Exploring Biologic Treatment Hesitancy Among Black and Indigenous Populations in Canada: a Review.

Biologics are becoming an increasingly important part of patient care across Canada. Recent studies from the USA show that Black patients are less likely than White patients to receive biologic treatment for several medical conditions. The relative lack of race-based data in Canada makes it difficult to replicate such studies in Canada. As a result, there is a paucity of literature that explores the association between biologic usage and race in Canada. Our review aims to explore the factors that might be driving racial treatment disparity in Canada that likely parallels the inequalities found in the USA. We provide a summary of the available literature on the factors that contribute to biologic treatment hesitancy among Black and Indigenous populations in Canada. We highlight several solutions that have been proposed in the literature to address biologic treatment hesitancy. Our review found that biologic treatment decision at the individual level can be very complex as patient's decisions are influenced by social inputs from family and trusted community members, biologic-related factors (negative injection experience, fear of needles, formulation, and unfamiliarity), cultural tenets (beliefs, values, perception of illness), and historical and systemic factors (past research injustices, socioeconomic status, patient-physician relationship, clinical trial representation). Some proposed solutions to address biologic treatment hesitancy among Black and Indigenous populations include increasing the number of Black and Indigenous researchers involved in and leading clinical trials, formally training physicians and healthcare workers to deliver culturally competent care, and eliminating financial barriers to accessing medications. Further research is needed to characterize and address race-based new treatment inequalities and hesitancy in Canada.

Hebbian learning for olfactory sequences.

The present paper explores the generality of the Hebb repetition effect to the learning of olfactory sequences in order to assess commonality of memory functioning across sensory modalities. Participants completed a serial-order reconstruction task comprising sequences of four olfactory stimuli. Following presentation of each sequence, participants were re-presented with the odours and were required to reconstruct their order of presentation. Surreptitious re-presentation of the repeated sequence occurred on every third trial. This order reconstruction task produced a serial-position function comprising recency only for both the non-repeated and the repeated sequences. Importantly, serial-order reconstruction for the repeated odour sequence produced improved performance for that sequence compared to the non-repeated sequences. This observation of a Hebb repetition effect for olfactory sequences further supports the proposition that sequential learning can operate amodally.