TEDxProvidence
Alyson McGregor: Why medicine often has dangerous side effects for women
Alyson McGregor: Zašto lijekovi imaju opasne nuspojave za žene
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Većinu prošlog stoljeća lijekovi koji su se odobravali i puštali na tržište testirani su samo na muškarcima, što je dovelo do neodgovarajućeg doziranja lijekova i do nepoželjnih nuspojava kod žena. Važne fiziološke razlike između muškaraca i žena tek su nedavno uzete u obzir u medicinskim istraživanjima. Liječnica prve pomoći Alyson McGregor proučava te razlike i u ovom fascinantnom govoru govori o pozadini situacije u kojoj je muškarac postao polazišna točka za medicinska istraživanja i o tome kako razumijevanje razlika između muškaraca i žena može dovesti do učinkovitijeg liječenja i za muškarce i za žene.
Alyson McGregor - Women's health pioneer
Alyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men. Full bio
Alyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men. Full bio
Double-click the English transcript below to play the video.
00:12
We all go to doctors.
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Svi mi idemo doktorima,
00:16
And we do so with trust and blind faith
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i to s povjerenjem i slijepo vjerujući
00:21
that the test they are ordering
and the medications they're prescribing
and the medications they're prescribing
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da su pretrage na koje nas šalju
i lijekovi koje nam prepisuju
i lijekovi koje nam prepisuju
00:25
are based upon evidence --
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utemeljeni na dokazima -
00:28
evidence that's designed to help us.
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dokazima koji su zamišljeni
s ciljem da nam pomognu.
s ciljem da nam pomognu.
00:32
However, the reality is that that hasn't
always been the case for everyone.
always been the case for everyone.
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No, to nije uvijek bilo tako za sve.
00:39
What if I told you
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Što kad bih vam rekla
00:40
that the medical science discovered
over the past century
over the past century
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da je zdravstvena znanost
otkrivena tijekom prošlog stoljeća
otkrivena tijekom prošlog stoljeća
00:44
has been based on only
half the population?
half the population?
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temeljena na samo polovici populacije?
00:48
I'm an emergency medicine doctor.
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Ja sam liječnik hitne pomoći.
00:50
I was trained to be prepared
in a medical emergency.
in a medical emergency.
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Obučena sam za nošenje
s hitnim slučajevima.
s hitnim slučajevima.
00:54
It's about saving lives. How cool is that?
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Spašavanje života je najvažnije.
Nije li to cool?
Nije li to cool?
01:00
OK, there's a lot of runny noses
and stubbed toes,
and stubbed toes,
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Dobro, ima tu i puno prehlada
i udarenih nožnih prstiju,
i udarenih nožnih prstiju,
01:03
but no matter who walks
through the door to the ER,
through the door to the ER,
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ali bez obzira na to tko prolazi kroz
vrata do sobe za pružanje hitne pomoći,
vrata do sobe za pružanje hitne pomoći,
01:07
we order the same tests,
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pošaljemo ih na iste pretrage,
01:09
we prescribe the same medication,
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prepišemo im iste lijekove
01:11
without ever thinking about the sex
or gender of our patients.
or gender of our patients.
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ne razmišljajući o spolu
i rodu naših pacijenata.
i rodu naših pacijenata.
01:17
Why would we?
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Zašto bismo?
01:19
We were never taught that there were
any differences between men and women.
any differences between men and women.
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Nikad nas nisu učili da postoje
ikakve razlike između muškaraca i žena.
ikakve razlike između muškaraca i žena.
01:22
A recent Government Accountability study
revealed that 80 percent of the drugs
revealed that 80 percent of the drugs
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Nedavno istraživanje o odgovornosti Vlade
otkrilo je da je 80 % lijekova
otkrilo je da je 80 % lijekova
01:27
withdrawn from the market
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maknuto s tržišta
01:29
are due to side effects on women.
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jer je izazivalo određene
nuspojave kod žena.
nuspojave kod žena.
01:33
So let's think about that for a minute.
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Razmislimo o tome na trenutak.
01:35
Why are we discovering
side effects on women
side effects on women
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Zašto nuspojave kod žena otkrivamo
01:39
only after a drug has been
released to the market?
released to the market?
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tek nakon što je lijek pušten u prodaju?
01:43
Do you know that it takes years
for a drug to go from an idea
for a drug to go from an idea
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Znate li da su potrebne godine
da se lijek pretvori iz ideje
da se lijek pretvori iz ideje
01:49
to being tested on cells in a laboratory,
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u nešto što se testira
na stanicama u laboratoriju,
na stanicama u laboratoriju,
01:52
to animal studies,
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kasnije na životinjama,
01:54
to then clinical trials on humans,
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pa se rade klinička ispitivanja na ljudima
01:56
finally to go through
a regulatory approval process,
a regulatory approval process,
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sve dok se ne dođe do postupka odobravanja
02:00
to be available for your doctor
to prescribe to you?
to prescribe to you?
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kako bi vam ga vaš liječnik
mogao prepisati?
mogao prepisati?
02:06
Not to mention the millions and billions
of dollars of funding
of dollars of funding
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A da ne spominjemo milijune
i milijarde dolara uloženih
i milijarde dolara uloženih
02:09
it takes to go through that process.
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u sam proces.
02:13
So why are we discovering
unacceptable side effects
unacceptable side effects
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Zašto onda neželjene nuspojave otkrivamo
02:16
on half the population
after that has gone through?
after that has gone through?
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na polovici populacije
nakon što je lijek prošao sve to?
nakon što je lijek prošao sve to?
02:23
What's happening?
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Što se događa?
02:24
Well, it turns out that those cells
used in that laboratory,
used in that laboratory,
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Ispostavilo se da su stanice
korištene u laboratoriju
korištene u laboratoriju
02:28
they're male cells,
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zapravo muške stanice,
02:30
and the animals used
in the animal studies were male animals,
in the animal studies were male animals,
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a životinje na kojima se lijek testirao
također su mužjaci,
također su mužjaci,
02:34
and the clinical trials have been
performed almost exclusively on men.
performed almost exclusively on men.
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a klinička ispitivanja provode se
gotovo isključivo na muškarcima.
gotovo isključivo na muškarcima.
02:41
How is it that the male model became
our framework for medical research?
our framework for medical research?
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Kako to da nam je muškarac postao
okvir rada za medicinska istraživanja?
okvir rada za medicinska istraživanja?
02:46
Let's look at an example that has been
popularized in the media,
popularized in the media,
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Proučimo primjer populariziran u medijima.
02:50
and it has to do
with the sleep aid Ambien.
with the sleep aid Ambien.
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a vezan je uz Ambien, lijek za spavanje.
02:53
Ambien was released on the market
over 20 years ago,
over 20 years ago,
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Ambien se na tržištu pojavio
prije više od 20 godina,
prije više od 20 godina,
02:58
and since then, hundreds of millions
of prescriptions have been written,
of prescriptions have been written,
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a otada je pacijentima
prepisan stotine milijuna puta,
prepisan stotine milijuna puta,
03:03
primarily to women, because women
suffer more sleep disorders than men.
suffer more sleep disorders than men.
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najčešće ženama jer žene češće pate
od poremećaja spavanja od muškaraca.
od poremećaja spavanja od muškaraca.
03:09
But just this past year,
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No, prošle godine
03:11
the Food and Drug Administration
recommended cutting the dose in half
recommended cutting the dose in half
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FDA je preporučila
da se njegovo doziranje prepolovi
da se njegovo doziranje prepolovi
03:14
for women only,
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samo za žene
03:17
because they just realized
that women metabolize the drug
that women metabolize the drug
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jer su shvatili da žene
sporije probavljaju lijek
sporije probavljaju lijek
03:20
at a slower rate than men,
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od muškaraca,
03:23
causing them to wake up in the morning
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zbog čega se one ujutro probude
03:25
with more of the active drug
in their system.
in their system.
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s više aktivne droge u organizmu
03:28
And then they're drowsy and they're
getting behind the wheel of the car,
getting behind the wheel of the car,
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pa postanu pospane, sjednu za volan
03:32
and they're at risk
for motor vehicle accidents.
for motor vehicle accidents.
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i riskiraju izazivanje prometnih nesreća.
03:36
And I can't help but think,
as an emergency physician,
as an emergency physician,
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Kao liječnica prve pomoći,
ne mogu ne pomisliti
ne mogu ne pomisliti
03:40
how many of my patients
that I've cared for over the years
that I've cared for over the years
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koliko je mojih pacijenata
koje sam liječila tijekom godina
koje sam liječila tijekom godina
03:45
were involved in a motor vehicle accident
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sudjelovalo u automobilskoj nesreći
03:48
that possibly could have been prevented
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koja se mogla spriječiti
03:52
if this type of analysis was performed
and acted upon 20 years ago
and acted upon 20 years ago
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da se ovakva analiza provela i da su se
ti zaključci primijenili prije 20 godina
ti zaključci primijenili prije 20 godina
03:57
when this drug was first released.
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kad se ovaj lijek tek pojavio na tržištu.
04:01
How many other things need
to be analyzed by gender?
to be analyzed by gender?
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Koje se još stvari
trebaju analizirati po spolovima?
trebaju analizirati po spolovima?
04:05
What else are we missing?
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Što nam je još promaklo?
04:09
World War II changed a lot of things,
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Drugi svjetski rat
promijenio je puno toga,
promijenio je puno toga,
04:13
and one of them was this need
to protect people
to protect people
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a jedna od tih stvari bila je
potreba za zaštitom ljudi
potreba za zaštitom ljudi
04:16
from becoming victims of medical research
without informed consent.
without informed consent.
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od toga da budu žrtve medicinskih
istraživanja bez informiranog pristanka.
istraživanja bez informiranog pristanka.
04:21
So some much-needed guidelines
or rules were set into place,
or rules were set into place,
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Postavljene su neke
nužne smjernice i pravila,
nužne smjernice i pravila,
04:25
and part of that was this desire
to protect women of childbearing age
to protect women of childbearing age
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a dio toga bila je ta želja da se zaštiti
žene koje su u reprodukcijskoj dobi
žene koje su u reprodukcijskoj dobi
04:30
from entering into any
medical research studies.
medical research studies.
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od sudjelovanja u bilo kakvim
medicinskim istraživanjima.
medicinskim istraživanjima.
04:34
There was fear: what if something
happened to the fetus during the study?
happened to the fetus during the study?
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Strahovalo se od toga da se fetusu
nešto ne dogodi tijekom istraživanja.
nešto ne dogodi tijekom istraživanja.
04:39
Who would be responsible?
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Tko bi bio odgovoran?
04:41
And so the scientists
at this time actually thought
at this time actually thought
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Znanstvenici su
u to vrijeme zaista mislili
u to vrijeme zaista mislili
04:44
this was a blessing in disguise,
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da je to bila sreća u nesreći
04:47
because let's face it -- men's bodies
are pretty homogeneous.
are pretty homogeneous.
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jer su tijela muškaraca prilično homogena.
04:52
They don't have the constantly
fluctuating levels of hormones
fluctuating levels of hormones
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Nemaju stalne promjene u razinama hormona
04:56
that could disrupt clean data
they could get if they had only men.
they could get if they had only men.
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koje bi ometale čiste podatke koje su
dobivali istraživanjima s muškarcima.
dobivali istraživanjima s muškarcima.
05:01
It was easier. It was cheaper.
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Bilo je lakše, jeftinije,
05:05
Not to mention, at this time,
there was a general assumption
there was a general assumption
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a da ni ne pričamo
o tome kako se vjerovalo
o tome kako se vjerovalo
05:08
that men and women
were alike in every way,
were alike in every way,
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da su muškarci i žene
potpuno isti u svakom pogledu,
potpuno isti u svakom pogledu,
05:12
apart from their reproductive organs
and sex hormones.
and sex hormones.
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osim njihovih reproduktivnih organa
i spolnih hormona.
i spolnih hormona.
05:17
So it was decided:
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Donesena je odluka:
05:21
medical research was performed on men,
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medicinska istraživanja
provodila su se na muškarcima,
provodila su se na muškarcima,
05:24
and the results were later
applied to women.
applied to women.
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a njihovi rezultati
kasnije su primijenjeni na žene.
kasnije su primijenjeni na žene.
05:29
What did this do to the notion
of women's health?
of women's health?
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Što je to učinilo za žensko zdravlje?
05:32
Women's health became synonymous
with reproduction:
with reproduction:
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Žensko zdravlje postalo je sinonim
za reprodukciju:
za reprodukciju:
05:37
breasts, ovaries, uterus, pregnancy.
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grudi, jajnici, maternica, trudnoća.
05:42
It's this term we now refer
to as "bikini medicine."
to as "bikini medicine."
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To je pojam koji sada nazivamo
medicinom bikini-zone,
medicinom bikini-zone,
05:46
And this stayed this way
until about the 1980s,
until about the 1980s,
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a tako je i ostalo do 1980-ih
05:49
when this concept was challenged
by the medical community
by the medical community
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kad je taj koncept pokušalo osporiti
medicinsko društvo
medicinsko društvo
05:52
and by the public health policymakers
when they realized that
when they realized that
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i tvorci zdravstvene politike
kad su shvatili
kad su shvatili
05:56
by excluding women
from all medical research studies
from all medical research studies
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da smo ženama, isključivši ih iz formalnih
medicinskih istraživanjima,
medicinskih istraživanjima,
06:01
we actually did them a disservice,
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učinili medvjeđu uslugu
06:04
in that apart from reproductive issues,
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jer se osim reproduktivnih pitanja
06:06
virtually nothing was known
about the unique needs
about the unique needs
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gotovo ništa nije znalo
o jedinstvenim potrebama
o jedinstvenim potrebama
06:09
of the female patient.
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pacijentica.
06:12
Since that time, an overwhelming amount
of evidence has come to light
of evidence has come to light
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Otada je ogromna količina dokaza
izašla na vidjelo
izašla na vidjelo
06:18
that shows us just how different
men and women are in every way.
men and women are in every way.
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koji pokazuju kako su
muškarci i žene potpuno drugačiji.
muškarci i žene potpuno drugačiji.
06:29
You know, we have this saying in medicine:
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U medicini koristimo ovu izreku:
06:32
children are not just little adults.
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djeca nisu samo odrasli u malom.
06:36
And we say that to remind ourselves
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To si govorimo da se podsjetimo
06:38
that children actually have
a different physiology than normal adults.
a different physiology than normal adults.
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da djeca zapravo imaju drugačiju
fiziologiju od normalnih odraslih ljudi.
fiziologiju od normalnih odraslih ljudi.
06:44
And it's because of this that the medical
specialty of pediatrics came to light.
specialty of pediatrics came to light.
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Zbog toga se rodila pedijatrija.
06:49
And we now conduct research on children
in order to improve their lives.
in order to improve their lives.
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Sad možemo provoditi istraživanja
na djeci kako bismo im poboljšali živote.
na djeci kako bismo im poboljšali živote.
06:57
And I know the same thing
can be said about women.
can be said about women.
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Isto se može reći i za žene.
06:59
Women are not just men
with boobs and tubes.
with boobs and tubes.
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Žene nisu samo muškarci
s grudima i jajovodom -
s grudima i jajovodom -
07:06
But they have their own
anatomy and physiology
anatomy and physiology
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one imaju vlastitu anatomiju i fiziologiju
07:10
that deserves to be studied
with the same intensity.
with the same intensity.
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koja zaslužuje biti proučavana
istim intenzitetom.
istim intenzitetom.
07:15
Let's take the cardiovascular
system, for example.
system, for example.
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Npr. promotrimo kardiovaskularni sustav.
07:18
This area in medicine has done the most
to try to figure out
to try to figure out
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Ovo područje medicine potrudilo se saznati
07:22
why it seems men and women have
completely different heart attacks.
completely different heart attacks.
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zašto muškarci i žene doživljavaju
potpuno različite srčane udare.
potpuno različite srčane udare.
07:27
Heart disease is the number one killer
for both men and women,
for both men and women,
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Bolesti srca vodeći su uzročnik smrti
i muškaraca i žena,
i muškaraca i žena,
07:33
but more women die within the first year
of having a heart attack than men.
of having a heart attack than men.
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ali više žena umire tijekom godine dana
nakon doživljenog srčanog udara.
nakon doživljenog srčanog udara.
07:39
Men will complain
of crushing chest pain --
of crushing chest pain --
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Muškarci se žale
na teške bolove u prsima -
na teške bolove u prsima -
07:43
an elephant is sitting on their chest.
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kao da im slon sjedi na prsima.
07:46
And we call this typical.
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To je za njih tipično.
07:49
Women have chest pain, too.
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I žene pate od bolova u prsima,
07:52
But more women than men
will complain of "just not feeling right,"
will complain of "just not feeling right,"
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ali žene se žale na to da se
"jednostavno ne osjećaju dobro",
"jednostavno ne osjećaju dobro",
08:00
"can't seem to get enough air in,"
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"nemaju dovoljno zraka u plućima",
08:03
"just so tired lately."
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"u zadnje vrijeme su umorne".
08:07
And for some reason we call this atypical,
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Iz nekog razloga to je netipično
08:09
even though, as I mentioned,
women do make up half the population.
women do make up half the population.
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iako, kao što već spomenuh,
žene čine polovicu populacije.
žene čine polovicu populacije.
08:15
And so what is some of the evidence
to help explain some of these differences?
to help explain some of these differences?
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Kojim dokazima možemo objasniti
neke od ovih razlika?
neke od ovih razlika?
08:21
If we look at the anatomy,
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Promotrimo anatomiju:
08:24
the blood vessels that surround the heart
are smaller in women compared to men,
are smaller in women compared to men,
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krvne žile koje okružuju srce
kod žena su manje nego kod muškaraca,
kod žena su manje nego kod muškaraca,
08:30
and the way that those blood vessels
develop disease is different
develop disease is different
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a drugačiji je i način na koji
te krvne žile razvijaju bolesti
te krvne žile razvijaju bolesti
08:35
in women compared to men.
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kod žena i muškaraca.
08:37
And the test that we use to determine
if someone is at risk for a heart attack,
if someone is at risk for a heart attack,
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Test kojim ispitujemo prijeti li nekome
opasnost od srčanog udara
opasnost od srčanog udara
08:43
well, they were initially designed
and tested and perfected in men,
and tested and perfected in men,
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osmišljen je, ispitan
i usavršen na muškarcima,
i usavršen na muškarcima,
08:47
and so aren't as good
at determining that in women.
at determining that in women.
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stoga nije toliko dobar
u utvrđivanju opasnosti kod žena.
u utvrđivanju opasnosti kod žena.
08:52
And then if we think
about the medications --
about the medications --
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Zatim lijekovi -
08:55
common medications
that we use, like aspirin.
that we use, like aspirin.
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uobičajeni lijekovi koje koristimo,
lijekovi poput aspirina.
lijekovi poput aspirina.
08:59
We give aspirin to healthy men to help
prevent them from having a heart attack,
prevent them from having a heart attack,
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Aspirin dajemo zdravim muškarcima
u svrhu prevencije srčanog udara,
u svrhu prevencije srčanog udara,
09:04
but do you know that if you
give aspirin to a healthy woman,
give aspirin to a healthy woman,
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ali jeste li znali da
ukoliko aspirin date zdravoj ženi,
ukoliko aspirin date zdravoj ženi,
09:08
it's actually harmful?
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to zapravo može biti štetno?
09:12
What this is doing is merely telling us
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To nam govori
09:14
that we are scratching the surface.
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da smo tek zagrebali ispod površine.
09:19
Emergency medicine
is a fast-paced business.
is a fast-paced business.
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Medicina prve pomoći ubrzan je posao.
09:23
In how many life-saving areas of medicine,
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U koliko područja medicine
koji se bave spašavanjem života,
koji se bave spašavanjem života,
09:26
like cancer and stroke,
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poput raka i moždanog udara,
09:30
are there important differences between
men and women that we could be utilizing?
men and women that we could be utilizing?
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postoje važne razlike između muškaraca
i žena koje bismo mogli koristiti?
i žena koje bismo mogli koristiti?
09:36
Or even, why is it that some people
get those runny noses
get those runny noses
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Ili zašto nekim ljudima curi nos
09:41
more than others,
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više nego drugima
09:43
or why the pain medication that we give
to those stubbed toes
to those stubbed toes
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ili zašto lijekovi protiv bolova
koje dajemo za udarene nožne prste
koje dajemo za udarene nožne prste
09:46
work in some and not in others?
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na neke djeluje, a na druge ne djeluju?
09:53
The Institute of Medicine has said
every cell has a sex.
every cell has a sex.
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Institut medicine tvrdi
da svaka stanica ima spol.
da svaka stanica ima spol.
09:59
What does this mean?
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Što to znači?
10:02
Sex is DNA.
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Spol je DNK.
10:04
Gender is how someone
presents themselves in society.
presents themselves in society.
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Rod je način na koji se netko
predstavlja u društvu,
predstavlja u društvu,
10:09
And these two may not always match up,
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a to dvoje ne podudara se baš uvijek,
10:12
as we can see with our
transgendered population.
transgendered population.
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kao što možemo primijetiti
kod transrodnih pojedinaca.
kod transrodnih pojedinaca.
10:16
But it's important to realize
that from the moment of conception,
that from the moment of conception,
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Kako bilo, važno je shvatiti
da od trenutka začeća
da od trenutka začeća
10:21
every cell in our bodies --
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svaka stanica u našim tijelima -
10:23
skin, hair, heart and lungs --
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koža, kosa, srce i pluća -
10:27
contains our own unique DNA,
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sadrži naš jedinstveni DNK,
10:30
and that DNA contains
the chromosomes that determine
the chromosomes that determine
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a taj DNK sadrži kromosome koji određuju
10:34
whether we become
male or female, man or woman.
male or female, man or woman.
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hoćemo li postati muško ili žensko,
muškarac ili žena.
muškarac ili žena.
10:40
It used to be thought
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Nekoć se smatralo
10:42
that those sex-determining
chromosomes pictured here --
chromosomes pictured here --
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da ti kromosomi koji određuju spol
i koji su prikazani ovdje -
i koji su prikazani ovdje -
10:46
XY if you're male, XX if you're female --
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XY za muškarca, XX za ženu -
10:49
merely determined whether you
would be born with ovaries or testes,
would be born with ovaries or testes,
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samo određuju hoćete li se roditi
s jajnicima ili s testisima,
s jajnicima ili s testisima,
10:54
and it was the sex hormones
that those organs produced
that those organs produced
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a spolni hormoni
koje su ti organi proizvodili
koje su ti organi proizvodili
10:58
that were responsible for the differences
we see in the opposite sex.
we see in the opposite sex.
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odgovorni su za razlike koje vidimo
na suprotnom spolu.
na suprotnom spolu.
11:04
But we now know that
that theory was wrong --
that theory was wrong --
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Sad znamo da je ta teorija bila pogrešna -
11:09
or it's at least a little incomplete.
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ili barem da je bila nepotpuna.
11:12
And thankfully, scientists like Dr. Page
from the Whitehead Institute,
from the Whitehead Institute,
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Srećom, znanstvenici poput dr. Pagea
s Instituta Whitehead
s Instituta Whitehead
11:16
who works on the Y chromosome,
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koji radi na kromosomu Y
11:18
and Doctor Yang from UCLA,
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i dr. Yang sa Sveučilišta u Kaliforniji
11:21
they have found evidence that tells us
that those sex-determining chromosomes
that those sex-determining chromosomes
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pronašli su dokaze koji nam pokazuju
da ti kromosomi koji određuju spol,
da ti kromosomi koji određuju spol,
11:26
that are in every cell in our bodies
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a koji se nalaze
u svakoj stanici našeg tijela,
u svakoj stanici našeg tijela,
11:29
continue to remain active
for our entire lives
for our entire lives
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ostaju aktivni tijekom
cijelih naših života
cijelih naših života
11:36
and could be what's responsible
for the differences we see
for the differences we see
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i mogli bi biti odgovorni
za razlike koje vidimo
za razlike koje vidimo
11:40
in the dosing of drugs,
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kod doziranja lijekova
11:42
or why there are differences
between men and women
between men and women
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ili zašto postoje razlike
između muškaraca i žena
između muškaraca i žena
11:45
in the susceptibility
and severity of diseases.
and severity of diseases.
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u podložnosti i ozbiljnosti
pojedine bolesti.
pojedine bolesti.
11:51
This new knowledge is the game-changer,
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To novostečeno znanje mijenja sve,
11:57
and it's up to those scientists
that continue to find that evidence,
that continue to find that evidence,
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a na znanstvenicima, koji još uvijek
pronalaze takve dokaze,
pronalaze takve dokaze,
12:00
but it's up to the clinicians
to start translating this data
to start translating this data
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ali i na liječnicima je
da počnu proučavati te podatke
da počnu proučavati te podatke
12:05
at the bedside, today.
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prije spavanja - još danas.
12:09
Right now.
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Odmah.
12:13
And to help do this, I'm a co-founder
of a national organization
of a national organization
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Kako bih im u tome pomogla,
suosnovala sam državnu organizaciju
suosnovala sam državnu organizaciju
12:16
called Sex and Gender
Women's Health Collaborative,
Women's Health Collaborative,
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"Spol i rod - suradnja za žensko zdravlje"
12:19
and we collect all of this data
so that it's available for teaching
so that it's available for teaching
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i prikupljamo sve te podatke
kako bi bilo dostupno za poučavanje
kako bi bilo dostupno za poučavanje
12:24
and for patient care.
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i brigu o pacijentima.
12:26
And we're working to bring together
the medical educators to the table.
the medical educators to the table.
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Radimo na tome
da okupimo profesore medicine.
da okupimo profesore medicine.
12:31
That's a big job.
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Velik je to posao
12:34
It's changing the way medical training
has been done since its inception.
has been done since its inception.
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koji mijenja način na koji se provodi
medicinska obuka još od njezinih začetaka.
medicinska obuka još od njezinih začetaka.
12:41
But I believe in them.
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No, ja vjerujem u njih.
12:43
I know they're going to see the value
of incorporating the gender lens
of incorporating the gender lens
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Znam da će oni uvidjeti važnost
uključivanja i uvažavanja spola
uključivanja i uvažavanja spola
12:49
into the current curriculum.
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u trenutni kurikulum.
12:52
It's about training the future
health care providers correctly.
health care providers correctly.
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Radi se o pravilnom obučavanju
budućih zdravstvenih djelatnika.
budućih zdravstvenih djelatnika.
13:00
And regionally,
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Regionalno
13:01
I'm a co-creator of a division within
the Department of Emergency Medicine
the Department of Emergency Medicine
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ja sam sukreatorica odsjeka unutar
Odjela za prvu pomoć
Odjela za prvu pomoć
13:05
here at Brown University,
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na Sveučilištu Brown
13:07
called Sex and Gender
in Emergency Medicine,
in Emergency Medicine,
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pod nazivom "Spol i rod
u medicini prve pomoći"
u medicini prve pomoći"
13:09
and we conduct the research to determine
the differences between men and women
the differences between men and women
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i provodimo istraživanje kako bismo
utvrdili razlike između muškaraca i žena
utvrdili razlike između muškaraca i žena
13:14
in emergent conditions,
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u hitnim stanjima
13:16
like heart disease and stroke
and sepsis and substance abuse,
and sepsis and substance abuse,
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poput bolesti srca, moždanog udara,
sepse i zlouporabe droga,
sepse i zlouporabe droga,
13:21
but we also believe
that education is paramount.
that education is paramount.
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ali također vjerujemo da su odgoj
i obrazovanje najvažniji.
i obrazovanje najvažniji.
13:27
We've created a 360-degree
model of education.
model of education.
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Stvorili smo model odgoja i obrazovanja
od 360 stupnjeva.
od 360 stupnjeva.
13:31
We have programs for the doctors,
for the nurses, for the students
for the nurses, for the students
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Imamo programe za liječnike,
za medicinske sestre, za studente
za medicinske sestre, za studente
13:37
and for the patients.
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i za pacijente
13:39
Because this cannot just be left up
to the health care leaders.
to the health care leaders.
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jer ovo ne smije biti prepušteno
samo zdravstvenim djelatnicima.
samo zdravstvenim djelatnicima.
13:44
We all have a role in making a difference.
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Svi imamo ulogu u stvaranju promjena,
13:48
But I must warn you: this is not easy.
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ali moram vas upozoriti da nije lako.
13:53
In fact, it's hard.
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Štoviše, teško je.
13:57
It's essentially changing the way
we think about medicine
we think about medicine
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U biti se radi o mijenjanju načina
na koji razmišljamo o medicini,
na koji razmišljamo o medicini,
14:01
and health and research.
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zdravlju i istraživanjima.
14:05
It's changing our relationship
to the health care system.
to the health care system.
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To će promijeniti naš odnos
prema zdravstvenom sustavu,
prema zdravstvenom sustavu,
14:09
But there's no going back.
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ali nema povratka.
14:13
We now know just enough
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Znamo tek toliko
14:17
to know that we weren't doing it right.
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da smo svjesni toga
da smo nešto radili krivo.
da smo nešto radili krivo.
14:21
Martin Luther King, Jr. has said,
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Martin Luther King je rekao:
14:24
"Change does not roll in
on the wheels of inevitability,
on the wheels of inevitability,
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"Promjena ne dolazi
na krilima neizbježnosti,
na krilima neizbježnosti,
14:28
but comes through continuous struggle."
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već kroz neprestanu borbu."
14:32
And the first step
towards change is awareness.
towards change is awareness.
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Prvi korak prema promjeni jest svijest
14:36
This is not just about improving
medical care for women.
medical care for women.
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koja se ne tiče samo poboljšavanja
zdravstvene skrbi za žene,
zdravstvene skrbi za žene,
14:40
This is about personalized,
individualized health care for everyone.
individualized health care for everyone.
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već se tiče i individualiziranije,
osobnije zdravstvene skrbi za sve.
osobnije zdravstvene skrbi za sve.
14:47
This awareness has the power to transform
medical care for men and women.
medical care for men and women.
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Ta svijest može promijeniti
zdravstvenu skrb za muškarce i žene.
zdravstvenu skrb za muškarce i žene.
14:54
And from now on, I want you
to ask your doctors
to ask your doctors
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Odsada pa nadalje želim
da pitate svoje liječnike
da pitate svoje liječnike
15:00
whether the treatments you are receiving
are specific to your sex and gender.
are specific to your sex and gender.
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je li terapija koju dobivate
prilagođena vašem spolu i rodu.
prilagođena vašem spolu i rodu.
15:06
They may not know the answer --
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Možda vam neće znati
odgovoriti na to pitanje -
odgovoriti na to pitanje -
15:08
yet.
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bar ne još.
15:11
But the conversation has begun,
and together we can all learn.
and together we can all learn.
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Dijalog je počeo,
a zajedno svi možemo učiti.
a zajedno svi možemo učiti.
15:15
Remember, for me
and my colleagues in this field,
and my colleagues in this field,
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Zapamtite da je meni i mojim kolegama
na ovom području
na ovom području
15:20
your sex and gender matter.
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vaš spol i rod važan.
15:23
Thank you.
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Hvala vam.
15:24
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Alyson McGregor - Women's health pioneerAlyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men.
Why you should listen
Alyson J. McGregor MD is co-founder and director for the Sex and Gender in Emergency Medicine (SGEM) Division (formerly Women’s Health in Emergency Care) within the Department of Emergency Medicine at Warren Alpert Medical School of Brown University.
Her group's aim is to establish research and educational endeavors that promote sex- and gender-specific medicine and women’s health as they relate to emergency care. Dr. McGregor received her medical degree at Boston University School of Medicine and residency training at Brown, where she continues to work as an attending physician at RI Hospital Emergency Department. Dr. McGregor is an Associate Professor of Emergency Medicine and also serves as co-director for the SGEM Fellowship and co-founder of the national organization Sex and Gender Women’s Health Collaborative.
Alyson McGregor | Speaker | TED.com