There is evidence supporting individuals with type 2 diabetes benefit from lifestyle changes through a nutrition intervention that improves diabetic (blood glucose and HgbA1c) and cardiovascular (total cholesterol, HDL, LDL, and triglycerides) biomarkers. The objective of this systematic review was to evaluate if patients with type 2 diabetes following a low carbohydrate, high fat eating pattern is more effective than following a reduced caloric, high carbohydrate eating pattern in the improvement of diabetic (blood glucose and HgbA1c) and cardiovascular (total cholesterol, HDL, LDL, and triglycerides) biomarkers. A literature search was conducted on peer-reviewed research trials registered in PubMed, from January 2007 to September 2019 using combinations of the search terms: Diabetes Mellitus, Type 2 AND Diet, Ketogenic; OR Diet, Carbohydrate-Restricted. The literature was analyzed in chronological order; grouping in four year increments from 2007 to 2019. The thirty-six articles reviewed provide evidence to support the use of a low carbohydrate diet in patients with type 2 diabetes versus a reduced caloric diet. This systematic review highlighted diabetic (HgbA1c and fasting blood glucose) and cardiovascular biomarkers (HDL) of type 2 diabetic patients improve significantly when following a low-carbohydrate, high fat diet versus a reduced calorie, high carbohydrate intake.

Objective: To assess the physiological outcomes and interpersonal influences that should be considered when making the decision to provide artificial nutrition and hydration (AN&H) for patients in hospice/palliative programs. Methods: A systematic review was conducted using items from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist. Distinct search strategies were employed to find primary research articles that addressed: General health outcomes of artificial nutrition and hydration interventions and nutrition therapy interventions (n = 16), nutrition-related symptoms in end-of-life care (n = 8), and the attitudes of patients and providers toward artificial nutrition and hydration (n = 21). Results: The effect of AN&H on health outcomes, quality-of-life measures and nutrition-related symptoms is limited and may vary by patient setting and diagnosis. In the absence of consistent evidence for specific health outcomes, decisions regarding AN&H should be made in context of the desires and beliefs of a patient, their family, and their medical providers. These beliefs may not be consistent with likely outcomes or may be inconsistent between individuals involved in the decision-making process, and individuals of different cultures or geographic regions may approach AN&H decisions from different perspectives. To help navigate the intersection of nutrition-related health outcomes and patient/provider beliefs, palliative care teams may employ a variety of strategies for approaching the decision-making process, and may benefit from specific involvement of a Registered Dietitian to help contribute to or lead these discussions.

There is substantial evidence supporting individuals with polycystic ovary syndrome (PCOS) benefit from lifestyle changes through a nutrition intervention that improves small to moderate weight loss, restore ovulation, improve menstrual regularity, along with clinical (anthropometrics) and biochemical features (glucose tolerance, insulin, menstrual cycle, testosterone levels, free androgen index (FAI), and sex hormone binding globin). The objective of this systematic review was to evaluate individuals with PCOS and their body responses to different diets following a DASH, Mediterranean/Low-glycemic diet/low carbohydrate diet, and hypocaloric, diet in the improvement of clinical (anthropometrics) and biochemical (glucose tolerance, insulin, menstrual cycle, testosterone levels, free androgen index [FAI], and sex hormone binding globin) features. The literature was analyzed in different diet groups supporting nutrition intervention for PCOS in overweight/obese women in term of finding in clinical (anthropometrics- body mass index [BMI], waist circumference, and weight loss) and biochemical features (glucose tolerance, insulin, menstrual cycle, testosterone levels, FAI, and sex hormone binding globin), which will provide evidence to determine the best nutrition intervention for PCOS. This systematic review highlighted significant improvements in BMI, insulin resistance, menstrual irregularity and decrease testosterone levels in PCOS patients when following different diets (DASH, hypocaloric, Mediterranean/low-glycemic diet/low carbohydrate diet) when they are being compared among each other. Each diet supported different improvements in anthropometrics or biochemical biomarkers.

The Quality Work Out, a rapid-cycle improvement initiative, was put into place to prepare a complex 5-hospital system for The Joint Commission and the concept of the "next patient." The patient care team, a group of 11 change agents, was tasked with developing, leading, and implementing projects using the rapid-cycle approach. The authors outline key strategies that led to a successful The Joint Commission survey and measurable change at the bedside.

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