The Women's Health Initiative studies were begun in 1997, in large part the result of women's health activists who for 40 years questioned the safety of hormone use at menopause and criticized the menopause as disease ideology. The studies were prematurely discontinued when investigators found that heretofore acclaimed benefits of hormone use were not supported. Risks to health such as stroke, breast cancer, and thrombophlebitis were found. A feeling of vindication was experienced by feminists but was quickly replaced by cautious optimism as strategies to continue hormone use were published and quality of life issues tied to symptom management emerged. The focus of this article is a review of the hormone story, a discussion of the implications of the Women's Health Initiative results, and strategies for resolution of the continuing hormone dilemma.
Keywords Menopause . Women's health initiative . Hormone replacementIn 1993, the National Institutes of Health (NIH), under great pressure from professional, feminist, and women's groups, funded the largest ever scientific study on women's health. The Women's Health Initiative (WHI) (2004) was a randomized clinical trial to evaluate the effects of commonly prescribed hormone therapy on the incidence of heart dis-A. M. Voda ( ) Professor Emerita,
The authors describe the Healing Web, a partnership between nursing service and education that encourages the best use of nurses education clinical experience and personal competencies. Based on differentiated practice and education of nursing students in multi-level roles the Healing Web partnership is demonstrating at multiple institutions, that education and nursing service can work collaboratively to position the profession of nursing for maximum effectiveness in the 21st century.
On-line documentation by nurses and a comprehensive text management system are functional in several facilities of intermountain Health Care (IHC). The following articles detail factors in the design and implementation of this computerized network as experienced at LDS Hospital, part of the IHC system. Areas discussed are the system's applications for medical decision support, communication, patient classification, nurse staffing versus cost, emergency department usage, patient problem/event recording, clinical outcomes, and text publication. Users express satisfaction with the time saving, consistency of reporting, and cohesiveness of these applications.
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