OBJECTIVE -This study evaluated the Diabetes Outpatient Intensive Treatment (DOIT) program, a multiday group education and skills training experience combined with daily medical management, followed by case management over 6 months. Using a randomized control design, the study explored how DOIT affected glycemic control and self-care behaviors over a short term. The impact of two additional factors on clinical outcomes were also examined (frequency of case management contacts and whether or not insulin was started during the program).RESEARCH DESIGN AND METHODS -Patients with type 1 and type 2 diabetes in poor glycemic control (A1c Ͼ8.5%) were randomly assigned to DOIT or a second condition, entitled EDUPOST, which was standard diabetes care with the addition of quarterly educational mailings. A total of 167 patients (78 EDUPOST, 89 DOIT) completed all baseline measures, including A1c and a questionnaire assessing diabetes-related self-care behaviors. At 6 months, 117 patients (52 EDUPOST, 65 DOIT) returned to complete a follow-up A1c and the identical self-care questionnaire.RESULTS -At follow-up, DOIT evidenced a significantly greater drop in A1c than EDUPOST. DOIT patients also reported significantly more frequent blood glucose monitoring and greater attention to carbohydrate and fat contents (ACFC) of food compared with EDUPOST patients. An increase in ACFC over the 6-month period was associated with improved glycemic control among DOIT patients. Also, the frequency of nurse case manager follow-up contacts was positively linked to better A1c outcomes. The addition of insulin did not appear to be a significant contributor to glycemic change.CONCLUSIONS -DOIT appears to be effective in promoting better diabetes care and positively influencing glycemia and diabetes-related self-care behaviors. However, it demands significant time, commitment, and careful coordination with many health care professionals. The role of the nurse case manager in providing ongoing follow-up contact seems important. Diabetes Care 26:3048 -3053, 2003D ay-to-day clinical care in diabetes is driven by the understanding that long-term complications can be delayed and/or prevented by improving metabolic control early in the disease course (1-6). Appropriate medical management is a critical intervention for success but may not be sufficient by itself over the long term. Due to the nature of diabetes, ongoing self-care is also essential, and so efforts must be made to help the patient become knowledgeable about his or her disease, skilled in selfmanagement, and enthused about pursuing effective self-care. Structured diabetes self-management training has been shown to be of value in each of these areas (7), but it is typically separated in time and place from medical management. This can be problematic, especially when different or even contradictory recommendations about diabetes and diabetes care are presented by the various health care providers.As a first step toward addressing this issue, clinicians at the Joslin Diabetes Center develope...
<p> This thesis is a catalogue raisonné of El Lissitzky’s The Constructor (Self-Portrait). El Lissitzky’s The Constructor (Self-Portrait) is an iconic photograph of the Russian avant-garde. While historians have recognized the photograph has variants, none have attempted to compile a comprehensive inventory. Based on publications, museum catalogue records, auction catalogue records, email correspondence, and for 2 prints, in-person analysis, this thesis catalogues the 3 negatives, 53 prints, 9 reproductions, and 15 documents that relate to the photograph. Chapter 1 describes a precursory Self-Portrait. Chapter 2 describes elements used in The Constructor (Self-Portrait) and is broken down into 4 sections: selfportrait, hand with compass, self-portrait with hand and compass, and letterhead. Chapter 3 describes The Constructor (Self-Portrait) and breaks its variants down into 8 distinct batches. </p>
<p> This thesis is a catalogue raisonné of El Lissitzky’s The Constructor (Self-Portrait). El Lissitzky’s The Constructor (Self-Portrait) is an iconic photograph of the Russian avant-garde. While historians have recognized the photograph has variants, none have attempted to compile a comprehensive inventory. Based on publications, museum catalogue records, auction catalogue records, email correspondence, and for 2 prints, in-person analysis, this thesis catalogues the 3 negatives, 53 prints, 9 reproductions, and 15 documents that relate to the photograph. Chapter 1 describes a precursory Self-Portrait. Chapter 2 describes elements used in The Constructor (Self-Portrait) and is broken down into 4 sections: selfportrait, hand with compass, self-portrait with hand and compass, and letterhead. Chapter 3 describes The Constructor (Self-Portrait) and breaks its variants down into 8 distinct batches. </p>
Toda escritura implica la puesta en juego de un sujeto, sujeto que sostiene la escritura y que al mismo tiempo adviene gracias a ella. En este trabajo nos abocamos a mostrar la particularidad del sujeto contenido en la poesía de Tomás Harris. Para ello nos basamos en los postulados de Paul Ricoeur, Hayden White y Hannah Arendt. Para el análisis nos centramos en "El hombre sin brazos", conjunto de poemas perteneciente a Ítaca, y Crónicas maravillosas.
T omás Harris1 es un poeta y sus libros, mediante el título poesía inscrito en ellos, llaman al lector a sellar el "pacto" de lectura de éstos como poesía. ¿Por qué nos obstinamos en sellar un nuevo pacto y leer la poesía desde un marco genérico desplazado, tal es el de las teorías sobre la narración? Primero, porque esta posible lectura está inscrita en el texto mismo: es el propio tejido y la estructura de estos poemas los que apelan a una lectura distinta. Y segundo, porque creemos (y procuraremos mostrarlo) que una lectura así puede hacer hablar al texto más ricamente que una lectura más canónica.En relación a la "inscripción narrativa" en la poesía de Harris, basta un vistazo somero a los índices de cada uno de sus poemarios para percibir de inmediato la presencia de estas estructuras. En Cipango, los poemas se agrupan bajo un título que semánticamente actúa como elemento de coherencia: "Zonas de peligro", "La forma de los muros", "Diario de navegación", "El último viaje" y "Cipango". Al interior de "Zonas de peligro" encontramos la técnica de la seriación, la que se mantiene como recurrente en sus libros posteriores. Es decir, * Este trabajo es parte del proyecto de investigación Fondecyt Nº 11075019, titulado Constitución de un sujeto sobreviviente en la poesía de Tomás Harris: Trauma, cuerpo y narración.1 Tomás Harris (nacido en 1956) se ubica dentro de la generación del ochenta y cuenta con una vasta producción poética, la que consta hasta el momento de los siguientes poemarios: Zonas de peligro (1985), Diario de navegación (1986), El último viaje (1987, Alguien que se sueña, Madame (1987), Noches de brujas y otros hechos de sangre
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