ABSTRACT
Health issues unique to women and differences in healthcare experiences have recently gained attention as health plans and systems seek to extend and improve health promotion and disease prevention in the population. Successful efforts focused on enhancing quality of care will require information from the patient's perspective on how to improve such services to best support women's attempts to lead healthy and productive lives. The National Centers of Excellence in Women's Health program (CoE), sponsored by the Office on Women's Health within the Department of Health and Human Services, is based on an integrated model uniting research, training, healthcare, and community education and outreach. To examine women's concept and definitions of healthcare quality, 18 focus groups comprising 137 women were conducted nationwide on experiences and attributes of healthcare that women value in primary care. Following the focus groups, a woman-focused healthcare satisfaction instrument was developed for the purpose of assessing and improving healthcare delivery. We describe the qualitative results of the focus group study.
Subject(s)
Patient Satisfaction , Primary Health Care/standards , Women's Health Services/standards , Adolescent , Adult , Delivery of Health Care/standards , Female , Focus Groups , Humans , Middle Aged , United States , United States Dept. of Health and Human ServicesABSTRACT
The National Centers of Excellence in Women's Health Program (CoE) represents a new model for women's health in academic health centers that unites women's health research, teaching, clinical care, public education and outreach, and career advancement for women in the health sciences. Lessons learned from the first 3 years of implementation indicate that this type of model requires a transformation from the traditionally fragmented set of activities in academic health centers to an integrated system united around the goal of advancing women's health. The transformation requires institutional commitment, dedicated players, and an ability to build on existing resources and bring added value to the institution. Challenges and strategies to link women's health activities and increase collaboration are also discussed.
Subject(s)
Academic Medical Centers/organization & administration , Delivery of Health Care, Integrated/organization & administration , Interinstitutional Relations , Models, Organizational , Program Development/methods , Women's Health Services/organization & administration , Career Mobility , Community-Institutional Relations , Continuity of Patient Care , Cooperative Behavior , Female , Health Education/organization & administration , Humans , Needs Assessment , Organizational Innovation , Organizational Objectives , United States , United States Dept. of Health and Human ServicesABSTRACT
1. 30 European starlings, kept for 20 months under a constant 12-hour photoperiod and at constant temperature, were investigated at regular monthly intervals with regard to the state of gonadal development, bill coloration and moult. 8 male male lived in individual cages (group 1), 10 male male were housed together in a group cage (group 2), and 6 male male lived together with 6 female female in another group cage (group 3). All birds had acoustical contact with each other. In addition, the birds of groups 2 and 3 could see one another. 2. In all male male the testes regressed following the beginning of the experiment in April. Subsequently they carried out a complete postnuptial moult. In the following spring, all male male went through a full cycle of testicular size which was followed by a second postnuptial moult. The bills of all birds turned yellow as the testes grew and blackened as the testes regressed (fig. 1).--Most of the female female showed similar circannual rhythms of gonadal growth and regression, bill coloration and moult (fig. 2). 3. In 6 male male of groups 1 and 2, a small increase of testicular size was observed subsequent to the termination of the first postnuptial moult. This transient testicular activity most probably corresponds to the autumnal sexual activity known from freeliving starlings. Hence, these results suggest that both spring and autumnal sexual activity of the starling are endogenously preprogrammed. 4. The testes of most male male of group 3 developed to full size immediately after the termination of the first postnuptial moult; subsequently they remained active for at least 7 months. This observation suggests that stimuli emitted by the female female augment the endogenously preprogrammed readiness for autumnal sexual activity and prevent the subsequent testicular regression. It is concluded that exogenous factors from the social environment are capable of modifying the endogenous annual pattern of testicular function in the starling.
