The Prevalence of Natural Health Product Use in Patients with Acute Cardiovascular Disease

Background: Natural health products (NHP) use may have implications with respect to adverse effects, drug interactions and adherence yet the prevalence of NHP use by patients with acute cardiovascular disease and the best method to ascertain this information is unknown. Objective: To identify the best method to ascertain information on NHP, and the prevalence of use in a population with acute cardiovascular disease. Methods: Structured interviews were conducted with a convenience sample of consecutive patients admitted with acute cardiovascular disease to the University of Alberta Hospital during January 2009. NHP use was explored using structured and open-ended questions based on Health Canada’s definition of NHP. The medical record was reviewed, and documentation of NHP use by physicians, nurses, and pharmacists, compared against the gold-standard structured interview. Results: 88 patients were interviewed (mean age 62 years, standard deviation [SD 14]; 80 % male; 41 % admitted for acute coronary syndromes). Common co-morbidities included hypertension (59%), diabetes (26%) and renal impairment (19%). NHP use was common (78 % of patients) and 75 % of NHP users reported daily use. The category of NHP most commonly used was vitamins and minerals (73%) followed by herbal products (20%), traditional medicines including Chines

Injury rates and injury risk factors among federal bureau of investigation new agent trainees

<p>Abstract</p> <p>Background</p> <p>A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training.</p> <p>Methods</p> <p>Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy.</p> <p>Results</p> <p>A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity.</p> <p>Conclusion</p> <p>The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents.</p

Baseline characteristics and discharge diagnosis.

<p>Values are N (%) unless otherwise stated. STEMI = ST elevation myocardial infarction. NSTEMI = non-ST elevation myocardial infarction. COPD = chronic obstructive pulmonary disease. GERD = gastroesophageal reflux disease. PUD = peptic ulcer disease.</p

Frequency of natural health product use.

<p>Other infrequently used products used included [4 uses each] coenzyme Q10, and flax oil; hawthorn, chondroitin, ginko biloba, ginseng, and vitamin B6; [2 uses each] serrapeptase enzyme, methylsulfonylmethane, cayenne pepper, peppermint, green tea, herbal tea, thai tea, folic acid, and replavite; [1 use each] lutein, white willow bark, motherwort, bilberry, lavender, eucalyptus, wintergreen, menthol, camphor, opti-i-see eye drops, bromelain, turmeric, Echinacea, graviola, rat root plant leaf, banana leaf extract, cranberry supplement, celery herbal, rosemary herbal, seaweed herbal, chamomile tea, carboxymethylcellulose, collagen supplements, vitamin B50 complex, gelatin, and agar.</p

Frequency of natural health products documentation by clinical staff when compared to direct structured interview.

<p>*N represents the number of matched histories of natural health product use (between profession and direct interview).</p><p>**N represents the number matched unique NHP products.</p

Frequency of NHP intake.

<p>Frequency of NHP intake.</p