Enrollment Options Research Articles

Health Education Careers in a Post-Health Reform Era.

Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law's provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

Racial/Ethnic Patterns of Kindergarten School Enrollment in the United States.

Enrollment into unequal schools at the start of formal education is an important mechanism for the reproduction of racial/ethnic educational inequalities. We examine whether there are racial/ethnic differences in school enrollment options at kindergarten, the start of schooling. We use nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) to model whether parents seek information about their child's school before enrolling, whether parents move to a location so that a child can attend a certain school, or whether parents enroll their child in a school other than the assigned public school. Results indicate that enrollment patterns differ greatly across race/ethnicity. Whereas Black families are the most likely to seek information on a school's performance, White families are the most likely to use the elite option of choosing their residential location to access a particular school. These differences persist when controlling for socioeconomic status and sociogeographic location. Kindergarten enrollment patterns preserve the advantages of White families, perpetuating racial/ethnic disparities through multiple institutions and contributing to intergenerational processes of social stratification. Research should continue to examine specific educational consequences of housing inequities and residential segregation.

Recruitment and retention in an SMS-based health education program: Lessons learned from Text2BHealthy

While text messages or short messaging service programs are increasingly utilized for delivering health education, few studies have explored the unique challenges of recruiting and retaining participants in such programs. This study utilizes survey and focus group data from Text2BHealthy, a short messaging service-based nutrition and physical activity promotion program, to examine barriers to enrollment and facilitators of retention among parents of elementary school students. Results show that participants were hard to reach with recruitment materials, had difficulty with self-enrollment, and were apprehensive about program costs. However, 89-90 percent of participants were retained. Results suggest that providing manual enrollment options, alternative program delivery methods (e.g. email messages), and opportunities to reenroll may facilitate participation in short messaging service-based health education and promotion programs.

TU‐A‐206‐00: Professional Liability Insurance ‐ What You Need to Know

Professional liability insurance is an important tool to manage risks to a medical physicist's assets that can result from errors or omissions in the course of professional practice. AAPM has partnered with Mercer Consumer to offer coverage tailored to the professional activities and specific risks encountered in medical physics practice. This program has specific eligibility criteria, benefit options, exclusions, and enrollment options for both self‐employed medical physicists and those who practice in an employment setting.There are important nuances to the form of coverage chosen and the determination of the coverage period for individual policies. The need for and role of professional liability insurance varies for each individual physicist, and one of the most important factors is the physicist's employment or self‐employment status and involvement in consulting activities.This session will provide an overview of the AAPM‐sponsored program (administered by Mercer) and the various options available to consulting and employed physicists. The fundamental concepts of professional liability insurance in general will be reviewed, and the roles of occurrence and claims‐made coverage forms within the AAPM program will be explained. Information drawn from claims data from the AAPM program will be used to illustrate the role of professional liability insurance benefits in realistic cases involving losses and liabilities due to errors and omissions in medical physics practice. Learning Objectives: Explain how professional liability insurance protects a medical physicist in the event of a lawsuit. Understand the basic concepts of the professional liability insurance coverage forms: occurrence and claims‐made. Explain AAPM's professional liability insurance program for the consulting and non‐consulting medical physicist. Understand the recent claim/expense data from AAPM's professional liability insurance program.Graham Fuller is an employee of Mercer Consumer.

TU‐A‐206‐02: Is Professional Liability Insurance Really Necessary

Professional liability insurance is an important tool to manage risks to a medical physicist's assets that can result from errors or omissions in the course of professional practice. AAPM has partnered with Mercer Consumer to offer coverage tailored to the professional activities and specific risks encountered in medical physics practice. This program has specific eligibility criteria, benefit options, exclusions, and enrollment options for both self‐employed medical physicists and those who practice in an employment setting.There are important nuances to the form of coverage chosen and the determination of the coverage period for individual policies. The need for and role of professional liability insurance varies for each individual physicist, and one of the most important factors is the physicist's employment or self‐employment status and involvement in consulting activities.This session will provide an overview of the AAPM‐sponsored program (administered by Mercer) and the various options available to consulting and employed physicists. The fundamental concepts of professional liability insurance in general will be reviewed, and the roles of occurrence and claims‐made coverage forms within the AAPM program will be explained. Information drawn from claims data from the AAPM program will be used to illustrate the role of professional liability insurance benefits in realistic cases involving losses and liabilities due to errors and omissions in medical physics practice. Learning Objectives: Explain how professional liability insurance protects a medical physicist in the event of a lawsuit. Understand the basic concepts of the professional liability insurance coverage forms: occurrence and claims‐made. Explain AAPM's professional liability insurance program for the consulting and non‐consulting medical physicist. Understand the recent claim/expense data from AAPM's professional liability insurance program.Graham Fuller is an employee of Mercer Consumer.

TU‐A‐206‐01: Professional Liability Insurance ‐ Protecting You and Your Practice

Professional liability insurance is an important tool to manage risks to a medical physicist's assets that can result from errors or omissions in the course of professional practice. AAPM has partnered with Mercer Consumer to offer coverage tailored to the professional activities and specific risks encountered in medical physics practice. This program has specific eligibility criteria, benefit options, exclusions, and enrollment options for both self‐employed medical physicists and those who practice in an employment setting.There are important nuances to the form of coverage chosen and the determination of the coverage period for individual policies. The need for and role of professional liability insurance varies for each individual physicist, and one of the most important factors is the physicist's employment or self‐employment status and involvement in consulting activities.This session will provide an overview of the AAPM‐sponsored program (administered by Mercer) and the various options available to consulting and employed physicists. The fundamental concepts of professional liability insurance in general will be reviewed, and the roles of occurrence and claims‐made coverage forms within the AAPM program will be explained. Information drawn from claims data from the AAPM program will be used to illustrate the role of professional liability insurance benefits in realistic cases involving losses and liabilities due to errors and omissions in medical physics practice. Learning Objectives: Explain how professional liability insurance protects a medical physicist in the event of a lawsuit. Understand the basic concepts of the professional liability insurance coverage forms: occurrence and claims‐made. Explain AAPM's professional liability insurance program for the consulting and non‐consulting medical physicist. Understand the recent claim/expense data from AAPM's professional liability insurance program.Graham Fuller is an employee of Mercer Consumer.

A spatial model of school district open enrollment choice

We provide an analysis of the determinants of adoption of inter-district open enrollment policies by school districts in Ohio. Legislation passed in 1997 allows Ohio's school districts to adopt one of the following open enrollment options: 1) prohibit enrollment of students from any other school district in the state (no open enrollment), 2) permit enrollment of students from adjacent school districts, or 3) permit enrollment of students from any school district in the state. We employ a recently developed spatial autoregressive lag multinomial logit model to examine the determinants of adoption of each open enrollment alternative. Among the most influential factors are school districts' demographic characteristics, financial factors, and competitive environment. More importantly, the results show evidence of strategic interaction, with a positive correlation in policy choice between neighboring school districts of about 0.4.

Stakeholder Perceptions of Barriers and Solutions to Significant Post-Secondary Enrollment Option Expansion for High School Students

Post-secondary experiences for students still in high school have been promoted as a means to increase academic rigor and create a better-trained workforce. Yet little is known regarding supports needed to significantly increase such options. This study obtained input from 411 stakeholders in one Midwestern state, including 201 district superintendents, 181 high school principals, and 23 college dual enrollment officers regarding their use of these options, their perceptions of barriers to program expansion, and their ranking of possible solutions to overcome the barriers. Findings demonstrate that all parties find postsecondary options of value, with traditional dual enrollment the most used option. Although all groups identified funding as a primary barrier, other systemic barriers were of great concern. Participants suggest that expansion of Advanced Placement and early and middle college programs, financial assistance for dually enrolled students, and increased program availability for career and technical options would be beneficial.

Presidents page

One focus area during my year as ASIS&T president is recruiting student members and fostering their continuing engagement in our Society. I have a long-standing interest in student involvement in ASIS&T. When I joined the faculty at Illinois in 1977, I worked with master's student Barbara Rapp (now chief, Office of Planning and Analysis, National Library of Medicine) to establish a student chapter, and in 1979 then-president James Cretsos appointed me special consultant to him on student membership. My goal then, as now, is to identify more ways in which student members can benefit from and contribute to ASIS&T. Almost 40 ASIS&T student chapters give students an opportunity to plan and participate in programs and activities. While master's students lead many of these chapters, undergraduate and doctoral students may also be involved. Students can also participate in chapter activities if they live in an area served by one of the regional chapters. Students can compete for one of several awards, including the Thomson Reuters Doctoral Dissertation Proposal Scholarship, ASIS&T/ProQuest Doctoral Dissertation, Pratt-Severn Best Student Research Paper and Student Chapter-of-the-Year. Students can contribute to program planning and communications activities of SIGs. Many students find opportunities to share their research and project results through posters, papers, panels and demos at ASIS&T Annual Meetings. The Bulletin of the American Society for Information Science and Technology includes a student member on its Advisory Board, and students can submit papers for potential publication in both the Bulletin and the Journal of the American Society for Information Science and Technology. The 2010 ASIS&T Annual Meeting pioneered two new ways for involving student members. Under the leadership of Barbara Wildemuth, professor and associate dean for academic affairs at University of North Carolina at Chapel Hill, a student design competition was held. Several cross-institution design teams formed at the beginning of the meeting, and team members worked together for the next few days to come up with a solution to the assigned design problem. Their efforts culminated in presentations of their work to a panel of judges at a special session of the conference, at which they demonstrated their creativity and enthusiasm. The other new initiative, the New Leaders Award which is described in more detail elsewhere in this issue of the Bulletin, features students who have already been involved as leaders in their student chapters and now have an opportunity to contribute their talents to SIGs, committees and regional chapters. One of the challenges facing student chapters is the dramatic increase in online education, so that potential members are no longer co-located. At Illinois, for example, more than half of our master's students earn their degrees through our online enrollment option. But just as technology enables such students to study at a distance, it can also facilitate participation in student chapter events. As one example, Illinois student chapter president and master's student Adam Rusch organized a meeting on December 2, 2010, exploiting web-conferencing technology to enable students in Champaign and remote locations to hear, see and interact with Cassidy Sugimoto, ASIS&T Chapter Assembly Director and faculty member at Indiana University's School of Library and Information Science, as she discussed her research on the MPACT project (www.ibiblio.org/mpact/). While Cassidy joined the group from a neighboring state, the same technology could be used to reach speakers and involve students from around the United States and beyond. Just as the student design competition demonstrated the benefits of cross-institution collaboration, multiple student chapters could collaborate in exploiting web-conferencing technology in delivering programs that would benefit students from more than one institution. This is just one example of networking and collaboration that could go beyond the face-to-face activities possible at ASIS&T Annual Meetings. I welcome more ideas for strategies to involve student members and foster their continuing engagement with ASIS&T as they graduate.

Overturning Barriers Will Take Heavy Lifting

Overturning Barriers Will Take Heavy Lifting

Analyses of Dual Credit in Rural Eastern Colorado

The purpose of this study was to analyze the available data on dual credit programs at 29 high schools served through five college centers of one community college over a time span of nine years. This is the first study completed in Colorado examining the PSEO (Post Secondary Enrollment Options) Act that allows dual credit programs funded by the state. It investigates the variables associated with student access and selection. The results of the study suggest that the purpose of the legislation is being met. Nearly all of the selected high schools provide some dual credit courses to eligible high school students. The data also indicated that there is a strong relationship between distance education among schools linked by networks and the rate of participation.

College Knowledge: What It Really Takes for Students to Succeed and What We Can Do to Get Them Ready (review)

Reviewed by: College Knowledge: What It Really Takes for Students to Succeed and What We Can Do to Get Them Ready Donovan R. Walling (bio) David T. Conley. College Knowledge: What It Really Takes for Students to Succeed and What We Can Do to Get Them Ready. San Francisco: Jossey-Bass, 2005. 256 pp. Cloth: $24.95. ISBN: 0-7879-7397-7. College Knowledge is based on a three-year project, Knowledge and Skills for University Success (KSUS), 1998–2001, designed and directed by the author. This project, sponsored by the Association of American Universities, had the goal of identifying what students who enter college need to know and be able to do to succeed in entry-level courses. David T. Conley, a professor of Educational Policy and Leadership and founding director of the Center for Educational Policy Research at the University of Oregon, brings solid research credentials to this work, along with practice in higher education and 12 years of public school teaching and administration. Conley contends that high schools are increasingly successful at preparing students to gain admission to college but less successful at ensuring that their college-bound graduates can successfully do college coursework. He divides the book into three parts. Part 1, the first six chapters, focuses on high school aspects of college preparation. The three chapters in Part 2 then focus on the college experience, particularly the first year. Part 3, roughly the second half of the book, pinpoints knowledge and skills standards for college success in six areas: English, mathematics, natural sciences, social sciences, second languages, and the arts. Part 3 concludes with a useful chapter of university work samples. The book's appendix is a helpful checklist for college readiness. The premise from which the author proceeds is straightforward: "High schools are designed to get students to graduate and, in the case of college-bound students, to make them eligible for admission to college—generally the public university in that state. They are not necessarily designed to enable students to succeed in college" (p. 3). If the reader accepts this premise at face value, then the book unfolds predictably. The premise is not unfounded, but the ground here is not as solid as the author would have us believe. Indeed, one suspects that many high school educators, the target audience for this book, will reject this assertion on the grounds that the role of high schools is neither merely to produce diploma-holders nor to fit up their college-bound students for entry into higher education. High schools do fulfill these roles; but they are and do much more, an argument that Conley acknowledges but implicitly [End Page 541] dismisses. He avers that this book "adopts an inclusive perspective by encompassing all forms of postsecondary education" (p. 9). It is clear from later statements that this "inclusive perspective" is predicated on high schools preparing most, if not all, of their students for college. Early on, in Chapter 4, Conley takes the measure of current strategies to increase college readiness, such as Advanced Placement, the International Baccalaureate, and dual high school/college enrollment options, and concludes that all such strategies fall short of ensuring college success. The author proposes an "alignment and challenge audit" (p. 62), a strategy developed by his Center for Educational Policy Research that is designed to help high schools match what they teach to KSUS standards. Conley later states, concluding Part 2, "The goal of this book is to offer those interested in improving the relationship between high school and college a starting point for concrete action . . . a path down which those who are interested in improving college success for all students may begin their journey" (p. 168). The message is that it will be up to the high schools to change, not the colleges. The "disconnect between high school and college programs of study" (p. 153), which the author emphasizes throughout the book, is undeniable. However, readers likely will question whether this book's top-down approach to high school reform will encourage meaningful change, given the resistance such an approach will surely meet. Notwithstanding this resistance, readers would do well not dismiss this book out of hand. Thoughtful...

Medicare/Medicaid

Medicare and Medicaid are the U.S. government's two main publicly funded health insurance programs. The two programs-and the differences between them-are often confused. Understanding Medicare and Medicaid eligibility requirements, enrollment options, and benefits can be a challenge. Knowledge of the information and resources available through government Web sites can assist consumers, physicians, and health care providers to become better informed so they can take charge of their health care options. This article gives an overview of Medicare and Medicaidtheir histories and differences, the scope of the individual programs, and the relationship between Medicare and Medicaid. The article discusses the Centers for Medicare and Medicaid Services Web site, http://www.Medicare.gov, and the U.S. Department of Social Security Administration Web sites and explains how to navigate them to access important information.

PREDICTING GRADUATION RATES FOR THREE GROUPS OF NEW ADVANCED-STANDING COHORTS

The present study examined the impact of demographic variables, high school and pre-transfer college academic characteristics, transfer student cohort, and post-transfer college academic characteristics on the variable of bachelor's degree completion at a large, public, urban university in the Midwest. Subjects were 1,327 transfer students from 2- and 4-year post-secondary institutions and former Post-secondary Enrollment Options participants who matriculated at the study institution during 1994-95. Subjects' enrollment and graduation status were assessed after spring quarter 1998. Logistic regression analyses were used to identify significant predictor variables. Transfer cohort was a significant predictor of graduation status. Results revealed that membership in the 4-year transfer cohort had a more positive impact on graduation than membership in the other two cohorts, even when entry credits were controlled. Other variables significant in the prediction of graduation status included ethnicity, last year/term, first term credits completed, last term GPA, last term credits completed, term count, and last college. Transfer cohort was a significant predictor of degree efficiency. Other significant predictors included last year/term, entry credits total, last term credits completed, last college, entry GPA, and cohort.

Lessons about School Choice from Minnesota: Promise and Challenges

What impact have Minnesota's public school choice options had on the state's education system overall? Mr. Nathan and Mr. Boyd report on some unanticipated positive results, some negative predictions that did not come to pass, and a few unfortunate instances that underscore the need for careful monitoring of the programs and the schools participating in them. THE SUPREME Court's voucher decision in July 2002 adds to the importance of understanding the promise and challenges of school choice within the public school system.1 An analysis of Minnesota's experience with school choice programs between 1985 and 2002, conducted by researchers at Penn State University and the Hubert H. Humphrey Institute, shows that school choice programs can be valuable and can help to stimulate improvement in the broader system. But the research we conducted also makes clear that any school choice plan needs to be carefully monitored and that participating schools should be reviewed regularly.2 Data for this project were gathered in several ways. More than 2,000 students were surveyed, including students who took advantage of the state's Post-Secondary Enrollment Options law and students at six representative alternative schools in rural, urban, and suburban areas. More than 50 individuals, including representatives of key state education, community, and business organizations, were also interviewed. An extensive research and literature review was carried out, and, in cooperation with Minnesota's Department of Children, Families, and Learning (the state education department), information was gathered and analyzed from previously unpublished state records. A Brief Overview of Minnesota's School Choice Laws Minnesota began passing public school choice legislation in 1985 and has enacted four major programs. * Postsecondary options (1985). This program allows high school juniors and seniors to attend a college or university full or part time, with state funds following the students to pay tuition and lab and book fees. Any student admitted by a college or university is eligible, and the decision to apply is left to the student. * Second-chance options (1987). This program allows 12- to 21-year-old students who have not succeeded in traditional schools, according to a variety of measures, to attend smaller alternative schools created by a district, a group of districts, or a private organization that can convince a district to give it a contract. * Open (1988). This program allows K-12 students to move across district lines as long as the receiving district has room and the movement does not harm desegregation efforts. * Charter schools (1991). This program allows educators to create new schools or convert existing public or private nonsectarian schools into public charter schools with no admissions tests. The schools are responsible for improving achievement, or they are closed. These schools must be authorized or sponsored by one of several groups, including local districts, postsecondary institutions, or nonprofit organizations with at least $1 million in assets. Who Participates in School Choice? A great deal of discussion has taken place about enrollment and charter schools. But our research demonstrated that the largest school choice programs in Minnesota -- by far -- were those authorized by the 1987 law allowing students who had not succeeded in traditional school settings to attend a different, often much smaller, alternative school. This program is also the fastest growing. According to state figures, the number of students participating in second-chance programs grew from 4,050 in 1988-89 to more than 100,000 in 2000-01. Meanwhile, participation in the open program grew from 140 in 1988 to just over 28,000 in 2000-01. From 1988 to 2000, overall K-12 grew 17%, but the number of students participating in one of the four statewide choice programs grew more than 1,300%. …

A Comparison of Learning Outcomes for Dual-Enrollment Mathematics Students Taught by High School Teachers Versus College Faculty

Dual enrollment, an accelerated mechanism allows high school students to enroll in college courses while concurrently enrolled in high school (Title XVI, Florida Statutes, 1999), is available in 47 states, 21 of which have comprehensive programs where the state subsidizes the tuition for the courses and students receive credit toward both college and high school graduation (Education Commission of the States, 2001). Considerably flexible by design, dual enrollment courses can be taught on high school or college campuses, by high school teachers or college faculty members, and may take place before, during, or after normal high school hours. Depending on local agreements, program logistics or statutes, such programs may also be called dual credit or enrollment; however, the basic premise of providing postsecondary enrollment options to high school students remains the same. Unlike those students enrolled in Advanced Placement (AP) courses, dual enrollment students do not need to take test administered by an external source to qualify for the college credit. In AP courses a tremendous premium is placed on one day's performance (Harkins, 1998, p. 60). awarding of credit through dual enrollment is based upon the entire course, giving teachers many opportunities to evaluate learning (p. 62). Studies show dual enrollment partnerships are beneficial to students, parents, high schools, and postsecondary alike (Greenburg, 1989). Motivated students earn college credit in high school, parents realize substantial financial savings, high schools are able to offer courses might otherwise not be available to students, and colleges gain access to some of the high schools' brightest students. While the concept is simple, it is not without problems. premise of dual enrollment programs has been motivated high school students could build transcript of college coursework that would move students through the baccalaureate process quicker (Windham, 1997, p. 9). However, from the start there has been increasing concern about the willingness of colleges to accept the credit earned . (Wilbur & LaFay Jr., 1978, p. 23). students have to repeat the courses they took as dual enrollment students once they enroll at university, then the acceleration aspect of dual enrollment is lost (Windham, 1997, p. 10). If credits cannot be easily transferred, the intent of the program cannot be realized. Generally, acceptance of credits earned through dual enrollment can only be guaranteed at the institution (or in the case of Florida, the state system) offers the program. In fact, primary limitation of dual enrollment continues to be transferability of credit. Greenburg (1989) found There is no guarantee credits be accepted at other institutions (p. 25). The college credits earned by students ... are transferable only to the extent other colleges are willing to accept them (p. 29) and the transferability of the college credits earned by the high school students depends on the articulation the community college has been able to arrange with four-year institutions (p. 36). Policymakers across the country are raising concerns, as some students are finding concurrent enrollment credits earned while they were in high school not (Boswell, 2001, p. 13). As with any transfer credits, each institution evaluates and accepts credits in accordance with the institution's own policies. When it comes to dual enrollment credits, proponents see it as win-win program (Mees, 1999) will significantly cut down the time and expense to an associate or baccalaureate degree (Andrews, 2000, p. 16). sentiment of many university officials, however, was summed up by Gary Ripple, Lafayette College's director of admissions. We believe college-level course should be offered on college campus, taught by college professor, with college students in the room. …

Enrollment and Communication Support: Putting Your Insurance Provider to Work

By capitalizing on the communication and enrollment resources offered by insurance carriers and their sales and enrollment partners, employers can meet high expectations regarding benefit packages without incurring additional expenses and without assuming the burden of administering a marketing program. By choosing a carrier with a flexible menu of enrollment options, an employer can address the concerns of today’s workers by providing benefit options that are portable and customizable, with provisions for financial security. This article discusses the wide range of services offered by insurance companies and their partners to help develop and implement successful enrollment—at little to no additional cost to employers.

State Policy and Postsecondary Enrollment Options: Creating Seamless Systems

AbstractHundreds of thousands of secondary students across the nation—as many as 10 percent of high school students in some states—are participating in various forms of postsecondary enrollment options. State policymakers are considering a range of new policy options to accelerate student educational progress in light of projected demands for access to public colleges and universities by the "baby boom echo."

Dual Enrollment Options: Columbus State Community College Model for Successful Implementation

AbstractOhio Senate Bill 140 was enacted in 1989 to allow dual enrollment. The legislative intent and components are reviewed in this chapter, followed by an overview of criteria and procedures at Columbus State Community College. Methods that foster student success and growth are also discussed.

Pioglitazone hydrochloride in combination with metformin in the treatment of type 2 diabetes mellitus: A randomized, placebo-controlled study

Background: Their complimentary mechanisms of action suggest that a combination of pioglitazone hydrochloride and metformin may have clinically beneficial effects in the treatment of patients with type 2 diabetes. Objective: This study was undertaken to assess the efficacy and tolerability of pioglitazone in combination with metformin in patients with type 2 diabetes mellitus. Methods: This was a 16-week, double-blind study with the option of enrollment in a separate open-ended, open-label study. It included patients with poorly controlled diabetes mellitus (glycated hemoglobin [HbA 1c] ≥8.0%, fasting C-peptide >1.0 ng/mL) who had been receiving a stable regimen of metformin for ≥30 days. Patients with diabetic retinopathy, nephropathy, or neuropathy; impaired liver or kidney function; or unstable cardiovascular or cerebrovascular conditions were excluded. Patients were randomized to receive once-daily pioglitazone 30 mg + metformin or placebo + metformin. Patients in the open-label extension received pioglitazone 30 mg (with optional titration to 45 mg) + metformin. Results: Three hundred twenty-eight patients were randomized to treatment (168 pioglitazone + metformin, 160 placebo + metformin), and 249 completed the study. Of these, 154 elected to enter the open-label extension study. Patients' mean age was 56 years; most (84%) were white and slightly more than half (57%) were male. Patients receiving pioglitazone 30 mg + metformin had statistically significant mean decreases in HbA 1c (−0.83%) and fasting plasma glucose (FPG) levels (−37.7 mg/dL) compared with placebo + metformin ( P ≤ 0.05). Decreases in FPG levels occurred as early as the fourth week of therapy, the first time point at which FPG was measured. The pioglitazone + metformin group had significant mean percentage changes in levels of triglycerides (−18.2%) and high-density lipoprotein cholesterol (+8.7%) compared with placebo + metformin ( P ≤ 0.05). Mean percentage increases were noted in low-density lipoprotein cholesterol levels (7.7%, pioglitazone + metformin; 11.9%, placebo + metformin) and total cholesterol (4.1%, pioglitazone + metformin; 1.1%, placebo + metformin), with no significant differences between groups. In the extension study, patients treated with open-label pioglitazone + metformin for 72 weeks had mean changes from baseline of −1.36% in HbA 1c and −63.0 mg/dL in FPG. The incidence of adverse events was similar in both groups. Throughout the study, no patient in either treatment group had an alanine aminotransferase (ALT) value ≥3 times the upper limit of normal, a commonly used marker of potential liver damage. Thus, no evidence of drug-induced hepatotoxicity or drug-induced elevations in serum ALT was observed. Conclusions: In this study in patients with type 2 diabetes mellitus, pioglitazone + metformin significantly improved HbA 1c and FPG levels, with positive effects on serum lipid levels and no evidence of drug-induced hepatotoxicity. These effects were maintained for >1.5 years, including the open-label extension.