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Gender and Health Knowledge Agenda
Abstract and Figures
The Gender and Health Knowledge Agenda summarises the gaps in our knowledge of gender and health, and serves as a basis for new research programming, including a future National Gender and Health knowledge programme. This publication is a translation of the Dutch Gender and Health Knowledge Agenda, and reflects the situation in the Netherlands (May 2015).
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... Zum Beispiel nehmen Frauen deutlich häufiger medizinische Hilfe in Anspruch als Männer [9] und haben signifikant mehr berufliche Fehltage [10]. Zum Beispiel treffen Ärzte und Ärztinnen zuweilen unterschiedliche Entscheidungen bezüglich Diagnose und (medikamentöser) Behandlung [11,12]. ...
... die protektive Wirkung des weiblichen Sexualhormons Östrogen) verhindern eine Anpassung der männlichen an die weibliche Lebenserwartung [13]. Als Folge kann dann beobachtet werden, dass Frauen während der Jahre, in denen sie länger leben, häufig unter chronischen Krankheiten leiden und geringe krankheitsbezogenen Lebensqualität mit deutlichen Funktionseinschränkungen berichten [12]. ...
Zusammenfassung
Geschlechtersensible Gesundheitsversorgung umfasst eine interdisziplinäre Perspektive, die den meisten Gesundheitsbereichen eine neue Dimension eröffnen sollte. Um dies zu ermöglichen, ist eine entsprechende Ausbildung zukünftiger Public Healther*innen notwendig. Wichtig für die Public Health Lehre ist dabei die Vermittlung geschlechtersensibler Fragestellungen (z.B. bezüglich Ätiologie) und Analysen (z.B. Stratifizierung) sowie die Integration geschlechtergerechter Didaktik und interdisziplinärer Projekte (z.B. gemeinsam mit der Geschlechterforschung).
... Over the last two decades, sex and gender have been recognized as important determinants of health and disease and as important aspects of clinical practice (Annandale, 2009;Phillips, 2005;Bird & Rieker, 1999;Baggio et al., 2013;Schenck-Gustafsson et al., 2012;Senten, 2015). Sex is a binary concept that refers to the biological differences (e.g., chromosomes, hormones, and sex organs) between men and women. ...
Sex and gender are important determinants of healthcare that need to be taken into account for medical teaching. Education is more effective if tailored to students’ subjectively-perceived needs and connected to their prior knowledge and opinions. This study explored first-year medical students thoughts about sex and gender differences in general and in specifically in healthcare, and what their educational preferences are in learning about these concepts during their medical training. Therefore six focus groups were conducted with 26 first-year medical students, 7 male and 19 female students, within one Dutch medical faculty. The discussions were audio-recorded and transcribed verbatim. After that a thematic analysis was performed which included descriptive coding, interpretative coding, and definition of overarching themes. Three major themes were identified. (1) Students’ self-perception of concepts sex and gender, including three major domains: (a) The unavoidable allocation of individuals to groups, (b) The role of stereotypes, and (c) The effect of sex/gender on career choice options. (2) Students’ goal orientedness in learning about sex/gender. (3) Students’ struggles between the binary system of medicine and the complexity of reality. Continuous reflection during medical school might help medical students to acquire sex- and gender-sensitive competencies that can be applied in their future work. To increase awareness about the influence of sex and gender differences in healthcare and on career choices, we recommend addressing these themes explicitly early on in the medical curriculum.
... The value of integrating sex and gender into medicine has been increasingly acknowledged over the past decades (Berg et al. 2015;Schenck-Gustafsson et al. 2012;WHO 2006). Several publications on topics such as pharmacotherapy, cardiovascular diseases, developmental disorders and doctor-patient communication suggest that sex and gender make a difference at distinct stages of prevention, diagnosis, treatment and prognosis (Baggio et al. 2013; Bartley and Fillingim 2013;Dielissen et al. 2011;Janssen and Lagro-Janssen 2012;Mosca et al. 2011;Soldin and Mattison 2009;Wijngaarden-Cremers et al. 2014). ...
Although several projects have addressed the importance of gender health issues in medical education, the sustainability of change efforts in medical education has rarely been addressed. Understanding the possible facilitators or barriers to sustainability may help to develop future interventions that are effective in maintaining gender health issues as a topic in medical curricula. The aim of this study is to provide a longitudinal evaluation of changes regarding gender health issues that occurred in the past decade and the factors that influenced this process. The coursebooks of eight theoretical courses of the Nijmegen medical curriculum were screened on the basis of criteria for an integrated gender perspective in medical education. To assess the sustainability of gender health issues, the screening results from 2014 were compared with those of a similar project in 2005. In addition, open interviews were conducted with eight coordinators to identify facilitators and barriers influencing the sustainability of gender health issues. Analysis showed that, over the past decade, the implementation of gender health issues was mainly sustained and additional changes were made, resulting in an ongoing gender perspective in the Nijmegen medical curriculum. The coordinators mentioned several factors that influenced the sustainability of implementation in medical education: coordinators’ and teachers’ gender-sensitive attitude, competing demands, the presence of sex and gender in learning objectives, examinations and evaluation, organizational support and curriculum revisions. Our findings suggest that, in implementing sex and gender in medical education, medical faculties need to focus on top-down support in incorporating sex and gender into core objectives and time spent on incorporating sex and gender into medicine, and on the continuous training of teaching staff.
Background
Gender is an important biological, behavioral, societal and cultural factor influencing affecting health and health care utilization. In medical education, gender tends to be less prioritized and limiting gender sensitivity among medical professionals leading to compromised and substandard health care. Our study aims to investigate the gender perceptions among medical students and practitioners identifying possibilities and challenges in better integrating gender into medical curriculum.
Method
Quantitative data were collected from 249 respondents (151 medical students, 33 service providers and 65 service recipients) by using structured questionnaires. Descriptive and univariate analysis were conducted to assess socio-demographic characteristics and gender perceptions of participants respectively. To determine the relations of mean perception score with socio-demographic variables, we used one-way ANOVA tests. Finally, we performed multivariate linear regression to determine socio-demographic variables predicting perceptions of respondents towards gender. SPSS version 25 was used for analysis. For qualitative data 16 key informants (6 administrative staffs, 2 policy makers and 8 teaching staffs) were interviewed. The interviews were analyzed manually using thematic analysis procedure.
Result
Mean score of perception on ‘gender’ among medical students and medical professionals were 10.29 (SD = 2.70) with 52% positive perception and 9.94 (SD = 2.98) with 50% positive perception out of 20 respectively. Significantly greater perception was found among female compared to male. Mean perception score was found significantly higher among respondents aged 20–25 years and students studying in Government medical college. In terms of opinion regarding gender integration in medical or dental curriculum, maximum respondents (91%) thought that inclusion may initiate gender sensitive attitude and respectful behavior and 85% respondents thought people’s health care rights will be ensured. Regarding challenges of integrating greater gender content in medical curriculum, majority service providers (42%) said there are no challenges, but 70% of students responded that due to the huge syllabus, it may create an extra burden to students. The majority of respondents recommended to start reviewing curriculum by a review board (91%) and to develop an intention module (85%). Qualitative findings supported the quantitative results.
Conclusion
An early sensitization on gender among medical personnel and it’s influence on health care system could contribute in ensuring gender equitable health services and achieving SDGs.
ZUSAMMENFASSUNG
Soziale, aber auch biologische Geschlechteraspekte von Patienten sowie medizinischem Fachpersonal spielen eine wichtige Rolle im medizinischen Versorgungs- und Kommunikationsprozess. Studien bestätigen einen oft unbewussten „Gender Bias“, bei dem die Bedeutung von Geschlecht über- oder unterschätzt wird und damit Fehler während der Diagnose und Behandlung entstehen können. Patienten scheinen Symptome oft unterschiedlich wahrzunehmen und mitzuteilen. Aber auch Ärzte treffen zuweilen geschlechterabhängig unterschiedliche behandlungsrelevante Entscheidungen. Eine zunehmende Sensibilisierung des medizinischen Fachpersonals durch Forschung und Lehre, aber auch der breiten Öffentlichkeit ist dringend notwendig.
In May of 2014, the NIH Director together with the Director of the Office of Research on Women's Health announced plans to take a multi-dimensional approach to address the over reliance on male cells and animals in preclinical research. The NIH is engaging the scientific community in the development of policies to improve the sex balance in research. The present, past, and future presidents of the Organization for the Study of Sex Differences, in order to encourage thoughtful discussion among scientists, pose a series of questions to generate ideas in three areas: 1. research strategies, 2. educational strategies, and 3. strategies to monitor effectiveness of policies to improve the sex balance in research. By promoting discussion within the scientific community, a consensus will evolve that will move science forward in a productive and effective manner.
De eerste Verkenning jeugdgezondheid van het RIVM in samenwerking met het Nederlands Centrum Jeugdgezondheid geeft een samenhangend landelijk overzicht van de jeugdgezondheid en de rol van de jeugdgezondheidszorg hierin. Het rapport gaat in op fysieke en psychosociale gezondheid, leefstijl en problemen in de sociale omgeving. De Nederlandse jeugd is over het algemeen gezond, maar er zijn ontwikkelingen die aandacht vragen, waaronder het toenemend sociale mediagebruik en extreem alcoholgebruik onder jongeren. De jeugdgezondheidszorg richt zich op de belangrijkste gezondheidsproblemen, maar zou meer kunnen investeren in 'zorg op maat' voor risicogroepen en in adviezen over gezondheidsbeleid in de wijk of op school. Dit is een uitgave van: Rijksinstituut voor Volksgezondheid en Milieu Postbus 1 | 3720 BA Bilthoven www.rivm.nl Februari 2014 006003 Gezond opgroeien Verkenning jeugdgezondheid(szorg) 2014 Gezond opgroeien Verkenning jeugdgezondheid
With a uniquely perspective on the key factors in recovery from eating disorders, this practical guide for patients and clinicians draws from relevant, real-life case studies. Focuses on real-life recovery strategies that involve motivational factors, physical and psychological health, and issues such as self-esteem, body attitude, emotion regulation and social relationships. Draws on extensive qualitative research with more than 80 former sufferers. Offers experience-based guidance for professionals assisting clients in their recovery process.
CMD can be sustained by several pathogenetic mechanisms. The importance of these mechanisms appears to vary in different clinical settings, but several of them may coexist in the same condition. Structural abnormalities of small coronary arteries can be responsible for CMD and have been described, in particular, in patients with hypertrophic cardiomyopathy or arterial hypertension. Functional microvascular abnormalities responsible for CMD have been described in most cases, and may consist of impaired coronary microvascular dilatation (endothelium-dependent and/or endothelium-independent) and/or increased coronary microvascular constriction. Finally, extravascular mechanisms, resulting in increased compression of resistive vessels by increased intramural pressure, may also sustain CMD.
Background Recent randomized clinical trials have suggested that estrogen plus progestin does not confer cardiac protection and may increase the risk of coronary heart disease (CHD). In this report, we provide the final results with regard to estrogen plus progestin and CHD from the Women's Health Initiative (WHI). Methods The WHI included a randomized primary-prevention trial of estrogen plus progestin in 16,608 postmenopausal women who were 50 to 79 years of age at base line. Participants were randomly assigned to receive conjugated equine estrogens (0.625 mg per day) plus medroxyprogesterone acetate (2.5 mg per day) or placebo. The primary efficacy outcome of the trial was CHD (nonfatal myocardial infarction or death due to CHD). Results After a mean follow-up of 5.2 years (planned duration, 8.5 years), the data and safety monitoring board recommended terminating the estrogen-plus-progestin trial because the overall risks exceeded the benefits. Combined hormone therapy was associated with a hazard rati...