Download pdf - Are Wound Care Protocols Evidence Based?

Title: THE FACTORS ASSOCIATED WITH DIETARYSUPPLEMENT USE IN COLLEGE STUDENTS

Author(s): M. E. Geraghty, J. Bates-Wall, C. A. Taylor; MedicalDietetics, The Ohio State University, Columbus, OH

Learning Outcome: To describe the dietary supplement use incollege students in terms of type, indication for use, perceived sideeffects and source of supplement information and recommendation.

Text: Dietary supplement use has increased substantially over thepast decade in college students. Many have received formal healtheducation concerning effects of alcohol consumption or drug use, butfew have studied the efficacy and safety of dietary supplements. Toassess the supplement intake patterns of college students at a major,Midwestern university, an online survey was available for studentsin a business and an allied medical professions survey course. Anemail was sent from the instructors inviting students to participate,providing a study description, participation criteria, and anembedded link to the survey. Questions were modified from aprevious survey to identify the proportion of students using dietarysupplements, the specific supplements taken, indications, and sideeffects. Of the 336 students completing the survey, approximately40% reported current or previous use of dietary supplements. Themost common supplement types were dietary/ herbal supplements-without vitamins/minerals( 35%); dietary/herbal supplement withvitamins/minerals, (26%); and vitamin supplements alone (21%). Themost frequently cited reasons for taking dietary supplements were to:increase energy; lose weight; ensure adequate nutritional status;prevent illness; and enhance athletic performance. Side effectsreported included nausea, light-headedness and jitteriness andtachycardia. Family members were the most common source ofinformation/recommendation regarding dietary supplements, withtwice the influence than friends or health food stores. The prevalenceof the use of dietary supplements warrants the availability ofStudent Health Center RD consultations as well as the developmentand strategic marketing of evidence-based dietary supplementcurricular offerings.

Funding Disclosure: None

Title: HALF OF THE HOMEBOUND ELDERLY LIVING IN A LARGEMIDWESTERN CITY RELY ON THEIR PHYSICIANS FOR ADVICEREGARDING TAKING OR NOT TAKING VITAMIN OR MINERALSUPPLEMENTS

Author(s): J. A. Driskell, S. A. Minor; Nutrition and Health Sciences,University of Nebraska, Lincoln, NE

Learning Outcome: To gain insight into the reasons given by thehomebound elderly for taking or not taking vitamin or mineralsupplements and where these individuals got dietary supplementinformation.

Text: The prevalence of vitamin and mineral supplement usage by ahomebound elderly population in a large Midwestern city was evaluated bysex and ethnic groups. Their motivation for supplement use or nonuse wasalso evaluated. A descriptive vitamin mineral supplement usagequestionnaire was completed by a group (23 males, 38 females) ofhomebound elderly (60 years and above) individuals. Forty-one subjectswere white and 20, non-white. Forty-seven percent reported taking vitaminor mineral supplements. About half of the supplement users reportedtaking supplements because they were prescribed or recommended, withthe next two predominant reasons being general health and to preventdisease. Significantly larger (p�0.05) percentages of non-whites thanwhites took a multivitamin to improve their general health and to feelbetter. The most frequently used individual vitamin or mineralsupplements were calcium, vitamin D, vitamin E, and vitamin C. Thepredominant reason subjects gave for not using supplements was thatsupplements had not been prescribed or recommended, followed by theirbeing unsure which supplements to take. A significantly larger (p�0.01)percentage of non-whites than whites indicated not taking supplementsbecause they were unsure which ones to take. Most subjects received theirinformation regarding supplements from a health care professional, mostoften a physician, with four subjects reporting getting information fromregistered dietitians. This study indicates that the homebound elderlygenerally get advice regarding the usage of vitamin or mineralsupplements from physicians. Dietitians working with the homeboundelderly should be giving advice regarding dietary supplement usage.

Funding Disclosure: USDA W-1002 Regional Research Funds

Title: PATTERNS OF NONVITAMIN AND NONMINERALSUPPLEMENT USE ARE SIMILAR AMONG ADULTS FROMDIFFERENT INCOME AND ETHNICITY GROUPS

Author(s): L. Kinsella,1 B. Henry2; 1Nutrition Services, AdvocateTrinity Hospital, Chicago, IL, 2Family Consumer Nutrition Sciences,Northern Illinois University, DeKalb, IL

Learning Outcome: Increase awareness of nonvitamin nonmineralsupplement use among patients of diverse backgrounds to identifycommunication strategies and messages for health care.

Text: Objective: Determine usage patterns of nonvitamin nonmineral(NVNM) supplements among adults of different income and ethnic groups.

Methods/ Subjects/ Design: Descriptive study utilized survey designwith adult patients attending a Midwestern Family Medicine Clinic over athree-day period, with each patient having an equal chance of participation.One-on-one personal interviews, based on a 10-item structured questionnairewere conducted with 100 volunteers of 150 adults approached.

Analysis/ Results: Participants were economically and ethnically diverse,though the majority was female; 48 met criteria of NVNM supplement use.Data analyzed by Fisher’s exact test revealed no difference in usagepatterns of NVNM supplements between income or ethnic groups. Thirtyparticipants (63%) described use as everyday. Most NVNM supplementusers (94%) expected health benefits from use, though not more likely toalert a health care professional, and 85% obtained supplement informationfrom sources other than healthcare professionals. Thirteen participants(27%) identified as ‘at risk’ for adverse interactions were not more likely toinform a health care professional regarding NVNM supplement use. Of 22participants (46%) who reported NVNM supplement use to a health careprofessional, four were asked. Conclusions/implications: NVNMsupplement use cannot be estimated by income or ethnicity.Communication strategies about NVNM supplements are needed to informpatients about possible benefits and adverse interactions. Positivemessages for health care professionals should aim for greaterunderstanding of patients’ concerns and beliefs about management of theirhealth. Consistently changing trends, new products, and new regulationsrequire ongoing research by dietitians regarding NVNM supplements.


Title: ARE WOUND CARE PROTOCOLS EVIDENCE BASED?

Author(s): J. Hill, P. Landers, J. Butcher, H. Solnok;Nutritional Sciences, University of Oklahoma Health SciencesCenter, Oklahoma City, OK

Learning Outcome: The participant will be able to determinewhich macronutrients and micronutrients to include in a woundhealing protocol for optimum results.

Text: For several years, wound care protocols in health caresettings have included arginine, vitamin C, zinc, and protein,either together or alone as treatment(s) for various types ofwounds. Is this treatment evidenced based or is it expertopinion? Using established search methods, this investigationsought to locate and evaluate controlled trials focusing onarginine, vitamin C, zinc, and protein and their use in woundhealing. The clinical outcome desired was wound healing asevidenced by reduced wound surface area, reduced wound depth,reduced exudate volume, and/or increase in hydroxyprolinedeposition. The search restrictions included subjects aged 18years and older and English language. There were no restrictionson setting or date. Four of 11 potentially relevant articles wereincluded for analysis. Exclusionary criteria ranged from a studywith fewer than 10 subjects per group to a study on riskbehaviors. This review and analysis failed to demonstrate thatsupplementation with vitamin C and/or zinc was beneficial toreduce the time it took for wounds to heal. Arginine improvedcollagen deposition in surgically placed catheters. Protein had apositive effect on wound healing. The implication for clinicians isthat protein supplementation and in some instances, arginine,may be beneficial for the patient with wound healing needs.Supplementation with vitamin C and/or zinc has not been shownto be effective in studies of any size.


SUNDAY, OCTOBER 26

POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY

Journal of the AMERICAN DIETETIC ASSOCIATION / A-29