Federal Practitioner最新文献_第4页

My Kidney Is Fine, Can't You Cystatin C? 我的肾脏很好，难道胱抑素 C 就不行吗？

Federal Practitioner Pub Date : 2024-02-01 DOI: 10.12788/fp.0440

Alexander Beckstead

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My Kidney Is Fine, Can't You Cystatin C? 我的肾脏很好，难道胱抑素 C 就不行吗？

Federal Practitioner Pub Date : 2024-02-01 DOI: 10.12788/fp.0440

Alexander Beckstead

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Reducing or Discontinuing Insulin or Sulfonylurea When Initiating a Glucagon-like Peptide-1 Agonist 开始使用胰高血糖素样肽-1 激动剂时减少或停用胰岛素或磺酰脲类药物

Federal Practitioner Pub Date : 2024-02-01 DOI: 10.12788/fp.0452

Emily Herron

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Reducing or Discontinuing Insulin or Sulfonylurea When Initiating a Glucagon-like Peptide-1 Agonist 开始使用胰高血糖素样肽-1 激动剂时减少或停用胰岛素或磺酰脲类药物

Federal Practitioner Pub Date : 2024-02-01 DOI: 10.12788/fp.0452

Emily Herron

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Implementing Trustworthy AI in VA High Reliability Health Care Organizations 在退伍军人事务部高可靠性医疗机构中实施值得信赖的人工智能

Federal Practitioner Pub Date : 2024-02-01 DOI: 10.12788/fp.0454

David Isaacks

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Piperacillin/Tazobactam Use vs Cefepime May Be Associated With Acute Decompensated Heart Failure 使用哌拉西林/他唑巴坦与头孢吡肟可能与急性失代偿性心力衰竭有关

Federal Practitioner Pub Date : 2024-02-01 DOI: 10.12788/fp.0451

Hans Scheerenberger

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Building Tailored Resource Guides to Address Social Risks and Advance Health Equity in the Veterans Health Administration 在退伍军人健康管理局建立量身定制的资源指南，以应对社会风险并促进健康公平

Federal Practitioner Pub Date : 2024-01-01 DOI: 10.12788/fp.0446

Lauren E Russell

{"title":"Building Tailored Resource Guides to Address Social Risks and Advance Health Equity in the Veterans Health Administration","authors":"Lauren E Russell","doi":"10.12788/fp.0446","DOIUrl":"https://doi.org/10.12788/fp.0446","url":null,"abstract":"Background: Health care organizations, including the Veterans Health Administration (VHA), are increasingly adopting programs to address social determinants of health. As part of a comprehensive social risk screening and referral model, tailored resource guides can support efforts to address unmet social needs. However, limited guidance is available on best practices for the development of resource guides in health care settings. Observations: This article describes the development of geographically tailored resource guides for a national VHA quality improvement initiative, Assessing Circumstances and Offering Resources for Needs (ACORN), which aims to systematically screen for and address social needs among veterans. We outline the rationale for using resource guides as a social needs intervention and provide a pragmatic framework for resource guide development and maintenance. We offer guidance based on lessons learned from the development of ACORN resource guides, emphasizing a collaborative approach with VHA social workers and other frontline clinical staff, as well as with community-based organizations. Our how-to guide provides steps for identifying high-yield resources along with formatting considerations to maximize accessibility and usability among patients. Conclusions: Resource guides can serve as a valuable cross-cutting component of health care organizations’ efforts to address social needs. We provide a practical approach to resource guide development that may support successful implementation within the VHA and other clinical settings.","PeriodicalId":513268,"journal":{"name":"Federal Practitioner","volume":"101 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronicling Health Care Transformation: Federal Practitioner Looks Back 40 Years 记录医疗变革：联邦从业者回顾 40 年

Federal Practitioner Pub Date : 2024-01-01 DOI: 10.12788/fp.0453

引用次数: 0

Leader Rounding for High Reliability and Improved Patient Safety 领导查房实现高可靠性，提高患者安全

Federal Practitioner Pub Date : 2024-01-01 DOI: 10.12788/fp.0444

John Murray

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Low-Carbohydrate and Ketogenic Dietary Patterns for Type 2 Diabetes Management 治疗 2 型糖尿病的低碳水化合物和生酮饮食模式

Federal Practitioner Pub Date : 2024-01-01 DOI: 10.12788/fp.0429

Robert C Oh

{"title":"Low-Carbohydrate and Ketogenic Dietary Patterns for Type 2 Diabetes Management","authors":"Robert C Oh","doi":"10.12788/fp.0429","DOIUrl":"https://doi.org/10.12788/fp.0429","url":null,"abstract":"Background: Type 2 diabetes mellitus (T2DM) has been traditionally considered a chronic, progressive disease. Since 2017, guidelines from the US Department of Veterans Affairs and US Department of Defense have included low-carbohydrate (LC) dietary patterns in managing T2DM. Recently, carbohydrate reduction, including ketogenic diets, has gained renewed interest in the management and remission of T2DM. Observations: This narrative review examines the evidence behind carbohydrate reduction in T2DM and a practical guide for clinicians starting patients on therapeutic LC diets. We present an illustrative case and provide practical approaches to prescribing a very LC ketogenic (< 50 g), LC (50-100 g), or a moderate LC (101-150 g) dietary plan and discuss adverse effects and management of LC diets. We provide a medication management and deprescription approach and discuss strategies to consider in conjunction with LC diets. As patients adopt LC diets, glycemia improves, and medications are deprescribed, hemoglobin A 1c levels and fasting glucose may drop below the diagnostic threshold for T2DM. Remission of T2DM may occur with LC diets (hemoglobin A 1c < 6.5% for ≥ 3 months without T2DM medications). Finally, we describe barriers and limitations to applying therapeutic carbohydrate reduction in a federal health care system. Conclusions: The effective use of LC diets with close and intensive lifestyle counseling and a safe approach to medication management and deprescribing can improve glycemic control, reduce the overall need for insulin and medication and provide sustained weight loss. The efficacy and continuation of therapeutic carbohydrate reduction for patients with T2DM appears promising. Further research on LC diets, emerging strategies, and long-term effects on cardiometabolic risk factors, morbidity, and mortality will continue to inform practice.","PeriodicalId":513268,"journal":{"name":"Federal Practitioner","volume":"52 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0