Presentation on theme: "Natalie Vicca Good Food for New Arrivals Project ASeTTS"— Presentation transcript:
1Natalie Vicca Good Food for New Arrivals Project ASeTTS Vitamin DNatalie ViccaGood Food for New Arrivals ProjectASeTTS
2ASeTTS Association for Services to Torture and Trauma Survivors Free & Confidential serviceCounselling, advocacy, support, group and community activities
3Good Food for New Arrivals Funded by Australian Government under the Stronger Families and Communities Invest to Grow Program.
4Services at ASeTTS www.asetts.org.au Counselling & Advocacy Community development programs and support groupsPersonal Support ProgramVolunteer programSettlement grants programTraining, professional development & consultationStrength to Strength Relationship supportGood Food for New Arrivals Nutrition ProjectIntegrated service centre MDT at selected PrimariesNewly Arrived Youth Support ServiceSessional psychiatrist
5Australia’s Humanitarian Programme Nationally 13,000 accepted each year2006Total under 18 years = 56%Under 9 years old = 27%200 visa is refugee visa or 204 woman at riskThe SHP includes those that are sponsored to come by other family members and PPV and TPV as well as the onshore processed visasNumbers from =12144Total under 18 years = 56% = 6735Under 9 years old = 27% = 3262
6Learning Objectives Be aware of sources and function of Vit D Be aware of the effects of Vit D deficiencyRecognise groups at risk of deficiencyThe situation in WAIdentify screening/treatment strategies
7Sources Sunlight -D3 cholecalciferol Diet -D2 ergocalciferol Fish, Eggs, Margarine, Milk, some meatsRequirements = 5-15 Micrograms/day(Nutrient Reference Values for Australia and New Zealand 2006)Where do we get the stuff and how much do we need?19-50yrs = 5mcg51-70yrs = 10 mcg>70yrs = 15mcg
8Function Variety of neuromuscular and physiological functions Maintains serum calcium and phosphorusRole in enhancing immune function
9sunlight skin 7 -dehydrocholesterol cholecalciferol Vitamin D3 (fish, meat)Vitamin D2 (supplements)liverThe vitamin is activated through multiple organ systemsWhen anything is wrong with these systems there may be issues with Vitamin D i.e kidney failure, bowel disease25 dihydroxyvitamin D31,25-dihydroxyvitamin D3↑Ca absorption small intestine↑Urinary calcium reabsorption (kidney)↑Bone mineralisationkidney
10Deficiency Rickets in children Osteoporosis and Osteomalacia adults Implicated in development ofPsoriasisType 1 Diabetes MellitusMultiple SclerosisGastrointestinal CancersDifference due to pathogenesis of growing versus mature bone
11WA SituationMigrant Health found approx 16% of children and 11% of adults have moderate to severe vitamin D deficiencyMany more with mild deficiency - 40%Have been emergency presentations due to hypocalcaemic seizures40% of all those seen have inadequate levels of vitamin D
12Who is at risk? Those who do not get enough sunlight. Covered for cultural reasonsDark skin needs longer exposureElderlyBreastfed babies of deficient mothersBabies not introduced to solids appropriatelyWho are we talking about?Insufficient sun exposureElderly do not metabolise as efficiently
13Sun exposure Outside of peak hours Without sun screen for short periods onlyHands, arms and face if possibleDarker skins require longer exposure7 minutes in summer for moderate to fair skin, up to 3-4 times longer for highly pigmented skins.
14Symptoms and Signs Young Infants Restlessness Poor sleep Craniotabes (Soft posterior skull due to reduced mineralisation)Obviously difficult to assess!!
15Older infants Delayed sitting/crawling Delayed closure fontanelle Bossing of skullCostochondral beadingDelayed tooth developmentPhotos courtesy of Tom D Thacher, MD