History Of Exclusion Research Articles

Perceptions about dementia clinical trials among underrepresented populations: a nationally representative survey of U.S. dementia caregivers

BackgroundThe research community has historically failed to enroll diverse groups of participants in dementia clinical trials. A unique aspect of dementia care research is the requirement of a study partner, who can attest to the care recipient’s clinical and functional capacity. The aim of this study is to assess racial and ethnic differences and the importance of various trial considerations among dementia caregivers, in their decision to participate in clinical research as study partners.MethodWe embedded a vignette about a hypothetical dementia clinical trial in a nationally representative survey of U.S. dementia caregivers, oversampling non-Hispanic Black and Hispanic caregivers. Dementia caregivers were asked about their willingness to participate in the trial with their care recipient and rated the importance of nine considerations in hypothetical decisions to participate. Caregiver demographic characteristics were analyzed as predictors of trial participation in a base demographic model. In a second reasons model caregiver demographic characteristics and the rated importance of the nine considerations were separately analyzed as predictors; both models used survey-weighted logistic regression.ResultThe sample consisted of 610 dementia caregivers, including 156 non-Hispanic Black and 122 Hispanic caregiver participants. In the base demographic model, hypothetical trial participation was negatively associated with older caregiver age (OR (odds ratio) = 0.72, p = < 0.001). In the reasons model, the rated importance of a social responsibility to help others by participating in research was significantly associated with participation (OR = 1.56, p = 0.049), while the importance of the possibility of the care recipient experiencing serious side effects was negatively associated with participation (OR = 0.51, p = 0.003). In both models there was no significant difference in hypothetical participation between non-Hispanic Black and non-Hispanic White caregivers, or between Hispanic and non-Hispanic White caregivers.ConclusionHispanic and non-Hispanic Black dementia caregivers were not less likely than non-Hispanic White dementia caregivers to participate in a hypothetical dementia clinical trial. Our study suggests that failures to recruit diverse populations in dementia clinical research are not attributable to less willingness among members of underrepresented groups but may instead reflect structural barriers and historic exclusion from trial participation.

Menstrual and oral contraceptive pill cycles minimally influence vascular function and associated cellular regulation in premenopausal females.

Historical exclusion of females in research has been, in part, due to the perceived influence of natural menstrual (NAT) and oral contraceptive pill (OCP) cycles on vascular outcomes. NAT and OCP cycle phases may influence brachial artery (BA) endothelial function, however, findings are mixed. Minimal research has examined arterial stiffness, smooth muscle, and lower limb endothelial function. The purpose of this study was to investigate the influence of NAT and OCP cycles on cardiovascular outcomes and cellular regulation. Forty-nine premenopausal females (n = 17 NAT, n = 17 second generation OCP, n = 15 third generation OCP) participated in two randomized order visits in the low (LH, early follicular/placebo) and high (HH, midluteal/active) hormone cycle phases. BA and superficial femoral artery (SFA) endothelial function [flow-mediated dilation (FMD) test], smooth muscle function (nitroglycerine-mediated dilation test), and carotid and peripheral (pulse wave velocity) arterial stiffness were assessed. Cultured female human endothelial cells were exposed to participant serum for 24 h to examine endothelial nitric oxide synthase (eNOS) and estrogen receptor-α (ERα) protein content. BA FMD was elevated in the HH vs. LH phase, regardless of group (HH, 7.7 ± 3.5%; LH, 7.0 ± 3.3%; P = 0.02); however, allometric scaling for baseline diameter resulted in no phase effect (HH, 7.6 ± 2.6%; LH, 7.1 ± 2.6%; P = 0.052, d = 0.35). SFA FMD, BA, and SFA smooth muscle function, arterial stiffness, and eNOS and ERα protein content were unaffected. NAT and OCP phases examined have minimal influence on vascular outcomes and ERα-eNOS pathway, apart from a small effect on BA endothelial function partially explained by differences in baseline artery diameter. NEW & NOTEWORTHY Comprehensive evaluation of the cardiovascular system in naturally cycling and second and third generation OCP users indicates no major influence of hormonal phases examined on endothelial function and smooth muscle function in the arteries of the upper and lower limbs, arterial stiffness, or underlying cellular mechanisms. Study findings challenge the historical exclusion of female participants due to potentially confounding hormonal cycles; researchers are encouraged to consider the hormonal environment in future study design.

First Peoples economic landscape: analysis of the ecosystem

PurposeThis paper focuses on First Peoples Founders of for-profit entities in Australia and the role of the Indigenous Economic Development Agencies (IEDAs). We explore the challenges facing First Peoples enterprises, influenced by historical exclusion from white settler society, and the practices of the IEDAs from the perspectives of Founders and agencies.Design/methodology/approachA qualitative study utilising Indigenous Standpoint Theory and Indigenous research methods, elevating Founder perspectives, in the Yaruwu language - the Nilangany Ngarrungunil, owners of knowledge, to that of research collaborators.FindingsThe First Peoples economic landscape is continually evolving with IEDAs contributing to that evolution despite contentious identity ownership definitions. Founders secure in their own identity, are focused on self-determination and opportunities provided by IEDAs, government and corporate sector policies. However, opportunities are undermined by ongoing racism, discrimination and prevailing stereotypes leading to homogeneity, invisibility and exclusion. Founders question organisational commitments to overcoming systemic exclusion in particular their commitment to building respectful relationships and understanding First Peoples ways of working. Instead, Founders focus on building a sustainable First Peoples economic ecosystem through relationship-based practices rather than transactional reconciliation which ignores the reality of the lived experience of everyday racism.Originality/valueThis study extends the scholarly discourse on First Peoples for-profit enterprise success written with an Indigenous voice. We demonstrate how this Founder generation are strengthened by culture with identity infused in organisational practices underpinning their aspirations of economic self-determination.

Injuries in Male and Female Wrestlers.

» With historical exclusion from the sport and lack of research on the subject, there is a paucity of data regarding the injury incidence, treatment, and recovery of female wrestlers as compared with their male counterparts.» Data demonstrate that female wrestlers are more likely to experience sprains/strains, whereas male wrestlers experience more concussions and fractures.» Variations in behavior and physiology including risk-taking habits and ligament laxity may contribute to differences in injury incidence between male and female wrestlers.» Rapid weight loss and eating disorders are important areas of future investigation for male and female wrestlers alike.

An interview with Gerald Cupchik: Equity, diversity and inclusion

How should we address equity, diversity, and inclusion issues in the ‘Post-COVID era’? Some students just want the degree, whereas others miss the social intimacy of classroom experiences. In this interview, we address a dissociation between university administrations with top-down, ideologically driven agendas, and the lived experiences of students. Students become immersed in diversity by participating in classes based on shared interests that cut across backgrounds and reflect experiential learning; moving from ‘cliques to networks.’ Inclusion cannot be mandated by the university and formally required of lecturers. Rather, it reflects a student’s feeling of belonging based on acceptance by others in the classroom setting and this is something that lecturers can foster. Equity is a more delicate theme tied to past exclusions that touch many communities. Gatekeepers have historically excluded students based on race or cultural affiliation. Attempts to redress this imbalance for specific communities can forget the historical exclusion of others. My approach favors ‘inclusive authenticity,’ whereby students are in touch with their heritage, and ‘reflective awareness,’ a sensitivity to the political dynamics that surround them. We can move from ‘surface to depth,’ both as institutions and individuals by fostering critical thinking and listening to the voices of students.

Perceptions about dementia clinical trials among underrepresented populations: A nationally representative survey of U.S. dementia caregivers.

The research community has historically failed to enroll diverse groups of participants in dementia clinical trials. A unique aspect of dementia care research is the requirement of a study partner, who can attest to the care recipient's clinical and functional capacity. The aim of this study is to assess racial and ethnic differences and the importance of various trial considerations among dementia caregivers, in their decision to participate in clinical research as study partners. We embedded a vignette about a hypothetical dementia clinical trial in a nationally representative survey of U.S. dementia caregivers, oversampling non-Hispanic Black and Hispanic caregivers. Dementia caregivers were asked about their willingness to participate in the trial with their care recipient and rated the importance of nine considerations in hypothetical decisions to participate. Caregiver demographic characteristics were analyzed as predictors of trial participation in a base demographic model. In a second reasons model caregiver demographic characteristics and the rated importance of the nine considerations were separately analyzed as predictors; both models used survey-weighted logistic regression. The sample consisted of 610 dementia caregivers, including 156 non-Hispanic Black and 122 Hispanic caregiver participants. In the base demographic model, hypothetical trial participation was negatively associated with older caregiver age (OR (odds ratio) = 0.72, p = < 0.001). In the reasons model, the rated importance of a social responsibility to help others by participating in research was significantly associated with participation (OR = 1.56, p = 0.049), while the importance of the possibility of the care recipient experiencing serious side effects was negatively associated with participation (OR = 0.51, p = 0.003). In both models there was no significant difference in hypothetical participation between non-Hispanic Black and non-Hispanic White caregivers, or between Hispanic and non-Hispanic White caregivers. Hispanic and non-Hispanic Black dementia caregivers were not less likely than non-Hispanic White dementia caregivers to participate in a hypothetical dementia clinical trial. Our study suggests that failures to recruit diverse populations in dementia clinical research are not attributable to less willingness among members of underrepresented groups but may instead reflect structural barriers and historic exclusion from trial participation.

Experiences of religious acceptance and rejection among currently religious and out transgender young adults in the United States

ABSTRACT Religious communities, across religious traditions, remain a source of support and community for many people in the United States. Despite reduced engagement in religious activity and historic exclusion of the wider LGBTQ+ community, a contingent of people, including young transgender people, are a part of religious communities. Based on data from the 2015 U.S. Transgender Survey report, this study focused on transgender young adults (n = 769; aged 18–24) and their experiences in congregations. Reviewing race, gender identity, sexual orientation, disability status, education level, and religious affiliation, this study investigated how sociodemographic identity is correlated with religious rejection or acceptance for transgender young adults. The findings highlight that race, educational attainment, and religious conservatism are most salient when assessing whether transgender young adults are accepted or rejected in their religious congregations.

Navigating the Complexities of Brain Metastases Management.

The management of brain metastases, a potentially devastating complication of advanced cancers, has become increasingly complex with advancements in local and systemic therapies. Improved outcomes and extended survival for patients with metastatic solid tumors have led to a surge in the prevalence and possibly incidence of brain metastases, affecting up to 40% of individuals with solid tumors. Enhanced imaging technologies contribute to more accurate and early detection, shaping the understanding of the intricate landscape of this condition. Traditionally, surgery and radiation stood as the mainstays of treatment because of the limited efficacy of systemic therapies within the brain. However, emerging clinical data, particularly in melanoma, lung, and breast cancers, reveal promising results with novel systemic treatments such as immunotherapy and targeted therapies. Despite the historical exclusion of patients with active brain metastases from clinical trials, a shift is occurring toward a more inclusive approach. This chapter delves into the multifaceted challenges associated with managing brain metastases, with a focus on the evolving landscape of systemic approaches as well as the intricacies of shared decision making, providing a comprehensive overview of the current state and future directions in navigating the complexities of brain metastases management.

Navigating multiple and complex systems of care and support with ageing family carers from multicultural backgrounds in Australia

Ageing family caregivers of family members with disability must navigate complex social care systems within a single household for long-term and end-of-life transitions. This is particularly challenging for migrants from culturally and racially marginalised (CaRM) backgrounds, given their historical exclusion from developing disability and aged care support systems. Limited research exists on the lived experiences of new and second-generation CaRM communities providing informal care to family members with disabilities, globally and in Australia. This paper highlights the challenges faced by CaRM families navigating racial, ethnic, and immigration politics while seeking access to appropriate disability and ageing social care supports. The findings reveal that Many CaRM families face isolation and difficulty accessing needed support due to misconceptions about their strong local networks. Moreover, the significance of place, especially in low-resource urban areas, poses challenges for ageing family primary caregivers managing a dual long-term care arrangement, leading to uncertainties about their future.

Opinion & Special Article: Community Approach Toward Inclusion of Sex and Gender Diversity in Graduate Neurology Education.

Sex and gender diverse (SGD) neurology trainees include transgender, nonbinary, and intersex people. There has been historical exclusion of SGD trainees from participating in clinical care, medical research, and academic training programs. Therefore, neurology educators have unique opportunities to support SGD trainees and colleagues, but may lack the education to appropriately do so. Training programs and professional organizations can collaborate to create safe pathways for SGD trainees to disclose their identities in professional settings. Referral to community support and resources is important for SGD trainees considering professional disclosure. Educators should address the challenges and discrimination unique to SGD graduate trainees in neurology, such as lack of inclusion, affirming environments, supportive policies, and medical accommodations. Faculty training on sensitivity, bias, and bystander effects should be ongoing among institutions. Topics regarding sex and gender diversity are lacking in graduate medical education. Educational curricula often use outdated terminology or binary paradigms to teach about sex and gender. Health care training inequities may cause downstream harm to SGD patients; therefore, training curricula that are reflective of an accurate and affirming understanding of sex and gender may mitigate the potential for inequities. This article provides recommendations to support SGD neurology trainees and to incorporate specific training on sex and gender diversity in academic neurology curricula. Such support is critical to the career success and development of SGD neurology trainees.

Medicine, emotience, and reason

Medicine is faced with a number of intractable modern challenges that can be understood in terms of hyper-intellectualization; a compassion crisis, burnout, dehumanization, and lost meaning. These challenges have roots in medical philosophy and indeed general Western philosophy by way of the historic exclusion of human emotion from human reason. The resolution of these medical challenges first requires a novel philosophic schema of human knowledge and reason that incorporates the balanced interaction of human intellect and human emotion. This schema of necessity requires a novel extension of dual-process theory into epistemology in terms of both intellect and emotion each generating a distinct natural kind of knowledge independent of the other as well as how these two forms of mental process together construct human reason. Such a novel philosophic schema is here proposed. This scheme is then applied to the practice of medicine with examples of practical applications with the goal of reformulating medical practice in a more knowledgable, balanced, and healthy way. This schema’s expanded epistemology becomes the philosophic foundation for more fully incorporating the humanities in medicine.

Transgender Men and Non-Binary Students Managing Their Identities to Pay for College

Compared to previous generations, U.S. college students must increasingly rely on non-government sources of money to pay for college. Yet, paying for college looks markedly different for students from marginalized communities, given historical exclusion and inequitable access to financial capital. Using data from a longitudinal study of transgender men and nonbinary students, I argue that identity management is a key tactic these students use to pay for college and navigate competing financial priorities. Ultimately, this study can help researchers and policymakers better address issues of affordability, while more clearly understanding the unique nature of identity management for transgender students.

A study of the Asian diaspora experience: from historical exclusion to knowledges that count in education

ABSTRACT This article examines the Asian diaspora experience from historical exclusion to the production of oppositional and alternative knowledges that count in education. The first section critically examines historical and contemporary discourses across disciplines on the construction of identity such as who is considered an Asian and Asian American, who comprises the Asian diaspora, and with what consequences. The second section explores theoretical frameworks proposed by scholars for deconstructing received knowledge about Asians as an ontological subject constructed within binaries and hierarchies and radical methodologies for research that speak to the lived diaspora experience. The third section presents Asian diaspora counterstories of resistance, activism, and advocacy and the production of transformative knowledges worth knowing in education. The article concludes with the hope that the Asian diaspora experience will open possibilities for Asian Diaspora Experience (ADE) as a field of inquiry in continuing the cultural and political work of social and educational change.

Visions of the Earth: Colombian Indigenous Women Learning English from a Gender-Based and Multilingual Perspective

This case study is the result of a pedagogical intervention within the project Visions of the Earth in which 18 Colombian Indigenous women participated. Participants came from diverse Indigenous communities across different regions of Colombia. The project, Visions of the Earth, emerged as an initiative in collaboration with the Colombian Network of Indigenous Women in the Academia (RedColmia) and Universidad de Caldas. The project aimed to strengthen participants’ academic English through a year-long online program. Bi-monthly sessions were conducted by university professors and international guests, exploring visions of the Earth through texts by Indigenous writers who addressed historical exclusion and discrimination faced by Indigenous women in academia. Data were collected through two semi-structured surveys and participants’ artifacts. Despite debates on language erosion, participant perceptions underscore the importance of learning English as an empowering tool. Findings reveal that learning English under an Indigenous women gender-based perspective and multilingual approach is a medium for cultural appreciation, identity redefinition, and a means to share their unique perspectives on the Earth. This study provides insights into the intersection of language development, cultural identity, and academic empowerment for Indigenous communities.

Visualizing Black Telephone Users: Technological Whiteness and Racial Exclusion in Bell System Advertising.

This study considers the broad implications of white technological modernity as a mode of symbolic and systemic exclusion. The visual absence of Black telephone users in mass-market advertising-and the struggle to make them visible-underscores the exclusionary power of technological whiteness and its lasting effects on conceptions of Black technology users, communities, and innovation. In the first half of the twentieth century, American Telephone and Telegraph (AT&amp;T) tirelessly promoted its national telephone network as a model of technological progress and universal service, but this vision did not include African Americans. This article examines the historical exclusion of African Americans in Bell System advertising and the emergence of Black telephone users in advertising imagery during the 1950s and 1960s, drawing attention to the civil rights work of Ramon S. Scruggs, the first African American to rise to Bell System upper management.

Difficulties and advances in access to and use of health services by transgender women and travestis in Brazil.

To understand the narratives of transgender women and travestis (TGW) from four Brazilian cities regarding access to and use of health services. Qualitative study carried out within the scope of the TransOdara project, cross-sectional multicenter mixed methods research conducted between 2019-2021. Fifty-two in-depth interviews with TGW in Manaus, Campo Grande, Porto Alegre and São Paulo were analyzed. The analysis was guided by philosophical hermeneutics. Reports of discrimination, stigmatization and pathologization reiterate the difficulties faced by TGW in seeking healthcare. The recurrence of disrespect for the social/corrected name reveals obstacles to the recognition of transgender identities and, in some cases, the intention of inhibiting transsexuality-travestilidade. Other difficulties arise from actions that disregard the health specificities of TGW or the precarious social conditions that affect some of them. On the other hand, based on experiences of respect and adequate care, participants identify an ongoing change, which is expressed in greater availability of services and improved assistance. There is an expectation of continued expansion of services, technologies and training of health professionals. The identified change has been undertaken at the interface of public health policies with LGBT+ activism and the production of knowledge about TGW health needs. Although the identified advances are insufficient to change the scenario of the historical exclusion experienced by TGW in health services, they point to promising ways to improve their health conditions.

Perceptions about Dementia Clinical Trials

AbstractBackgroundThe research community has historically failed to enroll diverse populations in dementia clinical trials. A unique aspect of dementia care research is the requirement of a study partner, who can attest to the care recipient’s clinical and functional capacity. The aim of this study is to assess racial and ethnic differences and the importance of various trial considerations, among dementia caregivers, in their decision to participate in clinical research as study partners.MethodWe embedded a vignette about a hypothetical dementia clinical trial in a nationally representative survey of dementia caregivers, oversampling Black non‐Hispanic and Hispanic caregivers. They were asked about their willingness to participate in the trial with their care recipient, and rated the importance of nine considerations in hypothetical decisions to participate. Caregiver demographic characteristics, care recipient characteristics, and relational characteristics were analyzed as predictors of trial participation in a demographic model. In a second model, caregiver demographic characteristics and the rated importance of the nine considerations were separately analyzed as predictors; both models used survey‐weighted logistic regression.ResultThe sample consisted of 610 caregivers, including 156 Black non‐Hispanic and 122 Hispanic participants. In the demographic model, hypothetical trial participation was negatively associated with caregiver age [OR (odds ratio) = 0.46, P = &lt;0.001], and with care recipient male gender [OR = 0.34, P = 0.007]. In the second model, responsibility to help others by participating in research was significantly associated with participation [OR = 1.56, P = 0.049], while the possibility of the care recipient experiencing serious side effects was negatively associated with participation [OR = 0.51, P = 0.003]. In both models there was no significant difference in hypothetical participation between non‐Hispanic Black and non‐Hispanic White caregivers, or between Hispanic and non‐Hispanic White caregivers.ConclusionHispanic and non‐Hispanic Black dementia caregivers were not less likely than non‐Hispanic White dementia caregivers to participate in a hypothetical dementia clinical trial. Our study suggests that failures to recruit diverse populations in dementia clinical research are not attributable to less willingness among members of underrepresented groups, but may instead reflect structural barriers and historic exclusion from trial participation.

Safety and Efficacy of Direct Oral Anticoagulants in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Introduction Direct oral anticoagulants (DOACs) are widely used for treatment of venous thromboembolism (VTE) and stroke prophylaxis in patients with atrial fibrillation. Liver cirrhosis increases the risk of conditions necessitating anticoagulation, but also increases the risk of bleeding, complicating anticoagulation use. Traditionally, low molecular weight heparin (LMWH) or Vitamin K Antagonists (VKA) have been used in this patient population. However, VKA use can be complicated due to difficulty monitoring in the context of synthetic dysfunction and baseline INR abnormalities. DOACs have emerged as alternative agents, with less proposed reliance on hepatic elimination. Apixaban, rivaroxaban, edoxaban and dabigatran are eliminated by the liver at 75%, 65%, 50% and 20% respectively. However, safety data on DOACs in cirrhosis patients is limited due to historic exclusion from larger trials. Patients with severe Child-Pugh (CP) classes are notably underrepresented in major trials. Various guidelines currently classify CP class C (and sometimes B) as contraindications to DOACs. Methods A literature search of MEDLINE and Embase from inception to Jan 2023 identified randomized controlled trials (RCTs) and cohort studies comparing DOACs to LMWH/VKA in cirrhosis patients. Two independent reviewers screened and extracted data at title, abstract, and full-text. Patient characteristics, CP class, and anticoagulation regimens were extracted. The primary outcome was major bleeding per ISTH criteria. Secondary outcomes include clinically relevant non-major bleeding (CRNMB) and minor bleeding per ISTH criteria as a composite outcome, VTE incidence, and arterial thromboembolism (ATE) incidence. Results were stratified into two subgroups: CP B&amp;C Exclusive, and CP Unspecified (primary study did not report or stratify by CP class). A meta-analysis was conducted using the Mantel-Haenszel random-effects model and presented as odds ratios (OR) with corresponding 95% confidence intervals (CI). Results Of 794 articles screened, 21 articles (2 RCTs, 1 prospective cohort, 13 retrospective cohorts, 5 abstracts) were included for analysis (n = 5738). Overall, DOACs were associated with a lower risk of major bleeding compared to controls (OR=0.63 [0.45, 0.89], p&amp;lt;0.01). This result was consistent in the CP B&amp;C Exclusive subgroup (OR=0.42 [0.29, 0.62], p&amp;lt;0.01, 5 studies) but not in the CP Unspecified subgroup (OR=0.71 [0.48, 1.08], p=0.11, 13 studies). One large study (n=3213), Lawal 2023, weighed 20.1% in the CP B&amp;C Exclusive group, favoured DOACs in reduction of major bleeding (OR=0.37, 95%CI [0.24,0.57]). Removal of this study in a post-hoc sensitivity analysis led to no differences in major bleeding in the CP B&amp;C subgroup (OR=0.79, 95%CI [0.31,1.97]), CP Unspecified subgroup (OR=0.71, 95%CI [0.48,1.08]), or overall bleeding (OR=0.75, 95%CI [0.55,1.03]). For CRNMB and minor bleeding, DOACs did not differ from control overall or in any subgroups. DOACs significantly reduced the risk of VTE in the CP Unspecified subgroup and overall. The difference in VTE incidence was non-significant in the CP B&amp;C Exclusive subgroup, however the analysis only had two studies. The difference in ATE incidence in the overall sample and all subgroups was non-significant. Conclusion In this analysis comparing DOACs to LMWH/VKAs in patients with liver cirrhosis, DOACs were associated with a statistically significant reduction in the risk of major bleeding overall and in the more advanced subgroups (CP B&amp;C). The association between DOACs and the risk of CRNMB and minor bleeding was non-significant. Patients using DOACs had lower VTE incidence compared to those using LMWH/VKA, with no difference in ATE incidence. Limitations include the inability to stratify CP class B and C due to limited CP class C evidence, reducing confidence in our ability to differentiate a differing effect in these two groups. Furthermore, a single large study (Lawal 2023), heavily influenced the major bleeding outcome; its removal shifted the conclusion from favouring DOACs to non-significant differences. Nevertheless, these results provide reassurance on the safety profile of DOACs in comparison to LMWH/VKA in patients with cirrhosis, particularly in those with moderate to severe liver cirrhosis, a population of clinical uncertainty. There is no concerning evidence for future trials, which are much needed, to include this population.

An Analysis of Post-Apartheid Anti-Fronting Interventions Fostering Mainstreaming of the Black South Africans into Corporate Sector

While the colonial and apartheid regimes utilised draconian, arbitrary, segregated, discriminatory, and exclusive anti-black social-socioeconomic policies and laws to deny the majority of black South Africans access to and participation in various economic activities, post 1994 democratic South Africa has strategically introduced progressive policies and laws to ensure that black South Africans play active productive roles in socio-economic activities in all sectors. While this is commendable, various corporations and businesses owned by white companies are supposed to ensure that black people become part and parcel of the businesses, and companies are being denied active participation, using fronting purposefully to circumvent the requirements of the anti-fronting laws. Against this backdrop, this paper seeks to analyse the post-apartheid anti-fronting interventions that foster the mainstreaming of black South Africans into the corporate sector. The paper uses a literature review methodology to find and analyse primary and secondary sources of data relating to equality, BEE, and fronting. This paper presents the historical exclusion of blacks through the instrumentality of colonial and apartheid apparatuses and laws brutally utilised to exclude blacks from economic activities. Post 1994 democratic transformative interventions—laws—have been enacted to redress the segregated and exclusive laws; however, fronting activities and practices continue to undermine and circumvent successful implementation. This said, the post 1994 government continues to tackle impunity through the exploration of civil and criminal responsibilities and accountability of perpetrators and use the rule of law-judicial means to hold perpetrators accountable. This paper found that fronting is a persisting issue in South Africa despite anti-fronting legislative measures developed over the past years when the B-BBEE Act was amended. This paper advises more on pro-active anti-fronting measures to pro-actively foster the mainstreaming of black South Africans into the corporate sector.

Perceptions of psychedelic-assisted therapy among Black Americans

The present study investigated differences in perceptions of psychedelic-assisted therapy between Black and White Americans, as well as factors that may influence these perceptions. A final sample of 294 adults (42% female, 44% Black/African American or Mixed Race (of Black/African ancestry), 56% White American; Mage = 36.3 years) completed an online survey which assessed baseline knowledge and views of psychedelic-assisted therapy. Participants were then provided brief psychoeducation related to MDMA and psilocybin-assisted therapy. After psychoeducation, participants were queried on their perceptions of psychedelic-assisted therapy and factors potentially influencing these perceptions, including trauma history, current depressive and PTSD symptoms, perceived stress, and perceived barriers to psychological treatments. Psychoeducation had a positive impact on both level of interest and positivity of views of psychedelic-assisted therapy across groups. Black American participants reported more positive views of psychedelic-assisted therapy than White participants following psychoeducation. Greater depression and PTSD symptom severity was associated with greater baseline interest in Black and White Americans and there was significant interactions in predicting baseline view and interest, such that Black participants who reported greater depression symptom severity were more interested and had more positive views of PAT. Despite historical exclusion from psychedelic clinical trials and experiences of unethical treatment in research, Black Americans demonstrate more positive views of psychedelic therapy, and Black Americans more in need of novel mental health care demonstrate more interest and more positive views. Our findings demonstrate that the onus for diversification of psychedelic research samples is on research groups. These findings also provide an impetus for the psychedelic research community to rebuild trust in psychedelic research among Black Americans, conduct outreach, and provide culturally attuned psychedelic-assisted interventions that are accessible to Black Americans.