Summer 2000 - Volume 4 Number 3

Original Research

Effect of "Time Famine" on Women's Self-Care and Household Health Care
Nancy Vuckovic, PhD

The author introduces her concept of "time famine" and ties together two elements of contemporary culture: time pressure and pill-taking. She finds evidence that one effect of time pressure is increased use of medicines.
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Psychiatric Disorders and Functional Disability in Patients with Fibromyalgia.
Arne Beck, PhD; George Breth, MD; Rob Hays, MD; Colleen Miller, RNP

This study describes the prevalence of current psychiatric disorders and functional disability among a sample of patients attending a fibromyalgia group clinic in the Rheumatology Department at Kaiser Permanente Colorado.
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Clinical Contributions

Management of Libido Problems in Menopause
Jeanne L. Leventhal, MD

This article reviews the causes and treatment of the common decrease in sexual activity and satisfaction experienced by many menopausal women. Causes include physiologic changes, depression, decreased sexual functioning of the partner, and individual cultural or psychological factors. Treatment, which includes counseling and medications, needs to be individualized according to the specific identified etiologic factors.
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Likelihood That a Woman Will Have No Major Risk Factors At the Time of First Myocardial Infarction or Stroke
Diana B. Petitti, MD; Stephen Sidney, MD; Charles P. Quesenberry, Jr, PhD; Arthur L. Klatsky, MD

A substantial minority of women who experience a first heart attack or stroke do not have known major risk factors, as here documented from Kaiser Permanente hospitalization databases. Age differences in presence of individual risk factors were also noted, with smoking more prevalent in younger women and hypertension more prevalent in older women. The data have implications both for clinical evaluation of women with symptoms and with respect to screening needs for all women.
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Kaiser Permanente Medicine 50 Years Ago: The Gynecological Cancer Detection Clinic
Wilson Footer, MD
Commentary by Steven A. Vasilev, MD, MBA

The reprinted 56-year-old article by an early Kaiser Permanente physician shows that Permanente Medicine in the 1940s was clearly on the cutting edge of early diagnosis of gynecologic cancers. The described clinic was one of the few in operation at the time. Dr Vasilev's accompanying current Commentary authoritatively reviews the history of this topic. He details major technological advances over the past half century as well as ongoing limitations. He points out the needs for more education and more universal application of this cornerstone of preventive medicine in women's health.
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Health Systems

Commentary: Women's Health--It's More Than Ob-Gyn
Jill M. Steinbruegge, MD

Dr Jill Steinbruegge presents a must-read personal viewpoint on women's health and concludes by presenting a challenge for the Permanente family in improving "the gender balance among our Permanente workforce and leadership."
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Commentary: Kaiser PermanenteRecognizing the Importance of Women
Rhoda Nussbaum, MD

This commentary by Dr Rhoda Nussbauma Permanente physician from Northern California and a respected national leader in women's healthprovides an excellent introduction to the Health Systems' articles on this subject.
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Studies of Women's Health Care: Selected Results.
Rhoda Nussbaum, MD

Dr Nussbaum reports on the studies that the Women's Health Task Force in Northern California has undertaken to better understand the desires and underlying values of the women members in their region.
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Proposed Care Management for Women with Estrogen Deficiency: Identification, Risk Stratification, and Treatment.
Phillip J. Tuso, MD, FACP

Dr Phillip Tuso from Southern California describes an information technology process for identifying women who have estrogen deficiency and assist in their management.
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Editors' Comments

A Tribute to Women
Tom Janisse, Editor-in-Chief
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Women's Health: Permanente Medicine
Lee Jacobs, MD, Associate Editor, Health Systems
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External Affairs

The Heart of a True Partnership: Dr Oliver Goldsmith Receives "Winning Spirit Award for Partnership."
Deidre S. Lind

With the support of The Southern California Permanente Medical Group (SCPMG) Medical Director, Oliver Goldsmith, MD, a Kaiser Permanente patient and physician teamed up to create a very successful program to improve the care of breast cancer patient. Dr Goldsmith was honored by WIN ABC, a national non-profit organization, with the Winning Spirit Award for Partnership.
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We Have Come a Long Way: Women's Health at the Turn of the Millennium
M. Jean Gilbert, PhD

M. Jean Gilbert, former Director of Cultural Competence for the Southern California Region, writes about women's health care leading up to the new millennium. She discusses the possibilities for the coming decades, and she reviews Kaiser Permanente's Women's Healthcare Program.
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Women's Health and Federal Policy.
Joanne L. Hustead, JD; Donald W. Parsons, MD

Don Parsons, MD, Permanente Federation's Associate Executive Director of Health Policy and Joanne L. Hustead JD, Director of Legal and Public Policy at the National Partnership for Women and Families, discuss women's heath on the federal level. They look at past, present, and future legislation.
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Abstracts

Abstracts of articles authored or coauthored by Permanente clinicians
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Letters to the Editor

Letters from our readers
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Book Reviews

Your Guy's Guide to Gynecology: a Resource for Men and Women
Bruce Bekkar, MD and Udo Wahn, MD
Review by Patricia C. Gallo, PA-C

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Lymphedema: A Breast Cancer Patient's Guide to Prevention and Healing
Jeannie Burt & Gwen White, PT; Foreword by Judith Casley-Smith, MD
Review by Diane C. Strum
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To Life! Select Recipes and Nutritional Guidance for a Healthy Heart Mended Hearts Chapter 188, compilers
Review by Jeanne Weissman, Viviana Lombrozo, Louise Felitti
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Medical Guides
Review by Eve F. Lynch
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Women's Cancers: How to Prevent Them, How to Treat Them, How to Beat Them
Kerry A. McGinn, RN, NP and Pamela J. Haylock, RN
Review by Eve F. Lynch
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Soul of the Healer

"Dream."
Mohamed Osman, MD
Art

In the Shadow of Obesity--Part 1
Eric Blau, MD, FACP
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Women in Medicine--A Living History
Kate Scannell, MD
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"Life on Mars."
Mohamed Osman, MD
Art

"Parental Respect."
Mohamed Osman, MD
Art