Attitudes, behaviours, and self-reported confidence of Australian pharmacy students and interns towards nutritional counselling.

INTRODUCTION: Pharmacists play a prominent role in the counselling and education of patients complementary to provision of medicines. The increase in non-communicable diseases associated with poor quality diets has placed a greater demand on pharmacists to play a role in the provision of nutritional education to patients. This study aimed to investigate pharmacy students' and interns' attitudes, behaviours, and self-reported confidence towards nutritional counselling and to examine factors associated with their intention to counsel patients in nutrition. METHODS: An online survey was designed using the theory of planned behaviour and was distributed to final-year pharmacy students and interns enrolled at the University of Sydney. Data analysis was conducted to test for correlations between behavioural intentions, attitudes, confidence, subjective norms, and perceived behavioural control. RESULTS: Sixty-six surveys were completed, representing an average response rate of 19.6%. Half of all participants reportedly were providing nutritional advice to patients at least once per week or more often when working in a pharmacy. Participants' intention to counsel patients about nutrition was influenced by preceptors' encouragement. The participants' average level of confidence in having the knowledge and skills to provide nutritional counselling, reported over 13 medical conditions, showed that they were on average "somewhat confident" in providing nutritional counselling, with the level of confidence differing depending upon the specific topic areas. CONCLUSIONS: Participants acknowledged the role of pharmacists in the provision of nutritional counselling, but a more comprehensive nutrition curriculum integrated within existing pharmacy curricula is warranted to increase pharmacy students' and interns' confidence.

Top consumer uses of bestselling, single-ingredient vitamin and mineral supplements.

OBJECTIVE: Vitamin and mineral supplements are widely used for self-care of a variety of medical conditions, but little is known about the specific conditions for which they are used. This study mined consumer product reviews to determine specific ways vitamin and mineral supplements are being used therapeutically. DESIGN/SETTING: A cross-sectional analysis of user reviews for top-selling, single-ingredient vitamin and mineral products from a popular online retailer was performed to identify the most frequently appearing words associated with medical conditions. Results of individual analyses were compared to achieve consensus on the top, relevant keywords for each supplement. The full text of the reviews was searched for these keywords to distinguish whether they referred to therapeutic uses or adverse effects. RESULTS: A total of 14 vitamin and 11 mineral supplements were analyzed. The number of user reviews for the analyzed products varied from 41 for manganese to over 5000 for biotin and vitamin D (median = 547 reviews per product). Cohen's kappa test for investigator-selected keywords related to medical conditions was generally greater than 0.6, indicating good interrater reliability. From these lists, the top consumer self-care uses were identified for 24 supplements. Commonly reported adverse effects were also noted for several products. CONCLUSION: This study used data mining to identify the top ways consumers use an array of bestselling, single-ingredient vitamin and mineral supplements. These results can provide healthcare and nutrition professionals with information to anticipate the supplement-related education needs of patients and provide researchers with priority areas for clinical studies.

Complementary and alternative medicine use during chemotherapy for neuroendocrine tumours.

Exploring the patient experience of complementary and alternative medicine (CAM) can provide insight into the needs, preferences and values of patients with an neuroendocrine tumour (NET). Use and interest in CAM after a NET diagnosis has not been investigated until now. The authors aimed to identify the types of CAM being used by patients undergoing chemotherapy and what types of CAM patients considered most beneficial. Patients were identified for clinical audit from one hospital's NET nurse chemotherapy database. A questionnaire was given to 79 patients who had completed intravenous chemotherapy during the previous 3 years. CAM use by NET patients was found to be popular and included practices to support both physical and emotional health. Massage and taking vitamin and mineral supplements were most widely used. The antioxidant effects of some high-dose supplements may impact on chemotherapy outcomes. Massage, despite its irregular use, was perceived by patients to be the most useful CAM.

Nutrient Composition and Content of Vitamin and Mineral Supplements and Their Appropriateness for Pregnant and Lactating Women in Korea / 대한지역사회영양학회지

OBJECTIVES: Use of dietary supplements containing vitamins and minerals is growing in Korean adults, especially in pregnant and lactating women. Vitamin and mineral supplements are available in different composition and in a wide range of contents. The purposes of the study were to examine nutrient composition and content of vitamin and mineral supplements for pregnant and lactating women and assess their appropriateness as dietary supplements. METHODS: Information on the name, manufacturer, nutrient composition, and usage of vitamin and mineral supplements for pregnant and lactating women were obtained from the homepage of the Food Safety Information Portal managed by the Ministry of Food and Drug Safety, and Korean Index of Medical Specialties. A total of 264 products were identified. RESULTS: Among 264 products, 26.1% were single nutrient products, and 73.9% were multinutrient products. The most commonly included nutrient was iron (70.1%), folic acid (66.3%), vitamin B12 (45.8%), vitamin C (38.6%), and vitamin B6 (38.6%). Although more than 50% of products contained nutrients less than 150% of Recommended Nutrient Intakes or Adequate Intakes for daily use, some products contained inappropriately high amounts of nutrients. When a maximum daily dose of supplements was taken as described on the label, iron in 73 products (39.5%), folic acid in 14 products (8.0%) were likely to be consumed in amounts greater than Tolerable Upper Intake Levels. Most products were assessed as inappropriate for pregnant women due to the possibility of excessive intake of vitamins or minerals when compared with Dietary Reference Intakes. CONCLUSIONS: Pregnant and lactating women need to carefully select dietary supplements containing adequate amounts of vitamins and minerals. Nutritionists should provide guidelines regarding selection of appropriate vitamin and mineral supplements for pregnant and lactating women.

Nutrient Composition and Content of Vitamin and Mineral Supplements and Their Appropriateness for Pregnant and Lactating Women in Korea / 대한지역사회영양학회지

OBJECTIVES: Use of dietary supplements containing vitamins and minerals is growing in Korean adults, especially in pregnant and lactating women. Vitamin and mineral supplements are available in different composition and in a wide range of contents. The purposes of the study were to examine nutrient composition and content of vitamin and mineral supplements for pregnant and lactating women and assess their appropriateness as dietary supplements. METHODS: Information on the name, manufacturer, nutrient composition, and usage of vitamin and mineral supplements for pregnant and lactating women were obtained from the homepage of the Food Safety Information Portal managed by the Ministry of Food and Drug Safety, and Korean Index of Medical Specialties. A total of 264 products were identified. RESULTS: Among 264 products, 26.1% were single nutrient products, and 73.9% were multinutrient products. The most commonly included nutrient was iron (70.1%), folic acid (66.3%), vitamin B12 (45.8%), vitamin C (38.6%), and vitamin B6 (38.6%). Although more than 50% of products contained nutrients less than 150% of Recommended Nutrient Intakes or Adequate Intakes for daily use, some products contained inappropriately high amounts of nutrients. When a maximum daily dose of supplements was taken as described on the label, iron in 73 products (39.5%), folic acid in 14 products (8.0%) were likely to be consumed in amounts greater than Tolerable Upper Intake Levels. Most products were assessed as inappropriate for pregnant women due to the possibility of excessive intake of vitamins or minerals when compared with Dietary Reference Intakes. CONCLUSIONS: Pregnant and lactating women need to carefully select dietary supplements containing adequate amounts of vitamins and minerals. Nutritionists should provide guidelines regarding selection of appropriate vitamin and mineral supplements for pregnant and lactating women.

Self-Administration of Medicines and Dietary Supplements Among Female Amateur Runners: A Cross-Sectional Analysis.

INTRODUCTION: Self-administration of medicines or dietary supplements without any physician's advice is a widespread behavior and appears to be more frequently practiced by women. Moreover, reasons to self-administer products are often pains and injuries especially among athletes who might also use remedies to improve physical performance. The objective of this study was thus to assess the prevalence of self-administration of medicines and dietary supplements as well as its determinants among female amateur runners. METHODS: Our sample was comprised of women who took part in amateur running events. Data regarding self-administration of substances, exclusively aiming at being physically prepared for the running event (i.e., intake the week before), were collected through an anonymous self-administered questionnaire including four specific themes (i.e., general information, self-administered medicines and dietary supplements, context of self-administration of substances and knowledge of the anti-doping regulations). RESULTS: A total of 136 women, with a median age of 39 years (interquartile range: 27-47), volunteered. Among them, 34.6% reported self-administration of medicines during the period immediately preceding the running event, with the aim to be physically prepared. More than one third (33.8%) also declared self-administration of dietary supplements. Furthermore, we observed that about 8.1% of the sample had consumed a potentially doping substance. After adjustments for confounding variables, the probability of self-administration of products (medicines or supplements) increased significantly with the intensity of the activity and the membership in a sports club. CONCLUSIONS: Our study showed that self-administration of products among female runners seems to be a widespread behavior, where the intensity of the sports practice and the network of runners seem to influence the decision to resort to this behavior.