Research projects of the Equal Opportunities Office of the MHH
Further information on the project and the research content can be found here.
Gender has a major influence on health (or illness) and consequently also on healthcare. The analysis of this complex subject area has a long tradition in women's and gender studies in the social and health sciences and has recently been strengthened with the establishment of gender-sensitive medicine. Both perspectives complement each other; however, a synergy of the respective research approaches has only taken place in isolated cases to date. There is not only a need for action here, but also for theoretical-conceptual and methodological development, which we want to address with this project using the example of transplantation medicine. Based on the awareness that, in addition to pure medical expertise, erroneous assumptions ("myths") made by those treating women and men with regard to certain diseases have a strong influence on medical care, we will question some of these myths in order to equalize the unequal treatment of the sexes resulting from them at a new, higher level through improved diagnostics and therapy. One example of a myth is the often unconsciously assumed lower cardiovascular risk in women compared to men, which in the field of transplant medicine sometimes leads to inadequate diagnosis and treatment of women due to the underestimated risk.
This innovative, interdisciplinary approach will be tested using the example of kidney transplantation from an epidemiological, internal medicine, immunological and sociological perspective. In addition to a scientific evaluation, this also allows the prevailing assumptions about gender differences in treatment practice to be examined and, if necessary, corrected. On the one hand, the results of the research project are directly relevant for action and can be consolidated in the long term by feeding them into guideline processes. On the other hand, the research approach chosen here can provide important impulses for complex and integrative gender-specific research projects in all areas of medicine beyond transplantation research.
Main applicant/spokesperson:
Prof. Dr. Dr. Anette Melk, Department of Kidney, Liver and Metabolic Diseases, MHH
Subproject 1: Epidemiology of gender differences in kidney transplantation
Prof. Dr. Siegfried Geyer, Research and Teaching Unit Medical Sociology, MHH
This sub-project aims to answer the following questions: 1) Is there a difference between women and men undergoing dialysis in terms of the likelihood of being placed on the waiting list for a kidney transplant? 2) Is there a difference between women and men who are on a waiting list for a kidney transplant in terms of the likelihood of being transplanted or in terms of the length of the waiting time for transplantation? 3) Do women and men who have been transplanted differ with regard to the risks of complications after transplantation? 4) Do women and men who have been transplanted differ with regard to the risk of graft loss, i.e. return to dialysis?
Subproject 2: Gender-specific differences in the extent of diagnosis and intensity of therapy of cardiovascular end organ damage before and after kidney transplantation
PD Dr. Bernhard M.W.Schmidt, Clinical Department for Renal and Hypertensive Diseases, MHH
In view of the lower attention paid to cardiovascular disease in women in the general population, we would like to investigate the following questions: 1) Do women who are accepted for kidney transplantation differ from male patients who are accepted in terms of cardiovascular end-organ damage? 2) Is the extent of cardiovascular pre-diagnosis different in women and men? 3) Are cardiovascular diseases in women diagnosed and treated in the same way as in men after kidney transplantation?
Subproject 3: Comparison of the frequency and clinical significance of the antibody response in women and men with kidney transplants
Prof. Dr. Dr. Christine S. Falk, Institute for Transplantation Immunology, MHH
Based on the negative influence of increased PRA activity on the probability of receiving a kidney transplant and the potentially increased risk of new antibody formation after transplantation, the following questions will be addressed: 1) Is a higher HLA-specific antibody reactivity (PRA) with complement activation actually detectable in women before transplantation than in men and do mothers form the subgroup with particularly high antibody activity? 2) Do women with high panel reactivity more frequently form new true DSAs against the transplanted kidney?
Subproject 4: Verification of the experimental findings using the AOKN dataset
Prof. Dr. Siegfried Geyer, Research and Teaching Unit Medical Sociology, MHH
PD Dr. Bernhard M.W. Schmidt, Clinical Department of Renal and Hypertensive Diseases, MHH
SP4 serves to verify the findings obtained in SP2 and SP3 as part of the monocentric prospective cohort study in the anonymized health insurance data of the AOKN used in SP1, whereby treatment figures from the database are used as a proxy for the experimental and diagnostic findings. For SP2, these are findings on gender-related cardiovascular diagnostics, cardiovascular morbidity, cardiac interventions and drug measures; for SP3, therapeutic measures in a transplant rejection crisis, which are recorded as plasmapheresis, immunoglobulin or rituximab administration. It is investigated whether examination routines and correlations that are practiced in the selected patient group of a site are also generally applied. This question is aimed at the transferability of the results to the whole of Lower Saxony and ultimately to the Federal Republic of Germany. This combination of clinical and epidemiological investigation methods is an explorative, but at the same time highly innovative part of the overall project, which has not yet been practiced in this form.
Subproject 5: Gender differences in kidney transplantation - requirements for and implementation in guidelines
Prof'in Dr. Birgit Babitsch, Department of New Public Health, University of Osnabrück
1) Do national and international guidelines on kidney transplantation take gender-specific differences into account? Which gender-specific aspects are addressed in the guidelines? 2) What gender-specific differences can be identified in kidney transplantation? How should the level of evidence be assessed? 3) What significance do the identified gender differences have for high-quality treatment before, during and after kidney transplantation? How should these gender differences be integrated into the guidelines for kidney transplantation? 4) How do experts and developers assess the feasibility of implementing gender specification in the existing guidelines on kidney transplantation? What steps need to be taken during implementation?
Sub-project 6: Knowledge transfer, networking and distribution of findings in the public debate
Prof'in Dr. Christine S. Falk, Institute for Transplantation, MHH
Prof. Dr. Birgit Babitsch, Department of New Public Health, University of Osnabrück
Dr. Bärbel Miemietz, Equal Opportunities Office, MHH
One of the aims of this cross-sectional sub-project is to initiate a sustainable transfer of knowledge between the project participants and other scientists from various disciplines, in particular from the fields of transplantation medicine and gender research. The aim is to achieve an understanding of language (terminology, subject-specific jargon, everyday language) and of subject-specific working methods and organizational framework conditions. The aim is to establish a network of epidemiologists, health scientists, natural scientists and physicians who conduct research in the field of sex/gender issues. It is also planned to disseminate the findings locally (MHH), nationally (Lower Saxony and federal government) and internationally. As the project described is intended to serve as a model, the discussion and preparation of a transfer to other areas of solid organ and stem cell transplantation is an integral component. With regard to the realization of the complex and interdisciplinary research approach, an in-depth discussion with experts in gender research in medicine is being sought. Extensive preliminary work and expertise at the MHH as well as many years of networking in this field of research can already be drawn on here. The aim is also to collect knowledge and ideas for a graduate school in the field of gender-sensitive medicine, which may be envisaged at a later date.
To mark the 50th anniversary of the MHH, the Equal Opportunities Office conducted the study "The way to the top - 50 years of top careers for women at the MHH".
The anniversary provided an opportunity to take stock of the achievements of women in the male-dominated field of medicine and to use their experiences for the present and future of a more gender-equitable professional culture.
The study examined how women have succeeded in achieving leading positions in Clinical Department and science since the MHH was founded. To this end, biographical interviews were conducted with (emeritus) female professors. The project was supported by the Ministry of Science and Culture of Lower Saxony.
Project duration: October 2014 - May 2016
Project management
Dr. Bärbel Miemietz
Equal Opportunities Officer of the MHH
Carl-Neuberg-Straße 1
30625 Hanover
E-mail: gleichstellung/at/mh-hannover.de
Telephone: 0511/532-6501
Project assistant
Claudia Froböse, Dipl. Sozialwiss.
Research assistant
Carl-Neuberg-Straße 1
30625 Hanover
E-mail: froboese.claudia/at/mh-hannover.de
Telephone: 0511/532-6521
In the one-year preliminary study at Hannover Medical School, the aim was to identify the reasons for the persistently low proportion of women in top university medical positions.
For female physicians, there are apparently two decisive hurdles on the university career ladder: the phase between doctorate and habilitation and the time after habilitation, when the appointment as professor is pending or does not materialize. This second hurdle is faced above all by female senior physicians, who are often already habilitated but still have no clear career prospects. Biographical interviews were therefore used to record and analyze the previous career paths and future career intentions of female senior physicians at the MHH.
In a second step, the motivations for leaving university medicine were examined. The contrasting comparison of female senior physicians and female physicians who left the MHH promised a more differentiated view of the interplay of individual, structural and organizational factors of female career paths.
Duration: January - December 2015
Project management:
Prof. Dr. Corinna Onnen
Sociology, Institute of Social Sciences and Philosophy
University of Vechta
Driverstraße 22
49377 Vechta
e-mail: Corinna.onnen/at/uni-vechta.de,
here to the website
Co-project management:
Dr. Bärbel Miemietz
Hannover Medical School, Equal Opportunities Officer
Carl-Neuberg-Straße 1
30625 Hanover
E-mail: gleichstellung/at/mh-hannover.de
Telephone: 0511-532-6501
Project collaboration:
Monique Tannhäuser, M.A. Sociology
Institute for Social Sciences and Philosophy
University of Vechta
Driverstraße 22
49377 Vechta
Maria Neumann
Equal Opportunities Office of the Hannover Medical School
Carl-Neuberg-Straße 1
30625 Hanover
Telephone: 0511 532 6502
e-mail: Neumann.Maria/at/mh-hannover.de
Scientific publications from the Equal Opportunities Office
Froböse, Claudia; Miemietz, Bärbel (2017): A path on the precipice? Career paths of female professors using the example of a university medical center. In: Onnen, Corinna & Rode-Breymann, Susanne (eds.): On the self-image of gender studies. Methods - methodologies - theoretical discussions and empirical translations. Barbara Budrich/Budrich UniPress publishing house, 113-132.
Miemietz, Bärbel (2016/2017): Why does it actually take so long? The difficult path of sex and gender into the medical mainstream. In: Katharina Stengler (ed.): Gender Perspectives in Medicine (GPmed). Abstract volume of the conference series at the University of Leipzig. Leipzig 2016/2017, pp. 81-83. Online at: http://gender.medizin.uni-leipzig.de/fileadmin/user_upload/GPmed_Abstractband_final_web.pdf
Neumann, Maria; Meyer, Henriette; Froböse, Claudia; Miemietz, Bärbel (2017): Hopes - expectations - motives. How do young female scientists start a mentoring program? Results of a pilot study from university medicine. In: Onnen, Corinna & Rode-Breymann, Susanne (eds.): On the self-image of gender studies. Methods - methodologies - theoretical discussions and empirical translations. Barbara Budrich/Budrich UniPress publishing house, pp. 133-151.
Neumann, Maria; Froböse, Claudia; Miemietz, Bärbel (2016): On the career path. Promoting young female scientists in university medicine. Personnel and organizational development in Facilities or Institutions of teaching and research. 11, 1: 22-26.
Engelmann, Carsten; Grote, Gudela; Miemietz, Bärbel; Vaske, Bernhard & Geyer, Siegfried (2015): Gone - place passed? Deutsche Medizinische Wochenschrift. 140, 4: e28-e35.
Miemietz, Bärbel (ed.) with the collaboration of Nino Polikashvili (2013). Medicine and gender. Perspectives for teaching, research and patient care. Lengerich/Berlin/Bremen/Miami/Riga/Viernheim/Vienna/Zagreb: Pabst Science Publishers.
Miemietz, Bärbel, Ivanov, Christine, Othmer, Regine (2011): Medicine and gender: perspectives for teaching, practice and research. Conference from September 3-4, 2010 in Hanover. Gender 3rd vol. 1, pp. 144-149.
Miemietz, Bärbel, Ljiljana Verner, Larissa Burruano (2007): Integration of gender-specific content into the medical curriculum. A project to improve the quality of teaching at Hannover Medical School. In: Zeitschrift für Frauenforschung & Geschlechterstudien 25/2 (Special issue: "Gesundheitswissenschaftliche Frauen- und Geschlechterforschung - multidisziplinäre Projekte und Ansätze"), pp. 98-110.