A New Case Manager for Diabetic Patients: A Pilot Observational Study of the Role of Community Pharmacists and Pharmacy Services in the Case Management of Diabetic Patients.

The adherence of type 2 diabetes mellitus (DM2) patients with an individual care plan (ICP) is often not satisfactory, nor does it allow for a significant improvement in outcome, because of poor accessibility to services, poor integration of pathway articulations, poor reconciliation with the patient's life, or the lack of a constant reference person. The purpose of this study was to evaluate the contribution of community pharmacists and pharmacy services in improving adherence with periodic controls in DM2. The study was conducted at a rural pharmacy. A sample of 40 patients was calculated with respect to a historical cohort and subsequently enrolled. Clinical and personal data were collected in an electronic case report form. Pharmacists acting as a case manager followed patients carrying out their ICP developed by an attending physician. Some of the activities foreseen by the ICP, such as electrocardiogram, fundus examination, and self-analysis of blood and urine, were carried out directly in the pharmacy by the pharmacist through the use of telemedicine services and point of care units. Activities that could not be performed in the pharmacy were booked by the pharmacist at the accredited units. Examination results were electronically reported by the pharmacist to the attending physician. The primary endpoint was the variation in patient adherence with the ICP compared to a historical cohort. Secondary endpoints were variation in waiting time for the examinations, mean percentage change in glycated hemoglobin (HbA1c) and low-density lipoprotein (LDL) cholesterol levels and blood pressure, impact on healthcare-related costs, and perceived quality of care. Adherence to the ICP significantly increased. Waiting times were reduced and clinical outcomes improved with conceivable effects on costs. Patients appreciated the easier access to services. Community pharmacists and pharmacy services represent ideal actors and context that, integrated in the care network, can really favor ICP adherence and obtain daily morbidity reduction and cost savings through proper disease control and an early diagnosis of complications.

Brechas hacia una alimentación saludable y barreras económicas en hogares de bajos ingresos de seis regiones de la Argentina / Gaps towards healthy eating and economic barriers in low-income households from six regions of Argentina

La población argentina enfrenta tres problemas convergentes; malnutrición por exceso e inseguridad alimentaria crecientes y bajos consumos de alimentos de buena calidad nutricional. El acceso a una alimentación saludable se encuentra más comprometido en los sectores de bajos ingresos, a la vez afectados por el contexto COVID-19, por lo que los precios de los alimentos y los comercios en los que habitualmente compran emergen como temas de interés en torno a su alimentación, ya que podrían ser limitantes para acceder a una dieta de calidad. Así, la reciente disponibilidad de la base de datos de la Encuesta Nacional de Gasto de los Hogares (ENGHo 2017-2018) representa una oportunidad para estudiar los consumos de alimentos en los hogares argentinos, así como los precios implícitos pagados por éstos y los canales de compra con el objetivo de medir de calidad nutricional efectiva, estimar brechas en relación a una conformación saludable de canasta y su relación con los precios y canales de compra como posibles limitantes al acceso a una calidad nutricional saludable. Se espera contar con resultados que tengan implicancias en el diseño de estrategias de promoción de alimentación saludable y de remediación de los efectos de la inflación en la dieta de hogares de bajos ingresos.

Polarization mode dispersion properties of constantly spun randomly birefringent fibers.

We calculate the asymptotic first-order polarization mode dispersion statistics of constantly spun fibers. We show that in the long length regime the mean differential group delay of constantly spun fibers grows linearly with distance at the same rate as for unspun fibers. Conversely, the short length regime of constantly spun fibers may be much longer, even for limited spin rates.

Calculation of the mean differential group delay of periodically spun, randomly birefringent fibers.

Spinning is one of the most effective and well-known ways to reduce polarization mode dispersion of optical fibers. In spite of the popularity of spinning, a detailed theory of spin effects is still lacking. We report an analytical expression for the mean differential group delay of a randomly birefringent spun fiber. The result holds for any periodic spin function with a period shorter than the fiber's beat length.