BACKGROUND: Many Americans are using alternative medical therapies as well as nutritional or dietary supplements that include vitamins, minerals, herbal products, tissue extracts, protein solutions, and other chemicals. Potential for both good and harm exists in taking many of these preparations. METHODS: We surveyed 200 consecutive patients older than 18 years attending a family practice clinic. In addition to demographic data, we asked them about their intake of dietary supplements during the past year, perceived benefits from supplements, source of information, estimated cost of products, and whether their physician knew that they were taking the product. RESULTS: Fifty-two percent of the patients had taken 1 or more supplements during the past year, 18 percent used 2 to 5 supplements, and 3 percent took 6 to 13 different dietary supplements. Twenty-nine percent took them for diet and energy enhancement, and 24 percent for cancer prevention and immune system enhancement. The media was the principal source of patient information. Thirty-three percent of patients had not told their physician of their supplement use. The average estimated expenditure was $ 6.60 per month with a maximum of $ 68.90 per month. Eighty-two percent of the supplements taken were vitamins and minerals at recommended daily allowances (RDAs), whereas 18 percent were other supplements such as herbal products, megadose vitamins, and protein and amino acid preparations. Demographically, only educational level correlated significantly with supplement consumption. Patients with a high school education took significantly fewer supplements than those with more advanced education. CONCLUSIONS: Physicians should have a dialogue with their patients about dietary supplements because their use is widespread. Whereas many supplements are taken in safe doses, for others neither safety nor effectiveness has been proven, and for a few there are known toxicities. Additional research is needed to investigate both the safety and effectiveness of these products.

Adult↗

PubMedDate not supplied

Personal values related to primary care specialty aspirations.

BACKGROUND AND OBJECTIVES: Two recent studies showed that personal values influence specialty choice. However, both studies assessed the perceived influence of values instead of measuring values directly. The present study measured and compared the values of aspirants to primary care versus other specialties. METHODS: In 1993, first-year medical students, entering residents, and graduating residents at a private Midwestern medical school completed a questionnaire on their specialty aspirations and completed the Schwartz Values Survey, which measures the importance of 10 types of values: achievement, benevolence, conformity, hedonism, power, security, self-direction, stimulation, tradition, and universalism. A three-factor MANOVA (specialty aspiration, gender, level of training) was performed on the importance ratings. RESULTS: The three MANOVA main effects were significant. Primary care aspirants rated power and self-direction values lower and benevolence values higher than did aspirants to other specialties. Women gave higher ratings to universalism and benevolence and lower ratings to power, tradition, and conformity values than did men. Medical students rated security values lower than did the two resident groups. CONCLUSIONS: This study demonstrates the relationship of personal values and specialty choice and provides empirical support for admissions policies that incorporate personal values into the admissions process.

Career Choice↗

PubMedDate not supplied

Dietary supplement users: demographics, product use, and medical system interaction.

BACKGROUND: Dietary supplements-defined as vitamins and minerals, herbal products, tissue extracts, proteins and amino acids, and other products-are purchased to improve health and prevent disease. Little has been published, however, about the characteristics of either the products or the people who use them. METHODS: Consecutive customers visiting two health food stores during a 15-day period were interviewed by telephone. They were asked about their use of dietary supplements, demographics, and their use of the established health care system. RESULTS: Of the 194 customers contacted, 136 (70.1 percent) completed the survey. Respondents took a total of 805 supplements, most often to prevent a health problem (84.3 percent). Herbal products were most commonly used. Garlic, ginseng, and Ginkgo biloba were the herbs most frequently used. Fifty products were found to have previously reported toxicities, including vitamin A, which 9 customers were taking in megadoses. Most customers were white (94.1 percent), female (75.7 percent), had at least 1 year of college education (70.6 percent), had health insurance (95.6 percent), and had a regular physician (85.3 percent). CONCLUSION: Most of the dietary supplements consumed appear to be safe, but 50 of 805 had previously reported toxicities including megadoses of vitamin A. Garlic, ginseng, and Ginkgo biloba were the most commonly ingested herbs, and the medical literature supports their effectiveness for some conditions in humans. Customers of two health food stores had average to above-average education and took dietary supplements to stay healthy. They used the conventional health care system but did not typically consult their physician about dietary supplements. The pattern of use suggests that physicians might not be adequately addressing preventive and wellness issues in discussions with their patients. Furthermore, physicians might need to learn about dietary supplements so they can communicate with patients about them.

Adult↗

PubMedDate not supplied

Care of the premature infant.

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Child, Preschool↗