non-Indigenous Women Research Articles

Syndemic Connections: Overdose Death Crisis, Gender-Based Violence and COVID-19

This article will use syndemic theory to identify and analyze overlapping health and social conditions, focusing specifically on how gender-based violence is systemically interconnected with contemporary public health issues. The overdose death crisis that continues to afflict Canadian populations is not an isolated health issue. Across Canada, it is intertwined with mental health, HIV/AIDS, COVID-19 and structural violence—the chronic and systemic disadvantages affecting those living in poverty and oppressive circumstances. Opioid use is an often-avoidant coping strategy for many experiencing the effects of trauma, relentless fear, pain, ill health and social exclusion. In particular, Indigenous and non-Indigenous women’s experiences with opioid addiction are entangled with encounters with gender based-violence, poverty and chronic ailments within structurally imposed processes and stressors shaped by a history of colonialism, ruptured lifeways and Western ways of knowing and doing, leading to disproportionate harms and occurrences of illness. While biomedical models of comorbidity and mortality approach substance misuse, gender-based violence and major infectious diseases such as HIV/AIDS and COVID-19 as distinct yet compounding realities, this article argues that these conditions are synergistically interrelated via the critical/reflexive lens of syndemic frameworks. Through secondary research using academic, media and policy sources from the past decade in Canada, complemented by prior ethnographic research, the synergistic connections among opioid addiction, gender-based violence and the effects of the COVID pandemic on diverse women will be shown to be driven by socio-structural determinants of health including poverty, intergenerational trauma, the legacy of colonialism and Western optics. Together, they embody a contemporary Canadian syndemic necessitating coordinated responses.

Notification rates for syphilis in women of reproductive age and congenital syphilis in Australia, 2011-2021: a retrospective cohort analysis of national notifications data.

To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia. Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data. Women aged 15-44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011-2021. Numbers and rates of infectious syphilis notifications, by Indigenous status and age group; numbers and rates of congenital syphilis, by Indigenous status of the infant; antenatal care history for mothers of infants born with congenital syphilis. During 2011-2021, 5011 cases of infectious syphilis in women aged 15-44 years were notified. The notification rate for Aboriginal and Torres Strait Islander women rose from 56 (95% confidence interval [CI], 45-65) cases per 100 000 in 2011 to 227 (95% CI, 206-248) cases per 100 000 population in 2021; for non-Indigenous women, it rose from 1.1 (95% CI, 0.8-1.4) to 9.2 (95% CI, 8.4-10.1) cases per 100 000 population. The notification rate was higher for Aboriginal and Torres Strait Islander women than for non-Indigenous women (incidence rate ratio [IRR], 23.1; 95% CI, 19.7-27.1), lower for 15-24- (IRR, 0.7; 95% CI, 0.6-0.9) and 35-44-year-old women (IRR, 0.6; 95% CI, 0.5-0.7) than for 25-34-year-old women, and higher in remote regions than in major cities (IRR, 2.7; 95% CI, 2.2-3.8). During 2011-2021, 74 cases of congenital syphilis were notified, the annual number increasing from six in 2011 to a peak of 17 in 2020; the rate was consistently higher among Aboriginal and Torres Strait Islander infants than among non-Indigenous infants (2021: 38.3 v 2.1 per 100 000 live births). The mothers of 32 infants with congenital syphilis (43%) had not received antenatal care. The number of infectious syphilis notifications for women of reproductive age increased in Australia during 2011-2021, as did the number of cases of congenital syphilis. To avert congenital syphilis, antenatal screening of pregnant women, followed by prompt treatment for infectious syphilis when diagnosed, needs to be improved.

Death at Butterabby: the case of Belo and Mumbleby and Aboriginal women’s place in the nineteenth-century criminal justice system

The Butterabbey gravesite is significant for its evidence of Aboriginal peoples’ resistance to colonial pastoral expansion and the dispossession of land and water sources in Western Australia. It is also significant to the case of R v Mumbleby and Belo (1865) which exemplifies the experiences of Aboriginal women defendants in nineteenth-century Western Australia whose experiences in the criminal justice system were different to both non-Indigenous women and Indigenous men. This paper analyses the case of R v Mumbleby and Belo within its historical context of frontier violence to reveal the treatment of Aboriginal women accused of homicide, and determine the power struggles at play.

Assessing the Role of Echocardiography in Pregnancy in First Nations Australian Women: Is it an Underutilised Resource?

Rheumatic heart disease (RHD) remains prevalent within First Nations Australian communities. RHD is more common in females and peak prevalence corresponds with childbearing age. Significant valvular disease can complicate pregnancy. Current practice in Northern Australia is to refer pregnant women for echocardiography if there are signs or symptoms of possible cardiac pathology or a history of acute rheumatic fever (ARF) or RHD. It is not currently routine practice to offer echocardiographic screening for all pregnant women at high risk of RHD. This study aimed to assess the current referral practices for echocardiography and disease patterns in pregnant women in the Northern Territory, Australia-a region with a known high prevalence of RHD in the First Nations population. A retrospective analysis of all echocardiography referrals of pregnant women over a 4-year period was performed. Data included indication for echocardiography, clinical history, echocardiographic findings, and location of delivery. Comparisons were made using Fisher's exact and Mann-Whitney U tests. A total of 322 women underwent echocardiography during pregnancy: 195 First Nations and 127 non-Indigenous women (median age, 25 vs 30 years, respectively; p<0.01). Indications for echocardiography differed by ethnicity, with history of ARF or RHD being the most common indication in First Nations women, and incidental murmur the most common in non-Indigenous women. First Nations women were more likely to have abnormal echocardiograms (35.9% vs 11.0% in non-Indigenous women; p<0.01) or a history of ARF or RHD (39.5% vs 0.8%; p<0.01), but less likely to have documented cardiac symptoms as an indication for echocardiography (8.2% vs 20.5%; p<0.01). New cardiac diagnoses were made during pregnancy in 11 (5.6%) First Nations and two (1.6%) non-Indigenous women (p=0.02). Moderate or severe valve lesions were detected in 26 (13.3%) First Nations women (all previously diagnosed), and 11 (5.6%) had previous cardiac surgery. No severe valve lesions were identified in the non-Indigenous group. Interstate transfer to a tertiary centre with valve intervention services was required during pregnancy or the puerperium for 12 (6.2%) First Nations women and no non-Indigenous women. Amongst pregnant women in the Northern Territory who had an indication for echocardiography, First Nations women were more likely to have abnormal echocardiograms. This was mainly due to valvular disease secondary to RHD. Cardiac symptoms were infrequently recorded as an indication for echocardiography in First Nations women, suggesting possible underappreciation of symptoms. Having a low threshold for echocardiographic investigation, including consideration of universal screening during pregnancy, is important in a high RHD-burden setting such as ours. A better understanding of the true prevalence and spectrum of disease severity in this population would enable health services to invest in appropriate resources.

Maternal deaths among Brazilian indigenous women-Analysis from 2015 to 2021.

This study examines maternal mortality among Brazilian indigenous women from 2015 to 2021, contrasting their causes of death with non-indigenous women. An observational study utilizing Ministry of Health data analyzed maternal deaths' characteristics, comparing indigenous and non-indigenous groups based on death certificates and live-birth records. Variables included age, region, location, time, and cause of death. Maternal mortality ratios (MMR) were calculated with linear regression and outliers identified with Grubbs test. Prevalence ratios compared MMR and causes of death. Between 2015 to 2021, Brazil recorded 13 023 maternal deaths. Among these, with 205 among indigenous women (1.60% of total). Indigenous women had higher MMR (115.14/100 000), than non- indigenous women (66.92/100 000), consistently across years. Hemorrhagic causes notably contributed to the indigenous women's elevated MMR. Indigenous Brazilian women face elevated maternal mortality rates across all causes, primarily due to hemorrhage, contrasting wih national trends.

Abstract PO5-27-04: The epidemiological profile and lifestyle of non-village indigenous women from Amazonas, Brazil and the likely impact on breast cancer mortality

Abstract Introduction: The high and growing incidence of breast cancer is a reality in almost every continent. However, the low mortality from this neoplasm among indigenous people of Amazonas, Brazil, is an intriguing fact (table 1). Inspite having a lower life expectancy at birth, the magnitude of low mortality is even greater. Indigenous women have gradually integrated into the non-indigenous community, and the reality of low mortality from breast cancer may be at risk of not existing in the future if the justification is in their reproductive epidemiological profile and lifestyle. Objective: This work seeks to find variables that can justify the fact that indigenous women from the Amazon region die less from breast cancer when compared to non-indigenous women. To achieve this, we evaluated reproductive epidemiological factors and lifestyle in non-village indigenous women and compared them with the same data in non-indigenous women. Methods: This is a cross-sectional study consisting of a convenience sample in which all indigenous people treated at the Mastology Outpatient Clinic of the Getúlio Vargas University Hospital of the Federal University of Amazonas were invited to participate from September 2020 to March 2023. There were 126 women: 39 non-village indigenous people who have lived in Manaus for more than 5 years and are integrated into society, 47 non-village indigenous people who live in riverside and interior populations of Amazonas - or in Manaus for less than 5 years - and 40 non-indigenous individuals. A questionnaire in interview format was administered with the objective of evaluating epidemiological and reproductive aspects such as age, education, BMI, menarche, parity, age at first pregnancy, breastfeeding, use of hormonal medications as well as lifestyle factors including smoking, alcohol consumption, dietary habits, physical activity, use of herbs, roots and seeds for therapeutic purposes and practice of religious devotional habits. Results: There was no difference in age, BMI, education, menarche and parity between the interviewed patients, nor in the assessment of the consumption of milk, sugar, fruits, vegetables and legumes, smoking habits, alcohol intake or physical activity between the groups. Indigenous women living in Manaus had a lower age at first pregnancy when compared to non-indigenous women. The variable “breastfeeding time” did not reach statistical significance but demonstrated a very close index (p 0.058) and a tendency to suggest that indigenous people, regardless of their place of residence, breastfeed for a longer duration. Non-indigenous women had a longer history of using hormonal medications when compared to indigenous women living in Manaus. Regarding meat consumption habits, indigenous women living in riverside and interior populations showed higher percentages of sporadic consumption of beef, sporadic consumption of wild animals, and daily consumption of white meat compared to non-indigenous people. On the other hand, non-indigenous women had a higher percentage of never having consumed wild animal meat when compared to the two other groups. Among indigenous women from riverside populations, there was a lower percentage of religious practices. The consumption of herbs, roots or seeds for therapeutic purposes was more commonly observed among indigenous people living in Manaus when compared to non-indigenous people. Conclusion: No epidemiological or lifestyle variables were found in both groups of indigenous people that justify the low mortality from breast cancer in these women. However, although the variable “breastfeeding time” did not reach statistical significance, it demonstrated a very close index (p 0.058) and a tendency to suggest that indigenous people, regardless of their place of residence, breastfeed for a longer duration. This could be a potential explanation for the low mortality from this disease among indigenous women. Table 1: Participation of breast cancer deaths in the total number of deaths in women over 20 years of age in the State of Amazonas Source: prepared by researchers Table 2 - Menarch, parity (childbirth and miscarage), breastfeed, Family history of breast cancer, image exam Table 3: Red and white meat consumption Citation Format: Maria Riselda Vinhote Da Silva, Lilian Cristina De Souza Guimarães, Afonso Nazário, Mariana Guimaraes De Oliveira Castro. The epidemiological profile and lifestyle of non-village indigenous women from Amazonas, Brazil and the likely impact on breast cancer mortality [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-27-04.

Improving Breast Cancer Outcomes for Indigenous Women in Australia.

In Australia, the incidence rate of breast cancer is lower in Indigenous* women than non-Indigenous women; however, the mortality rate is higher, with Indigenous women 1.2 times more likely to die from the disease. This paper provides practical and achievable solutions to improve health outcomes for Indigenous women with breast cancer in Australia. This research employed the Context-Mechanism-Outcome (CMO) framework to reveal potential mechanisms and contextual factors that influence breast cancer outcomes for Indigenous women, stratified into multiple levels, namely, micro (interpersonal), meso (systemic) and macro (policy) levels. The CMO framework allowed us to interpret evidence regarding Indigenous women and breast cancer and provides nine practical ways to improve health outcomes and survival rates.

Indigenous Women Perspectives on Gender Equality and Feminism: A Case Study of Jahai Women in Peninsular Malaysia

Most research on gender equality and feminism have been concentrated on non-indigenous women worldwide, with very few studies focusing specifically on Jahai tribe women. Indigenous women are important in advancing the ideas of feminism and gender equality within their societies. This paper is a case study focuses on the indigenous women which is the Jahai tribe women in Royal Belum State Park, Malaysia. In this case study, we explored Jahai women’s perspectives of gender equality and feminism aspects in this indigenous society. This case study employed a quantitative and a qualitative method for data collection. A total of 20 Jahai women were selected to complete a set of questionnaires and five of them were chosen for the in-depth interview. From the study, there were four main themes that emerged including socio- economic equality, equal treatment, gender responsibilities and egalitarian leadership and decision-making prospects. This research study was guided by the Transnational Feminism Theory and Theory of Gender Equality approach. The findings revealed that there was the similarities and distinctions perceptions in gender equality and feminism aspects among Jahai women. The study's conclusions shed new light on the gender equality and feminism interpretations and challenges those women in indigenous societies face. As a result, this study is important for future research since it adds to the body of knowledge about gender equality and concerns pertaining to indigenous women.

Looking after bubba for all our mob: Aboriginal and Torres Strait Islander community experiences and perceptions of stillbirth.

The stillbirth rate among Aboriginal and Torres Strait Islander women and communities in Australia is around double that of non-Indigenous women. While the development of effective prevention strategies during pregnancy and improving care following stillbirth for women and families in communities has become a national priority, there has been limited progress in stillbirth disparities. With community permission, this study aimed to gain a better understanding of community experiences, perceptions, and priorities around stillbirth. We undertook an Indigenous researcher-led, qualitative study, with community consultations guided by a cultural protection protocol and within an unstructured research framework. A total of 18 communities were consulted face-to-face through yarning interviews, focus groups and workshops. This included 54 community member and 159 health professional participants across remote, regional, and urban areas of Queensland, Western Australia, Victoria, South Australia, and Northern Territory. Thematic analysis of consultation data identified common themes across five focus/priority areas to address stillbirth: Stillbirth or Sorry Business Baby care needs to be family-centered; using Indigenous "ways of knowing, being, and doing" to ensure cultural safety; application of Birthing on Country principles to maternal and perinatal care; and yarning approaches to improve communication and learning or education. The results underscore the critical need to co-design evidence-based, culturally appropriate, and community-acceptable resources to help reduce existing disparities in stillbirth rates.

‘A Great First Cause in Colonisation’: Early Radio, ‘Transceiver-Listening’, Gender and Settlement in Australia

Historical acoustemology allows us to contemplate practices and meanings of non-Indigenous listening in Central Australia and determine how they aligned with processes of settlement. In the 1930s, a new form of listening emerged among remote non-Indigenous women. Modern communities of female transceiver-listeners used radio for two-way communication and networking, and feminist broadcasters quickly picked up the model, undermining pessimistic analyses of early Australian radio and female listeners as passive consumers. But writers integrated transceiver-listening into a narrative of nation that sought to colonise remote Australia with and through white women listeners, and linked transceiver listening to a pervasive metaphor of ‘inland silence’ that was conceptually deaf to Indigenous presence. Transceiver-listening also usurped forms of communication involving Indigenous people, putting up barriers towards them just as it lowered others. Transceiver-listening had powerful yet complex impacts on modernising remote life, feminist broadcasting, and the settlement of the Australian interior.

The next seven generations: at the heart of care alongside Mi’kmaw women

The strawberry is connected to heart teachings for many Indigenous people. The strawberry plant produces beautiful things. However, when exploring the topic of Indigenous women and heart health, the focus of the conversation is most often around deficits. Indigenous women have diseases related to the heart at a higher proportion than both non-Indigenous women and Indigenous men. There is a lack of understanding specific nations’ relationships to heart, and there is little to no research available specific to Mi’kmaw (adjective for a Mi’kmaq (First Nations people, Atlantic provinces, Canada, who call themselves L’nu) person) women and heart health. The focus of this Mi’kmaq research, which aligned with community-based participatory research, was to explore and gain a better understanding of what heart means to Mi’kmaw women on the west coast of Newfoundland, Canada. Four Mi’kmaw women joined the research and shared their experiences to co-create knowledge about heart health. This knowledge in turn shaped my understanding of nursing practice.

The effectiveness of maternal pertussis vaccination for protecting Aboriginal and Torres Strait Islander infants against infection, 2012-2017: a retrospective cohort study.

To evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age. Retrospective cohort study; analysis of linked administrative health data. Mother-infant cohort (Links2HealthierBubs) including all pregnant women who gave birth to live infants (gestational age ≥ 20 weeks, birthweight ≥ 400 g) in the Northern Territory, Queensland, and Western Australia during 1 January 2012 - 31 December 2017. Proportions of women vaccinated against pertussis during pregnancy, rates of pertussis infections among infants under seven months of age, and estimated effectiveness of maternal vaccination for protecting infants against pertussis infection, each by Indigenous status. Of the 19 892 Aboriginal and Torres Strait Islander women who gave birth to live infants during 2012-2017, 7398 (37.2%) received pertussis vaccine doses during their pregnancy, as had 137 034 of 259 526 non-Indigenous women (52.8%; Indigenous v non-Indigenous: adjusted odds ratio, 0.66; 95% confidence interval [CI], 0.62-0.70). The annual incidence of notified pertussis infections in non-Indigenous infants declined from 16.8 (95% CI, 9.9-29) in 2012 to 1.4 (95% CI, 0.3-8.0) cases per 10 000 births in 2017; among Aboriginal and Torres Strait Islander infants, it declined from 47.6 (95% CI, 16.2-139) to 38.6 (95% CI, 10.6-140) cases per 10 000 births. The effectiveness of maternal vaccination for protecting non-Indigenous infants under seven months of age against pertussis infection during 2014-17 was 68.2% (95% CI, 51.8-79.0%); protection of Aboriginal and Torres Strait Islander infants was not statistically significant (36.1%; 95% CI, -41.3% to 71.1%). During 2015-17, maternal pertussis vaccination did not protect Aboriginal and Torres Strait Islander infants in the NT, Queensland, and WA against infection. Increasing the pertussis vaccination rate among pregnant Aboriginal and Torres Strait Islander women requires culturally appropriate, innovative strategies co-designed in partnership with Indigenous organisations and communities.

Clinical variants of the metabolic syndrome in young people living in the Khanty-Mansiysk autonomous region – Yugra

Currently the “rejuvenation” and an increase in the number of components of the metabolic syndrome (MS) determine its clinical significance in the earlier development of diabetes mellitus, cardiovascular diseases and related complications. Aim of the study was to investigate the features of the MS clinic picture in a population of young men and womenliving in the Khanty-Mansiysk autonomous region – Yugra.Material and methods. The study included 863 young people between 18 and 44 years of age, including 344 men and women with MS and 519 people in the comparison group. Studied subgroups are represented by non-indigenous men and women living in urban and rural areas, and indigenous rural residents. The analysis of MS clinical and laboratory parameters was carried out and its clinical variants in ethnic groups were identified.Results and its discussion. According to the results of the survey of young people with metabolic syndrome, it was revealed that the combination of abdominal obesity and two components of MS were most common in young people with MS (in 50.0 % men and in 55.5 % women). The study defined regression models for each MS group and threshold values for waist circumference were set, which changes in lipid and carbohydrate metabolism were predicted.Conclusions. In groups with MS, hypertriglyceridemia was determined as its most common component. The study identified the most frequent association of abdominal obesity with hyper-LDL cholesterol and hypertriglyceridemia in patients with metabolic syndrome, in ethnic groups, this combination is more common in indigenous rural men (53.3 %) and in non-indigenous urban women (54.3 %).

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action.

Cervical cancer, primarily caused by human papillomavirus (HPV) infection, poses a significant global health challenge. Due to higher levels of poverty and health inequities, Indigenous women worldwide are more vulnerable to cervical cancer than their non-Indigenous counterparts. However, despite constituting nearly 10% of the population in Latin America and the Caribbean (LAC), the true extent of the burden of cervical cancer among Indigenous people in this region remains largely unknown. This article reviews the available information on cervical cancer incidence and mortality, as well as HPV infection prevalence, among Indigenous women in LAC. The limited existing data suggest that Indigenous women in this region face a heightened risk of cervical cancer incidence and mortality compared to non-Indigenous women. Nevertheless, a substantial knowledge gap persists that must be addressed to comprehensively assess the burden of cervical cancer among Indigenous populations, especially through enhancing cancer surveillance across LAC countries. Numerous structural, social and cultural barriers hindering Indigenous women's access to HPV vaccination and cervical cancer screening worldwide have been identified and are reviewed in this article. The discussion highlights the critical role of culturally sensitive education, community engagement, and empowerment strategies in overcoming those barriers. Drawing insights from the success of targeted strategies in certain high-income countries, the present article advocates for research, policies and healthcare interventions tailored to the unique context of LAC countries.

Association of &lt;i&gt;CSK, MTHFR, ACE, ADRA2B, TCF7L2&lt;/i&gt; gene polymorphisms with dyslipidemia among indigenous and non-indigenous people of Khanty-Mansy Autonomous Okrug – Yugra

The increase in cardiovascular diseases and their complications, diabetes mellitus and metabolic syndrome determines the relevance of early diagnosis and prevention of lipid metabolism disorders by identifying and studying genetic markers of predisposition to dyslipidemia in various populations depending on gender, age and ethnicity.Aim of the study was to investigate the associations of candidate genes CSK, MTHFR, ACE, ADRA2B and TCF7L2 with dyslipidemia in the young indigenous and non-indigenous population living in the Khanty-Mansy autonomous Okrug – Ugra.Material and methods. 863 young people aged 18–44 years were examined, clinical population included nonindigenous and indigenous men and women with metabolic syndrome (n = 344), the comparison group included non-indigenous and indigenous men and women without metabolic syndrome (n = 519). A study of the lipid profile and molecular genetic study was carried out using the polymerase chain reaction method for single nucleotide polymorphisms (SNPs): rs1378942 of the gene CSK, rs1801133 (C677T) of the gene MTHFR, gene ADRA2B, rs7903146 of the gene TCF7L2, rs1799752 of the gene ACE.Results. A high frequency of hypercholesterolemia (79.0 %) and hypertriglyceridemia (65.8 %) was found in the examined men and women. Statistically significant differences were established in the frequency of dyslipidemia in patients with metabolic syndrome by ethnicity and gender (p &lt; 0.001). In the general cohort of men with metabolic syndrome hypercholesterolemia is associated with the TT genotype of SNP rs1801133 (C677T) of the gene MTHFR (p = 0.039), in the women – with the DD genotype of the gene ADRA2B (p = 0.010). In indigenous men of the clinical group an association of hypercholesterolemia with the minor T allele of the gene MTHFR (p = 0.005), of hypertriglyceridemia – with the minor T allele of the gene MTHFR (p = 0.031) and the T allele of the gene TCF7L2 (p = 0.031) was revealed. Among indigenous women of the clinical group hypercholesterolemia is associated with carriage of the minor T allele of the gene CSK (p &lt; 0.001) and hypertriglyceridemia – with the D allele of the gene ADRA2B (p = 0.046).Conclusions. Carriage of minor alleles T of the MTHFR gene and D of the ADRA2B gene is associated with hypercholesterolemia among the examined young people and is statistically significantly higher in the group of patients with metabolic syndrome, as well as among indigenous residents of the KhantyMansiysk Autonomous Okrug – Ugra.

Cervical cancer screening in Brazilian Amazon Indigenous women: Towards the intensification of public policies for prevention

Background Indigenous women are vulnerable to cervical cancer. Screening is a strategy to reduce the burden of the disease. Objective To evaluate the prevalence profile of cervical cancer screening cytological results in Brazilian indigenous women by age and frequency of tests compared to non-indigenous women. Methods A cross-sectional study evaluating the prevalences of screening test results in indigenous women assisted in the Brazilian Amazon from 2007 to 2019 (3,231 tests), compared to non-indigenous women (698,415 tests). The main outcome was the cytological result. Other variables were frequency, age groups, and population. The frequency was categorized as "1st test", the first test performed by the women in their lifetime, or "screening test," tests from women who had previously participated in screening. Analyzes were based on prevalences by age group and population. We used Prevalence Ratios (PR) and 95% Confidence Intervals for risks and linear regression for trends. Results Data from the 1st test showed a higher prevalence of Low-grade Squamous Intraepithelial Lesion (LSIL) in indigenous women. Peaks were observed in indigenous under 25, 35 to 39, 45 to 49, and 60 to 64. The prevalence of High-grade Squamous Intraepithelial Lesion or more severe (HSIL+) was low in both groups in women younger than 25. The indigenous HSIL+ prevalence curve showed a rapid increase, reaching peaks in women from 25 to 34 years, following a slight decrease and a plateau. In screening tests, HSIL+ was more prevalent in indigenous from 25 to 39 (PR 4.0,2.3;6.8) and 40 to 64 (PR 3.8,1.6;9.0). In indigenous, the PR of HSIL+ results in screening tests over 1st tests showed no screening effect in all age groups. In non-indigenous, there was a significant effect toward protection in the age groups over 25. Conclusion This screening study of indigenous women from diverse ethnicities showed a higher prevalence of cytological LSIL and HSIl+ than in non-indigenous women. The protective screening effect in reducing HSIL+ prevalence was not observed in indigenous.

The Impact of Chronic Disease on the Corrected QT (QTc) Value in Women in a British Columbia First Nations Population

BackgroundIndigenous women have higher rates of chronic disease than Indigenous men and non-Indigenous women. Long QT syndrome (LQTS) can be inherited or acquired; the latter may occur with chronic disease. A prolonged corrected QT value (QTc) is an independent risk factor for ventricular arrhythmias and sudden death, but few studies have quantified the impact of chronic disease on the QTc. We assessed the association between chronic disease and QTc prolongation in a population of First Nations women previously ascertained to study a high rate of inherited LQTS due to a unique genetic (founder) variant in their community. MethodsThis substudy focusing on women expands on the original research where patients with clinical features of LQTS and their relatives were assessed for genetic variants discovered to affect the QTc. Medical records were retrospectively reviewed and chronic diseases documented. Using multivariate linear regression, adjusting for the effect of genetic variants, age, and QTc-prolonging medications, we evaluated the association between chronic disease and the QTc. ResultsIn total, 275 women were included. After adjustments, a prolonged QTc was associated with coronary artery disease (26.5 ms, 95% confidence interval [CI] 9.0-44.1 ms; P = 0.003), conduction system disease (26.8 ms, 95% CI 2.2-51.4 ms; P = 0.033), rheumatoid arthritis (28.9 ms, 95% CI 12.7-45.1 ms; P = 0.001), and type 2 diabetes mellitus (17.9 ms, 95% CI 3.6-32.3 ms; P = 0.015). ConclusionsThis quantification of the association between chronic disease and QTc prolongation in an Indigenous cohort provides insight into the nongenetic determinants of QTc prolongation. Corroboration in other populations will provide evidence for generalisability of these results.

‘Does she know how to read?’ An intersectional perspective to explore Twitter users’ portrayal of women Mapuche leaders

ABSTRACT Social media offer new opportunities for women in politics, but also new ground for the expression of bias and stereotypes. Drawing upon literature about mediated representations of women in politics, gendered digital violence, and intersectionality, this study explores how Twitter users portray indigenous women leaders who were elected as representatives for Chile’s Constitutional Convention. We use a mixed-methods approach based on a manual content analysis of tweets (N = 6,000), aimed at comparing the main attributes associated to indigenous and non-indigenous women Convention representatives in users’ tweets, as well as the valence of these tweets and the engagement of Twitter users, in two time points – the inaugural and the closing days of the Convention. This is complemented with a qualitative thematic analysis focused on tweets directed toward Mapuche women (N = 3,352). Our findings show that indigenous and non-indigenous women’s capacities were discussed by Twitter users, and although both groups experienced online hostility while serving for the Convention, indigenous leaders received negative messages notoriously based on their ethnic background: tweets were mostly positive at the beginning of the process, but became more negative by the end, suggesting a narrative arc that went from an ephemeral moment of symbolic reparation to the restoration of prejudices and stereotypes.

INDICATORS OF PLACENTAL MORPHOMETRY OF THE REPUBLIC SAKHA (YAKUTIA) INDIGENOUS WOMEN AT PHYSIOLOGICAL PREGNANCY

The Republic of Sakha (Yakutia) is located in harsh climatic conditions, which is reflected in structural compensatory-adaptive changes in the placenta among residents of the region, but they remain poorly studied. The goal was to study the morphology of placentas of residents of the Republic of Sakha (Yakutia) under conditions of physiological pregnancy. All placentas corresponded to 36–41 weeks of gestation and delivered healthy children. The first observation group consisted of placentas of women of the indigenous population - Yakuts, Evenks, Evens and other small peoples of the North, born and permanently residing in the Republic of Sakha (79 cases); Group II – placentas from non-indigenous women (Russians, Ukrainians, Tatars and others) living in the Republic of Sakha for more than 10 years (70 observations) of the first and second mature periods. In this work, research was carried out at the organ and tissue levels of structural organization using a complex of morphological, clinical and instrumental methods. It was found that indigenous women were more likely to have paracentral umbilical cord attachment (65.8%), and in the group of non-indigenous women, central umbilical cord attachment was 3.3 times more likely to be observed (30%). Linear parameters of the placenta are characterized by the absence of statistically significant differences between the study groups. Histological studies showed that in non-indigenous women of the republic, compared with the group of indigenous women, the area of terminal villi was significantly greater than that in non-indigenous women by 1.8 times (p=0.016). With identical indicators of the number of vessels in the terminal villi, a low vascular-stromal coefficient of terminal villi was determined (p=0.019) due to an increase in the stromal component (p=0.03), which indicates the presence of relative hypovascularization. An increase in the area of terminal villi was revealed by 1.8 times in the placentas of the group of indigenous women (p=0.016), which is significantly greater than the same indicator in the group of non-indigenous women. The identified data can be considered as evidence of adaptive restructuring in the fetal part of the blood-placental barrier of the placenta to specific ecological and territorial living conditions.

Socioeconomic Inequalities and Factors Associated with the Use of Modern Contraceptive Methods in Women of Childbearing Age in Ecuador, 2018.

The objective of this study was to determine the socioeconomic inequalities and factors associated with the use of modern contraceptive methods (MCM) in the population of sexually active women of childbearing age in Ecuador. This was an analytical observational study, based on a secondary data analysis of the 2018 National Health and Nutrition Survey (ENSANUT). Information on 19,106 sexually active, married, or cohabiting women between the ages of 15 and 49 were included. Concentration curves (CC) and Erreygers concentration indices (ECI) were calculated, taking into account the use of MCM as the dependent variable and the wealth index as the independent variable. Crude and adjusted prevalence ratios with 95% confidence intervals were calculated using generalized linear models of the Poisson family. We found that 92.8% of the women surveyed used some type of MCM in the last month. A higher educational level presented a significant pro-rich concentration in the use of MCM (EIC: 0.05; p = 0.004). On the other hand, women belonging to the age group of 20 to 29 years (ECI: -0.027; p = 0.027), women with no job (ECI: -0.025; p = 0.004), and non-indigenous women (EIC: -0.031; p < 0.001), presented a pro-poor concentration. Factors significantly associated with MCM use were age, marital status, occupation, parity, ethnicity, area of residence, and living on the coast. In Ecuador, there are socioeconomic inequalities at different levels of population subgroups in women of childbearing age. Measures to promote the use of MCM are required, focusing on groups that present inequality, taking into account the factors associated with their use.