The objective of this study was to determine Thai women's nutrition awareness of folic acid and its role in the prevention of neural tube defects. Three hundred and two Thai women between 18-45 years completed a 30 itemized survey. There was a significant lack of nutrition awareness of folic acid. Many women (n= 274; 91.9%) had not heard of neural tube defects (NTD) and only 8.1 % (n=24) had heard of spina bifida/NTD. More than 50% (n=176) were unaware of NTD. Only 11.6% of the women (n=35) thought consuming vitamins during pregnancy would reduce the risk of birth defects. More than 80% of the women reported the best time to take folic acid supplement was during pregnancy. Less than 20% of the women indicated taking folic acid supplement before or after pregnancy. In this population, nutrition awareness of folic acid was minimal. / Department of Family and Consumer Sciences

Graduation date: 1978

Thesis (M.S.)--Eastern Illinois University, 1998. / Includes bibliographical references (leaves 51-53).

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Thesis (M.S.)--Eastern Illinois University, 2004. / Includes bibliographical references (leaves 49-54).

Thesis (Ph. D.)--University of Texas at Austin, 2001. / "Fmet" after tRNA in title is superscript. Vita. Includes bibliographical references (leaves 102-119). Available also in a digital version from Dissertation Abstracts.

Thesis (M.P.H.)--Georgia State University, 2007. / Title from file title page. Russ Toal, committee chair; Catherine McCarroll, Joseph Mulinare, committee members. Electronic text (83 p. : ill.) : digital, PDF file. Description based on contents viewed Jan 8, 2008. Includes bibliographical references (p. 79-83).

Typescript (photocopy). / Digitized by Kansas Correctional Industries

This thesis investigates the use of scientific evidence in the process of making public health policy. A case study located within a food regulation setting is used. The aim is to test theory against this case study. The outcome is a theoretical understanding of the use of scientific evidence in the policy-making process in a food regulation setting. Food regulation can influence food composition and food labelling and thereby affect the population's dietary intake. Frequently there are contested values, beliefs, ideologies and interests among stakeholders regarding the use of food regulation as a policy instrument to effect public health outcomes. The protection of public health and safety, taking into account evidence based practice, is generally employed by food regulators as the priority objective during the policy-making process to adjudicate among the competing expectations of stakeholders. However, this policy objective has not been clearly defined and is vulnerable to interpretation and application. The process by which folate fortification policy was made in Australia, in response to epidemiological evidence of a relationship between folate intake during the periconceptional period and reduced risk of neural tube defects, was analysed as a case study of the policy-making process. The folate fortification policy created a precedent for both food fortification and subsequently health claims policy in Australia. A social constructivist method was used to analyse the case study. The method involved deconstructing the food regulatory system into three levels; decision-making process; procedural; and political environment. Data aligned with each level of analysis was collected from 22 key informant interviews, documentary sources, field notes and surveys of both a random sample of the Australian population's knowledge of folate and use of folic acid-containing supplements (n = 5422), and the implementation of folate fortified food products into stores (n = 60). The insights that emerged from each of the three levels of analysis were assessed iteratively to identify a pattern of interrelationships associated with the policy-making process within the food regulatory system. The identified pattern was interpreted against existing theory to gain a theoretical understanding of the public health policy-making process in this political setting. The central argument of this thesis extends Sabatier and Jenkins-Smith's Advocacy Coalition Framework theory to a food regulation setting. The argument is that within the contemporary political climates of neoliberalism and globalisation, a coalition between corporate interests and the values of scientists with a positivist-reductionist approach to public health research is privileged so as to invoke certain scientific evidence to, in turn, legitimise food regulation policy decisions. The theory will help to inform policy-makers about how and why the public health policy objective in a food regulation setting is interpreted and applied. This will contribute to improving policy practice intended to effect public health outcomes. It is concluded that irrespective of the quantity and quality of the scientific evidence that is being made available, scientific evidence cannot be assumed to speak for itself Policy-making is an inherently political and value-laden process and the potential for politically motivated interpretation and application of otherwise value-neutral scientific evidence can undermine the investment in its generation. From this perspective, evidence based practice, far from liberating policy-making from political influence, can itself become part of the problem rather than the solution. Nevertheless, rational evidence based practice is an ideal to strive for and a series of recommendations is proposed to help make the use of evidence in current food regulation policy processes more transparent and democratic.

Maternal folate intake and levels of folate in milk, serum and red cells were assessed in 57 healthy, lactating women, ages 22-38 years, throughout early (0-6 months) and later (7-23 months) lactation. Average maternal folate intake from diet alone was 212 µg/day or 78.5% RDA (1989) and mean total folate intake from diet and supplements was 314% RDA (878 µg/day) at 0-6 months and 238% RDA (620 µg/day) at >6 months. Human milk folate was sufficient to meet the RDA (1989) for infants. Milk folate was not related to maternal folate intake, maternal serum or red cell folate and was unaffected by extended lactation (7-23 months), perhaps at the expense of maternal folate stores. Compared with early lactation, serum folate decreased (p=0.0004) and red cell folate tended to decrease (p=0.08) in later lactation and were both increased by folate supplementation (p < 0.001).Level of folic acid supplementation appeared to predict red cell folate concentration. An average of 884 µg supplemental folate/day was associated with red cell folate levels >400 ng/mL, which have previously been reported as optimal for prevention of folateresponsive neural tube defects. The addition of an 880 µg/day folic acid supplement to the diet of lactating women may raise red cell folate concentrations of lactating women to protective levels. / Department of Family and Consumer Sciences