Margarethe Hochleitner

The Mosque Campaign: a cardiovascular prevention program for female Turkish immigrants

ZusammenfassungHINTERGRUND: Das Frauengesundheitsbüro des Landes Tirol, Österreich, führt regelmäßig Informations- und Präventionskampagnen speziell für Frauen zum Thema Herz-Kreislauf-Erkrankungen durch. Türkischstämmige Frauen nahmen bislang jedoch nicht an den zahlreichen Veranstaltungen teil. Das Ziel der Moscheen-Kampagne war es, ein türkischsprachiges kultursensibles Herz-Kreislauf-Präventionsprogramm speziell für Türkinnen durchzuführen, um eine Verbesserung des Wissens um Risikofaktoren zu erzielen und bestehende kulturelle und sprachliche Barrieren abzubauen. METHODIK: Das Pilotprojekt wurde während der Schuljahre 1999/00, 2000/01 sowie 2001/02 in allen 28 Moscheen in Tirol durchgeführt. Nach einem türkischsprachigen Vortrag und der Möglichkeit eines ärztlichen Beratungsgesprächs beantworteten insgesamt 2446 Frauen einen Fragebogen zur persönlichen Einschätzung eigener Herz-Kreislauf-Risikofaktoren. Zusätzlich wurden 1992 Blutdruckmessungen durchgeführt. ERGEBNIS: Die überwiegende Mehrzahl zählte zur ersten Generation weiblicher Migrantinnen und gab an, keine deutschsprachigen Medien zu nutzen. Ein Drittel empfand sich selbst als übergewichtig. Mehr als 13 % zeigten entweder einen erhöhten systolischen und/oder diastolischen Blutdruck. Von 1999/00 bis 2001/02 nahm die Unwissenheit der befragten Türkinnen um Herz-Kreislauf-Erkrankungen signifikant ab: Gesamtcholesterin von 57,4 % auf 32,4 % (p < 0,001), Blutdruck von 41,3 % auf 29,6 % (p < 0,001) und Blutzucker von 49,7 % auf 25,2 % (p < 0,001). SCHLUSSFOLGERUNGEN: Obwohl in Österreich ein freier Zugang zum Gesundheitssystem gewährleistet wird, war eine große Zahl der befragten türkischstämmigen Migrantinnen nicht über Risikofaktoren von Herz-Kreislauf-Erkrankungen informiert. Die Moscheen-Kampagne bewährte sich als eine effektive Methode, um Aufklärungsarbeit zu leisten und türkischstämmige Frauen zu erreichen. Sprachlich angepasste und kultursensible Programme sind notwendig um die Situation ethnischer Minderheiten zu verbessern und die notwendige Gleichstellung zu sichern.SummaryBACKGROUND: The Womens Health Office of the State of Tyrol, Austria, provides cardiovascular disease (CVD) prevention programs for women. However, local Turkish women have not participated in our programs. The aim of the so-called Mosque Campaign was to conduct a Turkish-language, culture-sensitive CVD prevention program tailored to the needs of Turkish women to improve their knowledge of CVD risk factors and to minimize ethnic differences in participation rates for preventive programs. METHODS: The pilot program was conducted in all 28 mosques in Tyrol during the years 1999/00, 2000/01 and 2001/02. A Turkish educational lecture and the opportunity for a private medical consultation were provided, and 2,446 Turkish women completed a questionnaire on their personal knowledge of CVD. In addition a total of 1,992 blood pressure readings were taken. RESULTS: Most of the women belonged to the first generation of female immigrants and reported not using German-language media. About one-third of the women considered themselves to be obese. More than 13 % had raised systolic and/or diastolic blood pressure. We observed a significant decrease in unawareness of the main CVD risk factors from 1999/00 to 2001/02: unawareness of cholesterol level decreased from 57.4 % to 32.4 % (p < 0.001), of blood pressure from 41.3 % to 29.6 % (p < 0.001) and of blood glucose from 49.7 % to 25.2 % (p < 0.001). CONCLUSIONS: Even though Austria provides free access to healthcare services, a large number of Turkish women were not aware of their CVD risk factors. The Mosque Campaign reached female Turkish migrants and was effective in reducing their level of unawareness about CVD. Language-adapted and culture-sensitive programs are necessary to ensure greater equality for ethnic minority groups.

The Health of Women and Girls Determines the Health and Well-Being of Our Modern World: A White Paper From the International Council on Women's Health Issues

The International Council on Womens Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of womens health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girls health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally.

How do we get gender medicine into medical education

Gender medicine, which takes a differentiated look at human beings as individuals and aims to provide targeted, gender-specific medical care, is slowly gaining recognition and acceptance. Nevertheless, this medical science that cuts across all medical disciplines has been only marginally incorporated into medical education curricula. The authors will look at the incorporation of gender medicine into the curriculum of Innsbruck Medical University to discuss the factors and the strategy that helped to establish it.

Mediation analysis of the relationship between sex, cardiovascular risk factors and mortality from coronary heart disease: Findings from the population-based VHM&PP cohort.

BACKGROUND In Europe, annually about 77,000 women, but 253,000 men die prematurely from coronary heart disease (CHD) before the age of 65 years. This gap narrows with increasing age and disappears after the eighth life decade. However, little is known regarding the contribution of cardiovascular risk factors to this sex difference. OBJECTIVE We investigated to what extent mens higher risk of dying from CHD is explained through a different risk factor profile, as compared to women. METHODS Mediation analysis technique was used to assess the specific contributions of blood pressure, cholesterol, glucose, and smoking to the difference between men and women regarding CHD mortality in a large Austrian cohort consisting of 117,264 individuals younger than 50 years (as a proxy for pre-menopausal status) and 54,998 older ones, with 3892 deaths due to CHD during a median follow-up of 14.6 years. RESULTS Adjusting for age and year of examination, we observed a male versus female CHD mortality hazard ratio (HR) of 4.7 (95% CI: 3.4-5.9) in individuals younger than 50 years, of which 40.9% (95% CI: 27.1%-54.7%) was explained through risk factor pathways, mainly through blood pressure. In older participants, there was a HR of 1.9 (95% CI: 1.8-2.0) of which 8.2% (95% CI: 4.6%-11.7%) was mediated through the risk factors. CONCLUSION The extent to which major risk factors contribute to the sex difference regarding CHD mortality decreases with age. The female survival advantage was explained to a substantial part through the pathways of major risk factors only in younger individuals.

Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators

BackgroundMistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students’ perception of university climate for reporting sexual harassment was assessed.MethodIn the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students’ experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment.ResultThe most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men.ConclusionMistreatment of female and male students should be focused on using a gender perspective because types of mistreatment can differ by gender. Additionally, interventions should include the societal level as there was a high prevalence of mistreatment perpetrated by strangers. Also the issue of trust in the university needs to be addressed and the organization is called on to visibly demonstrate that it represents and protects its students as well as its staff.

Support for Female Physicians at a University Hospital: What Do Differences Between Female and Male Physicians Tell Us?

The focus of this chapter is on the support and the challenges experienced by female physicians in the formerly male-dominated medical profession. This study was part of a project investigating physicians at university hospitals in seven European countries: 111 physicians (44 women, 67 men) from Austria participated in the study. It examined how women experience being supported by others and how these findings contribute to an understanding of support mechanisms for women. Findings show more similarities than differences between women and men. It is noteworthy that being a parent had an effect on women, but not on men, for example in terms of being less often a research leader, and feeling more supported by other health care personnel. The findings suggest that a gender segregation of women and men in private life might extend to their professional life. This raises the question what are the resources that offer the best possible support for female physicians at university hospitals.

Validation of the Internal Structure of a German-Language Version of the Gender Role Conflict Scale – Short Form

The Gender Role Conflict Scale – Short Form (GRCS-SF) assesses a person’s masculine gender role conflict. Masculine gender role conflict results when a person experiences discomfort showing a certain behavior because it is in conflict with masculine norms. The aim of the study was to test the questionnaire’s psychometric properties in an Austrian sample of older men. Three alternative structural models of the GRCS-SF were tested with confirmatory factor analyses (CFA). The maximum-likelihood method and the Bollen–Stine Bootstrap Method were used to estimate the fit indices of the CFA. Convergent validity was tested by correlating the GRCS-SF with the Sexual Performance Belief Scale (SPBS). Participating in the study were 127 male in-patients of a university hospital. Men’s average age was 59.5 (SD = 14.6) years. The one-factor model did not fit the empirical data well. In contrast, both the four-factor structure model and the bifactor structure model were supported. Good internal consistencies indicated acceptable reliabilities of the questionnaire’s scales. As expected, moderate to large correlations with the SPBS were detected. These findings support the claim that the GRCS-SF is a reliable and valid tool for assessing men’s gender role conflict also in a sample of older men in Austria.

Gender-related Outcome in Bladder Cancer Patients undergoing Radical Cystectomy

Background: The impact of gender on oncological outcome after radical cystectomy (RC) is not fully understood yet. The aim of the study was to evaluate gender-related differences in histopathological parameters and prognosis of patients with bladder cancer undergoing RC. Methods: A retrospective analysis of a 10-year single-center cystectomy database was performed. Kaplan-Meier survival and Cox-regression analyses with sex-specific interactions were performed to determine the impact of gender on recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS), in addition to established clinicopathological factors. Results: 259 patients (212 [81.8%] men and 47 [18.2%] women) were enrolled. Although women had a greater propensity for extravesical (≥pT3) disease (53.2% vs. 33.9%, p=0.03) and heterotopic urinary diversion (72.3% vs. 49.5%, p=0.006), gender did not independently predict RFS, CSS or OS on multivariate analysis. Extravesical tumor disease was the sole independent predictor concerning RFS (hazard ratio [HR]=4.70; p<0.001), CCS (HR=2.77; p=0.013), and OS (HR=1.93; p=0.041). Orthotopic urinary diversion (HR=0.36; p=0.002) had an independent effect only on RFS. Rates of 5-year RFS (73.7% vs. 48.3%; p=0.001), CSS (72.5% vs. 44.9%; p<0.001) and OS (62.6% vs. 37.8%; p<0.001) were higher in orthotopic versus heterotopic diversions. Conclusion: In our series, women presented with more advanced tumors and higher rates of heterotopic urinary diversions, but their survival outcome was not significantly inferior to that of men. Extravesical disease was independently related to poorer survival after RC.

Abortion as one aspect of Women's Health

ABSTRACT Womens Health is closely tied to sexuality. In the European context the European Womens Rights Movement fought for womens sexual rights and the right of women to self-determination over a womans own body. However, there appears to still be an ongoing struggle to have such rights (e.g. abortion) reflected in legislation. In response to the article “Womens Health as an Ideological and Political Issue: Restricting the Right to Abortion, Access to In Vitro Fertilization Procedures and Prenatal Testing in Poland” (Żuk & Żuk, 2017), the potential influence of the Catholic Church on abortion legislation is discussed. In this connection Austria is used as example to illustrate differences in the influence of the Catholic Church in predominantly Catholic countries. Additional aspects of womens sexual and reproductive rights are included in this comment, such as access to contraceptives, emergency contraceptives, cost coverage and quality of health care. Given the development of the political situation in Europe, womens rights and Womens Health are in danger of becoming a victim of recent political developments. Thus, a close look at these matters is needed.

Drafting Intersections in the Career of Female Medical Doctors

Abstract The predicted doctors’ shortage in Austria and the increasing feminisation of the medical profession are aspects of a passionate debate on gender inequality in medical careers and particularly on sufficient medical care in Austria. Therefore, this review summarises main findings on gender inequality in medical careers in Austria using an intersectional lens. The intersections derived from literature elucidate that gender inequality is not predominantly dependent on having a family including children, but that various combinations of these intersections influence women’s careers. There is a need to further investigate intersections influencing medical careers in women and to relate these to affirmative action measures. Affirmative action measures need quotas and consideration of various areas besides work–family balance. There is a need to evaluate and adapt interventions to promote women in medicine according to the intersections derived from the literature.