Situating Arab women’s writing in a feminist ‘global gothic’ : madness, mothers and ghosts

This article sketches a new way of approaching some contemporary Levantine (Egyptian and Lebanese) feminist texts. Extending Glennis Byron’s notion of the ‘global gothic’, I examine Hanan Al-Shaykh’s The Story of Zahra (1986), Mansoura Ez Eldin’s Maryam’s Maze (2007) and Joumana Haddad’s The Seamstress’ Daughter (2019) as examples of an Arab feminist Gothic approach, which serves as a framework to theorise difficult and pressing questions that feminism poses regarding women’s rights. Arab feminist Gothic writers use the jahiliyyah period, or the ‘time of ignorance’, as a folkloric referential backdrop for texts which theorise the female condition under contemporary patriarchal society. The presence of ghosts, madness, doubles in the form of the folkloric qarina spirit-doubles and dreams can be read as part of a local Gothic feminist mode. This as-yet unacknowledged Arab feminist Gothic tradition, while emerging from debates over statehood and postcolonial subjectivities, delves into the intensity of personal traumas through the lens of women’s relationships to other women, especially mothers and daughters. Taking Arab feminist fiction as its focus, this article models how feminist scholarship can use genre, particularly the Gothic, to trace artistic feminist theorising in non-western contexts

Blood Pressure Classification Status in Children With CKD Following Adoption of the 2017 American Academy of Pediatrics Guideline

Accurate detection of hypertension is crucial for clinical management of pediatric chronic kidney disease (CKD). The 2017 American Academy of Pediatrics (AAP) clinical practice guideline for childhood hypertension included new normative blood pressure (BP) values and revised definitions of BP categories. In this study, we examined the effect of applying the AAP guideline’s normative data and definitions to the Chronic Kidney Disease in Children (CKiD) cohort compared with use of normative data and definitions from the 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Observational cohort study. Children and adolescents in the CKiD cohort. Clinic BP measurements. BP percentiles and hypertension stages calculated using the 2017 AAP guideline and the Fourth Report from 2004. Agreement analysis compared the estimated percentile and prevalence of high BP based on the 2017 guideline and 2004 report to clinic and combined ambulatory BP readings. The proportion of children classified as having normal clinic BP was similar using the 2017 and 2004 systems, but the use of the 2017 normative data classified more participants as having stages 1-2 hypertension (22% vs 11%), with marginal reproducibility (κ=0.569 [95% CI, 0.538-0.599]). Those identified as having stage 2 hypertension by the 2017 guideline had higher levels of proteinuria compared with those identified using the 2004 report. Comparing use of the 2017 guideline and the 2004 report in terms of ambulatory BP monitoring categories, there were substantially more participants with white coat (3.5% vs 1.5%) and ambulatory (15.5% vs 7.9%) hypertension, but the proportion with masked hypertension was lower (40.2% vs 47.8%, respectively), and the percentage of participants who were normotensive was similar (40.9% vs 42.9%, respectively). Overall, there was good reproducibility (κ=0.799 [95% CI, 0.778-0.819]) of classification by ambulatory BP monitoring. Relationship with long-term progression and target organ damage was not assessed. A greater percentage of children with CKD were identified as having hypertension based on both clinic and ambulatory BP when using the 2017 AAP guideline versus the Fourth Report from 2004, and the 2017 guideline better discriminated those with higher levels of proteinuria. The substantial differences in the classification of hypertension when using the 2017 guideline should inform clinical care