Maureen H. Fitzgerald

Further analyses on Micronesian banana, taro, breadfruit and other foods for provitamin A carotenoids and minerals

Few Micronesian foods have been analyzed for nutrient content. Information is needed on locally grown, culturally acceptable foods that could be promoted to alleviate, vitamin A deficiency in the Federated States of Micronesia. Using an ethnographic approach that included key informant interviews and observation, Micronesian cultivars with potential for high-carotenoid content according to their coloration were identified. These cultivars of banana, giant swamp taro, breadfruit and other foods were analyzed for alpha- and beta-carotene using high-performance liquid chromatography (HPLC) and for nine minerals using inductively coupled plasma (ICP). A wide range of provitamin A carotenoid levels was found in banana, taro, and breadfruit cultivars, some containing very high levels (beta-carotene content from 515 to 6360 mug/100 g in banana, 260 to 1651 mug/100 g in taro, and 295 to 868 mug/100 g in breadfruit, edible portion). Other cultivars contained moderate levels, but as they can be eaten in large quantities, they may contribute significantly to vitamin A status. The taro samples contained very high levels of zinc (mean 5.9 mg/100 g) and significant levels of other minerals (mean content of calcium was 120 mg/100 g). These staples with cultural acceptability and high availability potentially could play a role in vitamin A, micronutrient, and chronic disease programs in the Pacific

Carotenoid-Rich Bananas: A Potential Food Source for Alleviating Vitamin A Deficiency

This review article points out that bananas are an important food for many people in the world. Thus, banana cultivars rich in provitamin A carotenoids may offer a potential food source for alleviating vitamin A deficiency, particularly in developing countries. Many factors are associated with the presently known food sources of vitamin A that limit their effectiveness in improving vitamin A status. Acceptable carotenoid-rich banana cultivars have been identified in Micronesia, and some carotenoid-rich bananas have been identified elsewhere. Bananas are an ideal food for young children and families for many regions of the world, because of their sweetness, texture, portion size, familiarity, availability, convenience, versatility, and cost. Foods containing high levels of carotenoids have been shown to protect against chronic disease, including certain cancers, cardiovascular disease, and diabetes. Because the coloration of the edible flesh of the banana appears to be a good indicator of likely carotenoid content, it may be possible to develop a simple method for selecting carotenoid-rich banana cultivars in the community. Research is needed on the identification of carotenoid-rich cultivars, targeting those areas of the world where bananas are a major staple food; investigating factors affecting production, consumption, and acceptability; and determining the impact that carotenoid-rich bananas may have on improving vitamin A status. Based on these results, interventions should be undertaken for initiating or increasing homestead and commercial production.

Reflection in intercultural learning: examining the international experience through a critical incident approach

Professionals are increasingly being required to work in diverse, multicultural environments. Accordingly, skills in intercultural practice are a prerequisite to professional knowledge and competence. Ensuring that these are developed is increasingly part of the core business of universities. Currently, however, there is a gap in the knowledge base as to the learning processes that underpin the acquisition of such intercultural understandings, knowledge and competence. This article represents an attempt to address this gap through describing some of the findings of a qualitative, interdisciplinary study undertaken by the authors with students at Charles Sturt University, Australia. The purpose of the study was to illuminate key processes in the development of cultural knowledge and intercultural competence through exploring the experiences of education and health professional students undertaking fieldwork and study in Indonesia and Vietnam. In this article we illustrate and discuss a continuum of learning to be interculturally competent, grounded in the data, and conclude with a series of recommendations for future practice and research.

Carotenoid and vitamin content of Karat and other Micronesian banana cultivars

We previously found high carotenoid levels in Karat and other Micronesian bananas, indicating potential importance for alleviating vitamin A deficiency and other nutritionally related health problems in the Federated States of Micronesia. Past work focused on carotenoid and mineral analyses, whereas here we investigated 16 cultivars (most not previously analysed) for a broader micronutrient profile, including seven vitamins. Karat carotenoid levels were higher than in previous analyses, confirming Karat as exceptionally carotenoid-rich. We identified an additional 10 carotenoid-rich cultivars, expanding the range having potential for alleviating vitamin A deficiency. A striking finding is the high riboflavin level in Karat, including high levels of uncharacterized flavonoids. Niacin and α-tocopherol are at levels that may contribute importantly to dietary intake within normal patterns of consumption. These data present a more complete basis for promoting the nutritional benefits of these banana cultivars where they are consumed in the Pacific, and potential benefits for promoting elsewhere.

Insights on food and nutrition in the Federated States of Micronesia: a review of the literature

BACKGROUND Nutrition-related disorders, including vitamin A deficiency (VAD) and chronic diseases, are serious problems in the Federated States of Micronesia (FSM). Many suggest that these disorders are new problems related to dietary and lifestyle changes. In the past four decades, imported foods, such as white rice, flour, sugar, refined foods and fatty meats, have increasingly replaced local foods in the diet. AIM A literature review was conducted to understand underlying issues related to dietary change and obtain insights for nutrition research and interventions. METHOD Published and unpublished papers from different disciplines were reviewed and collated for information on food and nutrition in FSM. Topics covered were historical background, local foods, infant and child feeding, dietary assessment, and nutritional status. Particular focus was on information and data relating to VAD, the primary topic that led to the review of the literature. CONCLUSIONS FSM, a tropical country of abundant agricultural resources, has suffered a great loss in production and consumption of local foods. Inconsistent external and internal government policies and food aid programmes have contributed to the problem. Further research on the nutrient content of local foods and factors affecting production, acquisition and consumption is needed, as well as a broad, well-planned, intersectoral intervention aimed at dietary improvement for all age groups in the population.

The Hidden Disability Dilemma for the Preservation of Self

Abstract Oliver Sacks’ work focuses our attention on the use of narrative and the issue of the “preservation of self.” Chronic illness and acquired disabilities require a reappraisal of ones concept of self and often result not only in a modification of self concept but modifications of ones self narrative and occupational behaviours as well as strategies for the preservation of the emotional and physical self. Hidden disabilities, those not easily discerned by others, present unique challenges to this reappraisal, both because they are hidden and because they can often be kept hidden. This paper draws on the narratives of two small groups of women with hidden disabilities ‐ women from Hawaii with Temporomandibular Joint Syndrome(TMJ) and women from Australia with “hidden” Multiple Sclerosis(MS) . In their narratives we see a struggle towards the reconciliation of a dilemma for the preservation of self: if the illness or disability is kept hidden one can maintain a certain public image of self but there...

The challenge of interdisciplinary collaboration in acute psychiatry: Impacts on the occupational milieu

This paper, based on a larger ethnographic exploration of the acute inpatient environment for older people with mental illness, describes and provides interpretations of staff perceptions and actions in order to highlight tensions between professional groups which adversely affect opportunities for patients to engage in meaningful occupations. Fieldwork conducted in 1999-2000, supplemented by 20 in-depth interviews with a range of mental health professionals, provides the foundation for suggesting that the extent and nature of occupational engagement is significantly impacted by interdisciplinary relations. The skill of occupational therapists to collaborate with their nursing colleagues in a socially complex environment, and the importance of personal leadership skills among our new graduates are discussed.

The changing world of HIV care: The impact on health professionals

Recent advances in treatment have improved the health of many people living with HIV/AIDS. The research described in this paper shows that the changing context of care is also impacting significantly on people who provide services. In this paper, we explore both perspectives by comparing recent service provider data with that derived from research involving people living with HIV/AIDS. We explore four themes: (1) hope and optimism; (2) changing context, roles and identities; (3) changing relationships; and (4) quality of life. Treatment advances and a new focus on living has altered the context of working with people living with HIV/AIDS and challenges health professionals to find new meanings and relationships within that context. Study findings have implications for the wider health care context and the changing roles and power balances within this arena.

Families and nursing home placements: a cross-cultural study.

With the aging of many populations, health careworkers and families increasingly findthemselves jointly involved in situationsinvolving decisions about nursing homeplacements. How each approaches suchsituations is affected by beliefs andassumptions about the role of family members inthe care of family members and the decisionmaking process. This paper explores theresponses of people from four cultural groupsliving in Australia (Anglo-Celtic Australian,Chinese, Greek, Lebanese) to a criticalincident scenario about a Russian family inAustralia faced with such a decision. Theresponses to this scenario were remarkablysimilar across the four cultural groups. Allsaw making such a decision as difficult, butthe reasons for the difficulty suggest someinteresting cross-cultural distinctions. Somegroups viewed care of a family member more interms of a social and role obligation whileothers addressed it as a personalresponsibility. To not care for elderlyparents in the home was accompanied by a senseof guilt among some respondents and a sense ofpublic social shame among others. Ambivalenceabout nursing homes and placing a family memberin a nursing home, culture change andcross-generational differences, and roles androle support were other important themes. Theresults are consistent with other data analysedin conjunction with the InterculturalInteraction Project. The findings from thisresearch suggests a need to examine moreclosely the beliefs and assumptions associatedwith nursing home placements and one way tohelp students and health professionals to doso.

Provitamin A carotenoid content of different cultivars of edible pandanus fruit

As part of an overall study to identify vitamin A-rich foods, a study was carried out in the Federated States of Micronesia (FSM) to provide information on production, acquisition, consumption and cultural acceptability of edible pandanus cultivars, Pandanus teetorius, and to identify their carotenoid content. Samples of five pandanus cultivars were collected and analyzed for alpha- and beta-carotene by HPLC. The results showed that the two cultivars with yellow fruit coloration contained low levels of carotenoids, while the orange fruits, which were also well liked as a food in the community, contained higher levels at maxima of 190 mug/100 g and 393 mug/100 g for alpha- and beta-carotene, respectively. Common patterns of intake when the fruit is available show that pandanus can provide a large proportion of estimated requirements of retinol equivalents. Local people were generally unaware that pandanus had health benefits, although the food was very popular. Nevertheless, key informants report that production had greatly decreased in recent years. To reverse this trend, those acceptable cultivars high in carotenoid content should be promoted both for their general enjoyment and their health benefits