Sex differences in neurology: a scoping review.

OBJECTIVE: Historically, neurology research has demonstrated a sex bias with mainly male subjects included in clinical trials as well as lack of reporting of data by sex. In recent years, emphasis has been placed on increased participation of female participants and explicit declaration/evaluation of sex differences in clinical research.We aimed to review the available literature examining sex differences across four subspecialty areas in neurology (demyelination, headache, stroke, epilepsy) and whether sex and gender terms have been used appropriately. DESIGN: This scoping review was performed by searching Ovid MEDLINE, Cochrane Central Registry of Controlled Trials, EMBASE, Ovid Emcare and APA PsycINFO databases from 2014 to 2020. Four independent pairs of reviewers screened titles, abstracts and full texts. Studies whose primary objective was to assess sex or gender differences among adults with one of four neurological conditions were included. We report the scope, content and trends of previous studies that have evaluated sex differences in neurology. RESULTS: The search retrieved 22 745 articles. Five hundred and eighty-five studies met the inclusion criteria in the review. The majority of studies were observational, often examining similar concepts designed for a different country or regional population, with rare randomised controlled trials designed specifically to assess sex differences in neurology. There was heterogeneity observed in areas of sex-specific focus between the four subspecialty areas. Thirty-six per cent (n=212) of articles used the terms sex and gender interchangeably or incorrectly. CONCLUSIONS: Sex and gender are important biological and social determinants of health. However, the more explicit recognition of these factors in clinical literature has not been adequately translated to significant change in neuroscience research regarding sex differences. This study illustrates the ongoing need for more urgent informed action to recognise and act on sex differences in scientific discovery and correct the use of sex and gender terminology. TRIAL REGISTRATION: The protocol for this scoping review was registered with Open Science Framework.

Addressing the Mental Health Needs of Inmates Through Education for Correctional Officers-A Narrative Review.

INTRODUCTION: People with mental illness are overrepresented in correctional facilities. Correctional officers (COs) lack education to respond to inmates with mental illness. A review was conducted of mental health education programs for COs to identify factors related to effectiveness. METHODS: Medical and criminal justice databases were searched for articles describing mental health education for COs. Studies including measurable outcomes were analyzed using an inductive analytic approach. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Data were synthesized using Moore seven levels of outcomes for continuing professional development education. Findings were grouped by curriculum content and described according to levels of outcome. RESULTS: Of 1492 articles, 11 were included in the analysis. Six described mental health programs, two described skill-specific programs, and three described suicide prevention programs. Programs reviewed content about mental illness, practical skills, included didactic and experiential teaching. The programs achieved level 5 on Moore taxonomy. Programs led to improvements in knowledge, skills, and attitudes among officers; however, improvements declined post-training. Officers were receptive to facilitators with correctional or lived mental health experience. Experiential teaching was preferred. Common themes related to programs' effectiveness included applicability to COs, information retention, program facilitators, and teaching methods. DISCUSSION: There is limited, but positive literature suggesting that education programs are beneficial. The decline in improvements suggests need to ensure sustainability of improvements. This review can guide the planning of future education programs for COs based on continuing professional development best practices.

Sex differences in neurology: a scoping review protocol.

INTRODUCTION: Sex and gender are independently important in health and disease but have been incompletely explored in neurology. This is in part contributed to by the pre-existing male bias in scientific literature that results in fewer females being included in clinical research and the often interchangeable use of sex and gender in the literature. This scoping review intends to identify the advances as well as under-explored aspects of this field to provide a road map for future research. This paper outlines the methods for a scoping review of published, peer-reviewed literature on sex and gender differences in four subspecialty areas of neurology: demyelination, stroke, epilepsy and headache. METHODS AND ANALYSIS: A detailed search strategy will be used to search five databases pertaining only to sex differences. Specific inclusion and exclusion criteria will be applied to capture relevant literature published from 2014 to 2020. Data will be collected and synthesised to provide an overview of information retrieved, a narrative synthesis of each subspecialty area and map of results. ETHICS AND DISSEMINATION: Research ethics board approval was not required for this study. This study will aid in mapping recent trends in sex differences in four major neurological conditions and will help identify areas for further research. A manuscript will be compiled for publication and presentations of findings. REGISTRATION DETAILS: The final protocol is registered with the Open Science Framework (https://osf.io/n937x/).