Top image: Preparing for a recital, Columbia, SC
SUBMITTED..
- Policy brief with Gender Equity Hub under the WHO Global Health Workforce Network, I contributed to a policy action paper on gender equity and occupational segregation in the global health and care workforce.
PUBLISHED ARTICLES AND BOOK CHAPTERS
- Franco C, Iyengar S, CIRS/SWB Webinar Series Builds Momentum. This article can be found here at Amstat News - the membership magazine of the American Statistical Association (ASA).
- Wenberg JL, El-Harakeh A, Kiplagat S, Abubakar AA, Iyengar S, Marconi AM, Vaghaiwalla TM, Kalbarczyk A, Harrison M. We aren’t just ‘Slack’ing off: Utilizing a digital tool to connect emerging women leaders in global health. Accepted as part of Strengthening Women’s Leadership in Global Health Special Collection in the Annals of Global Health.
- Background: Investing in women leaders in global health catalyzes growth and positive outcomes for individuals and their communities, yet large gender disparities persist in leadership within the field due to several barriers. The use of digital tools facilitates cross-institutional and international collaborations to allow individuals or groups to create or share information, ideas, career interests, and other forms of expression via virtual communities. Digital tools can dramatically expand access to and the quantity and quality of opportunities for networking, mentoring, and collaboration to support women in their professional development.
- Objectives: The objective of this paper is to document tangible examples of positive experiences, connections, or collaborations resulting from connecting with other participants in a Slack network. We aimed to evaluate this network to understand how to better build, model, and scale advantageous digital networks of women leaders in global health moving forward.
- Methods: Semi-structured interviews were conducted virtually with seven members of the Slack network from Africa and North America who volunteered to share their experiences. Transcripts of six of these interviews were analyzed for key points using thematic analysis to derive short vignettes from each interview.
- Findings: The findings of this study indicate that Slack is a highly beneficial tool for women in global health to use for facilitating job searches, mentoring opportunities, promoting project collaborations, and proposing programming and outreach ideas in a remote environment. We found distinct recommendations for utilizing this digital networking tool in a way that best supports and engages women in global health. It is important to spread awareness and ensure visibility of the network to recruit and maintain members, design the network in a way that inspires internal motivation, encourage consistent and meaningful engagement, send weekly emails, and maintain accessibility for a global membership base.
- Conclusions: The Slack network provides an engaging digital tool that facilitates communication, opportunities, and growth among women in global health. Digital tools such as Slack can help to increase opportunities for participants from low- and-middle-income countries to engage in the same networking and leadership opportunities as individuals from high-income countries. It remains critical to continue to build, advance, and scale advantageous networks like Slack to promote equity and accessibility among women leaders in the global north and south into the post-pandemic world.
- Schmidt AM, Iyengar S. First CIRS/SWB webinar draws a large international crowd. This article can be found here at Amstat News - the membership magazine of the American Statistical Association (ASA).
- Iyengar S, Ehrlich J, Chung E, Marconi AM, Karpes Matusevich AR, Abubakar AA, Zia N, Kalbarczyk A. Evaluation of a virtual networking event for emerging women leaders in global health. Published in: Annals of Global Health. The paper can be found here. This paper is part of Strengthening Women’s Leadership in Global Health Special Collection in the Annals of Global Health.
- Background: Networks are critical for leadership development but not all networks and networking activities are created equally. Women and people of color face unique challenges accessing networks, many of which were exacerbated during the COVID-19 pandemic. Virtual platforms offer opportunities for global professionals to connect and can be better tailored to meet the needs of different groups. As part of the Consortium of Universities for Global Health annual meeting in 2021, we organized a networking session to provide a networking space for emerging women leaders in global health (i.e. trainees, early career professionals, and/or those transitioning to the field).
Objectives: We evaluated the virtual networking session to better understand participants’ perception of the event and its utility for professional growth and development.
Methods: We distributed online surveys to participants immediately after the event and conducted a 3-month follow-up. Twenty-four participants (of 225) responded to both surveys and their data was included in the analysis. We conducted descriptive quantitative analysis for multiple choice and Likert scale items; qualitative data was analyzed for themes.
Findings: Participants represented eight countries and a range of organizations. Participants appreciated the structure of the networking session; all participants agreed that they met someone from a different country and most indicated they had plans to collaborate with a new connection. When asked if the event strengthened their network and if they will keep in touch with new people, most participants strongly agreed or agreed in both surveys. However, after the follow-up, participants noted challenges in sustaining connections including lack of follow-up and misaligned expectations of networks.
Conclusions: The virtual networking event brought together women in global health from diverse backgrounds. This study found that while networking events can be impactful in enhancing professional networks, ensuring sustained connections sustainability remains a challenge., and will require intentional efforts. While virtual networking events can greatly enhance professional networks, This study also suggests that measures to increase the depth and meaningfulness of these connections in a virtual setting and enabling post-event collaboration can help networks become more inclusive and sustainable.
- Background: Networks are critical for leadership development but not all networks and networking activities are created equally. Women and people of color face unique challenges accessing networks, many of which were exacerbated during the COVID-19 pandemic. Virtual platforms offer opportunities for global professionals to connect and can be better tailored to meet the needs of different groups. As part of the Consortium of Universities for Global Health annual meeting in 2021, we organized a networking session to provide a networking space for emerging women leaders in global health (i.e. trainees, early career professionals, and/or those transitioning to the field).
- Harrison, M, Tran DN, Pena A, Iyengar S, Abubakar AA, Hoernke K, John-Akinola YO, Kiplagat S, Marconi AM, Vaghaiwalla TN, Kalbarczyk A, Weinberg JL. Strategies to improve women's leadership preparation for early-career global health professionals: suggestions from two working groups. Published in: Annals of Global Health. The paper can be found here. This paper is part of Strengthening Women’s Leadership in Global Health Special Collection in the Annals of Global Health.
- Background: Despite advances in gender equality. women still experience inequitable gaps in global health leadership. Barriers to women’s leadership in global health have been well described in the literature. In 2021, the Johns Hopkins Center for Global Health conducted two virtual working groups for emerging women leaders to share challenges and suggest solutions to advance women’s leadership in global health. In this paper, we present emerging themes from the working groups, provide a framework for the results, and discuss strategies for advancing women’s leadership in global health.
- Objectives: The objective of this paper is to share the results of the two working group sessions in order to provide strategies for improving women’s leadership training and opportunities.
- Methods: Approximately 182 women participated in two working group sessions that took place over Zoom. Participants were divided into breakout rooms to discuss pre-assigned topics related to women’s leadership in global health before sharing their ideas in a plenary session. Notes from the breakout rooms and transcripts from the plenary session were analyzed through a participatory and iterative thematic analysis approach.
- Findings: The acquisition of individual essential skills and the existence of enabling institutional environments are both critical for emerging women leaders to find success in global health leadership. The participants shared challenges as well as solutions including the use of technologies to increase training and networking opportunities, intersectionality in mentorship and sponsorship, combatting impostor syndrome, and the importance of work-life balance.
- Conclusions: Investing in women and their leadership potential has the promise to improve health and wealth at the individual, institutional, and community levels. We offer lessons learned and propose solutions for increasing women’s leadership through improving individual level essential skills and fostering environments in which women leaders can emerge and thrive.
- Prasad N, Iyengar S, Denny HM, Gunawan YA, Innamuri R, Phillip S, Samuel O. Mental health during COVID-19 pandemic and its effects on migrant laborers, women and adolescents in South-East Asia: qualitative review. Submitted to the International Journal of Multidisciplinary Research and Analysis (IJMRA). The abstract is below:
- Objective: The COVID-19 pandemic has affected the physical, mental, and social well-being of millions of people across the globe. This paper will discuss the impact of COVID-19 on preexisting and emerging mental health issues amongst various subgroups of the vulnerable population in Southeast Asia
- Methods: Qualitative review of existing knowledge on mental health issues during COVID-19 pandemic among migrant laborers, women and adolescents.
- Conclusion: Given the profound impact of COVID -19 beyond physical health, policy makers, scientific communities and faith-based institutions should make every effort to turn the COVID-19 crisis into an opportunity by developing a strong and robust consensus that is based on building public trust in partnership to provide societal mental health, which is an unappreciated asset of a nation. We conclude that while there is considerable amount of work in the field of mental health has been done, many efforts are siloed, and do not consider the unique cultural characteristics involved. In addition to providing ventilators and acute care to COVID-19 affected patients at the hospitals, we need to design policies to allocate resources for the post-pandemic burden on our communities and develop multi-disciplinary approaches. We suggest that these approaches should become routine in healthcare settings and should be appropriate to the individual’s cultural context. We argue that the generation of robust data, scientific evidence, and multi-disciplinary resources-sharing are required that would necessitate to produce the interventions that are culturally specific and scalable
- (Policy brief): Mental health as a matter of rights.
- Authors: Ali Hasnain, James Sale, Sarah Klin
- Advisors: Shekhar Saxena, Charlene Sunkel, Kay Lankreijer, Peter Bedimak Yaro, Shayni Geffen, Sloka Iyengar, Laure Mourgue d’Algue.
- Summary: In this policy brief with United for Global Mental Health (the Global Mental Health Action Network Universal healthcare Working Group), we write on the theme that every person has the right to the highest attainable level of mental health and the right to make their own decisions. We talk about mental health as a human rights issue and make a case for it being included in universal healthcare plans.
- Iyengar S, Hosur CR, Thakkar M, Mehta D, Kotak V. Reflections on Bharatanatyam and Neuroscience. A Dance Studies Perspective. International Review of Social Research 2021; 11(1): doi: 10.48154/irsr.2021.0027. Link here.
- Summary: Building on recent interest in the convergence of arts and sciences, we propose specific areas of intersection between the disciplines of Bharatanatyam, a classical Indian dance, and neuroscience. We present personal reflections by practitioners of both disciplines and propose that Bharatanatyam can be used to understand and explain brain functioning and that neuroscience can help analyze the dancing Bharatanatyam brain. We explore conceptual areas of convergence between the two fields as well as specific points of connection using language acquisition, rhythm, music, and cognition as examples. We conjecture that Bharatanatyam training and practice support long-term neuronal plasticity in various parts of the brain, including but not limited to the hippocampus, motor, premotor cortex, and the cerebellum. The beginning of the study of the intersection between these disciplines will pave the way for additional allied fields of rich thinking, exploration and potentially, therapy.
- Thippaiah SM, Pradhan B, Voyiaziakis E, Iyengar S, Carol O, Tang Y. Possible role of Parvalbumin interneurons in meditation and psychiatric illness. Accepted in Journal of Psychiatry and Neuroscience.
- (Book chapter) Iyengar SS. Urban Health for the Aging Population in the United States. In Urban Health: Emerging Public Health Perspectives. Edited by Edmond Fernandes and Indu Grewal. A link to the book is here, and abstract is below.
- Summary: Seniors comprise a diverse age group, with large variability in ability, function, income, and past experiences. The United States (US) is a country which is rapidly aging and consists of specific elderly population that are vulnerable. While there are many health challenges faced by seniors (like deterioration of biological and mental health, decrease in visual acuity, and dementia) which are seen across the world, many issues are specific to the US. The physiological consequences of aging are exacerbated by the increase in life expectancy, lack of universal health care, and a lack of safety net in the US. These effects influence the large proportion of the country's aged living in poverty in distinct and harmful ways. This chapter highlights the policies and laws in place to protect the health and human rights of seniors in the US and summarizes gaps in this field ranging from programmatic areas to cultural barriers in the form of ageism and stigma. We describe healthy aging, the domains of healthy aging in an urban setting in the US, and ways to achieve healthy aging for all.
- Martin M, Chaverneff F, Iyengar S, and Gregorian OP. Understanding and Meeting the Challenges of Displaced Scientists in the 21st Century. Science and Diplomacy. August 2021. Link here.
- Summary: Recent years have seen an increase in the number of scientists displaced by persecution or political turmoil. In seeking to maintain their scientific careers, either to rebuild their country’s scientific capacity upon their return or to establish themselves in their new countries, these displaced scientists face a range of challenges. An organized response to meet these challenges will benefit their host countries while preserving scientific capacity for their home countries. In this article, we talk about our work with the Scholar Rescue Fund as well as what the wider scientific, academic, and diplomatic communities can do to support displaced scientists.
- Iyengar S, Kantor K, Cyriac S, Remadevi K, Usha V, Robinson S, Rani A, Rajagopal MR, Broderick A. No family should suffer from cervical cancer twice - the palliative care role in HPV prevention. J Pain Symptom Manage. 2021 Jul 10:S0885-3924(21)00420-6. doi: 10.1016/j.jpainsymman.2021.06.022. Epub ahead of print. PMID: 34256090. Link here.
- Summary: Cervical cancer, caused by human papillomavirus (HPV) infection, is the source of significant personal and societal burden, and robs more than one hundred thousand Indian women and their families of the chances of a healthy and productive life each year. As outlined by the World Health Organization (WHO), the three-pronged approach of screening, vaccination, and reduction in mortality by early treatment presents the possibility of the elimination of cervical cancer as a public health problem in the next decade. Unfortunately, these approaches are all associated with significant barriers in India. In this paper, we suggest that offering prevention strategies for HPV aligns with the idea of preventing suffering and is within the scope of palliative care clinicians.
- Thippaiah SM, Iyengar S, and Yaragudri VK. Exo- and endocannabinoids in depressive and suicidal behaviors. Front. Psychiatry. doi: 10.3389/fpsyt.2021.636228. Link here.
- Summary: Cannabis (marijuana) has been known to humans for thousands of years but its neurophysiological effects were sparsely understood until recently. A dysfunction in the endocannabinoid system, located in brain regions such as prefrontal cortex and limbic structures is implicated in mood regulation, impulsivity and decision-making, may increase the risk of negative mood and cognition as well as suicidality. The literature discussed in this paper suggests that the endocannabinoid system may be a viable target for treatments of these neuropsychiatric conditions.
- The CURE Infantile Spasms Consortium, Lubbers L, Iyengar S. A Team Science Approach to Discover Novel Targets for Infantile Spasms (IS). Epilepsia Open. 2020. doi: 10.1002/epi4.12441. Link here.
- Summary: Infantile spasms (IS) is a devastating epilepsy syndrome that typically begins in the first year of life. Symptoms consist of stereotypical spasms, developmental delay, and electroencephalogram (EEG) that may demonstrate Hypsarhythmia. Current therapeutic approaches are not always effective, and there is no reliable way to predict which patient will respond to therapy. Given this disorder's complexity and the potential impact of a disease‐modifying approach, Citizens United for Research in Epilepsy (CURE) employed a “team science” approach to advance the understanding of IS pathology and explore therapeutic modalities that might lead to the development of new ways to potentially prevent spasms and Hypsarhythmia. This approach was a first‐of‐its‐kind collaborative initiative in epilepsy. The IS initiative funded 8 investigative teams over the course of 1‐3 years. Projects included the following: discovery on the basic biology of IS, discovery of novel therapeutic targets, cross‐validation of targets, discovery of biomarkers, and prognosis and treatment of IS.
- Kingeter AK, Raghunathan K, Munson SH, Hayashida DK, Zhang X, Iyengar S, Bunke M, Shaw AD. Association between albumin administration and survival in cardiac surgery: a retrospective cohort study. Can J Anaesth. 2018. 65(11):1218-1227. Link here.
- Summary: Albumin is widely used during and after on-pump cardiac surgery, although it is unclear whether this therapy improves clinical outcomes. In this large retrospective study, we found that 5% albumin solution was associated with significantly decreased odds of in-hospital mortality and all-cause 30-day readmission rate compared with administration of crystalloids alone in adult patients undergoing on-pump cardiac surgery. These results warrant further studies to examine fluid receipt, including 5% albumin, in surgical populations via randomized-controlled trials.
- Shaw AD, Mythen MG, Shook D, Hayashida DK, Zhang X, Skaar JR, Iyengar S, Munson SH. Pulmonary artery catheter use in adult patients undergoing cardiac surgery: a retrospective, cohort study. Perioper Med (Lond). 2018; 7:24. Link here.
- Summary: The utility of pulmonary artery catheters (PACs) and their measurements depend on a variety of factors including data interpretation and personnel training. This US multi-center, retrospective electronic health record (EHR) database analysis was performed to identify associations between PAC use in adult cardiac surgeries and effects on subsequent clinical outcomes. We found that the use of a PAC during adult cardiac surgery is associated with decreased length of stay, reduced cardiopulmonary morbidity, and increased infectious morbidity but no increase in the 30-day in-hospital mortality. This suggests an overall potential benefit associated with PAC-based monitoring in this population.
- Simonato M, Iyengar S, Brooks-Kayal A, Collins S, Depaulis A, Howells DW, Jensen F, Liao J, Macleod MR, Patel M, Potschka H, Walker M, Whittemore V, Sena ES. Identification and characterization of outcome measures reported in animal models of epilepsy: Protocol for a systematic review of the literature - a TASK2 report of the AES/ILAE Translational Task force of the ILAE. Epilepsia. 2017; 58 Suppl 4:68-77. Link here.
- Summary: The specific goals of this study are to define systematically the phenotypic characteristics of the most commonly used animal models, and to effectively compare these with the manifestations of human epilepsy. This will provide epilepsy researchers with detailed information on the strengths and weaknesses of epilepsy models, facilitating their refinement and future research. Ultimately, this could lead to a refined use of relevant models for understanding the mechanism(s) of the epilepsies and developing novel therapies.
- Lancman ME, Fertig EJ, Trobliger RW, Perrine K, Myers L, Iyengar S, Malik M. The effects of lacosamide on cognition, quality-of-life measures, and quality of life in patients with refractory partial epilepsy. Epilepsy Behav. 2016; 61:27-33. Link here.
- Summary: The objective of this study was to examine cognitive and quality-of-life measures/quality of life outcomes with adjunctive lacosamide therapy in patients with treatment-resistant partial epilepsy. Lacosamide appeared to have low risks of significant changes in cognition or mood/quality of life. In addition, the present study supports prior studies that have proven lacosamide as an effective adjunctive therapy for the treatment of resistant partial epilepsy.
- Marks A, Iyengar S. Improving cancer patients' access to precision medicines. Institute for Patient Access. 2016. Link here.
- Summary: We propose that precision diagnostics offer unparalleled potential for the treatment of cancer, but certain barriers prevent patient access. Healthcare professionals, regulatory bodies, patient advocacy groups, insurers and other stakeholders must unite to ensure that cancer patients can benefit from these breakthrough technologies. Education programs for healthcare professionals, an updated paradigm for regulatory oversight and a restructured healthcare coverage approach will ensure that cancer patients can access precision medicine
- Iyengar S. Reactive Astrogliosis in Epilepsy - Passive bystandars no more. Journal of Neurology and Stroke, 5 (4). Link here.
- Summary: I review a paper where the authors examined whether reactive astrogliosis by itself was sufficient to cause epilepsy, and if so, what are the underlying mechanisms
- Iyengar S, LaFrancois JJ, Friedman D, Drew LJ, Denny CA, Burghardt NS, Wu MV, Hsieh J, Hen R, Scharfman HE. Suppression of adult neurogenesis increases the acute effects of kainic acid. Exp Neurol. 2015. 264:135-49. Link here.
- Summary: Adult neurogenesis, the generation of new neurons in the adult brain, occurs in the hippocampal dentate gyrus (DG) and the olfactory bulb (OB) of all mammals, but the functions of these new neurons are not entirely clear. Originally, adult-born neurons were considered to have excitatory effects on the DG network, but recent studies suggest a net inhibitory effect. Therefore, we hypothesized that selective removal of newborn neurons would lead to increased susceptibility to the effects of a convulsant. Our data support the hypothesis that reduction of adult-born neurons increases the susceptibility of the brain to effects of the convulsant kainic acid.
- Pearce PS, Friedman D, Lafrancois JJ, Iyengar S, Fenton AA, Maclusky NJ, Scharfman HE. Spike-wave discharges in adult Sprague-Dawley rats and their implications for animal models of temporal lobe epilepsy. Epilepsy Behav. 2014. 32:121-31. Link here.
- Summary: Spike-wave discharges (SWDs) are thalamocortical oscillations that are often considered to be the EEG correlate of absence seizures. In this paper, we discuss the implications of the results and ways to avoid the potential problems associated with SWDs in animal models of temporal lobe epilepsy (TLE).
- Iyengar S, Mott D. Neuregulin blocks synaptic strengthening after epileptiform activity in the rat hippocampus. Brain Res. 2008.1208:67-73. Link here.
- Synaptic strengthening produced by epileptiform activity may contribute to seizure progression and cognitive impairment in epilepsy. Agents that limit this form of plasticity may have therapeutic benefit. A role for neuregulin in epilepsy has not been explored. We show that by opposing synaptic strengthening caused by epileptiform activity, neuregulin may reduce the generation and spread of seizures as well as memory deficits associated with epilepsy.