More than 200 million children under the age of 5 years are affected by malnutrition worldwide according to the World Health Organization. The Barbados Nutrition Study (BNS) is a 55-year longitudinal study on a Barbadian cohort with histories of moderate to severe protein-energy malnutrition (PEM) limited to the first year of life and a healthy comparison group. Using quantitative electroencephalography (EEG), differences in brain function duringchildhood(lower alpha1 activity and higher theta, alpha2 and beta activity) have previously been highlighted (...) between participants who suffered from early PEM and controls. In order to determine whether similar differences persisted intoadulthood, our current study used recordings obtained during a Go-No-Go task in a subsample of the original BNS cohort [population size (N) = 53] at ages 45–51 years. We found that previously malnourished adults [sample size (n) = 24] had a higher rate of omission errors on the task relative to controls (n= 29). Evoked-Related Potentials (ERP) were significantly different in participants with histories of early PEM, who presented with lower N2 amplitudes. These findings are typically associated with impaired conflict monitoring and/or attention deficits and may therefore be linked to the attentional and executive function deficits that have been previously reported in this cohort in childhood and again in middle adulthood. (shrink)

BackgroundFew studies have paid attention to ethical responsibility related to malnutrition in elder care. The aim was to illuminate whether politicians and civil servants reason about malnutrition in elder care in relation to ethical responsibility, and further about possible causes and how to address them.MethodEighteen elected politicians and appointed civil servants at the municipality and county council level from two counties in Sweden were interviewed. They worked at a planning, control and executive level, with responsibility for both the (...) elder care budget and quality of care. Qualitative method was used for the data analysis.ResultsTwo themes emerged from their reasoning about malnutrition related to ethical responsibility. The theme assumed role involves the subthemes quality of care and costs, competent staff and govern at a distance. Old and ill patients were mentioned as being at risk for malnutrition. Caregivers were expected to be knowledgeable and stated primary responsible for providing adequate nutritional care. Extended physician responsibility was requested owing to patients' illnesses. Little was reported on the local management's role or on their own follow-up routines. The theme moral perception includes the subthemes discomfort, trust and distrust. Feelings of discomfort concerned caregivers having to work in a hurried, task-oriented manner. Trust meant that they believed for the most part that caregivers had the competence to deal appropriately with nutritional care, but they felt distrust when nutritional problems reappeared on their agenda. No differences could be seen between the politicians and civil servants.ConclusionNew knowledge about malnutrition in elder care related to ethical responsibility was illuminated by persons holding top positions. Malnutrition was stressed as an important dimension of the elder care quality. Governing at a distance meant having trust in the staff, on the one hand, and discomfort and distrust when confronted with reports of malnutrition, on the other. Distrust was directed at caregivers, because despite the fact that education had been provided, problems reappeared. Discomfort was felt when confronted with examples of poor nutritional care and indicates that the participants experienced failure in their ethical responsibility because the quality of nutritional care was at risk. (shrink)

This paper uses multilevel modelling and Demographic and Health Survey data from five African countries to investigate the relative contributions of compositional and contextual effects of socioeconomic status and place of residence in perpetuating differences in the prevalence of malnutrition among children in Africa. It finds that community clustering of childhood malnutrition is accounted for by contextual effects over and above likely compositional effects, that urban–rural differentials are mainly explained by the socioeconomic status of communities and households, that (...) childhood malnutrition occurs more frequently among children from poorer households and/or poorer communities and that living in deprived communities has an independent effect in some instances. This study also reveals that socioeconomic inequalities in childhood malnutrition are more pronounced in urban centres than in rural areas. (shrink)

Bangladesh continues to experience stubbornly high levels of rural malnutrition amid steady economic growth and poverty reduction. The policy response to tackling malnutrition shows an overwhelmingly technocratic bias, which depoliticizes the broader question of how the agro-food regime is structured. Taking an agrarian and human rights-based approach, this paper argues that rural malnutrition must be analyzed as symptomatic of a deepening agrarian crisis in which the obsession with productivity increases and commercialization overrides people’s democratic right to culturally (...) appropriate, good, nutritious food. Using qualitative insights from a case study of three villages, this research illustrates how agricultural modernization and commercialization reproduce rural malnutrition by degrading local biodiversity and the rural poor’s access to nutrient-rich diets. In so doing, it undermines the official discourse’s simplistic and literal reading of malnutrition as a pathological health condition resulting from the mere absence of certain micronutrients in the human body, and thus questions the adequacy of the proposed solutions. Instead, this research suggests that solving malnutrition in large part involves facilitating the rural poor’s access to nutritious diets through democratizing and reorganizing the agriculture sector in a manner that is eco-friendly and unconstrained by market imperatives. It cautiously advances agroecology and food sovereignty as possible alternatives, while recognizing that overcoming the challenges agrarian class conflict, gender disparity and urban–rural divide pose would not be easy. (shrink)

The Malnutrition-Inflammation Score was initially proposed to evaluate malnutrition-inflammation complex syndrome in end-stage renal disease patients. Although MICS should be routinely evaluated to reduce the hospitalization and mortality rate of ESRD patients, the inconvenience of the MIS might limit its use. Cerebral complications in ESRD, possibly induced by MICS, were previously assessed by using spectral electroencephalography via the delta/theta ratio and microstate analysis. Correspondingly, EEG could be used to directly assess MICS in ESRD patients, but the relationships among (...) MICS and these EEG features remain inconclusive. Thus, we aimed to investigate the delta/theta ratio and microstates in ESRD patients with high and low risks of MICS. We also attempted to identify the correlation among the MIS, delta/theta ratio, and microstate parameters, which might clarify their relationships. To achieve these objectives, a total of forty-six ESRD subjects were willingly recruited. We collected their blood samples, MIS, and EEGs after receiving written informed consent. Sixteen women and seven men were allocated to low risk group. Additionally, high risk group contains 15 women and 8 men. Here, we discovered that delta/theta ratio and most microstate parameters were significantly different between subject groups. We also found that the delta/theta ratio was not correlated with MIS but was strongly with the average microstate duration ; hence, we suggested that the average microstate duration might serve as an alternative encephalopathy biomarker. Coincidentally, we noticed positive correlations for most parameters of microstates A and B and stronger negative correlations for all microstate C parameters. These findings unveiled a novel EEG biomarker, the MIC index, that could efficiently distinguish ESRD patients at high and low risk of MICS when utilized as a feature in a binary logistic regression model. We expected that the average microstate duration and MIC index might potentially contribute to monitor ESRD patients in the future. (shrink)

This article reviews the effects of malnutrition on early brain development using data generated from animal experiments and human clinical studies. Three related processes, each with their own functional consequences, are implicated in the alteration of brain development. (1) Maternal undernutrition at the start of pregnancy results in reduced transfer of nutrients across the placenta, allowing the conservation of effort for future reproductive episodes. (2) Differential allocation to growing organs by the fetus in response to nutritional stress spares the (...) brain to a large though still limited degree, reflecting the organ’s relative contribution to survival and reproductive success. (3) Prenatal malnutrition disrupts developing neurotransmitter systems, which results in the expression of specific cognitive and affective traits. It is argued that the increasing size and therefore cost of the brain, in conjunction with increasing ecological instability and marginality, reinforced selection for maternally controlled growth suppression of offspring, reallocation of organ growth rates by offspring, and behavioral changes related to development of neurotransmitter systems. (shrink)

This article compares two transnational public–private partnerships against hunger and malnutrition, the Global Alliance for Improved Nutrition and the International Alliance Against Hunger with regard to their degree of business involvement and their input and output legimacy. We examine the participation of stakeholders, the accountability and transparency of the decision-making process, and the perceived provision of a public good. We identify a link between business involvement and output legitimacy, and we discuss the implications for public and private food governance.

Background Informed consent is a universally accepted precondition for scientific researches involving human participants. However, various factors influence the process of obtaining authentic informed consent, and researchers particularly working in resource-poor countries often face considerable difficulties in implementing the universally recommended procedures for obtaining informed consent. We have conducted this Rapid Ethical Assessment to accommodate the local cultural norms and to understand the relevant ethical issues in the Silti community before the conduct of a cluster-randomized controlled trial. Methods This REA (...) was conducted in two purposively selected Woredas/Districts and Worabe Town administration of Silti Zone. Data were collected using in-depth interviews and focus group discussions. Purposive and convenient sampling techniques were used to select respondents. Five in-depth interviews and 15 Focus Group Discussions were conducted in the Amharic language. The collected data was transcribed, translated, and analyzed using a thematic approach. Result Most of the community members never heard about research and therapeutic misconception was common. In the area, the permission of people working in the formal and informal community administration is essential before approaching individuals. The male head of the household should also be involved in the decision before individual household members participate in research. Furthermore, sensitizing the community using public and religious gatherings was suggested before individual recruitment. In the consent process, delivering selected information particularly the purpose and benefits of the research was emphasized and the tendency of preferring verbal consent was documented despite the willingness of the individuals to sign on the consent form. Local health workers were identified as appropriate personnel to communicate information and the procedures of the research were found to be acceptable. However, the value of small incentives was suggested to motivate potential participants. Finally, involving all concerned stakeholders and respecting the cultural norm of the community was emphasized. Conclusion Through REA, we understand the research awareness of the community, their expectation, and the cultural norms relevant to the ethical conduct of research. It enabled us to devise culturally sensitive and scientifically sound strategies to secure authentic informed consent. The process of conducting REA was found to be feasible, quick, and efficient. (shrink)

This article is concerned with a discussion of the plausibility of the claim that GM technology has the potential to provide the hungry with sufficient food for subsistence. Following a brief outline of the potential applications of GM in this context, a history of the green revolution and its impact will be discussed in relation to the current developing world agriculture situation. Following a contemporary analysis of malnutrition, the claim that GM technology has the potential to provide the hungry (...) with sufficient nourishment will be discussed within the domain of moral philosophy to determine whether there exists a moral obligation to pursue this end if and only if the technology proves to be relatively safe and effective. By using Peter Singer’s duty of moral rescue, I argue that we have a moral duty to assist the third world through the distribution of such GM plants. I conclude the paper by demonstrating that my argument can be supported by applying a version of the Precautionary Principle on the grounds that doing nothing might be worse for the current situation. (shrink)

Starting from methodological aspects of a study performed about features that characterized social representation of infantile malnutrition, qualitative and quantitative treatment of the data are presented. Traditional quantitative studies are characterized for the emphasis in the definition of the..

Malnutrition among children is prevalent in almost all the states in India. This study assesses the extent and causes of malnutrition in two eastern Indian states with similar climates, namely West Bengal and Assam, using data from the National Family Health Survey 1998s educational status, working status of the mother, mother’s age at delivery of the children, source of drinking water, toilet facilities and standard of living of the household. Logistic regression was carried out separately for each of (...) the three indices on the explanatory variables for both the states. It was found that not all variables are equally important in determining whether a baby is underweight, or suffering from acute or chronic malnutrition. Also, the importance of variables is not the same in the two states. It was observed that the coefficients associated with the variables in determining weight-for-height are not significant compared with those for weight-for-age and height-for-age. (shrink)

One‐third of all human deaths are due to poverty‐related causes, to malnutrition and to diseases that can be prevented or cured cheaply. Yet our politicians, academics, and mass media show little concern for how such poverty might be reduced. They are more interested in possible military interventions to stop human rights violations in developing countries, even though such interventions – at best – produce smaller benefits at greater cost. This Western priority may be rooted in self‐interest. But it engenders, (...) and is sustained by, a deeply flawed moral presentation of global economic cooperation. The new global economic order we impose aggravates global inequality and reproduces severe poverty on a massive scale. On any plausible understanding of our moral values, the prevention of such poverty is our foremost responsibility. (shrink)

Niger is regularly affected by food insecurity, mainly due to the high sensitivity of its agricultural sector to climate variability. Despite the support from multiple development institutions and households’ willingness to address food security, hunger and malnutrition continue to challenge many vulnerable households. This study aims to analyze household livelihood strategies toward food security and assess factors determining their resilience. To address the issue, cluster analysis and the principal component analysis were used to identify the different livelihood strategies and (...) to construct a resilience index, respectively. Regression analysis was used to identify the most significant factors determining households’ resilience. The results indicate there were six different household types—pastoralist-extensive agriculturalists, farmers, agro-pastoralists, public service employees, entrepreneurs and wage employees—however, the majority of households obtained their livelihood from both agriculture and livestock (agro-pastoral systems). The principal component analysis highlighted that the pastoralist-extensive agriculturalists are the most resilient followed by public service employees, while households focused on wage labor are the least resilient, followed by entrepreneurs. In terms of gender, the study reveals that households headed by men are more resilient than those headed by women. However, the resilience components including income and food access, assets and adaptive capacity are the most correlated with the households’ resilience to food insecurity. Furthermore, the regression analysis results reveal that the household size, crop production, farming experience, livestock size and number of coping strategies are the most significant factors determining household resilience to food insecurity. Consequently, to face the challenges of climate change and food security, rational investments in agriculture are necessary to transit rural household land-use practices to climate-smart agriculture. (shrink)

Weight- (WAZ), height- (HAZ), and BMI-for-age (BMIZ) are frequently used to assess malnutrition among children. These measures represent different categories of risk and are usually hypothesized to be affected by distinct factors, despite their inherent relatedness. Life history theory suggests weight should be sacrificed before height, indicating a demonstrable relationship among them. Here we evaluate impact of family composition and household economics on these measures of nutritional status and explore the role of WAZ as a factor in HAZ. Anthropometrics, (...) family demographics, and measures of household economy were collected from Sidama agropastoralist children in a peri-urban village in southwestern Ethiopia (n = 157; 79 girls). Just over half of the sample (50.9%) had z-scores of − 2SD or below on at least one measure, indicating an elevated risk of morbidity/mortality; 30% were at or below − 2SD on two or more measures. We used hierarchical linear regression with random intercept analysis to model WAZ and HAZ. Siblings and crop sales significantly decrease WAZ while electricity, agriculture, and polygyny improve z-scores; however, an interaction between polygyny and siblings indicates negative effects of siblings in polygynous families and positive effects in nonpolygynous ones (adj. R2 = 66.5%). For HAZ, agriculture and electricity are positively associated with z-scores whereas siblings have a negative effect; the interaction term again indicates that effects of siblings vary in polygynous and nonpolygynous families (adj. R2 = 74.2%). A mediation model exploring the role of weight in height outcomes suggests not only that WAZ has direct effects on HAZ but also that effects of electricity and agriculture on HAZ are partially mediated by WAZ. Our findings indicate that WAZ and HAZ are primarily affected by shared variables, but effects of siblings vary by polygyny status. Long-term outcomes (HAZ) among Sidama children would likely benefit from interventions focused on stabilizing WAZ across family members. (shrink)

It is estimated that over 800 million people are hungry each day and two billion are suffering from the consequences of vitamin and mineral deficiencies. While a paradigm shift towards a multi-dimensional and multi-sectoral approach to food and nutrition insecurity is emerging, technical approaches largely prevail to tackle the causes of hunger and malnutrition. Founded in original in-depth field research among smallholder farmers in southwest Kenya, we argue that incorporating cultural or social dimensions in this technical debate is imperative (...) and that by systematically overlooking these dimensions, food insecurity cannot be accurately captured nor properly addressed. Based on a sub-location in rural southwest Kenya where the food plate is rapidly narrowing towards a high-calorie low nutrient diet and where over 80 % of households experience food shortages at least once a year, conclusions suggest that preferences, the local function of food, and the practices that emerge therefrom can affect the regularity of meals and their composition. The findings allow us to complement emerging research and program development with a more comprehensive and locally adapted approach to tackle food and nutrition insecurity. (shrink)

Sara Suleri has written recently, in Meatless Days, of being treated as an "otherness machine"-and of being heartily sick of it.20 Perhaps the predicament of the postcolonial intellectual is simply that as intellectuals-a category instituted in black Africa by colonialism-we are, indeed, always at the risk of becoming otherness machines, with the manufacture of alterity as our principal role. Our only distinction in the world of texts to which we are latecomers is that we can mediate it to our fellows. (...) This is especially true when postcolonial meets postmodern; for what the postmodern reader seems to demand of Africa is all too close to what modernism-in the form of the postimpressionists-demanded of it. The role that Africa, like the rest of the Third World, plays for Euro-American postmodernism-like its better-documented significance for modernist art-must be distinguished from the role postmodernism might play in the Third World; what that might be it is, I think, too early to tell. What happens will happen not because we pronounce on the matter in theory, but will happen out of the changing everyday practices of African cultural life.For all the while, in Africa's cultures, there are those who will not see themselves as Other. Despite the overwhelming reality of economic decline; despite unimaginable poverty; despite wars, malnutrition, disease, and political instability, African cultural productivity grows apace: popular literatures, oral narrative and poetry, dance, drama, music, and visual art all thrive. The contemporary cultural production of many African societies, and the many traditions whose evidences so vigorously remain, is an antidote to the dark vision of the postcolonial novelist. 20. Sara Suleri, Meatless Days , p. 105. Kwame Anthony Appiah, professor of philosophy and literature at Duke University, is the author of a number of books, including For Truth in Semantics , Necessary Questions , and In My Father's House , a collection of essays on African cultural politics. His first novel, Avenging Angel, was published in 1990. (shrink)

After a decades-long economic slump, the city of Flint, Michigan, struggled to address chronic issues of toxic water supply, malnutrition, and food security gaps among its residents. A community-engaged research project proposed a resilience assessment that would use panarchy theory to move the city toward a more sustainable food system. Flint is one of many examples that demonstrates how panarchy theory is being applied to understand and influence change in complex human-natural systems. Applied Panarchy, the much-anticipated successor to Lance (...) Gunderson and C.S. Holling's seminal 2002 volume Panarchy, documents the extraordinary advances in interdisciplinary panarchy scholarship and applications over the past two decades. Panarchy theory has been applied to a broad range of fields, from economics to law to urban planning, changing the practice of environmental stewardship for the better in measurable, tangible ways.Panarchy describes the way systems--whether forests, electrical grids, agriculture, coastal surges, public health, or human economies and governance--are part of even larger systems that interact in unpredictable ways. Although humans desire resiliency and stability in our lives to help us understand the world and survive, nothing in nature is permanently stable. How can society anticipate and adjust to the changes we see around us? Where Panarchy proposed a framework to understand how these transformational cycles work and how we might influence them, Applied Panarchy takes the scholarship to the next level, demonstrating how these concepts have been modified and refined. The book shows how panarchy theory intersects with other disciplines, and how it directly influences natural resources management and environmental stewardship.Intended as a text for graduate courses in environmental sciences and related fields, Applied Panarchy picks up where Panarchy left off, inspiring new generations of scholars, researchers, and professionals to put its ideas to work in practical ways. (shrink)

This cross sectional study was carried out among the workers of British American Tobacco Company, Dhaka with a view to explore their nutritional status, personal hygiene and health seeking behavior as because they are working on a tobacco processing company. The sample size was 179 which were selected purposively. The study showed that out of 179 respondents 89 (49.7%) were in the age groups of 30-39 years and the mean age of the respondents were 31.99 ± 6.01 years. A large (...) number of respondents (55.9%) had monthly family income of Taka 10001-20000 and the mean family income was Taka 12776.54 ± 5230.13. Maximum respondents (73.7%) were Muslim, more than half (54.2%) were shift in charge, 39.1% of the respondents consisted of 4 family members, 43.6% respondents were accustomed to other type of eating habit and 38.5% respondents knew that malnutrition was the effect of lack of proper nutrition, 59.8% of the respondents knew that night blindness was the disease due to malnutrition, most of the respondents (91.6%) performed duties to maintain health, majority (62.0%) respondents used to do nothing to maintain healthcare for their children and 35.9% visited doctor’s single time in a month, 40.2% of the respondents told regular tooth brushing as type of healthy habits. Majority (64.8%) respondents used to brush twice a day, majority (50.8%) respondents used to wash hand after toileting, majority (62.08%) respondents used to bath daily, 43.0% and 31.8% of the respondents told that dysentery and diarrhea was due to eating without proper hand washing respectively. Majority (53.6%) respondents informed that they learned about personal hygiene from television, 45.8% respondents understood that use of safe water in every work as sanitation. Majority (50.84%) came from nuclear family; most (84.92%) had exercise habit and 40.22% had education level of class VIII. Most (75.42%) of the respondents had semi pucca houses and majority (69.83%) of the respondents used only water as materials for hand washing. This study provided some important information which might help the concerned authority to take appropriate measures to improve the health status of the workers. (shrink)

On the winter morning of 16 June 1976, fifteen thousand black children marched on Orlando Stadium in Soweto, carrying slogans dashed on the backs of exercise books. The children were stopped by armed police who opened fire, and thirteen-year-old Hector Peterson became the first of hundreds of schoolchildren to be shot down by police in the months that followed. If, a decade later, the meaning of Soweto’s “year of fire” is still contested,1 it began in this way with a symbolic (...) display of contempt for the unpalatable values of Bantu education, a public rejection of the “culture of malnutrition” with which blacks had been fed.2 The local provocation for the Orlando march was a ruling that black children be taught arithmetic and social studies in Afrikaans—the language of the white cabinet minister, soldier, and pass official, prison guard, and policeman. But the Soweto march sprang from deeper grievances than instruction in Afrikaans, and the calamitous year that passed not only gave rise to a rekindling of black political resistance but visibly illuminated the cultural aspects of coercion and revolt.The children’s defacement of exercise books and the breaking of school ranks presaged a nationwide rebellion of uncommon proportion. The revolt spread across the country from community to community, in strikes, boycotts, and street barricades. It represented in part the climax of a long struggle between the British and Afrikaans interlopers for control over an unwilling black populace and was at the same time a flagrant sign of the contestation of culture, an open declaration by blacks that cultural value, far from shimmering out of reach in the transcendent beyond, would now be fought for with barricades of tires, empty classrooms, and precocious organization. 1. At least three general analyses of the Soweto uprising have emerged: deeper African National Congress involvement in the community; strains on the educational system, unemployment and recession, with greater industrial militancy stemming from the strikes in the early seventies; and the emergence of Black Consciousness ideology. See Tom Lodge, Black Politics in South Africa Since 1945 , pp. 321-62.2. See M. K. Malefane, “ ‘The Sun Will Rise’: Review of the Allahpoets at the Market Theatre, Johannesburg,” Staffrider ; reprinted in Soweto Poetry, ed. Michael Chapman, South African Literature Studies, no. 2 , p. 91. Soweto Poetry will hereafter be cited as SP. Anne McClintock is a Ph.D. candidate in English at Columbia University. She is the author of a monograph on Simone de Beauvoir and is working on a dissertation on race and gender in British imperial culture. Her previous contribution to Critical Inquiry , “No Names Apart: The Separation of Word and History in Derrida’s ‘Le Dernier Mot du Racisme,’ ” appeared in the Autumn 1986 issue. (shrink)

As a result of evolution, human babies are born with outstanding abilities for human communication and cooperation. The other side of the coin is their great sensitivity to any clear and durable violation in their relationship with caregivers. Infant sustained social withdrawal behavior was first described in infants who had been separated from their caregivers, as in Spitz's description of “hospitalism” and “anaclitic depression.” Later, ISSWB was pointed to as a major clinical psychological feature in failure-to-thrive infants. Fraiberg also described (...) freezing behavior as one of the earliest modes of infant defense in the face of adverse situations threatening the infant's ability to synchronize with caregivers. We hypothesize that ISSWB behaviors are associated with poor vagal brake functioning and that an impaired social engagement system is induced by an impoverished and/or dangerous environment. Recent research using animal models highlight the neurobiology and the genetics of the social Approach/Withdrawal Behavior in infants. The present paper is therefore a plea for social withdrawal behavior to be attributed a more important role as a major psychological defensive mechanism in infancy, and for research into early development and early intervention to make more practical and theoretical use of this concept, thus decreasing the challenge of translation in social neurosciences. This work presents several situations involving developmental hazards in which assessment of ISSWB by means of the Alarm Distress Baby Scale has proven useful, i.e., malnutrition, effects of major maternal depression and or traumatization, assessing social withdrawal in infants with an chronic organic illness or assessing ISSWB in out of home placed infants during parental visitation. Relationships between ISSWB and other biophysiological behavioral systems are discussed, particularly links with attachment processes and Porges's polyvagal theory. (shrink)

Alice Dunbar-Nelson is mostly remembered as a poet, activist, and ex-wife of Paul Laurence Dunbar. Her volume The Goodness of St. Rocque and Other Stories (1899) has been largely overshadowed as a result. Yet, the collection contains a portfolio of heroines analogous and contemporaneous to the famed New Woman figure of the fin de siècle. In this article, I consider Dunbar-Nelson’s heroines in light of their New Woman-esque agency and autonomy as they find remedies and power in objects and materials (...) steeped in New Orleans’s cultural heritage. Ceded neither social nor political self-governance nor domestic comfort, this article reads these transcendental, metaphysical objects as sources of self-care. With close analysis of “The Goodness of St. Rocque,” “Tony’s Wife,” and “Little Miss Sophie,” I argue that Dunbar-Nelson’s protagonists exert influence over their lives, specifically in the negotiation of romantic relationships, through voodoo charms, Catholic candles, tarot cards, sewing machines, and knitting needles. Covering courtship, break-ups, and unhappy marriages, I demonstrate the ways in which these empowering spiritual objects respond to health concerns, including malnutrition and domestic violence, in turn, situating them as alternatives to patriarchal and historically racist medical institutions. Valorizing the cultural milieu of New Orleans and the customs of the Caribbean and European heritage, and thereby conveying Dunbar-Nelson’s resistance to white and male supremacist ideologies in late-nineteenth-century Southern America, the article ultimately assesses the parallels with (predominantly white) New Woman fiction, through shared themes of fraught heterosexual dynamics and women’s declining health. (shrink)

Health is higher on the international agenda than ever before, and improving the health of poor people is a central issue in development. Poor people suffer from far higher levels of ill health, mortality, and malnutrition than do those better off, and their inadequate health is one of the factors keeping them poor or for their being poor in the first place. Health is a crucially important economic asset, particularly for poor people. Their livelihoods depend on it. When poor (...) people become ill or injured, their entire household can become trapped in a downward spiral of lost income and high healthcare costs—a vicious circle of poverty and ill health. (shrink)

Exposing food violences – hunger,malnutrition, and poisoning from environmentalmismanagement – requires policy action thatconfronts the structured invisibility of theseviolences. Along with the hidden deprivation offood is the physical and political isolation ofcritical knowledge on food violences and needs,and for policy strategies to address them. Iargue that efforts dedicated on behalf of ahuman right to food can benefit from thetheoretical analysis and activist work of theinternational Women's Rights are Human Rights(WRHR) movement. WRHR focuses on women andgirls; the food rights movement (...) operates onbehalf of all people, with an emphasis on thepoor. Both attend to the protection of bodilyintegrity against physical and psychicviolences. Both cope with bodily violences thatare socially privatized and spatiallysegregated from public institutions of relief,that is, they are tacitly omitted from publicdiscourse and purview. Most typically, but notexclusively, these violences unfold in privatehousehold space. Both rights movements mustmobilize political rights to demand economicand social rights and security. I introduce theUnited Nations' early Declaration (1948) andCovenant (1966) language on the human right tofood and review problems of household accessand grassroots engagement that are ``writteninto'' this early documentation. An abbreviatedoverview of the WRHR movement describes how thepublic/private and economic/political rightsdichotomies have been critiqued andre-formulated. A case study set in Polandacross the transition from (more) communist to(more) capitalist political economies attemptsto illuminate the discussion through agrounded example. (shrink)

Although we do not know exactly how many people die each year of malnutrition or related health problems, the number is very high, in the millions. By giving money to support famine relief efforts, each of us could save at least some of them. By not giving, we let them die.

Control over food supply was advanced in the kingdom of France in the Eighteenth century by Physiocrat economists under the seemingly advantageous label of 'freedom of grain trade'. In 1764 these reforms brought about a rise in grain prices and generated an artificial dearth that ruined the poor, some of whom died from malnutrition. The King halted the reform and re-established the old regime of regulated prices; in order to maintain the delicate balance between prices and wages, the monarchy (...) tried to limit speculation in subsistence goods and achieved some success in regulating the provisioning of public markets. Le Mercier de la Riviere concluded that executing these reforms required more effective political control. After 1774 the new king gave the Physiocratic reforms a second chance, reforming property rights and establishing an aristocracy of the landed rich. Again, this led to price hikes and as a result so-called 'popular emotions' erupted. Turgot ordered military intervention to dispel the protesters, marking a first rupture between the monarchy and the people over speculation on subsistence. Turgot's experiment failed and he was dismissed, but the Physiocracy had discovered that the market in subsistence offered new opportunities for economic power under the misleading legitimacy of 'economic laws'. Turgot's followers, Dupont de Nemours and Condorcet, continued to develop this 'theory' that was later translated into a 'scientific language' that ultimately asserted the autonomy of the economic sphere and its alleged independence from ethics and politics. The paper examines the continuity of events through the six great jacqueries and the French Revolution, including the all- important agrarian reform that ensued after 1792. Robespierre's concept of 'popular political economy' is analysed and compared with the notion of unfettered private property rights that lies at the heart of neoliberalism. (shrink)

By any reasonable standard of assessment, it is clear that human beings lead lives of wildly varying quality. People who live in different societies or belong to different social classes often differ greatly in their life expectancy, material resources, political rights and personal freedoms, and levels of nutrition and health, as well as in their access to education and medical care and their vulnerability to violence and assault. At the extremes, at least, these differences are normally accompanied by great differences (...) in the range of options people have available to them, in their prospects of achieving their aims, and in their sense of satisfaction with their own lives. Whereas many people in many countries enjoy a high level of prosperity and material comfort, and have a reasonable chance of achieving a significant measure of personal fulfillment over the course of their lives, there are many others who can look forward to little more than a miserable life and an early death. Although great progress has been made in combating the worst forms of poverty in recent decades, there continue to be people who live in conditions of extreme deprivation and malnutrition; people whose lack of medical care leaves them defenseless against infection and disease; people who have never received a formal education, have no political.. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral (...) tube feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

An argument is advanced to show that affluent and moderately affluent people, like you and me, are morally obligated: (O1) To provide modest financial support for famine relief organizations and/or other humanitanan organizations working to reduce the amount of unnecessary suffering and death in the world, and (O2) To refrain from squandering food that could be fed to humans in situations of food scarcity. Unlike other ethical arguments for the obligation to assist the world’s absolutely poor, my argument is not (...) predicated on any highly contentious ethical theory that you likely reject. Rather, it is predicated on your beliefs. The argument shows that the things you currently believe already commit you to the obligatoriness of helping to reduce malnutrition and famine-related diseases by sending a nominal percentage of your income to famine relief organizations and by not squandering food that could be fed to them. Consistency with your own beliefs implies that to do any less is to be profoundly immoral. (shrink)

There is a lot of talk around about Globalisation and its mana-like benefits; indeed, there are many, in areas such as the spread of communication capabilities, social media, and wider distribution of goods in the free trade marketplace that in previous decades were ‘protected’ by exorbitant excise tariffs, licensing restrictions, and low turn-overs. Since Weber, Robertson, Wallerstein, Appadurai, Tambiah et al, there has been much theorizing on the inevitability of Globalisation and its neat corollaries, Free Trade, Liberalisation, Parallel Modernities, and (...) Economic Rationalism. Yet, Globalisation has both its protagonists and antagonists alike. The paper focuses on case studies from the Indian-end, impelled by the question: in what ways has Globalisation benefited and hurt India’s economy, the slow growth and periodic stagnation of its capabilities, the stability of the nation and its people? As part of the reciprocal deal on Liberalisation, Free Trade agreement has enabled myriads of TNCs with to reign in large Western capital-investment and start-up industrial bases, which have undoubtedly helped push India to becoming the third largest world economy. However, the encroachments of TNCs and their impact on agro-economics, biodiversity, the plight of farmers, the further disenfranchisement of numerically small from a share in the national weal, the uneven regional deliverance from poverty, malnutrition, the disproportionate gender-ratio, rural illiteracy among the neglected, and other fall-outs, have worried critics of India’s ‘easy ride’ on the highway of Globalisation. The arguments will be developed extensively with illustrations. (shrink)

Autism spectrum disorder affects an estimated 1 in 54 children aged 8 years in the United States. For many of these children, there are concomitant eating and/or behavioral challenges that can make managing their nutritional health challenging. This commentary responds to a particularly challenging case in which a pediatric patient with ASD presented to the local hospital’s emergency department with severe weight loss and malnutrition.

ABSTRACTThis article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV‐infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women AIDS cases in order to (...) support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non‐existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV‐tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

Everyone knows that British doctors are emigrating and that other doctors, mostly from the third world, are immigrating to Britain. Also everyone thinks that he knows the reasons why. However, the Edinburgh Medical Group thought the various reasons for this medical migration should be examined more closely, and held a symposium (Chairman, Professor A S Duncan, Professor Emeritus of Medical Education in the University of Edinburgh) to examine the causes for medical migration at the present time. Medical teaching and practice (...) is still basically as it has been developed in the West and so overseas doctors trained in Britain take with them not only the medical knowledge and skills but also the attitudes of the West when they return to their own countries. Consequently they wish to settle in the towns and practise as consultants when the real medical problems in many of the developing countries are those of a rural population needing health care rather than treatment in what have been called `disease palaces'. As speakers made clear, a new responsibility must fall on those training doctors from overseas in the British medical schools to fit them not for the dream world of the sophisticated medical scene but for the realities of working in often badly equipped clinics and dealing with common conditions such as malnutrition and other problems of maternity and child health. The symposium also included discussions as to why British doctors wished to emigrate. Money seemed to be the most compelling motive, but opportunities were being limited for their migration for economic and political reasons. Finally, a look at the whole of the medical scene in Britain: perhaps the standard sought in Britain both by the doctor and the patient is too high and too individualistic. Events will show if this be true. (shrink)

Despite triggering one of the largest civilian death tolls in modern history, the policy and human consequences of economic sanctions on Iraq between 1990-2003 remain largely unexamined. This lack of scrutiny mirrors the euphemism and mis-information surrounding the embargo itself and the Oil-for-Food program ostensibly adopted to protect Iraq's civilian population. But it also reflects incomprehension among Western publics - long removed from the realities of hunger and economic destitution - of the intimate link between economic conditions and mortality. Iraq (...) suffered an estimated 1.5 million excess deaths because of a catastrophic undermining of civilian livelihood triggered by the embargo; an outcome termed slow famine in the demographic literature. With much of the population fully dependent on daily food rations of less than 21 cents per person for much of the sanctions period, OfF `relief' was inherently incapable of substituting for a functioning civil economy. Recent positive accounts of the impact of OfF, in the form of the Independent Inquiry Committee into the Oil-for-Food Program, are refuted by close analysis of malnutrition and mortality rates across the sanctions period. The example of Iraq reveals the danger in treating economic sanctions as a cheap, `non-violent' tool for conflict resolution. In reality their deadly power is terrorizing for societies not protected from their application by permanent member status on the UN Security Council, a threat which continues to generate global insecurity. The Iraq experience reveals how current, narrowly framed, international law prohibitions on starvation as a weapon of war need to be extended to cover interference with civilian livelihood and hence access to food. (shrink)

The World Bank is committed to “work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility”.1 Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues—which are often not acknowledged by commentators—that are the subject of this paper. It asks why there should be a focus on the (...) poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level and the country level. (shrink)

This article is concerned with a discussion of the plausibility of the claim that GM technology has the potential to provide the hungry with sufficient food for subsistence. Following a brief outline of the potential applications of GM in this context, a history of the green revolution and its impact will be discussed in relation to the current developing world agriculture situation. Following a contemporary analysis of malnutrition, the claim that GM technology has the potential to provide the hungry (...) with sufficient nourishment will be discussed within the domain of moral philosophy to determine whether there exists a moral obligation to pursue this end if and only if the technology proves to be relatively safe and effective. By using Peter Singer’s duty of moral rescue, I argue that we have a moral duty to assist the third world through the distribution of such GM plants. I conclude the paper by demonstrating that my argument can be supported by applying a version of the Precautionary Principle on the grounds that doing nothing might be worse for the current situation. (shrink)

SummaryThe nutritional status of under-five children is a sensitive sign of a country's health status as well as economic condition. This study investigated the differential impact of some demographic, socioeconomic, environmental and health-related factors on the nutritional status among under-five children in Bangladesh using Bangladesh Demographic and Health Survey 2007 data. Two-level random intercept binary logistic regression models were used to identify the determinants of under-five malnutrition. The analyses revealed that 16% of the children were severely stunted and 25% (...) were moderately stunted. Among the children under five years of age 3% were severely wasted and 14% were moderately wasted. Furthermore, 11% of the children were severely underweight and 28% were moderately underweight. The main contributing factors for under-five malnutrition were found to be child's age, mother's education, father's education, father's occupation, family wealth index, currently breast-feeding, place of delivery and division. Significant community-level variations were found in the analyses. (shrink)

The Ethics of Agricultural Intensification: An Interdisciplinary and International Conversation Paul B. Thompson and John Otieno Ouko* Global agriculture faces a number of challenges as the world approaches the second decade of the third millennium. Predictions unilaterally indicate dramatic increases in world population between 2010 and 2030, and a trend in developing countries toward greater consumption of animal products could multiply the need for prod- tion of basic grains even further. Although global food production in 2000 was estimated to be (...) adequate for the existing population, hunger and malnutrition are persistent problems that have led decision makers to recognize that increasing food production in specific regions may be the most effective way to address food se- rity for impoverished peoples. At the same time, there will need to be policy adju- ments that improve poor people’s access to current food supplies without simultaneously undercutting the ability of local producers to obtain needed cash income. What is more, the uncertain effects of global climate change on agricultural ecosystems complicate planning for this process, while poorly understood processes of globa- zation create additional unknowns from the side of social systems. In short, despite surpluses in many parts of the developed world, finding ways to increase food p- duction on both selected regional and a total global basis remains a priority for many farmers, policy makers and agricultural researchers. (shrink)

We live in a world in which one of every five persons does not get enough to eat. Each day more than ten thousand people die of starvation; thousands more, both adults and children, suffer brain damage and other functional abnormalities because of malnutrition. Often there is simply not enough drinking water or not enough food available. Some people must do without. A drought has come and some are allowed to die. Or, less food has been grown because less (...) fertilizer was imported and hundreds or thousands die. (shrink)