Problematising the discourses of the dominant: whiteness and reconciliation

This article investigates how underlying forms of power can affect the political actions of those in the dominant group, in this case white Australians. To do this we identify connections between the discourses used by white Australians involved in Reconciliation, the power and privilege of whiteness in Australia, and participants’ understandings and actions towards Reconciliation. Using Parker’s (1992) approach to discourse analysis, four discourses were identified from interviews and focus groups with white Australians involved in Reconciliation. These were labelled ‘indigenous project’, ‘institutional change’, ‘challenging racism’, and ‘bringing them together’. We argue that understanding the power relations that underlie the political actions of those in dominant positions is critical to ensuring the goals of anti-racism are achieved. Discourse analysis may allow us to gain a deeper understanding of the power and the potential impacts that may flow from particular positions and how power may be made more visible to the dominant group

Examining discourses of whiteness and the potential for reconciliation

The aim of this paper is to explore how examining discourses of whiteness can contribute to an anti-racism that does not simply reduce racism to problems located with the ‘other’ or focus on the benefits of anti-racism for the dominant group. We discuss how by examining discursive negotiations at the micro level we are able to critique dominance and privilege at the macro level. To illustrate this we use the findings from a discourse analysis (Henriques, Hollway, Urwin, Venn, & Walkerdine, 1998)of discussions with white Australians about their involvement in Reconciliation. In particular, we identify spaces for the examination and critique of whiteness within white Australians’ discursive negotiations of Reconciliation. We also discuss how engagement with Indigenous knowledges is a necessary part of the critique of whiteness

Educating for anti-racism: producing and reproducing race and power in a university classroom

In this paper I explore some of the issues associated with teaching about race, culture and ethnicity in a psychology program. These curriculum initiatives are part of a broader agenda of raising awareness about racialised oppression and exclusion and contributing to the development of ways of researching and practising psychology that are transformative and culturally sensitive. I overview the broader context and describe our subject and the guiding principles. This is followed by a description and analysis of two events in the classroom that illustrate the ways in which students differentially respond to the challenges posed by writings that challenge taken for granted understandings of race. Part of the analysis shows that students can often engage in the reproduction of oppressive practices and invest in whiteness. It is suggested that more than single semester subjects are required to promote and support the development of critical capacities for anti-racism practice

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk