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Clomiphene, Metformin, Or Both For Infertility In The Polycystic Ovary Syndrome, Richard S. Legro, Huiman X. Barnhart, William D. Schlaff, Bruce R. Carr, Michael P. Diamond, Sandra A. Carson, Michael P. Steinkampf, Christos Coutifaris, Peter G. Mcgovern, Nicholas A. Cataldo, Gabriella G. Gosman, John E. Nestler, Linda C. Guidice, Phyllis C. Leppert, Evan R. Myers M.P.H. Jan 2007

Clomiphene, Metformin, Or Both For Infertility In The Polycystic Ovary Syndrome, Richard S. Legro, Huiman X. Barnhart, William D. Schlaff, Bruce R. Carr, Michael P. Diamond, Sandra A. Carson, Michael P. Steinkampf, Christos Coutifaris, Peter G. Mcgovern, Nicholas A. Cataldo, Gabriella G. Gosman, John E. Nestler, Linda C. Guidice, Phyllis C. Leppert, Evan R. Myers M.P.H.

Obstetrics and Gynecology Publications

Background

The polycystic ovary syndrome is a common cause of infertility. Clomiphene and insulin sensitizers are used alone and in combination to induce ovulation, but it is unknown whether one approach is superior. Methods We randomly assigned 626 infertile women with the polycystic ovary syndrome to receive clomiphene citrate plus placebo, extended-release metformin plus placebo, or a combination of metformin and clomiphene for up to 6 months. Medication was discontinued when pregnancy was confirmed, and subjects were followed until delivery.

Results

The live-birth rate was 22.5% (47 of 209 subjects) in the clomiphene group, 7.2% (15 of 208) in the …


Enhanced Care Assistant Training To Address The Workforce Crisis In Home Care: Changes Related To Job Satisfaction And Career Commitment, Constance L. Coogle, Iris A. Parham, Rita Jablonski, Jason A. Rachel Jan 2007

Enhanced Care Assistant Training To Address The Workforce Crisis In Home Care: Changes Related To Job Satisfaction And Career Commitment, Constance L. Coogle, Iris A. Parham, Rita Jablonski, Jason A. Rachel

Virginia Center on Aging Publications

Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically signifi cant increase in Intrinsic Job Satisfaction scores for participants 18–39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically signifi cant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily …


Re-Imagining The Experience And Study Of Aging, Edward F. Ansello Jan 2007

Re-Imagining The Experience And Study Of Aging, Edward F. Ansello

Director's Editorials from Age in Action

A small group of Japanese and American gerontologists have been working together toward developing a gerontology curriculum that would help people to understand the experience of aging. The group suggested adding business, information technology/communication, and education to the curriculum. The group also acknowledged that a curriculum on aging should include a way to help those of us who are not old to understand the importance for many who are old of the search for the infinite, the true self, the oneness, the spirit, or the divine, at the core of life.


Health Care Reform And Family Caregivers, Edward F. Ansello Jan 2007

Health Care Reform And Family Caregivers, Edward F. Ansello

Director's Editorials from Age in Action

Health care reform is in the air. Family caregivers need recognition, reinforcement, and a reliable resource of assistance. They need for the Commonwealth to recognize that they are the bedrock of long-term care. Minimizing investment in family caregivers would short circuit any serious effort to improve the health status and care of older Virginians.


Fiscal Year Retrospective, Edward F. Ansello Jan 2007

Fiscal Year Retrospective, Edward F. Ansello

Director's Editorials from Age in Action

The Virginia Center on Aging relies on the dedication and selflessness of so many collaborating groups, agencies, and individuals to make our work for older Virginians possible. Drawing from official and informal reports from the 2006-2007 fiscal year, we thank them deeply and look forward to continuing these partnerships.


Acute And Chronic Pain Challenges For Arthritis Patients In An Acute Care Setting, Janet M. Bykowski Jan 2007

Acute And Chronic Pain Challenges For Arthritis Patients In An Acute Care Setting, Janet M. Bykowski

Case Studies from Age in Action

Educational Objectives

1. Demonstrate the importance of chronic pain management in an acute care environment.

2. Discuss the special impact of co-morbidity of arthritis upon pain management intervention.

3. Provide education to clinicians, patients, and caregivers that would promote an interdisciplinary plan of care for acute and chronic concurrent pain management.


“Powerful Tools For Caregivers”: Teaching Skills That Reduce Stress And Increase Self-Confidence, Ed Rosenberg, Natasha Gouge Jan 2007

“Powerful Tools For Caregivers”: Teaching Skills That Reduce Stress And Increase Self-Confidence, Ed Rosenberg, Natasha Gouge

Case Studies from Age in Action

Educational Objectives

1. Describe caregiving stress and burnout symptoms and effects experienced by older caregivers.

2. Report implementation and evaluation of the “Powerful Tools for Caregivers” workshop, which is designed to increase knowledge and skills in caring for elders and reduce caregiver stress.

3. Suggest ways to alleviate caregiver burden at both micro and macro levels.


Teens Teaching Alzheimer’S Caregivers To Become Tech- Savvy: The Power Of Community And Intergenerational Partnerships, Ann Bruner Duesing, Marilyn Pace Maxwell Jan 2007

Teens Teaching Alzheimer’S Caregivers To Become Tech- Savvy: The Power Of Community And Intergenerational Partnerships, Ann Bruner Duesing, Marilyn Pace Maxwell

Case Studies from Age in Action

Educational Objectives

1. Describe a successful technology project for Alzheimer’s caregivers in rural, far southwest Virginia which recruited and trained teenagers to teach computer skills to Alzheimer’s caregivers and taught the teenagers about caregiving and the disease.

2. Identify barriers for Alzheimer’s caregivers to learning and using technology to assist and support them in their caregiving, and identify successful ways to address these barriers.


Pace: Program Of All-Inclusive Care For The Elderly, Laura R. Gadsby Jan 2007

Pace: Program Of All-Inclusive Care For The Elderly, Laura R. Gadsby

Case Studies from Age in Action

Educational Objectives

1. Describe the Program of Allinclusive Care for the Elderly model of care for frail seniors with chronic health care needs.

2. Demonstrate how PACE benefits providers in the delivery of services.

3. Explain how the PACE concept complements Virginia’s Long Term Care Reform, as well as initiatives to develop further the PACE program in Virginia.


Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?, Nina E. Mclain Jan 2007

Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?, Nina E. Mclain

Theses and Dissertations

Researchers have studied memory recall of crisis-oriented or emotional events in non-educational settings. However, within the health care field, there has been a limited study of the the concept of recall of crisis oriented or emotional events in& health care education. Crisis-oriented events such as natural disasters, acts of bioterroism, and industrial accidents, have been reported to impact memory. Patient safety is a primary focus in anesthesia education, appropriate crisis management is imperative to quality anesthesia care. Due to the critical nature of anesthesia delivery, there is a strong, constant need to develop methods that will enhance, support, and improve …


Obesity As A Risk Factor For Preeclampsia: Role Of Inflammation And The Innate Immune System, Tanvi Jayendra Shah Jan 2007

Obesity As A Risk Factor For Preeclampsia: Role Of Inflammation And The Innate Immune System, Tanvi Jayendra Shah

Theses and Dissertations

Obesity is a known risk factor for preeclampsia, but the reason for this risk is unknown. We sought to demonstrate how obese individuals are predisposed to preeclampsia by mechanisms involving inflammation and the innate immune system. First, we used immunohistochemical studies to identify neutrophil infiltration, NF-κB activation and COX-2 expression in vascular tissue of obese women. We then demonstrated similar neutrophil infiltration and vascular inflammation in preeclamptic women.We used in vitro experiments to test if neutrophils and their products, reactive oxygen species (ROS) and tumor necrosis factor-alpha (TNFα) can activate NF-κB and cause expression of its inflammatory products, COX-2, thromboxane …


Improving Life Satisfaction Of Elders Through Oral History: The Narrator's Perspective, Mary B. Ligon Jan 2007

Improving Life Satisfaction Of Elders Through Oral History: The Narrator's Perspective, Mary B. Ligon

Theses and Dissertations

Oral history is a method of preserving historical information through in-depth interviews. Because the process requires narrators to use remote recall while sharing their life experiences, it can also be considered a reminiscence-related activity. Before this study, the positive effects on narrators of providing an oral history were noted in the research literature but had not been evaluated through quantitative methods. Based on theoretical constructs of Erikson and Butler, it was hypothesized that participation in oral history interviews would improve the life satisfaction of narrators. Life satisfaction was operationalized and measured using the Life Satisfaction Index Version A (LSIA). The …