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Background Malnutrition among women of childbearing age is especially prevalent in Asia and sub-Saharan Africa and can be harmful to the fetus during pregnancy. In the most recently available Demographic and Health Survey (DHS), approximately 10% to 20% of pregnant women in India, Pakistan, Mali, and Tanzania were undernourished (body mass index [BMI] Methods and findings Using nationally representative estimates from the 2017 GBD study, we conducted an individual-based dynamic microsimulation of population cohorts from birth to 2 years of age in India, Pakistan, Mali, and Tanzania. We modeled the effect of maternal nutritional supplementation on infant birth weight, stunting and wasting using effect sizes from Cochrane systematic reviews and published literature. We used a payer's perspective and obtained costs of supplementation per pregnancy from the published literature. We compared disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (ICERs) in a baseline scenario with existing antenatal IFA coverage with scenarios where 90% of antenatal care (ANC) attendees receive either universal MMS, universal BEP, or MMS + targeted BEP (women with prepregnancy BMI Conclusions In this study, we observed that MMS + targeted BEP averts more DALYs and remains cost-effective compared to universal MMS. As countries consider using MMS in alignment with recent WHO guidelines, offering targeted BEP is a cost-effective strategy that can be considered concurrently to maximize benefits and synergize program implementation., Author(s): Nicole Young *, Alison Bowman, Kjell Swedin, James Collins, Nathaniel D. Blair-Stahn, Paulina A. Lindstedt, Christopher Troeger, Abraham D. Flaxman Introduction Pregnancy requires increased energy and nutritional consumption to [...]

When adults repeat questions, children often give inconsistent answers. This study aimed to test the claim that these inconsistencies occur because children infer that their first answer was unsatisfactory, and that the adult expects them to change their answer. Children aged 4, 6, and 8 years (N= 134) were asked about vignettes in which an adult repeated a question, with manipulation of the adult's overt dissatisfaction (high vs. low pressure) and knowledge about the information sought. On a separate occasion, the children were given an unrelated event recall interview containing repeated questions. All age groups showed sensitivity to adult dissatisfaction, interpreting question repetition as an implicit request for answer change more frequently in the high than in the low-pressure vignettes. Overall, however, these "change-expected" interpretations were least frequent in the younger children, who were the most prone to shifting. Also there was no evidence that these interpretations were associated with more frequent shifting in the recall interview. The results do not provide clear support for a simple conversational inference account of shifting, especially in younger children. (Contains 2 tables, 1 figure, and 1 footnote.)

Possibilities for growing dryland lucerne (Medicago sativa L.) productively in drier parts of central-western and western New South Wales (NSW) were investigated by consideration of meteorological records. Annual rainfall data and estimated evapotranspiration data for 1995–1999 were compiled to calculate lucerne growing days and N2-fixing days at Condobolin, Trangie, Cobar and Wentworth. This information was used in conjunction with seasonal indices of dry matter production and nitrogen fixation derived from the work of Bowman et al. [Aust J Exp Agric 42 (2002) 439] at Trangie to estimate yearly biomass production and N2 fixation for the four locations. It was concluded that (i) there are good prospects for growing lucerne productively on suitable soils located in that extensive region of central-western and western NSW between the 450 and 300 mm isohyets if it is feasible to develop techniques for establishment and management to maintain stands at an acceptable density—not less than eight plants/m2, (ii) there are only poor prospects for growing lucerne in those western parts of the state where annual rainfall averages less 300 mm, and (iii) annual rainfall, irrespective of other factors such as erratic distribution, is a rough guide to potential lucerne production. In addition, there were indications that, were the threshold for cessation of lucerne N2 fixation reduced by 2 °C (say from 10 to 8 °C), annual N2 fixation would be enhanced by more than 20%. [Copyright &y& Elsevier]