Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle-income contexts.

BACKGROUND: Qualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs). METHODS: We conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted. RESULTS: One hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%). CONCLUSIONS: A reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.

A Critical Understanding of Inclusion in Oral Microbiome Research through the Lens of Racial Capitalism.

There are important calls for greater inclusion of Indigenous and racialised communities in oral microbiome research. This paper uses the concept of racial capitalism (the extractive continuity of colonialism) to critically examine this inclusion agenda. Racial capitalism explicitly links capitalist exploitations with wider social oppressions e.g., racisms, sexism, ableism. It is not confined to the commercial sector but pervades white institutions, including universities. By using the lens of racial capitalism, we find inclusion agendas allow white institutions to extract social and economic value from relations of race. Racially inclusive research is perceived as a social good, therefore, it attracts funding. Knowledge and treatments developed from research create immense value for universities and pharmaceutical companies with limited benefits for the communities themselves. Moreover, microbiome research tends to drift from conceptualisations that recognise it as something that is shaped by the social, including racisms, to one that is determined genetically and biologically. This location of problems within racialised bodies reinforces racial oppressions and allows companies to further profit from raciality. Inclusion in oral microbiome research must consider ways to mitigate racial capitalism. Researchers can be less extractive by using an anti-racism praxis framework. This includes working with communities to co-design studies, create safer spaces, giving marginalised communities the power to set and frame agendas, sharing research knowledges and treatments through accessible knowledge distributions, open publications, and open health technologies. Most importantly, inclusion agendas must not displace ambitions of the deeper anti-oppression social reforms needed to tackle health inequalities and create meaningful inclusion.

Teaching Scottish medical students about global health in partnership with LMIC institutions. Does it change their views on volunteering in LMIC settings?

CONTEXT: An elective placement is a core part of most United Kingdom (UK) medical degrees, and a significant proportion of students choose to pursue their elective in low- and middle-income countries (LMIC). There is a risk that students are ill-prepared for some of the ethical challenges that they will face during these placements, and that they have little appreciation for some of the negative effects that their placement can have on the host healthcare system. This study sought to address some of these negative consequences by exploring the preparation of medical students for these experiences, and the effect of including the LMIC perspective in preparation materials. METHODS: This qualitative study used thematic analysis to explore the attitudes of final year medical students at a Scottish medical school to international volunteering, after completing a module on global health. This module was designed and delivered in partnership with academics from Malawi, Rwanda and Zambia, thus incorporating a strong LMIC perspective. FINDINGS: This study demonstrated the ability of a global health module with a strong LMIC perspective to influence the attitudes of final year medical students in the following ways: 1) Challenging assumptions around international volunteering and, in particular, around some of the negative effects of international volunteering that had not previously been considered. 2) Changing future practice around international volunteering. IMPLICATIONS: This study provides good evidence that having a strong LMIC voice in preparation materials for medical students embarking on LMIC electives has the ability to increase awareness of some of the potential harms, and to positively influence how they plan to have discussions around and approach such experiences in the future.

Why and how is photovoice used as a decolonising method for health research with Indigenous communities in the United States and Canada? A scoping review.

Globally, including in North America, Indigenous populations have poorer health than non-Indigenous populations. This health disparity results from inequality and marginalisation associated with colonialism. Photovoice is a community-based participatory research method that amplifies the voices of research participants. Why and how photovoice has been used as a decolonising method for addressing Indigenous health inequalities has not been mapped. A scoping review of the literature on photovoice for Indigenous health research in the United States and Canada was carried out. Five electronic databases and the grey literature were searched, with no time limit. A total of 215 titles and abstracts and 97 full texts were screened resulting in 57 included articles. Analysis incorporated Lalita Bharadwaj's Framework For Building Research Partnerships with First Nations Communities. Photovoice was selected to improve knowledge mobilisation and participant empowerment and engagement. Studies incorporated relationship building, meaningful data collection, and public dissemination but had a lesser focus on the inclusion of Indigenous peer researchers or participant involvement in analysis. For photovoice to truly realise its decolonising potential, it must be incorporated into a broader participatory and decolonising research paradigm. In addition, more resources are required to support the involvement of Indigenous people in the research process.

Codesigning culturally safe oral health care with First Nations Kidney Warriors experiencing kidney disease in South Australia.

BACKGROUND: This paper describes how First Nations Kidney Warriors (Aboriginal and Torres Strait Islander people living with kidney disease), dental hygienists, kidney health care professionals, an Aboriginal hostel accommodation manager and researchers co-designed an approach to improve oral health in South Australia. Kidney Warriors have strong connection to Country, Community and family that underpins health, wellbeing and approaches to research. However, significant colonisation, racism and marginalisation have impacted Kidney Warriors' social, cultural and financial determinants of health, leading to increased chronic conditions including kidney disease. Access to culturally safe, affordable and responsive oral health care is vital but challenging for First Nations Peoples undergoing dialysis and kidney transplantation; Australian oral health care is generally provided privately, in metropolitan centres, by professionals who may hold unconscious bias about First Nations Peoples and incorrect assumptions regarding equal access to care. METHODS: The AKction - Aboriginal Kidney Care Together Improving Outcomes Now kidney care oral health working group codesigned strategies to address disparities and gaps in care, and co-create more accessible, responsive, culturally safe and sustainable models of care. A decolonising and collaborative participatory action research was informed by Dadirri Deep Listening and Ganma Knowledge Sharing with repeated cycles of Look and Listen, Think and Discuss, Take Action Together. A small pilot evaluation survey of clinical placement in an Aboriginal setting was undertaken. RESULTS: Four phases of collaboration were undertaken. Community and health professional consultations identified key gaps and priorities. Clinical yarning and cultural safety training and an interprofessional skills day was co-facilitated. Dental hygienist student clinical placement at Kanggawodli Aboriginal Hostel was initiated and evaluated. First Nations Kidney Warriors were positioned as educators and experts of their own lives and health care needs. A new framework for kidney health-oral health cultural safety and clinical education was developed. CONCLUSION: This codesigned approach involving inter-professional collaboration and joint decision making with community members has significantly informed improvements in oral health care information, services and referral with and for First Nations Peoples with kidney disease. This project provides a working example of how to decolonise health service and education programs from the ground up. TRIAL REGISTRATION: NHMRC PAR 2004389.

Diversifying the dental curriculum: A review of the Bachelor of Dental Surgery degree reading lists in a UK dental school.

INTRODUCTION: Analysis of the diversity of reading lists on courses offered by universities is one way to assess what is being taught and how it shapes our understanding of the world. Very little work has been carried out so far within dentistry on decolonising the curriculum. Existing work looks at the representation of women or ethnic minorities but not at the dental curriculum per se. This article starts to address this. METHODS: The reading lists within the 5 year Bachelor of Dental Surgery curriculum in a large UK dental school were collected and assessed. A data extraction spreadsheet was developed and journal articles on every course reading list across the 5 year curriculum were read in detail. Information on authorship and author affiliations, alongside patient and population representation within the article itself, were collected and collated. RESULTS: We found that there are 2.5 times more male authors than female authors, and almost three times more male lead authors in the articles evaluated. The majority of journal articles included in the reading lists are written by academics and/or clinicians affiliated with institutions in the United Kingdom and most articles are from the global north. In addition, 65% of articles do not specify the focus patient or population group studied. DISCUSSION: It is unlikely that current reading lists within dentistry fully reflect the composition of the profession itself, the variety of knowledge needed to provide evidence-based practice in a globalised oral health arena or the heterogeneous nature of the patient population.

The coloniality of age: Navigating the chronopolitics of Black childhood.

For Black, Indigenous, and other colonised peoples, decolonisation and racial justice are urgent imperatives, but their demands are often dismissed as utopian, impossible, or otherwise out-of-time. This article therefore introduces the coloniality of age as a theoretical framework that aims to open up possibilities for otherwise worlds. Departing from established accounts of the coloniality of time, the coloniality of age grounds the analysis of racialised time in the chronopolitical formations of tempus nullius and the paternalistic paradigm. Alongside the doctrine of terra nullius or 'uninhabited land', the doctrine of tempus nullius or 'uninhabited time' works to deny Black peoples the ability to make and remake history on their own terms. Supplementing theories of the barbarian other, the paternalistic paradigm identifies patriarchal father/child relations as a conceptual and historical precedent to race. The coloniality of age directs the analysis to the temporal limits of coloniality. I argue that the temporal limits of coloniality are constituted by Black childhood; the coloniality of age figures Black childhood as an age with no future. This framework is then applied to analyse young Black peoples' counter-narratives of Black childhood. The counter-narratives of being 'stuck', 'growing up', the 'pace' of racism, and 'regressing' centre the temporal agency of Black children as they navigate the chronopolitics of Black childhood. Each of these counter-narratives unsettles the coloniality of age. Read together, the counter-narratives tell a larger story of Black children confronting the temporal limits of coloniality, refusing the terms of White futurity, and instead opting to grow otherwise. The article concludes that Black childhood might be reframed as an age with otherwise futures beyond the temporal limits of coloniality.

"Listen with your ears and eyes and heart and your minds and your soul": Implications for decolonising consultation and occupational therapy from case studies on "Closing the Gap" policy implementation.

BACKGROUND: Including Aboriginal and Torres Strait Islander people and communities through consultation has been a key feature of policy implementation throughout the Australian Government's "Closing the Gap" (CTG) strategy. However, consultation often reinforces power imbalances between government and local community and can undervalue or marginalise Indigenous knowledge and leadership. Occupational therapy has a short history of examining colonial power structures within the profession, but there has been limited progress to decolonise consultation and practice. METHODS: Drawing on decolonising research methodology and positioned at the interface of knowledge, comparative case studies were used to understand policy implementation in two regions. In Shepparton, Victoria, CTG policy was implemented predominately through an Aboriginal Community Controlled Health Organisation, and in Southern Adelaide, South Australia, CTG policy was implemented through mainstream state government and non-government providers in the absence of a local Aboriginal-controlled organisation. Findings were examined critically to identify implications for occupational therapy. RESULTS: Our case studies showed that policy stakeholders perceived consultation to be tokenistic and partnerships were viewed differently by Aboriginal and non-Indigenous participants. Participants identified the need to move beyond a rhetoric of "working with" Aboriginal and Torres Strait Islander people, to promote Aboriginal leadership and really listen to community so that policy can respond to local need. The findings of this research show that Aboriginal-controlled services are best positioned to conduct and respond to community consultation. CONCLUSION: A decolonising approach to consultation would shift the status quo in policy implementation in ways that realign power away from colonial structures towards collaboration with Indigenous leadership and the promotion of Aboriginal-controlled services. There are lessons for occupational therapy from this research on policy implementation on authentic, decolonised consultation as a key feature of policy implementation. Shifting power imbalances through prioritising Indigenous leadership and honouring what is shared can drive change in CTG policy implementation processes and outcomes.

Moving beyond ontological (worldview) supremacy: Indigenous insights and a recovery guide for settler-colonial scientists.

Greater engagement and representation of Indigenous voices, knowledges and worldviews in the biological sciences is growing globally through efforts to bring more Indigenous academics into scientific research and teaching institutions. Although the intentions of such efforts may be admirable, these spaces often become sites of great personal tension for the Indigenous scholars who must 'bridge' or 'facilitate' a dialogue between Indigenous and settler-colonial (predominantly Western) knowledge traditions and worldviews. We are a small collective of early career Indigenous scholars from Australia, the United States and Aotearoa New Zealand, and we have gained insights into this situation through the unique experiential learning afforded by navigating such tensions. Here, we discuss tensions that bear remarkable similarities across geographies, cultures and settler-colonial contexts. In doing so, we aim to support other Indigenous scientists and scholars navigating settler-colonial and Western research institutions, while offering guidance, suggestions and reflections for the scientific community to allow the development of more nuanced strategies to support Indigenous academics than simply increasing Indigenous representation. We imagine transformed, innovative research and teaching agendas where Indigenous knowledges can thrive, and Indigenous scientists can apply themselves with mutual and balanced respect and reciprocity.

Decolonising dental educational research: reflections from a white researcher.

While there is an emerging scholarship on decolonising dentistry, the debate about reflexivity, positionality and white privilege in dental educational research and practice is still at a developmental stage. This article aims to contribute to this nascent debate by contemplating the question- is it appropriate, or possible, for a white researcher to undertake decolonisation work in dental education? If so, what would it entail or 'look' like? To answer this important question, the author offers a reflective account of their ethical and epistemological journey with this very question. This journey begins with how I, a white researcher, first became aware of the everyday racism experienced by my racially and ethnically minoritized students, the whiteness of dental educational spaces and how my white privilege and position as a dental educator consciously and unconsciously implicated me in these processes of exclusion and discrimination. While this revelation led to a personal commitment to do better in my practice, both as an educator and a researcher, I continue to struggle with my white ignorance and white fragility as I strive to make my work more inclusive. To illustrate this, I discuss an ethnodrama project on everyday racism that I lead on and how, despite choosing a more democratic research method, hegemonic whiteness continued to make its presence felt through my 'going it alone' method of work. This reflective account reaffirms that regular and routine self-reflection is key to ensuring that racialised inappropriate and damaging assumptions, frameworks of thinking, and ways of working are checked for. However, my praxis won't evolve through critical introspection alone. I need to be open to making mistakes, educating myself about racism and anti-racist practice, asking for help and guidance from my minoritized colleagues and more importantly, committing to working with people from minoritized communities rather than on them.

The 'conflict paradox': humanitarian access, localisation, and (dis)empowerment in Myanmar, Somalia, and Somaliland.

Since the World Humanitarian Summit in 2016, debates about the localisation of humanitarian aid have intensified. Dominant discourse focuses on reform, although calls for the broader decolonisation of aid are mounting. This paper examines the impact of neoliberal-inspired competition that incentivises institutional expansion and clashes with localisation. It introduces the concept of the 'conflict paradox' to illustrate how armed conflict and restricted humanitarian access for international actors can both empower and disempower local and national humanitarian actors (LNHAs). These themes are then demonstrated using case studies of Myanmar, Somalia, and Somaliland, revealing the potential for LNHAs to demand humanitarian system change, as well as the challenges to doing so. The paper concludes that for localisation to progress towards decolonisation, fundamental ideological shifts away from the neoliberal competitive mindset are essential. Notably, there is a need to move from low-quality localisation (subcontracting) to high-quality localisation grounded in solidarity and an emancipatory agenda.

Confronting Colonialism in Canadian Dietetics Curricula.

Many Canadian universities have committed to becoming more accountable to Indigenous Peoples by confronting the systemic, historical, and ongoing colonialism and anti-Indigenous racism that shape their campuses. In this Perspective in Practice piece, we invite the field of dietetics to consider how colonialism has shaped dietetics research, teaching, and practice. We also consider how we might transform the field of dietetics in ways that accept settler responsibility for interrupting racism and colonial harm; support the resurgence of Indigenous food and health practices; and recognise the connections between struggles to ensure that Indigenous Peoples can access culturally appropriate food and health care, and struggles for Indigenous sovereignty and self-determination. We do this by reviewing the history of the dietetics field, examining critical responses to existing Indigenisation and decolonisation efforts, and reflecting on recent changes to required dietetics competencies. We argue that curricula in dietetics programmes must teach the history of the colonial food system and equip students to identify and interrupt the individual and institutional colonial dynamics that contribute to the ongoing dispossession of Indigenous Peoples' lands and food sources and negatively impact Indigenous patients.

Sociology after the postcolonial: Response to Julian Go's 'thinking against empire'.

Julian Go's 'Thinking Against Empire' identifies the corpus of 'anticolonial thought' as being instructive for a wider rethinking of how sociology might rally its key conceptualisations of social relations. He insightfully identifies the marginalisation of such thinking from Sociology as an institutionalised discipline. In our response we take up some of the warnings Go provides in the closing sections of his essay-which concern the expanse of intellectual engagement being currently bracketed under or connected to the 'anti-colonial', not least vis-à-vis the 'decolonising/decolonial' turn-to further unpack how the 'anti-colonial' might be adapted for thinking through contemporary socio-political dynamics. Offering, first, a precis of some particularities of British Sociology vis-a-vis the contributions of anticolonial social theory, this article then expands upon the dilemmas arising when anticolonial theory contemporaneous to the pre-decolonisation era is transposed to contingencies of the present 21st century. Namely, whilst the anticolonial archive has proved invaluable to upending the omissions but also complicities of European social theory canons, allowing for a much more expansive sense of how the modern world and its violences were conjured and how we might accordingly escape its miseries, it is also clear that much of the postcolonial world has undergone sufficient shifts to warrant an adapted sense of how we consider the anti-colonial for our current politics. We suggest that the important deviations which anti-colonial theorisations might heed include the dangers of conflating the anticolonial with an affirmation of Global South, non-white nativist identity; the need to recognise some key conjunctural premises by which the anticolonial is no longer geographically indexed to a straightforward Global North-Global South distinction; and the need to acknowledge that, at its most radical, anticolonial thought is itself still invested in traversing both the dreams but also corruptions of those dreams as intrinsic to modernity.

'They Just Let Us Rot to Death:' Anti-Colonialism, Contestation, and Resistance to Reparations for Indian Residential School Abuse.

In the wake of increasing attention to reparations for settler colonialism in recent years, the politics of refusal and contestation of reparations has remained an underexplored area in socio-legal research. This article addresses this gap by foregrounding the perspectives of the colonised as a focal point to examine the strategies they mobilise to stage resistance to state-sponsored redress and to expose the harmful logics and legacies of ongoing settler colonialism. Strategies of resistance are discussed in the context of the Independent Assessment Process - a financial compensation process designed to provide redress to survivors of the physical and sexual violence they had suffered while attending Canada's Indian Residential Schools. This article explores how survivors disrupted the compensation process to advance an anti-colonial agenda, to politicise the violence, and to compel the settler state to recognise their lived experiences and realities of structural violence in the settler colonial present.

The Case for Decolonising the Dental Curricula in the UK.

Students across disciplines in UK universities are demanding decolonisation of their education. These demands aim to resist the white European colonial endeavour that create racist inequalities. To address racial inequalities, the dental discipline has predominantly focused on diversity rather than decolonisation. By using two inter-related referents of decolonisation to dental caries and cosmetic dentistry, this article demonstrates the epistemic violence exerted through the objective hierarchised knowledge practices in dentistry. First, by starting from the position of racisms, empire and slavery, the enduring colonial patterns of power and hierarchies come into view. We see how knowledge production in dentistry has neglected the interconnected histories of colonialism, racial capitalism and patriarchy that continue to shape oral health inequalities and work towards promoting white supremacist beauty ideals. Moreover, the interconnected character of inequalities - race, class and gender - begin to emerge. Second, by proceeding from the place of colonialism, the limits of dental knowledge and the violence embedded in knowledge practices emerge. This highlights the need for new ways of knowing. To decolonise is to confront and weaken the dental discipline's entanglement with the enduring colonial patterns of power and hierarchies that are complicit in maintaining inequalities. Diversity without decolonisation will simply subsume marginalised voices into the existing hierarchised knowledge paradigm and continue to reproduce a hierarchised, unequal world. I argue that if dental schools want to address racial and intersectional inequalities, they need new transformative ways of learning and knowing to equip students to work towards social justice in the outside world.

Realist evaluation in times of decolonising global health.

Realist evaluation (RE) is a theory-driven evaluation approach inspired by scientific realism. It has become increasingly popular in the field of global health where it is often applied in low- and middle-income countries. This makes it timely to discuss RE's relationship to the emerging decolonisation of global health movement. In this short perspective, we argue that the principles and practices that underpin RE have great potential to contribute to the decolonisation endeavour. Both the focus on the inclusion of local stakeholders and the openness to the rival theories these stakeholders bring to the fore, are promising. However, in practice, we see that a lack of acknowledgement of power imbalances and different ontologies and an overreliance on Western-based theories thwart this potential. We therefore suggest that realist evaluations performed by external researchers, especially in the field of global health, should actively engage with issues of (power) inequities. This is not only the just thing to do, but will also contribute to a better understanding of the intervention and may facilitate the emancipation of the disenfranchised. One way of doing this is through the adoption of participatory (action) research methods, currently underused in realist evaluations. We finally give a short example of an evaluation that combines emancipatory and participatory practice development with a realist approach. The Afya-Tek project in Tanzania has an innovative bottom-up approach throughout the full evaluation cycle and shows the possible strength of the proposed combination to create better interventions, more empowered stakeholders, and more illuminating programme theories.

"Working from home is one major disaster": An analysis of student feedback at a South African university during the Covid-19 lockdown.

The Covid-19 global pandemic has resulted in many countries moving teaching and learning online. South Africa is a country with major inequalities in terms of access to electricity, internet and information technologies, which have created considerable problems for online learning at institutions of higher learning in the country. In this paper, we analyse student feedback from two large undergraduate English courses at a school of Education of a major South African university. We specifically focus on two qualitative questions which asked students about the challenges they faced and the skills they developed in online learning. Results are considered through the lens of critical digital pedagogies and decolonisation. Our findings indicate that a lack of access and resources, disruptive home environments and unfamiliarity with online learning methods were significant obstacles for students. In addition, many students indicated developing computer skills and learning how to use online resources during the courses. The study suggests that online teaching and learning in South Africa and similar contexts exacerbates inequalities, and must be accompanied by rigorous support structures for students who are vulnerable in these contexts.

Antifungal activity of boric acid, triclosan and zinc oxide against different clinically relevant Candida species.

BACKGROUND: The genus Candida includes about 200 different species, but only a few are able to produce disease in humans. The species responsible for the highest proportion of human infections is Candida albicans. However, in the last two decades there has been an increase in the proportion of infections caused by other Candida species, including C. glabrata (Nakaseomyces glabrata), C. parapsilosis, C. tropicalis, C. krusei (Pichia kudriavzevi) and more recently C. auris. Decolonisation of patients has been used as an infection control strategy for bacterial infections, but information about decolonisation products used in clinical practice for Candida and other fungal pathogens is limited. Compounds with antimicrobial activity, such as triclosan (TR), boric acid (BA) and zinc oxide (ZO), are mainly used in personal care products. These products can be used for long periods of time without an abrasive skin effect and are a possible alternative for patient decolonisation in healthcare settings. OBJECTIVE: The aim of this study was to evaluate the antifungal activity of boric acid (BA), triclosan (TR) and zinc oxide (ZO), individually and combined, against clinically relevant Candida species. MATERIALS AND METHODS: Compounds to be screened for antifungal activity were evaluated at different concentrations, alone, and combined, using a well diffusion assay. The statistical evaluation was performed using analysis of variance (ANOVA) and a post hoc analysis using the multiple comparisons method. RESULTS: Individually, BA and TR showed antifungal activity against all Candida species evaluated but ZO did not show any antifungal activity. Mixtures of BA [5%]-TR [0.2%]; BA [5%]-TR [0.3%]; BA [5%]-TR [0.2%]-ZO [8.6%]; and BA [5%]-TR [0.2%]-ZO [25%] yielded the highest antifungal activity. An increased antifungal effect was observed in some mixtures when compared with individual compounds. CONCLUSIONS: We demonstrated antifungal activity of BA and TR against multiple Candida species, including against a clade of the emerging healthcare-associated pathogen C. auris. Additionally, this study shows enhancement of the antifungal effect and no antagonism among the mixtures of these compounds. Further research is needed to determine whether these compounds can reduce the burden of Candida on skin.

Pandemics, Protests, and Pronouns: The Changing Landscape of Biomedical Visualisation and Education.

Events in early 2020 changed the landscape of education for the foreseeable future, perhaps permanently. Three events had a significant impact; (1) the Coronavirus disease 2019 (COVID-19) pandemic, (2) the death of George Floyd, which resulted in the most recent Black Lives Matter (BLM) protests, and (3) the Twitter storm, the resultant societal fallout and freedom of speech campaigns, following comments made by author JK Rowling which many deemed transphobic. These events had a differential impact on biomedical sciences, when compared to other sectors. COVID-19 resulted in a global lockdown, with higher education institutions closing campuses and moving to online-only delivery. This rapid change required radical shifts in the use of technology, with mass delivery of teaching at short notice. The BLM protests further raised awareness of the inequalities within society, particularly those experienced by Black people and other oppressed groups. As a result, there have been calls for the decolonisation of the curriculum. The implications of these three key events have led institutions to rethink their policies, teaching delivery, assessment, curricula, and physical environments. This chapter considers (1) the implications of a swift change in the primary mode of curriculum delivery within Higher Education to online formats and (2) how recent adverse events have resulted in calls for much-needed changes in visual representations within biomedical sciences. Finally, we consider (3) the role of the hidden curriculum and the potential impact of visual representations in curricula on the delivery of healthcare and the fight against health inequalities, which are often as a result of implicit biases. The year 2020 has proven timely in presenting the opportunity for change, provided through the power of imagery.

Decolonising the medical curriculum: psychiatry faces particular challenges.

Colonial thinking runs deep in psychiatry. Recent anti-racist statements from the APA and RCPsych are to be welcomed. However, we argue that if it is to really tackle deep-seated racism and decolonise its curriculum, the discipline will need to critically interrogate the origins of some of its fundamental assumptions, values and priorities. This will not be an easy task. By its very nature, the quest to decolonise is fraught with contradictions and difficulties. However, we make the case that this moment presents an opportunity for psychiatry to engage positively with other forms of critical reflection on structures of power/knowledge in the field of mental health. We propose a number of paths along which progress might be made.