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  • eNews - PEN eNews 13(2) February 2023 - What is the Latest on Kidney Stones?
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PEN eNews 13(2) February 2023 - What is the Latest on Kidney Stones?

PEN® eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.


What is the Latest on Kidney Stones? It is Time to Test Your Knowledge!


The Nephrology - Kidney Stones Knowledge Pathway has been updated. Do you know the answers to these seven practice questions? Click on the practice questions for the answers.

What dietary factors are associated with a decreased risk of developing kidney stones in individuals with no previous history of kidney stones?

What dietary and lifestyle factors are associated with an increased risk of developing kidney stones in individuals with no previous history of kidney stones?

What dietary factors, other than fluid intake, are associated with a decreased recurrence of kidney stones in individuals with a prior history of kidney stones?

What are the effects of consuming fluids on the recurrence of kidney stones?

What dietary recommendations can decrease the risk of uric acid kidney stones in individuals with a prior history of uric acid kidney stones?

What dietary recommendations can decrease the risk of calcium oxalate kidney stones in individuals with a prior history of calcium oxalate kidney stones?

What dietary recommendations can decrease the recurrence of cystine kidney stones in individuals with cystinuria?


Looking for a quick overview of these practice questions? Check out the Nephrology - Kidney Stones Summary of Recommendations and Evidence.

Did you know that the PEN System has seven Nephrology Knowledge Pathways? To recognize World Kidney Day, we will be featuring more nephrology content in March. Stay tuned!


  • Nephrology 

What is the Latest on Household Food Insecurity Screening?

The Question

What tools are recommended to screen for financial constraints to determine the risk of household food insecurity in individuals accessing health care services?

Key Practice Point

Recommendation

There is no validated tool that solely identifies poverty among individuals accessing health care services, therefore no recommendations can be provided for a tool to use. One question with high sensitivity compared to low income cut offs (LICOs) identified in a pilot Canadian study is “Do you (ever) have difficulty making ends meet at the end of the month?”. The evidence reviewed emphasizes that screening cannot replace conversations about financial barriers with clients. Thus, it is recommended for clinicians to discuss financial barriers with clients in addition to any screening.


Remarks

While specific housefood food insecurity (HFI) screening tools exist with adequate sensitivity and specificity, such tools center the issue and actions around food budgeting, skill building and food-based solutions, which do not address the root cause of HFI. Consequently, financial constraints are recommended to be identified as an opportunity for the client and health practitioner to understand the client’s unique needs and experiences regarding how financial constraints impact food decisions for improved health care, which aligns with HFI being an issue of inadequate income and material deprivation.

Screening tools are constructed to gather information relevant to dietetic practice and should also be used to build rapport. To understand how to prevent harm when having these conversations, see Additional Content: Household Food Insecurity Background. 

To see the full practice question, including the Evidence Summary, Evidence Statements, Comments, Rationale and References, click here.


Wondering what else is new or updated? Click here.

  • Food Security 

What is the Latest on Celiac Disease and Type 1 Diabetes?


The Celiac/Coeliac and Type 1 Diabetes Knowledge Pathway has been updated. Check out these updated practice questions:

When should individuals with type 1 diabetes be screened for celiac disease?

How does the timing of exposure to gluten during infancy and early childhood impact the risk of developing type 1 diabetes in individuals with a genetic risk for type 1 diabetes?

What strategies support children and adolescents with both type 1 diabetes and celiac disease to follow a gluten-free diet?

What impact does initiating a gluten-free diet have on insulin requirements in individuals with both celiac disease and type 1 diabetes?

Does following a gluten-free diet help individuals with both type 1 diabetes and celiac disease reduce their risk of hypoglycemia?

Looking for more information on diabetes? The PEN System has 13 Knowledge Pathways specific to diabetes and more than 180 practice questions. Try our Search and see the Power of PEN.

Are you looking for a new way to apply your nutrition practice knowledge?


Become a PEN System Reviewer - it’s good for the PEN System and good for you, too!

As a reviewer you will:

  • Contribute to advancing evidence-based nutrition practice by helping nutrition practitioners access timely, current and authoritative guidance on food and nutrition practice

  • Become aware of the most up-to-date research and evidence-informed recommendations before the content is published on the PEN System. 

  • Support your professional portfolio by demonstrating your knowledge of the field or critical appraisal skills. 

Opportunities are available to review PEN Backgrounds, Practice Questions and Client Handouts (Canadian).

Learn more about becoming a PEN reviewer by visiting our FAQ and reading our current opportunities to get involved. Reach out with additional questions to coordinator@dietitians.ca


  • Dietetic Practice, 
  • PEN Applied, 
  • Evidence Literacy 

Practice Guidance Toolkits - There for you!


In April 2013, the PEN® Team introduced the Practice Guidance Toolkits. These toolkits make the access to essential information on nutrition assessment, diagnosis, intervention, monitoring, associated tools and education materials based on nutrition-related conditions/diseases more 'up-front' and easier to retrieve. The toolkits present information in a format consistent with Nutrition Care Process Terminology (NCPT) with direct access to succinct information that dietitians use in their practice. The toolkits are a stand-alone tool used primarily for clinical knowledge pathways and also include the associated Summary of Recommendations and Evidence.  

To find them on the PEN home page, click on the Toolkits icon, which leads to all available toolkits. 

They can also be found on the Knowledge Pathways Table of Contents page. Click on any of the icons under the Practice Guidance Toolkit column. Alternatively, within a knowledge pathway, click on the “Toolkit “ tab on the right-hand side of the page. The Toolkit tab will only display as an option if the knowledge pathway has a toolkit.



Helpful Features in the Toolkits  

  • Click on any of the items on the Table of Contents of the right-hand side of a toolkit to get quick, direct access to any section within the toolkit.  
  • Flags! Where information is specific to a particular country, you have the option of seeing only your country’s information or viewing other’s information as well. Simply click the box at the top of the page for the country information that you would like to view, and it will be displayed (or alternatively unclick the box to hide it).

Below is a list of toolkits that have recently been added or updated: 

  • Bone Health and Osteoporosis Practice Guidance Toolkit
  • Gastrointestinal System - Inflammatory Bowel Disease (IBD) Practice Guidance Toolkit
  • Musculoskeletal/Connective Tissue Disorders - Fibromyalgia Practice Guidance Toolkit
  • Metabolic and Bariatric Surgery Practice Guidance Toolkit

Adapted from an April 2013 PEN eNews article.


  • PEN Features 
  

How Do I … access PEN® client handouts from the PEN® Handout Collection?

   


What are food sources of iodine? What are diet and cancer prevention basics? What are eating guidelines for food allergies and intolerances? Take a look at our PEN® Client Handout Collections. The number of client handouts has grown over the years, so the PEN Team has redesigned the handout collection to make handouts easier to access and use. Outlined below is how you can access the handouts.

The PEN® Handout Collections are available from the PEN home page:   
 
Individual handouts are also identified in relevant search results.

There are now seven handout categories available:

There is a + symbol next to some of the categories, that, when clicked, display subcategories and their related handouts. Click on each category to see the lists of PEN client handouts available.
 

Need handouts in a language other than English?
  • Most handouts have been translated into French.
  • Some have other language translations (Chinese, Hindi, Gujarati, Punjabi, Spanish, Tamil, Urdu and Vietnamese). 

Need handouts that have been adapted to cultural foods?
  • There are cultural adaptations to some handouts: African, Caribbean, Chinese, Gujarati, Hispanic, Latin, North and South Asia, North and South Indian, Pakistani, Sri Lankan. Some of these have also been translated, as in the example below: Heart Healthy Eating: Triglycerides – Adapted North Indian and Pakistani and translated into Gujarati, Hindi, Punjabi and Urdu. 

Here is an example in the Cardiovascular Disease subcategory under Disease Conditions:
 
 

You also have the option of seeing handout titles in French. At the top of each category under the title is English/Français option tab and when you click on Français you will see the handout titles in French.

 


Did you know you can share and customize handouts?
  • Add your customized nutrition advice to the Notes section by entering it from your computer under the ‘Additional Notes From Your Health Care Professional’, (See How do I…Customize Notes to Client Handouts) or you can write your comments in the Notes section of a printed copy.
  • Add your company logo in the Distribution By box 
  • Print out or email the handouts to your clients.

To learn how to complete these actions, you can:
  • go to the Help icon at the top of the PEN home page, 
  • go to Using PEN Power Tools and click on the various sections you need. 
  • Read the PEN eNews article: How do I… Customize Client Handouts .

We hope the redesign of the Client Handout Collection helps you in your practice.

As always, we welcome your feedback.

Reposted from an article in PEN eNews February 2016

  • PEN Features 
PEN eNews
PEN: The Global Resource for Nutrition Practice  
February 2023  Volume 13 (2)


A Publication of the PEN® System Global Partners,
a collaborative partnership between International Dietetic Associations.
Learn more about PEN.
Copyright Dietitians of Canada . All Rights Reserved.
Articles in this issue
  • What is the Latest on Kidney Stones? It is Time to Test Your Knowledge!
  • What is the Latest on Household Food Insecurity Screening?
  • What is the Latest on Celiac Disease and Type 1 Diabetes?
  • Are you looking for a new way to apply your nutrition practice knowledge?
  • Practice Guidance Toolkits - There For You!
  • How Do I … access PEN client handouts from the PEN Handout Collection?
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    Copyright © Dietitians of Canada 2005 - 2023. All rights reserved. While individual copies of documents may be reproduced for the convenience of the licensed subscriber according to the end user license, distribution to non subscribers or reproduction of multiple copies of PEN content is strictly prohibited without prior written permission. Licensed subscribers may download, duplicate and distribute copies of the PEN-branded client handouts for educational use with their own clients. Institutions must have sufficient numbers of site licenses in order to make multiple copies to meet client needs. The PEN website may also contain information which is copyrighted by others; multiple copies of these documents may not be reproduced without the prior written permission of the copyright holder.

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