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"Sullivan, Shannon"
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White privilege
\"Some embrace the idea of white privilege as an important concept that helps us to make sense of the connection between race and social and political disadvantages, while others are critical or even hostile. Philosopher Shannon Sullivan cuts through the confusion and cross-talk to challenge what 'everybody knows' about white privilege\"-- Provided by publisher.
Book
The impact of the COVID-19 pandemic on sleep medicine practices
Study Objectives:The COVID-19 pandemic required sleep centers to consider and implement infection control strategies to mitigate viral transmission to patients and staff. Our aim was to assess measures taken by sleep centers due to the COVID-19 pandemic and plans surrounding reinstatement of sleep services.Methods:We distributed an anonymous online survey to health care providers in sleep medicine on April 29, 2020. From responders, we identified a subset of unique centers by region and demographic variables.Results:We obtained 379 individual responses, which represented 297 unique centers. A total of 93.6% of unique centers reported stopping all or nearly all sleep testing of at least one type, without significant differences between adult and pediatric labs, geographic region, or surrounding population density. By contrast, a greater proportion of respondents continued home sleep apnea testing services. A total of 60.3% reduced home sleep apnea testing volume by at least 90%, compared to 90.4% that reduced in-laboratory testing by at least 90%. Respondents acknowledged that they implemented a wide variety of mitigation strategies. While no respondents reported virtual visits to be ≥ 25% of clinical visits prior to the pandemic, more than half (51.9%) anticipated maintaining ≥ 25% virtual visits after the pandemic.Conclusions:Among surveyed sleep centers, the vast majority reported near-cessation of in-laboratory sleep studies, while a smaller proportion reported reductions in home sleep apnea tests. A large increase in the use of telemedicine was reported, with the majority of respondents expecting the use of telehealth to endure in the future.Citation:Johnson KG, Sullivan SS, Nti A, Rastegar V, Gurubhagavatula I. The impact of the COVID-19 pandemic on sleep medicine practices. J Clin Sleep Med. 2021;17(1):79–87.
Journal Article
Public health impact and cost-effectiveness of introducing MenACWY vaccination strategies in Germany
Background
The invasive meningococcal disease (IMD) routine immunization recommendation in Germany is a meningococcal serogroup C (MenC) conjugate vaccine for toddlers aged 12 months with a catch-up for unimmunized up to 17 years. However, there are no recommendations for routine meningococcal serogroups A, C, W, Y (MenACWY) vaccination or for adolescent vaccinations; this differs from other European countries. This analysis aimed to understand the benefits of implementing adolescent MenACWY vaccination in Germany.
Methods
A static population-cohort model evaluating IMD burden and related health outcomes (e.g., cases, cases with long-term sequelae, deaths) was developed to compare any two meningococcal vaccination strategies. We compared hypothetical vaccination strategies that included different approaches to adolescent vaccination in Germany, such as vaccinating at 13-year olds versus 16-year olds and vaccinating with MenC versus MenACWY. Additional strategies considered the benefit that could be provided by switching the current MenC vaccine recommendation in toddlers to MenACWY.
Results
All strategies that included MenACWY vaccine were effective in decreasing the number of cases, preventing mortality and offered good value for money. The greatest benefit was observed in individuals vaccinated with MenACWY at 12 months and 16 years of age (2,978 IMD cases averted; 563 IMD deaths prevented). Compared with the current strategy of MenC vaccination at 12 months of age, two-dose strategies that included MenACWY reported incremental cost-effectiveness ratios <€13,205 per quality-adjusted life year. Adolescent strategies of MenC or MenACWY vaccine at 16 years old (with no vaccination at 12 months) dominated current vaccination strategies. Adolescent vaccination at 16 years old versus 13 years old offered slightly better value for money.
Conclusions
With recent increases in IMD cases and outbreaks occurring globally following the COVID-19 pandemic, there is a greater urgency to proactively implement a MenACWY vaccine recommendation to protect adolescents in Germany. This recommendation would provide direct protection to a group at increased risk and offer indirect protection to other population groups. Implementation of a school-based immunization program could increase vaccine uptake and overcome hurdles in adolescent vaccination.
Journal Article
Persistently active neurons in human medial frontal and medial temporal lobe support working memory
Using single-neuron recordings in the human brain during a working-memory task, the authors show both stimulus-specific and nonspecific types of persistent activity in neurons of the medial frontal and medial temporal lobes. Persistent activity in hippocampus and amygdala was predictive of memory content and displayed dynamic attractor patterns.
Persistent neural activity is a putative mechanism for the maintenance of working memories. Persistent activity relies on the activity of a distributed network of areas, but the differential contribution of each area remains unclear. We recorded single neurons in the human medial frontal cortex and medial temporal lobe while subjects held up to three items in memory. We found persistently active neurons in both areas. Persistent activity of hippocampal and amygdala neurons was stimulus-specific, formed stable attractors and was predictive of memory content. Medial frontal cortex persistent activity, on the other hand, was modulated by memory load and task set but was not stimulus-specific. Trial-by-trial variability in persistent activity in both areas was related to memory strength, because it predicted the speed and accuracy by which stimuli were remembered. This work reveals, in humans, direct evidence for a distributed network of persistently active neurons supporting working memory maintenance.
Journal Article
Revealing whiteness : the unconscious habits of racial privilege
[A] lucid discussion of race that does not sell out the black
experience. -- Tommy Lott, author of The Invention of
Race Revealing Whiteness explores how white privilege operates as
an unseen, invisible, and unquestioned norm in society today. In this personal and
selfsearching book, Shannon Sullivan interrogates her own whiteness and how being
white has affected her. By looking closely at the subtleties of white domination,
she issues a call for other white people to own up to their unspoken privilege and
confront environments that condone or perpetuate it. Sullivan's theorizing about
race and privilege draws on American pragmatism, psychology, race theory, and
feminist thought. As it articulates a way to live beyond the barriers that white
privilege has created, this book offers readers a clear and honest confrontation
with a trenchant and vexing concern.
eBook
What Guidance Are Researchers Given on How to Present Network Meta-Analyses to End-Users such as Policymakers and Clinicians? A Systematic Review
Network meta-analyses (NMAs) are complex methodological approaches that may be challenging for non-technical end-users, such as policymakers and clinicians, to understand. Consideration should be given to identifying optimal approaches to presenting NMAs that help clarify analyses. It is unclear what guidance researchers currently have on how to present and tailor NMAs to different end-users.
A systematic review of NMA guidelines was conducted to identify guidance on how to present NMAs. Electronic databases and supplementary sources were searched for NMA guidelines. Presentation format details related to sample formats, target audiences, data sources, analysis methods and results were extracted and frequencies tabulated. Guideline quality was assessed following criteria developed for clinical practice guidelines.
Seven guidelines were included. Current guidelines focus on how to conduct NMAs but provide limited guidance to researchers on how to best present analyses to different end-users. None of the guidelines provided reporting templates. Few guidelines provided advice on tailoring presentations to different end-users, such as policymakers. Available guidance on presentation formats focused on evidence networks, characteristics of individual trials, comparisons between direct and indirect estimates and assumptions of heterogeneity and/or inconsistency. Some guidelines also provided examples of figures and tables that could be used to present information.
Limited guidance exists for researchers on how best to present NMAs in an accessible format, especially for non-technical end-users such as policymakers and clinicians. NMA guidelines may require further integration with end-users' needs, when NMAs are used to support healthcare policy and practice decisions. Developing presentation formats that enhance understanding and accessibility of NMAs could also enhance the transparency and legitimacy of decisions informed by NMAs.
Journal Article
Sleep medicine exposure offered by United States residency training programs
Study Objectives:To understand the sleep medicine educational exposure among parent specialties of sleep medicine fellowships, we conducted an online survey among Accreditation Council of Graduate Medical Education–approved training programs.Methods:Target respondents were program directors of family medicine, otolaryngology, psychiatry, neurology, pediatrics, and pulmonary and critical care training programs in the United States. The survey was based on the Sleep Education Survey, a peer-reviewed, published survey created by the American Academy of Neurology Sleep Section. The modified 18-question survey was emailed via Survey Monkey per published methods totaling 3 requests approximately 1 week apart in January 2017.Results:A total of 1228 programs were contacted, and 479 responses were received for an overall response rate of 39%. Some programs in every specialty group offered a sleep medicine elective or a required rotation to trainees. Pulmonary and critical care and neurology reported the highest percentages of sleep medicine rotation as an option for housestaff (85.7% and 90.8%, respectively), and pulmonary and critical care had the highest portion of programs indicating a rotation requirement (75.4%). Teaching format was a mixture of didactic lectures, sleep center/laboratory exposure, and case reports, with lectures being the most common format. Didactics averaged 4.75 h/y. Few programs reported trainees subsequently pursuing sleep medicine fellowship (<10% produced a fellow over 5 years), and even fewer reported having a trainee who pursued grant funding for sleep-related research over 5 years.Conclusions:There is wide variability and overall low exposure to sleep medicine education among United States “parent” Accreditation Council of Graduate Medical Education training programs whose medical boards offer sleep medicine certification.Citation:Sullivan SS, Cao MT. Sleep medicine exposure offered by United States residency training programs. J Clin Sleep Med. 2021;17(4):825–832.
Journal Article