Background and Purpose: Over 30 million people in the United States (U.S.) have diabetes mellitus, which comprises about 9% of the population, and about 90% of individuals with diabetes have type 2 diabetes (Centers for Disease Control and Prevention [CDC], 2017). Adults with type 2 diabetes at a local internal medicine clinic were consistently having high glycated hemoglobin (HbA1C) levels, demonstrated by data collected from the electronic health record (EHR), and there was no ordering process for referring patients to diabetes management education and support (DSMES) services. The purpose of this project was to improve glycemic control, demonstrated by lower HbA1C levels, and reach a diabetes education attendance rate of 62.5% at an internal medicine clinic in Chandler, Arizona.

Methods: An electronic health record (EHR) template was created and brief staff training was completed to connect patients with diabetes in the community to a local formal diabetes education program. HbA1C levels were measured before and three months after adults with education program. HbA1C levels were measured before and three months after adults with type 2 diabetes mellitus (T2DM) received physicians’ orders for a DSMES program, and rates of attendance to the program were calculated. Data was collected through the EHR and through feedback from the DSMES program. Descriptive statistics were used in data analysis.

Outcomes: The participants’ results did not demonstrate significant differences in pre-referral and post-referral HbA1C results after they were ordered DSMES services (p = .506). The proportion of education attendance (30%) was lower than the project goal of 62.5%, but increased from the clinic baseline.

Conclusions: EHR template implementation for referral to DSMES may increase rates of formal diabetes education and improve glycemic control. Larger sample sizes, longer project periods, alternative methods of communication, and increased follow-up of participants may be required to produce significant results.

While the majority of the scholarship around surrealist relationships with fashion look at the era of the 1930s onwards, this article considers the first period of surrealism during the 1920s, including its prehistory in the mouvement flou as it emerged via Paris Dada and Littérature, asking two related questions: what was the presence and status of the discourse of fashion for surrealism during these formative years; and in what kinds of fashion practices did its members engage? In response to the first of these, an examination of the group’s journals, publications and documents suggests that fashion stands as a significant and abiding area of interest for the group and its members. Writings by André Breton, Louis Aragon, René Crevel and others are correlated with surrealist images and artworks to reflect upon this sustained and informed engagement with men’s and above all women’s fashion, and suggest a particularly keen awareness of the changes in clothing styles over the recent past. The second question has rarely been asked in a systematic way: how did the early Parisian surrealists reflect these interests in their own day-to-day fashion choices and preferences? Given that the majority of the early Parisian surrealist group was male, the focus here is predominantly on men’s fashion, and analysis of memoirs, correspondence and documents such as the photographs taken in the Bureau de recherches surréalistes provides evidence of collective and individual positions. The fashion choices of Simone and André Breton form a particular area of concern, revealing some nuanced developments and unorthodox moments in their day-to-day attitudes.

During his wartime exile in New York City, André Breton responded to the popular entrenchment of Surrealism as a language of shop window merchandising by leading a small group of artists and writers to take the publicity of Surrealism into their own hands. At Breton’s behest, Marcel Duchamp designed three shop windows to advertise texts released by the French publishing arm of the Fifth Avenue bookstore Brentano’s in 1943 and 1945. Although art historians have called attention to the relationship between these designs and the iconography of better-known works by Duchamp, this paper considers them as instantiations of Breton’s evolving thought within the context of a commercial environment already saturated with surrealist imagery. It places them within an iconographic web that includes, among others, Salvador Dalí’s famed fashion displays of the preceding decade, multiple iterations of Duchamp’s “twine,” and works by Kurt Seligmann, Roberto Matta, and Breton himself. The paper argues that, exemplifying the prewar surrealist motif of interior and exterior permeability and bringing it to a breaking point, these obscure windows for French-language texts became an important laboratory for the engaged critique of consumerism that would come to the forefront of the surrealist movement during the postwar period.

Stress of transitioning to parenthood, hormonal fluctuations as well as physical changes, and complications during postpartum could be addressed at the routine postpartum follow-up visit to avoid long-term adverse effects. While emphasis on preconception and prenatal care has increased nationwide, attendance at this important visit is on the decline. The purpose of this project was to investigate how enhanced prenatal education and concurrent scheduling of a well-baby visit at four weeks, instead of the traditional six weeks, could increase adherence to recommended follow-up care at a federally qualified health clinic in the Southwestern United States.

The Theory of Reasoned Action guided the intervention while Rosswurum and Larrabee’s evidence-based practice model was used to develop the project. The pre-existing weekly prenatal education program was enhanced with information regarding the importance of a four-week postpartum follow-up visit. Front desk schedulers were educated to offer same day appointments for the postpartum care visit and one-month well-baby appointment. Data collection took place for three months after implementation of the project and was compared to adherence rates during the three months prior to the intervention. Providers and scheduling staff members participated in a short post-intervention interview. Prenatal education and convenience of concurrent scheduling increased the percentage of adherence to follow-up visits over a three-month period. Providers and clinic staff recommend continuing with the process changes to increase patient’s access to family centered care.

Purpose/Aims: The purpose of this project was to evaluate how patient education can improve medication adherence.

Background and Significance: An exhaustive literature search was conducted with critical appraisal and evidence synthesis to evaluate the effectiveness of patient education on medication adherence. The search concluded that adherence is crucial to chronic disease processes. However, there was no one intervention that emerged as being superior for improving medication
adherence. Working with patients individually to address needs through a variety of methods appeared was the best way to improve medication non-adherence.

Methods: A project to improve medication adherence in an outpatient mental health clinic incorporated electronic medical record (EMR) technology with patient education materials. The project evaluated provider satisfaction with the EMR handout system and evaluated providers’ perceptions of improved medication adherence. Providers (n=9) were followed for eight weeks once system was live. Appraisal was conducted on the providers and pre-test, mid project test, and an eight week post-test were administered. The instrument used was the Technology Acceptance Model-2 (TAM-2).

Outcomes: Friedman Test was conducted. Results obtained showed no significant difference between the three tests (χ2 (2) =2.889, p>0.05). The pretest had a standard deviation of 14.24. The posttest standard deviation was 23.75.

Conclusion: Providers educate patients about a variety of topics such as chronic conditions and wellness. It is beneficial to focus on education more broadly, instead of only medication adherence.

Keywords: patient education, medication adherence, physician perceptions

Diabetes is a leading cause of morbidity in the world. About 42 million people worldwide have
diabetes. Poorly managed diabetes leads to long term complications and mortality. Diabetes self-management education (DSME) has been effective in preventing or delaying complications.The purpose of this project is to implement a diabetes self-management education (DSME)
program in primary care and to evaluate its impact on glycemic control and diabetes knowledge in a selected group of adults 18 years or older in a community-based practice.