Faculty Bibliography

COVID-19 has tragically taken the lives of more than 6.5 million people globally, significantly challenging healthcare systems and service delivery, especially in low-and middle-income countries (LMICs). This systematic review aims to: (1) evaluate the feasibility of telemedicine interventions for COVID-19 management; (2) assess the adoption of telemedicine interventions during the COVID-19 pandemic; (3) examine the cost-effectiveness of telemedicine implementation efforts and (4) analyze the sustainability of telemedicine interventions for COVID-19 disease management within LMIC service settings. We reviewed studies from selected public health and health science databases, focusing on those conducted in countries classified as low and middle-income by the World Bank, using telemedicine for confirmed COVID-19 cases, and adhering to Proctor's framework for implementation outcomes. Of the 766 articles identified and 642 screened, only 3 met all inclusion criteria. These studies showed reduced reliance on antibiotics, prescription drugs, and emergency department referrals among telemedicine patients. Statistical parity was observed in the length of stay, diagnostic test ordering rates, and International Classification of Diseases (ICD)-10 diagnoses between telemedicine and in-person visits. Telemedicine interventions designed for post-COVID physical rehabilitation demonstrated safety, sustainability, and enhanced quality of life for patients without requiring specialized equipment, proving adaptable across contexts with appropriate technology. These interventions were also economically sustainable and cost-effective for healthcare systems as a whole. Proposed strategies to bridge implementation gaps include community-level assessments, strategic planning, multisectoral partnerships of local hospital administration and lawmakers, legal consultations, and healthcare informatics improvements. Increased investment in telemedicine research focusing on infectious disease management is crucial for the continued development and refinement of effective strategies tailored to resource-constrained regions.

BACKGROUND/UNASSIGNED:Digital health technologies have been proposed as a potential solution to improving maternal cardiovascular (CV) health in the postpartum (PP) period. In this context we performed a systematic scoping review of digital health interventions designed to improve PP CV health. METHODS/UNASSIGNED:We conducted a systematic review of PubMed/MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library. We included studies of PP women, with an intervention involving digital or mobile health (wearable devices, telemedicine, or remote monitoring). We included studies that measured an outcome related to CV health. RESULTS/UNASSIGNED:= 27 studies) showed no significant benefit in terms of lowered caloric intake and/or weight loss up to 1 year PP. 6 studies examined improvements in cardiometabolic markers such as lipids and glucose levels, of which the majority showed no benefit. CONCLUSION/UNASSIGNED:The majority of studies we reviewed found that digital health interventions such as mobile health, telemonitoring and wearable devices were feasible and had mixed effectiveness in improving postpartum CV health in the postpartum period.

Burnout among radiologists is increasingly prevalent, with the potential for having a substantial negative impact on physician well-being, delivery of care, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments; it also provides guidance on best practices to characterize burnout. Fifty-seven studies published between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random-effects models. The reported burnout prevalence ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on the instrument version used. Among MBI subcategories, the pooled prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded a burnout prevalence of 39% (95% CI, 34-45%), whereas the validated single-item instrument yielded a burnout prevalence of 34% (95% CI, 29-39%). Standardized instruments for assessing prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change occurring over time.

Objective: To identify the current state of knowledge among adolescent and young adults (AYAs) with sickle cell disease (SCD) on fertility, family building, and contraception. We aimed to identify recommendations and guidance for communication strategies and counseling methods in these areas. Design: Full-text publications were included if they focused on individuals with SCD, were published in English in peer-reviewed journals, and addressed patient or family knowledge of fertility, family building, or contraception. A comprehensive search using PubMed, CINAHL, Ovid MEDLINE, Embase, and PsycINFO was performed. Multiple reviewers independently assessed each abstract for inclusion, and a senior librarian resolved disagreements. Results: Of 2,885 publications screened, 314 underwent full review, and 11 were included. Of the included studies, three discussed fertility only, two discussed family building only, two discussed contraception only, two discussed contraception and fertility, one discussed contraception and family building, and one discussed fertility and family building. Two overarching gaps were identified: a lack of counseling related to reproductive healthcare provided to AYAs with SCD and limited knowledge regarding their own disease sequelae. Conclusion: Many AYAs are not counseled and are not knowledgeable about their fertility risks, family building options, and contraception choices. Furthermore, previous counseling guidelines on these subjects are limited, leading to incomplete and highly variable discussions between patient and clinicians on these subjects. This review highlights counseling recommendations and areas in which more concrete guidelines and evidence are important for the standardization of comprehensive reproductive healthcare in the AYA SCD population.

BACKGROUND:The start of the COVID-19 pandemic resulted in the implementation of nonpharmaceutical interventions by US institutions of higher education at an unprecedented level. During the backdrop of an emerging pandemic, younger adults (eg, college students) had an overall lower risk for severe outcomes for SARS-CoV-2, making this population a potential source of transmission for age groups with high susceptibility and negative health outcomes. We examine how college students' level of concern for COVID-19 was influenced by different sources of information, their living status, income level, and other demographic identifiers and its association with prevention behavior change. OBJECTIVE:We sought to examine the level of concern, defined as the extent to which the participant would take corrective action to mitigate contracting or spreading the virus (to family or friends) by using personal protective equipment such as a face mask, practicing social distancing, and following other public health recommendations, among college students during the COVID-19 pandemic. METHODS:A cross-sectional, web-based survey was conducted in 2021 among 185 college students aged 18-41 years, with most living in New York City and the United States (n=134, 72.4%). Out of 185 college students, 94 provided their zip codes, with 51 of those college students indicating they lived in New York City areas. The participants completed the survey via a QR code. Study participants who did not complete the full survey or were not college students in any US college or university were excluded. Analyses were conducted using R (version 4.2.2; R Foundation for Statistical Computing). RESULTS:Of 185 respondents participated in the study, 25 (13.5.%) used emails from their schools, 51 (27.6%) used mainstream media, and 109 (58.9%) used social media and other sources to obtain information about COVID-19. Of the 109 participants who learned about the pandemic from social media, 91 (83.5%) were concerned; however, only 63% (32/51) and 60% (15/25) of the participants who sourced information from mainstream media and their schools' email, respectively, were concerned. Further, the participants who received information from social media and other sources were about 3 times more likely to be concerned about COVID-19 than participants who received information from the university via email (P=.036; OR=3.07, 95% CI: 1.06-8.83).. CONCLUSIONS:College students who received information from social media and other sources were more likely to be concerned about COVID-19 than students who received information from their school via emails.

BACKGROUND/UNASSIGNED:Hypertension (HTN) currently affects over 120 million Americans, in the United States (US). Thus, the implementation of evidence-based interventions (EBI) for blood pressure (BP) reduction is pivotal in minimizing this burden. We sought to evaluate evidence from published literature on the effectiveness of musical interventions for BP reduction within the US. METHODS/UNASSIGNED:A systematic review of studies that utilize music interventions to manage BP was conducted in October of 2022. An extensive search of several databases utilizing MeSH terms and relevant keywords was conducted for articles published through October 2022. An updated search was conducted in October 2023 to identify additional studies. RESULTS/UNASSIGNED:2,381 studies were screened for title/abstract relevancy. 1,885 studies were deemed irrelevant, and 495 studies were examined for full-text review; of which 384 were excluded due to being non-US-based. Overall, 25 studies were found where BP was the primary outcome and discussed musical interventions within the US. Of the 25 studies, 72% reported a significant decrease in BP after the administration of a musical intervention and only 28% reported the race and ethnicity of participants. CONCLUSION/UNASSIGNED:There are limited studies that examine the effect of music interventions on BP reduction in the US, as a primary outcome. However, based on the evidence, musical interventions are effective for BP reduction. Moreover, the studies that were conducted in the US include a low percentage of high-risk racial and ethnic minority populations. Future EBI should target this underserved/high-burden group to improve disparity gaps within BP reduction via non-pharmacological means. SYSTEMATIC REVIEW REGISTRATION/UNASSIGNED:Open Science Framework, doi: 10.17605/OSF.IO/4G3EB.

BACKGROUND:Biobanking and genomic research requires collection and storage of human tissue from study participants. From participants' perspectives within the African context, this can be associated with fears and misgivings due to a myriad of factors including myths and mistrust of researchers. From the researchers angle ethical dilemmas may arise especially with consenting and sample reuse during storage. The aim of this paper was to explore these ethical considerations in the establishment and conduct of biobanking and genomic studies in Africa. METHODS:We conducted a narrative synthesis following a comprehensive search of nine (9) databases and grey literature. All primary research study designs were eligible for inclusion as well as both quantitative and qualitative evidence from peer reviewed journals, spanning a maximum of 20 years (2000-2020). It focused on research work conducted in Africa, even if data was stored or analysed outside the region. RESULTS:Of 2,663 title and abstracts screened, 94 full texts were retrieved and reviewed for eligibility. We included 12 studies (7 qualitative; 4 quantitative and one mixed methods). Ethical issues described in these papers related to community knowledge and understanding of biobanking and genomic research, regulation, and governance of same by research ethics committees, enrolment of participants, types of informed consents, data collection, storage, usage and sharing as well as material transfer, returning results and benefit sharing. ca. Biospecimen collection and storage is given in trust and participants expect confidentially of data and results generated. Most participants are comfortable with broad consent due to trust in researchers, though a few would like to be contacted for reconsenting in future studies, and this would depend on whether the new research is for good cause. Sharing data with external partners is welcome in some contexts but some research participants did not trust foreign researchers. CONCLUSION/CONCLUSIONS:Biobanking and genomic studies are a real need in Africa. Linked to this are ethical considerations related to setting up and participation in biobanks as well as data storage, export, use and sharing. There is emerging or pre-existing consensus around the acceptability of broad consent as a suitable model of consent, the need for Africans to take the lead in international collaborative studies, with deliberate efforts to build capacity in local storage and analysis of samples and employ processes of sample collection and use that build trust of communities and potential study participants. Research ethics committees, researchers and communities need to work together to work together to adapt and use clearly defined ethical frameworks, guidelines, and policy documents to harmonize the establishment and running of biobanking and genomic research in Africa.

US correctional facilities operate under a binary interpretation of gender, which can yield inherent risks and conflicts for incarcerated transgender people. We conducted a scoping literature review on challenges unique to transgender individuals within US correctional settings. Online databases were searched to identify papers that addressed the challenges of incarcerated transgender adults age 18 + within US correctional institutions. A concurrent analysis of legal literature was reviewed with key policy recommendations extracted. A total of 33 papers (21 scientific studies and 12 legal analyses) met criteria for inclusion. Of the 21 scientific studies, the majority of papers (n = 14) focused on transgender women and most (n = 13) utilized qualitative methods. Emerging themes revealed challenges in key domains of violence, health, healthcare access, housing, and a pervasive culture of transphobia. Legal analyses supported policy changes such as implementing case-by-case housing classification systems, providing all forms of gender-affirming care, and safeguarding gender expression. Transgender persons face distinct obstacles while incarcerated in US correctional facilities and are in need of expanded protections. Working in tandem with efforts to decarcerate and reduce criminal legal involvement, widespread institutional policy change, such as redefining housing assignment policies, ensuring gender-affirming healthcare, and expanding transgender-specific competency trainings for correctional staff, is necessary.

BACKGROUND:Environmental factors have been implicated in various eye pathologies. The purpose of this review is to synthesise the published research on environmental effects on eye disease. METHODS:Four databases were searched for terms relating to environmental exposures and ophthalmic disease. Titles and abstracts were screened followed by full-text review. Data was extracted from 118 included studies. Quality assessment was conducted for each study. RESULTS:Air pollutants, including nitrogen dioxide, nitrites, sulphur dioxide, particulate matter, carbon monoxide, ozone and hydrocarbons are associated with ocular conditions ranging from corneal damage to various retinopathies, including central retinal artery occlusion. Certain chemicals and metals, such as cadmium, are associated with increased risk of age-related macular degeneration. Climate factors, such as sun exposure, have been associated with the development of cataracts. Living in rural areas was associated with various age-related eye diseases whereas people living in urban settings had higher risk for dry eye disease and uveitis. CONCLUSION/CONCLUSIONS:Environmental exposures in every domain are associated with various ophthalmic conditions. These findings underscore the importance of continued research on the interplay between the environment and eye health.

OBJECTIVE/UNASSIGNED:Nurses play a crucial role in cancer control. Prior reviews presented the effectiveness of nursing interventions such as tobacco cessation counseling and cervical cancer screening but did not focus on low- and middle-income countries (LMICs). This scoping review addresses a gap in the literature by describing the roles and activities of nurses in cancer prevention and early detection in LMICs. METHODS/UNASSIGNED:Following Arksey and O'Malley's scoping review framework, we searched seven databases using subject headings and keywords from 1990 to January 2021 and updated in April 2022. The reference lists of relevant studies were also searched. Two reviewers independently screened the relevance of studies through Rayyan, assessed full text articles, and extracted data using a Google Form. Conflicts were resolved by a third reviewer. RESULTS/UNASSIGNED: ​= ​9). CONCLUSIONS/UNASSIGNED:This scoping review provides a comprehensive picture of nurses' role in cancer prevention and early detection in LMICs, across all six World Health Organization regions. Additional cancer workforce data sources at the country level are needed to fully understand the activities of nurses in cancer prevention. Future research is also needed to measure the impact of nursing educational and other interventions in both primary and secondary cancer prevention.