Tag Archive for: research

Behind the Science: Empowering Women Through Maternal Health Research In Iran


Interviewee: Madelyn Sedehi, Bachelor of Science (Midwifery)  Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinator).

Published: February 10, 2023

Could you please tell us more about the work that you’ve done in women’s health in Iran?

I was educated and worked as a midwife on a multidisciplinary maternity ward at a Golestan Province Hospital, affiliated with the Golestan University of Medical Sciences. I worked in different parts of a maternity ward, including the admission and labour and delivery rooms, and also as a unit manager in the women’s ward. Following that, I worked at a congenital anomaly research centre with a team of gynecologists, pediatricians, and a genetic specialist. We collaborated together to find many different risk factors that may be involved in the development of birth defects. The purpose of our work was to determine how to have a healthy pregnancy and to evaluate how these risk factors are affecting pregnancy outcomes in our area. Some of the areas we worked on were maternal nutrition, pregnancy complications, mortality and morbidity in newborns, maternal knowledge of pregnancy –  especially in youth and young women who were pregnant. We also studied nutrient absorption and even underlying diseases like diabetes or gestational diabetes, as well as conducted experimental research at the university. We’ve published nine articles from this research, three of which I was the first author.

It sounds like you were looking at many different factors in your work. Can you tell us more about that? 

Yes, we worked in a very wide field by working with many different specialists and especially by having an affiliation with the university. We were able to gather and collect data from all over the province to generate a data bank about birth defects, studying related and unrelated factors in our area. 

What led you to become interested in maternal and child health?

I would say it was working as a midwife and being involved with pregnant mothers in many complicated cases, especially the ones who were very young when they got pregnant, based on the culture and traditions in our country, to elevate their level of knowledge toward themselves to be more healthy. I was, and I am, and I always will be passionate about women’s health in the different parts of their life. Women have a very significant role in society, in the family, and for themselves. Being able to educate them as much as we can and give them a chance to know about their body and how they can take care of themselves at different stages of their life is amazing. That’s going to have many different benefits for their family, for themselves, for society, for the government – and, I believe, for everyone. And it starts with research. That’s why it’s great that research opens a gate to accomplish these advancements in different areas of human health and well-being.  

Now that you’re in Canada, what kind of research are you interested in?

I’m very much a newcomer! I would really love to get connected with research here, especially in midwifery, and different areas of pregnancy health and outcomes. However, I’m open to pursuing research related to different areas of women’s health, such as depression, maternity care, vaccination, and even psychology. When you have love, passion, hard work, and organization, you can do well as a researcher. When I first started, I didn’t have any experience as a researcher so I learned by myself, and then the university reached out to me and they wanted me to do more. I believe if you love your job and do your best, that keeps you going. Then, you can help other people gain knowledge and skills. I’m very interested in being connected to the research field here! 

Madelyn Sedehi is currently looking to be involved in women’s health research in Vancouver. If you are interested in contacting Madelyn to join your research team, please reach out to her at ml7.sedehi@gmail.com

Behind the Science: Promoting Women’s Mental HealthThrough Social Interventions

Authors: Romina Garicia de leon and Negin Nia, Women’s Health Blog Coordinators | Interviewee: Dr. Saima Hirani, Ph.D., University of British Columbia

Published: September 9th, 2022 

Can you please tell us a bit about your career trajectory as a registered nurse, and now Assistant Professor of Nursing?

I’m an internationally educated nurse. I completed my Bachelors of Science and Master of Science in Nursing from The Aga Khan University in Pakistan. I began  my nursing career as an intensive care unit and cardiac intensive care unit nurse in Pakistan, which involved a lot of technical, high tech, critical care.

I then came to Canada and completed my PhD in Nursing with a focus on mental health at the University of Alberta. After PhD, I went back to Pakistan and worked as an Assistant Professor in the Aga Khan University. In 2019, I joined University of British Columbia (UBC) as a postdoctoral research fellow and currently, I am Assistant Professor,  at UBC,  School of Nursing.

What got you interested in Mental health Nursing? 

After I started working in the ICU, I got some experience with mental health nursing and I got to work with a variety of women, some of whom were incarcerated, survivors of sexual assault or domestic violence. This got me interested in mental health, and many of my teachers recommended me to enter the field.  In 2007, I joined a multidisciplinary research project as a co-investigator that aimed to promote mental health and empowerment in women. My master’s thesis was also part of that larger project. By the time I came to Canada for my PhD, it was very clear that I wanted to focus on women’s health and mental health specifically. My PhD focused on development and testing of social support intervention for women’s resilience and quality of life. My program of research mainly focuses on mental health promotion of individuals including women who live in socioeconomic disadvantaged settings. 

You recently published a paper on COVID-19 and its effects on mental health. Can you elaborate on that study? 

So that was a team that I was working with during my postdoctoral work. Dr. Emily Jenkins led this work which was about the impact of COVID-19 on Canadian Mental Health. The first findings that we published showed  an anticipated change in mental health issues among the population, and especially women experienced more mental health issues than men, globally. COVID-19 has affected women badly, as we all know there are some social issues at play. For example, many working women were also taking care of kids at home so there is a double burden. Sex differences were also observed for employment losses i.e. women’s employment has been affected more than men.There’s actually a layer of complexity into women’s well being and in turn the well being of the families and the children. 

You touched a bit on this, but why is women’s health important to you?

Women’s Health has been very close to me for a long time. This passion started when I was a master’s student 15 years ago. I actually joined a multidisciplinary research team back in Pakistan, and it was made up of nurses, psychologists, and psychiatrists. The team’s goal was to develop and test economic skill building and life skill interventions for women, and that’s where my masters thesis came from. So I actually developed and tested that lifestyle building intervention and tested it for feasibility. Intervention development is not an easy task, I went through a lot  of literature, and interviewed several women who were living in some more vulnerable conditions, and some low socio economic communities. I would go to the urban slum areas of Karachi, Pakistan to work with these women. I learnt a lot from these women, it was a life changing experience for me. That was what laid the foundation for my work. After 15 years, I’m still very passionate about that work. 

And the way I think about it is, there are the two main reasons women’s health is important. The first and foremost is, women’s health is directly linked with the children and families health, which is the cornerstone of a family’s overall health. Working in different contexts  of Pakistan and Canada, I learnt that  in general women and mothers play the same roles across countries. There are some universal gender roles attached to women, therefore, women’s mental health is directly associated with their children’s wellbeing.  To pay attention to women’s health and well being is to make children’s lives better and create healthier families. 

And the second reason to focus on women’s health is the high prevalence and high risk of developing certain health challenges among women, as women experience unique healthcare issues more than men. Such as reproductive health issues, violence and abuse, depression and anxiety. These issues are more prevalent globally, and not only in low and middle income women. Moreover, women don’t just experience higher prevalence to diseases but more barriers in accessing  health care than men. Some women may lack economic independence in certain countries, meaning no or lack of education opportunities, or unemployment. If women don’t have the freedom to decide for themselves, this creates a large barrier to reach out for help and support.  Mostly, I’ve seen these issues come up in Pakistan, when women get married. A lot  of attention goes to their families and children, leading them to overlook their own health. So I think this realization and awareness drove the focus of my research, and to empower women, and help them prioritize their health. 

Where can people go to learn more about the work that you do? 

I have  twitter @HiraniSaima and people can look at my Google Scholar or PubMed. 

 

Should Domperidone Be Reconsidered as a Treatment For Low Breastmilk Supply?

Author: Janet C. Currie, MSW, PhD, Research Collaborator at the UBC School of Nursing. Editors: Suzanne Hetzel Campbell PhD, RN, FCNEI, IBCLC, CCSNE, Negin Nia and Arrthy Thayaparan (Blog Coordinators)

Published: March 11th, 2022

Domperidone is a dopamine blocker that is being increasingly prescribed off-label in British Columbia and other provinces to treat low milk supply (LMS). Domperidone increases prolactin, which can stimulate milk production, an unintended side effect.

There is a global consensus on the importance of at least six months of exclusive breastfeeding because of its overwhelming health benefits. An average of 90 per cent of Canadian mothers intend to breastfeed and go on to initiate it. However, by three months the rate of mothers exclusively breastfeeding their newborns has decreased to 51.7 per cent and by six months to 14.4 per cent. One of the most common reasons mothers give for stopping breastfeeding early is because of LMS.

Low milk supply

Physiological factors can contribute to LMS. These include conditions such as mammary hypoplasia, which is limited breast glandular tissue. The prevalence of physical barriers to breastfeeding is thought to be low – from 1 to 15 per cent.

In most cases, LMS appears to be caused by other factors that affect milk supply. These include a mother’s confidence in her milk supply and/or a lack of information about lactation, infant nutritional needs, sleep patterns and hunger cues.  

LMS can also be related to the degree a mother receives sustained help with breastfeeding and the medicalization of breastfeeding which can result in a premature diagnosis of LMS and the early introduction of formula.

Increasing use of domperidone in Canada

Two Canadian studies have documented the rise in domperidone use to treat LMS. In BC, between 2002 and 2011, Smolina et al. found that domperidone use increased from 8 to 19 per cent for term births and from 17 to 32 per cent for preterm births. This research showed an increase in the median daily dose from 60 to 80 mg/day and a longer duration of use.  

A recent study in BC, Alberta, Saskatchewan, Manitoba and Ontario found domperidone use increased between 2004 and 2017 with some reduction in use after Health Canada’s 2012 domperidone advisor.

Off-label use of domperidone

Health Canada has only approved domperidone to treat digestive problems. When it is prescribed for LMS this is an-off-label, unapproved use. Off-label prescribing occurs when a drug that has been approved for specific use by Health Canada is prescribed for another use for which the drug has not been approved. Off-label prescribing can be beneficial especially when few treatments exist for a condition, but without data derived from the drug approval process it can be difficult to assess a drug’s benefits and harms. In addition, ADRs from off-label uses are not systematically collected or analyzed to identify safety problems. 

Domperidone has not been approved for any use in the United States and the distribution or importation of domperidone-containing products into the US violates the law. Domperidone has not been used to treat LMS anywhere in the world. 

Safety concerns of domperidone

Domperidone is a QT-prolonging drug which means that it can trigger ventricular arrhythmias. In the most serious cases, this can lead to Torsades de Pointes, an abnormal heart rhythm that can result in cardiac death.  

The cardiac risks of domperidone are dose-related. In a 2015 advisory, Health Canada recommended that domperidone be used at a maximum daily dose of 30 mg/day for a short duration. However, Canadian research indicates that domperidone is being prescribed above recommended guidelines, sometimes over 80 mg/day.

Taking other QT-prolonging drugs with domperidone increases cardiac risks. Many common prescription drugs are QT-prolonging. They include fluoroquinolone antibiotics (e.g., Cipro), antidepressants (e.g., escitalopram and citalopram, antifungals (e.g., miconazole), and some antipsychotics.

Using a QT-prolonging drug along with CYP3A4 Inhibitors, a type of enzyme, can trigger risks. Substances with CYP3A4 inhibitors include drugs like erythromycin and foods like grapefruit/ grapefruit juice. Other factors that increase the potential risks of domperidone include having a personal or family history of cardiac problems, liver disease, electrolyte problems, and low blood levels of potassium and magnesium. Female sex is an independent risk factor.

Domperidone is an antipsychotic (neuroleptic). Antipsychotics are psychiatric drugs usually approved to treat conditions like psychoses and schizophrenia. Even if someone is taking domperidone for LMS and not for a mental health condition, the potential for adverse drug reactions (ADRs) can be the same. ADRs may intensify if the drug is reduced or stopped rapidly, especially from high doses.

Recent case studies and reports to the Infant Risk Information Centre at Texas Technical University indicate that some people using domperidone for LMS are experiencing serious adverse reactions when they stop. ADRs effects from stopping domperidone could include fatigue, movement/muscle problems, weight gain, anxiety, agitation, palpitations, dry mouth/eyes, dizziness/ poor balance, gastrointestinal problems, insomnia, cognition problems, listlessness and depression and, in serious cases, psychoses or suicidal feelings.

To reduce antipsychotic withdrawal symptoms, domperidone should be tapered consistently and slowly in small increments with a period of 2-4 weeks between reductions or at a pace that is tolerable. A tapering plan should be discussed with a healthcare provider knowledgeable about antipsychotic withdrawal. 

The safety of domperidone absorbed by babies through breastmilk has not yet been clearly established.

Effectiveness of domperidone

Evidence of domperidone’s effectiveness from randomized control trials is of low quality with small study enrollment, short-term tracking, (1-2 weeks), a focus on low doses, a lack of meaningful outcome measures such as duration of breastfeeding and limited reporting of ADRs. In most cases, where domperidone resulted in an increase in milk volume, the increase was not significant. Higher dose levels were not associated with significant increases in milk volume. 

Women’s Health in Review: 2020

Authors: Arrthy Thayaparan and Alex Lukey (Blog Coordinators)

Published: January 15th, 2021

With the dawn of a new year, many are hoping to move past the tumultuous events of 2020. But who can blame them? 2020 will be memorialized in future history books as the year the world came crashing down. In particular, women felt the strain with increases in domestic violence and economic consequences disproportionate to men. For much of the past year, the news and social media painted a grim picture of the world. So it begs to question, did anything good happen in 2020? Is there hope that 2021 will be any better?

In fact, there were many triumphs in women’s rights and health in 2020. While 2020 was a year of unprecedented challenges, the year also highlighted the resilience of women across the globe. Below, we’ve highlighted several successes in 2020 worth celebrating as we begin the new year. 

Argentina legalizes abortion

After 12 hours of debate and tension, Argentina’s Senate voted and legalized abortion. Historically seen as a conservative region, this decision is a major victory for women and activists fighting for the right. It is believed that hundreds of thousands of underground abortions are performed in Argentina every year. The new abortion laws would legalize the procedure and ensure safe practices for women choosing to undergo it. The arrival of these new laws also brings hope for surrounding Latin American countries, in the desire that they will follow suit and also legalize the procedure. 

Pakistan banned virginity tests

A few weeks ago, the high court of Lahore, Pakistan outlawed the use of virginity tests on female rape survivors. Justice Ayesha Malik stated that invasive tests had no legal basis or medical requirement for them to be carried out. Additionally, the practice was deemed a humiliating offense on victims with dangerous potential to re-traumatize them. While the judgement will only apply in the state of Pubjab, it was nevertheless a historic moment for Pakistani activists and the feminist movement. 

25th anniversary of the Beijing Declaration on women’s rights

This year marks the 25th anniversary of the Fourth World Conference on Women, which set a historic agenda for women’s rights. At this conference, over 30,000 activists and representatives from 189 countries adopted a declaration and platform to oversee the equal rights and opportunities of all women. However, other than celebrating this historic event, the anniversary is a wake-up call for countries committed to the declaration. No country has fully delivered or is close to the 2020 goals envisioned by the conference. With COVID-19 exacerbating inequalities and risks for women, it becomes even more essential to continue pushing for women’s rights and women’s health in the coming years. As Hillary Clinton so rightly phrased at this very conference 25 years ago, “Women’s rights are human rights, and human rights are women’s rights.”

Two women scientists awarded Nobel prize in chemistry

Emmanuelle Charpentier and Jennifer Doudna were awarded the 2020 Nobel Prize in chemistry for their work on gene-editing technology. Their tool, known as CRISPR-Cas9, has already had encouraging results in experimental treatments for sickle cell disease. The women mark the eighth and ninth women to ever receive this award since 1901. Despite previous history of women receiving the honour, Charpentier and Doudna make history as the first all-female winners for the Nobel’s chemistry stream. 

Vast improvements of sex inclusion in biological studies

Since the 1990s, the limitation of sex-biased studies and the need for the inclusion of females has been highlighted in research. A 2009 report by Beery and Zucker further highlighted sex-inclusive practices and policies that could mitigate biases and prompted the United States National Institutes of Health to implement a policy that required researchers to consider sex as a biological variable. The policy was intended to ensure equal representation of males and females in studies but received backlash by those who saw the change as unnecessary, time consuming, costly, and complicated. Now over ten years later, a follow-up study has found that the policy has significantly helped in increasing the number of sex-inclusive studies across most biological fields. While much work is still required, there is hope that the scientific community is aware and starting to understand the need for sex-inclusive research. 

Ground-breaking mRNA research is foundation to COVID-19 vaccine

Dr. Katalin Karikó is one of the co-developers of a method that utilizes synthetic mRNA to fight disease. Her discovery is now the foundation of the COVID-19 vaccine. But her story hasn’t been an easy one. After leaving her native Hungary in 1985, Karikó became a researcher at Philadelphia’s Temple University and later at University of Pennsylvania’s School of Medicine. For years she attempted to gain funding for mRNA research, which was deemed too financially risky to fund. She was later demoted from her position at UPenn and underwent a hard battle with cancer, but Karikó stayed true to her ideas. Eventually, she was able to make her discovery, alongside former UPenn colleague Drew Weissman, and is finally receiving recognition for her work. 

Oxford-AstraZeneca vaccine brings hope

Dr. Sarah Gilbert is a Professor of Vaccinology at the University of Oxford, who has recently made waves in the world with her team’s Oxford-AstraZeneca vaccine. Interim data showed that the highly effective vaccine provides 70% protection from COVID-19, but some believe that slight alterations can lead up to 90% protection. Dr. Gilbert’s team has been working to create vaccines for Ebola and MERS for several years. As such, their expertise with these viruses enabled them to design a COVID-19 vaccine soon after Chinese scientists had published the genetic structure of the virus. 

Moving forward into 2021

Without question, the events of 2020 disproportionately impacted women. The stories and events we’ve highlighted here are evidence of women’s determination to advance despite adversity.  While 2021 will undoubtedly bring many more challenges, as shown here, these writers are confident that women will continue to rise to the occasion. 

 

Sex Differences Are No Afterthought

Authors:  Jolande Fooken, Xiuyun Wu, & Doris Chow | Editors: Alex Lukey and Arrthy Thayaparan (Blog Coordinators) 

Published: November 12th, 2020

In recent years more scientists have advocated an increased focus on the role of sex and gender differences in neuroscience research. Specifically, it is important to study sex-related mechanisms in the brain and how they affect sensory processing and motor behaviour. 

Considering that historically most research included only male participants, research standards are trending in the right direction. Today, researchers are strongly encouraged to take sex and gender into consideration for their research. However, is it enough to simply collect the same number of male and female participants or should we think about sex as a scientifically relevant and meaningful variable?

Missed Opportunities in Present Research

A recent study by Mathew and colleagues investigated the effect of sex as a biological variable on hand-eye coordination and processing by the brain, led us to reconsider how sensory and motor neuroscience currently take sex differences into account.[1] It’s true that researchers pay greater attention to sex and gender balance in their research than in the past. However, we still know very little about how visuomotor function might vary between people of different sex and gender. 

Driven by that very question, Mathew and colleagues decided to analyze how the ability to manually track a moving target varies between self-reported male and females.[1] Whereas the general research question could fill a large gap in our current literature, the authors missed their chance to make a significant contribution and advance our knowledge about the importance of sex as a biological variable.

The study, entitled “Sex Differences in Visuomotor Tracking”, was published in July 2020 in Scientific Reports and could potentially reach a high impact in the field. Yet, this study has several gaps, which we will later discuss,  that are not sufficiently addressed in the paper. Therefore, the conclusions drawn should raise red flags as they may mislead some readers and future research. In the following, we will comment on three major points that scientists—interested in sex differences in behavioural neuroscience—should take into account

1. Sex differences are no afterthought

We are living in a time where there are vast amounts of data being used for scientific research. Often scientists publish a subset of the full dataset that was collected, reporting only those measures that address the current research question. At the same time, there may be additional information about the participants, such as age, handedness, or biological sex not included in the analysis. Therefore, it is very tempting to later re-analyze the data to look for differences across various variables. Such differences are exactly what Mathew and colleagues reported.

The authors analyzed data from a manual-tracking baseline task that usually preceded the main experiment in their lab. Manual tracking is a common task in sensorimotor research, in which participants move a joystick to align a visual cursor with a moving target. Typically, experiments aim to investigate how participants adapt their visuomotor control to changes in the visual scene. In the study by Mathew et al., the baseline task required participants to track the moving target as closely and accurately as possible. The authors observed differences between female and male participants: females tracked the unpredictably moving target with a larger time lag than their male counterparts.

These findings should spark interest in any curious scientist. However, there is also a problem: the authors did not have an a priori hypothesis (reasoning based on inference before the study, rather than evidence) about the role of biological sex with respect to visuomotor tracking. Instead, they performed their analyses after the fact. Accordingly, several factors that may influence the role of sex and gender on the results were not controlled for. 

One factor that may have skewed the results of this study is video-gaming, an activity more common among males.[2, 3] Video game experience most likely influences participants’ ability to accurately use a joystick to track a moving target. Additionally, general personality traits could explain the observed individual differences in manual tracking behaviour. For example, risk-averse individuals may track the target with a higher time lag to be able to adjust their hand movements more precisely to sudden changes of target motion. All of this is of course speculative. The study was not designed to study sex differences and therefore cannot answer if visuomotor tracking truly differs between males and females.

 

2. The battle of the sexes: what is a male advantage?

Some readers may cringe when they read that Mathew and colleagues wrote that they found, “a clear male advantage in hand tracking accuracy”. The study shows differences, yes, but an advantage? Tracking a target as fast as possible does not necessarily translate to advantages in everyday life in which timing is often relevant. 

Imagine getting into a car with someone who is trying to follow the car in front as closely as possible—keeping a larger distance may in fact be the safer option. Driving and many other naturalistic scenarios may require us to choose a tracking behaviour that differs from a pure distance minimization. To study optimal visuomotor behaviour we need to first define normative models that allow us to evaluate a decision or judgement.[4] What is the goal of the actor? What does it mean to be successful in a task? What is the error we should aim to minimize?

In motor control, there may be some tasks in which action accuracy is easy to judge. For example, how well a person can throw a ball can be measured in the distance the ball has travelled. However, when we change the definition of success, we also change our measure of accuracy. For daily activities, it may be relatively easy to judge success, but in basic sensorimotor research, it is less clear. 

Thus, optimal performance during manual tracking can be defined in different ways: it may be optimal to track a moving target as closely as possible or to track it as smoothly as possible and thereby reduce overall movement cost. Defining optimal task performance is key to understanding individual strategies when solving any given task. Only then can we draw conclusions about so-called advantages.

3. Males are different from females, now what?

For a moment let’s assume that, despite all the weaknesses in the study by Mathew et al., that we have pointed out, that there is a difference between male and female participants during visuomotor tracking. What does that mean? 

First, we should aim to investigate where such a difference originates. Mathew and colleagues conclude that males may rely on “faster decisional processes dynamically linking visual information of the target with forthcoming hand actions”.[1] However, some of these proposed processes, such as visual processing and early visual brain regions have relatively fixed time scales.

So the question that arises is at what stage of the decision process do differences occur? Does the transformation from visual information into motor commands take longer in female participants? Why? Does this difference change with experience or training? Or are there other factors, such as knowledge about motor uncertainty, that influence visuomotor tracking? Again, we simply don’t know yet and we need more carefully designed research to find these answers.

Another important question that we should ask ourselves is what the implications of the observed differences are. For example, visuomotor control has become very important in the medical field, where robotic devices enable complicated brain surgeries. Are such devices tailored to an average operator? Should we design different devices for female neurosurgeons as compared to males? Is there an actual physiological difference between males and females or are we just measuring differences along a spectrum of individual performance variability? At this time we do not have concrete answers to these questions. So, until we have better answers to the questions of how these differences arise, it may be harmful to make sweeping statements of sex-based advantages. 

We have the opportunity to study sex differences in sensory and motor neuroscience in a meaningful and thorough way. Let’s not report sex differences as an afterthought, but instead study biological sex as an interesting and important factor at the centre of our research agenda.   

REFERENCES

1. Mathew, J., Masson, G. S., & Danion, F. R. (2020). Sex differences in visuomotor tracking. Scientific reports, 10(1), 1-12. https://doi.org/10.1038/s41598-020-68069-0

2. Terlecki, M.S., Newcombe, N.S. (2005). How Important Is the Digital Divide? The Relation of Computer and Videogame Usage to Gender Differences in Mental Rotation Ability. Sex Roles, 53, 433–441. https://doi.org/10.1007/s11199-005-6765-0

3. Quaiser-Pohl, C., Geiser, C., & Lehmann, W. (2006). The relationship between computer-game preference, gender, and mental-rotation ability. Personality and Individual Differences, 40(3), 609-619. https://doi.org/10.1016/j.paid.2005.07.015

4. Körding, K. (2007). Decision theory: what” should” the nervous system do?. Science, 318(5850), 606-610. https://doi.org/10.1126/science.1142998

Images courtesy Joel Staveley, Jehoots and Photologic on Unsplash

Sex/Gender Research: Resources for the Early Integrator to the Advanced Champion

Author: Jennifer Williams, PhD Candidate, McMaster University | Twitter: @jennyswilliams

The importance of integrating sex/gender in health research has been evident in the calls for action by researchers, funding organizations, and peer-reviewed journals alike. Especially in the midst of the global COVID-19 pandemic, this remains at the forefront of study design, illuminated recently by the first of the Women’s Health Research Cluster blogs. Over the past few years as a graduate trainee, I have been involved in research projects either integrating sex-based differences or examining female-specific conditions to fill gaps evident in cardiovascular research. Mentored by leaders in the field, much of my passion for sex/gender research has also been directed to supporting education of undergraduate and graduate trainees through mentorship, teaching, and volunteering with the CIHR Institute of Gender and Health Trainee Network. 

However, in reflecting on my research journey, it occurred to me that many trainees may be presently searching for resources and a network of colleagues considering these important questions. As the upcoming semester approaches, my hope is that this blog will serve as a useful guide to explore sex/gender in your future research studies, whether you’re an early integrator (like me) or an advanced champion (like many of my mentors). By no means is this an exhaustive list, so I encourage you to continue the conversation by sharing your favourite resource on Twitter with the #sexandgender.

Getting Started

What is Sex? What is Gender? When I started to ask myself these questions, I found the following definitions and infographic on the CIHR website helpful in finding the answers. Furthermore, this video (3min) provided me with an explanation about why learning about sex/gender is important. 

The CIHR Institute of Gender and Health curates an excellent list of resources for researchers to consider when integrating sex/gender into research. Check out their guide here, which is updated frequently with new resources and published studies. 

Training Modules

The following training courses/modules served as a foundation for developing my understanding of sex/gender in health research. 

Resources for Grant Applications

In addition to the training modules provided by CIHR, this video (5min) is a helpful resource for understanding what grant reviewers are looking for in assessing your integration of sex/gender into your research study design. This video, alongside a resource for reviewers, entitled “Key considerations for the appropriate integration of sex and gender in research”, can provide insight into what makes a strong research design, and hopefully a successful grant application.

The following article by Day et al. (2017) is a useful guide for understanding how to create your study proposal, based on some essential metrics outlined in their paper: “Essential metrics for assessing sex & gender integration in health research proposals involving human participants”. See Table 1 to do an early evaluation of your proposal (or your trainee’s proposal) and recognize gaps to fill prior to grant submission.

What are Researchers Saying? Research Articles & Guideline Documents 

The following article about the Sex and Gender Equity in Research (SAGER) guidelines are recommended for all researchers to review and include in their research study designs. Find out more here (Table 1 includes a comprehensive checklist of considerations).

Strategies have also been well detailed by the following articles:

Finally, this website from Gendered Innovations, curated by a worldwide group of researchers, has a Health & Medicine Checklist for considering sex/gender at each stage of the research process and case studies on sex/gender in health to use as examples for researchers and educators. 

Journal Clubs: One of the most impactful ways I’ve found for integrating sex/gender into discussions within my lab is in suggesting journal articles during journal club gatherings. Here’s an extensive list of articles curated by the NIH and a list of articles from the CIHR here.

Championing Sex/Gender Research: Organizations to Get Involved With 

Become a Sex and Gender Champion on collaborative research initiatives with CIHR. Similarly, consider joining the Institute of Gender and Health Trainee Network as a trainee mentee or Faculty mentor, and spearhead local initiatives at your institution with the support of this network. You can subscribe to the trainee network’s newsletter here.

CIHR Institute of Gender and Health also provides resources and events to engage with. Find out about Sex & Gender Events here, and consider becoming involved in the Organization of the Study of Sex Differences (OSSD) through their annual conference and journal. 

Finally, look for mentors and collaborators who are experienced in exploring sex and gender in research. If exploring women’s health, the Women’s Health Research Cluster directory is useful for connecting with individuals from across Canada, but primarily in BC, and similar for this directory in Ontario.

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Have a resource to share not on this list? Continue the conversation by sharing your favourite resource on Twitter with the #sexandgender.