The Sexual Impact of Infertility Among Women Seeking Fertility Care.

IntroductionInfertility affects approximately 6.7 million women in the United States. Couples with infertility have significantly more anxiety, depression, and stress. This is compounded by the fact that almost 40% of couples undergoing assisted reproduction technology still cannot conceive, which can have an ongoing effect on quality of life, marital adjustment, and sexual impact.AimTo assess the sexual impact of infertility in women undergoing fertility treatment.MethodsThis study is a cross-sectional analysis of women in infertile couples seeking treatment at academic or private infertility clinics. Basic demographic information was collected. Respondents were surveyed regarding sexual impact and perception of their infertility etiology. Multivariate regression analyses were used to identify factors independently associated with increased sexual impact.Main outcome measureSexual impact of perceived fertility diagnosis.ResultsIn total, 809 women met the inclusion criteria, of whom 437 (54%) agreed to participate and 382 completed the sexual impact items. Most of the infertility was female factor only (58.8%), whereas 30.4% of infertility was a combination of male and female factors, 7.3% was male factor only, and 3.5% was unexplained infertility. In bivariate and multivariate analyses, women who perceived they had female factor only infertility reported greater sexual impact compared with woman with male factor infertility (P = .01). Respondents who were younger than 40 years experienced a significantly higher sexual impact than respondents older than 40 years (P < .01). When stratified by primary and secondary infertility, respondents with primary infertility overall reported higher sexual impact scores.ConclusionIn women seeking fertility treatment, younger age and female factor infertility were associated with increased sexual impact and thus these women are potentially at higher risk of sexual dysfunction. Providers should consider the role young age and an infertility diagnosis plays in a women's sexual well-being

Analisis Kepatuhan Akuntan Manajemen dalam Menerapkan Standar Akuntansi Pajak Penghasilan (PSAK No. 46)

Management accountant is profession of accountancy in the company. That is why he or she tied up to profession ethics and must obedient in apply the relevant accounting standard, including the statement of income tax accounting standard (Pernyataan Standar Akuntansi Pajak Penghasilan, PSAK No. 46), in order the financial report which are prepared get the high degree of opinion from independent auditor

Community-based educational program for adjudicated juveniles

The goal of this project is to research if state funds could be saved, supervision for probation and parole could be shortened and more juvenile offenders in Aiken County could attain academic achievement prior to being released from the juvenile justice system if DJJ provided a community-based educational site

Gold potential of the Southwest Pacific : Papua New Guinea, Solomon Islands, Vanuatu, Fiji

For more about the East-West Center, see http://www.eastwestcenter.org/</a

Early Infant Diagnosis of HIV in Three Regions in Tanzania; Successes and Challenges.

By the end of 2009 an estimated 2.5 million children worldwide were living with HIV-1, mostly as a consequence of vertical transmission, and more than 90% of these children live in sub-Saharan Africa. In 2008 the World Health Organization (WHO), recommended early initiation of Highly Active Antiretroviral Therapy (HAART) to all HIV infected infants diagnosed within the first year of life, and since 2010, within the first two years of life, irrespective of CD4 count or WHO clinical stage. The study aims were to describe implementation of EID programs in three Tanzanian regions with differences in HIV prevalences and logistical set-up with regard to HIV DNA testing. Data were obtained by review of the prevention from mother to child transmission of HIV (PMTCT) registers from 2009-2011 at the Reproductive and Child Health Clinics (RCH) and from the databases from the Care and Treatment Clinics (CTC) in all the three regions; Kilimanjaro, Mbeya and Tanga. Statistical tests used were Poisson regression model and rank sum test. During the period of 2009 - 2011 a total of 4,860 exposed infants were registered from the reviewed sites, of whom 4,292 (88.3%) were screened for HIV infection. Overall proportion of tested infants in the three regions increased from 77.2% in 2009 to 97.8% in 2011. A total of 452 (10.5%) were found to be HIV infected (judged by the result of the first test). The prevalence of HIV infection among infants was higher in Mbeya when compared to Kilimanjaro region RR = 1.872 (95%CI = 1.408 - 2.543) p < 0.001. However sample turnaround time was significantly shorter in both Mbeya (2.7 weeks) and Tanga (5.0 weeks) as compared to Kilimanjaro (7.0 weeks), p=<0.001. A substantial of loss to follow-up (LTFU) was evident at all stages of EID services in the period of 2009 to 2011. Among the infants who were receiving treatment, 61% were found to be LFTU during the review period. The study showed an increase in testing of HIV exposed infants within the three years, there is large variations of HIV prevalence among the regions. Challenges like; sample turnaround time and LTFU must be overcome before this can translate into the intended goal of early initiation of lifelong lifesaving antiretroviral therapy for the infants

Univalent Foundations and the UniMath Library

We give a concise presentation of the Univalent Foundations of mathematics outlining the main ideas, followed by a discussion of the UniMath library of formalized mathematics implementing the ideas of the Univalent Foundations (section 1), and the challenges one faces in attempting to design a large-scale library of formalized mathematics (section 2). This leads us to a general discussion about the links between architecture and mathematics where a meeting of minds is revealed between architects and mathematicians (section 3). On the way our odyssey from the foundations to the "horizon" of mathematics will lead us to meet the mathematicians David Hilbert and Nicolas Bourbaki as well as the architect Christopher Alexander

Clinical Applications of Pediatric Pulmonary Function Testing: Lung Function in Recurrent Wheezing and Asthma

Pulmonary function testing remains the gold standard for the diagnosis and management of wheezing disorders in older children and adults. Although wheezing disorders are among the most common clinical problems in pediatrics, most young children and toddlers cannot perform most of the currently clinically available pulmonary function tests. In this article, we review the different types of pulmonary function tests available and discuss the applicability and utility in the different age groups with specific reference to suitability in the diagnosis and management of wheezing disorders.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90475/1/ped-2E2010-2E0060.pd

An introduction to the soils of the Esperance advisory district

With descriptions, illustrations and notes on seven common soils.https://researchlibrary.agric.wa.gov.au/bulletins/1025/thumbnail.jp

Corrigin area land resources survey

This land resource survey of the Corrigin area covers some 1.8 million hectares of the central wheatbelt over the shires of Beverley, Brookton, Bruce Rock, Corrigin, Cuballing, Cunderdin, Dumbleyung, Kellerberrin, Kondinin, Kulin, Lake Grace, Merredin, Narembeen, Narrogin, Pingelly, Quairading, Tammin, Wandering and Wickepin. The survey is part of a regional scale soil-landscape mapping program designed to deliver seamless soil information for the agricultural area of south western Australia. The information provided will assist planners, researchers and land managers make decisions affecting sustainable land use and is designed for use at regional and catchment scales. This report and accompanying CD-ROM summarizes primary and interpreted information on the soil-landscapes of the Corrigin area. The report outlines the main degradation issues and supplies background information on climate, native vegetation and geology. An important additional outcome of the survey is a new theory on soil formation that has wide-ranging ramifications for agriculture, soil science, botany and geomorphology. Thirty-six soil-landscape systems, together with their component sub-systems and phases were recognised, mapped and described during the survey. This information, together with unmapped soil types and land qualities, is provided in the CD-ROM. The CD also showcases the main soils, provides geo-referenced soil pit and auger descriptions, maps of soil-landscapes and maps of selected degradation hazards