Search Results (43)

Agrarian women are at the forefront of rural livelihoods increasingly affected by the frequency and severity of climate change impacts. However, their household livelihood resilience (HLR) remains limited due to gender-blind policies, scarce sex-disaggregated data, and inadequate consideration of gender-specific needs in resilience-building efforts. Grounded in participatory feminist research, this study employed a multi-method qualitative approach, including semi-structured interviews and oral history narratives, with 60 women in two climate-vulnerable provinces. Data were analyzed through thematic coding, CATWOE (Customers, Actors, Transformation, Worldview, Owners, Environmental Constraints) analysis, and descriptive statistics. The findings identify nine major climate-related events disrupting livelihoods and reveal a limited understanding of HLR as a long-term, transformative concept. Adaptation strategies remain short-term and focused on immediate survival. Barriers to HLR include financial constraints, limited access to agricultural resources and technology, and entrenched gender norms restricting women’s leadership and decision-making. While local governments, women’s associations, and community networks provide some support, gaps in accessibility and adequacy persist. Participants expressed the need for financial assistance, vocational training, agricultural technologies, and stronger peer networks. Strengthening HLR among agrarian women requires gender-sensitive policies, investment in local support systems, and community-led initiatives. Empowering agrarian women as agents of change is critical for fostering resilient rural livelihoods and achieving inclusive, sustainable development. Full article

Background/Objectives: Frailty is a multifactorial clinical syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. It is increasingly recognized as a predictor of poor outcomes in cardiac rehabilitation (CR). However, how frailty is defined, assessed, and addressed across outpatient CR programmes remains unclear. This scoping review aimed to map the extent, range, and nature of research examining frailty in the context of outpatient CR, including how frailty is measured, its impact on CR participation and outcomes, and whether sex and gender considerations or participation barriers are reported. Methods: Following the PRISMA-ScR guidelines, we conducted a comprehensive search across six electronic databases (from inception to 15 May 2025). Eligible peer-reviewed studies included adult participants assessed for frailty using validated tools and enrolled in outpatient CR programmes. Two reviewers independently screened citations and extracted data. Results were synthesized descriptively and narratively across three domains: frailty assessment, sex and gender considerations, and barriers to CR participation. The protocol was registered with the Open Science Framework. Results: Thirty-nine studies met inclusion criteria, all conducted in the Americas, Western Pacific, or Europe. Frailty was assessed using 26 distinct tools, most commonly the Kihon Checklist, Fried’s Frailty Criteria, and Frailty Index. The median pre-CR frailty prevalence was 33.5%. Few studies (n = 15; 38.5%) re-assessed frailty post-CR. Sixteen studies reported sex or gender data, but none applied sex- or gender-based analysis (SGBA) frameworks. Only eight studies examined barriers to CR participation, identifying physical limitations, emotional distress, cognitive concerns, healthcare system-related factors, personal and social factors, and transportation as key barriers. Conclusions: The literature on frailty in CR remains fragmented, with heterogeneous assessment methods, limited global representation, and inconsistent attention to sex, gender, and participation barriers. Standardized frailty assessments and individualized CR programme adaptations are urgently needed to improve accessibility, adherence, and outcomes for frail individuals. Full article

Background: Mobility limitation is a pivotal but under-documented dimension of disability in Saudi Arabia. Leveraging the 2017 National Disability Survey, this cross-sectional study provides a population-wide profile of mobility-related physical difficulty. Objectives: Five research aims were pursued: (1) estimate national prevalence and severity by sex; (2) map regional differentials; (3) examine educational and marital correlates; (4) characterize cause, duration, and familial context among those with multiple limitations; and (5) describe patterns of assistive-aid and social-service use. Methods: Publicly available aggregate data covering 20,408,362 Saudi citizens were cleaned and analyzed across 14 mobility indicators and three baseline files. Prevalence ratios and χ² tests assessed associations. Results: Overall, 1,445,723 Saudis (7.1%) reported at least one functional difficulty; 833,136 (4.1%) had mobility difficulty, of whom 305,867 (36.7%) had mobility-only impairment. Severity was chiefly mild (35% of cases), with moderate (16%) and severe (7%) forms forming a descending pyramid. Prevalence varied more than threefold across the thirteen regions, peaking in Aseer (9.4%) and bottoming in Najran (2.9%). Mobility difficulty clustered among adults with no schooling (36.1%) and widowed status (18.5%), with sharper female disadvantage in both domains (p < 0.001). Among those with additional limitations, chronic disease dominated etiology (56.3%), and 90.1% had lived with disability for ≥25 years; women were overrepresented in the longest-duration band. Aid utilization was led by crutches (47.7%), personal assistance (25.3%), and wheelchairs (22.6%), while 83.8% accessed Ministry rehabilitation services, yet fewer than 4% used home or daycare support. Conclusions: These findings highlight sizeable, regionally concentrated, and gender-patterned mobility burdens, underscoring the need for education-sensitive prevention, chronic-care management, investment in advanced assistive technology, and distributed community services to achieve Vision 2030 inclusion goals. Full article

Metabolic analysis systems require binary sex input, conflating biological sex with gender, limiting inclusivity. This study aimed to determine whether sex input altered metabolic or pulmonary variables during self-paced walking and running. Twenty adults completed two 5-min walking and running trials under both female (FC) and male (MC) input conditions in randomized order. Dependent t-tests determined differences between conditions; p-values < 0.05 were considered significant, and effect sizes were calculated. No significant within-participant differences were found between FC and MC for any variable. During walking, mean relative VO₂ (mL/kg/min) was 11.13 ± 2.73 (FC) and 10.81 ± 2.39 (MC), p = 0.08, R² = 0.93; mean energy expenditure (kcal) was 18.28 ± 4.74 (FC) and 17.86 ± 4.33 (MC), p = 0.12, R² = 0.94. During running, mean relative VO₂ was 28.80 ± 5.89 (FC) and 28.82 ± 6.06 (MC), p = 0.90, R² = 0.98; mean energy expenditure was 45.79 ± 13.08 (FC) and 45.55 ± 12.26 (MC), p = 0.99, R² = 0.98. Binary sex input in the TrueOne 2400 system did not affect variables, supporting inclusive sex and gender data collection to improve research ethics, accuracy, and representation of gender-diverse people without compromising integrity. Full article

The latest Relationships Education, Relationships and Sex Education, and Health Education (RSHE) Draft Guidance seeks to reduce the inclusion of LGBT themes in English schools. Additionally, the Gender Questioning Draft Guidance for Schools and Colleges and the Cass Review overlook the rights of trans and non-binary young people, further intensifying the heated debates surrounding their lives. In response, the author draws upon research conducted in a primary school in Greater London in 2021, when statutory RSHE, including LGBT content, was first introduced. The research aimed to understand how teachers felt about teaching RSHE and to collaborate with them to enhance pupil learning within and beyond the RSHE curriculum. This paper critiques lesson observations and teachers’ reflections on their lessons using a Framework for Sexuality Education and Queer Theory. The researcher’s call to rethink how RSHE is taught should not be taken to mean it should not be taught. To the contrary, the findings suggest a need for the school to broaden its curriculum, teaching methods, and strategies to become a truly ‘LGBT-inclusive’ environment. However, the paper also illuminates the apprehensions these primary school teachers experienced, which in turn influenced pedagogical decisions. The article concludes by recommending specific whole-school approaches and effective pedagogical practices for RSHE in the school, which could be beneficial to other primary school settings. Effective teaching of LGBT themes requires clear support for educators, especially within the complexity of a primary school setting and given the changing political and social climate. Full article

The experience of loneliness in old age has gained relevance for social gerontology due to its association with the adverse biopsychosocial health status of the elderly, significantly impacting quality of life in old age. Therefore, the objective of this study was to understand the experiences of loneliness, analysing the perception of its risk and protective factors, as well as the coping strategies used by older people in Chile and Spain, through a transnational qualitative approach, with a view to identifying the influence of cultural variables in the presence of this problem. This research was a descriptive study which used qualitative methodologies for data collection and analysis. The research participants were 30 older people of both sexes who participated in a semi-structured interview about their experiences of loneliness. The main results showed that loneliness in old age was experienced as an emotional disconnection and lack of intimacy and company, mainly in family relationships. Among the most prominent risk factors were old age, gender roles, widowhood, economic limitations, and loss of autonomy. Protective factors included active social participation, religious practice, and participation in meaningful social activities. As for coping strategies, these ranged from strengthening relationships to using digital tools and accepting loneliness as part of life. The findings of this study underline the importance of designing interventions focused on social inclusion and subjective well-being in old age, which contribute to preventing the experience of loneliness at this stage of the life cycle. Full article

Teacher education is paramount for nurturing democratic, critical, and participative citizenship. Educators should approach identity formation from an intersectional perspective, encompassing sex–gender, racial, and cultural diversities. This perspective highlights social inequalities and challenges the power structures that sustain them. Teachers play a crucial role in shaping and reflecting on these identities since their responsibilities extend beyond knowledge transmission. Their ability to incorporate intersectional perspectives into teaching influences students’ understanding of intersectionality, thereby supporting the development of inclusive identities and promoting democratic citizenship. This article opens with the results of research on how trainee teachers acquire competencies in feminist critical visual literacy. Following this review, we analyzed educational materials to examine stereotypes, racism, and the invisibility of racialized and cultural minority communities. We also addressed the identification and counteraction of hate speech targeting the LGTBIQ+ community as well as different gender-based violence. Comparative data from participating universities provide insights into the critical skills of pre-service teachers across international contexts. This study highlights an urgent need for further research into integrating intersectionality in teacher training, supported by educational policies that strengthen critical competencies through a holistic, gender- and race-sensitive approach aimed at social justice. These initiatives would promote an education system responsive to multifaceted diversities. Full article

Background: Diet significantly impacts the onset and progression of inflammatory bowel disease (IBD), and diet offers unique opportunities for treatment and preventative purposes. However, despite growing interest, no diet has been conclusively associated with improved long-term clinical and endoscopic outcomes in IBD, and evidence-based dietary guidelines for IBD remain scarce. This narrative review critically examines dietary assessment methods tailored to the unique needs of IBD, highlighting opportunities for precision and inclusivity. Methods: We conducted a comprehensive literature review using search terms related to diet, diet assessment, nutrition, food, sex, gender, equity, and IBD. Results: The identified dietary assessment tools evaluated nutritional quality, dietary patterns, food processing, lifestyle interactions, inflammatory potential, and effects of specific nutrients. Advanced methods, including biomarkers, multi-omics approaches, and digital tools, were highlighted as being complementary to traditional approaches, offering enhanced precision and real-time monitoring. Women remain under-represented in dietary research but face unique nutritional needs due to hormonal cycles, pregnancy, and higher malnutrition risks in IBD. Discussion: Traditional diet assessment methods remain valuable but are often limited by misreporting biases. Advanced approaches may provide greater precision, enabling real-time monitoring and personalised dietary tracking. Incorporating considerations of sex, gender, age, ethnicity, socioeconomic, and sustainability enhances the relevance and applicability of these methods. Addressing these multifaceted aspects of dietary assessment in IBD can facilitate robust interventional trials. Conclusions: Diet assessment tools are essential for developing personalised dietary interventions in IBD, informing evidence-based guidelines, and improving health outcomes and quality of life in IBD. Full article

Autoimmune diseases are identified by the chronic inflammation and tissue damage resulting from unregulated immune responses throughout the body. Systemic lupus erythematosus, type 1 diabetes mellitus, and Hashimoto’s thyroiditis are among the 80+ characterized conditions, 80% of which are diagnosed in women. The compounded effects of biological sex and hormones; social identities, such as age, race, and gender; and other determinants on health highlight a pressing need for an inclusive approach to address disparities for women living with autoimmune diseases. Such an approach must recognize and incorporate intersectional experiences of diverse populations of women into biomedical research, clinical practice, and policy solutions. Research must prioritize inclusive designs, data collection, and representation of women in clinical studies. Clinical care must focus on developing guidelines and promoting patient–provider interactions that meet a range of demographic needs. Health care policies must support financial investments in research and equitable access to care. This review provides an overview of the impacts of autoimmune diseases on women’s health through an intersectional lens, identifies persistent gaps in addressing the unique needs of women, and proposes recommendations for a comprehensive, equity-focused approach to mitigate disparities and better serve all women at risk for or living with autoimmune diseases. Full article

This study investigates the effectiveness of inclusion measures for women with disabilities at a public university in southern Spain, aiming to understand their needs and experiences. Utilizing a gender perspective, the research engaged 12 women from various university roles in semi-structured interviews, later analyzed using NVivo 20, and organized into categories assessing institutional resources, working/academic conditions, and the interplay of disability and gender. Findings indicate that, despite no direct discrimination based on sex, the patriarchal social framework still fosters gender and inclusion gaps. Peer support emerges as a protective factor, whereas obstacles such as resource scarcity, access challenges, and a lack of awareness about disability measures pose risks. The study highlights the need for enhanced visibility of inclusive measures and the development of agile, individualized policies. It underscores the importance of raising awareness, particularly about non-visible disabilities, through educational initiatives. Full article

The intersection of religious beliefs and sex work has long been a subject of debate, with varying perspectives on the moral, social, and legal implications. This qualitative systematic review aimed to review the nuanced relationship between religious beliefs and sex work by synthesizing the existing literature and providing insights into the diverse perspectives and experiences. The rationale for this research is to understand how religious beliefs influence societal attitudes, policies, and the experiences of sex workers in order to inform more effective and culturally sensitive interventions and support mechanisms. This review focused on articles pertaining to female-identified sex workers, as the gendered discussion happens heavily in religious interpretations and in current anti-trafficking legislation, which now genders men as customers and not as sex workers. Five stages of systematic review were followed in this review. The following peer-reviewed electronic databases from 2000 to 2023 were utilized: Google Scholar, Scopus database, Science Direct, and PubMed. The search strategy focused on identifying studies that investigated the impact of religious beliefs on various aspects of sex work, including attitudes towards sex work within religious communities and the influence of religious teachings on the behavior and practices of sex workers. Inclusion criteria were defined based on population, exposure, study design, and outcomes, while exclusion criteria were established to ensure the relevance and rigor of the included studies. Only 25 relevant studies resulted from this research. Four themes emerged from this study: (1) religious attitudes towards sex work; (2) experiences of sex workers, including stigmatization and marginalization within religious contexts; (3) social control; and (4) empowerment and advocacy. The relationship between religious beliefs and sex work is complex and multifaceted, influenced by cultural, social, and historical factors. Recognizing and understanding these perspectives is essential for developing more inclusive and effective interventions and policies that address the needs and rights of sex workers within the context of their religious beliefs and communities. Full article

Non-alcoholic fatty liver disease (NAFLD) is common and presents in a large proportion—up to 30%—of the global adult female population. Several factors have been linked with NAFLD in women, such as age, obesity, and metabolic syndrome. To extract appropriate details about the topic, we conducted an extensive search using various medical subject headings and entry terms including ‘Menopause’, ‘Non-alcoholic fatty liver disease’, ‘Insulin resistance’, and ‘BMI’. This exhaustive search resulted in a total of 180 studies, among which only 19 were able to meet the inclusion criteria. While most of these studies indicated a significant rise in NAFLD prevalence among postmenopausal women, two did not find strong evidence linking menopause with NAFLD. Moreover, it was observed that women with NAFLD had higher insulin resistance levels and BMIs compared to those without the condition. In summary, it is important to consider specific factors like risk profile, hormonal status, and age along with metabolic components when treating women presenting with NAFLD. There is need for data-driven research on how gender affects the sensitivity of biomarkers towards NAFLD as well as the development of sex-specific prediction models—this would help personalize management approaches for women, who stand to benefit greatly from such tailored interventions. Full article

The growing interest in “Traineras”, a traditional competitive rowing modality prevalent in Northern Spain, underscores the need for a comprehensive analysis of the injury incidence associated with this sporting practice. Despite rowing’s significance in the international sports arena and its inclusion since the beginnings of the modern Olympic Games, research into injuries in this sport, especially in traditional modalities such as Traineras, has been limited. This study aimed to identify and describe the predominant injuries among Traineras rowers, analyzing their epidemiology, characteristics, affected body regions, and diagnoses, further differentiated by competitive level and gender. A retrospective survey completed by 773 rowers (24% women, 76% men) participating in various leagues (ACT, ARC1, ARC2, LGT1, LGT2, ETE, and LGT-F) during the season revealed that 68.2% suffered from at least one injury, predominantly due to overuse (91.1% in men, 83.1% in women). The most affected regions were the lower back and shoulders, with the main diagnoses being muscle cramps and tendinitis, showing statistically significant differences between sexes. The findings of this study not only provide a deeper understanding of the etiology and origin of injuries in this sport but also lay the groundwork for developing specific injury prevention plans, thereby contributing to the safety and optimal performance of athletes. Full article

In the biomedical field, the differentiation between sex and gender is crucial for enhancing the understanding of human health and personalizing medical treatments, particularly within the domain of orthopedics. This distinction, often overlooked or misunderstood, is vital for dissecting and treating musculoskeletal conditions effectively. This review delves into the sex- and gender-specific physiology of bones, cartilage, ligaments, and tendons, highlighting how hormonal differences impact the musculoskeletal system’s structure and function, and exploring the physiopathology of orthopedic conditions from an epidemiological, molecular, and clinical perspective, shedding light on the discrepancies in disease manifestation across sexes. Examples such as the higher rates of deformities (adolescent idiopathic and adult degenerative scoliosis and hallux valgus) in females and osteoporosis in postmenopausal women illustrate the critical role of sex and gender in orthopedic health. Additionally, the review addresses the morbidity–mortality paradox, where women, despite appearing less healthy on frailty indexes, show lower mortality rates, highlighting the complex interplay between biological and social determinants of health. Injuries and chronic orthopedic conditions such osteoarthritis exhibit gender- and sex-specific prevalence and progression patterns, necessitating a nuanced approach to treatment that considers these differences to optimize outcomes. Moreover, the review underscores the importance of recognizing the unique needs of sexual minority and gender-diverse individuals in orthopedic care, emphasizing the impact of gender-affirming hormone therapy on aspects like bone health and perioperative risks. To foster advancements in sex- and gender-specific orthopedics, we advocate for the strategic disaggregation of data by sex and gender and the inclusion of “Sexual Orientation and Gender Identity” (SOGI) data in research and clinical practice. Such measures can enrich clinical insights, ensure tailored patient care, and promote inclusivity within orthopedic treatments, ultimately enhancing the precision and effectiveness of care for diverse patient populations. Integrating sex and gender considerations into orthopedic research and practice is paramount for addressing the complex and varied needs of patients. By embracing this comprehensive approach, orthopedic medicine can move towards more personalized, effective, and inclusive treatment strategies, thereby improving patient outcomes and advancing the field. Full article

The 2022–2023 Mpox multi-country outbreak, identified in over 110 WHO Member States, revealed a predominant impact on cisgender men, particularly those engaging in sex with men, while less frequently affecting women. This disparity prompted a focused investigation into the gender-specific characteristics of Mpox infections, particularly among women, to address a notable knowledge gap. This review systematically gathers and analyzes the scientific literature and case reports concerning Mpox infections in women, covering a broad geographical spectrum including regions such as Argentina, Brazil, Colombia, Nigeria, Europe, Vietnam, and the United States. The analysis delves into various aspects of Mpox in women, including clinical features, epidemiology, psychological impacts, preparedness strategies, and case studies, with particular attention to pregnant women and those with underlying health conditions. Empirical data from multiple studies underscore the unique epidemiological and clinical patterns of Mpox in women. In the United States, a small percentage of Mpox cases were reported among cisgender women, with a notable portion involving non-Hispanic Black or African American, non-Hispanic White, and Hispanic or Latino ethnicities. The primary transmission route was identified as sexual or close intimate contact, with the virus predominantly manifesting on the legs, arms, and genital areas. Further, a study in Spain highlighted significant disparities in diagnosis delays, transmission modes, and clinical manifestations between genders, indicating a different risk profile and disease progression in women. Additionally, a case from Vietnam, linked to a new Mpox sub-lineage in women, emphasized the role of women in the transmission dynamics and the importance of genomic monitoring. This review emphasizes the necessity for inclusive surveillance and research to fully understand Mpox dynamics across diverse population groups, including women. Highlighting gender and sexual orientation in public health responses is crucial for an effective approach to managing the spread and impact of this disease. The findings advocate for a gender-diverse assessment in health services and further research to explore the nuances of Mpox transmission, behavior, and progression among different groups, thereby enhancing the global response to Mpox and similar public health challenges. Full article