British Association for Biological Anthropology and Osteoarchaeology: Equality, Diversity and Inclusion Race Equality Review

Racism continues to be widespread, subtle and often ignored or selectively attended to within organisations. This review sought to evaluate the British Association for Biological Anthropology and Osteoarchaeology (BABAO)’s existing race equality practices, to further support its movement towards becoming an antiracist organisation. The review arose from a commitment by BABAO to interrogate its current structures and redress problematic cultures within the organisation, following a member of colour expressing concerns. In itself, this provides an encouraging example both of the reflexivity of the organisation and the power of a single voice. Through focus groups and surveys, insights were gained with regards to the organisational culture and in response to issues concerning equality, diversity and inclusion (EDI), particularly regarding the need for BABAO to become a more racially literate organisation. The review attempted to glean members’ understanding of anti-racism and how some cultures within the organisation may be racially exclusive or marginalising. In addition to this, the reviewers engaged with stakeholders about where areas could be improved within BABAO in continuing their work towards becoming a racially cognizant organisation. Responses gleaned from the focus groups and survey questionnaire distributed to members revealed that BABAO as an organisation has made some tentative first steps towards race equality, but has some way to go. The paucity of Black, Asian and Minority Ethnic members made gaining perspectives a challenge in relation to experiences of racial discrimination. In itself, this is an indicator that inclusion is an area for growth and reflection. Other key findings included issues with reporting structures and governance processes, with a need for strong and courageous leadership to drive forward conversations around race and racism; a need for training and work to improve racial literacy of the organisation and its members; and a lack of engagement and participation from current members in EDI issues. Nevertheless, the review also indicated that the organisation has made significant strides towards establishing anti-racist practices and are working diligently to engage all members in this endeavour. To this end, the conclusions and recommendations provided aim to enhance current action and further enable BABAO to achieve an anti-racist, inclusive organisational culture.Based on the considerations outlined throughout the report, there were twenty-seven recommendations made. They reflect the need to build a foundation of awareness, understanding and safety upon which to develop a culture of learning, reflection and shared, collective action. High-level recommendations are synthesised below, with further detail in the body of the report

Efficacy and safety of autologous haematopoietic stem cell transplantation versus alemtuzumab, ocrelizumab, ofatumumab or cladribine in relapsing remitting multiple sclerosis (StarMS): protocol for a randomised controlled trial

Supplementary materials: Supplementary Data are available online at: https://doi.org/10.1136/bmjopen-2023-083582 .Introduction: Autologous haematopoietic stem cell transplantation (aHSCT) is increasingly used as treatment for patients with active multiple sclerosis (MS), typically after failure of disease-modifying therapies (DMTs). A recent phase III trial, ‘Multiple Sclerosis International Stem Cell Transplant, MIST’, showed that aHSCT resulted in prolonged time to disability progression compared with DMTs in patients with relapsing remitting MS (RRMS). However, the MIST trial did not include many of the current high-efficacy DMTs (alemtuzumab, ocrelizumab, ofatumumab or cladribine) in use in the UK within the control arm, which are now offered to patients with rapidly evolving severe MS (RES-MS) who are treatment naïve. There remain, therefore, unanswered questions about the relative efficacy and safety of aHSCT over these high-efficacy DMTs in these patient groups. The StarMS trial (Autologous Stem Cell Transplantation versus Alemtuzumab, Ocrelizumab, Ofatumumab or Cladribine in Relapsing Remitting Multiple Sclerosis) will assess the efficacy, safety and long-term impact of aHSCT compared with high-efficacy DMTs in patients with highly active RRMS despite the use of standard DMTs or in patients with treatment naïve RES-MS. Methods and analysis: StarMS is a multicentre parallel-group rater-blinded randomised controlled trial with two arms. A total of 198 participants will be recruited from 19 regional neurology secondary care centres in the UK. Participants will be randomly allocated to the aHSCT arm or DMT arm in a 1:1 ratio. Participants will remain in the study for 2 years with follow-up visits at 3, 6, 9, 12, 18 and 24 months postrandomisation. The primary outcome is the proportion of patients who achieve ‘no evidence of disease activity’ during the 2-year postrandomisation follow-up period in an intention to treat analysis. Secondary outcomes include efficacy, safety, cost-effectiveness and immune reconstitution of aHSCT and the four high-efficacy DMTs. Ethics and dissemination: The study was approved by the Yorkshire and Humber—Leeds West Research Ethics Committee (20/YH/0061). Participants will provide written informed consent prior to any study specific procedures. The study results will be submitted to a peer-reviewed journal and abstracts will be submitted to relevant national and international conferences. Trial registration number: ISRCTN88667898.Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership