TEDxProvidence
Alyson McGregor: Why medicine often has dangerous side effects for women
Alyson McGregor: Zakaj imajo zdravila pogosto nevarne stranske učinke za ženske
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večino preteklega stoletja, so bila odobrna zdravila testiranasamo na moških,kar je vodilo napačno doziranje in nesprejemljive stranske učinke pri ženskah. Pomombne fiziološke razlikemed moškimi in ženskami so šele pred nedavnim vzeli v obzir v medicinskem raziskovanju. Specialistka urgentne medicine Alyson McGregor preučuje terazlike in v tem navdušujočem govoru razglablja o o zgodovini za tem, kako je moški model postal okvir za medicinsko raziskovanje in kako lahko razumevanje razlik med moškim in žensko vodi v bolj učinkovito zdravljenje za oba spola.
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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Vsi obiskujemo zdravnike.
00:16
And we do so with trust and blind faith
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In slepo verjamemo
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 preiskave, ki jih opravijo
in zdravila, ki jih predpišejo
in zdravila, ki jih predpišejo
00:25
are based upon evidence --
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temeljijo na znanstvenih dokazih --
00:28
evidence that's designed to help us.
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dokazih, ki naj bi nam pomagali.
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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V resnici pa to ne drži za vsakogar.
00:39
What if I told you
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Kaj pa, če vam povem,
00:40
that the medical science discovered
over the past century
over the past century
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da so medicinski izsledki
iz zadnjih nekaj stoletij,
iz zadnjih nekaj stoletij,
00:44
has been based on only
half the population?
half the population?
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zasnovani le na polovici populacije?
00:48
I'm an emergency medicine doctor.
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Sem specialistka urgentne medicine.
00:50
I was trained to be prepared
in a medical emergency.
in a medical emergency.
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Izurjena sem bila za ukrepanje
v nujnih medicinskih primerih.
v nujnih medicinskih primerih.
00:54
It's about saving lives. How cool is that?
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Rešujem življenja. Ni to super?!
01:00
OK, there's a lot of runny noses
and stubbed toes,
and stubbed toes,
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Ja, res je veliko prehladov
in udarjenih nožnih prstov,
in udarjenih nožnih prstov,
01:03
but no matter who walks
through the door to the ER,
through the door to the ER,
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ampak vsem, ki pridejo
v urgentno ambulanto,
v urgentno ambulanto,
01:07
we order the same tests,
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opravimo enake preiskave,
01:09
we prescribe the same medication,
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predpišemo enaka zdravila,
01:11
without ever thinking about the sex
or gender of our patients.
or gender of our patients.
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brez da bi pomislili
na spol svojih pacientov.
na spol svojih pacientov.
01:17
Why would we?
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Zakaj le?
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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Nikoli nas niso učili, da obstajajo
razlike med moškimi in ženskami.
razlike med moškimi in ženskami.
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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Nedavna študija vladne odgovornosti
je pokazala, da je 80 % zdravil
je pokazala, da je 80 % zdravil
01:27
withdrawn from the market
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s trga odstranjenih
01:29
are due to side effects on women.
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zaradi stranskih učinkov pri ženskah.
01:33
So let's think about that for a minute.
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Razmislimo o tem.
01:35
Why are we discovering
side effects on women
side effects on women
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Zakaj ugotavljamo
stranske učinke pri ženskah
stranske učinke pri ženskah
01:39
only after a drug has been
released to the market?
released to the market?
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šele po tem, ko je zdravilo že na trgu?
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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Veste, da so potrebna leta,
da iz ideje razvijemo zdravilo,
da iz ideje razvijemo zdravilo,
01:49
to being tested on cells in a laboratory,
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ki ga testiramo sprva
na celicah v laboratoriju,
na celicah v laboratoriju,
01:52
to animal studies,
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nato na živalih,
01:54
to then clinical trials on humans,
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potem na ljudeh,
01:56
finally to go through
a regulatory approval process,
a regulatory approval process,
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in nato sledi še proces
nadzora pred odobritvijo.
nadzora pred odobritvijo.
02:00
to be available for your doctor
to prescribe to you?
to prescribe to you?
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Šele nato je zdravilo na
voljo zdravnikom za predpisovanje.
voljo zdravnikom za predpisovanje.
02:06
Not to mention the millions and billions
of dollars of funding
of dollars of funding
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Da sploh ne omenjam
milijonov in milijard dolarjev,
milijonov in milijard dolarjev,
02:09
it takes to go through that process.
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ki so potrebni za financiranje
takšnega procesa.
takšnega procesa.
02:13
So why are we discovering
unacceptable side effects
unacceptable side effects
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Zakaj torej odkrivamo
nesprejemljive stranske učinke
nesprejemljive stranske učinke
02:16
on half the population
after that has gone through?
after that has gone through?
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pri polovici populacije po tem,
ko smo opravili ta celoten proces?
ko smo opravili ta celoten proces?
02:23
What's happening?
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Kaj se dogaja?
02:24
Well, it turns out that those cells
used in that laboratory,
used in that laboratory,
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Izkaže se, da so tiste celice,
ki jih uporabljamo v laboratoriju,
ki jih uporabljamo v laboratoriju,
02:28
they're male cells,
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moške celice,
02:30
and the animals used
in the animal studies were male animals,
in the animal studies were male animals,
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da so živali, ki jih uporabljamo
v živalskih študijah, samci
v živalskih študijah, samci
02:34
and the clinical trials have been
performed almost exclusively on men.
performed almost exclusively on men.
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in da so tudi klinične študije opravljene
skoraj izključno na moških pacientih.
skoraj izključno na moških pacientih.
02:41
How is it that the male model became
our framework for medical research?
our framework for medical research?
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Zakaj pa so moški postali modeli
za naše medicinske raziskave?
za naše medicinske raziskave?
02:46
Let's look at an example that has been
popularized in the media,
popularized in the media,
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Oglejmo si en medijsko razvpit primer.
02:50
and it has to do
with the sleep aid Ambien.
with the sleep aid Ambien.
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Gre za sedativ z imenom Ambien.
02:53
Ambien was released on the market
over 20 years ago,
over 20 years ago,
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Ambien je na tržišče prišel
pred več kot dvajsetimi leti
pred več kot dvajsetimi leti
02:58
and since then, hundreds of millions
of prescriptions have been written,
of prescriptions have been written,
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in je bil od tedaj predpisan
na stotinam milijonov pacientov,
na stotinam milijonov pacientov,
03:03
primarily to women, because women
suffer more sleep disorders than men.
suffer more sleep disorders than men.
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predvsem pa ženskam, saj imajo
ženske pogosteje motnje spanja.
ženske pogosteje motnje spanja.
03:09
But just this past year,
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V zadnjem letu pa je
03:11
the Food and Drug Administration
recommended cutting the dose in half
recommended cutting the dose in half
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Agencija za hrano in zdravila
priporočila prepolovitev doze,
priporočila prepolovitev doze,
03:14
for women only,
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vendar le pri ženskah.
03:17
because they just realized
that women metabolize the drug
that women metabolize the drug
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Saj so ugotovili, da ženske
zdravilo presnavljajo
zdravilo presnavljajo
03:20
at a slower rate than men,
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počasneje kot moški.
03:23
causing them to wake up in the morning
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Zato se zjutraj zbudijo
03:25
with more of the active drug
in their system.
in their system.
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z več aktivnega zdravila v telesu,
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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so še omotične,
ko se usedejo za volan avtomobila
ko se usedejo za volan avtomobila
03:32
and they're at risk
for motor vehicle accidents.
for motor vehicle accidents.
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in zato tudi bolj
ogrožene za prometne nesreče.
ogrožene za prometne nesreče.
03:36
And I can't help but think,
as an emergency physician,
as an emergency physician,
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Ne morem si pomagati, da ne bi pomislila,
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 mojih pacientov, za katere sem
skrbela v preteklih letih,
skrbela v preteklih letih,
03:45
were involved in a motor vehicle accident
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je bilo udeleženih v prometnih nesrečah,
03:48
that possibly could have been prevented
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ki bi se jih dalo preprečiti,
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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če bi to analizo zdravila naredili
in primerno ukrepali pred dvajsetimi leti,
in primerno ukrepali pred dvajsetimi leti,
03:57
when this drug was first released.
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ko je zdravilo prišlo na tržišče.
04:01
How many other things need
to be analyzed by gender?
to be analyzed by gender?
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Kaj vse še moramo analizirati po spolu?
04:05
What else are we missing?
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Česa vsega še ne vemo?
04:09
World War II changed a lot of things,
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Druga svetovna vojna je
prinesla veliko sprememb
prinesla veliko sprememb
04:13
and one of them was this need
to protect people
to protect people
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in ena izmed njih je bila
potreba po zaščiti ljudi
potreba po zaščiti ljudi
04:16
from becoming victims of medical research
without informed consent.
without informed consent.
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pred sodelovanjem v medicinskih
raziskavah brez pristanka.
raziskavah brez pristanka.
04:21
So some much-needed guidelines
or rules were set into place,
or rules were set into place,
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Zato so določili nekatere nujno
potrebne smernice oziroma pravila.
potrebne smernice oziroma 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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Med drugim so želeli
zaščititi ženske v rodni dobi
zaščititi ženske v rodni dobi
04:30
from entering into any
medical research studies.
medical research studies.
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pred sodelovanjem v medicinskih študijah.
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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Bali so se, da se bo med
študijo kaj pripetilo zarodku.
študijo kaj pripetilo zarodku.
04:39
Who would be responsible?
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Kdo bi bil odgovoren za to?
04:41
And so the scientists
at this time actually thought
at this time actually thought
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Takrat so znanstveniki pravzaprav menili,
04:44
this was a blessing in disguise,
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da je ta uredba pravi blagoslov,
04:47
because let's face it -- men's bodies
are pretty homogeneous.
are pretty homogeneous.
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kajti moška telesa so precej homogena.
04:52
They don't have the constantly
fluctuating levels of hormones
fluctuating levels of hormones
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Pri moških ni stalno spreminjajočih-se
ravni hormonov,
ravni hormonov,
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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ki bi motile jasne podatke,
pridobljene le od moških.
pridobljene le od moških.
05:01
It was easier. It was cheaper.
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Tako je bilo preprosteje. In ceneje.
05:05
Not to mention, at this time,
there was a general assumption
there was a general assumption
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Da sploh ne omenjam, da so takrat mislili,
05:08
that men and women
were alike in every way,
were alike in every way,
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da so si moški in ženske
enaki v vseh pogledih,
enaki v vseh pogledih,
05:12
apart from their reproductive organs
and sex hormones.
and sex hormones.
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razen v spolnih organih in hormonih.
05:17
So it was decided:
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Padla je odločitev:
05:21
medical research was performed on men,
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medicinske raziskave
so opravljali na moških,
so opravljali na moških,
05:24
and the results were later
applied to women.
applied to women.
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rezultate pa kasneje
uporabljali na ženskah.
uporabljali na ženskah.
05:29
What did this do to the notion
of women's health?
of women's health?
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Kaj pa je to pomenilo za
koncept ženskega zdravja?
koncept ženskega zdravja?
05:32
Women's health became synonymous
with reproduction:
with reproduction:
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Zdravstvena oskrba žensk,
je postala sinonimna z reprodukcijo:
je postala sinonimna z reprodukcijo:
05:37
breasts, ovaries, uterus, pregnancy.
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prsmi, jajčniki, maternico in nosečnostjo.
05:42
It's this term we now refer
to as "bikini medicine."
to as "bikini medicine."
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Temu danes rečemo "bikini medicina."
05:46
And this stayed this way
until about the 1980s,
until about the 1980s,
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In tako je ostalo do
osemdesetih let 20. stoletja,
osemdesetih let 20. stoletja,
05:49
when this concept was challenged
by the medical community
by the medical community
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ko so medicinska skupnost
05:52
and by the public health policymakers
when they realized that
when they realized that
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in javnozdravstveni zakonodajalci
spoznali,
spoznali,
05:56
by excluding women
from all medical research studies
from all medical research studies
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da so ženskam z izključitvijo
iz medicinskih raziskav,
iz medicinskih raziskav,
06:01
we actually did them a disservice,
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povzročili škodo.
06:04
in that apart from reproductive issues,
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Saj z izjemo reprodukcije,
06:06
virtually nothing was known
about the unique needs
about the unique needs
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ni bilo nič znanega o edinstvenih potrebah
06:09
of the female patient.
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ženskih pacientk.
06:12
Since that time, an overwhelming amount
of evidence has come to light
of evidence has come to light
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Od tedaj smo odkrili ogromno dokazov,
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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ki kažejo številne razlike med
moškimi in ženskami na vseh področjih.
moškimi in ženskami na vseh področjih.
06:29
You know, we have this saying in medicine:
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Veste, v medicini imamo izrek:
06:32
children are not just little adults.
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"Otroci niso le pomanjšani odrasli."
06:36
And we say that to remind ourselves
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Ta izrek nam služi v opomin,
06:38
that children actually have
a different physiology than normal adults.
a different physiology than normal adults.
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da imajo otroci dejansko drugačno
fiziologijo kot normalni odrasli.
fiziologijo kot normalni odrasli.
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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Zaradi tega je tudi nastala
medicinska specializacija pediatrija.
medicinska specializacija pediatrija.
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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Sedaj na otrocih tudi izvajamo raziskave,
da bi izboljšali njihova življenja.
da bi izboljšali njihova življenja.
06:57
And I know the same thing
can be said about women.
can be said about women.
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Vem, da enako lahko rečemo tudi za ženske.
06:59
Women are not just men
with boobs and tubes.
with boobs and tubes.
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Ženske niso le moški s prsmi in jajčniki,
07:06
But they have their own
anatomy and physiology
anatomy and physiology
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pač pa imajo lastno
anatomijo in fiziologijo,
anatomijo in fiziologijo,
07:10
that deserves to be studied
with the same intensity.
with the same intensity.
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ki sta vredni enako
intenzivnega preučevanja.
intenzivnega preučevanja.
07:15
Let's take the cardiovascular
system, for example.
system, for example.
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Vzemimo na primer srčnožilni sistem.
07:18
This area in medicine has done the most
to try to figure out
to try to figure out
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Na tem področju si zelo
močno prizadevajo odkriti
močno prizadevajo odkriti
07:22
why it seems men and women have
completely different heart attacks.
completely different heart attacks.
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zakaj imajo moški in ženske drugačne
oblike srčnih kapi.
oblike srčnih kapi.
07:27
Heart disease is the number one killer
for both men and women,
for both men and women,
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Bolezni srca so najpogostejši vzrok
smrti tako pri moških kot pri ženskah,
smrti tako pri moških kot pri ženskah,
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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vendar, v primerjavi z moškimi, več žensk
umre v prvem letu po srčni kapi.
umre v prvem letu po srčni kapi.
07:39
Men will complain
of crushing chest pain --
of crushing chest pain --
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Moški bodo potožili, da imajo
tiščočo bolečino v prsih...
tiščočo bolečino v prsih...
07:43
an elephant is sitting on their chest.
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kot bi jim slon sedel na prsih.
07:46
And we call this typical.
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In mi rečemo, da je to tipično.
07:49
Women have chest pain, too.
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Tudi ženske občutijo bolečino v prsih.
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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A ženske pogosteje kot moški potožijo,
da se "enostavno ne počutijo dobro,"
da se "enostavno ne počutijo dobro,"
08:00
"can't seem to get enough air in,"
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"ne morejo zajeti dovolj sape,"
08:03
"just so tired lately."
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"so zadnje čase zelo utrujene."
08:07
And for some reason we call this atypical,
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In iz nekega razloga mi
to označimo za atipično,
to označimo za atipično,
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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čeprav, kot sem že omenila,
ženske predstavljajo polovico populacije.
ženske predstavljajo polovico 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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Kateri dokazi nam torej
pomagajo pojasniti te razlike?
pomagajo pojasniti te razlike?
08:21
If we look at the anatomy,
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Če si ogledamo anatomijo
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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vidimo, da so krvne žile okoli srca
pri ženskah manjše kot pri moških
pri ženskah manjše kot pri moških
08:30
and the way that those blood vessels
develop disease is different
develop disease is different
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in razvoj bolezni v teh žilah je drugačen
08:35
in women compared to men.
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pri ženskah v primerjavi z moškimi.
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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Tudi testi, ki jih uporabljamo za
določanje ogroženosti za srčno kap,
določanje ogroženosti za srčno kap,
08:43
well, they were initially designed
and tested and perfected in men,
and tested and perfected in men,
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so bili prvotno zasnovani, preizkušeni
in izpopolnjeni za moške
in izpopolnjeni za moške
08:47
and so aren't as good
at determining that in women.
at determining that in women.
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in posledično pri ženskah ne
delujejo enako dobro.
delujejo enako dobro.
08:52
And then if we think
about the medications --
about the medications --
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In če si sedaj ogledamo še zdravila...
08:55
common medications
that we use, like aspirin.
that we use, like aspirin.
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pogosto uporabljena zdravila,
na primer Aspirin.
na primer Aspirin.
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 moškim,
da preprečimo srčno kap.
da preprečimo srčno kap.
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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Ampak ali veste, da je predpisovanje
Aspirina zdravim ženskam
Aspirina zdravim ženskam
09:08
it's actually harmful?
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v resnici škodljivo?
09:12
What this is doing is merely telling us
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Kar nam ta primer pove, je,
09:14
that we are scratching the surface.
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da je to le vrh ledene gore.
09:19
Emergency medicine
is a fast-paced business.
is a fast-paced business.
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Urgentna medicina je
naglo razvijajoče-se področje.
naglo razvijajoče-se področje.
09:23
In how many life-saving areas of medicine,
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Na koliko življenjsko pomembnih
področjih medicine,
področjih medicine,
09:26
like cancer and stroke,
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na primer rakavih boleznih in infarktih,
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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obstajajo pomembne razlike med spoloma,
ki bi jih lahko s pridom uporabljali?
ki bi jih lahko s pridom uporabljali?
09:36
Or even, why is it that some people
get those runny noses
get those runny noses
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Celo pri vprašanju zakaj so
nekateri pogosteje prehlajeni
nekateri pogosteje prehlajeni
09:41
more than others,
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kot ostali.
09:43
or why the pain medication that we give
to those stubbed toes
to those stubbed toes
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Ali zakaj protibolečinska zdravila
pri tistih udarninah prstov
pri tistih udarninah prstov
09:46
work in some and not in others?
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nekaterim pomagajo, drugim pa ne.
09:53
The Institute of Medicine has said
every cell has a sex.
every cell has a sex.
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Inštitut za Medicino pravi,
da ima vsaka celica spol.
da ima vsaka celica spol.
09:59
What does this mean?
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Kaj to pomeni?
10:02
Sex is DNA.
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Spol je DNA.
10:04
Gender is how someone
presents themselves in society.
presents themselves in society.
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Spol v socialnem smislu, pa označuje
kako se človek predstavlja v družbi.
kako se človek predstavlja v družbi.
10:09
And these two may not always match up,
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Ta dva koncepta se ne ujemata vedno,
10:12
as we can see with our
transgendered population.
transgendered population.
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kar opazimo pri transseksualni populaciji.
10:16
But it's important to realize
that from the moment of conception,
that from the moment of conception,
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Pomembno pa se je zavedati,
da od trenutka spočetja
da od trenutka spočetja
10:21
every cell in our bodies --
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vsaka celica v našem telesu,
10:23
skin, hair, heart and lungs --
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kožna, srčna, pljučna ali celica las,
10:27
contains our own unique DNA,
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vsebuje našo edinstveno DNA
10:30
and that DNA contains
the chromosomes that determine
the chromosomes that determine
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in ta DNA vključuje kromosome,
ki določajo
ki določajo
10:34
whether we become
male or female, man or woman.
male or female, man or woman.
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ali bomo postali moški ali ženska.
10:40
It used to be thought
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Včasih so mislili,
10:42
that those sex-determining
chromosomes pictured here --
chromosomes pictured here --
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da spolni kromosomi na sliki,
10:46
XY if you're male, XX if you're female --
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XY za moške, XX za ženske,
10:49
merely determined whether you
would be born with ovaries or testes,
would be born with ovaries or testes,
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določajo le, ali se bo človek
rodil z jajčniki ali testisi.
rodil z jajčniki ali testisi.
10:54
and it was the sex hormones
that those organs produced
that those organs produced
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Spolni hormoni,
ki jih ta organa izdelujeta,
ki jih ta organa izdelujeta,
10:58
that were responsible for the differences
we see in the opposite sex.
we see in the opposite sex.
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pa naj bi bili odgovorni za
ostale razlike med spoloma.
ostale razlike med spoloma.
11:04
But we now know that
that theory was wrong --
that theory was wrong --
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Danes pa vemo, da je ta teorija napačna,
11:09
or it's at least a little incomplete.
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oziroma vsaj nepopolna.
11:12
And thankfully, scientists like Dr. Page
from the Whitehead Institute,
from the Whitehead Institute,
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Na srečo so znanstveniki kot dr. Page
iz Inštituta Whitehead,
iz Inštituta Whitehead,
11:16
who works on the Y chromosome,
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ki raziskuje kromosom Y
11:18
and Doctor Yang from UCLA,
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in doktor Yang iz UCLA,
11:21
they have found evidence that tells us
that those sex-determining chromosomes
that those sex-determining chromosomes
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odkrili dokaze, da spolni kromosomi,
11:26
that are in every cell in our bodies
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ki se nahajajo v vseh telesnih celicah,
11:29
continue to remain active
for our entire lives
for our entire lives
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ostanejo aktivni skozi celotno življenje
11:36
and could be what's responsible
for the differences we see
for the differences we see
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in bi lahko bili odgovorni za razlike
11:40
in the dosing of drugs,
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pri doziranju zdravil
11:42
or why there are differences
between men and women
between men and women
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ali za razlike med moškimi in ženskami pri
11:45
in the susceptibility
and severity of diseases.
and severity of diseases.
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dovzetnosti za bolezni
in resnosti bolezni.
in resnosti bolezni.
11:51
This new knowledge is the game-changer,
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Ta nova spoznanja spremenijo vse
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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in naloga znanstvenikov je, da nadaljujejo
z odkrivanjem novih dokazov,
z odkrivanjem novih dokazov,
12:00
but it's up to the clinicians
to start translating this data
to start translating this data
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vendar pa je tudi naloga zdravnikov,
da pričnejo uporabljati te podatke
da pričnejo uporabljati te podatke
12:05
at the bedside, today.
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ob bolnikovi postelji, še danes.
12:09
Right now.
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Takoj zdaj.
12:13
And to help do this, I'm a co-founder
of a national organization
of a national organization
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Da bi pomagala pri tem, sem
soustanoviteljica nacionalne zveze
soustanoviteljica nacionalne zveze
12:16
called Sex and Gender
Women's Health Collaborative,
Women's Health Collaborative,
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imenovane Spol: Skupnost za zdravje žensk,
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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kjer zbiramo vse te podatke,
zato da so dostopni za poučevanje
zato da so dostopni za poučevanje
12:24
and for patient care.
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in skrb za paciente.
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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Trudimo se vključiti tudi
medicinske izobraževalne ustanove.
medicinske izobraževalne ustanove.
12:31
That's a big job.
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To je pomembno delo.
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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Spreminjmo način poučevanja medicine,
ki je bil uveljavljen od samega začetka.
ki je bil uveljavljen od samega začetka.
12:41
But I believe in them.
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Vendar jaz verjamem vanje.
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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Vem, da bodo sprevideli koristnost
vključitve razlik med spoloma
vključitve razlik med spoloma
12:49
into the current curriculum.
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v sedanji učni načrt.
12:52
It's about training the future
health care providers correctly.
health care providers correctly.
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Gre se za to, da pravilno izučimo
bodoče izvajalce zdravstvenih storitev.
bodoče izvajalce zdravstvenih storitev.
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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pa sem soustanoviteljica divizije
znotraj oddelka za urgentno medicino
znotraj oddelka za urgentno medicino
13:05
here at Brown University,
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tu na Univerzi Brown,
13:07
called Sex and Gender
in Emergency Medicine,
in Emergency Medicine,
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ki se imenuje Spol v urgentni medicini.
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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Tu izvajamo raziskave s katerimi
ugotavljamo razlike med spoloma
ugotavljamo razlike med spoloma
13:14
in emergent conditions,
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v urgentnih stanjih,
13:16
like heart disease and stroke
and sepsis and substance abuse,
and sepsis and substance abuse,
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na primer srčnih boleznih in kapi,
sepsi in zlorabi prepovedanih drog.
sepsi in zlorabi prepovedanih drog.
13:21
but we also believe
that education is paramount.
that education is paramount.
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Hkrati pa verjamemo, da je
izobraževanje ključno.
izobraževanje ključno.
13:27
We've created a 360-degree
model of education.
model of education.
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Razvili smo vse-vključujoč
model izobrazbe.
model izobrazbe.
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 izobraževalne programe za zdravnike,
medicinske tehnike, študente
medicinske tehnike, študente
13:37
and for the patients.
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in za paciente.
13:39
Because this cannot just be left up
to the health care leaders.
to the health care leaders.
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Kajti tega problema ne moremo prepustiti
le izvajalcem zdravstvenih storitev.
le izvajalcem zdravstvenih storitev.
13:44
We all have a role in making a difference.
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Vsi imamo vlogo pri spreminjanju
sedanjega stanja.
sedanjega stanja.
13:48
But I must warn you: this is not easy.
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Moram pa vas posvariti,
da to ni preprosto.
da to ni preprosto.
13:53
In fact, it's hard.
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Pravzaprav je težko.
13:57
It's essentially changing the way
we think about medicine
we think about medicine
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V bistvu želimo spremeniti način,
kako razmišljamo o medicini,
kako razmišljamo o medicini,
14:01
and health and research.
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zdravju in raziskovanju.
14:05
It's changing our relationship
to the health care system.
to the health care system.
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Spreminjamo naš odnos do
zdravstvenega sistema.
zdravstvenega sistema.
14:09
But there's no going back.
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A ni poti nazaj.
14:13
We now know just enough
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Vemo ravno dovolj,
14:17
to know that we weren't doing it right.
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da se zavedamo, da smo se prej motili.
14:21
Martin Luther King, Jr. has said,
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Martin Luther King mlajši je rekel:
14:24
"Change does not roll in
on the wheels of inevitability,
on the wheels of inevitability,
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"Spremembe niso neizbežne,
14:28
but comes through continuous struggle."
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zanje je potreben neprestan trud."
14:32
And the first step
towards change is awareness.
towards change is awareness.
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Prvi korak proti spremembi
pa je zavedanje.
pa je zavedanje.
14:36
This is not just about improving
medical care for women.
medical care for women.
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Ne gre se samo za izboljšanje
zdravstvene oskrbe za ženske.
zdravstvene oskrbe za ženske.
14:40
This is about personalized,
individualized health care for everyone.
individualized health care for everyone.
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Gre za personalizirano, individualizirano
zdravstveno oskrbo za vse.
zdravstveno oskrbo za vse.
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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Zavedanje tega lahko spremeni medicinsko
oskrbo tako za moške kot za ženske.
oskrbo tako za moške kot za ženske.
14:54
And from now on, I want you
to ask your doctors
to ask your doctors
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Želim si, da od sedaj naprej vprašate
svojega zdravnika
svojega zdravnika
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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ali je terapija, ki jo prejemate,
namenjena prav vašemu spolu.
namenjena prav vašemu spolu.
15:06
They may not know the answer --
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Mogoče vam ne bodo znali odgovoriti...
15:08
yet.
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še.
15:11
But the conversation has begun,
and together we can all learn.
and together we can all learn.
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Ampak ta pogovor se je že začel
in skupaj se lahko vsi učimo.
in skupaj se lahko vsi učimo.
15:15
Remember, for me
and my colleagues in this field,
and my colleagues in this field,
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Zapomnite si, da je zame in moje
kolege na tem področju
kolege na tem področju
15:20
your sex and gender matter.
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vaš spol pomemben.
15:23
Thank you.
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Hvala vam.
15:24
(Applause)
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(Aplavz)
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