Department Websites Research Articles

Investigating SARS-CoV-2 Test Positivity Calculations Across US Jurisdictions

PurposeThroughout the COVID-19 pandemic, many US epidemiologists and policymakers turned to an indicator called test positivity, or the percent of tests coming back positive for SARS-CoV-2, to contextualize COVID-19 case counts with testing volume. But the nation's patchworked health data infrastructure, composed of 56 systems managed by each state and territory, complicated efforts to calculate the metric in a comparable way across US jurisdictions. We set out to map jurisdictional reporting differences in test positivity and investigate whether they interfered with its effectiveness and comparability as an indicator. Understanding these differences is important because jurisdictional test positivity informed consequential policy and individuals’ understanding of risk in their communities.Methods & MaterialsWe surveyed the health department websites of all US states and territories to examine how these jurisdictions were presenting test positivity on COVID-19 dashboards. When details about definitions were unavailable on jurisdictional websites, we reached out to jurisdictional public health officials for clarification. We also scored jurisdictions' presentations against best practices we identified for calculating the metric.ResultsAmong the 48 states and territories posting test positivity values, we observed no consensus on how to calculate the metric—jurisdictions used different units, test types, averaging techniques, and dating schemes. By looking at data for jurisdictions that posted multiple test positivity metrics, we observed that these definitional differences could result in variations from 31% to 300%. Only four states were following all ten of the best practices for reporting test positivity.ConclusionThe sheer number of ways states and territories define test positivity is alarming, given how much the indicator influenced US COVID-19 policy. Based on our survey, we believe the confidence of regulators in the precision and national comparability of test positivity is misplaced: The metric's value reflects state and territorial reporting decisions as much as actual viral prevalence. These findings underscore the need to invest in centralized public health infrastructure and create national reporting standards to improve unity of state reporting.

Gender Distribution of Faculty Is Strongly Correlated With Resident Gender at Canadian Radiology Residency Programs

Objective: Women are underrepresented in radiology overall, in radiology subspecialties, and in radiology leadership and academic positions. It is unclear why this disparity persists despite greater gender diversification in medicine. We sought to determine if a correlation exists between the proportion of female faculty at an institution, and the proportion of female residents in the associated residency program across Canada. Methods: Faculty gender for each Canadian Diagnostic Imaging Residency Program was obtained through publicly available sources (departmental websites and provincial physician registries) in the fall of 2020. Resident gender data was obtained through a survey emailed to programs following the April 2021 CaRMS match. Data was analyzed using Pearson's correlation coefficient. Research ethics approval was obtained. Results: Faculty information was available for 15 of the 16 Canadian radiology residency programs (94%) and resident information was obtained for 16 programs (100% response rate). Overall, women accounted for 31.4% of radiologist faculty and 31.9% of radiology residents, with a wide range between institutions (19.5-47.8% for faculty and 13.3%-47.1% for residents). There was a strong positive correlation between the proportion of female faculty and the proportion of female residents within individual programs (r=0.73; R2=0.54; p=0.002). Conclusion: Approximately one third of faculty and residents at Canadian Diagnostic Radiology residency programs were female but there was a wide range across the country with a strong correlation between faculty and resident gender distribution. Further exploration is warranted to determine causes of this correlation including the possible influence of role modeling, mentoring, female-friendly culture, and bias.

Community research partnership: A case study of San Antonio Research Partnership Portal

Research collaboration between academic researchers from universities, organizations and government local city departments can be tremendously useful to all institutions, but these collaborations involve a wide range of skill sets, making them difficult to establish and manage. For many local government city departments, finding research professionals and collaborators to solve community problems remains a big challenge. The information of research opportunities is either posted on the individual city department website or researchers are approached through a personal relationship with city department officials. As a result, a researcher interested in working with the city department would have to either navigate various websites or try to build a personal contact with city department officials. In this paper, we will look at the relevance of community research partnerships as well as the barriers that prevent them. We will also demonstrate the development of, Research Partnership Portal, a collaborative platform for academic researchers, organizations, and government city departments in San Antonio. This portal will assist academic researchers and organizations in collaborating with government city departments and using current administrative data to produce effective answers to community concerns.

Gender-Inclusive Fellowship Naming and Equity, Diversity, and Inclusion in Radiology: An Analysis of Radiology Department Websites in Canada and the United States.

Purpose: Transgender and gender non-binary (TGNB) individuals face numerous inequalities in healthcare and there is substantial work to be done in fostering TGNB culturally competent care in radiology. A radiology department's online presence and use of gender-inclusive language are essential in promoting an environment of equity, diversity, and inclusion (EDI). The naming of radiology fellowships and continuing medical education (CME) courses with terminology such as "Women's Imaging" indicates a lack of inclusivity to TGNB patients and providers, which could result in suboptimal patient care. Methods: We conducted a cross-sectional analysis of all institutions in Canada and the United States (US) offering training in Breast Imaging, Women's Imaging, or Breast and Body Imaging. Data was collected from each institution's radiology department website pertaining to fellowship names, EDI involvement, and CME courses. Results: 8 Canadian and 71 US radiology fellowships were identified. 75% of Canadian and 90% of US fellowships had gender-inclusive names. One (12.5%) Canadian and 29 (41%) US institutions had EDI Committees mentioned on their websites. Among institutions publicly displaying CME courses about breast/body or women's imaging, gender-inclusive names were used in only 1 (25%) of the Canadian CME courses, compared to 81% of the US institutions. Conclusions: Most institutions in Canada and the US have gender-inclusive names for their radiology fellowships pertaining to breast and body imaging. However, there is much opportunity to and arguably the responsibility for institutions in both countries to increase the impact and visibility of their EDI efforts through creation of department-specific committees and CME courses.

Artificial Intelligence Educational & Research Initiatives and Leadership Positions in Academic Radiology Departments

Rapid advances in artificial intelligence (AI) have generated significant interest in the radiology community. However, formal AI initiatives and leadership roles in academic radiology has not been formally evaluated. The purpose of this study was to assess the prevalence of formal AI initiatives and leadership roles in academic radiology departments. Radiology departments with National Institutes of Health funding in fiscal year 2019 were identified. AI educational and research initiatives, leadership roles, and industry partnerships were assessed by searching department websites for AI-related keywords. Correlations between NIH funding and the presence of AI initiatives were evaluated with linear regression. Sixty-two radiology departments with NIH funding were included in this study. Educational initiatives on AI were offered by 29 (47%) departments. Fifty-five (89%) departments had at least 1 AI researcher and 34 (55%) departments were affiliated with an AI research laboratory, center, or cluster. AI-specific leadership roles and industry partnerships were identified in 3 (5%) and 23 (37%) departments, respectively. The amount of NIH funding did not have a significant linear correlation with educational initiatives (P=0.08) but there was a significant linear correlation between funding and presence of research initiatives (P=0.003). AI educational initiatives were offered by almost half of radiology departments. Most departments had AI researchers and affiliated labs, but the majority were not led by the radiology department, and few had formal AI leadership roles. In the new AI era, these findings provide a benchmark for departments considering implementing formal AI initiatives.

Following the money: an analysis of financial transfers from the municipality of Rio de Janeiro, Brazil to social health organizations

This article analyzed the activity of Social Health Organizations (OSS) in the Brazilian Unified National Health System (SUS) and the use of management contracts and contract addenda as instruments of privatization. The article aimed to understand the processes that legitimize privatization, based on quantification of the amounts transferred through management contracts and contract addenda to organizations that signed contracts with the Rio de Janeiro Municipal Health Department, Rio de Janeiro, Brazil, from 2009 to 2018. A descriptive, exploratory, mixed-methods study was developed to analyze the amounts transferred to the OSS. The study used secondary public data available on the Health Department's websites and other official documents. A total of 268 documents were identified, 61 of which were contracts and 207 addenda, related to 15 institutions. The funds transferred to these organizations totaled BRL 15.94 billion (USD 2.9 billion). The OSS that received the most public funds was IABAS (Institute of Primary and Advanced Health Care), with a total of BRL 4.021 billion (USD 731 million). In 2014, Rio de Janeiro's total health budget was approximately BRL 4 billion (USD 727 million), of which BRL 2.5 billion (USD 455 million) was transferred to OSS, representing 62% of the municipal health budget. The data show that management contracts and contract addenda serve as instruments for privatization of the SUS. This privatization does not employ the conventional model but a functional and fluctuating one.

Sex Differences in Faculty Positions Among Top-Ranked US Otolaryngology Departments.

ObjectiveThis study aims to characterize the top-ranked departments in otolaryngology to provide an indicator of the state of diversity within otolaryngology and to draw a comparison with other medical and surgical fields.Study DesignThis cross-sectional study examined the 20 highest-ranked otolaryngology programs according to the US News & World Report ranking of best hospitals for ear, nose and throat.SettingAcademic otolaryngology departments in the United States.MethodsFaculty demographic and biographical data were collected from departmental websites. The Web of Science h-index was used as a surrogate for academic productivity. Descriptive statistics and chi-square analysis were used to characterize the cohort and compare otolaryngology with other fields.ResultsOf 562 otolaryngologists on faculty at the 20 highest-ranked programs, 413 (73.5%) were men and 149 (26.5%) were women. Among the faculty in the cohort, 174 (31.0%) were professors, 145 (25.8%) were associate professors, and 183 (32.6%) were assistant professors. Across faculty appointments, the proportion of women grew smaller as academic rank increased. When compared with all faculty across US medical schools, the departments in this study had significantly lower proportions of female professors (P = .0047), associate professors (P = .0009), and assistant professors (P = .0005). Male faculty members had higher h-indices than their female counterparts among professors (P = .004), associate professors (P = .008), assistant professors (P = .0002), and clinical assistant professors (P = .0009).ConclusionWomen are underrepresented across all academic ranks in top-ranked otolaryngology programs. The current state of diversity in otolaryngology yields many opportunities to advance representation for women in the field.

Collaborating to create the At-Risk Afghanistan Web Archive (ARAWA): A project at the University of California-Berkeley Library

Twenty years later, as the U.S. “Afghanistan Project” concluded in 2021 with the U.S. troop withdrawal and civilian evacuation, it became clear that despite our good intentions to develop and foster a democratic state in Afghanistan, it was only a partial success. Despite the corruption within the ranks of certain Afghan officials and the frustrating outcomes for the planned projects, a semblance of functioning civil society had emerged across several urban centers in Afghanistan. The levels of corruption, ineptitude, and missed chances have been documented in the series of reports with the title “What We Need to Learn: Lessons from Twenty Years of Afghanistan Reconstruction,” prepared by the Special Inspector General for Afghanistan Reconstruction. The central government in Kabul had a web presence through several departmental websites and those of the regional, provincial governments. Besides governmental websites, several educational institutions of higher learning, artists, social activists, and nongovernmental organizations (NGOs) described themselves, expressed their opinions, reported policy decisions, and communicated other information through their web presence on official websites and social media sites.

Research During Foot and Ankle Orthopaedic Fellowship and Association with Careers Following Fellowship

Category:OtherIntroduction/Purpose:Performing research during fellowship continues to develop vital critical thinking skills for orthopaedic surgeons as they move into their careers. As fellowships and academic careers become more competitive, research plays an important role in fellow selection and future academic appointments. The purpose of this study was to assess if research during fellowship, measured through journal publications, was associated with careers in academic medicine and if those who published early in their training continued to do so into their careers.Methods:A list of foot and ankle fellows, from 2008-2013, were collected from the AOFAS website. In February 2021, all collected fellows were searched on pubmed.gov to generate all orthopaedic publications with a PubMed identifier published before residency, during residency, during fellowship and after fellowship. Each publication's 2020 Thomson Reuters 5-Year Journal Impact Factor and fellows first authorship were noted. The collected fellows were searched through Doximity.com for the name of their medical school, residency and fellowship. The fellows were further searched for their current location of employment and whether it was academic or not. An employment location was considered academic if they were listed on a department website that also was involved in teaching residents. The number of publications, journal Impact Factor and number of first authorships were compared between the academic and non-academic groups during their time before residency, during residency, during fellowship and after fellowship.Results:A total of 246 fellows were included, with a mean (+- SD) of 0.8 +- 1.4 publications per fellow during fellowship. During the years in review, 27% (67/246) of fellows entered a career in academics. Before residency, there was no difference in the number of publications between those that went into academic and those that did not [academics 0.54 +- 1.85, non-academic 0.27 +- 1.05 (p=0.154)]. During residency and fellowship, those that went into academics were statistically significantly more likely to publish than those that did not go into academics [during residency: academic 2.82 +- 4.53, non-academic 1.24 +- 2.00 (p=0.0002); during fellowship: academic 1.10 +- 1.57, non-academic 0.69 +- 1.34 (p=0.038)] as well as more first authorships and in journals with higher impact factors.Conclusion:As fellowships and academic positions become more competitive, the quality and number of journal publications are likely to become increasingly more important. This study noted that an interest in academics likely develops during orthopaedic residency. This study may help improve mentorship earlier on to those who are more likely to pursue a career in academics.

The Landscape of State and Local School-Located Vaccination Clinics: Practices, Policies, and Lessons Learned for Providing COVID-19 and Routine Vaccinations.

For decades, school-located vaccinations clinics (SLVs) have successfully offered influenza and routine childhood immunizations that have contributed to lowering the morbidity and mortality of vaccine-preventable diseases. These SLVs laid the foundation for state and local health departments and school districts to quickly implement SLVs in response to COVID-19. To support school nurses and immunization programs in implementing future SLVs during the COVID-19 pandemic, we explored the landscape of SLVs between August 2019 and late summer 2021 using publicly available information from school and health department websites, news articles reporting on SLVs, and internal documents provided by school nurses and immunization programs who hosted SLVs. Our scan identified variability in the reach, scope, and approach to SLVs, but consistent themes persist such as the importance of partnerships and SLVs as an opportunity to promote equitable access to vaccinations. Useful documents and resources for planning and hosting SLV clinics were compiled into a table. With COVID-19 vaccines now available to all school-age children, SLVs provide an even greater opportunity to improve school and community health. The included resources are designed to provide support for those interested in SLV implementation.

Miriam Fuchs, Life Writing, and Life

Miriam Fuchs, Life Writing, and Life Craig Howes (bio) Others contributors to this collection will movingly and accurately capture what Miriam was like as a coeditor, coauthor, crew member, and dear friend. Except for the paddling, I knew her in all of these roles, but I will begin this Biography tribute with some words about her as a researcher and scholar. Her biography on the University of Hawaiʻi at Mānoa English Department website listed her principal interests as modernism and modern American literature, twentieth century women’s literature, autobiography theory and criticism, and “all modes of life writing.” Her academic journey explains how her interests became her recognized expertise. She received her BA in 1970 from SUNY Buffalo, a major center for the study of modern and contemporary literature. The title of her 1979 NYU doctoral dissertation was “‘Persistent Pattern and Significant Form’: The Conceptual and Formal Impact of The Waste Land on Selected Anti-Realistic American Novels,” and she would go on to publish essays on T. S. Eliot, William Gaddis, Nathanael West, and Hart Crane. What she soon became best known for, however, was her work on women and modernism. She published extensively on Djuna Barnes and H.D. She edited and included her own work in Marguerite Young, Our Darling: Tributes and Essays. And in 1989 she coedited with Ellen G. Friedman the collection Breaking the Sequence: Women’s Experimental Fiction. Their introduction has been called “practically a monograph” in itself, and the volume played an important role in “the continuing feminist project of the recovery and foregrounding of women writers.” This landmark collection was reprinted in 2014 by Princeton University Press as part of its Legacy Library series. In the mid-1980s, Miriam’s interest in modernism brought her to Hawaiʻi for a seminar conducted by the noted William Butler Yeats and Hart Crane scholar John Unterecker. Shortly afterwards, she resigned her associate professorship at Elizabeth Seton College and settled permanently here. For Miriam, moving to a world center for modernism studies like Honolulu after years of toiling in the literary and cultural backwater of New York City was an easy decision to make—after all, Jack Unterecker and Leon Edel had already done the same thing. But I suspect that someone named Alan Holzman probably had something to do with it as well. She [End Page 135] spent her first years as a visiting assistant professor in English at the University of Hawaiʻi at Mānoa—she always remembered who was collegial, and who was . . . otherwise. She came on the tenure track in 1989, in 1993 she was tenured and promoted early, and she became a full professor in 2003. As a lifewriting scholar, Miriam’s status is indisputable. Part of the University of Wisconsin Press’s renowned Studies in Autobiography series, her 2004 book, The Text Is Myself: Women’s Life Writing and Catastrophe, fulfilled Susanna Egan’s prophetic assessment: “Miriam Fuchs is breaking new ground. Her remarkable exploration of catastrophe writing will be important in autobiography studies and fascinating to all who care about self-representation as a mode of survival.” This book brought Miriam’s many interests together—modernism, women’s literature, autobiographical fiction, art, and Hawaiʻi and the Pacific—in her outstanding opening chapter on the diaries of Queen Liliʻuokalani, but also in the book’s dedication: “To the women paddlers—Lanikai, Kumulau, Bora Bora.” I’ll let other contributors to this tribute address the autobiographical dimensions of a book entitled The Text Is Myself, mentioning only its major theme: “however much the past may be shaped into a discernable storyline, it is the uncertain present that preoccupies these writers.” And of course, Miriam had a long and profoundly influential impact upon Biography: An Interdisciplinary Quarterly and the Center for Biographical Research. Cynthia G. Franklin offers some personal and detailed remarks on their collaborations as coeditors and friends; let me set the stage with an origin story, and a few personal notes. When I took over as editor of Biography in 1994, I asked Miriam to replace me as one of the literary editors; a year later, she was listed as “literary editor in chief...

Assessment of COVID-19 Website Communication in Languages Other than English by Local Health Departments in the United States

ABSTRACT Managing the information needs of diverse populations through accessible, high-quality, and evidence-based health communication is critical to controlling the COVID-19 pandemic. Access to comprehensive information is especially important for the >25 million limited English proficient (LEP) individuals in the U.S. who prefer to communicate in languages other than English. We assessed the alignment of COVID-19 communication with LEP constituents’ needs by examining multilingual content availability on the health department websites of the largest U.S. cities by population. To guide content analysis, we designed a codebook to evaluate six content types, six delivery modes, and three score measures for each website; for each, we measured Holsti’s percent of agreement. We then compared the amount of information provided in all combined content types across cities and languages by delivery mode. We thematically analyzed open-ended responses about users’ experiences with each city’s webpages. We found that COVID-19 information was not presented consistently across languages: many cities provided less information among several delivery modes in other languages compared to English. We found a discrepancy in the amount of information, presentation quality, and ease of navigability of the information among languages and between cities. Users described having negative experiences with most cities’ COVID-19 websites in languages other than English. Our findings indicate a gap in the application of the cultural sensitivity approach by local health departments to address issues related to equitable multilingual, multimodal emergency communication, and underscore the need to improve guidelines for communicating public health information as a component of advancing health equity.

Corrigendum: CSL-SHARE: A Multimodal Wearable Sensor-Based Human Activity Dataset

In the original article, there was a mistake in Table 1 as published. In the version we submitted, all 5 the activity names in the first column except "V-cut"s are lowercase, but in the published version, "Sit," 6 "Stand," "Walk," and "Run" have been changed to start with uppercase. This may cause ambiguity for 7 potential users in the usage of the labels. As a correction, please change these four words to all lowercase. Because of the recent update of the department's website, this dataset has a new link. However, to ensure 27 that the dataset can always be obtained, we have made a redirect from the original link shown in the 28 published article to the new link, so currently, there is no need to worry about its accessibility. In order to 29 ensure the dataset's availability in the future and match the site name of our new pages, please help update 30 the link in the Data Availability Statement to https://www.uni-bremen.de/en/csl/research/human-activity-31 recognition. After this update, it is expected that the site's name and the dataset link will not be changed 32 again in the foreseeable future.

Epidemiology of Cardiovascular Diseases in Southeast Asia: A Systematic Review

BACKGROUND: Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, which includes coronary heart disease, cerebrovascular disease, and peripheral artery disease. It is currently the leading cause of death worldwide. Currently, there is paucity in the available epidemiologic data of CVD in Southeast Asia (SEA). OBJECTIVE: To determine the prevalence, mortality rate, and associated risk factors of CVD (specifically ischemic heart disease, stroke, and peripheral artery disease) among adult populations in SEA. METHODS: A systematic review of published articles between 2015 and 2020 was conducted. The authors also searched the World Health Organization database and publicly available health department websites of Southeast Asian countries. RESULTS: The overall prevalence of CVDs in SEA is 5.48%. Specifically, the prevalence of ischemic heart disease is 1.54% and is highest in Thailand (2.54%). Ischemic stroke has a prevalence of 1.03% and is highest in Indonesia (1.97%). Prevalence of peripheral artery disease is 1.36% and is also highest in Thailand (1.92%). Mortality rate from CVD in SEA is 13.41%. Hypercholesterolemia, smoking, and hypertension are the most common risk factors, with prevalence of 41.2%, 21.1%, and 20.9%, respectively. CONCLUSION: The prevalence and mortality rate of CVD in SEA remain high and are associated with high prevalence of underlying risk factors. Interventions should be strengthened to improve the overall picture in the region. Collaborative efforts among Southeast Asian countries are essential not only in generating comparative epidemiologic data but also in sharing best practices in lowering CVD mortality and morbidity. KEYWORDS: cardiovascular disease, ischemic heart disease, stroke, peripheral artery disease, risk factors, Southeast Asia

Addressing Systemic Racism by Creating a Diversity, Equity, and Inclusion Department Initiative

The ongoing COVID-19 pandemic has underscored the need to optimize care for one of the most affected sectors: older adults in nursing homes and more specifically highly vulnerable populations such as residents with dementia. Research developed in collaboration with stakeholders can optimize impact, relevance, and trustworthiness of study findings thereby informing advances in care. Yet, evidence on stakeholder driven research for enhancing dementia care is limited. This symposium will provide examples of stakeholder-driven research questions that were addressed with stakeholder engagement. First, we will present current evidence about the perspectives of caregivers, including those from communities of color. The second presentation will discuss the perspective of clinical training stakeholders responsible for supporting system-wide clinical program implementation and their experiences with early and later adopter nursing homes within the context of a clinical trial. The third presentation will address the perspective of policy makers and payers via the effect of state-mandated dementia training on resident outcomes. The fourth and final present the findings from a study that examined how nursing home stakeholders responded to a payor requirements for pharmacy services and the relationship between that response and patient outcomes. We will conclude the session with a discussion of stakeholder-engagement methods and recommendations for future nursing home research, which champions stakeholder collaboration.

The Effect of COVID-19 on Domestic Violence and Assaults.

The purpose of this research was to examine the effect of COVID-19 on four outcomes including calls for service for domestic violence, calls for service for assaults, arrests for domestic violence, and arrests for assaults in Burlington, Vermont. The data for each outcome collected over the time periods January 2012 through May 2021 were obtained from the Burlington Police Department website and then a monthly time-series data set were created. The analyses including an independent samples t-test, a Poisson regression test, and a monthly interrupted time-series analyses (ITSA) were employed to test the effects of COVID-19 on the previously mentioned outcomes. The results of the ITSA showed that in the first month following the onset of the COVID-19 pandemic, domestic violence calls statistically significantly increased, but no statistically significant change was observed in domestic violence arrests, while assault calls and assault arrests statistically significantly decreased. In addition, during COVID-19, there was a statistically significant decreasing trend in domestic violence calls and domestic violence arrests, while there was no statistically significant change in the trends of assault calls and assault arrests. The results suggest that COVID-19 had an immediate as well as a persistent effect on the numbers of domestic violence and assaults. The results and limitations of this study were also discussed.

National Institutes of Health Funding Trends to Ophthalmology Departments at U.S. Medical Schools

ABSTRACT Purpose To analyze trends in National Institutes of Health (NIH) funding in ophthalmology and characterize its distribution to departments and principal investigators (PIs) affiliated with U.S. medical schools. Design Longitudinal descriptive analysis. Methods We queried publically accessible data from the Blue Ridge Institute for Medical Research and NIH RePORTER to determine annual funding trends in ophthalmology from 2009 to 2020. To characterize the distribution of funding, we further ranked the top departments and principal investigators (PIs). Department websites (among other online resources) were utilized to extract characteristics of the latter cohort. Results After adjusting for inflation, we observed a modest 9% increase in median NIH funding to academic ophthalmology departments between 2009 and 2020. In the same time period, among individual PIs, this translated to a 9% decline in median funding. Our results among both departments and PIs indicated a persistent inequality in NIH funding. In 2020, 10 ophthalmology departments received 44% of total funding, which is consistent with findings from prior years. Our ranking of PIs by average annual NIH funding indicated a disproportionate representation of males (76%) and PhDs (58%) in the top 50. Conclusions Overall, the results of this investigation suggest NIH funding remains limited for individual investigators, reflecting the increasingly competitive nature of the grant application process. Systemic alterations will be required to reverse these trends. If not accomplished, nascent and established researchers alike will continue to endure challenges in obtaining and maintaining funding.

Diversity in Academic Laryngology: An Evaluation of Academic Advancement and Research Productivity.

Diversity within the medical profession with respect to sex and racial minorities has been shown to have a positive effect on health and healthcare. Characterization of a field is key to evaluating trends and the advancement of diversity in an otolaryngology subspecialty. Observational study. A comprehensive list of all the academic laryngologists was compiled from the Accreditation Council for Graduate Medical Education accredited otolaryngology residency programs in 2020. The last 20 past presidents of the American Laryngological Association (ALA) and American Broncho-Esophogological Association (ABEA) were analyzed. Academic rank and years in practice were determined from departmental websites, with online search tools used as secondary resources. The h-index was utilized as a measure of research productivity. Regression analysis was performed to analyze these variables. There are 184 academic laryngologists in the 124 programs. The majority of the population is Caucasian 76.6% (141/184), followed by Asian 16.3% (30/184), African American 4.34% (8/184), and then Hispanic 1% (2/184). There are 47 full professors with 83% Caucasian, 14.1% Asian, and 2.1% African American and 91.5% male and only 8.5% female. Past ALA presidents were 90% male and for the ABEA 75% male. H-index revealed a statistically significant difference between Caucasian and African American colleagues [P value (<.0005)]. Minorities are disproportionately underrepresented in laryngology. Women are less likely to be in leadership roles in laryngology and become full professors. Laryngology lags behind other surgical specialties in the representation of minorities and women. Continued efforts should be made to increase diversity in the field of laryngology, especially in regard to underrepresented minorities. NA Laryngoscope, 132:1245-1250, 2022.

Transparency, health equity, and strategies in state-based protocols for remdesivir allocation and use.

BackgroundThe Emergency Use Authorization (EUA) of remdesivir for coronavirus disease 2019 raised questions on transparency of applied strategy, and how to equitably allocate and prioritize eligible patients given limited supply of the medication. The absence of federal oversight highlighted the critical role by states in health policymaking during a pandemic.ObjectiveTo identify public state-based protocols for remdesivir allocation and clinical guidance for prioritizing remdesivir use and assess approaches and inclusion of language promoting equitable access or mitigating health disparities.MethodsWe identified remdesivir allocation strategies and clinical use guidelines for all 50 states in the U.S. and the District of Columbia accessible on state health department websites or via internet searches. Public protocols dated between May 1, 2020 and September 30, 2020 were included in the study. We reviewed strategies for allocation and clinical use, including whether protocols contained explicit language on equitable access to remdesivir or mitigating health disparities.ResultsA total of 38 states had a remdesivir allocation strategy, with 33 states (87%) making these public. States used diverse allocation strategies, and only 10 (30%) of the 33 states included language on equitable allocation. A total of 30 states had remdesivir clinical use guidelines, where all were publicly accessible. All guidelines referenced recommendations by federal agencies but varied in their presentation format. Of the 30 states, 12 (40%) had guidelines that included language on equitable use. Neither an allocation strategy or clinical use guideline were identified (public or non-public) for 10 states and the District of Columbia during the study period.ConclusionsThe experience with the remdesivir EUA presents an opportunity for federal and state governments to develop transparent protocols promoting fair and equal access to treatments for future pandemics.

Trends in the Regulation of Per- and Polyfluoroalkyl Substances (PFAS): A Scoping Review.

Products containing per- and polyfluoroalkyl substances (PFAS) have been used for decades in industrial and consumer products. These compounds are persistent in the environment, bioaccumulative, and some are toxic to humans and other animals. Since the early 2000s, laws, policies, and regulations have been implemented to reduce the prevalence of PFAS in the environment and exposures to PFAS. We conducted a scoping literature review to identify how PFAS are regulated internationally, at the U.S. national level, and at the U.S. state level, as well as drivers of and challenges to implementing PFAS regulations in the U.S. This review captured peer-reviewed scientific literature (e.g., PubMed), grey literature databases (e.g., SciTech Premium Collection), Google searches, and targeted websites (e.g., state health department websites). We identified 454 relevant documents, of which 61 discussed the non-U.S. PFAS policy, 214 discussed the U.S. national-level PFAS policy, and 181 discussed the U.S. state-level PFAS policy. The drivers of and challenges to PFAS regulation were identified through qualitative analysis. The drivers of PFAS policy identified were political support for regulation, social awareness of PFAS, economic resource availability, and compelling scientific evidence. The challenges to implementing PFAS regulations were political limitations, economic challenges, unclear scientific evidence, and practical challenges. The implications for PFAS policy makers and other stakeholders are discussed.