Mixed-race Women Research Articles

Epidemiological profile of syphilis during pregnancy in the state of Amapá, Amazon, Brazil, between 2018 and 2022

Syphilis is a Sexually Transmitted Infection (STI) that, during pregnancy, can cause miscarriages, fetal malformations, blindness, deafness, mental disabilities, and/or stillbirth. It is considered a key tool in evaluating the quality of prenatal care. This article aimed to outline the epidemiological profile of syphilis in pregnant women in the state of Amapá, Amazon, Brazil, between 2018 and 2022, using data from DATASUS. A total of 2,069 cases of syphilis in pregnant women were reported during the study period. There was an increase in the number of cases from 282 in 2018 to 364 in 2019. In 2020, likely due to the pandemic, the number of diagnoses decreased to 309. The year 2021 saw the highest number of cases, with a total of 594 reports, followed by 520 in 2022. Most patients were mixed-race women, had completed elementary education, and were between 20 and 39 years old. The most frequent clinical classification was primary syphilis, a period with a high likelihood of vertical transmission. Although most cases were reported in the city of Macapá, the state’s capital was the only capital in Brazil where the detection rate of syphilis in pregnant women was lower than the state average. Cases from islands in Pará, such as Afuá, Breves, and Chaves, were also reported, likely due to the proximity of these municipalities to health reference centers located in municipalities in Amapá. As a result, Amapá recorded a detection rate of syphilis in pregnant women of 36.24 in 2021 and 34.52 cases per 1,000 live births in 2022, ranking as the fourth highest in the country and the second highest in the northern region. In light of these findings, there is a need for strategies to prevent syphilis in susceptible populations, as well as for appropriate diagnosis and treatment of syphilis cases in pregnant women, thus avoiding the incidence of congenital syphilis and other complications, especially in rural areas.

Racial/ethnic disparity in severe maternal morbidity among women who conceived by in vitro fertilization

BackgroundIn vitro fertilization (IVF) as a fertility treatment is associated with adverse perinatal outcomes. Racial/ethnic disparity in severe maternal morbidity (SMM) in women who conceived by IVF is understudied. ObjectiveTo examine differences in the association between race/ethnicity and SMM between women who conceived spontaneously and those who conceived using IVF. MethodsWe included all singleton live births and stillbirths in the United States, 2016–2021; data were obtained from the National Center for Health Statistics. Maternal race/ethnicity included non-Hispanic White (NHW), non-Hispanic Black (NHB), American Indian and Alaska Native (AIAN), Asian, Pacific Islander (PI), Hispanic, and mixed-race categories. The SMM composite outcome included eclampsia, uterine rupture, peripartum hysterectomy, blood transfusion, and intensive care unit (ICU) admission. We used logistic regression to adjust for potential confounders (such as age, education, parity, prepregnancy body mass index, smoking during pregnancy, chronic hypertension, and preexisting diabetes) and to assess modification of the association between race/ethnicity and SMM by IVF. ResultsThe study population included 21,585,015 women: 52% were NHW, 15% NHB, 0.8% AIAN, 6% Asian, 0.2% PI, 24% Hispanic, and 2% were of mixed race. IVF was used by 183,662 (0.85%) women; the rate of the SMM composite outcome was 18.5 per 1000 deliveries and 7.9 per 1000 deliveries in the IVF and spontaneous conception groups, respectively (unadjusted rate ratio 2.34, 95% confidence interval [CI] 2.26–2.43). In women with spontaneous conception, NHB, Asian and mixed-race women had elevated odds of SMM compared with NHW women (adjusted odds ratio [aOR]=1.39, 95% CI 1.37–1.41; aOR=1.04, 95% CI 1.02–1.07; and aOR=1.42, 95% CI 1.38–1.46, respectively). Racial/ethnic disparities in SMM and its components were not different between the IVF and spontaneous conception groups for the mixed-race category. NHB and Hispanic women had significantly higher aORs for uterine rupture/intrapartum hysterectomy compared with NHW women in the IVF group, while Asian women had a higher aOR for ICU admission compared with NHW women in the IVF group. ConclusionWomen who conceived by IVF have a greater than two-fold higher risk of SMM and this higher risk is evident across all racial/ethnic groups. However, NHB and Hispanic women who conceived by IVF had a higher risk of uterine rupture/hysterectomy, and Asian women who conceived by IVF had a higher risk of ICU admission. Our results warrant further investigation examining pregnancy and postpartum care issues among racial/ethnic minority women who conceive using IVF.

Community-acquired pneumonia associated with immunosuppression due to follicular thyroid cancer: a case report

BackgroundWe present the case of a woman with cancer, which weakened the immune system and increased the risk of infection. Thus, infections are a frequent complication of cancer. The development of community-acquired pneumonia, an acute respiratory infectious disease that damages the lung parenchyma, caused by the invasion of pathogenic microorganisms, can lead to respiratory failure with multiorgan failure due to respiratory sepsis.Case presentationCase report of a 38-year-old mixed-race woman with diabetes mellitus and irregular treatment, who was admitted with community-acquired pneumonia complicated by type I respiratory failure requiring mechanical ventilation. During her hospital stay, she developed ventilator-associated pneumonia, recurrent empyema, bronchopleural fistula, refractory septic shock and multiorgan dysfunction despite multiple interventions. The patient required prolonged mechanical ventilation, vasopressor support and antibiotic therapy. After 62 days, metastatic papillary thyroid carcinoma was diagnosed. She presented with hypoparathyroidism and permanent hypocalcemia. She died after multiple complications and a refractory critical condition.ConclusionThe case exemplifies the potential severity of community-acquired pneumonia in a patient with risk factors such as diabetes and immunosuppression. It highlights the complexity of treating multiple comorbidities and the importance of multidisciplinary management with close surveillance for timely interventions for complications.

Headache as the most prevalent post-vaccination adverse event after Covid-19 vaccination

Context: In 2020, the first vaccines were approved, according to the WHO. However, speculations have arisen regarding its efficacy and post-vaccination adverse events (AEFI). Objective: To evaluate the prevalence of headache as AEFI from the SARSCoV-2 vaccine in Piauí, Brazil.Methods: This is a quantitative, observational, cross-sectional and prevalence study. The data were provided by the Post-Vaccination Adverse Events Information System (SI-AEFV), of cases reported in the period from January to September 2021. The data were analyzed and the research was approved by the Research Ethics Committee of the UFPI. Results: 2,008 cases were analyzed. Headache was reported in 752 cases (27.99%) as AEFI after vaccination against SARS-CoV-2. In most cases, the patients were from Teresina (67.62%), of mixed race/ethnicity (52.67%), female (79.00%) and the majority were not healthcare professionals (54. 27%). The most common age of patients, with the original data, was 33 years old. After correcting the data, the most common age was 28 years old. The majority of these cases were not serious (96.44%) and the majority of cases were associated with the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine (43.18%). Conclusion: Thus, it is concluded from the partial analysis of the results that headache is the most common adverse event after vaccination against SARS-CoV-2. The profile of patients with the most notifications was mixed-race women aged between 30 and 40 years who received the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine. Regarding the severity of the events, the vast majority were considered non-serious and no deaths were mentioned, demonstrating the safety of immunobiologicals.

Visions of the East: Orientalism and Imperialism in the Memoirs of Crimean War Nurses

ABSTRACT The article examines the memoirs of four women who provided nursing care in the Crimean War: Mary Seacole, Elizabeth Davis, Martha Nicol and Fanny Margaret Taylor. It argues that these memoirs are also Orientalist travelogues that reflect the women’s participation in Britain’s informal empire in the eastern Mediterranean. These women used Orientalist tropes, such as scenic vistas, idle servants and foreign customs like the harem, to attract a readership for their publications. Additionally, by allying themselves with the British civilizing mission, these women sought acceptance from British society. The middle-class volunteer nurses, like Fanny Margaret Taylor or Martha Nicol, attempted to excuse their seemingly unconventional behavior in journeying far from the traditional female domestic sphere to serve as war nurses, while Elizabeth Davis, a working-class nurse, aimed to overcome the stereotypes of intemperance and immorality associated with her profession. Finally, as a mixed-race woman, Mary Seacole faced a great difficulty in gaining the sympathy of her white British readership but by intensively associating herself with the British military and its customs, she gained the affection of the British public.

Reframing Perceptions of Signares in French Colonial Senegal

Fifteenth to nineteenth-century French Colonial Senegal was a period of unprecedented cultural contact and convergence in Western Africa. With these interactions came new social hierarchies and the emergence of the signare identity. Signares were wealthy mixed-race and African Women who became involved with French men. This paper examines nineteenth-century art by Frenchman David Boilat and Stanislas Darondeau, and the eighteenth-century house of signare Anne Pepin. It critiques the racism and sexism depicted within Boilat and Darondeau’s work as well as its misinterpretations by contemporary scholars Mark Hinchman and George E. Brooks. Signares were knowledgeable entrepreneurs rather than manipulative and seductive women, which I argue with the support of contemporary scholars Marylee Crofts and Hilary Jones’ work. As I complicate existing research and develop an alternative narrative, I urge readers to question the diverse narratives about these African and mixed-race women in French Colonial Senegal.

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and Human Immunodeficiency virus infection: dilemmas in diagnosis and management: a case series

BackgroundMyelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently described autoimmune inflammatory disorder of the central nervous system (CNS). There is limited data on the association between Human Immunodeficiency virus (HIV) infection and MOGAD. We report three patients with HIV infection and myelin oligodendrocyte glycoprotein (MOG) antibodies in the setting of other central nervous system infections.Case descriptionsThe first patient, a 44-year-old black African man, presented with acute disseminated encephalomyelitis (ADEM) with positive serum MOG antibodies. He made a significant recovery with corticosteroids but had a quick relapse and died from sepsis. The second patient, an 18-year-old black woman, presented with paraplegia and imaging revealed a longitudinally extensive transverse myelitis and had positive serum MOG antibodies. She remained paraplegic after methylprednisone and plasmapheresis treatments. Her rehabilitation was complicated by development of pulmonary embolism and tuberculosis. The third patient, a 43-year-old mixed-race woman, presented with bilateral painless visual loss. Her investigations were notable for positive MOG antibodies, positive Varicella Zoster Virus on cerebral spinal fluid (CSF) and hyperintense optic nerves on magnetic resonance imaging (MRI). Her vision did not improve with immunosuppression and eventually died from sepsis.ConclusionOur cases illustrate the diagnostic and management challenges of MOGAD in the setting of advanced HIV infection, where the risk of CNS opportunistic infections is high even without the use of immunosuppression. The atypical clinical progression and the dilemmas in the diagnosis and treatment of these cases highlight gaps in the current knowledge of MOGAD among people with HIV that need further exploration.

Singing of Sex and Freedom: Courtesans and Erotic Arts in “Zabet”

Abstract: This article examines depictions of mixed-race courtesans in the eighteenthcentury Creole courtesan song “Zabet” which was originally transcribed in an unpublished document by the travel writer Moreau de Saint-Méry (1750–1819). My analysis of “Zabet” interrogates the intersecting oppressions of racism, sexism, and imperialism. Specifically, this article demonstrates how the lyrics of this song present a woman-to-woman sexual mentorship that provides a space of resistance for women of color to these intersecting oppressions. Through this mentorship, the song’s narrator/singer provides important lessons for mixed-race women in how to manipulate racialized and gendered stereotypes of the sexual marketplace in colonial Saint-Domingue.

Association between food environments and fetal growth in pregnant Brazilian women

IntroductionBirth weight is described as one of the main determinants of newborns’ chances of survival. Among the associated causes, or risk factors, the mother’s nutritional status strongly influences fetal growth and birth weight outcomes of the concept. This study evaluates the association between food deserts, small for gestational age (SGA), large for gestational age (LGA) and low birth weight (LBW) newborns.DesignThis is a cross-sectional population study, resulting from individual data from the Live Birth Information System (SINASC), and commune data from mapping food deserts (CAISAN) in Brazil. The newborn’s size was defined as follows: appropriate for gestational age (between 10 and 90th percentile), SGA (< 10th percentile), LGA (> 90th percentile), and low birth weight < 2,500 g. To characterize food environments, we used tertiles of the density of establishments which sell in natura and ultra-processed foods. Logistic regression modeling was conducted to investigate the associations of interest.ResultsWe analyzed 2,632,314 live births in Brazil in 2016, after appropriate adjustments, women living in municipalities with limited availability of fresh foods had a higher chance of having newborns with SGA [OR2nd tertile: 1.06 (1.05–1.07)] and LBW [OR2nd tertile: 1.11 (1.09–1.12)]. Conversely, municipalities with greater availability of ultra-processed foods had a higher chance of having newborns with SGA [OR3rd tertile: 1.04 (1.02–1.06)] and LBW [OR2nd tertile: 1.13 (1.11–1.16)]. Stratification by race showed that Black and Mixed/Brown women had a higher chance of having newborns with SGA [OR3rd tertile: 1.09 (1.01–1.18)] and [OR3rd tertile: 1.06 (1.04–1.09)], respectively, while Mixed-race women also had a higher chance of having newborns with LBW [OR3rd tertile: 1.17 (1.14–1.20)]. Indigenous women were associated with LGA [OR3rd tertile: 1.20 (1.01–1.45)].ConclusionThe study found that living in areas with limited access to healthy foods was associated with an increased risk of SGA and low birth weight among newborns, particularly among Black and Mixed/Brown women. Therefore, urgent initiatives aimed at reducing social inequalities and mitigating the impact of poor food environments are needed in Brazil.

Benefits and Challenges of Peer Interaction in Calculus Group Exams: Perspectives of Latina/Hispanic & Mixed Race Women

Collaborative assessment techniques are needed to align with shifting approaches to learning that center peer interaction. Furthermore, it is critical to understand how collaborative assessments work for students belonging to historically marginalized groups. This study reports the perspectives of four mixed race and Latina/Hispanic women regarding peer interaction and group exams in university mathematics courses. Three primary themes emerged from interviews: (a) benefits of communication during group exams, (b) challenges of working with peers during group exams, and (c) consideration of gender balance when assigning exam groups. These findings have implications for how college instructors implement collaborative exams in intentional ways that benefit students.

Nella Larsen’s Passing: Ambiguous Symbology &amp; Weather

Nella Larsen wrote Passing in 1929, a novella that explored the relationship between two women of mixed race: Irene and Clare. This article highlights the complimentary weather elements with the emotional turbulence experienced by Irene as she tells the story; Clare’s warmth and beauty to Irene’s cold and lack thereof. This article also explores the skills of Larsen to write these ambiguous complimentary weather elements in Passing by highlighting her other novella Quicksand, published the year before.

The Nightmare Island: Representations of St. Barthélemy in Swedish Novels

The Nightmare Island: Representations of St. Barthélemy in Swedish Novels

HIV-1 remission and possible cure in a woman after haplo-cord blood transplant

Previously, two men were cured of HIV-1 through CCR5Δ32 homozygous (CCR5Δ32/Δ32) allogeneic adult stem cell transplant. We report the first remission and possible HIV-1 cure in a mixed-race woman who received a CCR5Δ32/Δ32 haplo-cord transplant (cord blood cells combined with haploidentical stem cells from an adult) to treat acute myeloid leukemia (AML). Peripheral blood chimerism was 100% CCR5Δ32/Δ32 cord blood by week 14 post-transplant and persisted through 4.8 years of follow-up. Immune reconstitution was associated with (1) loss of detectable replication-competent HIV-1 reservoirs, (2) loss of HIV-1-specific immune responses, (3) invitro resistance to X4 and R5 laboratory variants, including pre-transplant autologous latent reservoir isolates, and (4) 18months of HIV-1 control with aviremia, off antiretroviral therapy, starting at 37months post-transplant. CCR5Δ32/Δ32 haplo-cord transplant achieved remission and a possible HIV-1 cure for a person of diverse ancestry, living with HIV-1, who required a stem cell transplant for acute leukemia.

Padrões de síndrome metabólica e fatores associados em mulheres do ELSA-Brasil: uma abordagem com análise de classes latentes

Abstract: This study aimed to identify patterns of metabolic syndrome among women and estimate their prevalence and relationship with sociodemographic and biological characteristics. In total, 5,836 women were evaluated using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patterns of metabolic syndrome were defined via latent class analysis, using the following metabolic abnormalities as indicators: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and reduced HDL cholesterol. The relationship between these patterns and individual characteristics was assessed using latent class analysis with covariates. Three patterns of metabolic syndrome were identified: high metabolic expression, moderate metabolic expression, and low metabolic expression. The first two patterns represented most women (53.8%) in the study. Women with complete primary or secondary education and belonging to lower social classes were more likely to have higher metabolic expression. Black and mixed-race women were more likely to have moderate metabolic expression. Menopausal women aged 50 years and older were more often classified into patterns of greater health risk. This study addressed the heterogeneous nature of metabolic syndrome, identifying three distinct profiles for the syndrome among women. The combination of abdominal obesity, hyperglycemia, and hypertension represents the main metabolic profile found among ELSA-Brasil participants. Sociodemographic and biological factors were important predictors of patterns of metabolic syndrome.

Intercultural Communication in the Work of Leslie Marmon Silko

The paper discusses Leslie Marmon Silko’s contribution as a writer born and bred in the Four-Corner Area of the United States (where the states of Utah, Colorado, Texas and New Mexico come together), a contact zone characterized by the meeting of three cultures: Pueblo, Chicano and Anglo-American. A mixed-race woman, Silko was perhaps the most suitable person, because of her family heritage and her life at the limits of the Laguna Pueblo, to explore multiculturalism from both a Native and a Euro-American perspective. She has become a bridge between cultures, writing for a Native American and a planet-wide audience. We explore Silko’s best-known work, the novel Ceremony and the short story Yellow Woman, focusing on the new literary devices and philosophical perspectives that open up through intercultural mediation.

PMON247 Prevalence of Polycystic Ovary Syndrome in Eastern Siberia: a Cross-Sectional Study.

Abstract Background There is a lack of data on the prevalence of PCOS and its phenotype in many geographic regions. Siberia is a unique region of the Russian Federation with a multi-raced population living in similar geographic and socio-economic conditions for centuries. Therefore, we considered this population optimal for epidemiological research. Objectives To determine the prevalence of PCOS and the PCOS phenotypes in unselected women in the Eastern Siberia region. Population: We performed the institution-based, cross-sectional Eastern Siberia PCOS Epidemiology &amp; Phenotype (ESPEP) Study during 2016-2019 (СlinicalTrials.gov ID: NCT05194384) and recruited 1148 premenopausal women aged 34.3±6.3 yrs., of which 63.2% were Caucasians, 27.6% Asians, and 9.2% Mixed-race. All subjects provided written informed consent. Exclusion criteria were: current pregnancy or lactation, history of hysterectomy, bilateral oophorectomy, endometrial ablation, uterine artery embolization; and current or previous hormonal medications or insulin-sensitizers intake. The study was approved by the Institutional Ethics Committee of the Scientific Center for Family Health a Human Reproduction (Irkutsk, Russian Federation). Methods include questionnaires, anthropometry, vital signs, gynecological examination, mF-G scoring, pelvic U/S, and blood sampling. For PCOS diagnosis we used the Rotterdam (2003) criteria. Serum samples were analyzed for total testosterone (TT) using LC-MS/MS. DHEAS, SHBG, prolactin, TSH, and 17-OHP were assessed by ELISA. Free Androgen Index (FAI) was calculated (i.e. [TT/SHBG]×100). The upper normal limit (UNL) for the mF-G score was 4, as determined using a 2k-cluster analysis in the total study population. The upper normal limits (UNL) for androgens were determined from the 98th percentiles for these parameters in 143 women, identified as the "super-controls". Pearson Chi-square and Fisher exact one-tailed tests were used to comparing proportions and categorical variables. A p-value of 0.05 was considered statistically significant. Results The total prevalence of PCOS in premenopausal women from Eastern Siberia was estimated as 13.3%, with the following distribution of PCOS phenotypes: 29.1% (A), 9.9% (B), 26.2%(C), and 34.8% (D). There was no significant difference in PCOS prevalence by race: 13.4% in Caucasians, 11.0% in Asians, and 19.8% in Mixed race women (pχ2=0.07). Classic PCOS phenotype A was found in a comparable number of PCOS women (28% in Caucasians, 31.2% in Asians, and 30% in Mixed race); whereas Asian PCOS patients demonstrated the highest proportion of phenotype B (25% vs 5.6% in Caucasians and 5% in mixed-race). The number of hirsute women (with mF-G score &amp;gt;4) was dependent on race and reached 22%, 29%, and 36% among Caucasians, Asians, and mixed-race women, respectively (p χ2=0.001). Conclusions The results of the ESPEP study, conducted in a multi-race unselected population of premenopausal women from Eastern Siberia demonstrated a 13.3% total prevalence of PCOS and race-dependent difference in the clinical manifestation of PCOS. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Reflections on Diversity and Exclusion

Personal opinion as a mixed-race woman in the NHS

'Depending on where I am…' Hair, travelling and the performance of identity among Black and mixed-race women.

A growing interdisciplinary literature examines the role of hair textures and styles in Black and mixed-race women's identity performances. Through an analysis of travel narratives, this paper extends and complements research on the context-dependency of racialized identity performances. This paper presents an analysis of 24 qualitative interviews with Black and mixed-race women in England and Germany. The question it seeks to answer is: 'How do changes in context alter Black and mixed-race women's hairstyling practices as a performance of identity?' Navigating a novel context could lead the women to (1) conform to local standards of beauty and femininity, (2) resist external expectations, (3) try out novel performances and (4) negotiate the complex performance of belonging. All in all, this paper shows that Black and mixed-race women dialogically re/negotiated and performatively re/created how they identify and how they are identified by others as they moved from one context to another.

Mixed-ish: race, class and gender in 1950s–60s Kampala through a life history of Barbara Kimenye

ABSTRACT Vibrant social scene, intellectual hub and diverse glitterati: this was Kampala for its beau monde in the late 1950s and early 1960s. The city enjoyed a liberal reputation with ‘rosy’ race relations, attracting thinkers and socialites from across Africa and the world. It was in this singular space that Barbara Kimenye, a Black mixed-race woman of dual English and Caribbean heritage, self-identified Ugandan, and ‘one of East Africa’s most prolific children’s writers’, moved. An examination of her life in the Ugandan capital illuminates the nature of race and class, as brought about by British colonialism, in 1950s and 1960s Kampala. As a mixed-race woman, Kimenye occupied a unique position, living at the intersections of Black Ugandan and white expatriate communities. Her movement in Kampala’s elite circles, as an economically challenged single mother of two, was in part enabled through her proximity to whiteness. Drawing on Kimenye’s serialised memoirs and other archival sources, this article will demonstrate how her unique positionality challenged colonial taxonomies of race and class, highlighting their insubstantial and porous nature, and providing a new understanding of the nature of the post-colonial East African city.

A Radical Practice of Inclusion

Ananya Dance Theatre directs our present‐day concern for racial and gender diversity toward a radical practice. Choreographer Ananya Chatterjea includes white and mixedrace women as well as black male‐presenting artists in her dances that place the global, social justice stories of black and brown women and femmes at their center.