Abdominoplasty, Liposuction and Brazilian Butt Lift (BBL) in Kinshasa in the Democratic Republic of Congo. My Experience in This Aesthetic Plastic Surgery with Black African Women in a Low-Income Country

Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my experience and the challenges of this aesthetic plastic surgery among black African women. Material and Methods: A retrospective study was conducted about the abdominoplasties, liposuctions and Brazilian butt lift (BBL) which I operated in public and private hospitals at Kinshasa (Democratic Republic of Congo) in black African women. It covers a period of 13 years, going from December 1, 2010 to December 1, 2023. For this study, I had at least 6 months period (to Juin 1, 2024) to assess the occurrence of early and late postoperative complications. Results: I performed 84 abdominoplasties, 144 liposuctions and 23 Brazilian butt lifts (BBL). The average age at the time of abdominoplasty was 44 years with extremes ranging from 26 to 55 years and a concentration of cases (60.7%) in the age group of 40 to 49 years. The age group of 20 to 29 years old represented the lowest rate of requests for abdominoplasty (4.7%). Patients with a BMI of 30 to 2 were the majority (61.9%), followed by those between 25 to 2 (29.7%). 67.8% of patients were obese (BMI ≥ 30 kg/m2). The average age at the time of liposuction was 41 years with extremes ranging from 21 years to 69 years;and more than half of cases (68%) in the age group between 30 and 49 years. As for Brazilian butt lift (BBL), the average age was 33 years with extremes ranging from 24 to 42 years and a concentration of patients (91.3%) between 20 and 39 years. The immediate postoperative complications of abdominoplasties observed were: seroma in 7% of cases, hematoma and partial infection of the surgical site in 5% of cases. Pathological scars (hypertrophic, keloid) after abdominoplasties were observed in 9% of cases. The most common complication of liposuction was contour deformity. I observed 16 patients (11.1%) with soft-tissue depressions or elevations, skin panniculus or folds. For Brazalian Butt Lift (BBL), complications like asymmetry for 2 patients (8.9%), contour irregularities for 2 patients (8.9%), and excessive fat removal for 6 patients (26%), had observed. I have not recorded any cases of death or pulmonary embolism. Conclusion: I perform aesthetic plastic surgery procedures in black African women with a high socioeconomic standard of living compared to the average of the general population. The renunciation of planned surgery is motivated by the impossibility of paying the cost of the operation as well as by popular and religious perceptions regarding cosmetic surgery. The results of these aesthetic plastic surgery procedures carried out are very satisfactory for them. The challenges to overcome are mainly threefold: the unforeseeable complications of these cosmetic plastic surgery procedures, popular and religious perceptions of cosmetic surgery as well as the poverty of the population.

Wrist circumference: A new marker for insulin resistance in African women with polycystic ovary syndrome

BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS women.Research has shown that hyperinsulinemia is correlated with increased bone mass.Given that most women with PCOS are insulin resistant,which is independent from body fat and characterized by hyperinsulinemia,it could be hypothesized that there would be an increased bone mass in the patient as a result.Subsequently,increased bone mass could be measured using the wrist circumference method.AIM To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.METHODS Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group,were enrolled in the study(mean age 24.33±5.36 years).Fasting biochemical parameters,and the Homeostasis Model Assessment of insulin resistance(HOMA-IR)and body composition were evaluated.The nondominant wrist circumference was measured manually,as was the waist circumference(WC),hip circumference,height and weight.Calculated measures included evaluation of body mass index(BMI),Waist-to-Height(WHtR)and Waist-to-hip ratio(WHR).In addition,body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.RESULTS The non-dominant wrist circumference was more closely correlated with HOMAIR(r=0.346;P=0.003)and was the best anthropometrical marker correlated with IR(P=0.011)compared with other anthropometrical markers in women with PCOS:Dominant Wrist Circumference(r=0.315;P=0.007),Waist Circumference(WC)(r=0.259;P=0.028),BMI(r=0.285;P=0.016),WHR(r=0.216;P=0,068)and WHtR(r=0.263;P=0.027).The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic(ROC)curve analysis showed that the area under the ROC curve was 0.72.A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR in Congolese women with PCOS.CONCLUSION Non-dominant wrist circumference is,to date,the best anthropometrical marker of IR in Sub-Saharan African women with PCOS.It could be suggested as an easy-to-detect marker for assessing IR.

African Women Writing Resistance

An Anthology of Contemporary Voices AFRICAN Women Writing Resistance is the first transnational anthology to focus on women’s strategies of resistance to the challenges they face in Africa today.The anthology brings together personal narratives,testimony,interviews, short stories,po-

Benefits and barriers to physical activity among African women:A systematic review

Black women have always been likened to being a less physically active group compared to women of other races/ethnicity,with reports of a high prevalence of obesity and other cardiometabolic diseases among them.The purpose of this study is to examine the health benefits of physical activity on women of color,as well as barriers that inhibit their participation.We searched PubMed and Web of Science databases for relevant research articles.Included articles were:Published in the English Language from 2011 to February 2022;conducted predominantly on black women,African women,or African American women.Articles were identified,screened,and data extracted following the Preferred Reporting Item for Systematic Review and Meta-Analysis(PRISMA)guidelines.The electronic search produced 2043 articles,and 33 articles were reviewed after meeting the inclusion criteria.13 articles focused on the benefits of physical activity while 20 articles addressed the barriers to physical activity.It was found that physical activity has various benefits for black women participants but they are being hindered from participation by some factors.These factors were grouped into four themes,namely Individual/Intrapersonal barriers,Socio-economic barriers,Social barriers,and Environmental barriers.Various studies have examined the benefits and barriers of physical activity among women of different racial and ethnic backgrounds,but there have been very few studies of African women,with the majority focusing on one geographical area.In addition to exploring these benefits and barriers,this review offers recommendations on the areas researchers should focus on to promote physical activity in this population.

The Unmet Needs of African American Women with Breast Cancer

Breast cancer is the most common cancer in women and treatment includes various combinations of surgery, chemotherapy, and/or hormone therapy. The multimodal treatment of breast cancer improves survival outcomes, but it also contributes to a prolonged period of medical intervention with associated physical and emotional consequences. However, we know less about the specific clinical experiences of African American (AA) women during treatment for breast cancer and in survivorship. The studies that have addressed the issue of breast cancer in AA women have focused primarily on early detection and epidemiological variables such a screening, mortality and staging at diagnosis. In our study, in-depth semi-structured phone interviews were conducted to explore the clinical experiences, concerns and needs of AA women who had survived breast cancer. The AA women reported that their physicians did not provide adequate disease and treatment information;did not discuss clinical trials with them;and did not offer access to support services.

The Benefits and Barriers Related to Regular Participation in Physical Activity by African-American Women: Implications for Intervention Development

A common strategy for improving health behaviors is to emphasize the benefits and reduce the barriers to behavior change. This study investigated potential differences in perceived benefits and barriers related to participation in physical activity (PA) between women in pre-maintenance versus the maintenance phase of PA behavior to determine if perceived benefits were greater and perceived barriers lower in women with more extensive and successful PA participation experience. Data were collected from a community-based sample (N = 113) of middle-aged African-American women. The sample was stratified into two groups according to how long they had been regularly engaging in PA (6 months or longer versus less than 6 months). Chi-square analyses were conducted to investigate possible differences between the two groups of women in regard to perceived benefits and barriers associated with PA. Descriptive data showed that nearly all of the benefits and barriers to PA were perceived as being important for a majority of the participants and chi-square and t-test results indicated few significant between-group differences (p < .05) in regard to these perceptions. Additional analyses indicated there was no significant between-group difference (p < .05) for Body Mass Index. The results suggest the benefits and barriers related to PA behavior are already valued and understood by many African-American women. Further, the results do not support the commonly held belief that effective health behavior improvement programming should emphasize the benefits and reduce the barriers related to the behavior. Practitioners should consider focusing on other evidenced based factors proven to promote PA behavior such as counseling regarding social support (e.g., buddy system) and increasing self-efficacy (e.g., goal setting) to initiate and sustain a physically active lifestyle.

Rubella Immunity among Pregnant Women in Bangui, Central African Republic

Sero-positivity rates of the rubella virus among pregnant women vary from country to country widely throughout the world. In the Central African Republic, rubella vaccination is not included in the national immunization schedule. Thus, we propose to evaluate the immune status of pregnant women. This was an analytical retrospective study that consulted the records of pregnant women received in prenatal consultations at the Bangui Community Hospital maternity ward from January to December 2020. Socio-demographic and laboratory data (IgM, IgG) were collected from January to June 2021. Chi2 test was used. A total of 289 pregnant women were analyzed. Women with an IgM+ response accounted for 4.15%. Those with an IgG+ were 14.87%. The distribution by age group shows that patients aged 20 - 24 and those aged 25 - 29 had a rubella profile suggesting persistent infection (p = 0.010). The average age of women included was 28 (±6) years. The average parity for the entire sample was 2.18 (1.93). At any age pregnant women were not significantly exposed to rubella infection (p = 0.96), (ORbrut = 1.03;CI95% = [0.32 - 3.34]). Both immunized and non-immunized individuals are similarly exposed [OR = 0.86;95% IC95% = 0.44 - 1.68] with no difference (p = 0.96). Rubella infection remains particularly severe when it occurs during pregnancy. It would be wise to seek immunity in all girls of childbearing age in order to rule out any risk of rubella embryopathy.

Humoral Response to Toxoplasma gondii in Pregnant Women in Bangui Central African Republic

Toxoplasmosis is a cosmopolitan antrhropozoonosis widespread in mammals and birds. Normally asymptomatic in the subject health, it can have serious consequences for the fetus in the first trimester of pregnancy in the pregnant woman. It is in this context that we propose to assess the immune response to T. gondii in pregnant women in Bangui. This was a retrospective analytical study that consulted the records of pregnant women received in prenatal consultations at the Bangui Community Hospital Maternity ward from January 2019 to December 2019. Socio-demographic and laboratory data (IgM, IgG response to T. gondii) and results of HIV serology were collected from January to June 2021. Chi2 test was used. A total of 307 pregnant women were analyzed. The average age of the women included was 28 (±6) years. The average parity of the entire sample was 2.18 (±1.93). Toxoplasmosis infectious was 14.65%. Women with a positive IgM response accounted for 17.58% and those with an IgG-positive response for 42.99%. Patients with a positive HIV were 5.86%. Patients aged 20 - 29 had a serological profile suggesting a probable ongoing infection (p = 0.010). The paucipares were more represented with no statistically significant difference (p = 0.23). Pregnant women were not significantly exposed to toxoplasmosis infectious (p = 0.96). Immunized and non-immunized subjects were similarly exposed [OR = 0.97;CI 95% 0.4 = 6 - 2.05]. Toxoplasmosis remains particularly serious during pregnancy. Seroprevalence was significantly higher in the 20 - 24 year age group. Women were similarly exposed depending on whether they were immunized or not. This requires the establishment of a specific prevention program against this disease.

《退伍军人权利法案》对战后美国弱势群体高等教育发展的压制--基于公共政策外部性的考察

1944年颁布的《退伍军人权利法案》在美国教育史上具有独特的意义和价值,是美国历史上最成功的公共政策之一,不仅顺利达成政策目标,而且还产生了惊人的非预期的外部收益。然而,这一公共政策所产生的负向外部性却被忽略,即对弱势群体高等教育发展进程和发展空间的阻碍和挤压,由此所带来的社会不公和群体裂痕持续影响着美国高等教育的后续发展。公共政策的负向外部性如果不能得到及时与有效地纾解和治理,会诱发社会的结构性问题和民众对社会不公的愤怒。

作为民族志的个人叙述--从一位昆人妇女的生活史谈起

从《尼萨》这部民族志出发,本文探讨了民族志写作以及与之相关的真实性、代表性、田野伦理和口述史资料整理等人类学理论和方法问题。

身份建构中的双重话语——谈美国黑人女作家的创作思想和作品主题

美国黑人女作家的创作思想和作品主题突出反映了黑人女性积极建构种族文化身份以及女性身份的愿望,揭示了黑人女性所受的双重苦难———种族压迫和性别歧视。黑人女小说家的创作思想集中表现在她们的作品之中,反映了黑人女性在白人为主导和男权统治的社会环境中积极建构种族身份、寻找自我的经历。这些小说家们的努力不仅促进了黑人女性意识的发展,也推动了美国文学的进步。

形式与内容的完美统一——谈《他们眼望上苍》和《紫颜色》的叙事策略

话语权是女性在男性至尊的社会里寻求自我发展,实现自我价值的关键,对黑人女性尤其如此.在这一点上,两部小说的叙事模式与主题可以说是相得益彰,作者的创作理念由此也可见一斑.

“后种族”时代背景下的黑人女性身体叙事——托妮·莫里森《孩子的愤怒》解读

托妮·莫里森创作的最后一部小说《孩子的愤怒》聚焦于当代黑人女性身体遭受的隐性冷暴力,着墨于黑人女性身体在种族主义、白人文化、男权价值影响下的变化。莫里森借助身体叙事揭示了黑人女性身体遭受的冷暴力,她们的身体沦为可食用或可消费的满足欲望的客体,以此表达她对"后种族"的观点,即"后种族"意味着种族主义以隐性的、多变的、复杂的形式依然存在。

论19世纪美国黑人女性书写的社会性和政治性

Represented by Frances Harper, African American women writers in the late 19th century are not only pioneers in women literature, but also social activists, inseminating the minds of people with changes. As the new generation of intellectuals, these women are fully aware that a series of political, economic and social changes are happening in America. In spite of strong oppositions, they have helped to make such significant transitions from the old to the new nociety.

面具下的叙述:美国黑人女性小说作者型叙述声音的权威

20世纪70年代以前,由于社会历史语境的限制,黑人女作家只能选择适合自己的有限叙述策略来讲述女性的故事。为了建构自己声音的权威,黑人女性小说家在该时期主要采取了作者型叙述交流模式。这种模式一方面模糊了叙述者的种族与性别身份,另一方面第三人称作者型叙述声音模仿历史叙述,显得相对客观,有利于建构黑人女性声音的可信度,从而有利于建构女性声音的权威。左拉·尼尔·赫斯顿、波勒·马歇尔和托妮·莫里森都是带着这种性别模糊的"他"面具,偷偷参与以男性为主宰的社会话语权威建构。

喉罩全麻复合局麻在非洲妇女短小手术中的应用

目的：观察喉罩全麻复合局部麻醉在非洲妇女短小手术中的应用。方法：选择年龄16～45岁预行短小手术的非洲妇女60例,随机分为喉罩全麻复合局麻组（A组）和单纯气管插管全麻组（B组）,每组30例。观察记录麻醉前、置入喉罩/气管导管前后及术后拔除时的平均动脉压（MAP）、心率（HR）和SpO_2及苏醒时间、术后舒适情况及不良反应情况。结果：MAP、HR和SpO_2在两组间麻醉前和置入前比较差异无统计学意义（P〉0.05）,置入喉罩（气管导管）后及术后拔除时A组MAP、HR的数值明显低于B组（P〈0.05）,苏醒时间A组明显短于B组（P〈0.05）,术后舒适例数A组明显多于B组（P〈0.05）,术后体动、咽喉痛、呛咳的发生率A组也明显低于B组（P〈0.05）。结论：喉罩全麻复合局麻在患者诱导期和苏醒期拥有更加平稳的血流动力学,且苏醒时间明显短,术后不良反应发生率明显低,术后舒适度也明显高,是非洲妇女短小手术一种较为理想的麻醉方法。

论美国非裔女作家主体意识的发展

美国非裔女作家主体意识的觉醒是在黑人解放运动中产生的,包括种族意识和性别意识的双重觉醒。经历了19世纪中后期至1920年的萌芽时期、20世纪二三十年代的发展时期、20世纪60年代以后的成熟时期三个时期,最终形成了70年代以来的"黑人女性文艺复兴"。

弗莱雷解放教育思想与非洲女子教育的耦合

巴西著名批判教育学家保罗·弗莱雷,在《被压迫者教育学》一书中所诠释的解放教育思想,包括对人性的关怀、批判意识的建立、对话教学的开展等内容,对后世教育特别是弱势群体教育的发展产生了深远的影响。就非洲国家而言,女童和妇女一直是处于教育最边缘的人群,其辍学率和文盲率一直居高不下,生活得不到保障。弗莱雷通过教育获得解放的思想,对非洲女子教育有着重要的借鉴价值与启示意义。

《为母之乐》:透视非洲女性的新视角

长期以来,人们普遍认为非洲女性是受到了父权制社会残酷虐待的奴隶,是被父权制社会吞噬的"软食","生儿育女者"和"役畜"。然而,非洲女作家布奇·埃梅切特根据自己的人生经历创作的代表作之一《为母之乐》为我们提供了一个透视非洲女性的新视角。女主人公Nnu Ego一心想做母亲,最后实现了自己的愿望,养育了八个子女,但却未从中得到任何乐趣,最后孤零零地死在路边。文章通过分析Nnu Ego的悲剧成因后指出,做母亲并不总能带来幸福,女人的不幸在很大程度上是自己造成的;女人实际上有权力、有能力选择自己的命运。

美国华裔与非裔女性文学中母亲形象的对比研究——以二十世纪六七十年代以后的女性文学为例

"母亲"这个角色至关重要,她本身对于人们来说蕴含的意义丰富,而且在作家笔下更被赋予了更深层的含义,所以一直以来都是中外作家们笔下的"宠儿"。特别是二十世纪六七十年代以来随着美国女性主义运动的发展,母亲这一角色便更受少数族裔作家,特别是女性作家的钟爱。本文主要研究在少数族裔这个群体中同属于边缘文学,并受到主流文化排斥的华裔和非裔女性主义文学作品中女性作家笔下不同的母亲形象,分析具体原因并说明母亲对于孩子成长过程的影响。