Dietary and biochemical selenium status of urban 6- to 24-month-old South Island New Zealand children and their postpartum mothers

A community-based, cross-sectional survey was conducted in the South Island of New Zealand to assess the dietary and biochemical selenium status of children (n = 136) and their mothers (n = 302), and to assess factors influencing selenium status. Serum and plasma samples from children and their mothers were analyzed for selenium using graphite furnace atomic absorption spectrometry. Dietary selenium intakes were analyzed from 3-d weighed diet records, and food sources of selenium were quantified. Mean dietary selenium intakes in infants (6-11.9 mo), toddlers (12-24 mo), and mothers were below recommended levels. Toddlers had higher selenium intakes than infants (13.7 +/- 8.4 and 7.9 +/- 6.2 microg/d, respectively, P = 0.0001) and the selenium density of their diets was also higher [3.2 +/- 1.7 and 2.4 +/- 1.7 microg/(MJ . d), respectively, P = 0.003]. Household smoking was associated with lower serum selenium concentrations in infants and toddlers (P = 0.02). South Island women who were currently pregnant had lower plasma selenium concentrations (0.74 +/- 0.15 micromol/L) than nonpregnant lactating and nonpregnant nonlactating women (0.94 +/- 0.16 and 0.93 +/- 0.16 micromol/L, respectively, P = 0.0001). Clearly, pregnant women, infants and toddlers are at risk of suboptimal selenium status, and further research is warranted to assess potential effects in these groups. The finding of an association between household smoking and lower selenium concentrations in children should be investigated further. Dietary interventions are recommended to improve dietary selenium intakes in South Island children and their mothers.     

Environmental exposure to trace elements and prostate cancer in three New Zealand ethnic groups

A stratified random sample of 176 men was taken from a larger community prostate study group of 1405 eligible subjects from three ethnic groups in the Wellington region of New Zealand, in order to examine ethnic differences in exposure to cadmium (Cd), selenium (Se) and zinc (Zn) and possible associations of blood levels of Cd, Se and Zn with the prevalence of elevated serum Prostate Specific Antigen (PSA); a marker of prostate cancer. Maori and Pacific Islands men were found likely to have higher Cd exposure than New Zealand Europeans through diet, occupation and smoking. However, there was no significant difference between ethnic groups in mean blood Cd levels. Pacific Islands men had significantly higher levels of blood Se than both New Zealand European men and Maori men. Maori men had significantly higher levels of blood Zn than both New Zealand European men and Pacific Islands men. A positive association was found between blood Cd and total serum PSA. Se and Zn levels were not associated with elevated PSA. Maori and Pacific Islands men have higher prostate cancer mortality rates than New Zealand European men. Ethnic differences in mortality could be contributed to by differences in rates of disease progression, influenced by exposure and/or deficiency to trace elements. However, results did not reflect a consistent ethnic trend and highlight the complexity of the risk/protective mechanisms conferred by exposure factors. Further research is needed to ascertain whether the associations found between Cd and PSA levels are biologically important or are merely factors to be considered when interpreting PSA results clinically.     

Changing epidemiological trends of legionellosis in New Zealand, 1979-2009

This study evaluated the spatio-temporal variation of Legionella spp. in New Zealand using notification and laboratory surveillance data from 1979 to 2009 and analysed the epidemiological trends. To achieve this we focused on changing incidence rates and occurrence of different species over this time. We also examined whether demographic characteristics such as ethnicity may be related to incidence. The annual incidence rate for laboratory-proven cases was 2·5/100,000 and 1·4/100,000 for notified cases. Incidence was highest in the European population and showed large geographical variations between 21 District Health Boards. An important finding of this study is that the predominant Legionella species causing disease in New Zealand differs from that found in other developed countries, with about 30-50% of cases due to L. longbeachae and a similar percentage due to L. pneumophila for any given year. The environmental risk exposure was identified in 420 (52%) cases, of which 58% were attributed to contact with compost; travel was much less significant as a risk factor (6·5%). This suggests that legionellosis has a distinctive epidemiological pattern in New Zealand.     

Governmentality, discourse and space in the New Zealand health care system, 1991-2003

This paper considers recent health care reform in New Zealand in the context of the continuing evolution of the 'neoliberal project'. It advocates the adoption of a Foucauldian governmentality approach to analysis as a productive way to extricate the changing understandings of space within evolving New Zealand health discourses. We analyse two policy documents released 9 years apart which, when examined together, encapsulate the changing discourses of the health care system in the 1990s. We note that through the 1990s the central governing rationality has shifted from competition towards cooperation in health care delivery. While place was held to be subservient to the market at the beginning of the decade, health care has been increasingly re-territorialised through 'community' and its associated constructions.     

Serum selenium concentrations and dietary selenium intake of New Zealand children aged 5-14 years

Serum Se concentrations and dietary Se intakes have been determined in relation to age, sex, ethnicity, region and index of deprivation in a nationally representative sample of New Zealand children aged 5-14 years from the 2002 National Children's Nutrition Survey. Dietary intake was assessed from computer-assisted, multiple-pass 24 h diet recall interviews (n 3275). Serum Se concentrations were obtained from a subset of urban-based children (n 1547). Mean (95 % CI) serum Se concentration in children was 0.96 (0.93, 1.00) micromol/l. Males (1.00 micromol/l) had higher serum Se levels than females (0.93 micromol/l; P = 0.027). M?ori children had lower serum Se than Pacific Islands children (P = 0.038) and New Zealand European and Other children (P = 0.005). Children in the Upper North Island (1.06 micromol/l) had higher mean serum Se values than those in the Lower North Island (0.98 micromol/l, P < 0.0005) and South Island (0.79 micromol/l, P < 0.0005), and serum Se in the Lower North Island was higher than that in the South Island (P < 0.0005). Mean dietary Se intake was 36 (34, 37) microg/d. The intakes of children aged 5-6 years (31 microg/d) were lower than those of children aged 7-10 and 11-14 years (35 and 38 microg/d, respectively; P < 0.00 005) and the intakes of 7-10-year-olds were lower than those of 11-14-year-olds (P = 0.002). Serum Se was associated with dietary Se after adjusting for all variables, including region (P = 0.006). The Se status of our children falls in the middle of the international range of serum Se concentrations, but that for children in the South Island is among the lowest values reported and may be a cause for concern.     

Calcium,magnesium, sodium and potassium levels in foodstuffs from the second French Total Diet Study

Calcium (Ca), magnesium (Mg), sodium (Na) and potassium (K) contents in 1319 foodstuffs habitually consumed by the French population were determined for the second French Total Diet Study (TDS), using micro-sampling flame atomic absorption spectrometry after microwave-assisted digestion. Concentration and distribution of these minerals in food samples were reported and compared with results from the previous French TDS. For Ca, the results indicate that the food presenting the highest levels are dairy products (1597 mg kg^?1), tofu (802 mg kg^?1) and some fish and cereal products; for Mg, tofu (1340 mg kg^?1), “Sweeteners, honey and confectionery” (672 mg kg^?1) especially dark chocolate (2225 mg kg^?1) and certain grains such as nuts and oilseeds (1069 mg kg^?1) and some cereal products; for Na, processed meats such as delicatessen (12,422 mg kg^?1), “Salts, spices, soup and sauces” (21,028 mg kg^?1), some cheeses and cereal products; and for K, “Cereal and cereal products” (4378 mg kg^?1), “Meats and offal” (3993 mg kg^?1), “Nuts and oilseeds” (7355 mg kg^?1) and “Sweeteners, honey and confectionery” (3445 mg kg^?1) (especially chocolate).     

Equity in access to zero-fees and low-cost Primary Health Care in Aotearoa New Zealand: Results from repeated waves of the New Zealand Health Survey, 1996-2016

Primary Health Care in Aotearoa New Zealand is mainly funded through capitation-based funding to general practices, supplemented by a user co-payment. Funding is designed in part to keep the costs of care low for key groups in the population who have higher health needs. We investigated changes in the socio-demographic determinants of no-cost and low-cost access to Primary Health Care using data from sequential waves of the New Zealand Health Survey (1996/97–2016/17). Fees paid were self-reported and inflated using CPI-adjustment to the value of the 2018NZD.Over the 20-year study period, there was an increase in the population accessing low-cost care. Access to low-cost care was particularly high for Pacific people, but also higher for Māori and Asian people compared to Other/New Zealand European ethnicities. Area-level deprivation was a stronger predictor of access to low-cost care for non-Māori than for Māori. Although Māori were more likely than non-Māori to access low-cost care at all levels of deprivation, this was less evident in more deprived compared to more affluent areas. Given ongoing reported inequity for Māori being less able to afford primary health care, we suggest that future policies to improve access should be fully aligned with the articles of Te Tiriti o Waitangi and should focus on equity.     

Nutritional elements in U.S. diets: results from the Total Diet Study, 1982 to 1986

Through the Food and Drug Administration's Total Diet Study, the levels of 11 nutritional elements (sodium, potassium, calcium, phosphorus, magnesium, iron, zinc, copper, manganese, selenium, and iodine) in the diets of eight age-sex groups were determined for the 4 years between 1982 and 1986. The 234 Total Diet Study foods, which are representative of the U.S. food supply, were purchased, prepared for consumption, and analyzed for the elements four times each year. The results were combined with national food consumption data to estimate intakes for 6- to 11-month-old infants, 2-year-old children, 14- to 16-year-old boys and girls, 25- to 30-year-old men and women, and 60- to 65-year-old men and women. Six elements (calcium, magnesium, iron, zinc, copper, and manganese) were low (less than 80% of the Recommended Dietary Allowance or below the low end of the Estimated Safe and Adequate Daily Dietary Intake range) for three or more of the age-sex groups. Six elements were of concern for teenage girls and adult women, five for older women, three for 2-year-old children, two for teenage boys and older men, and only one for infants and adult men. Sodium levels (which did not include discretionary salt) were elevated for 2-year-old children and teenage boys, and iodine was elevated for all age-sex groups. A significant trend was noted only for iodine, the intake of which decreased during the 4-year period.(ABSTRACT TRUNCATED AT 250 WORDS)     

Premigration Harm and Depression: Findings from the New Immigrant Survey, 2003

Studies examining refugees from conflict areas have found that persecution in the place of origin is a risk factor for depression. No studies have looked at this association between mental health and the experience of premigration harm due to race, gender or religion in the general population of United States immigrants. The New Immigrant Survey baseline questionnaire was administered to a random sample of adults receiving legal permanent residency in the U.S. in 2003 (n = 8,573), including refugees, asylees and other immigrants. In multivariate analysis controlling for visa type, premigration harm was a predictor of general depression of borderline statistical significance [odds ratio (OR), 1.33; 95 % CI 0.98–1.80, p = 0.068] and a significant predictor of major depression with dysphoria (OR, 2.24; 95 % CI 1.48–3.38, p = 0.0001). These findings suggest that premigration harm is a risk factor for depression in the general immigrant population and not just among refugees.     

碘缺乏病区硒与胎儿脑海马区原癌基因表达

目的　研究微量元素硒 (Se)与胎儿脑海马区神经元原癌基因c-fos蛋白表达之间的关系。方法　在陕西省缺碘 (I)低硒区 (宜君县 )缺碘高硒区 (紫阳县 )及对照区 (临潼县 )共采集 5 1例脐血进行微量元素Se、I的检测 ,并在以上 3地共解剖孕 2 0～ 37周的水囊引产胎儿胎脑 2 0例 ,通过免疫组化学法检测胎脑海马区神经元原癌基因c -fos蛋白产物的表达。结果　 3地I水平无显著性差异 ,Se水平有显著性差异 (P <0 0 5 ) ,以紫阳为最高 ,宜君为最低 ;紫阳c-fos蛋白表达较强 ,与宜君相比有显著性差异 (P <0 0 5 )。结论　Se的水平可能影响胎脑海马区神经元c -fos蛋白的表达 ,并进而影响胎儿神经系统及智能的发育     

Diet Quality among the Brazilian Population and Associated Socioeconomic and Demographic Factors: Analysis from the National Dietary Survey 2008-2009

BackgroundEvaluating diet quality is a way to monitor a population’s adherence to dietary guidelines.ObjectiveTo adapt the Healthy Eating Index-2015 (HEI-2015) to the Brazilian population, to evaluate the validity and reliability of the adapted HEI-2015, and to assess diet quality of Brazilian adults as well as socioeconomic and demographic factors associated with diet quality.DesignIn this cross-sectional study, two dietary records from nonconsecutive days were used to obtain food intake information. The collected socioeconomic and demographic data included sex, age, education, per capita income, and residence area.Participants/settingA representative sample (n=27,760) of the Brazilian adult population participated in the Nutrition Dietary Survey 2008-2009.Main outcome measuresTotal and component scores for the adapted HEI-2015. The validity and reliability of the index were tested.Statistical analysis performedMean total and component scores were estimated for the adapted HEI-2015. Also, the proportion of subjects that achieved the maximum score for each component was calculated. Regarding validity and reliability analysis, principal components analysis examined the number of dimensions; Pearson correlations were estimated between total score, components, and energy, and Cronbach’s coefficient α was estimated. Diet quality was compared among socioeconomic and demographic categories.ResultsThe mean total score for the adapted HEI-2015 was 45.7 (95% CI: 45.4 to 46.0). Women had higher diet quality scores (46.4; 95% CI: 46.1 to 46.7) than men (44.9; 95% CI: 44.6 to 45.3). Age, education, and per capita income were directly associated with the adapted HEI-2015 total score. Greater than or equal to 50% of subjects received the maximum adapted HEI-2015 component scores for “total protein foods,” “seafood and plant proteins,” “fatty acids,” and “sodium.” In contrast, less than 30% of subjects received the maximum component scores for “total vegetables,” “dairy,” and “saturated fats.” Higher percentages of women received the maximum component scores for “total fruits,” “whole fruits,” “total vegetables,” “greens,” “dairy,” and “sodium,” whereas higher percentages of men received the maximum component scores for “total protein foods,” “seafood and plant proteins,” “fatty acids,” “added sugars,” and “saturated fats” components. Finally, validity analysis revealed weak correlations between component scores and energy and weak to moderate correlations with total scores; six dimensions were responsible for the total variance in diet quality and the standardized Cronbach’s coefficient α was .65 (unstandardized=.64).ConclusionsBrazilian adults have suboptimal diet quality as assessed by the adapted HEI-2015. Diet quality varied by socioeconomic and demographic factors. Results support the validity and the reliability of the index.     

Cross classification of the New Zealand population by ethnicity and deprivation: trends from 1996 to 2006

Objectives: To describe trends in the distribution of New Zealand's major ethnic groups by small area deprivation and trends in the ethnic composition of each deprivation category. Methods: Data sources were the 1996, 2001 and 2006 New Zealand Census of Population and Dwellings. Ethnicity (Māori, Pacific, Asian or European/Other) was defined using total response output. Each person was assigned a deprivation score by geocoding their usual residence (as recorded in the census) to meshblock level. For each time period (1996, 2001 and 2006) the deprivation score for each meshblock was calculated by principal components analysis from nine socio‐economic variables included in the corresponding census (the New Zealand Index of Deprivation). Results: Throughout the observation period, Māori and Pacific ethnic groups were over‐represented at the more deprived and under‐represented at the less deprived end of the deprivation spectrum. The European ethnic group displayed less‐marked skewing, and in the opposite direction, while the Asian ethnic group showed close to the expected uniform distribution. Neither the deprivation distribution of any ethnic group, nor the ethnic composition of any deprivation decile, showed any statistically significant change over the 10‐year observation period. Conclusions: Monitoring trends in the relative deprivation distributions of the ethnic groups helps assess progress towards social justice. Similarly, monitoring trends in the ethnic compositions of the different deprivation deciles is important in the formulation of social policy. Little change was found in either of these distributions over the relatively short observation period.     

National Diet and Nutrition Survey: Assigning mixed dishes to food groups in the nutrient databank

The National Diet and Nutrition Survey (NDNS) gathers information on the dietary habits and nutritional status of the UK population aged 1.5 years upward. Mixed dishes, being a mixture of components with varying proportions, prove problematic for categorising and reporting consumption—unlike basic foods, which can be classified into specific food groups relatively easily. For both purchased and homemade mixed dishes, it is advantageous to have a consistent method for assigning dishes to appropriate food groups, while retaining continuity with previous NDNS surveys to enable investigation of trends over time. Historically two main methods have been used to classify mixed dishes in the NDNS databank: either grouping by meat or fish content, or grouping by the main food component. Neither method is entirely satisfactory. In this study, selected foods were tabulated by both methods to determine which approach should be used in future work. Neither method proved entirely satisfactory alone, and in order to maintain consistency and continuity for the main survey of the new NDNS rolling programme, it was decided to take into account elements from both methods and to place comparable recipes together in the same food groups. A varied approach encompassing food names, proportions of ingredients and case-by-case judgement is the most appropriate way to classify mixed food dishes in a nutrient databank.     

Impact of prenatal exposure to cadmium on cognitive development at preschool age and the importance of selenium and iodine

The evidence regarding a potential link of low-to-moderate iodine deficiency, selenium status, and cadmium exposure during pregnancy with neurodevelopment is either contradicting or limited. We aimed to assess the prenatal impact of cadmium, selenium, and iodine on children’s neurodevelopment at 4 years of age. The study included 575 mother–child pairs from the prospective “Rhea” cohort on Crete, Greece. Exposure to cadmium, selenium and iodine was assessed by concentrations in the mother’s urine during pregnancy (median 13 weeks), measured by ICPMS. The McCarthy Scales of Children’s Abilities was used to assess children’s general cognitive score and seven different sub-scales. In multivariable-adjusted regression analysis, elevated urinary cadmium concentrations (≥0.8 µg/L) were inversely associated with children’s general cognitive score [mean change: ?6.1 points (95 % CI ?12; ?0.33) per doubling of urinary cadmium; corresponding to ~0.4 SD]. Stratifying by smoking status (p for interaction 0.014), the association was restricted to smokers. Urinary selenium was positively associated with children’s general cognitive score [mean change: 2.2 points (95 % CI ?0.38; 4.8) per doubling of urinary selenium; ~0.1 SD], although the association was not statistically significant. Urinary iodine (median 172 µg/L) was not associated with children’s general cognitive score. In conclusion, elevated cadmium exposure in pregnancy of smoking women was inversely associated with the children’s cognitive function at pre-school age. The results indicate that cadmium may adversely affect neurodevelopment at doses commonly found in smokers, or that there is an interaction with other toxicants in tobacco smoke. Additionally, possible residual confounding cannot be ruled out.     

Occupational exposure to bloodborne viruses in the Amsterdam police force, 2000-2003

OBJECTIVES: To assess and evaluate the rate and outcome of occupational exposure to hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in the Amsterdam police force. METHODS: Retrospectively, all accidents with risk for viral transmission reported to the Municipal Health Service between January 1, 2000 and December 31, 2003 were described and analyzed in 2004. RESULTS: Over a 4-year period, 112 exposures with a viral transmission risk were reported (the estimated exposure rate was 68/10,000/year). Of these exposures, 89 (79%) sources were tested, finding 4% HBV-positive, 4% HIV-positive, and 18% HCV-positive. Immunoglobulin for HBV infection was given 44 times; HIV post-exposure prophylaxis was prescribed 16 times and 13 of 16 discontinued the course within a few days because the transmission source tested HIV-negative. No seroconversions were seen in persons exposed. CONCLUSIONS: The rate of exposure is low. The majority of the sources could be traced and tested. However, a comprehensive and effective protocol is essential in minimizing the risk of occupational HBV, HCV, and HIV infection in police officers, even if HBV vaccination is provided.     

Occupational exposure to crystalline silica dust in the United States, 1988-2003

The purposes of this study were a) to summarize measurements of airborne (respirable) crystalline silica dust exposure levels among U.S. workers, b) to provide an update of the 1990 Stewart and Rice report on airborne silica exposure levels in high-risk industries and occupations with data for the time period 1988-2003, c) to estimate the number of workers potentially exposed to silica in industries that the Occupational Safety and Health Administration (OSHA) inspected for high exposure levels, and d) to conduct time trend analyses on airborne silica dust exposure levels for time-weighted average (TWA) measurements. Compliance inspection data that were taken from the OSHA Integrated Management Information System (IMIS) for 1988-2003 (n = 7,209) were used to measure the airborne crystalline silica dust exposure levels among U.S. workers. A second-order autoregressive model was applied to assess the change in the mean silica exposure measurements over time. The overall geometric mean of silica exposure levels for 8-hr personal TWA samples collected during programmed inspections was 0.077 mg/m3, well above the applicable American Conference of Governmental Industrial Hygienists threshold limit value of 0.05 mg/m3. Surgical appliances supplies industry [Standard Industrial Classification (SIC) 3842] had the lowest geometric mean silica exposure level of 0.017 mg/m3, compared with the highest level, 0.166 mg/m3, for the metal valves and pipe fitting industry (SIC 3494), for an 8-hr TWA measurement. Although a downward trend in the airborne silica exposure levels was observed during 1988-2003, the results showed that 3.6% of the sampled workers were exposed above the OSHA-calculated permissible exposure limit.