Digital Commons Network^™

Virginia Commonwealth University Courses [2019], Virginia Commonwealth University

VCU Bulletins

Listing of courses for the 2019-2020 year.

A Systematic Review Of Cases Of Meningitis In The Absence Of Cerebrospinal Fluid Pleocytosis On Lumbar Puncture, Michelle Troendle, Alexis Pettigrew

Emergency Medicine Publications

Background: Definitive diagnosis of meningitis is made by analysis of cerebrospinal fluid (CSF) culture or polymerase chain reaction (PCR) obtained from a lumbar puncture (LP), which may take days. A timelier diagnostic clue of meningitis is pleocytosis on CSF analysis. However, meningitis may occur in the absence of pleocytosis on CSF.

Areas of Uncertainty: A diagnosis of meningitis seems less likely without pleocytosis on CSF, leading clinicians to prematurely exclude this. Further, there is little available literature on the subject.

Methods: Ovid/Medline and Google Scholar search was conducted for cases of CSF culture-confirmed meningitis with lack of pleocytosis. …

Targeting Intracellular Calcium Stores Alleviates Neurological Morbidities In A Dfp-Based Rat Model Of Gulf War Illness, Laxmikant Deshpande, Edna Santos, Kristin Phillips, Robert Blair

Neurology Publications

Gulf War Illness (GWI) is a chronic multi-symptom disorder afflicting the veterans of the First Gulf War, and includes neurological symptoms characterized by depression and memory deficits. Chronic exposure to organophosphates (OP) is considered a leading cause for GWI, yet its pathobiology is not fully understood. We recently observed chronic elevations in neuronal Ca2+ levels ([Ca2+]i) in an OP- diisopropyl fluorophosphate (DFP) based rat model for GWI. This study was aimed at identifying mechanisms underlying elevated [Ca2+]i in this DFP model and investigating whether their therapeutic targeting could improve GWI-like neurological morbidities. Male Sprague-Dawley rats (9-wks) were exposed to DFP …

A Competency-Based Approach To Faculty Development, Betsy Ripley Md, Jean Bailey Phd, Kenneth Warren Edd, Katherine J T Henderson Med

Publications from the Office of the Dean

Background—Faculty development at the Virginia Commonwealth University School of Medicine (VCU SOM) has previously focused on enhancing teaching and learning in the medical and clinical education settings. While this work is important, this narrow focus does not address all facets a faculty member’s role. To broaden their programming, the VCU SOM faculty development team adopted a competency-based approach to the development and planning of faculty development activities.

Summary of work—The Senior Associate Dean for Faculty Affairs completed a research project focused on successful medical faculty who promote through the tenure process and advance in their careers. She identified …

Electronic Nicotine Delivery Systems: Vaping Away Gum Tissue, Christina Tulloch, Denise Thieleman

Dental Hygiene Student Scholarship

Objective: Conventional cigarettes have shown severe toxicity on immune cells and wound healing in the periodontium, but little is known about the comparative effects of vaping or electronic cigarettes. In a substantial shift away from conventional cigarettes, vaping and e-cigarette sales have increased nearly 600% since 2017. If current conventional cigarette users are to transition to a less detrimental alternative, the evidence must demonstrate if electronic nicotine delivery systems can be deemed safer than conventional options.

Methods: By compiling data from the PubMed database, the most recent perspectives on new smoking methods and effects of usage on periodontal tissues were …

Oil Pulling: Fact Or Fad?, Cassandra N. Cooper

Dental Hygiene Student Scholarship

Problem: There is a greater need in today’s world for better oral care across all populations. In developing countries, the tradition of oil pulling has provided an affordable and accessible alternative to antimicrobial rinse agents. Western society has taken note of this and oil pulling has emerged as the latest oral hygiene fad.

Methods: This review of literature used the following databases: PubMed, CINAHL and Google Scholar to identify relevant research articles. Search terms included oil pulling, coconut oil, sesame seed oil, oil swishing, oral health, periodontitis, gingivitis, and bacterial adherence. The studies reviewed used previously validated data collection methods …

Dental Dam Utilization By Dentists In An Intramural Faculty Practice, Terence A. Imbery, Caroline K. Carrico

General Practice Publications

Objectives: From casual observation of our colleagues, only a few individuals use the dental dam for operative procedures in their faculty practice. The purpose of this study was to obtain faculty perceptions of the dental dam, quantify its utilization in their intramural faculty practice, and determine the factors that influence dental dam usage.


Materials and Methods: A survey containing 11 questions was sent to 19 faculty members who teach full time and maintain an intramural dental practice involving operative dentistry. Thirty electronic dental health records of the 19 providers were reviewed to gather the following information from restorative procedures they …

Use Of Endoloop In Video-Assisted Thoracoscopic Enucleation Of A Very Rare Esophageal Tumor, Yahya Alwatari, Wayne Tse, Kasia Trebska-Mcgowan, Rachit D. Shah

Surgery Publications

A gastrointestinal stromal tumor is an infrequent tumor of the gastrointestinal tract with very rare involvement of the esophagus. We present a case of a patient with dysphagia and a 4 cm submucosal mass. The patient underwent thoracoscopic enucleation with complete resection of the mass. We present case details and operative video highlighting the important surgical steps of exposure and retraction. We believe that the Endoloop is a very useful tool in providing countertraction needed during minimally invasive resection of such lesions.

Association Of Anti-Mullerian Hormone With C-Reactive Protein In Men, Dinesh Kadariya, Nargiza Kurbanova, Rehan Qayyum

Internal Medicine Publications

While serum anti-mullerian hormone (AMH) levels are inversely associated with all-cause mortality in men, the underlying mechanisms are unclear. Elevated levels of inflammation, also associated with all-cause mortality, and may be the link between AMH and mortality. Hence, we examined the association of AMH with serum c-reactive protein (CRP), a biomarker of inflammation, in men. We included men ≥20 years from the National Health and Nutrition Examination Survey (1999–2004). We used survey weight-adjusted linear regression to examine the association between AMH and CRP without and with adjustment for age, race, body mass index (BMI), smoking, hypertension, diabetes, cholesterol, glomerular filtration …

Unsaturated Fatty Acids To Improve Cardiorespiratory Fitness In Patients With Obesity And Hfpef, Salvatore Carbone, Hayley E. Billingsley, Justin M. Canada, Dinesh Kadariya, Horacio Medina De Chazal, Brando Rotelli, Nicola Potere, Bishal Paudel, Roshi Markley, Dave L. Dixon, Cory R. Trankle, Benjamin W. Van Tassell, Francesco S. Celi, Antonio Abbate

Internal Medicine Publications

No abstract provided.

The Association Between Urinary Genistein Levels And Mortality Among Adults In The United States, Carolyn Marcelo, Melissa Warwick, Catherine Marcelo, Rehan Qayyum

Internal Medicine Publications

Background
Current research on the relationship between phytoestrogens and mortality has been inconclusive. We explored the relationship between genistein, a phytoestrogen, and mortality in a large cohort representative of the United States population.


Methods: Data were analyzed from the National Health and Nutrition Examination Survey (NHANES) from 1999–2010. Normalized urinary genistein (nUG) was analyzed as a log-transformed continuous variable and in quartiles. Mortality data were obtained from the National Death Index and matched to the NHANES participants. Survival analyses were conducted using the Kaplan-Meier analysis. Cox proportional hazard models were constructed for all-cause and cause-specific mortality without and with …

Remote Ischemic Pre-Conditioning Attenuates Adverse Cardiac Remodeling And Mortality Following Doxorubicin Administration In Mice, Zachary M. Gertz, Chad Cain, Donatas Kraskauskas, Teja Devarakonda, Adolfo G. Mauro, Jeremy Thompson, Arun Samidurai, Qun Chen, Sarah W. Gordon, Edward J. Lesnefsky, Anindita Das, Fadi N. Salloum

Internal Medicine Publications

Objectives

Because of its multifaceted cardioprotective effects, remote ischemic pre-conditioning (RIPC) was examined as a strategy to attenuate doxorubicin (DOX) cardiotoxicity.

Background

The use of DOX is limited by dose-dependent cardiotoxicity and heart failure. Oxidative stress, mitochondrial dysfunction, inflammation, and autophagy modulation have been proposed as mediators of DOX cardiotoxicity.

Methods

After baseline echocardiography, adult male CD1 mice were randomized to either sham or RIPC protocol (3 cycles of 5 min femoral artery occlusion followed by 5 min reperfusion) 1 h before receiving DOX (20 mg/kg, intraperitoneal). The mice were observed primarily for survival over 85 days (86 mice). An …

“We're Rags To Riches”: Dual Consciousness Of The American Dream In Two Critical History Classrooms, Hillary Parkhouse, Bryan P. Arnold

Teaching and Learning Publications

Within the United States, wealth disparities are growing and upward social mobility is becoming increasingly difficult to attain. These trends call into question the American Dream ideology that anyone can succeed through hard work. This meritocratic ideal has traditionally been one of the unifying ideologies promoted through the public school curriculum. The topic of economic inequality, on the other hand, is largely absent from most social studies curricula. When teachers do address this issue, they tend to omit discussions of causes or potential policy solutions. Students are thus left with few resources with which to develop positions on policies related …

Glycosaminoglycans And Glycosaminoglycan Mimetics In Cancer And Inflammation, Shravan Morla

Medicinal Chemistry Publications

Glycosaminoglycans (GAGs) are a class of biomolecules expressed virtually on all mammalian cells and usually covalently attached to proteins, forming proteoglycans. They are present not only on the cell surface, but also in the intracellular milieu and extracellular matrix. GAGs interact with multiple ligands, both soluble and insoluble, and modulate an important role in various physiological and pathological processes including cancer, bacterial and viral infections, inflammation, Alzheimer’s disease, and many more. Considering their involvement in multiple diseases, their use in the development of drugs has been of significant interest in both academia and industry. Many GAG-based drugs are being developed …

Jane Addams, Hull-House, And The “Danger” Of Women’S Work, Melanie L. Buffington, Courtnie N. Wolfgang, Pamela G. Taylor

The Melanie Buffington Papers

In this paper, we investigate the work of Jane Addams and Hull-House, through Cornel West’s (1999) ideas of prophetic pragmatism. In accordance with West’s writings, we consider the importance of investigating the historical underpinnings of what we believe to be true, while at the same time questioning existing practices, and considering where and from whose work these practices originate. Addams and Hull-House were revolutionary during their time and their work resulted in major neighborhood and community reform. Additionally, through the open forums and frequent visitors to Hull-House, the work there influenced many of Addams’ contemporaries, including John Dewey. Yet, historically, …

Pattern Project - Sugarcane, Apphia Peters

Pattern Project

The Pattern Project explores the process of developing visual patterns, intended for the built interior environment, through both hand and digital crafts. Inspirations evolve into pattern concepts that inform message and intention. The intended message then informs motif, color, density, composition, line, repetition, hierarchy, and texture. Drawing from history, designers assess the role of pattern within the built environment and its connection to architecture and building occupants. Traditional handcrafts have evolved and are now used in contemporary processes while new digital crafts have emerged as pattern-making tools. The patterns developed through the Pattern Project were produced to scale on paper …

Promoting Cultural Humility: Lgbtqia+ Education For Healthcare Providers, Lexi Robertson, Lauren Connelly

VCU Health Nursing

Abstract:

Purpose:

LGBTQIA+ patients experience devastating mental health and substance abuse disparities. While our organization has a broad non-discrimination statement that includes gender identity and sexual orientation, there is no guidance for how to best serve these patients. Evidence suggests training sessions are a successful means of increasing LGBTQIA+ cultural competency, with “Safe Zone” identified as being especially successful on college campuses. The Healthcare Equality Index also calls for education to demonstrate healthcare organizations’ commitment to LGBTQIA+ patients.

Intervention:

We developed an educational workshop - Safe Zone – with university psychologists. This workshop included interactive exercises that focused on increasing …

Own Your Outcomes: Driving Down Hapis In The Cardiac Surgery Intensive Care Unit, Linda Currie

VCU Health Nursing

Abstract:

Purpose (What): To achieve sustainable reduction of pressure injury (PI) rates through systematic culture change, in a quaternary, level 1, urban academic medical center cardiac surgery intensive care unit (CSICU).

Relevance/Significance (Why): The CSICU is a high-risk patient population, hosting multiple potential barriers to pressure injury prevention. Prior to 2012, the CSICU pressure injury rate was 17% higher than the National Database of Nursing Quality Indicators benchmark, negatively impacting patient outcomes and organizational goals. Leveraging Magnet principles of Evidence-Based Practice, CSICU advanced practice nurse leaders empowered and motivated bedside nurses to lead and sustain unit culture change.

Strategy and …

Multimodal Needs Assessments For Curricular Refinement – Learner, Expert, Emr, Catherine Grossman

Health Sciences Education Symposium

OBJECTIVES •Explore the educational formats and resource preferences of house staff •Identify ICU topics thought to be important by experts in the field •Identify clinically relevant ICU topics •Build an interactive, standardized cognitive aid that serves both as an instructional resource for house staff and a prompt for those teaching

A Guide To Prescribing Sufficient Post Surgical Quantities Of Opiate Pain Medications, Adam Pflugrath

Health Sciences Education Symposium

Purpose: To examine opiate pain medication prescription and consumption after surgical procedures at VCU Medical Center.

Mistreatment Of Providers By Patients In Emergency Medicine, Cyrus Massouleh

Health Sciences Education Symposium

Background: •Mistreatment and disrespect of healthcare providers including verbal harassment, sexual harassment, and physical harassment is relatively commonplace in the clinical setting. •Per Bureau of Labor Statistics, healthcare professionals are at a 16x greater risk of violence than professionals in other service fields1. •Much of this mistreatment is from colleagues and superiors2, but a significant portion is from patients and their families with prior studies showing anywhere from 6-67% percent of the mistreatment done by patients or their families2,4,5,6. •Providers may feel that being mistreated is an expected part of the job7,8. •Many resources have been dedicated to understanding and …

Using A Mixed Methods Approach To Explore Perceptions Of Early Learners In Classroom-Based Interprofessional Education Experiences, Abigale Matulewicz

Health Sciences Education Symposium

Background:

- Interprofessional education (IPE) is a global imperative

- Health profession education programs, motivated by accreditation requirements, have added IPE activities into their required curricula.

- Curriculum development varies considerably across institutions and debate exists regarding appropriate timing for introducing learners to IPE in order to optimally improve health outcomes.

- Some evidence shows benefit of early learner IPE in professional identity development, interprofessional socialization and positive attitude development toward interprofessional practice.

- At Virginia Commonwealth University (VCU), IPE is integrated longitudinally through the curriculum for several of the health professions programs via IPEC courses.

Stress And Wellness Levels In Emergency Medicine Residents And Attendings Compared To Residents And Attendings From Other Specialty Training Programs, Grace Hickam

Health Sciences Education Symposium

Introduction:

Physicians are at high risk for burnout when compared to the general population. Burnout is a constellation of symptoms characterized by emotional exhaustion, depersonalization and decreased/low sense of personal accomplishment¹. Burnout affects health, relationships, motivation, and patient outcomes. Elements of emergency medicine (EM) may make EM residents/attendings more vulnerable to stress. Examining physician resilience and finding ways to implement change is essential to improving the culture of residency training. The objective of this study was to compare well-being and stress between EM residents and other residents and to compare EM residents and attendings.

Follow Up: Medical Rhetoric – Making The Case For Oral Presentations, Rabia Qaiser

Health Sciences Education Symposium

Goal: •Oral case presentation skill is fundamental in clinical communication •This skill is first developed in medical school pre-clinical training •Continued development is often by “Trial and Error” – often without a formal curriculum Purpose: Development of a new curriculum designed to acknowledge the importance of this skill development and create a method in building this skill mindfully

Medical Education Board Game: Interactive Learning, Ulysses Davila

Health Sciences Education Symposium

Background:

Researchers have been interested in promoting improved retention of medical knowledge through custom designed board games for a number of years (Bochennek, et al 2007, Karbownik et al, 2016, and Shaw et al 2013). Studies demonstrate at least a subjective medical student desire to continue to develop study methods like board games for routine use in medical education.

Use Of 360-Degree Assessment During Interprofessional Simulation To Enhance Formative Feedback, Kelly Lockeman

Health Sciences Education Symposium

Background: •Effective interprofessional teamwork is essential for quality patient care [1], and within-team feedback improves team performance [2]. •Learners trained to assess peers are more confident and skilled at evaluating others and better prepared to provide meaningful feedback to their colleagues when they enter the workforce [3,4]. •This is particularly important in interprofessional teams where tensions between professional groups can create unique challenges [5].

Implementation Of A Workplace-Based Assessment To Measure Performance Of The Core Entrustable Professional Activities In The Pediatric Clerkship, Clifton Lee

Health Sciences Education Symposium

Background: In 2013, the AAMC convened a panel of medical education experts to delineate the 13 Core Entrustable Professional Activities (Core EPAs) medical school graduates should be able to perform without direct supervision by day one of their residency. 1 Assessment of these EPAs requires direct observation to render entrustment decisions. 2 As part of our engagement in the AAMC Core EPA pilot,3 we created a workplace-based assessment (WBA) system to assist in measurement of student performance for the Core EPAs at the Virginia Commonwealth University School of Medicine.

For the Pediatrics clerkship, we identified 6 Core EPAs to assess …

Prioritizing Urinary Incontinence For Current And Future Healthcare Professionals, Leighton N. Thumm

Health Sciences Education Symposium

Introduction: •Urinary incontinence (UI) is a common syndrome that often goes unreported and undiagnosed •As calls to action from the National Institute on Aging and American Geriatrics Society suggest, the healthcare workforce must work interprofessionally to meet the needs of people with UI •Understanding the challenges of and opportunities for improving continence care in Virginia is a first step •The primary goal of this study was to assess changes in awareness of and confidence in providing interprofessional UI care after participating in an interactive workshop

Go Slow To Move Fast: Best Practices For Engaging Community Leaders In A Transformative Strategic Plan, Logan Vetrovec

Health Sciences Education Symposium

The purpose of this poster is to expose VCU faculty, staff, students and team members to content focused on health equity concepts, related data, and the VCU Health Equity initiative.

• Health inequities exist and are defined by the World Health Organization as “systematic gaps in health outcomes between different groups of people that are judged to be avoidable and therefore are considered unfair and unjust.” Health inequities are exacerbated when socioeconomic factors are not considered as significant influencers of health.
• VCU and the VCU Health System share a vision that all faculty, staff, students and trainees are committed to improving …

Engaging Ideas For Pathology Student Interest Group Meetings, Kimberley Sanford

Health Sciences Education Symposium

Pathology Student Interest Groups (PSIG) are a recruitment tool supported by VCU Department of Pathology to attract medical students into pathology residency. VCU PSIG wanted to increase student attendance and engagement by choosing an off-site venue and employing gamification to increase student interaction with pathology residents and faculty.