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Shannon Sullivan is Chair of Philosophy and Professor of Philosophy and Health Psychology at UNC Charlotte. She specializes in feminist philosophy, critical philosophy of race, American philosophy (especially pragmatism), . and continental philosophy. She is the author of four books, most recently, Good White People: The Problem with Middle-Class White Anti-Racism (2014) and The Physiology of Sexist and Racist Oppression (2015). She also is co-editor of four books, including Race and Epistemologies of Ignorance (2007) and Feminist Interpretations of William James (2015). [ABSTRACT FROM AUTHOR]

The article presents authors criticism of John Lachs views that humane vision of world would celebrate life, liberty and pursuit of happiness. He also discusses the Lachs views on the Stoic Pragmatism and why practical philosophy is important to Lachs and philosophy is used enhance down-to-earth practices and also the experiences of human beings.

Grounded in feminist phenomenology in partnership with everyday citizenship research, this paper examines the everyday, lived experience of citizenship. Arguing that becoming a citizen involves the development of habits of citizenship, I examine felt habits of national belonging especially in the lives of children. How do children learn habits of citizenship that enable and even require citizens to distinguish themselves from those with ambiguous or no citizenship? My answer will be that much of this learning takes place in everyday situations and activities, ones in which the formation of citizenship habits often can seem 'invisible' but that are just as important to citizenship as are official procedures and laws. After explaining the theoretical framework of feminist phenomenology, I analyse examples from the lives of children in the United States to illustrate how they learn three related habits of national belonging: (1) habits based on exclusionary citizenship, (2) habits supporting sub-citizenship, and (3) habits grounded in subordinate citizenship. I conclude that rather than abandon the concept of citizenship, feminists need to find ways to transform habits of national belonging into tools for social justice. [ABSTRACT FROM AUTHOR]

Bilateral oophorectomy performed in women before they are menopausal induces surgical primary ovarian insufficiency, an acute and chronic deficiency of the hormones normally produced by the ovaries. Without hormone replacement therapy (HRT) most of these women develop severe symptoms of estrogen (E) deficiency and are at increased risk for osteoporosis, cardiovascular disease, cognitive decline, dementia, and the associated increases in morbidity and mortality. In cases in which a hysterectomy has been performed at the time of bilateral oophorectomy transdermal or transvaginal E2 replacement therapy without cyclic progestin replacement is the optimum hormonal management for these women. There is substantial evidence this approach even reduces the risk for breast cancer. Unfortunately, unwarranted fear of all menopausal HRTs has become widespread following the reports of the Women's Health Initiative studies. This fear has led to a steep decline in use of E therapy, even in women in whom HRT is clearly indicated. Discussion of possible ovarian conservation in women who are premenopausal is an integral part of the preoperative planning for any women undergoing hysterectomy. Timely and effective HRT for women who will experience surgical primary ovarian insufficiency is clearly indicated. [ABSTRACT FROM AUTHOR]

Primary ovarian insufficiency (POI) is a rare but important cause of ovarian hormone deficiency and infertility in women. In addition to causing infertility, POI is associated with multiple health risks, including bothersome menopausal symptoms, decreased bone density and increased risk of fractures, early progression of cardiovascular disease, psychologic impact that may include depression, anxiety, and decreased perceived psychosocial support, potential early decline in cognition, and dry eye syndrome. Appropriate hormone replacement therapy (HRT) to replace premenopausal levels of ovarian sex steroids is paramount to increasing quality of life for women with POI and ameliorating associated health risks. In this review, we discuss POI and complications associated with this disorder, as well as safe and effective HRT options. To decrease morbidity associated with POI, we recommend using HRT formulations that most closely mimic normal ovarian hormone production and continuing HRT until the normal age of natural menopause, ∼50 years. We address special populations of women with POI, including women with Turner syndrome, women with increased risk of breast or ovarian cancer, women approaching the age of natural menopause, and breastfeeding women. [ABSTRACT FROM AUTHOR]

In this article, the author, who authored the book "Good White People: The Problem with Middle-Class White Anti-Racism," discusses the book reexamines middle-class white anti-racism and also supports racial justice movement.

Objective: To estimate readmission rates of patients discharged home the same day after a minimally invasive myomectomy.Methods: This is a retrospective case series of patients who underwent minimally invasive myomectomy and were discharged the same day, which examines the feasibility and safety by rates of readmission within Kaiser Permanente Northern California. Chart review was performed for outcomes of interest including readmission rates, emergency department, and urgent clinic visits within 48 hours, 7 days, and up to 3 months along with surgical and demographic characteristics.Results: Of the 403 minimally invasive myomectomies performed during the study period, 88% (N=356) of patients were discharged home the same day. No readmissions required reoperation or were life-threatening. Two patients (0.6%) were readmitted within 48 hours for postoperative fever. A cumulative total of five patients (1.4%) were readmitted within 3 months. Urgent care and emergency department visits occurred in zero and seven patients (2.0%) within 48 hours of discharge, most commonly for pain and urinary retention. Median leiomyoma weight was 204 g, median body mass index was 26, median blood loss was 75 mL, and median surgical time was 157 minutes.Conclusion: Same-day discharge after minimally invasive myomectomy was found to have a low readmission rate and low health care utilization in the immediate postoperative period. Same-day discharge appears to be a safe option for healthy patients after undergoing an uncomplicated minimally invasive myomectomy. [ABSTRACT FROM AUTHOR]

Over the last decade, the biomarkers procalcitonin and C-reactive protein have gained interest in sepsis research. Procalcitonin is a unique biomarker that is specific to bacterial infection and has demonstrated utility in the risk stratification of patients with potential life-threatening bacterial infections. In addition, procalcitonin has been documented as having a role in reducing the rate of unnecessary antibiotics while positively impacting antibiotic resistance rates and cost savings. The purposes of this review article are to discuss the clinical relevance of C-reactive protein and procalcitonin as diagnostic and prognostic markers for sepsis with a focus on the use of serial procalcitonin levels as a component of antibiotic stewardship programs. The federal government has recently become invested in combating the progression of antibiotic resistance; a 5-year national plan has been developed to address these concerns. Establishing a reliable antibiotic stewardship program is one of the goals of this national plan. [ABSTRACT FROM AUTHOR]

Objectives: To systematically review health economic guidelines for information on how to present health economic evaluations and consider implications for nontechnical audiences such as policymakers.Methods: Electronic databases and supplementary sources were searched for economic evaluation guidelines. Guidelines were critically appraised. Descriptive characteristics, standard formats, supports for nontechnical audiences, presentation approaches, and common reporting recommendations were extracted. Frequencies were tabulated and trends identified.Results: Thirty-one guidelines were included. Twenty-two guidelines include a standard reporting format with some sample tables and graphs. Common presentation approaches include well-cited tables of data sources, transparent model diagrams and descriptions, disaggregated results, and tabular and graphical displays of sensitivity analyses. Despite most guidelines being funded by policymakers, only five guidelines provided advice on presenting economic evaluations to noneconomists. However, 11 guidelines included a glossary of economic terminology for nontechnical readers. Common concepts that may require further explanation include differences in economic perspectives, appropriateness of time horizons, how economic outcomes such as quality-adjusted life-years relate to their component clinical outcomes, and choice of sensitivity analyses.Conclusions: Health economists have consistent presentation formats and common reporting elements that should be considered when developing user-friendly explanations for general audiences. These overlap with policymakers' informational needs but may not be sufficient for understanding by nontechnical audiences. Developing presentation formats and tools that incorporate viewpoints of both economists and noneconomists will allow for better application of the results of economic evaluations and enhance the transparency and legitimacy of decision-making processes that are informed by economic evaluations. [ABSTRACT FROM AUTHOR]

Molinate, a thiocarbamate herbicide, is used to control broad-leaf and grassy weeds. Studies have shown that molinate alters a range of animal behaviors to produce the following symptoms following exposure: lethargy, erratic swimming, and tremors. Fish, in particular, showed variability in sensitivity to molinate. Possible mechanism of action in such observed behavior is alteration in the cholinergic nervous system responsible for messenger transmission in the central nervous system and peripheral nervous system. The current study examined the possible disruption of spawning behavior in zebrafish (Danio rerio) following molinate exposure. Findings indicate that while various forms of spawning behavior were not altered significantly in fish exposed to molinate, a significant difference was observed in the total number of eggs produced; control fish produced approximately twice as many eggs compared to molinate-treated fish. Furthermore, significantly higher levels of acetylcholinesterase activity were observed in male fish, indicating a compensatory mechanism following toxic insult. In conclusion, while molinate does not appear to impact male courtship behavior in zebrafish, the pesticide does appear to alter acetylcholinesterase activity in males, suggesting disruption of the nervous system in males. [ABSTRACT FROM AUTHOR]

Beginning with the experience of a white woman's stomach seizing up in fear of a black man, this essay examines some of the ethical and epistemological issues connected to white ignorance. In conversation with Charles Mills on the epistemology of ignorance, I argue that white ignorance primarily operates physiologically, not cognitively. Drawing critically from psychology, neurocardiology, and other medical sciences, I examine some of the biological effects of racism on white people's stomachs and hearts. I argue for a nonideal medical theory focused on improving wellness in a society that systematically has damaged the health of people of color. The essay concludes that to be fully successful, critical philosophy of race must examine not just the financial, legal, political, and other forms of racism, but also its biological and physiological operations. [ABSTRACT FROM AUTHOR]

Introduction: Network meta-analyses (NMAs) are complex methodological approaches that may be challenging for non-technical end-users, such as policymakers and clinicians, to understand. Consideration should be given to identifying optimal approaches to presenting NMAs that help clarify analyses. It is unclear what guidance researchers currently have on how to present and tailor NMAs to different end-users. Methods: A systematic review of NMA guidelines was conducted to identify guidance on how to present NMAs. Electronic databases and supplementary sources were searched for NMA guidelines. Presentation format details related to sample formats, target audiences, data sources, analysis methods and results were extracted and frequencies tabulated. Guideline quality was assessed following criteria developed for clinical practice guidelines. Results: Seven guidelines were included. Current guidelines focus on how to conduct NMAs but provide limited guidance to researchers on how to best present analyses to different end-users. None of the guidelines provided reporting templates. Few guidelines provided advice on tailoring presentations to different end-users, such as policymakers. Available guidance on presentation formats focused on evidence networks, characteristics of individual trials, comparisons between direct and indirect estimates and assumptions of heterogeneity and/or inconsistency. Some guidelines also provided examples of figures and tables that could be used to present information. Conclusions: Limited guidance exists for researchers on how best to present NMAs in an accessible format, especially for non-technical end-users such as policymakers and clinicians. NMA guidelines may require further integration with end-users' needs, when NMAs are used to support healthcare policy and practice decisions. Developing presentation formats that enhance understanding and accessibility of NMAs could also enhance the transparency and legitimacy of decisions informed by NMAs. [ABSTRACT FROM AUTHOR]

The article discusses Baruch Spinoza's and Friedrich Nietzsche's accounts of affect and ontology and how they can be significantly helpful to philosophical attempts to transform whiteness into an anti-racist identity. The author examines Spinoza's affinities with Nietzsche to explain the different ways that sad and joyful passions constitute and circulate through human beings in their interrelationships.

Primary ovarian insufficiency (POI), also known as premature ovarian failure, is a form of hypergonadotropic hypogonadism that causes infertility in ~1% of women <40 years of age. POI has important health consequences for affected patients; however, the mechanisms that cause ovarian dysfunction are poorly understood. Elucidating these mechanisms is paramount to developing better testing and treatment strategies for affected girls and women. For obvious reasons, studies looking directly at the human ovary are extremely limited. Recently, numerous genetically engineered mouse models have been developed to investigate the molecular mechanisms that may be involved in the pathogenesis of POI. Two potential mechanisms may be involved in the development of POI: (1) abnormalities in primordial follicle activation and (2) increased rates of apoptosis of oocytes. Each of these mechanisms may lead to early depletion of ovarian follicular reserve, and thus be a contributing factor in POI. This review addresses current knowledge of molecular mechanisms controlling primordial follicle activation and oocyte apoptosis, as evidenced from various genetic mouse models. Translation of these data into clinically effective treatments or even prevention strategies may improve fertility and quality of life for women with this form of reproductive dysfunction. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy (HDP), including pre-existing hypertension, gestational hypertension, and preeclampsia, further complicate already high-risk pregnancies in women with diabetes mellitus (DM). Women with both pre-existing and gestational diabetes are at increased risk for HDP, leading to higher maternal and fetal morbidity. Further, particularly in diabetic women and women with a history of gestational diabetes, HDP significantly increases the risk for future cardiovascular events. For clinicians, women with hypertension and diabetes during pregnancy pose a management challenge. Specifically, preconception management should stress strict control of glycemia, blood pressure, and prevention of diabetic complications, specifically nephropathy, which specifically increases the risk for preeclampsia. During gestation, clinicians must be aware of potential maternal and fetal complications associated with various anti-hypertensive therapies, including known fetotoxicity of ACE inhibitors and ARBs when given in the 2nd or 3rd trimester, and the risks and benefits of expectant management versus delivery in cases of severe gestational hypertension or preeclampsia. Indeed, diabetic women must be followed closely prior to conception and throughout gestation to minimize the risk of HDP and its associated complications. J Clin Hypertens (Greenwich). 2011;13:275-284. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The article presents a laboratory-based tests using the multiple sleep latency test (MSLT) and the maintenance of wakefulness test (MWT). The MSLT measures physiologic sleepiness while MWT aims to measure manifest sleepiness. The testing methods, clinical applications, and limitations of both studies are offered. MSLT is a reliable tool used in subjects with excessive daytime sleepiness (EDS) while MWT has been used to evaluate individuals who must remain awake for job safety.

The article presents an analysis of Josiah Royce's essay titled "Provincialism" which focuses on transforming whiteness into a non-oppressive and anti-racist. According to the author, Royce distinguishes both provincialism and its development as a conscious phenomena which includes consciousness of unity and place identity among provinces. She suggests that for members of a province to develop wise provincialism, they should have relations with other communities and make use of what they acquire for life and community development. She also advocates the determination to give the surroundings of a community with dignity, beauty and nobility. She further stresses that the white people are totally responsible for their whiteness because they do not have the sole control over their whiteness.

The article presents the response of William James, the author of the book "Revealing Whiteness: The Unconscious Habits of Racial Privilege, on the several comments from the authors including Charles Mills, Paul Taylor, and Cynthia Willett. James mentions the prime objective of his book which is to bring American philosophy into conversation with psychoanalytic theory on the issues of racism as well as white privilege. James provides various explanations and elaboration on the critics.

Natural variation in neuroendocrine traits is poorly understood, despite the importance of variation in brain function and evolution. Most rodents in the temperate zones inhibit reproduction and other nonessential functions in short winter photoperiods, but some have little or no reproductive response. We tested whether genetic variability in reproductive seasonality is related to individual differences in the neuronal function of the gonadotropin-releasing hormone network, as assessed by the number and location of mature gonadotropin-releasing hormone-secreting neurons under inhibitory and excitatory photoperiods. The experiments used lines of Peromyscus leucopus previously developed by selection from a wild population. One line contained individuals reproductively inhibited by short photoperiod, and the other line contained individuals nonresponsive to short photoperiod. Expression of mature gonadotropin-releasing hormone (GnRH) immunoreactivity in the brain was detected using SMI-41 antibody in the single-labeled avidin-biotin-peroxidase-complex method. Nonresponsive mice had 50% more immunoreactive GnRH neurons than reproductively inhibited mice in both short- and long-day photoperiods. The greatest differences were in the anterior hypothalamus and preoptic areas. In contrast, we detected no significant within-lines differences in the number or location of immunoreactive GnRH neurons between photoperiod treatments. Our data indicate that high levels of genetic variation in a single wild population for a specific neuronal trait are related to phenotypic variation in a life history trait, i.e., winter reproduction. Variation in GnRH neuronal activity may underlie some of the natural reproductive and life history variation observed in wild populations of P. leucopus. Similar genetic variation in neuronal traits may be present in humans and other species. [ABSTRACT FROM AUTHOR]

Comments on the paper by George Yancy about the African-American dialect and its role as a form of black resistance to white domination. Recognition of the inherent risks for white scholars and philosophers to venture into the semiotic space of the Afro-American experience through the use of language; Explanation of why letting white people into the code of linguistic understanding among Blacks also risks reinforcing a particular habit of white privilege, that of ontological expansiveness.

Comments on the article "Racial Prejudice and Friction," by John Dewey. Reaction on Dewey's definition of racial prejudice; Discussion of the problematic details of Dewey's solution to racial friction; Focus on Dewey's presentation of habit as structure that provides stability.

Polycystic ovary syndrome, a fertility disorder affecting &ap;7% of women, is characterized by elevated androgens, disrupted reproductive cycles, and high luteinizing hormone, the latter reflecting increased gonadotropin-releasing hormone (GnRH) release. In animal models, a similar reproductive endocrine phenotype occurs after prenatal androgen exposure. To study the effects of in utero androgen exposure directly on GnRH neurons, the central regulators of fertility, we prenatally androgenized (PNA) transgenic mice that express GFP in these cells. Pregnant females were injected with dihydrotestosterone, and their female offspring were studied as adults. PNA mice had irregular estrous cycles and elevated testosterone and luteinizing hormone levels, suggesting altered hypothalamo-pituitary-gonadal axis function. GnRH neurons receive a major input from γ-aminobutyric acid (GABA)ergic neurons, and GABA type A receptor activation may play a role in their regulation by steroids. We tested whether PNA alters GABAergic drive to GnRH neurons by comparing frequency and size of GABAergic postsynaptic currents in GnRH neurons from PNA and control females. Both postsynaptic current frequency and size were increased in PNA mice; these effects were reversed by in vivo treatment with the androgen receptor antagonist flutamide, suggesting that androgens mediated these effects. Changes in postsynaptic current frequency and size were action potential-independent suggesting the possibility that PNA increased connectivity between GABAergic and GnRH neurons. The ability of prenatal steroid exposure to initiate changes that alter functional inputs to GnRH neurons in adults has important implications for understanding the regulation of normal reproduction as well as the hypothalamic abnormalities of fertility disorders. [ABSTRACT FROM AUTHOR]

While Sigmund Freud and Maurice Merleau-Ponty both acknowledge the role that spatiality plays in human life, neither pays any explicit attention to the intersections of race and space. It is Franz Fanon who uses psychoanalysis and phenomenology to provide an account of how the psychical and lived bodily existence of black people is racially constituted by a racist world. More precisely, as I argue in this paper, Fanon's work demonstrates how psychical and bodily spatiality cannot be adequately understood apart from the environing space of the social world. For Fanon, body, psyche, and world mutually influence and constitute each other. In a raced and racist world, therefore, the lived bodily experience and the unconscious of human beings will be racially and racist-ly constituted as well. [ABSTRACT FROM AUTHOR]

Gonadotropin-releasing hormone (GnRH) neurons form the final common pathway for the central regulation of reproduction and are inhibited by negative energy balance. In normal adults, these neurons maintain elevated intracellular chloride so that GABA[subA] receptor activation is excitatory. We hypothesized that fasting alters homeostatic mechanisms to eliminate excitatory responses to GABA but rejected this hypothesis when brief, local GABA application elicited action currents in GnRH neurons from fed and fasted mice. This response was specific to GABA[subA] receptors, because glycine elicited no response. We next found that fasting reduced the frequency of spontaneous GABAergic postsynaptic currents (PSCs) and that this was reversed by in vivo treatment with leptin during the fast. In the presence of tetrodotoxin to minimize presynaptic actions, leptin also potentiated the postsynaptic response of these cells to GABA[subA] receptor activation. Postsynaptic effects of leptin on GABAergic miniature PSCs were eliminated by inhibiting JAK2/3 (Janus kinase), the tyrosine kinase through which leptin receptors signal. In all experiments, elimination of PSCs at E[subCl] or by treatment with the GABA[subA] receptor antagonist bicuculline confirmed that PSCs were specifically mediated by GABA[subA] receptor chloride channels. These data demonstrate that fasting and leptin act presynaptically and postsynaptically to alter GABAergic drive to GnRH neurons, providing evidence for GABAergic communication of metabolic cues to GnRH neurons, and suggest the possibility for functional leptin receptors on GnRH neurons. They further demonstrate cytokine modulation of the postsynaptic response to GABA in mammals, which may be important to central neural regulation in both healthy and diseased states. [ABSTRACT FROM AUTHOR]

Examines the shift in W. E. B. Du Bois' ideas about the unconscious and economic operations of racism as implicated in the "The Gift of Black Folk." Shift in Du Bois' thought concerning the motivations for and strategies against white racism; Problem of unconscious white resistance to recognizing white racism and white privilege; Comments on Du Bois' use of the term unconscious habit.

Explores the notion of reciprocity between races according to Jane Addams. Ways by which reciprocal relationships can be harmful to minority racial groups; Challenge of the critical race theory to racism; Lessons for contemporary pragmatist feminists and race theorists.

In my response to the comments of Vincent Colapietro, Charlene Seigfried, and Gall Weiss on Living Across and Through Skins (Sullivan 2001), I explain pragmatist feminism as an ecological ontology that understands bodies and environments as dynamically co-constitutive. I then discuss the relationship of pragmatist feminism to phenomenology, psychoanalysis, Nietzschean genealogy, and Darwinian evolutionary theory. Some of the specific concepts I examine include the anonymous body, the bodying organism, truth as transactional flourishing, and the preservation of racial and ethnic categories. [ABSTRACT FROM AUTHOR]

Present a response to comment by Silvia Stoller on the article 'Domination and Dialogue in Merleau-Ponty's Phenomenology of Perception,' written by the author. Argument that while phenomenology has much to offer feminism, feminists should be wary of Merleau-Ponty's notion of projective intentionality because of the ethical solipsism that it tends to involve; Clarification of the concept of hypothetical construction;

Demonstrates how academician John Dewey's notion of habit can aid in understanding gender as a constitutive structure of bodily existence. Fusion of Dewey's pragmatism and fellow academician Judith Butler's concept of performativity; Ways by which rigid binary configurations of gender might be transformed at the level of individual habit and cultural construct.

Presents an essay which develops an alternative to projective intentionality found in work by Maurice Merleau-Ponty entitled `Phenomenology of Perception,' called hypothetical construction. How meaning is socially constructed under hypothetical construction; Problematic nature of Merleau-Ponty's claim relating to the anonymous body.

Compares John Dewey's and Friedrich Nietzsche's work. Reference to Dewey's program of pragmatic democracy, and Nietzsche's `Beyond Good And Evil'; Information on Nietzsche's self-overcoming; Examination of Dewey's reconstruction.

Examines the role of passion as it relates to ethics in Soren Kierkegaard's journal `Either/Or.' Indepth look at Judge William's response to this issue; Reference to the play `The First Love'; The definitive nature of passion.

OBJECTIVE The Diabetes Prevention Program (DPP) trial investigated rates of progression to diabetes among adults with prediabetes randomized to treatment with placebo, metformin, or intensive lifestyle intervention. Among women in the DPP, diabetes risk reduction with metformin was greater in women with prior gestational diabetes mellitus (GDM) compared with women without GDM but with one or more previous live births. RESEARCH DESIGN AND METHODS We asked if genetic variability could account for these differences by comparing β-cell function and genetic risk scores (GRS), calculated from34 diabetes-associated loci, between women with and without histories of GDM. RESULTS β-Cell function was reduced in women with GDM. The GRS was positively associated with a history of GDM; however, the GRS did not predict progression to diabetes or modulate response to intervention. CONCLUSIONS These data suggest that a diabetes-associated GRS is associated with development of GDM and may characterize women at risk for development of diabetes due to β-cell dysfunction. [ABSTRACT FROM AUTHOR]

The study objective was to determine if mutations in mitochondrial DNA polymerase gamma (POLG) are associated with spontaneous 46,XX primary ovarian insufficiency (sPOI) using restriction fragment length polymorphism analysis of genomic DNA. Of 201 women with 46,XX sPOI analyzed, we found only one case (0.5%, 95% confidence interval 0-3%) of heterozygosity for a POLG mutation, suggesting that this is not a common genetic etiology for this form of infertility. [ABSTRACT FROM AUTHOR]

The author reflects on the study titled "Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the Metformin in Gestational Diabetes (MIG) trial: Responses to maternal metformin versus insulin treatment" by H.L. Barrett and colleagues published in a 2013 issue of the journal "Diabetes Care." Topics include metabolic risk in women with gestational diabetes, Metformin in Gestational Diabetes (MiG) Trial, and examination of metformin-treated and insulin-treated women.

It is clear that women with primary ovarian insufficiency are asking the health care community to alter the current standard, which requires the patient to seek a different specialist for each of her health care needs, and instead work as a team of caregivers that embraces each patient as a woman with complex and individual needs rather than as a disease process. [Copyright &y& Elsevier]