Individuals following vegetarian diets are at risk for developing vitamin B12 deficiency owing to suboptimal intake. As vitamin B12 is essential for the synthesis of nucleic acids, erythrocytes and in the maintenance of myelin, deficiency may result in a variety of symptoms. Some of these symptoms may be severe while others may be irreversible. The objective of this review was to assess vitamin B12 deficiency, based on reported serum vitamin B12, among individuals adhering to different types of vegetarian diets. A systematic literature search was carried out using multiple search engines including PubMed, Medline, CINAHL plus, ERIC, Nursing and Allied Health Collection and Nursing/Academic Edition. The inclusion criteria consisted of original studies that assessed serum vitamin B12, studies written in English, non-case studies and studies that reported actual percentages of vitamin B12 deficiency. Forty research studies were included. The deficiency prevalence among infants reached 45%. The deficiency among the children and adolescents ranged from 0 to 33.3%. Deficiency among pregnant women ranged from 17 to 39%, dependent on the trimester. Adults and elderly individuals had a deficiency range of 0-86.5%. Higher deficiency prevalence was reported in vegans than in other vegetarians. Thus, with few exceptions, the reviewed studies documented relatively high deficiency prevalence among vegetarians. Vegans who do not ingest vitamin B12 supplements were found to be at especially high risk. Vegetarians, especially vegans, should give strong consideration to the use of vitamin B12 supplements to ensure adequate vitamin B12 intake. Vegetarians, regardless of the type of vegetarian diet they adhere to, should be screened for vitamin B12 deficiency.
Postnatal depression has profound effects on the quality of life, social functioning, and economic productivity of women and families. This paper presents the findings of an earlier exploration of the perception of postnatal depression in African women immigrants in South East London. The aims of this research were twofold: firstly, to establish cultural elements related to postnatal depression through women's narratives regarding their daily life situations, including the nuances and complexities present in postnatal depression, and secondly, to help health professionals understand and acknowledge postnatal depression signs in these immigrant women and some of the cultural ambiguities surrounding them. The study used a qualitative approach mainly through the implementation of two focus groups. Thematic analysis of the women's narratives suggested that almost half of the participants in the study struggle with some signs of postnatal depression. The women did not perceive the signs as related to illness but as something else in their daily lives, that is, the notion “that you have to get on with it.” The study also highlights the fact that the signs were not identified by health visitors, despite prolonged contact with the women, due to the lack of acknowledgement of women's silence regarding their emotional struggle, household and family politics, and intercultural communication in health services.
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