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Introduction: Black, Asian, and Minority Ethnic (BAME) students in healthcare-related courses are exposed to various challenging experiences compared to their White counterparts, not only in the UK (United Kingdom) but across the globe. Underachieving, stereotyping, racial bias, and cultural differences, among other experiences, hinder their medical education, practice, and attainment. This review aimed to explore and understand the experiences of BAME students enrolled in healthcare related courses in the United Kingdom. Methods: Computerised bibliographic search was carried out using MeSH and free text descriptors via PubMed, Cochrane, Google Scholar, and Science Direct for eligible English-published studies exploring BAME experiences in the UK from 2010-2023. Results: A cumulative total of 813 studies were obtained from the literature search, of which five met the inclusion criteria. Quality assessment for risk of bias was assessed using the Newcastle Ottawa scale, yielding one study of satisfactory quality, while four were deemed to be of good quality. Conclusion: BAME students pursuing health-related courses across the UK. face a range of experiences, including racial discrimination, unconscious bias, and a lack of representation and support. Additionally, BAME students are more likely to report incidents of racial harassment and withdraw from their respective courses as well as experiencing mental health issues due to their experiences.
RESUMEN
BACKGROUND: Half of patients who achieve successful recanalization following endovascular thrombectomy (EVT) for acute ischemic stroke experience poor functional outcome. We aim to investigate whether the use of adjunctive intra-arterial antithrombotic therapy (AAT) during EVT is safe and efficacious compared with standard therapy (ST) of EVT with or without prior intravenous thrombolysis. METHODS: Electronic databases were searched (PubMed/MEDLINE, Embase, Cochrane Library) from 2010 until October 2023. Data were pooled using a random-effects model and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using ROBINS-I and ROB-2. The primary outcome was functional independence (modified Rankin Scale (mRS) 0-2) at 3 months. Secondary outcomes were successful recanalization (modified Thrombolysis In Cerebral Infarction (TICI) 2b-3), symptomatic intracranial hemorrhage (sICH), and 90-day mortality. RESULTS: 41 randomized and non-randomized studies met the eligibility criteria. Overall, 15 316 patients were included; 3296 patients were treated with AAT during EVT and 12 020 were treated with ST alone. Compared with ST, patients treated with AAT demonstrated higher odds of functional independence (46.5% AAT vs 42.6% ST; OR 1.22, 95% CI 1.07 to 1.40, P=0.004, I2=48%) and a lower likelihood of 90-day mortality (OR 0.71, 95% CI 0.61 to 0.83, P<0.0001, I2=20%). The rates of sICH (OR 1.00, 95% CI 0.82 to 1.22,P=0.97, I2=13%) and successful recanalization (OR 1.09, 95% CI 0.84 to 1.42, P=0.52, I2=76%) were not significantly different. CONCLUSION: The use of AAT during EVT may improve functional outcomes and reduce mortality rates compared with ST alone, without an increased risk of sICH. These findings should be interpreted with caution pending the results from ongoing phase III trials to establish the efficacy and safety of AAT during EVT.