Women with atrial fibrillation in the Middle East: utilization of oral anticoagulant agents in a population with bad baseline clinical profiles and risk scores

Background Atrial fibrillation (AF) is the most common sustained arrhythmia in women and men worldwide and in the Middle East. Several studies have shown that women with AF are undertreated despite worse baseline clinical and risk profiles compared with men. It is largely unknown if this also applies to Middle Eastern AF patients. Purpose To evaluate baseline clinical features and utilization of guideline-recommended oral anticoagulant medications (OACs) in Middle Eastern women with AF. Methods The Jordan AF prospective multicenter study enrolled 2160 patients with AF, including 1164 (53.9%) women, in 20 hospital and outpatient clinics (May 2019 through January 2021). Results Nonvalvular AF was present in 1038 (91.0%) of women and 935 (94.6%) of men. Compared with men, women were older (mean age 69.2±11.5 years vs. 66.1±14.9 years, p<0.001), and had higher prevalence of hypertension (79.1% vs. 69.5%, p<0.001), diabetes (46.1% vs. 41.7%, p=0.04) and obesity (60.5% vs. 34.6%, p<0.001). Women, however, had lower prevalence of two comorbidities; heart failure (21.5% vs. 28.6, p=0.001) and coronary artery disease (7.7% vs. 15.4%, p<0.001) compared with men. Rate of utilization of oral anticoagulant agents (OACs) was higher in women than men with high and intermediate CHA2DS2 VASc scores (Table). Direct OACs were used in 64.0% of women and 63.3% of men with high risk score (p=NS). Multivariate analysis did not show sex to be an independent predictor of use of OACs. Conclusions Middle Eastern women with AF have worse baseline clinical and risk score profiles compared with men. In disagreement with other regional studies, the majority of these women received guideline-recommended OACs. FUNDunding Acknowledgement Type of funding sources: None.

Postfeminism à la Turca

This essay analyzes how postfeminism is constructed on a visual level in the Turkish context. It uses theories of postfeminism to discuss new popular romantic comedies of Turkish cinema by comparing the new female protagonists with the women portrayed in Yeşilçam melodramas. Three films—Kocan Kadar Konuş (dir. Kıvanç Baruönü, 2014), Hadi İnşallah (dir. Ali Taner Baltacı, 2014), and Aşk Nerede? (dir. Semra Dündar, 2015)—are analyzed from a postfeminist perspective, opening up a new scholarly discussion about the place of postfeminism in the Turkish cinema. These films represent what may be termed “Turkified” postfeminism, which has been commonly discussed for the Western world but not sufficiently taken into account for Middle Eastern women.

MANAGING CONTRADICTIONS OF MULTICULTURALISM: NARRATIVES OF BELONGING AND BEING CANADIAN AMONG CANADIAN MIDDLE EASTERN WOMEN

This thesis investigates experiences of belonging and being Canadian among first-generation Canadian Middle Eastern women through one-on-one interviews with 13 women. Since the election of Justin Trudeau in 2015, Canada has recommitted to bolstering discourses of multiculturalism. There have been, however, lasting impacts from mainstream discourses that followed 9/11, which positioned Middle Eastern women as imperiled and Middle Eastern culture as backward. Additionally, liberal multiculturalism in Canada has done little to address systemic racism, and instead encourages a superficial level of acceptance. Contradictions of multiculturalism can be found in the narratives of these women, who sometimes repeat discourses that do not benefit them. Conversely, women who have access to discourses that position multiculturalism as ideological, have a difficult time expressing a Canadian identity and display a critical understanding of their experiences. These narratives are considered in a wider context of how race and racism structure Canada today.

MANAGING CONTRADICTIONS OF MULTICULTURALISM: NARRATIVES OF BELONGING AND BEING CANADIAN AMONG CANADIAN MIDDLE EASTERN WOMEN

This thesis investigates experiences of belonging and being Canadian among first-generation Canadian Middle Eastern women through one-on-one interviews with 13 women. Since the election of Justin Trudeau in 2015, Canada has recommitted to bolstering discourses of multiculturalism. There have been, however, lasting impacts from mainstream discourses that followed 9/11, which positioned Middle Eastern women as imperiled and Middle Eastern culture as backward. Additionally, liberal multiculturalism in Canada has done little to address systemic racism, and instead encourages a superficial level of acceptance. Contradictions of multiculturalism can be found in the narratives of these women, who sometimes repeat discourses that do not benefit them. Conversely, women who have access to discourses that position multiculturalism as ideological, have a difficult time expressing a Canadian identity and display a critical understanding of their experiences. These narratives are considered in a wider context of how race and racism structure Canada today.

From Invisible to Actualized: Imagery and Identity in Photos of Women in the Gulf

After reviewing how Middle Eastern women have been photographed historically, the paper explores how contemporary Gulf women represent themselves, both behind and in front of the camera. Initially, women were invisible, then eroticized or exoticized in Orientalist photography, only to appear in early twentieth-century family portraits as both the repository of cultural values and as the new, modern woman. The reaction of contemporary Gulf female photographers to perceptions of themselves as jobless, nameless, faceless, and voiceless is presented in examples of art photography-cum-political commentary. The media coverage of Qatar’s Shaykha Mūza is analyzed in terms of her use of clothing as nonverbal communication and as a form of soft-power politics. It is followed by a discussion of the rules – formal and informal – for publishing photos of females. The paper concludes with a survey of Gulf females’ use of selfies. Thus, three aspects of photography – as art, as photojournalism, and as private communication – demonstrate how Gulf women visually represent their identities.

Metabolic comparison of polycystic ovarian syndrome and control women in Middle Eastern and UK Caucasian populations

To determine if metabolic characteristics differed in women with and without polycystic ovary syndrome (PCOS) between a Caucasian and Middle East population. Comparative cross-sectional analysis. Demographic and metabolic data from Middle Eastern women from Qatar Biobank (97 with PCOS, 622 controls) were compared to a Caucasian PCOS biobank in Hull UK (108 with PCOS, 69 controls). In both populations, PCOS women showed a worse cardiovascular risk profile of increased systolic and diastolic blood pressure, increased C-reactive protein (CRP), reduced HDL, insulin resistance as well as increased androgens compared to their respective controls without PCOS. UK women without PCOS had higher systolic and diastolic blood pressures, and increased testosterone results (p < 0.01) compared to Middle Eastern women without PCOS who had higher inflammatory markers (WBC and CRP), HDL and insulin resistance (p < 0.001). UK PCOS women had a higher body mass index, systolic and diastolic blood pressures, triglycerides (p < 0.01), whilst Middle Eastern PCOS women showed increased testosterone, free androgen index, HDL and CRP (P < 0.01). There was no difference in insulin or insulin resistance between the two PCOS cohorts. This study highlights ethnic population differences because, whilst cardiovascular risk indices were increased for both PCOS cohorts, this may be for different reasons: BMI, waist and hip measurements, systolic and diastolic blood pressure, and triglycerides were higher in the UK cohort whilst testosterone, HDL and CRP were higher in the Middle East population. Insulin resistance did not differ between the two PCOS populations despite differences in BMI.