Sex-disaggregated Data Research Articles

Sex-specific prediction of cardiogenic shock complicating acute coronary syndromes: the SEX-SHOCK score

Abstract Background Mortality of cardiogenic shock (CS) complicating acute coronary syndromes (ACS) remained nearly unchanged over the last two decades. Female CS patients are less likely to receive guideline recommended care, while having worse in-hospital outcomes as compared to males.1 Presently available tools to assess the risk of developing CS in the setting of ACS, such as the ORBI risk score, were developed in predominantly male patient populations, while not considering inflammatory mediators or proxies of cardiorenal function. Purpose The present study aimed (i) to test the sex-specific performance of the ORBI model to predict in-hospital CS in patients presenting with ACS, and (ii) to develop and externally validate a better performing risk prediction model for both, women and men. Methods Among 44’220 ACS patients recruited in the Swiss AMIS-Plus study, the sex-specific performance of the ORBI risk score to estimate the probability for the development of CS was tested. By harnessing regression- and machine-learning based modelling approaches (ie, random forest [RF], multiple layer perceptron [MLR], and logistic regression [LR]), independent predictors of in-hospital CS were identified in sex-disaggregated data. Best performing models and variables were then used to develop SEX-SHOCK, a novel risk prediction model that accounts for sex-specific disease characteristics. External validation was done in 4’787 ACS patients recruited in the SPUM-ACS study. Results The ORBI risk prediction model demonstrated lower discriminatory performance in female patients relative to males (AUC [95%CI]: 0.76 (0.74-0.78) vs. 0.81(0.80-0.83); p<0.001). RF, MLR, and LR identified C-reactive protein, creatinine, left-ventricular function, and ST-segment elevation as most potent predictors of in-hospital CS beyond the parameters included in ORBI, with the performance of LR-based models superseding those of RF and MLR. By combining most important predictors with best performing models, the SEX-SHOCK score was developed, showing superior performance as compared to ORBI in both females (AUC 0.80, 95%CI 0.78-0.82; p<0.01) and males ACS patients (AUC 0.83, 0.82-0.85; p<0.001), which prevailed upon 10-fold cross validation. Following external validation in SPUM-ACS, SEX-SHOCK showed improved discriminatory performance over ORBI in both females (0.84, 95% CI 0.78-0.89; p<0.05) and males (0.81, 95% CI 0.78-0.85; p<0.01), with the most pronounced improvement observed in female patients (△C-statistics%=6.23 vs. 2.79%; p <0.001). Conclusion Our study highlights important sex differences in the performance of available tools for risk prediction of developing in-hospital CS among patients presenting with ACS. By harnessing regression- and machine-learning-based approaches, the SEX-SHOCK risk score was developed, outperforming existing risk prediction models in internal and external validation cohorts.

Biological Sex Is an Effect Modifier of Allergen-Mediated Alteration of the Lung Proteome.

Asthma exhibits a distinct sex bias in the disease prevalence, severity, and response to therapy. However, sex-related differences in alterations of the lung proteome mediated by aeroallergens critical in asthma, such as house dust mites (HDM), remain unknown. In this study, we define sex-related differences in the lung proteome using an HDM-challenged mouse model by 1D LC-MS/MS. Sex-disaggregated data analysis showed that 406 proteins were uniquely altered in females, 273 proteins were uniquely altered in males, and 414 proteins were altered in both females and males in response to HDM. In a linear mixed model analysis, sex modified the HDM exposure effect for 163 proteins, i.e., a significant sex:exposure interaction was identified in 84 proteins in females and 35 proteins in males. Of these, 12 proteins showed a significant sex effect in both female and male lungs. We further selected 3 proteins Tjp1, Lamtor1, and G3BP2 for independent confirmation studies. Our findings detail the sex-specific lung proteome in response to an aeroallergen critical in asthma and demonstrate that sex is a significant effect modifier of HDM response. These results will serve as a valuable resource for delineating sex-specific mechanisms in aeroallergen-driven responses in asthma research.

Interventions promoting resilience through climate smart agricultural practices for women farmers: A systematic review.

Climate change poses a significant threat to agricultural production worldwide, with developing countries being particularly vulnerable to its negative impacts. Agriculture, which is a crucial factor in ensuring food security and livelihoods, is particularly vulnerable to changes in climate patterns, such as increased temperatures, drought, and extreme weather events. One approach to addressing these challenges is by promoting the adoption of climate-smart agriculture (CSA) practices among farmers. CSA combines traditional agricultural practices with innovative techniques and technologies to adapt to and mitigate the impacts of climate change. infrastructure. By adopting CSA practices, farmers can enhance their resilience to climate variability and improve their productivity. This review examines the effectiveness of interventions promoting CSA to enhance farmers' knowledge of the benefits of CSA approaches, subsequent adoption of CSA, and disadoption of harmful agricultural practices in low- and middle-income countries (LMICs). We searched 39 academic and online databases, websites, and repositories and screened over 19,000 experimental and quasi-experimental publications to identify studies promoting CSA practices to women farmers. We conducted a citation tracking process on included studies and contacted experts to ensure a thorough search. The review focused on studies that included interventions promoting climate-smart agricultural approaches. Using EPPI Reviewer 4, two review authors independently screened the impact evaluation using a standardized screening tool. Information about participant characteristics, intervention characteristics, control conditions, research design, sample size, bias risk, outcomes, and results were gathered. Data collection and quantitative analysis were conducted using standard Campbell Collaboration methods. Eight impact evaluations were found (two randomized controlled trials) evaluating the effects of CSA practices on farmer's knowledge gains of the benefits of CSA practices and subsequent adoption. Knowledge dissemination approaches such as Farmer Field Schools and weather and climate information services were found to positively impact farmers' knowledge and adoption of specific CSA practices. However, the evidence supporting this claim is uncertain as a high risk of bias was assessed for five of the eight included studies. However, we found no effects on the disadoption of harmful practices such as pesticide overuse. The evidence base for studies promoting climate-smart agricultural approaches (CSA) to farmers in LMICs is small, and there is a lack of studies reporting sex-disaggregated data and studies explicitly targeting women farmers. The review suggests that knowledge dissemination techniques are significantly effective in improving CSA knowledge and adoption, including integrated pest management techniques and their benefits, adoption of climate-resilient rice seed varieties (STRVs), and use of botanical pesticides by farmers. More and better confidence studies are needed to inform policy and programming, including those that look at a wider range of interventions, including changing norms, values, and institutional arrangements.

Pathways to leadership: what accounts for women’s (in)equitable career paths in the health sectors in India and Kenya? A scoping review

ObjectivesWe aimed to capture evidence on enablers and barriers to improving equal opportunity and effective organisational interventions that can advance women’s leadership in India and Kenya’s health sectors.MethodsWe systematically searched...

Second Language Writing Anxiety among Faculty Scholars of a State University in the Philippines and Its Sex-Disaggregated Data

The study investigated the causes and the nature of writing anxiety specifically in the use of English as the second official language of the Philippines. Further, it accounted and analyzed its sex-disaggregated data. This was done among faculty scholars of Central Luzon State University. The respondents were randomly chosen from among the purposively identified faculty scholars of the university pursuing their graduate degrees - master’s and doctorate, in the different graduate curricular offerings in various universities in the Philippines and abroad, that require a thesis or dissertation as the final requirement for obtaining a graduate degree. The Second Language Writing Anxiety Inventory (SLWAI) of Cheng (2004), a questionnaire composed of 22 items with three open-ended questions was used to collect responses. The responses were scored and measured on a five-point Likert response scale. The differences in Second Language Writing Anxiety (SLWA) between male and female participants were analyzed using the Mann-Whitney Test, which is ideal for analyzing statistically the difference between the distributions of data of unparalleled groups with the comparison of ranks and scores. Based on the study findings, the most prominent nature of SLWA among participants is cognitive anxiety. Other sources of anxiety include the availability of external and internal resources and environmental elements. In relation to sex, males scored higher in terms of the level of anxiety compared to females. Lastly, it is forwarded that educators and the pedagogical approach may utilize a positive feedback mechanism as negative evaluation promotes anxiety even in composing in a second language.

Post-COVID-19 condition: a sex-based analysis of clinical and laboratory trends.

Post-COVID-19 condition (PCC) encompasses long-lasting symptoms in individuals with COVID-19 and is estimated to affect between 31-67% of patients, with women being more commonly affected. No definitive biomarkers have emerged in the acute stage that can help predict the onset of PCC, therefore we aimed at describing sex-disaggregated data of PCC patients from a local cohort and explore potential acute predictors of PCC and neurologic PCC. A local cohort of consecutive patients admitted with COVID-19 diagnosis between June 2020 and July 2021 were registered, and clinical and laboratory data were recorded. Only those <65 years, discharged alive and followed up at 6 and 12 months after admission were considered in these analyses. Multivariable logistic regression analysis was performed to explore variables associated with PCC (STATA v 18.0). From 130 patients in the cohort, 104 were contacted: 30% were women, median age of 42 years. At 6 months, 71 (68%) reported PCC symptoms. Women exhibited a higher prevalence of any PCC symptom (87 vs. 60%, p = 0.007), lower ferritin (p = 0.001) and procalcitonin (p = 0.021) and higher TNF levels (p = 0.042) in the acute phase compared to men. Being women was independently associated to 7.60 (95% CI 1.27-45.18, p = 0.026) higher risk for PCC. Moreover, women had lower return to normal activities 6 and 12 months. Our findings highlight the lasting impact of COVID-19, particularly in young women, emphasising the need for tailored post-COVID care. The lower ferritin levels in women are an intriguing observation, warranting further research. The study argues for comprehensive strategies that address sex-specific challenges in recovery from COVID-19.

The Territorial Planning Process of the Fez-Meknes Region from a Gender Perspective: An Exploratory Study

Since 2015, Morocco has become aware of the imperative to integrate the gender dimension into the territorial planning process. In this context, the region, as a key actor in territorial management, is called upon to take into account the gender approach during the elaboration of its Regional Development Programme (RDP) as a planning tool in accordance with Law 111-14 concerning regions in Morocco. This article aims to understand how the gender approach is integrated by stakeholders in the process of drawing up the RDP by analysing the specific interests and needs of women and men. Analysis of the various phases of the RDP elaboration process from a gender perspective, including preparation, diagnosis, strategic vision, action planning, budgeting, and finally, the implementation and monitoring-evaluation phase, led us to adopt a qualitative methodology. This approach was implemented through the mobilization of a single case study focusing on the RDP of the Fes-Meknes region for the period 2016-2021. Consequently, we conducted semi-structured interviews with a sample of 15 key informants directly involved in the elaboration of the RDP at its different stages. The results indicate that little account is taken of the specific needs of women at all stages of the process, from preparation to implementation and monitoring-evaluation. This is due to several factors, including the scarcity of sex-disaggregated data at the regional level, the ambiguity of the new legal text on the concept of gender and its integration into the RDP, the ineffectiveness of organizational mechanisms related to gender issues, the lack of knowledge and tools for gender-sensitive planning, as well as the weakness of the 'gender culture' among members of the regional council (RC).

Gaps in gender reporting in National Reports of Convention on Wetlands of International Importance (2021–2022)

Context The Ramsar Convention is the world’s premier environmental treaty for wetlands. This perspective evaluates gender reporting in Ramsar Convention National Reports and compliance with Gender and Wetlands Resolution XIII.18. A total of 71.8% (n = 42) of the sampled nation reports (n = 133) did not submit National Reports. Zero nations provided statistics on equitable pay or pay gaps by gender. In the sampled reports, only 10 nations submitted sex-disaggregated data. Further, only 7.5% (n = 123) of the sampled National Reports (n = 133) provided sex-disaggregated gender data relevant to the Ramsar Convention. Fifteen National Reports deleted the question on gender (Section H) on from their report entirely, including Denmark and Germany. With evidence drawn from the submitted National Reports, this perspective provides concrete empirical suggestions for improving gender reporting in the future. Gender initiatives, including Resolution XIII.18 and the related Sustainable Development Goals (SDGs) have improved transparent gender reporting in the Ramsar Convention National Reports to a degree. However, on the basis of this review, there is room for improvement in national reporting. Methods National Reports from 2021 to 2022 were reviewed for all instances of ‘gender’ and then evaluated for national replies to Section H, focused on gender. Key results Five years after Resolution XIII.18, there is still a need for system-wide improvements in gender reporting, including sex-disaggregated data, and equity for women (cis and trans) for the Ramsar Convention to become compliant with Resolution XIII.18. Complying with Resolution XIII.18 is one concrete, global and measurable way for wetland science and policy to mainstream gender. Conclusions No nation has prepared a comprehensive answer to Section H on gender and wetland policy and science, as defined below; instead, nations have submitted discrete elements. The analysis of each nation’s answers showed essential elements for a comprehensive answer. In the next 5 years of gender reporting, nations have the option to learn from the past and strive to comply with Resolution XIII.18 and provide transparent sex-disaggregated data on National Heads, community stakeholders, site interpreters, site managers and equitable salary data.

Achilles tendinopathy research has a gender data gap: A systematic review and meta-analysis.

A persisting gender bias has been recently highlighted in orthopaedics and sports medicine. The aim of this study was to evaluate the volume of gender-specific data and gender-specific results in the treatment of a common tendon disease, Achilles tendinopathy. Pubmed, Cochrane, and Web of Science were searched to identify all clinical studies focusing on Achilles tendinopathy treatment. The Visual Analogue Scale (VAS) and Victorian Institute of Sport Assessment-Achilles (VISA-A) data of women and men of the studies that disaggregated results by gender were collected, and a meta-analysis was conducted. Treatment response within and in between gender categories was evaluated, focusing on overall gender-disaggregated data, as well as within each of the three treatment categories: conservative treatment, injective treatmentand surgical treatment. A formal risk of bias analysis was conducted using Downs and Black's grading system. Out of the 8796 papers screened, 178 were included after the screening. The number of female study participants grew from 20% up to 1990 to 48% in the years 2019-2022. Only 373 out of 3423 (11%) female patients and 685 of 4352 (16%) male patients were found in sex-disaggregated studies. A meta-analysis was conducted on the 14 papers that reported sex-disaggregated data for VAS and VISA-A. The meta-analysis revealed that there was no difference in the overall treatment response between women and men and that both genders showed an overall significant treatment benefit in terms of VAS and VISA-A values. However, significant differences were documented within the treatment categories. While no differences were found in surgical studies, in conservative treatment studies, men experienced lower posttreatment VAS values (p = 0.004). The largest difference was found in injective treatments, with men experiencing a larger change in VAS values (men = -3.0, women = -1.0, p = 0.016) and higher posttreatment VISA-A values (p = 0.032). This systematic review and meta-analysis showed a lack of awareness of the importance of sex-specific data within Achilles tendinopathy treatment research. The proportion of female study subjects has grown over the years, but there is still a large data gap caused by the absence of sex-disaggregated data. The omission of sex-disaggregated data causes the loss of valuable knowledge on the true effectiveness of current Achilles tendinopathy treatment. The results of this study indicate that women profit less from available treatments, particularly injective approaches, which prompts further research for treatment adaptation by gender. Level IV.

Sex Differences in Cardiovascular Management: A Call for Better Acknowledgment-Part 1 Pharmacological Differences in Women and Men; How Relevant Are They?

Sex differences (SDs) in pharmacology of cardiovascular (CV) drugs have been described previously; however, paradoxically, there are scarce recommendations in therapy based on these differences. It is of utmost importance to identify whether these SDs determine a modified clinical response and the potential practical implications for this, to provide a base for personalized medicine. The aim of this article was to outline the most important pharmacological drivers of cardiovascular drugs that differ between women and men, along with their implications and challenges in clinical practice. A detailed assessment of English-written resources reflecting SDs impact in CV drug pharmacology was performed using PubMed and Embase databases. Despite large variations in CV drug pharmacokinetics and pharmacodynamics in individuals, correcting for height, weight, surface area, and body composition compensate for most "sex-dependent" differences. In addition, individual, cultural, and social factors significantly impact disease management in women versus men. Gender-biased prescribing patterns and gender-dependent adherence to therapy also influence outcomes. The development of sex-specific guidelines requires that they should reflect the SDs implications for the management of a disease and that the evidence should be carefully evaluated as to whether there is an adequate representation of both sexes and whether sex-disaggregated data are reported. Pharmacological drivers are under the influence of an impressive number of differences between women and men. However, to establish their significance in clinical practice, an adequate representation of women in studies and the reporting of distinct results is mandatory.

Sex Disaggregated Data (SDD) Analysis: Unveiling Educational Journeys of BSBA Marketing Management Graduates

This study determines the differences in profile and academic experiences of BSBA Marketing Management from Mariano Marcos State University (MMSU) from SY 2013-2014 to SY 2017-2018 using Sex Disaggregated Data (SDD) analysis and a descriptive research design. The data for 208 graduates was collected through an online survey. The study shows gender differences in various aspects, including civil status, region of origin, residence, honors, scholarships, and motivations for pursuing the degree. Male graduates were mainly single and residing in the city, while female graduates demonstrated greater geographic diversity and higher incidences of marital and parental responsibilities. Educational experiences highlighted that female graduates were more likely to receive academic honors (e.g., cum laude) and scholarships, whereas male graduates excelled in extracurricular activities. Motivations for degree pursuit also varied, with peer influence being more significant for males and familial influence being more critical for females. The findings suggest several strategies to address gender disparities in the BSBA Marketing Management program. These strategies include advanced scholarship programs, support services for female students, promotion of extracurricular activities among female students, career guidance and job networking, and flexible and accessible course offerings. The goal is to create a more equitable educational environment, ensuring equal opportunities and support for both male and female students. This study contributes to the existing research about gender equality in education by emphasizing the need for strategies to support diverse student needs and an inclusive academic environment.

Sex differences in response to COVID-19 mRNA vaccines in Italian population

Abstract Since the beginning of mass vaccination campaign for COVID-19 in Italy (December 2020) and following the rapidly increasing vaccine administration, sex differences have been emphasized. Nevertheless, incomplete and frequently incoherent sex-disaggregated data for COVID-19 vaccinations are currently available, and vaccines clinical studies generally do not include sex-specific analyses for safety and efficacy. We looked at sex variations in the COVID-19 vaccine’s effectiveness against infection and severe disease outcomes. We conducted a nationwide retrospective cohort study on Italian population, linking information on COVID-19 vaccine administrations obtained through the Italian National Vaccination Registry, with the COVID-19 integrated surveillance system, held by the Istituto Superiore di Sanità. The results showed that, in all age groups, vaccine effectiveness (VE) was higher in the time-interval ≤120 days post-vaccination. In terms of the sex difference in vaccination effectiveness, men and women were protected against serious illness by vaccination in a comparable way, while men were protected against infection to a somewhat greater extent than women. To fully understand the mechanisms underlying the sex difference in vaccine response and its consequences for vaccine effectiveness and development, further research is required. The sex-related analysis of vaccine response may contribute to adjust vaccination strategies, improving overall public health programmes.

Are Differences in Living Kidney Donation Rates a Sex or a Gender Disparity?

Sex-disaggregated data reveal significant disparities in living kidney donation, with more female than male living kidney donors in most countries and proportions over 60% in some countries. We summarize the present state of knowledge with respect to the potential drivers of this disparity and argue that it is primarily driven by gender-related factors. First, we present the differences between sex and gender and then proceed to summarize the potential medical reasons that have been proposed to explain why males are less likely to be living kidney donors than females, such as the higher prevalence of kidney failure in males. We then present counterarguments as to why biological sex differences are not enough to explain lower living kidney donation among males, such as a higher prevalence of chronic kidney disease among females, which could affect donation rates. We argue that gender differences likely provide a better explanation as to why there are more women than men living kidney donors and explore the role of economic and social factors, as well as gender roles and expectations, in affecting living kidney donation among both men and women. We conclude with the need for a gender analysis to explain this complex psychosocial phenomenon in living kidney donation.

Gender, rainfall endowment, and farmers’ heterogeneity in wheat trait preferences in Ethiopia

Wheat is a vital cereal crop for smallholders in Ethiopia. Despite over fifty years of research on wheat varietal development, consideration of gendered trait preferences in developing target product profiles for wheat breeding is limited. To address this gap, our study used sex-disaggregated survey data and historical rainfall trends from the major wheat-growing regions in Ethiopia. The findings indicated heterogeneity in trait preferences based on gender and rainfall endowment. Men respondents tended to prefer wheat traits with high straw yield and disease-resistance potential, while women showed a greater appreciation for wheat traits related to good taste and cooking quality. Farmers in high rainfall areas seemed to prioritize high straw yield and disease resistance traits, while those in low rainfall areas valued good adaptation traits more highly. Most of the correlation coefficients among the preferred traits were positive, indicating that farmers seek wheat varieties with traits that serve multiple purposes. Understanding men’s and women’s preferences and incorporating them in breeding and seed systems could contribute to the development of more targeted and effective wheat varieties that meet the diverse needs of men and women farmers in Ethiopia.

Does Participation in the “Grain for Green Program” Change the Status of Rural Men and Women? An Empirical Study of Northeast China

The Grain for Green (GfG) program is an afforestation project created by the Chinese Government to protect the environment. Farmers who participate in GfG return farmland to forest. Losing arable land means losing an income source, so farmers have to reorient their livelihood strategies, leading to potential changes in the gender division of labor. To assess gender differences in the impact of policies, we use indicators from the Women’s Empowerment in Agriculture Index (WEAI), which measures the status of women relative to that of men. Using sex-disaggregated data from farmers in mountainous areas of northeast China and applying the inverse probability weighted regression adjustment (IPWRA) estimator, we found that the status of men and women had increased with GfG participation, but women’s status had improved more than men’s. However, this was not because of their smooth participation in the program, but because of its challenges. Their decision-making skills improved unexpectedly due to pressure to protect their interests. Rural women worried about their families’ livelihoods, so they tried to improve their family welfare and diversified their income sources. In this process, women had more interactions with outside communities. Our results underline the strong need to continuously monitor the gender impacts of environmental policies.

Sex differences in COVID-19 deaths in the early months of the pandemic in Canada: An examination with an immigration lens.

At the onset of the COVID-19 pandemic, there was an overrepresentation of males in COVID-19 deaths worldwide, with Canada reporting more female COVID-19 deaths. This paper examines the overrepresentation of female COVID-19 deaths in Canada, with an immigration lens. Data were extracted from the COVID-19 Sex-Disaggregated Data Tracker to compare the sex distribution of COVID-19 deaths in Canada with that of other countries. A linkage of deaths to the Longitudinal Immigration Database (IMDB) allows for the comparison of sex-specific COVID-19 death rates by immigrant status for age and geography, as well as by major employment sector among immigrants, using the tax data from the IMDB. While there were proportionately more female than male COVID-19 deaths in Canada in the early months of the pandemic, this trend was mainly a phenomenon among non-immigrants aged 85 and older. In addition, COVID-19-specific death rates for males were higher than those for females across age groups by immigrant status, except for those aged 85 and older among the non-immigrant population. Among immigrants, the death rate among health care and social assistance workers was higher among males than among females (10.7 vs. 2.9 per 100,000 population). The initially observed overrepresentation of female COVID-19 deaths to male COVID-19 deaths in Canada evened out in the summer of 2021. The higher proportion of female COVID-19 deaths was likely related to the high concentration of COVID-19 deaths in long-term care facilities, where a lower institutionalization rate for immigrants had been observed. Since the implementation of vaccination targeting long-term care facility residents in Canada, the overrepresentation of female COVID-19 deaths ceased.

Water quality, WASH, and gender: differential impacts on health and well-being in Abeokuta City, Nigeria.

It is often assumed that humans experience the effect of poor water quality like multiple health and socioeconomic impacts in the same way. But these impacts are not gender neutral due to inequalities caused by physiological composition, age marginalization, and socioeconomic conditions, among others. A mixed method, comprising water quality assessment, a survey of 456 individuals, and medical record collection, was applied to examine the differential impacts of water quality and WASH practices in Abeokuta City, Nigeria. The assessment shows that without point-of-use water treatment, the water sources in the area are not safe for potable purposes, as the waters are hard in the sequence of borehole > surface water > hand-dug well > sachet water, with elevated levels of calcium (> 75 mg/L) and not free from microbial contamination. Among the area population segments, men and boys (relative to women and girls) may be more susceptible (55%) to the compounding health effects associated with the hardness and high calcium concentration in water. Girls are the most affected by the associated impacts of water collection. Men and boys are more vulnerable to the consequences of poor hygiene, while women are more susceptible to the health effects of toilet cleaning and the sharing of sanitation facilities, among others. We conclude that there are differential impacts of unsafe water, WASH services, and practices on human health. Gendered statistics through sex-disaggregated data is crucial to unmasking the differential impacts, which are neither gender neutral nor evenly distributed between women and men, and boys and girls.

Women’s land ownership in India: Evidence from digital land records

Women play critical roles in agricultural operations in many developing countries, yet they have limited ownership and de facto control over agricultural lands. Literature shows that insecure land rights constrain women’s economic prospects and make them vulnerable to poverty and violence. Despite initiating women-friendly amendments in existing polices in India, the situation has remained unresponsive. Clearly, the existing patriarchal mind-set, cultural and social ethos have imposed restrictions on women land ownership. For deriving important policy pointers, ground realities on land distribution and existing iniquities is required which is lacking in available databases. In this context, the paper aims to reinforce with evidence the bias against women in land rights at different stages so that policy can be rethought in new ways. The analysis is based on sex-disaggregated data extracted from nearly 16,000 original digital copies of land records for 12 States/Union Territories (UTs) in rural India, a first of its kind of exercise. Our results show that just having a title won’t resolve the bigger challenge of different levels of inequities that women still face when they own the land in terms of limited access to single land titles, lower shares, smaller size and inferior quality of land holdings. We also analyse the extent to which the States laws and provisions related to women land rights have controlled these biases, for which State-wise laws/ provisions were reviewed. We find mixed impacts of these provisions with significant variations across States, the reasons being lack of proper implementation and prevailing social attitudes/ customs. Finally, while emphasising the need to start rethinking and reinforcing these laws and provisions in a new way, the paper suggests feasible steps in this direction.

The christian religious education teachers’ attitudes toward the five-stage lesson plan framework in Kenya: A gender-based analysis

New approaches have emerged in teaching Christian Religious Education (CRE). Five-stage lesson plan framework (FSLP) is one of the innovative approaches applicable in all learning areas. Even though the framework is learner-oriented, understanding teachers' attitudes towards the framework are essential. Developing a positive attitude among the stakeholders remains crucial in implementing any teaching approach. Therefore, this study assessed gender differences in the attitude toward the five-stage lesson plan framework among CRE teachers in Meru County, Kenya. A multi-stage sampling technique randomly selected 143 and 83 female and male CRE teachers. Using a semi-structured questionnaire, quantitative data were collected in a cross-sectional survey. Chi-square and t-test statistics were applied to test the statistical significance of the dummy and mean value of continuous variables using sex-disaggregated data. The study revealed that teachers' attitudes towards the FSLP framework did not significantly differ between male and female teachers. The study employed multiple linear regression modeling to assess the determinants of the attitudes towards the five-stage lesson plan framework for male, female, and pooled teachers. Similar determinants influenced teachers' attitudes towards the FSLP framework: academic qualification, teaching experience, utilization, and awareness. Researchers established that educational qualification was a negative and significant determinant of attitudes towards the FSLP framework among the participants. Teaching experience, awareness, and utilization of the FSLP framework among CRE teachers were positive and significant determinants of the attitudes towards the FSLP framework. The study findings implied development of policies inclined to the attitudes supporting the proper implementation of newly emerged teaching strategies among the stakeholders. The supplement schemes should be restructured and shaped to meet teachers' specific needs and preferences regarding the utilization of educational innovations to enable CRE teachers to select and practice the FSLP framework.

Considering Sex and Gender in Therapeutics throughout the Product Life Cycle: A Narrative Review and Case Study of Gilteritinib.

Biological sex-related factors influence pharmacokinetic, pharmacodynamic, and disease processes that may affect the predictability of drug dosing and adverse effects, which may in turn have clinical consequences for patients' lives. Nonetheless, sex-related factors are not always taken into account in clinical trial design or clinical decision-making, for multiple reasons, including a paucity of studies that clearly and objectively study and measure sex-disaggregated and sex-related outcomes, as well as gaps in regulatory and policy structures for integrating these considerations. To complete a narrative review and use a case study to understand available evidence, inform future research, and provide policy considerations that incorporate information on sex- and gender-related factors into clinician-facing resources. A comprehensive review of available literature was conducted using a sex- and gender-based analysis plus (SGBA Plus) approach to identify sex- and/or gender-disaggregated information for gilteritinib, a chemotherapeutic agent. Systematic searches were performed in MEDLINE (Ovid), Embase (Ovid), CENTRAL (Wiley), International Pharmaceutical Abstracts (Ovid), Scopus, and ClinicalTrials.gov, from inception to March 18, 2021. The information was then summarized and compared with the Canadian product monograph for this drug. Of 311 records screened, 3 provided SGBA Plus information as a component of outcomes, rather than just as categories or demographic characteristics. Of these, 2 were case studies, and 1 was a clinical trial. No studies from the ClinicalTrials.gov database that were in progress at the time of this review provided details about sex-disaggregated outcomes. The Canadian product monograph did not include sex-disaggregated outcome data. The available evidence from clinical trials, other published literature, and guidance documents does not provide details about sex-disaggregated outcomes for gilteritinib. This paucity of available evidence may create a challenge for clinicians who are making decisions about the efficacy and safety of prescribed therapies in sex-specific populations that have not been well studied.