Physician's adherence to the standard protocol for diabetes treatment in Brooke Army Medical Center (BAMC)

The level of compliance with clinical practice guidelines for patients with Type II Diabetes Mellitus was evaluated in 157 patients treated at BAMC from 1 January 2006 to 1 January 2007. This retrospective analysis was conducted reviewing data from medical records and following the VA/DOD protocols that health care providers are expected to follow at this facility. Data collected included patient’s age and gender, presence or absence of complications of diabetes, physical examination findings, glycemic and lipid control, eye care, foot care, kidney function, and self-management and education. Subjects were selected performing systematic random sampling, and included both male and female patients, from a variety of ages and ethnic groups. The Diabetes complications screened for included glycemic and lipid complications, retinopathy, cardiovascular complications, peripheral circulation complications, and nephropathy. The results revealed that 19.10% had no complications and that the most common complications were: cardiovascular (49.68%), glycemic and lipid control (10.82%), retinopathy and peripheral circulation (8.28% each), and nephropathy (2.54%). Only 2.54% of the records reviewed did not include information on complications. Strictly following the Department of Defense guidelines, six treatment modules were evaluated independently and together to get a final percentage of adherence to the clinical practice guidelines. It was established that the level of adherence was going to be graded as follows: Extremely deficient: 0-15%; very poor: 16-30%; Poor and in need of improvement: 31-45%. Acceptable: 46-60%; Good: 61-80%, and Excellent: 81-100%. The results indicated that the percentage of physicians' adherence to each protocol was as follows: 88.31%, 89.93%, 90.63%, 89.42%, 89.42% and 89.64%. When the results were pooled, the level of adherence to the clinical practice guidelines was 89.55%, proving my hypothesis that Brooke Army Medical Center physicians have excellent adherence to the standard protocols for Diabetes Type II to treat their patients. ^

Zimmermann, Eduardo A. Los liberales reformistas. La cuestión social en la Argentina (1890-1916). Buenos Aires, Sudamericana - Universidad de San Andrés, 1995, 250 p.

Fil: Mastrangelo, Fabiana.

La trastienda de un estreno : las elecciones presidenciales de 1916 en Santa Fe

Es historia conocida el rol crucial que tuvieron los diecinueve electores de la provincia de Santa Fe en la elección del presidente en 1916. Después de algunas marchas y contramarchas, estos hombres pertenecientes al Radicalismo «disidente» santafesino volcaron sus votos en favor de Yrigoyen, otorgándole la mayoría en el colegio electoral necesaria para su consagración como presidente. Sin embargo, conocemos menos de la trama que posibilita este desenlace. Es allí donde este trabajo se detiene: en la coyuntura pautada por las elecciones a gobernador de la provincia de Santa Fe, de febrero de 1916, las presidenciales de abril de ese mismo año, y la reunión del colegio electoral en junio para elegir la fórmula presidencial. Interesa reconstruir el juego político en el distrito provincial santafesino, en esa coyuntura que tiene como nota sobresaliente el «estreno» de la ley Sáenz Peña en la elección de presidente, a través del análisis del comportamiento del Radicalismo, partido que detenta el poder provincial desde 1912, y que en la coyuntura estudiada se encuentra dividido entre «oficialistas» y «disidentes».

Horizontal profiles of longwave and shortwave radiation components over sea ice near Barrow, Alaska during the 2011 melt

An integrated instrument package for measuring and understanding the surface radiation budget of sea ice is presented, along with results from its first deployment. The setup simultaneously measures broadband fluxes of upwelling and downwelling terrestrial and solar radiation (four components separately), spectral fluxes of incident and reflected solar radiation, and supporting data such as air temperature and humidity, surface temperature, and location (GPS), in addition to photographing the sky and observed surface during each measurement. The instruments are mounted on a small sled, allowing measurements of the radiation budget to be made at many locations in the study area to see the effect of small-scale surface processes on the large-scale radiation budget. Such observations have many applications, from calibration and validation of remote sensing products to improving our understanding of surface processes that affect atmosphere-snow-ice interactions and drive feedbacks, ultimately leading to the potential to improve climate modelling of ice-covered regions of the ocean. The photographs, spectral data, and other observations allow for improved analysis of the broadband data. An example of this is shown by using the observations made during a partly cloudy day, which show erratic variations due to passing clouds, and creating a careful estimate of what the radiation budget along the observed line would have been under uniform sky conditions, clear or overcast. Other data from the setup's first deployment, in June 2011 on fast ice near Point Barrow, Alaska, are also shown; these illustrate the rapid changes of the radiation budget during a cold period that led to refreezing and new snow well into the melt season.