Medicine and Health Sciences Commons^™

Improving Medication-Enhanced Psychotherapy Options For Ptsd: The Potential Of Oxytocin As A Treatment For Hypervigilance In Women With A History Of Childhood Sexual Abuse And Related Ptsd, Elianna Bavuso

Auctus: The Journal of Undergraduate Research and Creative Scholarship

Childhood sexual abuse (CSA) is a notable public health concern, affecting a significant proportion of girls in high-income countries. A considerable number of CSA survivors develop Post-Traumatic Stress Disorder (PTSD) by adolescence, which is often considered to be a lifelong disorder with severe emotional and social consequences. Women with CSA-related PTSD display hypervigilance, which is characterized by significantly increased fear network activity and poor top-down control over the amygdala. This meta-analysis examines the potential of intranasal oxytocin (OT) as a treatment for hypervigilance symptoms in women with CSA-related PTSD. The evidence reviewed suggests that intranasal oxytocin can help normalize the …

Evidence-Based Decision Making At The Bedside Process, Roy E. Brown

VCU Libraries Faculty and Staff Publications

Evidence-based practice (EBP) is crucial in healthcare for improving care and organizational outcomes. However, there is a lack of consensus among various health professions regarding the definition and implementation of evidence-based practice in the clinical environment. This lack of consensus centers on whether EBP is project-based or if it occurs primarily at the bedside. This diagram illustrates how evidence is utilized to inform bedside decision-making. It demonstrates that the process is iterative and the intervention or decision made is contingent upon the evidence, one’s clinical experience, and the patient/situation.

The purpose of the diagram is to help those involved in …

Implementation Of A Cancer Education Program In Rural Counties With The Lowest Hpv Vaccination Rates And Health Rankings, Sarah Arezo, Shillpa Naavaal, Charlotte Garrett, Marcie S. Wright, Vanessa B. Sheppard, Michael A. Preston

Dental Public Health and Policy Publications

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). To address STIs, one rural county public school district developed a series of Family Life Programs to educate pre-teens about pertinent health information. The Schooling Cancer Program (SCP) was developed in partnership with the local Cancer Research and Resource Center to raise awareness about cancer risk factors including HPV-related cancers and HPV prevention methods. Methods: We collected a post-evaluation survey from students who attended a SCP session at one of the targeted middle schools. The SCP educated students about topics focusing on healthy lifestyles. The survey asked students’ …

Alcohol Use And Alcohol Use Disorder Differ In Their Genetic Relationships With Ptsd: A Genomic Structural Equation Modelling Approach, Tulsi Patel

VCU's Medical Journal Club: The Work of Future Health Professionals

Posttraumatic stress disorder (PTSD) is associated with an increased alcohol use and increased risk of developing alcohol use disorder (AUD). Previous literature suggests that the genetic association between PTSD and alcohol use differs from that between PTSD and AUD. Researchers in this study used a genomic Structural Equation Modeling, genomicSEM, to analyze data from a larger genome-wide association studies (GWAS). Participants in the study were of European descent.

Researchers investigated the genetic association between PTSD, alcohol use, and AUD through these large scale statistical analyses. Researchers observed a significant improvement in model fit (p < .001). Genetic correlations (rG) between PTSD and AUD were positive (rG: .36, p < .001), while those between PTSD and alcohol use were negative (rG: -0.17, p < .001). Researchers observed that when specific variables for alcohol use and AUD were isolated, key differences resulted in genetic association with PTSD, which indicated that the genetic makeup of alcohol-related behaviors is different in individuals with PTSD.

Effects Of Dextromethorphan On Mdma-Induced Serotonergic Aberration In The Brains Of Non-Human Primates Using [123i]-Adam/Spect, Sky Evans

VCU's Medical Journal Club: The Work of Future Health Professionals

MDMA, a widely used recreational drug belonging to the entactogen class, acts strongly on serotonin and dopamine receptors, potentially inducing neurotoxicity. In a study on primates, MDMA treatment resulted in reduced serotonin transporter levels, persisting for years. However, co-administration with dextromethorphan (DXM), an antitussive with anti-inflammatory properties, appeared to prevent this decrease, suggesting a protective effect against MDMA-induced serotonergic toxicity. The study employed SPECT scans with [123I]-ADAM radioligand to assess serotonin transporter levels in various brain regions, revealing significant differences between treatment groups.

The Clinical Inquiry Process Diagram Question Development Checklist, Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated handout, previously published in 2023, serves as a reference for those who are either in an EBP course or are practicing healthcare providers involved in questioning practices to improve patient care. The handout guides the user from identifying and developing a question to determining whether the clinical question, based on evidence, will be an evidence-based practice project/initiative, a performance improvement project, or a research project. It aligns with the fifth version of the Clinical Inquiry Process Diagram and now includes several different formats that can be used when trying to create a focused clinical question.

• Update of The …

Effect Of Psilocybin On Empathy And Moral Decision-Making, Sky Evans

VCU's Medical Journal Club: The Work of Future Health Professionals

Empathy is the ability for human beings, as well as all other mammals, to understand the mental state of another person on an emotional level. It allows us to feel compassion and promote the well-being of those around us. Impaired empathic abilities lead to severe negative social consequences and influence the development and treatment of several psychiatric disorders, specifically in disorders such as antisocial personality disorder. Furthermore, empathy has been shown to play a crucial role in moral and prosocial behavior. In neuroscience and psychiatry research, the serotonin system has been shown to be involved in modulating empathy and moral …

The Clinical Inquiry Process Diagram (V. 5), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated edition of The Clinical Inquiry Process Diagram improves on the 2023 version. It provides a depiction of the steps involved in the clinical inquiry process, covering research, performance improvement, and evidence-based practice. The revisions in this version emphasize the importance of alerting users to the iterative nature of clinical inquiry and the ongoing need to assess the situation or patient based on evolving evidence. It's crucial to recognize that the clinical inquiry process does not follow a linear, sequential progression. Instead, individuals may find themselves concurrently addressing different aspects of the process or revisiting prior steps as they …

Proposing An Rna Interference (Rnai)-Based Treatment For Human Immunodeficiency Virus (Hiv) Infection By Analyzing The Post-Transcriptional Gene Targeting Of Sars-Cov-2, Hepatitis C Virus, And A549 Lung Cancer Cells, Arjun Jagdeesh

Auctus: The Journal of Undergraduate Research and Creative Scholarship

Human Immunodeficiency Virus (HIV) is a retrovirus that infects CD4⁺ T cell lymphocytes in humans, leading to the development of Acquired Immunodeficiency Syndrome (AIDS) if left untreated. While current treatment methods, including antiretroviral combination treatments, effectively limit HIV replication, HIV can evade these treatments due to its high mutation rate. Long-term antiretroviral treatment can also be toxic to patients, meaning patients would benefit from a new mechanism of HIV treatment. RNA interference (RNAi) is an antiviral pathway found in mammals, plants, and insects that involves a small-interfering RNA that is incorporated into a protein complex called the RNA-induced Silencing …

A Three-Dimensional In Vitro Model Of Disease That Improves Preclinical Research By Incorporating Genetic Diversity And Increasing Physiological Accuracy, Akash Jagdeesh

Auctus: The Journal of Undergraduate Research and Creative Scholarship

Biomedical research is essential for the discovery of new medications and treatments, and is built upon the cooperation of preclinical (in vitro/vivo) research and clinical trials. However, 85% of treatments successful in vitro/vivo fail in clinical trials, suggesting that in vitro models are poor indicators of clinical success. The issue lies in conventional “two-dimensional” in vitro models containing genetically identical cells grown on a flat plate, which lack the variety of cell types and cooperation/structure found in real tissue. Moreover, 2D in vitro models do not simulate humans’ genotypic variability, which affects both pathophysiology and treatment effectiveness. In contrast, 3D …

Determining Effective Treatment Regimens For Breast Cancer Using Combined Immunotherapy And Chemotherapy In Vivo, Akhila Kunuthuru

Auctus: The Journal of Undergraduate Research and Creative Scholarship

Breast cancer has the highest incidence rate of all cancers globally in women, and those of African descent, especially West African females, face higher rates of triple-negative breast cancer (TNBC), a more aggressive form of breast cancer. Immunotherapy for breast cancer is a relatively new treatment option, and research is ongoing to identify the best combination treatments for increasing survival of those diagnosed with TNBC. Eganelisib (IPI-549: a PI3K-gamma inhibitor that works to shift M2 macrophages to M1 to augment T cell function) with other combinatory treatments has shown promising results in reducing tumor growth and increasing survival in mice. …

A Multifaceted Approach Using Implementation Science Methods To Increase Chg Bathing Compliance And Reduce Central Line Associated Blood Stream Infections On A Non-Icu Unit, Emily E. Warwick

VCU Health Nursing

BACKGROUND or RATIONALE:

The Acute Care Surgery unit (ACS) is a General and Progressive level of care post-operative unit at VCU Health system. Between quarter four 2021 and quarter one of 2023, five Central line associated blood stream infections (CLABSIs) occurred. NDNQI data revealed ACS had a higher CLABSI rate per 1,000 patient days than the national average of other similar type units in other magnet hospitals.

STATEMENT OF THE PROBLEM:

A GAP analysis revealed ACS did not achieve the 80% CHG compliance goal set by VCU Health’s Infection Prevention Department in all six quarters that these five CLABSIs occurred. …

Ur-Ine Good Hands In The Neuroscience Intensive Care Unit, Molly Lehatto, Courtney Hastings, Monika Mehlbrech, Christina Szabo

VCU Health Nursing

Purpose:

The purpose of this performance improvement project was to decrease the harm to patients related to catheter associated urinary tract infections (CAUTIs) in the Neuroscience Intensive Care Unit (NSICU). Historically, the NSICU had the highest CAUTI rates in our organization with as many as 6 CAUTIs per calendar year quarter. A core group of nurses partnered with providers, hospital infection preventionists and nursing leaders to improve practices for placing, removing, and managing urinary catheters and to implement guidelines for urine testing stewardship.

Description:

Significance: In 2020, the NSICU had 12 CAUTIs, the highest number of CAUTIs in the entire …

Infiltrating Cd8+ T Cells Exacerbate Alzheimer’S Disease Pathology In A 3d Human Neuroimmune Axis Model, Jefin Jose, Devam Purohit

VCU's Medical Journal Club: The Work of Future Health Professionals

In this study, Jorfi et al. employed a neuroimmune axis model containing neurons, astrocytes, and microglia to examine the role of immune cells in Alzheimer's disease. Jorfi et al. found that T cells selectively infiltrated the BRAIN compartment of the neuroimmune axis model as compared to B cells and monocytes. Jorfi et al. further found that CD8+ T cells demonstrated heightened cytotoxicity in the Alzheimer's disease brain, illuminating the role of immune cells in neurodegeneration. Upon further examination, the CXCR3-CXCL10 signaling pathway was found to have an important role in inflammation.

A Genome-Wide In Vivo Crispr Screen Identifies Essential Regulators Of T Cell Migration To The Cns In A Multiple Sclerosis Model, Jefin Jose

VCU's Medical Journal Club: The Work of Future Health Professionals

Kendirli et al. (2023) used a CRISPR screen to determine the proteins involved in T cell migration into the CNS in multiple sclerosis. Overall, eighteen facilitators and five brakes to T cell infiltration into the CNS were identified. Kendirli et al. specifically identified ITGA4, FERMT3, and HSP90B1 to make up the adhesion module, CXCR3, GNAI2, and TBX21 to make up the chemotaxis module, and GRK2 and S1PR2 to make up the egress module. This study demonstrated the ability of a CRISPR screen to identify elements in a disease process and thus identify targets for future multiple sclerosis therapies.

Pmh Connect, English (Greyscale For Printing), Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, EspañOl_Full Color, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, EspañOl_Greyscale For Printing, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, English, Full Color, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Rapid Onset Hydralazine-Induced Antineutrophil Cytoplasmic Antibody (Anca) Associated Vasculitis Presenting With Hemoptysis And Kidney Failure: Case Report, Rachel E. Easter, Andinet Gizaw, Natalie Klein

Internal Medicine Publications

Hydralazine-induced vasculitis can be challenging to recognize and diagnose as presenting symptoms vary and can mimic other conditions or diseases, however, swift intervention and treatment is key in halting progression of the disease and providing patients with the best possible outcomes. A 71-year-old African American female presented to the emergency department with weakness, fatigue, anemia, blood-streaked sputum, fever, chills, and severe myalgias. Hydralazine was prescribed to treat resistant hypertension eight months prior to presentation. Hydralazine was discontinued on hospital day (HD) 4. Pertinent laboratory values showed elevated inflammatory markers, positive antinuclear antibody (ANA), negative rheumatoid factor (RF), normal complement levels, …

Dermatologic Manifestations Of Rheumatic Disease: Cutaneous Manifestations Of Vasculitides, Julianna S. Kang, Julia Nunley, Tiffany Ho, Mavra Masood, Fnu Nutan, Beth Rubinstein

Open and Affordable Course Content at VCU

Cutaneous Manifestations of Vasculitides is a Powerpoint based learning module that begins with the definition of terms and findings often found in vasculitis, followed by a review of several systemic vasculitides, highlighting how characteristic cutaneous lesions may be predictive of the vessel of involvement as well as the associated histologic changes. Moreover, significant clinical and laboratory findings utilized to make the correct diagnosis will be emphasized. This module is not meant to be an exhaustive review of vasculitis, but to serve as an introduction to understanding disease processes and how systemic vasculitis and skin findings interrelate.

It is part of …

Dermatologic Manifestations Of Rheumatic Disease: Malignant Cutaneous Tumors, Divya Shan, Julianna S. Kang, Allison Cinats, Julia R. Nunley, Beth Rubinstein

Open and Affordable Course Content at VCU

Malignant Cutaneous Tumors is a Powerpoint-based learning module that focuses on skin cancers. It begins with the definition of terms and findings, followed by a review of several clinical cases. The goal of the module is to provide the students with the ability to differentiate the most common types of skin cancer and precancerous lesions and gain an awareness of cutaneous lymphomas. This module will include images and clinical findings from diverse skin tones to prepare students to identify cutaneous findings in a heterogeneous patient population. This module is not a comprehensive review of skin cancers but an introduction to …

Dermatoses Of The Breast During Lactation, Divya Shan, Sindhuja Koppu, Valerie Coleman, Gauri Gulati, Kimberly Salkey

Open and Affordable Course Content at VCU

Dermatoses of the Breast during Lactation is a PowerPoint-based learning module that focuses on skin diseases of the breast and nipple that occur during lactation. It covers the diagnosis, workup, and management of a wide range of breast dermatoses with overlapping clinical presentations. Topics covered in this OER include differential diagnoses for breast masses, infections, nipple discharge, and nipple lesions. The goal of the module is to provide students with the ability to differentiate both physiologic and pathologic causes of breast dermatoses and gain awareness of the skin conditions that present in breastfeeding individuals. This module includes images and descriptions …

Enhancing Clinical Judgment In Nursing Students, Mark Tanner

Health Sciences Education Symposium

Background/Objectives: Nurses need to be able to think critically and to use clinical judgment in order to competently do their work required of them in the clinical environment. The National Council of State Boards of Nursing (NCSBN) recognized this and developed the NCSBN Clinical Judgment Measurement Model (CJMM) in order to assess and measure clinical judgment on the NCLEX exams. This model was designed to give guidance to faculty so that they can help students develop the desired skills in critical thinking and clinical judgment. The faculty in a senior-level Adult Medical-Surgical Nursing used the CJMM to redesign the clinical …

Implementation Of A Required Professional Development Course Series In The Doctor Of Pharmacy Program, Nicole E. Omecene

Health Sciences Education Symposium

Purpose/Background: The assessment of professionalism is a challenging and evolving field. The pharmacy education literature describes approaches to assessing professionalism over time; however, an integrated professionalism course series spanning the duration of the program has not been described.1,2 Co-curricular experiences present an opportunity for students to apply content learned in the classroom to real-world experiences where professionalism is expected. These activities include leadership positions, career seminars and health outreach events. Previously described processes for tracking the co-curricular activities differ in the accuracy of data collected and the connection to a professional development course.3,4 The purpose of this educational project is …

An Interprofessional Active-Learning Laboratory On Urinary Incontinence, Krista L. Donohoe

Health Sciences Education Symposium

Background/Objectives:Urinary incontinence (UI) is a common syndrome with peak prevalence in older adulthood. Involuntary loss of urine from the bladder may be due to physical abnormalities, pelvic floor dysfunction, or reversible causes, like medication or infection.1 UI is an underreported and underdiagnosed geriatric syndrome that significantly impacts quality of life, increases risk of institutionalization, and contributes to significant patient- and system-level healthcare expenditures.1 Healthcare practitioners require knowledge and skills necessary to provide quality care to older adults with UI. The National Institute of Diabetes and Digestive and Kidney Diseases, National Institute on Aging, and American Geriatrics Society recommend the healthcare …

Interprofessional Development And Evaluation Of A Virtual Reality Haptic Surgical Training System For Retropubic Midurethral Slings, Lauren Siff

Health Sciences Education Symposium

Purpose and background: Procedures like the midurethral sling, performed without open visual or camera access rely on the surgeon’s spatial orientation of anatomical landmarks and haptic sensation. The “Blind” nature of this technique can results in serious complications^1–4. Surgeons are typically trained via an apprenticeship on live patients, static models, or, cadaver labs. These methods carry higher potential risks for patient safety, significant expense, often require travel, and are limited by distortion of anatomy after multiple uses. Adding haptics and AI to VR simulators has been shown to improve fidelity, realism, and educational value^ 5–10.We formed a transdisciplinary team to …

Virtual, Non-Clinical “Bootcamp” To Prepare For The Nbme Subject Matter (Shelf) Exam During The Pediatric Clerkship, Clifton Lee

Health Sciences Education Symposium

Background: Medical education changed due to the COVID-19 pandemic. Educational sessions were offered virtually. There are published education innovations for pre-clinical curricula (1). However, providing virtual education during the clinical clerkship was a daunting challenge. In addition to the delay in patient care exposure, students’ performance in the NBME Subject Matter (Shelf) Exam scores have declined during the pandemic (2). VCU School of Medicine also needed to provide continued instructions to students whose clinical clerkships were delayed.

Description of the Innovation: Due to the COVID-19 pandemic, the clinical start for the class of 2022 was delayed by 3 months. During …

The Value Of Positive Feedback: An Underutilized Tool In Ophthalmology Resident Education, Meagan Shinbashi

Health Sciences Education Symposium

Purpose/Background/Objectives: Little research has been performed on the use of positive feedback as a teaching tool in ophthalmology postgraduate medical education settings. Additionally, there is a paucity of research assessing the effectiveness of feedback from trainees’ perspectives. To address these gaps, we explored the effects of positive feedback on resident professional identity formation, performance, and wellness through a pilot program within the ophthalmology residency program’s wellness curriculum at Virginia Commonwealth University.

Methods: This study employed quantitative data collection through surveys before and after a positive feedback exercise activity of ophthalmology residents at the Virginia Commonwealth University Health System. Participants were …

Research4life (R4l) Scholar Program: New Initiative To Promote Diversity, Equity, And Inclusion In Medicine Through A Bottom-Up Approach, Somaya Albhaisi

Health Sciences Education Symposium

Purpose and background: According to the Pew Research Center, Hispanics are 17% of the workforce but only represent 8% of people in a science, technology, engineering and math (STEM) position. African Americans are 11% of the workforce but hold 9% of STEM jobs. The Research4Life (R4L) program is designed to increase the number of minority students who pursue medical education and careers in Medicine and research. A formalized mentorship and clinical research program is one pipeline to increase representation of underrepresented groups in medicine and academic medical careers.(1)

Description of Innovative Practice: The R4L scholar program is a structured summer …