1
|
Levinsson A, Zolopa C, Vakili F, Udhesister S, Kronfli N, Maheu-Giroux M, Bruneau J, Valerio H, Bajis S, Read P, Martró E, Boucher L, Morris L, Grebely J, Artenie A, Stone J, Vickerman P, Larney S. Sex and gender differences in hepatitis C virus risk, prevention, and cascade of care in people who inject drugs: systematic review and meta-analysis. EClinicalMedicine 2024; 72:102596. [PMID: 38633576 PMCID: PMC11019099 DOI: 10.1016/j.eclinm.2024.102596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
Background People who inject drugs (PWID) are a priority population in HCV elimination programming. Overcoming sex and gender disparities in HCV risk, prevention, and the cascade of care is likely to be important to achieving this goal, but these have not yet been comprehensively reviewed. Methods Systematic review and meta-analysis. We searched Pubmed, EMBASE and the Cochrane Database of Systematic Reviews 1 January 2012-22 January 2024 for studies of any design reporting sex or gender differences among PWID in at least one of: sharing of needles and/or syringes, incarceration history, injection while incarcerated, participation in opioid agonist treatment or needle and syringe programs, HCV testing, spontaneous HCV clearance, direct-acting antiviral (DAA) treatment initiation or completion, and sustained virological response (SVR). Assessment of study quality was based on selected aspects of study design. Additional data were requested from study authors. Data were extracted in duplicate and meta-analysed using random effects models. PROSPERO registration CRD42022342806. Findings 9533 studies were identified and 92 studies were included. Compared to men, women were at greater risk for receptive needle and syringe sharing (past 6-12 months: risk ratio (RR) 1.12; 95% confidence interval (CI) 1.01-1.23; <6 months: RR 1.38; 95% CI 1.09-1.76), less likely to be incarcerated (lifetime RR 0.64; 95% CI 0.57-0.73) more likely to be tested for HCV infection (lifetime RR 1.07; 95% CI 1.01, 1.14), more likely to spontaneously clear infection (RR1.58; 95% CI 1.40-1.79), less likely to initiate DAA treatment (0.84; 95% CI 0.78-0.90), and more likely to attain SVR after completing DAA treatment (RR 1.02; 95% CI 1.01-1.04). Interpretation There are important differences in HCV risk and cascade of care indicators among people who inject drugs that may impact the effectiveness of prevention and treatment programming. Developing and assessing the effectiveness of gender-specific and gender-responsive HCV interventions should be a priority in elimination programming. Funding Réseau SIDA-MI du Québec.
Collapse
Affiliation(s)
- Anna Levinsson
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada
- School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Camille Zolopa
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Educational & Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Farzaneh Vakili
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Sasha Udhesister
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Nadine Kronfli
- Division of Infectious Disease and Chronic Viral Illness Service, Department of Medicine, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Heather Valerio
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Sahar Bajis
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Phillip Read
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Elisa Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
- Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Lisa Boucher
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Leith Morris
- School of Public Health, Faculty of Medicine, Univerity of Queensland, Brisbane, Australia
| | - Jason Grebely
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Adelina Artenie
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jack Stone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, Bristol, United Kingdom
| | - Sarah Larney
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| |
Collapse
|
2
|
Yang W, Rubin JB. Treating sex and gender differences as a continuous variable can improve precision cancer treatments. Biol Sex Differ 2024; 15:35. [PMID: 38622740 PMCID: PMC11017567 DOI: 10.1186/s13293-024-00607-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/21/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The significant sex and gender differences that exist in cancer mechanisms, incidence, and survival, have yet to impact clinical practice. One barrier to translation is that cancer phenotypes cannot be segregated into distinct male versus female categories. Instead, within this convenient but contrived dichotomy, male and female cancer phenotypes are highly overlapping and vary between female- and male- skewed extremes. Thus, sex and gender-specific treatments are unrealistic, and our translational goal should be adaptation of treatment to the variable effects of sex and gender on targetable pathways. METHODS To overcome this obstacle, we profiled the similarities in 8370 transcriptomes of 26 different adult and 4 different pediatric cancer types. We calculated the posterior probabilities of predicting patient sex and gender based on the observed sexes of similar samples in this map of transcriptome similarity. RESULTS Transcriptomic index (TI) values were derived from posterior probabilities and allowed us to identify poles with local enrichments for male or female transcriptomes. TI supported deconvolution of transcriptomes into measures of patient-specific activity in sex and gender-biased, targetable pathways. It identified sex and gender-skewed extremes in mechanistic phenotypes like cell cycle signaling and immunity, and precisely positioned each patient's whole transcriptome on an axis of continuously varying sex and gender phenotypes. CONCLUSIONS Cancer type, patient sex and gender, and TI value provides a novel and patient- specific mechanistic identifier that can be used for realistic sex and gender-adaptations of precision cancer treatment planning.
Collapse
Affiliation(s)
- Wei Yang
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Joshua B Rubin
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| |
Collapse
|
3
|
Alipour P, Azizi Z, Raparelli V, Norris CM, Kautzky-Willer A, Kublickiene K, Herrero MT, Emam KE, Vollenweider P, Preisig M, Clair C, Pilote L. Role of sex and gender-related variables in development of metabolic syndrome: A prospective cohort study. Eur J Intern Med 2024; 121:63-75. [PMID: 37858442 DOI: 10.1016/j.ejim.2023.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/28/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION The burden of metabolic syndrome (MetS) and its components has been increasing mainly amongst male individuals. Nevertheless, clinical outcomes related to MetS (i.e., cardiovascular diseases), are worse among female individuals. Whether these sex differences in the components and sequalae of MetS are influenced by gender (i.e., psycho-socio-cultural factors)) is a matter of debate. Therefore, the purpose of this study was to determine the association between gender-related factors and the development of MetS, and to assess if the magnitude of the associations vary by sex. METHOD Data from the Colaus/PsyColaus study, a prospective population-based cohort of 6,734 middle-aged participants in Lausanne (Switzerland) (2003-2006) were used. The primary endpoint was the development of MetS as defined by the Adult Treatment Panel III of the National Cholesterol Education Program. Multivariable models were estimated using logistic regression to assess the association between gender-related factors and the development of MetS. Two-way interactions between sex, age and gender-related factors were also tested. RESULTS Among 5,195 participants without MetS (mean age=51.3 ± 10.6, 56.1 % females), 27.9 % developed MetS during a mean follow-up of 10.9 years. Female sex (OR:0.48, 95 %CI:0.41-0.55) was associated with decreased risk of developing MetS. Conversely, older age, educational attainment less than university, and low income were associated with an increased risk of developing MetS. Statistically significant interaction between sex and strata of age, education, income, smoking, and employment were identified showing that the reduced risk of MetS in female individuals was attenuated in the lowest education, income, and advanced age strata. However, females who smoke and reported being employed demonstrated a decreased risk of MetS compared to males. Conversely smoking and unemployment were significant risk factors for MetS development among male adults. CONCLUSIONS Gender-related factors such as income level and educational attainment play a greater role in the development of MetS in female than individuals. These factors represent novel modifiable targets for implementation of sex- and gender-specific strategies to achieve health equity for all people.
Collapse
Affiliation(s)
- Pouria Alipour
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada; Faculty of Medicine, McGill University, Montreal, Canada
| | - Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy; Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Colleen M Norris
- Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Heart and Stroke Strategic Clinical Networks-Alberta Health Services, Alberta, Canada
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Karolina Kublickiene
- Department of Clinical intervention, Science and Technology (CLINTEC), Section for Renal Medicine, Karolinska Institute and Karolinska University hospital, Stockholm, Sweden
| | - Maria Trinidad Herrero
- Clinical & Experimental Neuroscience (NiCE-IMIB-IUIE), School of Medicine. University of Murcia, Murcia, Spain
| | - Khaled El Emam
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario. Canada; Replica Analytics Ltd, Ottawa, Ontario, Canada
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Carole Clair
- Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada; Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montreal, QC, Canada.
| |
Collapse
|
4
|
Merdji H, Long MT, Ostermann M, Herridge M, Myatra SN, De Rosa S, Metaxa V, Kotfis K, Robba C, De Jong A, Helms J, Gebhard CE. Sex and gender differences in intensive care medicine. Intensive Care Med 2023; 49:1155-1167. [PMID: 37676504 PMCID: PMC10556182 DOI: 10.1007/s00134-023-07194-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/05/2023] [Indexed: 09/08/2023]
Abstract
Despite significant advancements in critical care medicine, limited attention has been given to sex and gender disparities in management and outcomes of patients admitted to the intensive care unit (ICU). While "sex" pertains to biological and physiological characteristics, such as reproductive organs, chromosomes and sex hormones, "gender" refers more to sociocultural roles and human behavior. Unfortunately, data on gender-related topics in the ICU are lacking. Consequently, data on sex and gender-related differences in admission to the ICU, clinical course, length of stay, mortality, and post-ICU burdens, are often inconsistent. Moreover, when examining specific diagnoses in the ICU, variations can be observed in epidemiology, pathophysiology, presentation, severity, and treatment response due to the distinct impact of sex hormones on the immune and cardiovascular systems. In this narrative review, we highlight the influence of sex and gender on the clinical course, management, and outcomes of the most encountered intensive care conditions, in addition to the potential co-existence of unconscious biases which may also impact critical illness. Diagnoses with a known sex predilection will be discussed within the context of underlying sex differences in physiology, anatomy, and pharmacology with the goal of identifying areas where clinical improvement is needed. To optimize patient care and outcomes, it is crucial to comprehend and address sex and gender differences in the ICU setting and personalize management accordingly to ensure equitable, patient-centered care. Future research should focus on elucidating the underlying mechanisms driving sex and gender disparities, as well as exploring targeted interventions to mitigate these disparities and improve outcomes for all critically ill patients.
Collapse
Affiliation(s)
- Hamid Merdji
- Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Micah T Long
- Departments of Anaesthesiology and Medicine, Division of Critical Care, University of Wisconsin Hospitals & Clinics, Madison, USA
| | - Marlies Ostermann
- Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK
| | - Margaret Herridge
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Sheila N Myatra
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Silvia De Rosa
- Centre for Medical Sciences - CISMed, University of Trento, Trento, Italy
- Department of Anesthesia and Intensive Care, Santa Chiara Regional Hospital, Trento, Italy
| | - Victoria Metaxa
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Katarzyna Kotfis
- Department of Anaesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland
| | - Chiara Robba
- Dipartimento di Scienze Chirurgiche Integrate e Diagnostiche, Università di Genova, Genova, Italy
- Anestesia e Rianimazione, IRCCS Policlinico San Martino, Genova, Italy
| | - Audrey De Jong
- Department of Anaesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, PhyMedExp, INSERM U1046, CNRS UMR, 9214, Montpellier, CEDEX 5, France
| | - Julie Helms
- Faculté de Médecine, Service de Médecine Intensive-Réanimation, Université de Strasbourg (UNISTRA)Hôpitaux Universitaires de StrasbourgNouvel Hôpital Civil, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - Caroline E Gebhard
- Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
| |
Collapse
|
5
|
Bolijn R, Muilwijk M, Nicolaou M, Galenkamp H, Stronks K, Tan HL, Kunst AE, van Valkengoed IG. The contribution of smoking to differences in cardiovascular disease incidence between men and women across six ethnic groups in Amsterdam, the Netherlands: The HELIUS study. Prev Med Rep 2023; 31:102105. [PMID: 36820382 PMCID: PMC9938300 DOI: 10.1016/j.pmedr.2022.102105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/14/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023] Open
Abstract
It is unclear to what extent differences in cardiovascular disease (CVD) risk between men and women are explained by differences in smoking, and whether this contribution to risk is consistent across ethnic groups. In this prospective study, we determined the contribution of smoking to differences in CVD incidence between men and women, also in various ethnic groups. We linked baseline data of 18,058 participants of six ethnic groups from the HELIUS study (Amsterdam, the Netherlands) to CVD incidence data, based on hospital admission and death records from Statistics Netherlands (2013-2019). The contribution of smoking to CVD incidence, as estimated by the population attributable fraction, was higher in men than in women, overall (24.1% versus 15.6%) and across most ethnic groups. Among Dutch participants, however, the contribution of smoking was higher among women (21.0%) than men (16.2%). Using Cox regression analyses, we observed that differences in smoking prevalence explained 22.0% of the overall lower hazard for CVD in women compared to men. Smoking contributed minimally to the lower hazards for CVD in women among participants of Dutch (0%), Ghanaian (4.9%) and Moroccan origin (0%), but explained 28.6% and 48.6% of the lower hazards in women in South-Asian Surinamese and African Surinamese groups, respectively. While smoking prevention and cessation may lead to lower CVD incidence in most groups of men and women, it may not substantially reduce disparities in CVD risk between men and women in most ethnic groups.
Collapse
Affiliation(s)
- Renee Bolijn
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands,Corresponding author at: Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Mirthe Muilwijk
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Mary Nicolaou
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Hanno L. Tan
- Department of Clinical and Experimental Cardiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands,Netherlands Heart Institute, Utrecht, The Netherlands
| | - Anton E. Kunst
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Irene G.M. van Valkengoed
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Campesi I, Montella A, Sotgiu G, Saderi L, Tonolo G, Seghieri G, Franconi F. Smoking and combined oral contraceptives should be considered as an independent variable in sex and gender-oriented studies. Toxicol Appl Pharmacol 2022; 457:116321. [PMID: 36423693 DOI: 10.1016/j.taap.2022.116321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
The influence of sex combined with smoking and combined oral contraceptives (COC) use on atherogenic indexes is scarcely studied. Thus, traditional lipid parameters were measured, and non-traditional atherogenic indexes were calculated in a young and healthy population of men, COC-free women, and COC users. Total cholesterol (TChol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and HDL/LDL ratio were lower in men, while triglycerides (TG)/HDL ratio, atherogenic index of plasma (AIP), Castelli's Risk Index I (CRII) and CRI-II, atherogenic coefficient (AC), creatinine, creatinine clearance, and estimated glomerular filtration rate (eGFR) were higher in men. The use of COC modified TChol, HDL, TG, TG/HDL, and AIP which had significantly higher values in COC users. In addition, TG were also increased in COC users in comparison with men. Smoking reduced sexually divergent parameters: BMI, TG, HDL/LDL, TG/HDL, AIP, CRII, CRI-II, and AC became similar among the three cohorts, losing the reported sex differences. Smoking also reduced differences in TChol, HDL, TG, and AIP between COC-free women and COC users, but it does not affect CRII, CRI-II, creatinine, creatinine clearance, and eGFR, underlining that COC users and COC-free women have to be considered two different populations. Our results represent a complex landscape suggesting that for both sexes smoking should be an independent variable in medical studies. Moreover, in women, the use of COC evidenced two different cohorts. Thus, more variables should be considered during a single study indicating that sex, smoking, and COC should be studied together to get a picture of the real-life context.
Collapse
Affiliation(s)
- Ilaria Campesi
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100 Sassari, Italy; Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100 Sassari, Italy.
| | - Andrea Montella
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100 Sassari, Italy; Unità Operativa di Genetica e Biologia Dello Sviluppo, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100 Sassari, Italy
| | - Laura Saderi
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100 Sassari, Italy
| | - Giancarlo Tonolo
- S.C. Diabetologia, P.O. San Giovanni di Dio, ASSL Olbia-ATS Sardegna, 07026 Olbia, Italy
| | | | - Flavia Franconi
- Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100 Sassari, Italy
| |
Collapse
|
7
|
Madla CM, Gavins FKH, Merchant HA, Orlu M, Murdan S, Basit AW. Let's talk about sex: Differences in drug therapy in males and females. Adv Drug Deliv Rev 2021; 175:113804. [PMID: 34015416 DOI: 10.1016/j.addr.2021.05.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/04/2021] [Accepted: 05/15/2021] [Indexed: 12/13/2022]
Abstract
Professor Henry Higgins in My Fair Lady said, 'Why can't a woman be more like a man?' Perhaps unintended, such narration extends to the reality of current drug development. A clear sex-gap exists in pharmaceutical research spanning from preclinical studies, clinical trials to post-marketing surveillance with a bias towards males. Consequently, women experience adverse drug reactions from approved drug products more often than men. Distinct differences in pharmaceutical response across drug classes and the lack of understanding of disease pathophysiology also exists between the sexes, often leading to suboptimal drug therapy in women. This review explores the influence of sex as a biological variable in drug delivery, pharmacokinetic response and overall efficacy in the context of pharmaceutical research and practice in the clinic. Prospective recommendations are provided to guide researchers towards the consideration of sex differences in methodologies and analyses. The promotion of disaggregating data according to sex to strengthen scientific rigour, encouraging innovation through the personalisation of medicines and adopting machine learning algorithms is vital for optimised drug development in the sexes and population health equity.
Collapse
Affiliation(s)
- Christine M Madla
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Francesca K H Gavins
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Hamid A Merchant
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom
| | - Mine Orlu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Sudaxshina Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Abdul W Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom.
| |
Collapse
|
8
|
Campesi I, Montella A, Sotgiu G, Dore S, Carru C, Zinellu A, Palermo M, Franconi F. Combined oral contraceptives modify the effect of smoking on inflammatory cellular indexes and endothelial function in healthy subjects. Eur J Pharmacol 2020; 891:173762. [PMID: 33253680 DOI: 10.1016/j.ejphar.2020.173762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022]
Abstract
Little information is available on the influence of sex in combination with smoking habits and combined oral contraceptives (COC) use on cellular inflammatory indexes such as neutrophil/lymphocyte ratio (NLR), derived NRL (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), mean platelet volume/platelet count (MPV/PLT), aggregate inflammation systemic index (AISI), and systemic inflammation response index (SIRI), which are cost-effective biomarkers to assessing inflammation. Therefore, the effect of COC was studied alone or in association with smoking and compared with results from healthy COC-free women and men. Furthermore, the association of cellular inflammatory indexes with endothelial function (arginine (Arg), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and lipid peroxidation (malondialdehyde MDA) biomarkers was evaluated. Blood was collected for hematological and biochemical analysis, which were used to calculate PLR, NLR, dNLR, MLR, MPV/PLT, AISI, and SIRI. Serum samples were assayed for Arg, ADMA, SDMA, and MDA. Monocytes, MLR, SIRI, and MPV/PLT were higher in men, while PLT count was higher in women. COC use increased lymphocytes and lowered PLR and MLR. Smoking reduced sexually divergent parameters, especially in COC users: smoking and non-smoking COC-free women displayed six divergent parameters, while COC users displayed only two (monocytes and MPV). In addition, COC affected endothelial function, reducing ADMA and Arg. Moreover, COC-free women had lower Arg levels than men. In conclusion, COC use strongly influence the effects of tobacco smoking, which are sex and parameter specific. Further, these data stress that COC use and smoking attitude select different cohorts indicating that sex and gender studies need intersectionality.
Collapse
Affiliation(s)
- Ilaria Campesi
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy; Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100, Sassari, Italy.
| | - Andrea Montella
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy; Unità Operativa di Genetica e Biologia Dello Sviluppo, Azienda Ospedaliero Universitaria di Sassari, 07100, Sassari, Italy
| | - Giovanni Sotgiu
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Simone Dore
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Ciriaco Carru
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Angelo Zinellu
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Mario Palermo
- Unità Operativa di Endocrinologia, Azienda Ospedaliero Universitaria di Sassari, 07100, Sassari, Italy
| | - Flavia Franconi
- Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100, Sassari, Italy
| |
Collapse
|
9
|
Tirado-Muñoz J, Lopez-Rodriguez AB, Fonseca F, Farré M, Torrens M, Viveros MP. Effects of cannabis exposure in the prenatal and adolescent periods: Preclinical and clinical studies in both sexes. Front Neuroendocrinol 2020; 57:100841. [PMID: 32339546 DOI: 10.1016/j.yfrne.2020.100841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/15/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Abstract
Cannabis is the most commonly used illicit drug among adolescents and young adults, including pregnant women. There is substantial evidence for a significant association between prenatal cannabis exposure and lower birth weight in offspring, and mixed results regarding later behavioural outcomes in the offspring. Adolescent cannabis use, especially heavy use, has been associated with altered executive function, depression, psychosis and use of other drugs later in life. Human studies have limitations due to several confounding factors and have provided scarce information about sex differences. In general, animal studies support behavioural alterations reported in humans and have revealed diverse sex differences and potential underlying mechanisms (altered mesolimbic dopaminergic and hippocampal glutamatergic systems and interference with prefrontal cortex maturation). More studies are needed that analyse sex and gender influences on cannabis-induced effects with great clinical relevance such as psychosis, cannabis use disorder and associated comorbidities, to achieve more personalized and accurate treatments.
Collapse
Affiliation(s)
- Judith Tirado-Muñoz
- Addiction Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Ana Belen Lopez-Rodriguez
- School of Biochemistry & Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Francina Fonseca
- Addiction Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Magi Farré
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germas Trias (HUGTP-IGTP), Badalona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Marta Torrens
- Addiction Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | | |
Collapse
|
10
|
Werbinski JL, Rojek MK, Cabral MDI. The Need to Integrate Sex and Gender Differences into Pediatric Pedagogy. Adv Pediatr 2019; 66:15-35. [PMID: 31230691 DOI: 10.1016/j.yapd.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Janice L Werbinski
- Department of Obstetrics and Gynecology, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA.
| | - Mary K Rojek
- Sex and Gender Health Collaborative, American Medical Women's Association, 1100 Woodfield Rd. #350, Schaumburg, IL 60173, USA
| | - Maria Demma I Cabral
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
| |
Collapse
|
11
|
Langhans W, Adan R, Arnold M, Banks WA, Card JP, Dailey MJ, Daniels D, de Kloet AD, de Lartigue G, Dickson S, Fedele S, Grill HJ, Jansson JO, Kaufman S, Kolar G, Krause E, Lee SJ, Le Foll C, Levin BE, Lutz TA, Mansouri A, Moran TH, Pacheco-López G, Ramachandran D, Raybould H, Rinaman L, Samson WK, Sanchez-Watts G, Seeley RJ, Skibicka KP, Small D, Spector AC, Tamashiro KL, Templeton B, Trapp S, Tso P, Watts AG, Weissfeld N, Williams D, Wolfrum C, Yosten G, Woods SC. New horizons for future research - Critical issues to consider for maximizing research excellence and impact. Mol Metab 2018; 14:53-59. [PMID: 29886182 PMCID: PMC6034110 DOI: 10.1016/j.molmet.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/08/2018] [Accepted: 05/08/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- Wolfgang Langhans
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland.
| | - Roger Adan
- Brain Center Rudolf Magnus, Dept. of Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, 3584, CG, The Netherlands; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Myrtha Arnold
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - William A Banks
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - J Patrick Card
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Megan J Dailey
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Derek Daniels
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - Annette D de Kloet
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, 32611, USA
| | - Guillaume de Lartigue
- The John B. Pierce Laboratory, New Haven, CT, 06519, USA; Department of Cellular and Molecular Physiology, Yale Medical School, New Haven, CT, 06519, USA
| | - Suzanne Dickson
- Dept Physiology/Endocrine, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 11, SE-405 30, Gothenburg, Sweden
| | - Shahana Fedele
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - Harvey J Grill
- Lynch Laboratories University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - John-Olov Jansson
- Dept Physiology/Endocrine, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 11, SE-405 30, Gothenburg, Sweden
| | - Sharon Kaufman
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - Grant Kolar
- Pathology, Saint Louis University School of Medicine, St. Louis, MO, 63104, USA
| | - Eric Krause
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, 32611, USA
| | - Shin J Lee
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - Christelle Le Foll
- Institute of Veterinary Physiology, University of Zurich, Winterthurerstrasse 260, CH 8057, Zurich, Switzerland
| | - Barry E Levin
- Department of Neurology, Rutgers, New Jersey Medical School, Newark, NJ, 07103, USA
| | - Thomas A Lutz
- Institute of Veterinary Physiology, University of Zurich, Winterthurerstrasse 260, CH 8057, Zurich, Switzerland
| | - Abdelhak Mansouri
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Gustavo Pacheco-López
- Metropolitan Autonomous University (UAM), Campus Lerma, Health Sciences Department, Lerma, Edo Mex, 52005, Mexico
| | - Deepti Ramachandran
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - Helen Raybould
- Dept. of Anatomy, Physiology and Cell Biology, UC Davis School of Veterinary Medicine, Davis, CA, 95616, USA
| | - Linda Rinaman
- Florida State University, Dept. of Psychology, Tallahassee, FL, 32303, USA
| | - Willis K Samson
- Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, 63104, USA
| | - Graciela Sanchez-Watts
- The Department of Biological Sciences, USC Dornsife College of Letters, Arts & Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Randy J Seeley
- Departments of Surgery, Internal Medicine and Nutritional Science, University of Michigan, Ann Arbor, MI 48109, USA
| | - Karolina P Skibicka
- Department of Physiology/Metabolic Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, SE-405 30 Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Sweden
| | - Dana Small
- Yale University School of Medicine, The Modern Diet and Physiology Research Center, New Haven, CT 06511, USA
| | - Alan C Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, 32306, USA
| | - Kellie L Tamashiro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Brian Templeton
- Midwest Community Fundraising, Inc., Cincinnati, OH, 45223, USA
| | - Stefan Trapp
- Centre for Cardiovascular and Metabolic Neuroscience; Department of Neuroscience, Physiology & Pharmacology, UCL, London WC1E 6BT, UK
| | - Patrick Tso
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45237, USA
| | - Alan G Watts
- The Department of Biological Sciences, USC Dornsife College of Letters, Arts & Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Nadja Weissfeld
- Physiology and Behavior Laboratory, ETH Zurich, Schorenstr. 16, 8603, Schwerzenbach, Switzerland
| | - Diana Williams
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, 32306, USA
| | - Christian Wolfrum
- Translational Nutrition Biology Laboratory, ETH Zurich, 8603, Schwerzenbach, Switzerland
| | - Gina Yosten
- Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, 63104, USA
| | - Stephen C Woods
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, OH, 45237, USA
| |
Collapse
|
12
|
Gielis WP, Welsing PMJ, van Spil WE, Runhaar J, Weinans H, de Jong PA. A sex-specific association between incident radiographic osteoarthritis of hip or knee and incident peripheral arterial calcifications: 8-year prospective data from Cohort Hip and Cohort Knee (CHECK). Osteoarthritis Cartilage 2017; 25:1814-1821. [PMID: 28757188 DOI: 10.1016/j.joca.2017.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/26/2017] [Accepted: 07/19/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES There is sparse evidence for a relationship between cardiovascular disease (CVD) and osteoarthritis (OA). We investigated the association between incidence of arterial calcifications and incidence of radiographic knee and/or hip OA. DESIGN We used baseline and 8-year follow-up data of Cohort Hip and Cohort Knee (CHECK). Knees and hips were either Kellgren-Lawrence (KL) grade 0 or 1 at baseline. Arterial calcifications were scored on hip and knee radiographs using a four-grade scale. Scores were summed for patient-level analyses. To investigate incidence, participants with arterial calcifications at baseline or missing follow-up were excluded. Incident OA was defined per joint as KL ≥ 2 or prosthesis at year eight. The association between incidenct of arterial calcifications and incident OA was studied using mixed-effects logistic regression. RESULTS Of 763 participants included, 623 (82%) were women. Mean (sd) age was 56 (5.1) years, mean (sd) body mass index (BMI) 26.2 (4.1) kg/m2. Arterial calcifications developed in 174 participants (283 joints). OA developed in 456 participants (778 joints). Sex modified the association between arterial calcification and OA. In women, incident arterial calcification around a joint was positively associated with incident OA in that joint (adjusted OR 2.51 (95% CI 1.57-4.03)). In men, no association was observed on joint-level, but at patient-level the arterial calcification sum score was negatively associated with incident OA (adjusted OR per point increase 0.70 (95% CI 0.54-0.90)) indicating a systemic effect. CONCLUSIONS We observed sex-dependent associations between incident arterial calcification and incident radiographic knee and/or hip OA, which differs between joint- and patient-level.
Collapse
Affiliation(s)
- W P Gielis
- UMC Utrecht, Department of Orthopedics, Utrecht, The Netherlands; UMC Utrecht, Department of Radiology, Utrecht, The Netherlands.
| | - P M J Welsing
- UMC Utrecht, Department of Rheumatology & Clinical Immunology, Utrecht, The Netherlands.
| | - W E van Spil
- UMC Utrecht, Department of Rheumatology & Clinical Immunology, Utrecht, The Netherlands.
| | - J Runhaar
- Erasmus, University Medical Center Rotterdam, Department of General Practice, Rotterdam, The Netherlands.
| | - H Weinans
- UMC Utrecht, Department of Orthopedics, Utrecht, The Netherlands; UMC Utrecht, Department of Rheumatology & Clinical Immunology, Utrecht, The Netherlands; Delft University of Technology (TU Delft), Department of Biomechanical Engineering, Delft, The Netherlands.
| | - P A de Jong
- UMC Utrecht, Department of Radiology, Utrecht, The Netherlands.
| |
Collapse
|
13
|
Abstract
It is remarkable that only a few years ago, discussions about women's health research often had to be prefaced with the expanded vision of what that concept should actually be in totality as the traditional approach to the health of women had focused on the reproductive system or “bikini medicine,” as Dr Marianne Legato, an internationally recognized specialist in women's health, and others have characterized it. Today, there is an almost universal appreciation of the broader perception of women's health and that research on women includes not just clinical trials but also basic investigation from the molecular level of genes to the many aspects of behavioral and societal influences. This evolution over the past 25 years of what should and does constitute women's health research has been important in influencing the design of biomedical and behavioral research studies and in elucidating factors now implicit in diagnostic and therapeutic approaches to both males and females.1 And examples of advances from research providing the foundation for public health policies and legislative initiatives only strengthen the understanding of the value of these efforts.2
Collapse
Affiliation(s)
- Vivian W Pinn
- National Institutes of Health Office of Research on Women's Health (retired), United States
| |
Collapse
|
14
|
Edwards LV, Dennis S, Weaks F. The WHISK (Women's Health: Increasing the Awareness of Science and Knowledge) Pilot Project: Recognizing Sex and Gender Differences in Women's Health and Wellness. Glob Adv Health Med 2014; 2:54-8. [PMID: 24416695 PMCID: PMC3833557 DOI: 10.7453/gahmj.2013.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Women's health encompasses a continuum of biological, psychological, and social challenges that differ considerably from those of men. Despite the remarkable advances in science, women's health and sex differences research is slowly gaining recognition and acceptance. It is important that women's health gain attention as women are usually the gatekeepers of care for the family. Women's health and health outcomes are strongly influenced by sex and gender differences as well as geography. Around the world, the interplay of biology and culture brings about differences in men's and women's health, which have been largely overlooked. The Women's Health: Increasing the Awareness of Science and Knowledge (WHISK) Pilot Project was a multidisciplinary project aimed to increase the awareness of sex and gender differences in women's health and research among healthcare professionals. Theater expression and creative art were used to translate knowledge, enhance understanding, and increase the awareness of sex differences. Findings from this project clearly showed an apparent increase in knowledge and cultivation of new insights.
Collapse
Affiliation(s)
- Lorece V Edwards
- Morgan State University, School of Community Health and Policy, Baltimore, Maryland, United States
| | - Sabriya Dennis
- Morgan State University, School of Community Health and Policy, Baltimore, Maryland, United States
| | - Francesca Weaks
- Morgan State University, School of Community Health and Policy, Baltimore, Maryland, United States
| |
Collapse
|