Digital Commons Network^™

Consideration For Care For Your Patient With Cerebral Palsy, Katlin R. Cannon, Melissa Stowe, Brooke Ryan

Dental Hygiene Student Scholarship

Cerebral palsy (CP) is a common developmental neurological disorder affecting about 2-3 children out of 1,000. CP is the result of infant brain damage or abnormal development resulting in impaired muscle control, coordination, tone, reflex, posture, and balance. These patients are unable to control motor movements of their muscles of mastication and facial expression, causing excessive drooling, clenching, bruxism, and other oral health-related issues. This lack of motor control affects their ability to swallow and often limits these patients to a liquid diet. This can lead to vitamin deficiencies and result in further developmental problems. As an example, a deficiency …

Got Caries? Breast Milk And Early Childhood Caries?, Megan L. Dean, Rebecca Fields, Hannah Fritz

Dental Hygiene Student Scholarship

Objective: To provide an analysis of the association between the longevity of breastfeeding and development of ECC. Determine the optimal time frame in which mothers should cease breastfeeding to reduce ECC development. Methods: Dr. Brickhouse, PubMed, Google Scholar and other scholarly databases were utilized to find current scientific evidence on the effects of breast milk on ECC. Relevant articles were summarized to write a review of literature. 16 articles published from 2015 to the present date were reviewed and cited. Results: From the studies, there is strong evidence to support breastfeeding beyond 12 months of age increases the prevalence …

"Epigenetic Silencing Of Socs3 Expression Contributes To Fibrosis In Crohn’S Disease", Emily T. Marshall, Chao Li, John F. Kuemmerle

MD Student Summer Research Fellowship Program Posters

Identified risk polymorphisms affecting the Jak-STAT3 pathway in patients with Crohn’s disease could affect TGF-β1 and collagen I expression and in the pathway’s negative regulator, SOCS3. Genetic factors, however, account for only ~25% of disease. Epigenetic events also shape gene expression. Recent experiments showed that autocrine IL-6 production in mesenchymal cells, subepithelial myofibroblasts (SEMF) and muscle cells, of patients with fibrostenotic Crohn’s disease causes sustained Jak-STAT3 activity, excess TGF-β1 and Collagen I production and fibrosis. SOCS3 paradoxically decreased in these cells. We now identify epigenetic mechanisms that silence SOCS3 expression in SEMF of patients with fibrostenotic Crohn’s disease. In a …

The Antioxidant Potential Of The Mediterranean Diet In Patients At High Cardiovascular Risk: An In-Depth Review Of The Predimed, Hayley E. Billingsley, Salvatore Carbone

Kinesiology and Health Sciences Publications

Cardiovascular disease (CVD) is the leading global cause of death. Diet is known to be important in the prevention of CVD. The PREDIMED trial tested a relatively low-fat diet versus a high-fat Mediterranean diet (MedDiet) for the primary prevention of CVD. The resulting reduction of the CV composite outcome resulted in a paradigm shift in CV nutrition. Though many dietary factors likely contributed to this effect, this review focuses on the influence of the MedDiet on endogenous antioxidant systems and the effect of dietary polyphenols. Subgroup analysis of the PREDIMED trial revealed increased endogenous antioxidant and decreased pro-oxidant activity in …

Contraceptive Utilization Among New Exotic Dancers: A Cross-Sectional Study, Mishka Terplan, Caitlin E. Martin, Jennifer Nail, Susan G. Sherman

Obstetrics and Gynecology Publications

Background
Female exotic dancers are a population at high risk of unintended pregnancy. The objective of this study is to describe the reproductive health needs and contraceptive utilization of exotic dancers.

Methods
New exotic dancers (< 6 months dancing) from 26 clubs in Baltimore City/County completed a one-time survey.

Results
Of 117 participants, 96 (82%) had current contraceptive need. The mean age was 24 years, and 55% were black. Sex work (45%), alcohol use disorder (73%), illicit (44%; e.g., heroin, crack, cocaine), and injection drug use (8%) were common. The majority (66%) reported contraception use in the prior 6 months. Condoms were reported by 46% whereas 45% reported non-barrier methods, most commonly hormonal …

Theoretical Open-Loop Model Of Respiratory Mechanics In The Extremely Preterm Infant, Laura Ellwein Fix, Joseph Khoury, Russell R. Moores Jr., Lauren Linkous, Matthew Brandes, Henry J. Rozycki

Mathematics and Applied Mathematics Publications

Non-invasive ventilation is increasingly used for respiratory support in preterm infants, and is associated with a lower risk of chronic lung disease. However, this mode is often not successful in the extremely preterm infant in part due to their markedly increased chest wall compliance that does not provide enough structure against which the forces of inhalation can generate sufficient pressure. To address the continued challenge of studying treatments in this fragile population, we developed a nonlinear lumped-parameter respiratory system mechanics model of the extremely preterm infant that incorporates nonlinear lung and chest wall compliances and lung volume parameters tuned to …

Wses Worldwide Emergency General Surgery Formation And Evaluation Project, Federico Coccolini, Yoram Kluger, Luca Ansaloni, Ernest E. Moore, Raul Coimbra, Gustavo P. Fraga, Andrew Kirkpatrick, Andrew Peitzman, Ron Maier, Gianluca Baiocchi, Vanni Agnoletti, Emiliano Gamberini, Ari Leppaniemi, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Walt Biffl, Fausto Catena

Surgery Publications

Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and nontraumatic acute conditions during the same admission in the hospital. EGS represents the easiest viable way to provide affordable and high-quality level of care to emergency surgical and trauma patients. It may result from the association of different physicians with other specialties in a cooperative model. The World Society of Emergency Surgery (WSES) has been working on the EGS organization and implementation since its foundation believing in the need of common benchmarks for …

Low Nt-Probnp Levels In Overweight And Obese Patients Do Not Rule Out A Diagnosis Of Heart Failure With Preserved Ejection Fraction, Leo F. Buckley, Justin M. Canada, Marco G. Del Buono, Salvatore Carbone, Cory R. Trankle, Hayley Billingsley, Dinesh Kadariya, Ross Arena, Benjamin W. Van Tassell, Antonio Abbate

Internal Medicine Publications

Background Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that presents clinicians with a diagnostic challenge. The use of natriuretic peptides to exclude a diagnosis of HFpEF has been proposed. We sought to compare HFpEF patients with N-terminal pro-brain natriuretic peptide (NT-proBNP) level above and below the proposed cut-off.

Methods Stable patients (n = 30) with left ventricular (LV) ejection fraction ≥ 50% were eligible if they had a diagnosis of HF according to the European Society of Cardiology diagnostic criteria. Characteristics of patients with NT-proBNP below (≤125 pg/mL) and above (>125 pg/mL) the diagnostic …

Intestine‐Specific Expression Of Human Chimeric Intestinal Alkaline Phosphatase Attenuates Western Diet‐Induced Barrier Dysfunction And Glucose Intolerance, Siddhartha S. Ghosh, Hongliang He, Jing Wang, William Korzun, Paul J. Yannie, Shobha Ghosh

Internal Medicine Publications

Intestinal epithelial cell derived alkaline phosphatase (IAP) dephosphorylates/detoxifies bacterial endotoxin lipopolysaccharide (LPS) in the gut lumen. We have earlier demonstrated that consumption of high‐fat high‐cholesterol containing western type‐diet (WD) significantly reduces IAP activity, increases intestinal permeability leading to increased plasma levels of LPS and glucose intolerance. Furthermore, oral supplementation with curcumin that increased IAP activity improved intestinal barrier function as well as glucose tolerance. To directly test the hypothesis that targeted increase in IAP would protect against WD‐induced metabolic consequences, we developed intestine‐specific IAP transgenic mice where expression of human chimeric IAP is under the control of intestine‐specific villin promoter. …

Autophagy-Deficient Breast Cancer Shows Early Tumor Recurrence And Escape From Dormancy, Masoud H. Manjili

Massey Comprehensive Cancer Center Publications

Breast cancer patients who initially respond to cancer therapies often succumb to distant recurrence of the disease. It is not clear why people with the same type of breast cancer respond to treatments differently; some escape from dormancy and relapse earlier than others. In addition, some tumor clones respond to immunotherapy while others do not. We investigated how autophagy plays a role in accelerating or delaying recurrence of neu-overexpressing mouse mammary carcinoma (MMC) following adriamycin (ADR) treatment, and in affecting response to immunotherapy. We explored two strategies: 1) transient blockade of autophagy with chloroquine (CQ), which blocks fusion of autophagosomes …

Determining The Quantitative Principles Of T Cell Response To Antigenic Disparity In Stem Cell Transplantation, Ali Salman, Vishal Koparde, Charles E. Hall, Max Jameson-Lee, Catherine Roberts, Myrna Serrano, Badar Abdulrazzaq, Jeremy Meier, Caleb Kennedy, Masoud H. Manjili, Stephen R. Spellman, Dayanjan Wijesinghe, Shahrukh Hashmi, Greg Buck, Rehan Qayyum, Michael Neale, Jason Reed, Amir A. Toor

Massey Comprehensive Cancer Center Publications

Alloreactivity compromising clinical outcomes in stem cell transplantation is observed despite HLA matching of donors and recipients. This has its origin in the variation between the exomes of the two, which provides the basis for minor histocompatibility antigens (mHA). The mHA presented on the HLA class I and II molecules and the ensuing T cell response to these antigens results in graft vs. host disease. In this paper, results of a whole exome sequencing study are presented, with resulting alloreactive polymorphic peptides and their HLA class I and HLA class II (DRB1) binding affinity quantified. Large libraries of potentially alloreactive …

Exploring Resilience Models In A Sample Of Combat-Exposed Military Service Members And Veterans: A Comparison And Commentary, Christina M. Sheerin, Kelcey J. Stratton, Ananda B. Amstadter, The Va Mid-Atlantic Mental Illness Research, Education, Clinical Center (Mirecc) Workgroup, Scott D. Mcdonald

Psychiatry Publications

Background: The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma.

Objective: illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load–resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample.

Method: In this combat-trauma exposed …

Supporting Play Exploration And Early Developmental Intervention Versus Usual Care To Enhance Development Outcomes During The Transition From The Neonatal Intensive Care Unit To Home: A Pilot Randomized Controlled Trial, Stacey C. Dusing, Tanya Tripathi, Emily C. Marcinowski, Leroy R. Thacke, Lisa F. Brown, Karen D. Hendricks-Muñoz

Physical Therapy Publications

Background

While therapy services may start in the Neonatal Intensive Care Unit (NICU) there is often a gap in therapy after discharge. Supporting Play Exploration and Early Development Intervention (SPEEDI) supports parents, helping them build capacity to provide developmentally supportive opportunities starting in the NICU and continuing at home. The purpose of this single blinded randomized pilot clinical trial was to evaluate the initial efficacy of SPEEDI to improve early reaching and exploratory problem solving behaviors.

Methods

Fourteen infants born very preterm or with neonatal brain injury were randomly assigned to SPEEDI or Usual Care. The SPEEDI group participated in …

Social Media Best Practices In Academic Libraries (2016), Sue Robinson, Bettina Peacemaker, Emily J. Hurst

VCU Libraries Faculty and Staff Data

In order to understand current trends and use of social media in libraries, VCU Libraries created and conducted an online survey using SurveyMonkey. Our approach was informed by the study of social media and public relations practice conducted by Wright and Hinson (Wright, Donald K. and Michelle Drifka Hinson. 2015. “Examining Social and Emerging Media Use in Public Relations Practice: A Ten-Year Longitudinal Analysis.” Public Relations Journal 9).

The VCU Libraries survey consisted of 22 multiple-choice, multiple-answer, and open ended questions. The survey was distributed to email discussion lists frequented by library professionals involved in management or communications. The data …

Virginia Commonwealth University Fall Commencement Program [2018], Virginia Commonwealth University

VCU Commencement Programs

No abstract provided.

Is Counseling Integral To Buprenorphine-Assisted Opioid Addiction Treatment? Examining Counseling Participation And Treatment Retention At A Richmond, Virginia Clinic, John R. Gyourko, Hilary Colin King

Social Work Student Works

Treatment providers in Virginia are required by law to offer counseling or referrals to all clients receiving medication-assisted opioid use disorder (OUD) treatment (American Society of Addiction Medicine, 2016; Medical Society of Virginia, 2018). Prescribing physicians widely regard counseling as a critical component of medication-assisted OUD treatment (Lin, Lofwall, Walsh, & Knudsen, 2019), and clients perceive counseling to be among the most important factors promoting recovery from opioid dependence (Hay, Huhn, Tompkins, & Dunn, 2019). Research investigating the efficacy of counseling as an OUD treatment component, however, has been equivocal to date (Brown, 2018; Dugosh et al., 2016). The current …

Reducing Anti-Lgbt Hate Crimes And Improving Services To Survivors, Liz Coston

Translational Research Fellows Policy Briefs

Over the course of a lesbian, gay, or bisexual individual's lifetime there is a 20% risk of experiencing hate violence, while a transgender individual's risk of violence is 27%. Three key recommendations are given for reducing the victimization of LGBT people by hate crimes.

Oral Health Impacts Educational Success, Tegwyn Brickhouse

Translational Research Fellows Policy Briefs

Children with poor oral health experience significant pain, which can affect their eating habits and growth, make them more likely to get sick and miss school, and undermine their ability to concentrate in school. If we want children to succeed in school, we need to understand how learning and oral health are linked.

Fashioning Appropriate Regulation Of Opioids For Palliative Care, J. Brian Cassel, Egidio Del Fabbro, Danielle Noreika, Tara Albrecht, Jessica Tsukanov

Translational Research Fellows Policy Briefs

Palliative care specialists, who care for patients with serious, life-limiting illnesses such as cancer, are experts in evaluating and managing acute pain. Amid concerns of substance abuse and diversion in patients with cancer, including those near the end of life, regulations and training for providers should encourage the development and use of distinct assessment and management guidelines for palliative care situations.

Toward Competitive Employment For Persons With Intellectual And Developmental Disabilities: What Progress Have We Made And Where Do We Need To Go, Paul Wehman, Joshua Taylor, Valerie Brooke, Lauren Avellone, Holly N. Whittenburg, Whitney Ham, Alissa Molinelli Brooke, Staci Carr

Physical Medicine and Rehabilitation Publications

Progress toward competitive integrated employment (CIE) for people with intellectual and developmental disabilities (IDD) over the last 40 years has been mixed. Despite evidence showing that supported employment interventions can enable adults with IDD to effectively get and keep jobs, national rates of integrated employment remain below a third of the working-age population. Progress is being made to improve these outcomes. Pathways have been identified that lead to CIE through supported employment, customized employment, internship experiences, and postsecondary education. The recent passage of the Workforce Innovation and Opportunity Act (WIOA) has created fresh momentum and increased the onus on interagency …

Pharmacy Staff Perspectives On Alcohol And Medication Interaction Prevention Among Older Rural Adults, Faika Zanjani, Hannah Allen, Rachel Vickers Smith, Demetra Antimisiaris, Nancy Schoenberg, Catherine Martin, Richard Clayton

Gerontology Publications

Older adults are at high risk for alcohol and medication interactions (AMI). Pharmacies have the potential to act as ideal locations for AMI education, as pharmacy staff play an important role in the community. This study examined the perspectives of pharmacy staff on AMI prevention programming messaging, potential barriers to and facilitators of older adult participation in such programming, and dissemination methods for AMI prevention information. Flyers, telephone calls, and site visits were used to recruit 31 pharmacy staff members who participated in semistructured interviews. A content analysis of interview transcriptions was conducted to identify major themes, categories, and subcategories. …

Improving Resident Understanding Of Healthcare Business And Policy Through The Development Of A High-Yield And Dynamic Educational Series, John Legge

Health Sciences Education Symposium

Objective: Residents have a strong desire to be engaged in and learn about the financial and societal impact of health care delivery and reform initiatives1,2. In order to address this need, a Business and Health Policy Educational Series was developed, with positive feedback from participating residents. Background: During the Program Evaluation Committee (PEC) meeting, as part of the annual review of the ACGME education curriculum for the Virginia Commonwealth University Neurology Residency Program, a deficiency was identified with regard to resident self-perception of understanding of the business and policy of healthcare and reform initiatives. This deficiency is one shared at …

Improving The Clinical Learning Environment: A Collaborative Workshop For Students, Residents, And Faculty, Deborah Diazgranados

Health Sciences Education Symposium

The AAMC Graduation Questionnaire (AAMC GQ) surveys the students at the completion of their training. Results from this survey show that students report mistreatment and unprofessional behavior during their training. The results of this survey, both locally and nationally, motivated faculty in the school of medicine to develop a workshop that would introduce the learning climate to students, and allow the students to interact with faculty to understand mistreatment and professionalism in the learning environment. In this presentation, we will highlight the need for educating students about the learning climate, professionalism and mistreatment; provide attendees with the definition of mistreatment; …

Central Venous Catheter Confirmation By Ultrasonography: A Novel Instructional Protocol, Jordan Tozer

Health Sciences Education Symposium

Central Venous Catheter Confirmation by Ultrasonography: A Novel Instructional Protocol

Implementation Of A Multi-Pronged Approach To Improve Education In Quality Improvement (Qi) And To Increase Resident Involvement In Qi Work, Ashlie Tseng

Health Sciences Education Symposium

Objective: To evaluate a multi-tiered approach to incorporating QI and PS training and participation in a pediatrics residency program. Methods: We developed a multi-tiered approach to QI/PS training during the 2013-14 year, and expanded upon it during subsequent years. We tracked resident participation in Departmental QI Grand Rounds and ACGME and Department survey results. The initial intervention involved didactic and small group sessions/to facilitate project development. We also instituted Departmental QI Grand Rounds. In the following year (2014-15), we increased the number of didactics and started a practice improvement project within the resident group practice where residents were provided individualized …

Teaching Cross-Sectional Anatomy In Parallel With Gross Anatomy Through A Curriculum Incorporating Ct Scanning Of Cadavers, Peter Haar

Health Sciences Education Symposium

Navigating and interpreting cross-sectional medical image sets are important skills used by most physicians to apply anatomical knowledge to patient care. However, few medical schools provide formal instruction in understanding cross-sectional anatomy. For these reasons, a curriculum was developed in which the medical school gross anatomy cadavers were CT scanned prior to dissection, and CT images of specific cadavers were correlated both to labelled atlas images and to direct structural observations of those same cadavers during dissection. The students were taught to navigate CT data sets in axial, coronal, and sagittal planes, to mentally synthesize three-dimensional understandings of individual cadaveric …

Implementation Of A School-Wide, Epa-Based Acting Internship Curriculum, Adam Garber

Health Sciences Education Symposium

Objectives. The core entrustable professional activities for entering residency (Core EPAs) were established by the AAMC as a framework to assess competency. The Acting Internship (AI) rotation is an excellent space to assess core EPAs, however many institutions have no structured AI curriculum. Our goal is to develop a standardized, school-wide AI curriculum that includes evaluation and assessment of designated core EPAs. Method. At our institution, two non-departmental AI directors were directed to oversee all AI rotations across the school and implement goals, objectives, and curriculum focused around specific core EPAs. A clinical skills-focused curriculum combining a mix of didactic …

Medical Rhetoric-Making The Case For Oral Presentations, Patrick Fadden

Health Sciences Education Symposium

The oral case presentation is a vital skill in clinical medicine. It not only serves the purpose of delivering clinical information but it also provides the platform in which providers explain diagnostic reasoning. Although it plays a central role in clinical care, the development and refinement of these communicative skills are often “trial and error” in medical training. This may lead to delayed acquisition in skill development which can impact the efficiency and effectiveness of patient care. The intent and purpose of the oral case presentation also has been shown to be incongruent among medical students and attendings, further dampening …

Why Residents’ Perceptions Of The Clinical Learning Environment Matter: Correlations Between The Acgme Resident Survey, Perceived Organizational Support, And Psychological Safety, Nital Appelbaum

Health Sciences Education Symposium

Purpose. To utilize two validated instruments to assess the cultural facets of the clinical learning environment in medical education and correlate findings with external program evaluation data. Identification of measurement tools could allow early intervention in graduate medical education to better facilitate work and learning processes. Method. During FY17, our institution surveyed residents across nineteen training programs on perceived organizational support and psychological safety to assess the clinical learning environment. These data were aggregated to the departmental level and correlated with nineteen residency program results on the FY17 ACGME Resident Survey. Results. Perceived organizational support correlated positively with domains of …

Leadership Skills Development For Pediatric Residents, Hadi Anwar

Health Sciences Education Symposium

Physicians are expected to be leaders. Pediatrics residents have identified a lack of leadership development in their training. Some residency programs have developed skills-based leadership curriculums that are perceived positively by participants. A leadership curriculum is being developed for VCU pediatrics residents in a fellowship track. A needs assessment was done to identify high-priority leadership skills. The curriculum aims to improve communication, conflict resolution, decision-making, and time management skills using role-play, reflection, and feedback from direct observation. Expected challenges are developing appropriate instructors and time constraints. Curriculum creators will collect evaluations from participants and qualitative feedback to continually improve the …