BACKGROUND: Drug therapy for Crohn's disease and ulcerative colitis is based on anti-inflammatory and immunodulating drugs, nutritional support and surgical resection. Recently, new drugs have been introduced. AIM: To report drug prescriptions, costs and adverse reactions among inflammatory bowel disease patients in Sweden between 1988 and 1997. METHODS: Drug use was calculated from the national Diagnosis and therapy survey and drug costs from prescriptions and drug sales. Adverse drug reactions were obtained from the Medical Products Agency's National Pharmacovigilance system. RESULTS: The annual drug exposure for Crohn's disease was 0.55 million daily doses per million population, mainly supplementation and aminosalicylic acids. Mesalazine and olsalazine had 61% within this group. For ulcerative colitis patients, drug exposure was 0.61 million daily doses per million per year and aminosalicylic acids fell from 70% to 65%. For inflammatory bowel disease patients, corticosteroids and nutritional supplementation were common. The annual average cost for inflammatory bowel disease drugs was 7.0 million US dollars. Annually, 32 adverse drug reactions were reported, mainly haematological reactions such as agranulocytosis and pancytopenia (60%), followed by skin reactions. Only two deaths were reported. Aminosalicylic acids were the most commonly reported compounds. CONCLUSIONS: Drug use for inflammatory bowel disease in the pre-biologic agent era rested on aminosalicylic acid drugs and corticosteroids with stable levels, proportions and costs. The level of adverse drug reactions was low but haematological reactions support the monitoring of inflammatory bowel disease patients.
The 25-hydroxyvitamin D concentration (25-OHD) in maternal and cord blood of 192 mothers was determined at delivery from June to the end of November. Ninety-nine mothers had received a daily supplementation of 12.5 micrograms of vitamin D during pregnancy and this group had a significantly higher 25-OHD concentration both in maternal and in cord blood than in the corresponding non-supplemented group. A daily supplement of 2.5 micrograms of vitamin D was given to 63 of the mothers during lactation. Of these mothers 44 were still lactating after 6 months. The dietary vitamin D intake of 31 mothers was calculated. We found a significant correlation between the maternal serum 25-OHD concentration 16-18 weeks after delivery and the total vitamin D intake. The intake (5.5 micrograms/d, including supplementation) was lower than that recommended for lactating mothers which is 10 micrograms/d (Food and Nutrition Board, 1980).
Behavior and lifestyle play an important part in determining our
health status and lifespan. Every day Alaskans make lifestyle choices that profoundly affect their health. Although heredity and environment play a part, the leading causes of death in Alaska (heart disease, cancer and unintentional injuries) are closely related to lifestyle factors. Lifestyle and behavioral factors that affect health include such things as diet, exercise, use of alcohol and
tobacco, and preventive health practices. Many premature deaths
and disabilities could be prevented through better control of these
behavioral risk factors.
Modification of risk behaviors that contribute to chronic disease,premature death and impaired quality of life is an important public health challenge. The Behavioral Risk Factor Surveillance System (BRFSS) collects information on risk factors, chronic disease prevalence and preventive practices that is essential for the development of chronic disease prevention and health promotion efforts aimed at modifying key risk factors. The Stateof Alaska began surveillance using the BRFSS in 1991 and has continued yearly since. The Alaska BRFSS is a collaborative project of the Centers for Disease Control and Prevention and the Alaska Division of Public Health.
Little has been published on cultural competency curriculum and dietetics considering the impact of food-related beliefs and behaviours on health. A 14-item online survey was administered in January 2016 to 145 participants (125 members of Dietitians of Canada Aboriginal Nutrition Network and 20 dietitians with an interest in Aboriginal nutrition). Questions included multiple choice and ranking responses and were pretested by 4 preceptors with the Northern Ontario Dietetic Internship Program (NODIP). Quantitative data analysis included frequencies, pivot tables, and averaging/grouping of ranking scores. A total of 42 individuals (29%) completed the survey. The majority rated the 5 health and cultural competencies and 6 food and nutrition competencies as "important" (90%-98% and 86%-100%, respectively). Overall, the competency related to identifying health status was ranked highest (78%), whereas developing culturally appropriate recipes was ranked lowest (83%). Most participants (95%) believed that all dietitians and graduating dietetic interns should be minimally competent in Aboriginal health and culture. The initial 11 draft competencies for dietetic interns were condensed to 6 minimum and 2 advanced competencies. Results will inform dietitians working with Aboriginal peoples and refinement of NODIP intern and preceptor tools, with the potential to integrate across Canadian dietetic internship programs.