period, influences the maturation of brain circuits involved in cognition. Importantly , new findings suggest that fragmented and unpredictable environmental and parental signals comprise a novel potent type of adversity , which contributes to subsequent vulnerabilities to cognitive illnesses via mechanisms involving disordered maturation of brain ‘wiring’. Neurological illnesses, including cognitive deficits and have advanced the recognition of the contribution of decline and dementia, are prevalent throughout the pre- existing genetic and societal factors to the associ- world, exerting an enormous toll in terms of both med- ation between conventional measures of adversity and ical costs and loss of human potential1,2. Genetic factors cognitive outcomes. Cognitive indicators include poor have been shown to influence brain function through- school performance and reduced ability in specific tasks out life3–5, and these factors, sometimes interacting with in childhood28,32–35 and reduced cognitive function dur- early- life experiences, account for a substantial propor- ing adult life.
    [Show full text]
  • E74080.Pdf (‎589.6Kb)
    EUR/01/5015946 ORIGINAL: ENGLISH UNEDITED E74080 17th Annual Meeting of CINDI Programme Directors Report on a WHO Meeting Qawra, Malta 9–10 June 2000 2001 EUR/01/5015946 ORIGINAL: ENGLISH UNEDITED REGIONAL OFFICE FOR EUROPE ___________________________ 17TH ANNUAL MEETING OF CINDI PROGRAMME DIRECTORS Report on a WHO meeting Qawra, Malta 9–10 June 2000 SCHERFIGSVEJ 8 DK-2100 COPENHAGEN Ø DENMARK TEL.: +45 39 17 17 17 TELEFAX: +45 39 17 18 18 TELEX: 12000 E-MAIL: [email protected] WEB SITE: HTTP://WWW.WHO.DK 2001 ABSTRACT The 17th Annual Meeting was held to discuss the implementation of the countrywide integrated noncommunicable disease intervention (CINDI) programme in the previous year and the plan of work for the coming year. Reports were presented on the implementation of CINDI in participating countries, and on the activities of the CINDI working groups on monitoring, evaluation and research; smoking; hypertension; the workplace; children and young people; nutrition and elevated blood cholesterol; nursing; diabetes; physical activity; guidelines and training for preventive practice; and policy development. The discussion on monitoring and evaluation focused on the methodology for surveys and data analysis. The first draft of an analysis of the second CINDI survey on policy development and implementation processes in CINDI country programmes was presented. In addition, the participants discussed networking at the regional and global levels, and a plan was presented to establish a WHO global network on an integrated approach to the prevention and control of noncommunicable diseases. Keywords CHRONIC DISEASE – prevention and control HEALTH PLANNING PUBLIC HEALTH ADMINISTRATION HEALTH SERVICES – organization and administration PROGRAM EVALUATION HEALTH CARE SURVEYS EUROPE EUROPE, EASTERN MALTA © World Health Organization – 2001 All rights in this document are reserved by the WHO Regional Office for Europe.
    [Show full text]