Search Results (677)

Black neurodiverse women with postsecondary education occupy an underexamined intersection of race, gender, and neurodiversity, yet little research has examined their access to affirming community support. This survey study (N = 53) examines community access and mental health among Black neurodiverse women with postsecondary education. Findings reveal a 54.7 percentage-point gap between how many participants rated community support as important (96.2%) and how many had found it (41.5%). Participants also reported high rates of anxiety (90.6%), depression (79.2%), and masking (77.4%). Using qualitative reflexive thematic analysis, the following four themes were developed, defined, and named: (1) living at the intersection of race, gender, and neurodiversity; (2) structural barriers to access; (3) finding and building community; and (4) community as emotional validation and intersectional recognition. Framed through Black Feminist Disability Theory and intersectionality, these findings position access to affirming community as a structural health need and a health equity issue. Implications are drawn for campus mental health services, community organizations, and future research. Full article

Mechanical forces generated by hairstyling practices are recognised causes of hair and scalp disorders, particularly traction alopecia, but the effects of prolonged, localised exposure to hairstyling accessories remain poorly characterised. We conducted a multicentre retrospective study of 10 women evaluated at five centres with chronic localised alopecia anatomically corresponding to the site of repeated accessory contact, analysing clinical, trichoscopic, histopathological and outcome data. Mean age was 51.3 years and mean disease duration 5.8 years; nine patients had vertex involvement, and one had an interparietal patch. Trichoscopy showed vellus hairs, with variable broken hairs, black and yellow dots, dystrophic, bent and coiled hairs, perifollicular casts and loss of follicular openings. Histopathology, available in seven patients, showed scarring alopecia in four and non-scarring alopecia in three. Implicated exposures included hairpins, clips, buns, rollers and a hair prosthesis. After accessory removal and variable treatment, four patients showed partial regrowth, four remained stable, one worsened, and follow-up was unavailable for one. The anatomical correspondence between alopecic patches and accessory exposure, with overlapping pressure, traction and friction-related features, is consistent with a proposed mixed mechanical injury from chronic low-intensity stress. Recognising hairstyling accessories as a potential cause of localised alopecia may facilitate diagnosis and prevent progression to irreversible damage. Full article

Black–White (B/W) multiracial women often experience racial identity invalidation (RII) due to holding races of opposite social status. Additionally, they may experience Eurocentric thinness pressures, while simultaneously navigating curvier body ideals valued in Black communities. B/W multiracial women’s eating and embodiment remains largely under-researched. This study examined associations between RII, curvy ideal idealization (CII), and maladaptive orthorexia symptoms (MOSs), in addition to the indirect effects of RII on MOSs via CII in a sample of B/W multiracial cisgender women, N = 290 (M_Age = 34; range = 18–61). Participants completed an online survey through Prolific assessing demographics, RII, MOSs, and CII. Pearson’s correlations demonstrated significant positive relationships between MOSs and RII distress, RII frequency, and CII—global; RII distress and CII—global, thick/curvy, and breast size; and RII frequency and CII—breast size. No significant associations emerged between RII frequency and CII—global, thick/curvy, and thin waist or RII distress and CII—thin waist. The indirect effect of RII distress on MOS via CII—global was the only significant pathway (β = 0.04, 95% CI: 0.01 to 0.07). The results call for the need to consider the internalization of opposing cultural body ideals and the experience of discriminatory stressors as potential clinically relevant sociocultural factors associated with orthorexic eating patterns in B/W multiracial women. Full article

Introduction: Racially and ethnically diverse women experience sub-optimal outcomes on both the HIV treatment and prevention cascade when compared to their white counterparts due to factors including racism, sexism, and xenophobia. While PrEP is a promising biomedical tool that can narrow this gap, similar trends are observed in PrEP utilization among culturally diverse women. We sought to explore the differences in diverse women’s preferences, challenges, and facilitators of PrEP uptake. Methods: From January 2022 to July 2023, thirty-one diverse women who could benefit from PrEP in Miami, FL, completed qualitative interviews with trained research staff to discuss their willingness, perceptions, and access to PrEP. Women also completed a demographic survey via Research Electronic Data Capture (REDCap). Semi-structured interviews were analyzed via NVivo using a hybrid inductive–deductive thematic analysis approach. Results: The majority of participants were Black (81%) and ethnically diverse (41.9% African American, 25.8% Hispanic/Latina, 16.1% Afro-Caribbean Black (non-Haitian) and 16.1% Haitian/Haitian American). Qualitative coding revealed numerous themes common across ethnic groups on (a) HIV transmission risk, reasons for prevention, and protective factors, (b) PrEP awareness, acceptability and willingness, (c) access to healthcare, and (d) relationships. Conclusions: To develop culturally sound interventions to increase PrEP uptake among women most impacted by HIV, an understanding of their perspectives and experiences is needed, as well as interventions/strategies informed by their insights. Full article

This paper is presented by a collective of Black women who have devoted years to sexual health as educators, programmers and facilitators. It offers an insider perspective on their experiences facilitating the pilot of the Sista2Sista project, a sexual health intervention adapted to the Canadian context for young Black women ages 15–29. The post-pilot focus groups were conducted with stakeholders and facilitators to gather feedback on the intervention. This approach centers the perspectives of facilitators and stakeholders in implementing sexual health programs for Black youth. Findings show that the Sista2Sista pilot benefited from Black women facilitators, whose positionality fostered a culturally affirming space for young Black women. Additionally, the findings highlight gaps in race-based data and sexual health programming for Black youth in Ontario specifically, and Canada more broadly. Participants highlighted the need for holistic, relevant and sustainably funded interventions that address sexual health alongside pleasure, body image and systemic barriers, such as anti-Black racism. Overall, this paper contributes to a deeper understanding of sexual health for young Black women by centring the lived experiences of Black women facilitators who informed the pilot intervention while advocating for contextually relevant approaches that reflect the realities of Black communities. Full article

Background: Age, race, body mass index (BMI), breast density, parity, smoking and alcohol use are associated with increased risk for breast cancer. These factors, as well as tumor characteristics, treatment regimens and comorbidities, are analyzed for associations with five-year event free survival (EFS) in a sample of women with Stage I-III breast cancer who received chemotherapy with curative intent. Methods: EFS was defined in terms of breast cancer recurrence, second primary, metastasis, and overall survival. Analyses were stratified by age (under age 65 vs. over age 65). EFS was estimated using the Kaplan–Meier method and compared using a Cox proportional hazard model. Results: In a sample of 821 women, mean age at diagnosis was 54 years, with 75% White and 22% Black. Younger women had higher proportions of Stage II and III tumors (p = 0.005), larger tumor size (p = 0.0004), and higher breast density (p = 0.003). Five-year EFS was 91% among younger vs. 82% among older women (p = 0.0005). In women aged < 65, there were 48 EFS events, and triple negative patients had significantly worse EFS compared to other subtypes (p = 0.003). Smokers also had worse EFS (p = 0.04). In women aged ≥ 65, there were 26 events, and both tumor size (p = 0.02) and mastectomy (p = 0.03) were significant for EFS. Conclusions: In our sample, triple negative subtype, smoking history, tumor size, and surgery type were significantly associated with shorter EFS. Race, BMI, alcohol use, parity, breast density, radiation treatment, and specific chemotherapy regimen were not significant for EFS in either age group. Full article

Background: Individuals with inflammatory bowel disease (IBD) are at substantially increased risk for Clostridioides difficile infection (CDI), which leads to significantly higher morbidity and mortality compared to the general population. However, comprehensive national-level analyses of long-term mortality trends in this population remain limited. This study examines mortality trends associated with IBD and CDI in the United States from 1999 to 2023. Methods: This descriptive study utilized the CDC WONDER Multiple Cause-of-Death database. Deaths involving IBD (ICD-10: K50, K51) and CDI (A04.7) were identified among adults aged 25 years and older. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated with 95% confidence intervals and stratified by sex, race/ethnicity, urbanization, and census region. Joinpoint regression was applied to estimate the annual percent change (APC) in mortality. Results: Between 1999 and 2023, 76,084 deaths were recorded. Medical facilities accounted for 46% of deaths, followed by decedents’ homes (28.3%) and nursing home/long-term care facilities (16.5%). Overall mortality declined gradually from 1999 to 2018 (APC: −0.23, p < 0.05), increased sharply through 2021 (APC: +12.75, p < 0.05), and was then followed by a non-significant change through 2023 (APC: −2.69; 95% CI: −8.24 to 3.19), consistent with a plateau. Men consistently exhibited higher AAMRs than women. Non-Hispanic White individuals had the highest AAMRs (1.844 in 2023), while Non-Hispanic Black individuals experienced a sustained increase from 2016 onward (APC: +7.11, p < 0.05). Hispanic mortality increased steadily throughout the study period (APC: +1.31, p < 0.05). Rural populations had higher overall AAMRs than urban populations. The Midwest recorded the highest regional AAMRs by 2023 (1.867). Conclusions: Mortality increased significantly between 2018 and 2021, coinciding with the COVID-19 pandemic, though our study design cannot prove causation. Disparities by race/ethnicity, urbanization, and region persisted. These findings underscore the need for ongoing antibiotic stewardship, equitable healthcare access, and targeted public health interventions for this vulnerable population. Full article

This article addresses the underrepresentation of religion in historical accounts of apartheid’s gendered political economy. It asks how colonial missionary discourse and apartheid law interacted in constructing and regulating Black womanhood, and how intersectionality and Bosadi hermeneutics can expose and contest the theological legitimation of Black women’s labour, sacrifice, and endurance. The study uses a qualitative historical-theological and contextual biblical method. It analyses selected historical scholarship, South African legislation, the Constitutional Court’s Mahlangu judgment, and Proverbs 31:10–31 and Ruth, through the lens of Kimberlé Crenshaw’s intersectionality and Madipoane Masenya’s Bosadi hermeneutics. The analysis finds that mission Christianity and the apartheid state were neither identical nor uniform, but influential Christian ideals of domesticity, respectability, service, and feminine sacrifice could converge with a racialised system that restricted African women’s land, mobility, residence, labour, and family life. Proverbs 31 and Ruth are therefore treated as contested resources: they can affirm women’s agency and economic intelligence, but they can also be appropriated to moralise overwork and precarious survival. The article contributes an integrated historical-theological account that links law, labour, religion, and biblical reception without reducing African women to passive victims. It recommends that churches and theological institutions audit the distribution of labour and authority, support decent work and shared care, and interpret biblical texts with women whose lives are shaped by racialised and gendered inequality. Full article

Sexual and reproductive health research has often centered women’s contraceptive and pregnancy-related experiences, while young men’s perspectives on sexual behavior, STI prevention, and reproductive responsibility remain less visible. This qualitative study explored how young Black heterosexual college men understood sexual health knowledge, masculinity, STI risk, condom use, pregnancy prevention, and readiness for fatherhood. Thirteen self-identified Black college men aged 19–22 years participated in individual semi-structured interviews at a Historically Black College/University (HBCU) in the southern United States. Interviews were conducted online, transcribed, de-identified, and analyzed using reflexive thematic analysis. Four themes were identified: fragmented sexual health knowledge and informal learning; learning masculinity through sexual socialization and developing sexual autonomy; experiential learning, STI stigma, and the negotiation of sexual risk; and reproductive responsibility and pregnancy prevention. Participants described limited formal sexual health education, peer and media influences on masculinity, risk judgments shaped by trust and familiarity, and stronger concern for pregnancy prevention than for STI prevention. Findings suggest that sexual health education and campus-based prevention should engage young Black men as reproductive actors with distinct needs, responsibilities, and relational contexts. Programs should integrate STI prevention, condom counseling, partner communication, alcohol-related risk reduction, and reproductive-intention counseling into male-centered, stigma-sensitive approaches. Full article

The appearance and spread of the image of the bicorporate sphinx in Scythia of 4th century BC can be regarded as an example of selective borrowing from ancient iconography. In the Greek world, this type is encountered rarely, but it gained considerable currency among the Scythians of the Northern Black Sea region. Its spread coincides with the period of expansion of the fantastic bestiary among the Scythians and the increasing complexity of the funerary rite of the Scythian elite. The predominance of finds in female burials indicates that this image was part of the circle of signs associated specifically with women’s high social status. The doubling of the body enhanced the image’s visual expressiveness and protective nature. More complex interpretations of the worldview are not supported by the sources and cannot be considered proven. Full article

Black children and youth remain disproportionately represented within child welfare systems across Canada, yet limited research has examined how Black girls experience trauma within out-of-home placements and how these experiences shape mental health and suicidality. This qualitative study examines the experiences of Black young women who aged out of care in Ontario, Canada, and explores how cumulative and intersecting forms of trauma, affected their emotional well-being and mental health. Drawing on critical race theory, Black girlhood studies, and critical suicidology, the study conceptualizes trauma as relational, structural, and cumulative rather than as a singular event. Findings drawn from six out of 10 participants reveal five key themes: dysfunctional foster families and complex traumas; trauma of multiple placement; lack of mental health support for the initial and ongoing traumas they experienced while in care; and mental health impacts of out-of-home placements and exposure to traumas and suicide-related behaviours of other youth in care. The participants highlighted the links between their experiences in foster care and the increased risk of suicide-related thoughts and behaviours. The findings highlight the need for models of care that are racially affirming, trauma-informed, and culturally responsive for child welfare and mental health interventions for Black girls in out-of-home placements. The key limitation of the study is the small sample size. Full article

Black women faced disproportionate social, emotional, and structural burdens during the dual pandemics of COVID-19 and racial injustice, yet their mental health experiences remain underexamined. This study explores how Black women understood, navigated, and coped with these intersecting crises. Seven Black women in North Carolina participated in a seven-session virtual photovoice study, including four photo discussion sessions. Participants generated four photo assignments, took photos, and discussed them using the SHOWeD framework. Recorded discussions were analyzed using Reflexive Thematic Analysis and Sort and Sift, Think and Shift, with participants supporting theme development. Narratives revealed multi-level mental health impacts: at the individual level, caregiving overload, compounded grief, and constant vigilance; at the interpersonal level, invisibility, racial misreading, and everyday racism that intensified distress and made help-seeking itself a labor of confronting providers’ biases; at the community level, trauma from witnessing racial violence and pandemic loss; and structural factors such as inequity, food insecurity, and policing as primary drivers of mental health strain. Participants employed healing as resistance through faith, nature, sister circles, and culturally concordant care. Black women’s mental health during the dual pandemics is inseparable from structural racism and gendered labor; healing is individual and collective, and crisis preparedness requires system-level change driven by Black communities. Full article

Background/Objectives: This study examined the association between low protein intake and pregnancy outcomes to test whether low protein intake was associated with higher rates of small for gestational age (SGA), gestational diabetes mellitus (GDM), and hypertensive disorders of pregnancy (HDP), and lower rates of large for gestational age (LGA). Methods: A secondary analysis was performed using the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (NuMoM2b). Participants missing diet data or pregnancy outcomes and whose pregnancy ended <20 weeks were excluded. Protein intake was calculated in grams per kilogram of bodyweight per day and stratified into quartiles. Multi-variable analyses were done to assess the association between protein intake quartiles and rates of HDP, GDM, SGA, and LGA, adjusting for relevant covariates. Results: Participants (n = 7067) were categorized into quartiles by daily protein intake: Q1 (<0.6 g/kg), Q2 (0.6–<0.8 g/kg), Q3 (0.8–<1.1 g/kg), and Q4 (≥1.1 g/kg). Lower protein intake was common among Black women (p = 0.001), women with less than a high school education (p < 0.001), unemployment (p = 0.004), lower income (p = 0.003), or government insurance (p = 0.04). After adjusting for age, insurance, education, income, chronic hypertension, and dietary kcal, protein intake resulted in significantly lower odds of developing SGA < 10th percentile for women in Q3 (aOR 0.78, 95% CI 0.61–0.99 for Q3). Protein in-take was not significantly associated with HDP, GDM or LGA. Conclusions: Moderate to high protein intake in the first trimester was associated with reduced SGA risk; however, these findings are exploratory and require confirmation in future studies. Full article

Breast cancer remains one of the leading causes of cancer-related mortality among women worldwide, where early and accurate diagnosis is critical for effective treatment. Although recent advances in deep learning have enabled automated radiology report generation from breast ultrasound images, most existing approaches function as black-box systems, limiting clinical trust and interpretability. This study proposes a trustworthy and explainable framework for automated breast ultrasound report generation that combines Vision-Language Modelling (VLM) with multi-level Explainable Artificial Intelligence (XAI). The proposed architecture integrates a Swin Transformer for visual feature extraction, BioBERT/ClinicalBERT for clinical text representation, and a GPT-2-based decoder for report generation through a dual cross-attention fusion mechanism. The framework is evaluated on benchmark breast ultrasound datasets paired with expert-annotated radiology reports using standard natural language generation metrics, including BLEU, ROUGE-L, METEOR, and CIDEr. Experimental results demonstrate that the multimodal architecture significantly improves report quality, clinical consistency, and semantic accuracy compared with conventional image-only and single-modal baselines. To address transparency and trustworthiness, the framework provides dual-level explanations through Grad-CAM visual heatmaps and LIME/SHAP-based token attribution analysis, enabling clinicians to understand both image regions and textual features influencing generated reports. Qualitative assessment further indicates strong alignment between model explanations and radiologist-identified diagnostic findings. Full article

Understanding how sensory preferences shape the acceptance of nutrient-dense foods is essential for improving prenatal nutrition. This exploratory study examined taste, smell, texture, appearance, and enjoyment factors influencing food acceptability among (n = 21) African American pregnant women, examining how determinants must be met for consumption. We administered surveys to identify preferred foods and analyzed the nutrient quantity of vitamin A, B vitamins, vitamin D, iodine, iron, calcium, magnesium, selenium, and omega-3 fatty acids in each food, given their influence on prenatal health. Nutrient-dense, anti-inflammatory foods were identified by ranking preferred foods by nutrients and selecting those that consistently ranked as top contributors. Focus groups further explored conditions that promote or hinder intake, and content analysis was conducted using NVivo. Preferred nutrient-dense, anti-inflammatory foods included cashews, peanuts, almonds, pistachios, black-eyed peas, pinto beans, salmon, carrots, red bell peppers, and spinach. Participants cited low acceptance due to allergies, undesirable textures (“dry” or “slimy”), unpleasant taste or appearance, a lack of cravings, preference for alternatives, unenjoyable preparation methods, and foods perceived as “display-only.” High acceptance was linked to appealing taste and texture, flexible preparation options, and perceived health benefits. These considerations suggest that taste, texture, appearance, and enjoyment are important considerations for prenatal food intake. Full article