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In India, progress against undernutrition has been slow. Given its importance for income generation, improving diets, care practices, and maternal health, the agriculture sector is widely regarded as playing an important role in accelerating the reduction in undernutrition. This paper comprehensively maps existing evidence along agriculture-nutrition pathways in India and assesses both the quality and coverage of the existing literature. We present a conceptual framework delineating six key pathways between agriculture and nutrition. Three pathways pertain to the nutritional impacts of farm production, farm incomes, and food prices. The other three pertain to agriculture-gender linkages. After an extensive search, we found 78 research papers that provided evidence to populate these pathways. The literature suggests that Indian agriculture has a range of important influences on nutrition. Agriculture seems to influence diets even when controlling for income, and relative food prices could partly explain observed dietary changes in recent decades. The evidence on agriculture-gender linkages to nutrition is relatively weak. Sizeable knowledge gaps remain. The root causes of these gaps include an interdisciplinary disconnect between nutrition and economics/agriculture, a related problem of inadequate survey data, and limited policy-driven experimentation. Closing these gaps is essential to strengthening the agriculture sector's contribution to reducing undernutrition. [ABSTRACT FROM AUTHOR]

Anemia is an important public health challenge and accurate prevalence estimates are needed for program planning and tracking progress. While venous blood assessed by automated hematology analyzers is considered gold standard, most population‐based surveys use point‐of‐care diagnostics and capillary blood to estimate population prevalence of anemia. Several factors influence hemoglobin (Hb) concentration, including human and analytic error, analysis method, and type of instrument, but it is unclear whether biological variability exists between venous and capillary blood. The objective of this paper was to systematically review sources of Hb variability and the potential biological basis for venous and capillary differences. We use data from a recent survey in the state of Uttar Pradesh, India, to illustrate the implications on anemia prevalence estimates. Significant differences in Hb concentration between capillary and venous blood samples are common. Most but not all find capillary Hb concentration to be higher than venous. Instrument/method variability and human error play an important role, but cannot fully explain these differences. A normative guide to data collection, analysis, and anemia diagnosis is needed to ensure consistent and appropriate interpretation. Further research is needed to fully understand the biological implications of venous and capillary Hb variability. [ABSTRACT FROM AUTHOR]

India has experienced a rising prevalence of cardiometabolic risk factors in the past 15 years: the prevalence of diabetes has increased from 5.9% to 9.1%, hypertension from 17.2% to 29.2%, and obesity from 4% to 15%. The increase is among all socioeconomic groups and in urban and rural populations, though the quantum of change varies. A concomitant increase in per capita consumption of sugar from 22 to 55.3 g/day and total fat from 21.2 to 54 g/day was observed, with significant differences between states of high and low human development index (HDI). Per capita consumption of sugar, salt, and fat is consistently and significantly associated with overweight and obesity but variably associated with the occurrence of hypertension and diabetes. Market research shows that approximately 50-60% of total salt, sugar, and fat in Indian markets is procured by bulk purchasers, generally for manufacturing processed food items. This sector of the Indian economy is among the fastest growing, with several policy incentives. It is not clear from most of the data sets whether available information on per capita sugar, salt, and fat consumption has considered the contribution of processed and ready-to-eat food items. The unprecedented changes of rapid urbanization, mechanization, and globalization demand close monitoring of social, developmental, and economic determinants. This paper provides pieces of evidence to justify a whole-of-society (WoS) framework for monitoring the inputs, processes, and behavioral components of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) in India. [ABSTRACT FROM AUTHOR]

Cultural experiences come in many different forms, such as immersion in a particular linguistic community, exposure to faces of people with different racial backgrounds, or repeated encounters with music of a particular tradition. In most circumstances, these cultural experiences are asymmetric, meaning one type of experience occurs more frequently than other types (e.g., a person raised in India will likely encounter the Indian todi scale more so than a Westerner). In this paper, we will discuss recent findings from our laboratories that reveal the impact of short- and long-term asymmetric musical experiences on how the nervous system responds to complex sounds. We will discuss experiments examining how musical experience may facilitate the learning of a tone language, how musicians develop neural circuitries that are sensitive to musical melodies played on their instrument of expertise, and how even everyday listeners who have little formal training are particularly sensitive to music of their own culture(s). An understanding of these cultural asymmetries is useful in formulating a more comprehensive model of auditory perceptual expertise that considers how experiences shape auditory skill levels. Such a model has the potential to aid in the development of rehabilitation programs for the efficacious treatment of neurologic impairments. [ABSTRACT FROM AUTHOR]

Adolescent motherhood has been linked with poor health outcomes at birth for children, including high neonatal mortality, low birthweight, and small‐for‐gestational‐age rates. However, longer‐term growth outcomes in the children of adolescent mothers in low‐resource settings remain inadequately studied. We used longitudinal data from the India Human Development Surveys, 2004–2005 and 2011–2012 (n = 12,182) and employed regression and propensity score matching analysis to compare the following growth indicators of children born to adolescent mothers (ages 19 years or below) with those born to older mothers. Growth indicators included height and weight during ages 0–5 years and 6–12 years and change in height and weight between the two periods. In regression‐based estimates, children born to adolescent mothers were 0.01 m shorter and weighed 0.2 kg less than children of older mothers at ages 0–5 years. At ages 6–12 years, those born to adolescent mothers were 0.02 m shorter and weighed 0.97 kg less. The height difference between the two groups increased by 0.01 m and the weight difference grew by 0.77 kg over time. Height and weight difference between the two groups worsened among boys over time, while for girls, only the weight gap worsened. The results were similar when using propensity score matching methods. Public policies for reducing child marriage, combined with targeted health, nutrition, and well‐being programs for adolescent mothers, are essential for both preventing adolescent childbearing and reducing its impact on growth failure among children in India. [ABSTRACT FROM AUTHOR]

Although many education and health programs aim to improve early childhood development, it is challenging to assess developmental levels of infants and small children through large household surveys. The Caregiver Reported EarlyDevelopment Instruments (CREDI) has been proposed as an adaptable, practical, and low-cost instrument for measuring the developmental status of children under 3 years of age at scale, as it is relatively short and collected by caregiver report. This study employed the CREDI tomeasure the development of a sample of 994 children ages 22-35 months in rural India and compared the results to those obtained using the Bayley Scales of Infant and Toddler Development (Bayley-III), a reliable and widely used instrument, albeit one not always suited to large-scale data collection efforts given its length, cost, and complexity of administration. The CREDI validation exercise showed that caregivers can provide assessments in keeping with the more interactive (hence more time-consuming and training-intensive) Bayley-III instrument. Noteworthy, therewas no indication that concordance of the instruments differed by education of the caregiver. This is important as it points to alternate feasible tools to measure child development outcomes through large-scale surveys. [ABSTRACT FROM AUTHOR]

Globally, no countries are on track to achieve the adopted global nutrition targets set for anemia in 2025. Given the linkages between water, sanitation, and hygiene (WASH) and nutrition, this secondary data analysis explores potential associations with anemia. Forty‐seven demographic and health surveys were used to explore the association between unimproved water and sanitation and anemia in women and children with adjusted odds ratios (ORs) calculated by country and cumulatively. In over 60% of countries, children with off‐premises water access had significantly increased odds of anemia. In over a quarter of countries, children exposed to surface water had higher odds of anemia. In Burundi, children were 1.65 times more likely to be anemic when reported to be living in households using surface water. However, in India, a protective effect was noted (adjusted OR: 0.70, P < 0.001) for surface water. In 60% and 65% of countries, women and children exposed to an open sanitation facility had higher odds of being anemic, respectively. There is evidence of an association between selected water and sanitation indicators and anemia. Promoting policies, practices and research that strengthen access to improved WASH should be considered for reducing anemia prevalence alongside standard nutrition interventions. [ABSTRACT FROM AUTHOR]

Although primary immunodeficiency diseases (PIDs) were first reported in India in the 1970s, those diagnoses were based predominantly on clinical presentations-very limited immunological analyses were performed. Therefore, the validity of many early reports of PIDs may be questionable. However, in the last 10-15 years, diagnoses of PIDs have been based on flow cytometric analysis and, in a few cases, by mutational analysis. In India, PIDs in adults are markedly underreported. We present data from two major centers where diagnosis of PID has been focused primarily in children. We highlight some of the limitations and challenges in the diagnosis and therapy of PID, and more recent efforts to establish PID Centers of Excellence and a national PID registry in India. [ABSTRACT FROM AUTHOR]

The Hyderabad Metropolitan Area had 562 lakes at one time, but only 162 now remain. These are polluted to various degrees and pose environmental and health hazards. The Hussain Sagar Lake provided water for irrigation and drinking until 1930 and supported aquatic life till 1976. It is now contaminated by organic chemicals discharged by many industrial estates in its basin. An estimated 28,190 cμm of industrial effluents and domestic sewage are let into it daily. Phenols, benzenes, cyanides, and toxic metals make it poisonous. The ground water around the lake is also polluted. The polluted lakes ruin vegetable farms, kill fetuses in the womb, and cause mental retardation, still births, and infertility. In the city's outskirts, clinically confirmed cancer is 11 times higher and heart ailments 16 times more than elsewhere. The Hyderabad Urban Development Authority (HUDA) took up a Lake Conservation and Restoration Project as part of its Green Environment Program in 2002. Several lakes have been restored by setting up effluent (or sewage) treatment plants. HUDA also built lake parks with recreation facilities and environment education centers. HUDA also organized jointly with the World Water Institute, Pune, India, an international workshop on urban lake conservation and management in June 2003. It adopted the Hyderabad Declaration which, among other things, states the worthy aim of restoring all the water bodies by 2009. Even if it takes a few more years, the restoration of all the polluted lakes will usher in multiple benefits to Hyderabad citizens. [ABSTRACT FROM AUTHOR]

Increased concern over the adverse health effects of air pollution has highlighted the need for air-pollution measurements, especially in urban areas, where many sources of air pollutants are normally monitored outdoors as part of obligations under the National Air Quality Strategies. Very little is known about air pollution indoors. In fact, the largest exposure to health-damaging indoor pollution probably occurs in the developing world, not in households, schools, and offices of developed countries where most research and control efforts have been focused to date. As a result much of the health impacts from air pollution worldwide seem to occur among the poorest and most vulnerable populations. The authors in their earlier studies have confirmed the importance of ambient air in determining the quality of air indoors. In this study an observation of air quality indoors and outdoors of domestic homes located in an urban environment from October 2004 to December 2005 in Agra, north central India, is performed. The purpose of this study was to characterize the indoor/outdoor (I/O) relationship of airborne pollutants and recognize their probable source in all three seasons, that is, winter, summer, and rainy season. Concentrations of SO2, NO2, CO2, Cl2, H2S, NH3, RSPM, and PAH were monitored simultaneously and I/O ratios were calculated. In order to investigate the effect of seasonality on indoor and ambient air quality, winter to summer and winter to monsoon average ratios were calculated. It is apparent that there is a general pattern of increasing levels from monsoon to summer to winter, and similarly from outdoor to indoor air. Regressions analysis had been done to further investigate the influence of outdoor air-pollutant concentrations on indoor concentrations. The most probable categories of sources for these pollutants have been identified by using principal-component analysis. Indoor air pollution is a complex function of energy housing and behavioral factors. On the basis of this study and observations, some interventions are also suggested. [ABSTRACT FROM AUTHOR]

The current trend in antipoverty policy emphasizes mandated empowerment: the poor are being handed the responsibility for making things better for themselves, largely without being asked whether this is what they want. Beneficiary control is now being built into public service delivery, while microcredit and small business promotion are seen as better ways to help the poor. The clear presumption is that the poor are both able and happy to exercise these new powers. This essay uses two examples to raise questions about these strategies. The first example is about entrepreneurship among the poor. Using data from a number of countries, we argue that there is no evidence that the median poor entrepreneur is trying his best to expand his existing businesses, even if we take into account the many constraints he faces. While many poor people own businesses, this seems to be more a survival strategy than something they want to do. The second example comes from an evaluation of a program in India that aims to involve poor rural parents in improving local public schools. The data suggest that despite being informed that they now have both the right to intervene in the school and access to funds for that purpose, and despite being made aware of how little the children were learning, parents opt to not get involved. Both examples raise concerns about committing ourselves entirely to antipoverty strategies that rely on the poor doing a lot of the work. [ABSTRACT FROM AUTHOR]

Rapidly industrializing India is described by the International Monetary Fund as a young, disciplined, and vibrant economy with a projected growth of 6.7% for 2005. The total workforce of 397 million has only 7% of workers employed in the organized sector with construction, where asbestos exposure is prevalent, employing 4.4%. The domestic production of asbestos declined from 20,111 tons in 1998–1999 to 14,340 tons in 2002–2003. The imports from Russia and Canada increased from 61,474 tons in 1997–1998 to 97,884 tons in 2001–2002. The production of asbestos cement products went up from 0.68 million tons in 1993–1994 to 1.38 million tons in 2002–2003. The asbestos industry has been delicensed since March 2003. The number of asbestos-based units stood at 32, with the western state of Maharashtra having the largest number. According to official figures, the industry employs 8000 workers. The occupational exposure standard is still 2 fibers/mL, worse still, mesothelioma is not recognized as an occupational disease. The latest cancer registry data have no information on mesothelioma. The health and safety legislation does not cover 93% of workers in the unorganized sector where asbestos exposures are extremely high. Workers remain uninformed and untrained in dealing with asbestos exposure. Enforcement agencies are not fully conscious of the risks of asbestos exposure. Industrial hygiene assessment is seldom carried out and pathologists do not receive training in identifying mesothelioma histopathologically. The lack of political will and powerful influence of the asbestos industry are pushing India toward a disaster of unimaginable proportion. [ABSTRACT FROM AUTHOR]

Iron deficiency anemia (IDA) is a significant public health issue in India affecting nearly all vulnerable segments of the population. Causes of IDA include low consumption of iron-rich foods combined with poor iron bioavailability of nonheme iron sources. To date, interventions aimed at correcting IDA focus on increasing iron intake through iron supplementation or fortification strategies. In contrast, dietary diversification is a long-term sustainable approach to improve bioavailable iron intake. In this context, the inclusion of vitamin C-rich fruits in the regular diet has proven to improve iron absorption, but the effect on iron status is inconclusive. Considering the ongoing national program for preschoolers in India, we designed a cluster randomized controlled trial (RCT) to test the hypothesis that inclusion of vitamin C-rich fruit in a regular meal would improve iron absorption and lead to better child iron and micronutrient status, cognitive development, gut health, and growth while reducing morbidity. This paper illustrates a context-specific framework and activities to design and functionalize an open-label, three-arm cluster RCT to test a specific hypothesis. The results of this designed trial should generate evidence to inform policy on the effect of a food-based intervention on iron status., (© 2018 New York Academy of Sciences.)

The paper outlines how the principles of convergent innovation (CI) can be applied to bring about a transformation in the pulse value chain. The paper presents three pioneering CI initiatives--two in conception and one in operation--by various actors in the pulse ecosystem, which are delivering economic and human development impact in particular segments of the pulse value chain. It goes on to propose the way forward to scale up these efforts and connect them into a roadmap so as to achieve transformation throughout society, calling into action a number of actors in the ecosystem., (© 2014 New York Academy of Sciences.)

There is a rapid transformation afoot in the rice value chain in Asia. The upstream is changing quickly-farmers are undertaking capital-led intensification and participating in burgeoning markets for land rental, fertilizer and pesticides, irrigation water, and seed, and shifting from subsistence to small commercialized farms; in some areas landholdings are concentrating. Midstream, in wholesale and milling, there is a quiet revolution underway, with thousands of entrepreneurs investing in equipment, increasing scale, diversifying into higher quality, and the segments are undergoing consolidation and vertical coordination and integration. Mills, especially in China, are packaging and branding, and building agent networks in wholesale markets, and large mills are building direct relationships with supermarkets. The downstream retail segment is undergoing a "supermarket revolution," again with the lead in change in China. In most cases the government is not playing a direct role in the market, but enabling this transformation through infrastructural investment. The transformation appears to be improving food security for cities by reducing margins, offering lower consumer rice prices, and increasing quality and diversity of rice. This paper discusses findings derived from unique stacked surveys of all value chain segments in seven zones, more and less developed, around Bangladesh, China, India, and Vietnam., (© 2014 New York Academy of Sciences.)

Undernutrition and inadequate stimulation both negatively influence child health and development and have a long-term impact on school attainment and income. This paper reports data from India and Pakistan looking at how families interact, play with, and feed children; their expectations of growth and development; and the perceived benefits, consequences, opportunities, and barriers of adopting recommended feeding and developmental behaviors. These data were collected as part of formative research for the Sustainable Program Incorporating Nutrition and Games (SPRING) trial. This trial aims to deliver an innovative, feasible, affordable, and sustainable intervention that can achieve delivery at a scale of known effective interventions that maximize child development, growth, and survival and improve maternal psychosocial well-being in rural India and Pakistan., (© 2014 New York Academy of Sciences.)

Nutritional and developmental insults in the first few years of life have profound public health implications, including substantial contributions to neonatal, infant, and early childhood morbidity and mortality, as well as longer term effects on cognitive development, school achievement, and worker productivity. Optimal development that can lead to the attainment of an individual's fullest potential, therefore, requires a combination of genetic capacity, adequate nutrition, psychosocial stimulation, and safe, clean physical environments. Researchers and policymakers have called for integrated child nutrition and development interventions for more than 20 years, yet there are only a handful of efficacy trials and even fewer examples of integrated interventions that have been taken to scale. While a critical component in the design of such interventions is formative research, there is a dearth of information in both the literature and policy arenas to guide this phase of the process. To move the field forward, this paper first provides an overview of formative research methods with a focus on qualitative inquiry, a description of the critical domains to be assessed (infant and young child feeding, responsive feeding, and child development), and currently available resources. Application of these methods is provided through a real-world case study--the design of an integrated nutrition and child development efficacy trial in Andhra Pradesh, India. Recommendations for next steps are discussed, the most important of which is the need for a comprehensive set of formative guidelines for designing locally tailored, culturally appropriate, integrated interventions., (© 2013 New York Academy of Sciences.)

The auditory system functions in the context of everyday life and the cultural environment in which we live. Although cultural-invariant, universal principles certainly contribute to sound processing, cultural factors play a role as well. In this review paper, we discuss two potential sources of cultural influence on auditory perception. We term the first type bottom-up, and use it to refer to the way that increased exposure to particular kinds of sound could shape our auditory and auditory-neural responses. The second type we term top-down, and use it to refer to the way our cultural upbringing broadly shapes how we think, which may in turn have an impact on how we perceive the world. An important consideration regarding cultural influences is that many individuals grow up with exposure to environmental stimulations of more than one culture. In our discussion, we will consider both mono- and bicultural experiences., (© 2012 New York Academy of Sciences.)

This paper reviews current behavioral health interventions and introduces a self-healing program based on the Indo-Tibetan tradition. While most work on behavior change emphasizes cognition and motivation, this review highlights stress-reactivity as a rate-limiting resistance to learning. Surveying cognitive-behavioral theories, it finds these limited in modeling stress-reactivity. Reviewing current interventions that address stress by integrating relaxation, mindfulness, imagery, or movement with cognitive-behavioral education, it attributes their limited effectiveness to the limits of their model of stress and their strategy of eclectically mixing techniques. Next, the article explores the Indic model of stress-cessation and self-healing assumed by mindfulness practice, concluding that it more fully reflects current findings on stress and learning. It reviews the theory and practice of mindfulness and of two less known contemplative "vehicles" preserved in Tibet, using more advanced techniques and insights better suited to lay lifestyles and secular cultures. It suggests that the Tibetan tradition of integrating all three vehicles of contemplative insight and skill in one self-healing practice should maximize coherence and effectiveness while minimizing confounding variables caused by eclecticism. Finally, the paper introduces an intervention that integrates mindfulness with techniques of cognitive analysis, affect modulation, motivational imagery, and reinforcing breathing, tailored over centuries into a complete, threefold path of self-healing. A pilot study of this intervention in women treated for breast and other gynecologic cancers suggests that the whole spectrum of Indo-Tibetan mind/body practices can be readily mastered and effectively used by Westerners to reduce stress and enhance learning and quality of life.

This paper reports a study to determine whether BCG vaccination is associated with an increase or decrease in GAD65 and I-A2 autoantibodies in cases of IDDM and NIDDM in southern India. It is concluded that BCG vaccination has an immunomodulatory role in these diseases.

This paper, while seeking to expose some of the basic ideas of Hindu cosmology, focuses on the philosophical and soteriological dimensions of the notions of "beginning" and "beginningless" in the discourses associated with dominant world-religions. It is hoped that a deeper grasp of these issues in a multi-religious context will help to bridge the distance between diverse traditions of thinking as well as facilitate the science-religion dialogue.

In this paper we first present methods and preliminary results of pilot surveys of "serious" mental retardation (IQ less than or equal to 55); the surveys included screening and diagnostic components and were carried out in the less-developed world. Next we discuss two problems raised by these surveys: one is the diagnosis of a case and its clinical dimensions, and the other is the interpretation of prevalence. In the next section we illustrate epidemiological approaches to the analysis of such data, in particular their relevance to prevention. Lastly, we propose that the two-stage survey approach developed in the course of the pilot work can provide a valuable basis for planning and prevention, if certain key conditions can be met.