Vitamin D Intake and Status in 12-Month-Old Infants at 63–66° N

The objective was to assess the vitamin D status in healthy 12-month-old infants in relation to quantity and sources of dietary vitamin D, breastfeeding and seasons. Subjects were 76 12-month-old infants. Serum levels of 25-hydroxyvitamin D (25(OH)D) ≥ 50 nmol/L were considered indicative of vitamin D sufficiency and 25(OH)D < 27.5 nmol/L as being indicative of increased risk for rickets. Additionally, 25(OH)D > 125 nmol/L was considered possibly adversely high. Total vitamin D at 9–12 months (eight data collection days) included intake from diet and supplements. The mean ± SD of vitamin D intake was 8.8 ± 5.2 μg/day and serum 25(OH)D 98.1 ± 32.2 nmol/L (range 39.3–165.5). Ninety-two percent of infants were vitamin D sufficient and none at increased risk for rickets. The 26% infants using fortified products and supplements never/irregularly or in small amounts had lower 25(OH)D (76.8 ± 27.1 nmol/L) than the 22% using fortified products (100.0 ± 31.4 nmol/L), 18% using supplements (104.6 ± 37.0 nmol/L) and 33% using both (110.3 ± 26.6 nmol/L). Five of six infants with 25(OH)D < 50 nmol/L had no intake of supplements or fortified products from 0 to 12 months. Supplement use increased the odds of 25(OH)D > 125 nmol/L. Breastfeeding and season did not affect vitamin D status. The majority of infants were vitamin D sufficient. Our findings highlight the need for vitamin D supplements or fortified products all year round, regardless of breastfeeding.     

Eligibility and willingness of young Icelandic women to participate in a HPV vaccination trial

BACKGROUND AND AIMS: Cervical cancer is an important health problem worldwide, and the incidence of preinvasive cervical cancer is increasing among young sexually active women. The causal association between human papilloma virus (HPV) and cervical cancer makes it theoretically possible to eradicate the disease through vaccination. The aim of this study was to analyze the eligibility and willingness of 18-23-year-old Icelandic women to participate in a vaccination trial to prevent HPV infection and to assess knowledge of HPV. MATERIAL AND METHODS: A questionnaire was formulated with questions on demographics, HPV knowledge, sexual behavior, attitude towards HPV vaccination, and other health-related issues. The questionnaire was tested on a subgroup of women before being mailed to 300 women aged 18-23 years, randomly selected by date of birth from the total population living in the Capital area of Reykjavík. RESULTS: The response rate of the mailed questionnaire was 54%. Of respondents, 96% reported having had sexual debut and 39% were aged 15 years or younger at first intercourse. Knowledge of HPV infections and associated diseases was limited, indicating the need for an educational campaign. Although 60% of the respondents were willing to participate in a HPV vaccination trial, the eligibility rate for the invited women was estimated to be approximately 13% (95% CI: 9-17%) after accounting for various exclusion criteria such as number of sexual partners, abnormal Pap smears, planning a pregnancy, or travelling abroad for more than 6 months. CONCLUSIONS: Icelandic women between 18 and 23 years of age have a sexual behavior profile and lifestyle that may decrease their eligibility in future prophylactic HPV vaccine trials. Improved education about HPV infection and its consequences is needed. Future trials may need to include younger women to improve recruitment.     

Cumulative exposure to premenopausal obesity and risk of postmenopausal cancer: A population-based study in Icelandic women

Obesity, often assessed at one point in time, is an established risk factor of several types of cancer, however, associations with cumulative exposure to obesity across the life course are not well understood. We investigated the relationship between combined measures of duration and intensity of premenopausal overweight and obesity and the incidence of postmenopausal breast, endometrial, and colorectal cancers in Icelandic women. Body mass index (BMI) trajectories between ages 20 and 50 of 88,809 women from the Cancer Detection Clinic Cohort were predicted using growth curve models. Indicators of overweight and obesity duration and intensity were computed and their association with risk of postmenopausal breast, endometrial, and colorectal cancers was examined using multivariate Cox models for subjects followed-up beyond the age of 50 (n = 67,488). During a mean follow-up of 17 years, incident events of 3,016 postmenopausal breast, 410 endometrial and 987 colorectal cancers were ascertained. Each 0.1 kg/m² per year increase in BMI between ages 20 and 50 was positively associated with risks of postmenopausal breast, endometrium and colorectal cancers with hazard ratios equal to 1.09 (95% Confidence Interval (CI):1.04–1.13), 1.31 (95% CI: 1.18–1.44) and 1.10 (95% CI: 1.00–1.21), respectively. Compared to women who were never obese, cumulative BMI × years of obesity were linearly positively associated with risk of endometrial cancer, whereas the association with breast cancer was initially positive, but leveled off with increasing cumulative BMI × years. Cumulative exposure to obesity may provide additional insights into the etiology of cancer and should be considered in future studies that assess obesity–cancer relationships.     

Trading autonomy for services: Perceptions of users and providers of services for disabled people in Iceland

This paper adopts a critical theory perspective, aligning itself with a growing body of critical disability research in Iceland. It draws attention to the importance of ensuring that the rights of disabled people to autonomy and independence enshrined in the CRPD are respected and upheld in the implementation of all service models, including “traditional” services. The paper draws on 22 interviews with disabled people and service providers in Iceland. Both groups reveal that they perceive there to be a limit to the autonomy of the user embedded in the concept of services provided by public authorities. The findings are examined in a theoretical context, concluding that the concept of services must be redefined to fully include the perspectives of disabled people if the autonomy and independence envisioned in the CRPD is to be achieved, particularly until such time that personalized services are realized for all.     

‘The self‐destruction force is so strong’: male survivors’ experience of suicidal thoughts following sexual violence

Suicidal thoughts are common among male sexual violence survivors. However, very few studies have focused specifically on this aspect. The purpose of this study was to explore the experience of male survivors themselves of suicidal thoughts following sexual violence within the framework of men and masculinity. The research methodology was The Vancouver School of Doing Phenomenology, and a total of 17 interviews were conducted with seven male survivors. The main findings of the study are that the source of the suicidal thoughts after sexual violence is based on an experienced strong self‐destruction force that involves almost unbearable and unexpressed suffering. The strong self‐destruction force appeared among other things in risk behaviour and negligence towards own life and health. Participants all agreed that the thought of suicide was a certain escape route, that is to be constantly trying to escape from oneself and inner suffering. Negative thoughts that were difficult to suppress developed into suicidal thoughts that developed into thinking about the best possible way to commit suicide. Shattered self‐esteem, shame and loneliness characterised the lives of participants, and they felt disgusting and worthless as human beings. Much self‐degradation was characteristic. Perceived common societal norms about male masculinity had major negative impact on participants, for example that they should not show emotions because they were men and therefore should not express emotional pain or disclose their traumas. This resulted in emotional silencing. Disclosing the violence proved extremely difficult for all participants, but they experienced a high level of positive energy following disclosure. Participants experienced lack of knowledge, understanding and appropriate support from healthcare professionals and felt that sexual violence survivors’ trauma history needed to be better explored within health care. It is important that professionals acquire knowledge and understanding of male sexual violence survivors, and their suicidal thoughts, and become able to provide trauma‐specific support.     

European genome-wide association study identifies SLC14A1 as a new urinary bladder cancer susceptibility gene

Three genome-wide association studies in Europe and the USA have reported eight urinary bladder cancer (UBC) susceptibility loci. Using extended case and control series and 1000 Genomes imputations of 5 340 737 single-nucleotide polymorphisms (SNPs), we searched for additional loci in the European GWAS. The discovery sample set consisted of 1631 cases and 3822 controls from the Netherlands and 603 cases and 37 781 controls from Iceland. For follow-up, we used 3790 cases and 7507 controls from 13 sample sets of European and Iranian ancestry. Based on the discovery analysis, we followed up signals in the urea transporter (UT) gene SLC14A. The strongest signal at this locus was represented by a SNP in intron 3, rs17674580, that reached genome-wide significance in the overall analysis of the discovery and follow-up groups: odds ratio = 1.17, P = 7.6 × 10(-11). SLC14A1 codes for UTs that define the Kidd blood group and are crucial for the maintenance of a constant urea concentration gradient in the renal medulla and, through this, the kidney's ability to concentrate urine. It is speculated that rs17674580, or other sequence variants in LD with it, indirectly modifies UBC risk by affecting urine production. If confirmed, this would support the 'urogenous contact hypothesis' that urine production and voiding frequency modify the risk of UBC.     

Knowledge translation in family nursing: does a short-term therapeutic conversation intervention benefit families of children and adolescents in a hospital setting? Findings from the Landspitali University Hospital Family Nursing Implementation Project

In an effort to examine translation of family nursing knowledge to practice, the Landspitali University Hospital Family Nursing Implementation Project (2007-2011), was thoughtfully initiated in Reykjavik, Iceland and systematically evaluated. The mission was to implement family nursing in every department of the hospital. This publication is the first formal research report from this landmark project. The purpose of this research was to evaluate the effectiveness of a short-term therapeutic conversation intervention with families who were receiving health care services at the Children's Hospital at Landspitali University Hospital in Iceland related to childhood and adolescent acute and chronic illnesses. The therapeutic conversation was guided by Family Systems Nursing and used the Calgary Family Assessment and Intervention Models (Wright & Leahey, 2005, 2009). Families (N = 76) were randomly assigned to either an experimental group (short-term therapeutic conversation: n = 41) or to a control group (traditional care: n = 35). Parents in the experimental group reported significantly higher family support after the intervention, compared to the parents in the control group. Differences were noted between families experiencing acute versus chronic illnesses. Recommendations are made for conducting and designing intervention research with families experiencing the hospitalization of a child or adolescent.     

Validity of retrospective diet history: Assessing recall of midlife diet using food frequency questionnaire in later life

Objectives

Limited information exists on the validity of dietary information given by elderly people on their past diet. Here we test the relative validity of a food frequency questionnaire asking older persons about their midlife diet.

Design

Retrospective food intake of 56–72-year-old subjects was estimated using a food frequency questionnaire designed for the AGES-Reykjavik Study (AGES-FFQ), an epidemiological study of older individuals. Results were compared with detailed dietary data gathered from the same individuals 18–19 years previously, i.e., in midlife, as part of a national cohort. Spearman correlation and cross-classifications were used to assess the ability of the AGES-FFQ to rank subjects according to their intake.

Setting

Nationwide, Iceland.

Participants

Subjects, born 1937–1952 (n=174), who participated in the 1990 Icelandic National Dietary Survey.

Measurements

Dietary intake, estimated by the AGES-FFQ (2008–2009), and dietary history obtained from the 1990 Icelandic National Dietary Survey as a reference method.

Results

The strongest correlation between the AGES-FFQ and the reference method was found for cod liver oil, r=0.53, p<0.001 and r=0.56, p<0.001, for men and women, respectively. For men the corresponding correlation coefficient for milk and dairy products was r=0.43, p<0.001. The correlation coefficients were lower but within a reasonably acceptable range (r=0.26–0.40) for meat, fish and potatoes for both genders, as well as fresh fruits and milk/dairy products for women and whole-wheat bread, oatmeal/muesli and blood/liver-sausage for men. No correlation was found between the AGES-FFQ and the dietary history for rye bread and vegetable consumption. Subjects were categorized into five groups according to level of consumption by the two methods. Cross-classification showed that 16–59% were classified into same group and 43–91% into same or adjacent group, 0–14% were grossly misclassified into opposite groups.

Conclusion

The AGES-FFQ on midlife diet was found suitable to rank individuals by their intake of several important food groups.     

Occupational exposure to solvents and bladder cancer: A population‐based case control study in Nordic countries

The objective of the study was to assess the relationship between exposure to selected solvents and the risk of bladder cancer. This study is based on the Nordic Occupational Cancer (NOCCA) database and comprises 113,343 cases of bladder cancer diagnosed in Finland, Iceland, Norway and Sweden between 1961 and 2005 and 566,715 population controls matched according to country, sex and birth year. Census‐based occupational titles of the cases and controls were linked with the job exposure matrix created by the NOCCA project to estimate quantitative cumulative occupational exposures. A conditional logistic regression model was used to estimate hazard ratios (HRs) and their 95% confidence intervals (95% CI). Increased risks were observed for trichloroethylene (HR 1.23, 95% CI 1.12–1.40), toluene (HR 1.20, 95% CI 1.00–1.38), benzene (HR 1.16, 95% CI 1.04–1.31), aromatic hydrocarbon solvents (HR 1.10, 95% CI 0.94–1.30) and aliphatic and alicyclic hydrocarbon solvents (HR 1.08, 95% CI 1.00–1.23) at high exposure level versus no exposure. The highest excess for perchloroethylene was observed at medium exposure level (HR 1.12, 95% CI 1.02–1.23). The study provides evidence of an association of occupational exposure to trichloroethylene, perchloroethylene, aromatic hydrocarbon solvents, benzene and toluene and the risk of bladder cancer.