Vanessa Lee

Extent of vitamin A deficiency among rural pregnant women in Bangladesh

OBJECTIVE To investigate the prevalence of vitamin A deficiency (VAD) among pregnant women in rural Bangladesh, and examine the relationship between various factors and vitamin A status. SETTING Community Nutrition Promoter (CNP) centres in Kapasia sub-district of Gazipur district, Bangladesh. DESIGN A cross-sectional study. SUBJECTS AND METHODS Two hundred women, aged 18-39 years, in their second or third trimester of pregnancy were selected from seventeen CNP centres in four unions of Kapasia sub-district where they usually visit for antenatal care. Various socio-economic, personal and pregnancy-related information, dietary intake of vitamin A and mid-upper arm circumference (MUAC) data were collected. Serum retinol (vitamin A) concentration was determined. RESULTS More than half (51 %) of the pregnant women had low vitamin A status (serum retinol <1.05 micromol/l) with 18.5 % having VAD (serum retinol <0.70 micromol/l). Fifty-three per cent of the womens vitamin A intake was less than the recommended dietary allowance. By multiple regression analysis, MUAC, per-capita expenditure on food and wealth index were found to have significant independent positive relationship with serum retinol concentration, while gestational age of the pregnant women had a negative relationship. The overall F-ratio (10.3) was highly significant (P = 0.0001), the adjusted R2 was 0.18 (multiple R = 0.45). CONCLUSION VAD is highly prevalent among rural pregnant women in Bangladesh. Gestational age, nutritional status, per-capita expenditure on food and wealth index appear to be important in influencing the vitamin A status of these women. An appropriate intervention is warranted in order to improve the vitamin A status.

Researching reflexivity: Negotiating identity and ambiguity in a cross-cultural research project

This article examines a multidisciplinary, ethnically diverse team of researchers and their relationship with the research in which they were engaged: a study of overseas trained doctors (OTDs) recruited to work in health services in Aboriginal and Torres Strait Islander communities across four Australian states. The reflexive analysis presented in this article is based on interviews of 13 of the 15 researchers engaged in that project, examining the ways in which the researchers construct their own identities in relation to the research and the commonalities and differences evident within and between clusters of researchers based on their own social and cultural backgrounds and migration histories. The analysis also identifies ways in which discourses emerging from this analysis influence further engagement with the research process itself and the findings of that research by making explicit the assumptions underlying qualitative observations and insights.

Building capacity through action research curricula reviews

In Australia, graduates of Master of Public Health (MPH) programmes are expected to achieve a set of core competencies, including a subset that is specifically related to Indigenous health. This paper reports on the methods utilised in a project which was designed using action research to strengthen Indigenous public health curricula within MPH programmes at Australian universities. This aim is achieved through the use of three interlinked ‘action–reflection’ cycles, involving individual Indigenous public health academics who, through their membership in a scholarly network, have undertaken a series of curriculum reviews, which have in turn influenced organisational change in universities. The project results demonstrated how action research can successfully strengthen Indigenous public health curricula.

Integration models for indigenous public health curricula

ABSTRACT All graduates of Master of Public Health (MPH) programmes in Australia are expected to achieve a core set of Indigenous public health competencies designed to train ‘judgement safe practitioners’. A curriculum framework document was developed alongside the competencies to assist programme providers to integrate appropriate Indigenous content, but it does not describe the intended integration model. A review of MPH programmes was undertaken to determine the extent of integration, identify examples of best practice and explore how integration can be improved. Data from the consolidated review findings were analysed using a staged approach. Several models of curricula integration were identified, building on known models, and definitions developed that differentiate features according to the extent of integration achieved. The model recommended in the literature as best practice, known to promote deep learning, was found in only one of the reviewed programmes. This combination model supports development of reflexive practitioners who can operate across different disciplines and ways of knowing. Enablers and barriers were explored to explain why some integration models were more commonly found. Implications for curriculum reform are outlined with strategies to assist implementation of a combined integration model, a necessary learning approach to enhance student cultural competence.

Expectations for dog ownership: Perceived physical, mental and psychosocial health consequences among prospective adopters

Dog ownership is popular worldwide, with most human-dog dyads forming successful attachment bonds. However, millions of dogs are surrendered to animal shelters annually, possibly due to mismatches between owner expectations and the realities of dog ownership. The aim of the current study was to explore the benefits and challenges people expect from dog ownership and how these expectations vary with previous ownership history. An Australian-wide sample of 3465 prospective adopters completed a self-administered online questionnaire about the physical, mental and psychosocial health benefits and challenges they associated with dog ownership. Among the potential benefits, respondents expected increased walking (89%), happiness (89%) and companionship (61%) and decreased stress (74%) and loneliness (61%). Among the challenges, they expected increased responsibility (64%) and dog training (62%). Ownership history influenced respondents’ expectations, with previous/current dog owners having consistently greater odds of expecting benefits and reduced odds of expecting challenges than non-owners. A possible explanation is that previous/current dog owners’ exhibit bias when considering dog ownership by selectively recalling positive experiences from previous ownership. Our findings support the need for education of prospective dog owners to ensure their expectations align with the reality of ownership, based on current scientific evidence.

Political determinants and Aboriginal and Torres Strait Islander women: don’t leave your integrity at the political gate

When the British colonized Australia, they did so under a paternalistic ideology that remains evident today as Australian federal, state, territory and local governments continue to implement paternalistic policies.. Paternalistic policies are those that restrict choices to individuals, ostensibly in their ‘best interest’ and without their consent. The goals of such policies are to change individuals’ behaviours in areas such as gambling, smoking, consumption of drugs and alcohol, or the reliance on welfare payments. The Oxford Dictionary of Philosophy refers to paternalism as ‘‘the government being the parent’’, p. 270. With this definition, and the gender-specific word ‘paternalism’, it is little wonder that Aboriginal and Torres Strait Islander women have been the victims of extraordinarily high levels of sexism, domestic violence, marginalization, work-place lateral violence and racism. The 2011 Australian Census showed that Aboriginal and Torres Strait Islander women experience poorer health than non-Indigenous women due to their life circumstances. These circumstances are evident across employment and education where 39 per cent of the Indigenous females The Federation’s Pages