- Email: [email protected]
Gender in medical education: The Dutch National Project
GENDERMEDICINE
gained in implementing health care based on these advances. The poster describes the elements and strategic steps of a progressive model of health care service delivery needed to translate sex- and gender-specific basic science into clinical practice. The elements are conceptually and scientifically iterative and reflected in an integrated, interdisciplinary, health service delivery model at 3 levels (individual pa-tient encounter, organizational structure, and community partnerships). Data will be presented describing the qual-ity and cost of health care. References: 1Exploring the Biologic Contributions to Human Health: Does Sex Matter?, Institute of Medidne 2000. 2Acad Med. 2000;75:1102-1106. 3Am J Obstet Gynecol. 2002 Sep;187(3 Suppl):S41-S43. 4ACHWP Guiding principles, sUS Office on Women's Health CCOE
79
There Is a Gender Difference in the Relationship Between Metabolic Syndrome and Oxidative Stress Among Japanese M a s a n o b u Tsuchiya; a n d Masako Tosaka
Masako Medical Clinic, Tokuyama, Japan
guides we identified gaps in gender-specific medical education, as well as courses in which specific gender issues could be integrated. Results of the screening were discussed with all medical school directors. Furthermore, we developed a knowledge center for gender-specific medical education (www.vrouwenstudiesgeneeskunde.nl) from which teachers could download study assigments, test questions, or order education videos. With c o m m i t m e n t of all deans and faculty leadership, we continued with the screening of education, material. In meetings with course organisers, we discussed concrete recommendations for improvement. Notes were taken at all meetings and presented for accordance afterwards. By interviewing the faculty leadership and key figures within the faculties, we evaluated the project. Gender has increasingly been brought under the attention of medical students in 6 medical schools and this is still an ongoing process. Examples are the subsequent integration of ethnic differences or the development of electives. A seventh school has started to incorporate gender after the project had ended.
81
Objective: The purpose of this study is to clarify whether
Acupuncture: Efficacy for Hot Flashes
there is a gender difference in the relationship between metabolic syndrome (MS) and oxidative stress a m o n g Japanese. Method: Fifty m e n and 50 age-, BMI-, sBP-, dBP-, TC-, HDLC-, TG-, FBS- and HbAlc-matched postmenopausal w o m e n were recruited. We examined the presence of MS according to the Japanese diagnostic criteria of MS. Serum hydroperoxides by d-ROM was measured as a maker of oxidative stress and BAP test was performed as a maker of anti-oxidant. Results: Postmenopausal w o m e n had higher hydroperoxides (279.3 + 39.5, 355.6 + 32.0 U.CARR; P < 0.001) and BAP (2345 + 245, 2531 + 323 M; P < 0.05) than m e n in non-MS group. Men and postmenopausal w o m e n in MS group showed no significant difference in d-ROM and BAP test. Visceral obesity (r = 0.321; P < 0.05) and the presence of MS (r = 0.586; P < 0.001) were positively correlated with hydroperoxides in men. Multiple regression analysis demonstrated that the major risk factors for the elevation of hydroperoxides was visceral obesity (r 2 = 0.226; P < 0.05) in men. But no factors were correlated with hydroperoxides and there were no risk factors for the elevation of hydroperoxides in p o s t m e n o p a u s a l w o m e n . Conclusion: Postmenopausal w o m e n had stronger oxidative stress t h a n m e n in non-MS group and MS was strongly associated with oxidative stress in m e n but not in postmenopausal w o m e n among Japanese.
A n n Vincent; Debra Barton; J a y a w a n t M a n d r e k a r ; S t e p h e n Cha; Teresa Zias; D i e t l i n d Wahner-Roeder; M a r i n a Keppler; a n d Charles Loprinzi
80 Gender in Medical Education: The Dutch National Project Petra Verdonk; a n d Toine L.M. Lagro-Janssen
Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands Despite the growing body of gender differences in health and illness, medical schools have been slow to integrate gender issues in their curricula. A project started in April 2002 to establish gender-specific curricula in at least 6 out of 8 medical schools in the Netherlands. In a pilot study, we had identified necessary conditions for the implementation of gender, most importantly offering concrete recommendations to course organisers. In the national project, by screening study
$66
Mayo Clinic, Rocheste~ MN, USA Background: Hot flashes are a significant problem in menopausal w o m e n and substantially affect quality of life. The world of estrogen replacement therapy has been thrown into turmoil with the recent results of the Women's Health Initiative trial report. Pursuant to a growing interest in the use of alternative therapies to alleviate menopausal symptoms and a few pilot trials that suggested t h a t acupuncture could modestly alleviate hot flashes, a prospective, randomized, single-blinded, sham-controlled, clinical trial was c o n d u c t e d in w o m e n experiencing h o t flashes. Methods: Participants, after being randomized to medical versus sham acupuncture, received bi-weekly treatments for 5 weeks, after a baseline assessment week. They were t h e n followed for an additional 7 weeks. Participants completed daily hot flash questionnaires, which formed the basis for analysis. Results: 103 Participants were randomized to medical or sham acupuncture. At week 6, the percent of residual hot flashes was 61% in the sham group and 62% in the medical acupuncture group, and at week 12 the percent of residual hot flashes was 60% in the sham group and 71% in the medical acupuncture group. Participants reported no adverse effects related to the treatments. Interpretation: The results of this study failed to suggest that the utilized medical acupuncture was any more effective for reducing hot flashes than was the chosen sham acupuncture. This is the first randomized sham-controlled trial completed in the United States evaluating the efficacy of acupuncture in hot flashes.
82
Gender-Specific Use of Complementary and Alternative Medicine: Results of a Survey of Patients Seen at Different Specialty Areas in a Tertiary-Care Center Dietlind L. Wahner-Roedler; Peter L. Elkin; A n n Vincent; Laura L. Loehrer; S t e p h e n S. Cha; a n d Brent A. Bauer
gained in implementing health care based on these advances. The poster describes the elements and strategic steps of a progressive model of health care service delivery needed to translate sex- and gender-specific basic science into clinical practice. The elements are conceptually and scientifically iterative and reflected in an integrated, interdisciplinary, health service delivery model at 3 levels (individual pa-tient encounter, organizational structure, and community partnerships). Data will be presented describing the qual-ity and cost of health care. References: 1Exploring the Biologic Contributions to Human Health: Does Sex Matter?, Institute of Medidne 2000. 2Acad Med. 2000;75:1102-1106. 3Am J Obstet Gynecol. 2002 Sep;187(3 Suppl):S41-S43. 4ACHWP Guiding principles, sUS Office on Women's Health CCOE
79
There Is a Gender Difference in the Relationship Between Metabolic Syndrome and Oxidative Stress Among Japanese M a s a n o b u Tsuchiya; a n d Masako Tosaka
Masako Medical Clinic, Tokuyama, Japan
guides we identified gaps in gender-specific medical education, as well as courses in which specific gender issues could be integrated. Results of the screening were discussed with all medical school directors. Furthermore, we developed a knowledge center for gender-specific medical education (www.vrouwenstudiesgeneeskunde.nl) from which teachers could download study assigments, test questions, or order education videos. With c o m m i t m e n t of all deans and faculty leadership, we continued with the screening of education, material. In meetings with course organisers, we discussed concrete recommendations for improvement. Notes were taken at all meetings and presented for accordance afterwards. By interviewing the faculty leadership and key figures within the faculties, we evaluated the project. Gender has increasingly been brought under the attention of medical students in 6 medical schools and this is still an ongoing process. Examples are the subsequent integration of ethnic differences or the development of electives. A seventh school has started to incorporate gender after the project had ended.
81
Objective: The purpose of this study is to clarify whether
Acupuncture: Efficacy for Hot Flashes
there is a gender difference in the relationship between metabolic syndrome (MS) and oxidative stress a m o n g Japanese. Method: Fifty m e n and 50 age-, BMI-, sBP-, dBP-, TC-, HDLC-, TG-, FBS- and HbAlc-matched postmenopausal w o m e n were recruited. We examined the presence of MS according to the Japanese diagnostic criteria of MS. Serum hydroperoxides by d-ROM was measured as a maker of oxidative stress and BAP test was performed as a maker of anti-oxidant. Results: Postmenopausal w o m e n had higher hydroperoxides (279.3 + 39.5, 355.6 + 32.0 U.CARR; P < 0.001) and BAP (2345 + 245, 2531 + 323 M; P < 0.05) than m e n in non-MS group. Men and postmenopausal w o m e n in MS group showed no significant difference in d-ROM and BAP test. Visceral obesity (r = 0.321; P < 0.05) and the presence of MS (r = 0.586; P < 0.001) were positively correlated with hydroperoxides in men. Multiple regression analysis demonstrated that the major risk factors for the elevation of hydroperoxides was visceral obesity (r 2 = 0.226; P < 0.05) in men. But no factors were correlated with hydroperoxides and there were no risk factors for the elevation of hydroperoxides in p o s t m e n o p a u s a l w o m e n . Conclusion: Postmenopausal w o m e n had stronger oxidative stress t h a n m e n in non-MS group and MS was strongly associated with oxidative stress in m e n but not in postmenopausal w o m e n among Japanese.
A n n Vincent; Debra Barton; J a y a w a n t M a n d r e k a r ; S t e p h e n Cha; Teresa Zias; D i e t l i n d Wahner-Roeder; M a r i n a Keppler; a n d Charles Loprinzi
80 Gender in Medical Education: The Dutch National Project Petra Verdonk; a n d Toine L.M. Lagro-Janssen
Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands Despite the growing body of gender differences in health and illness, medical schools have been slow to integrate gender issues in their curricula. A project started in April 2002 to establish gender-specific curricula in at least 6 out of 8 medical schools in the Netherlands. In a pilot study, we had identified necessary conditions for the implementation of gender, most importantly offering concrete recommendations to course organisers. In the national project, by screening study
$66
Mayo Clinic, Rocheste~ MN, USA Background: Hot flashes are a significant problem in menopausal w o m e n and substantially affect quality of life. The world of estrogen replacement therapy has been thrown into turmoil with the recent results of the Women's Health Initiative trial report. Pursuant to a growing interest in the use of alternative therapies to alleviate menopausal symptoms and a few pilot trials that suggested t h a t acupuncture could modestly alleviate hot flashes, a prospective, randomized, single-blinded, sham-controlled, clinical trial was c o n d u c t e d in w o m e n experiencing h o t flashes. Methods: Participants, after being randomized to medical versus sham acupuncture, received bi-weekly treatments for 5 weeks, after a baseline assessment week. They were t h e n followed for an additional 7 weeks. Participants completed daily hot flash questionnaires, which formed the basis for analysis. Results: 103 Participants were randomized to medical or sham acupuncture. At week 6, the percent of residual hot flashes was 61% in the sham group and 62% in the medical acupuncture group, and at week 12 the percent of residual hot flashes was 60% in the sham group and 71% in the medical acupuncture group. Participants reported no adverse effects related to the treatments. Interpretation: The results of this study failed to suggest that the utilized medical acupuncture was any more effective for reducing hot flashes than was the chosen sham acupuncture. This is the first randomized sham-controlled trial completed in the United States evaluating the efficacy of acupuncture in hot flashes.
82
Gender-Specific Use of Complementary and Alternative Medicine: Results of a Survey of Patients Seen at Different Specialty Areas in a Tertiary-Care Center Dietlind L. Wahner-Roedler; Peter L. Elkin; A n n Vincent; Laura L. Loehrer; S t e p h e n S. Cha; a n d Brent A. Bauer