Use of dietary supplements for cognitive health: results of a national survey of adults in the United States.

We studied use of vitamins, minerals, herbs, and other dietary supplements for cognitive health. We refer to these products as supplements. Data were from the 2007 National Health Interview Survey, which asked about complementary and alternative medicine (n = 22 783). Chi-square and multivariate logistic analyses were weighted for national representativeness, accounting for the survey design. Among supplement users, about 8.8% of those without cognitive problems used them for cognitive health; 15.7% of those with cognitive problems did so. Fish oil, Ginkgo biloba, and vitamins were commonly used for cognitive health. Among supplement users, 38% did not tell health care providers. In adjusted results, adults reporting cognitive problems were more likely than others to use supplements for cognitive health (odds ratio 1.77, confidence interval 1.39-2.25). Adults are more likely to use supplements to treat or cure cognitive problems than to prevent them. Many do not discuss this use with health care providers.

Career phase of board-certified general surgeons: workload composition and outcomes.

OBJECTIVE: To examine surgeon career phase and its association with surgical workload composition and outcomes of surgery. DESIGN: Cross-sectional study. SETTING: The study used data from calendar years 2004 through 2006 from 4 Florida general surgeon (GS) cohorts determined by years since board certification. PARTICIPANTS: American Board of Surgery-certified GSs regardless of subspecialty (n = 1187) performing 460 881 operations on adults 18 years or older. MAIN OUTCOME MEASURES: Workload composition based on the Clinical Classification System, complications identified by patient safety indicators, and in-hospital mortality. Poisson regression with robust error variance estimated adjusted rate ratios (RRs) for complications and mortality. RESULTS: Compared with late-career surgeons, the rate of complications from cardiovascular procedures was higher for surgeons in the early-career phase (RR, 1.23; 95% CI, 1.06-1.44) and the late middle-career phase (1.18; 1.02-1.37). The mortality rate for cardiovascular procedures also was higher for early-career surgeons (RR, 1.23; 95% CI, 1.04-1.46). For digestive procedures, early-career surgeons had lower complication rates than late-career surgeons (RR, 0.86; 95% CI, 0.75-0.99). CONCLUSION: Late-career GSs perform both better and worse compared with early-career GSs, relative to their workload composition and proportional surgical volume. Factors such as training and case complexity may contribute to these career-phase differences.