Medical Specialties Commons^™

Older Adults, Social Techniques, And Memory, Karla K. Ziegenbalg

Case Studies from Age in Action

Educational Objectives

1. To use a social psychological perspective to examine memory abilities of older adults.

2. To understand in what ways the social environment, through direct social interaction, affects the memory performance of older adults.

3. To find out what, if any, social factors support memory performance in older adults.

Older Homeless Women: Beneath The Safety Net, Anne J. Kisor, Lynne Kendal-Wilson

Case Studies from Age in Action

Educational Objectives

1. Discuss how there is no stereotypical experience of, or explanation for, homelessness among older women.

2. Discuss why it is important to study the experiences of older homeless women.

3. Discuss policy and practice recommendations and specific ways to bridge efforts of aging and homeless service providers.

Are You At Risk For Blindness? Don't Keep Glaucoma A Family Secret! Older Age Is A Risk Factor, Mary Price

Case Studies from Age in Action

Educational Objectives

1. Raise awareness of risk factors for glaucoma.

2. Encourage health care providers to educate the patient about glaucoma risk factors.

3. Educate glaucoma patients to encourage family members to seek a glaucoma examination.

Avoiding Medication Pitfalls, Jeffrey Delafuente

Case Studies from Age in Action

Educational Objectives

1. Discuss the prevalence and risk factors for adverse drug events in older people.

2. Identify selected medications that often should be avoided in older people.

3. Discuss methods to ensure safe medication use.

Enhancing The Quality Of Life Of Nursing Home Residents With Late Stage Alzheimer's Disease And Related Disorders, Felicity Sluga

Case Studies from Age in Action

Educational Objectives

1. Discuss the growing need for special programming and activities to improve the quality of life of nursing home residents with dementing illnesses.

2. Discuss program and activity options that have a positive impact on quality of life as measured by the resident's mood, behavioral symptoms, cognitive skills, physical condition and medication use.

3. Review the responses of a resident to our unit’s therapeutic interventions.

Bridging Aging And Domestic Violence Services In Our Communities, Janett Forte, Paula Knapp Kupstas, Stephanie White

Case Studies from Age in Action

Educational Objectives

1. To describe the problem of domestic violence in later life.

2. To show how the operating principles and service approaches of aging (APS and aging network) and domestic violence service providers differ and may cause them to interpret the same situation differently.

3. To encourage aging and domestic violence service providers to share information, expertise, resources, and philosophical perspectives with one another in order to improve the community response to older battered women.

Vision And Hearing Loss In The Older Adult - “Double Trouble”, Paige Berry

Case Studies from Age in Action

Educational Objectives

1. How to recognize age related vision and hearing loss.

2. How the loss of both vision and hearing affect the individual's day to day functioning.

3. Services and technology available to assist the professional in better meeting the needs of the individual who is experiencing a vision and hearing loss.

Adult Daycare: Sharing The Caring, Having A Life, Lory Phillippo Osorio

Case Studies from Age in Action

Objectives

1. Demonstrate the role of adult daycare in community-based services for older adults.

2. Illustrate the diversity of services provided in adult daycare/day health care centers in Virginia.

3. Encourage public policy and funding to expand quality adult daycare in the Commonwealth.

The Aging Woman And Hiv/Aids: Increasing Risk And Incidence, Loretta Brush Normile

Case Studies from Age in Action

Educational Objectives

1. Discuss the increasing incidence of HIV in the aging population.

2. Describe the ways HIV affects the aging person.

3. Identify implications for HIV education and risk assessment of the older population.

Pace: Program Of All-Inclusive Care Of The Elderly, A. Leigh Peyton, Wendy Boggs, Bill Miller, Nancy Allan

Case Studies from Age in Action

Educational Objectives

1. To describe the origin of PACE.

2. To identify essential services provided by the PACE model.

Aging With Cerebral Palsy: A Consumer’S Perspective, Bryan K. Lacy

Case Studies from Age in Action

Educational Objectives

1. To illustrate the necessity of an holistic approach to addressing the changing health care needs of adults with Cerebral Palsy.

2. To show the necessity of dealing honestly and creatively with the intimacy/sexuality concerns of older adults with Cerebral Palsy.

Low Vision In Older Adults, Jeffrey C. Michaels, Mary D. Bullock

Case Studies from Age in Action

Educational Objectives

1. Understand the epidemiology of visual impairments of older adults.

2. Understand the symptoms of functional loss secondary to visual impairments.

3. Understand the rehabilitative options available for those with vision loss.

4. Understand the multi-disciplinary approach in low vision rehabilitation.

5. Understand the impact of low vision rehabilitation services.

Ethical Concerns In The Care Of Individuals With Alzheimer’S Disease, Jeanne Sorrell

Case Studies from Age in Action

Educational Objectives

1. Identify important ethical concerns in the care of individuals with Alzheimer's Disease.

2. Describe the use of the Fairhill Guidelines as a frame-work for study of ethical issues related to the care of individuals with Alzheimer's Disease.

3. Discuss interventions to assist individuals with dementia and their family members in exploring ethical concerns.

Merging A Divided System: The Need To Integrate Care For Individuals Participating In Both The Medicare And Medicaid Programs, Regina L. Anderson-Cloud

Case Studies from Age in Action

Educational Objectives

1. Identify the underlying premises of the need to integrate care between the Medicare and Medicaid programs for individuals eligible for both insurances.

2. Discuss innovations aimed at assisting older adults with an improved Medicare/Medicaid system.

3. Describe relevant health care concerns related to the current fragmentation of the health care system for older adults who possess both Medicare and Medicaid.

Geriatric Interdisciplinary Team Training, Rita Jablonski, David A. Cifu, Peter A. Boling, Patricia Slattum, A. Leigh Peyton, F. Ellen Netting, Iris A. Parham, Joan B. Wood

Case Studies from Age in Action

Educational Objectives

1. To demonstrate the importance of training health care professionals in inter-disciplinary teamwork and geriatric health issues.

2. To increase one’s knowledge of the roles and responsibilities of the various disciplines involved in interdisciplinary teamwork.

Ovulatory And Metabolic Effects Of D-Chiro-Inositol In The Polycystic Ovary Syndrome, John E. Nestler, Daniela J. Jakubowicz , M.D., Paula Reamer , M.A., Ronald D. Gunn , M.S., Geoffrey Allan , Ph. D.

Obstetrics and Gynecology Publications

BACKGROUND

Women with the polycystic ovary syndrome have insulin resistance and hyperinsulinemia, possibly because of a deficiency of a d-chiro-inositol–containing phosphoglycan that mediates the action of insulin. We hypothesized that the administration of d-chiro-inositol would replenish stores of the mediator and improve insulin sensitivity.

METHODS

We measured steroids in serum and performed oral glucose-tolerance tests before and after the oral administration of 1200 mg of d-chiro-inositol or placebo once daily for six to eight weeks in 44 obese women with the polycystic ovary syndrome. The serum progesterone concentration was measured weekly to monitor for …

Effects Of Metformin On Spontaneous And Clomiphene-Induced Ovulation In The Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D., William S. Evans , M.D., Renato Pasquali , M.D.

Obstetrics and Gynecology Publications

ABSTRACT

Background Obese women with the polycystic ovary syndrome are relatively unresponsive to the induction of ovulation by clomiphene. We hypothesized that reducing insulin secretion by administering metformin would increase the ovulatory response to clomiphene.

Methods We performed oral glucose-tolerance tests before and after the administration of 500 mg of metformin or placebo three times daily for 35 days in 61 obese women with the polycystic ovary syndrome. Women who did not ovulate spontaneously were then given 50 mg of clomiphene daily for five days while continuing to take metformin or placebo. Serum progesterone was measured on days 14, 28, …

Preventing The Unnecessary Losses Of Alzheimer's Disease, Lin E. Noyes

Case Studies from Age in Action

Educational Objectives

1. To state the importance of early detection and diagnosis of Alzheimer's disease.

2. To describe common concerns of people in the early stages of Alzheimer's disease.

3. To describe interventions to help people who have recently been diagnosed with Alzheimer's disease or other dementias.

Reducing Medication Mismanagement In Adult Care Residences, Mary Ann F. Kirkpatrick

Case Studies from Age in Action

Educational Objectives

1. Describe the prevalence of medication mismanagement in adult care facilities in Virginia.

2. Explain the significance of selected medication management errors.

3. Recommend practices to improve medication management task performance in adult care facilities.

State Regulation Of Assisted Living Facilities, Sonya A. Sterbenz

Case Studies from Age in Action

Educational Objectives

1. To define the role of assisted living facilities in the continuum of long-term care options for older adults.

2. To present the various arguments concerning the regulation of the assisted living industry.

Medications And Falls, Patricia W. Slattum

Case Studies from Age in Action

Educational Objectives:

1. To describe potential causes of falls and ways to prevent them.

2. To illustrate how medications can contribute to an increased risk of falls and recommend strategies for reducing this risk.

A Comparison Of Rectal Diazepam Gel And Placebo For Acute Repetitive Seizures, Fritz E. Dreifuss , M.D., N. Paul Rosman , M.D., James C. Cloyd , Pharm.D., John M. Pellock , M.D., Ruben I. Kuzniecky , M.D., Warren D. Lo , M.D., Fumisuke Matsuo , M.D., Gregory B. Sharp , M.D., Joan A. Conry , M.D., Donna C. Bergen , M.D., Walter E. Bell , Ph.D

Neurology Publications

ABSTRACT

Background Acute repetitive seizures are readily recognizable episodes involving increased seizure frequency. Urgent treatment is often required. Rectal diazepam gel is a promising therapy.

Methods We conducted a randomized, doubleblind, parallel-group, placebo-controlled study of home-based treatment for acute repetitive seizures. Patients were randomly assigned to receive either rectal diazepam gel, at doses ranging from 0.2 to 0.5 mg per kilogram of body weight on the basis of age, or placebo. Children received one dose at the onset of acute repetitive seizures and a second dose four hours later. Adults received three doses — one dose at onset, and two …

Standing Up To Osteoporosis, Robert W. Downs

Case Studies from Age in Action

Educational Objectives

1. To provide basic information about osteoporosis, including risk factors, diagnostic testing, treatment, and prevention.

2. To get you to help us spread the word that osteoporosis can be diagnosed and treated, and that there are things you can do to decrease your future risk for developing osteoporosis.

Adverse Cerebral Outcomes After Coronary Bypass Surgery, Gary W. Roach , M.D., Marc Kanchuger , M.D., Christina Mora Mangano , M.D., Mark Newman , M.D., Nancy Nussmeier , M.D., Richard Wolman , M.D., Anil Aggarwal , M.D., Katherine Marschall , M.D., Steven H. Graham , M.D., Ph.D., Catherine Ley , Ph.D., Gerard Ozanne , M.D., Dennis T. Mangano , Ph.D., M.D., Ahvie Herskowitz , M.D., Vera Katseva , Ph.D, Rita Sears , R.N., M.S.

Anesthesiology Publications

ABSTRACT

Background Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic events, including cerebral injury.

Methods In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures).

Results Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of …

Decreases In Ovarian Cytochrome P450c17 Alpha Activity And Serum Free Testosterone After Reduction Of Insulin Secretion In Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D.

Obstetrics and Gynecology Publications

BACKGROUND

Insulin resistance and increased ovarian cytochrome P450c17α activity are both features of the polycystic ovary syndrome. P450c17α, which is involved in androgen biosynthesis, has both 17α-hydroxylase and 17,20-lyase activities. Increased activity of this enzyme results in exaggerated conversion of progesterone to 17α-hydroxyprogesterone in response to stimulation by gonadotropin. We hypothesized that hyperinsulinemia stimulates ovarian P450c17α activity.

METHODS

We measured serum steroid concentrations during fasting and the response of serum 17α-hydroxyprogesterone to leuprolide, a gonadotropin-releasing hormone agonist, and performed oral glucose-tolerance tests before and after oral administration of either metformin (500 mg three times daily) or placebo for four to …

Periodic Lateralized Epileptiform Discharges, Nathan Watemberg , M.D., Lawrence D. Morton , M.D.

Neurology Publications

No abstract provided.

A Comparison Of Standard-Dose And High-Dose Epinephrine In Cardiac Arrest Outside The Hospital, Charles G. Brown, Daniel R. Martin, Paul E. Pepe, Harlan Stueven, Richard O. Commins, Edgar Gonzalez, Michael Jastremski, The Multicenter High-Dose Epinephrine Study Group

Emergency Medicine Publications

BACKGROUND.

Experimental and uncontrolled clinical evidence suggests that intravenous epinephrine in doses higher than currently recommended may improve outcome after cardiac arrest. We conducted a prospective, multicenter study comparing standard-dose epinephrine with high-dose epinephrine in the management of cardiac arrest outside the hospital.

METHODS.

Adult patients were enrolled in the study if they remained in ventricular fibrillation, or if they had asystole or electromechanical dissociation, at the time the first drug was to be administered to treat the cardiac arrest. Patients were randomly assigned to receive either 0.02 mg of epinephrine per kilogram of body weight (standard-dose group, 632 patients) …

Elder-Caregiving Among University Employees: Responsibilities And Needs, Constance L. Coogle, Edward F. Ansello

Virginia Center on Aging Publications

Although many institutions of higher education often house the researchers who study eldercare, few have documented the need for information and services among their estimated 460,000 employees who face the difficult task of effectively balancing work and eldercare responsibilities. Even fewer have established programs to address this need.

Drs. Constance Coogle and Edward Ansello have recently completed an exhaustive survey of VCU employees (N = 11,430) to determine the extent to which they provide care to disabled parents or spouses.[1] A longer, more detailed survey was sent to those who indicated that they were eldercaregivers to measure their perceived …

The Effect Of Body Position Changes On Arterial Oxygen Saturation In Obesity As Measured Noninvasively By Pulse Oximetry, Anna Marie Angela Klosterman

Theses and Dissertations

This study utilized a quasi-experimental pretest-posttest design that compared the effect of body position changes on arterial oxygen saturation in obesity as measured noninvasively by pulse oximetry. The null hypothesis, that there would be no difference between oxygen saturation values measured by pulse oximetry with position change from sitting to supine in obese subjects as compared to nonobese subjects, was tested. Fourteen obese, American Society of Anesthesiologist (ASA) physical class status II subjects and 14 nonobese ASA physical class status I subjects were included in the sample population. Thirteen of the obese subjects were further classified as morbidly obese. After …

Pathophysiology Of Male Hypogonadism Associated With Endogenous Hyperestrogenism — Evidence For Dual Defects In The Gonadal Axis, Johannes D. Veldhuis, James R. Sower, Alan D. Rogol, Frederick A. Klein, Norman Miller, Maria L. Dufau

Surgery Publications

FEMINIZING tumors of the adrenal cortex are associated with symptoms that presumably reflect the combined effects of estrogen excess and androgen deficiency — gynecomastia, diminished libido, attenuated potency, and testicular and prostatic atrophy.1 2 3 4 5 Although such tumors are extremely rare, they provide a unique opportunity to appraise the nature of endogenous estrogen action on the gonadal axis in men. In principle, the pathophysiologic effects of estrogen hypersecretion could be expressed at the level of either the Leydig cell or the hypothalamic–pituitary axis (or both), with consequent suppression of androgen production. In the present studies, we investigated …