Medicine and Health Sciences Commons^™

Local Outcomes Of A National Pilot To Enhance Ambulatory Precepting, Mark Ryan

Health Sciences Education Symposium

Recruiting and retaining effective ambulatory preceptors in Family Medicine is a national priority (1), and the American Board of Family Medicine (ABFM) and the Society of Teachers of Family Medicine (STFM) have developed a collaborative program to enhance Family Medicine Precepting (2). As one of the first cohort of pilot sites participating in the Preceptor Improvement Project (PIP), VCU's Department of Family Medicine and Population Health developed a faculty development program to enhance clinical teaching at the Hayes E. Willis Health Center, one of the Department's key teaching locations. The PIP content was based on the learning needs identified by …

Knowing Their Limits: Assessing The Discernment Of Pre-Clinical Medical Students, Elizabeth P. Marlowe

Health Sciences Education Symposium

Introduction:

Discernment, or awareness of one’s limitations, is one of the qualities fundamental to entrustment (ten Cate et al., 2015). The AAMC Entrustable Professional Activities (EPA) pilot project lists discernment as an expectation of medical students entering residency (AAMC, 2014).

Our institution, Virginia Commonwealth University School of Medicine (VCU SOM), was selected to participate in the EPA pilot. Prior to implementing a pilot curriculum on discernment, our institution gathered data on the current practice of discernment among our pre-clinical medical students.

The Practice of Clinical Medicine (PCM) at VCU SOM is a pre-clinical longitudinal course which teaches the core skills …

Longitudinal Changes In Psychological Resilience And Wellness During Clinical Clerkship, Moshe Feldman

Health Sciences Education Symposium

Purpose: An individual’s capacity to monitor, anticipate, react, and recover from stressful events defines their resilience. Resilient coping strategies have been shown to reduce stress, burnout, and improve performance in medical students (Erschans 2018, Thompson 2016, Wetzel 2018), but less is known on how resiliency changes over time across different phases of medical school or whether it is a trait. Ideally, educators would understand the periods in the curriculum where resilience building and stress reduction interventions are most needed, and most effective. The purpose of this study was to assess longitudinal changes in resiliency and the association between resiliency and …

Loneliness In Later Life, Edward F. Ansello

Director's Editorials from Age in Action

The National Social Life, Health and Aging Project (NSHAP) at the University of Chicago notes that persistent loneliness in later life is the exception rather than the rule. When it occurs, it’s most likely to be a transient condition and remediable.

Blue Zones And Longevity, Edward F. Ansello

Director's Editorials from Age in Action

We can embrace the generalizable characteristics of Blue Zones: a plant-based diet, friendships, spiritual or religious grounding, awareness of and immersion in our community, physical activity as a regular, normalized part of our daily routine, and, more philosophically, an opening up to our own sense of place and purpose.

Dementia-Friendly Resources, Edward F. Ansello

Director's Editorials from Age in Action

While dementia caregiving challenges continue for individual caregivers and communities, Alzpossible.org and Dementia Friendly America (dfamerica.org) can offer immediate support and a hopeful vision.

Interprofessional Geriatrics: Improving The Health Of Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

We have received a five-year award (2019-2024) from the federal Health Resources and Services Administration (HRSA) to grow our Virginia Geriatric Education Center (VGEC) project, which aims to improve health outcomes across Virginia for older adults by developing a healthcare workforce that maximizes patient and family engagement, integrating geriatrics and primary care, and demonstrating measurable impact.

The Mason Music & Memory Initiative (M3i), Catherine J. Tompkins, Emily S. Ihara, Megumi Inoue, Christi Clark, Kristen Suthers Rumrill

Case Studies from Age in Action

Educational Objectives

1. Explain the benefits of a nonpharmacological intervention, such as the M3I, for persons with dementia.

2. Describe the work of M3I and its collaboration with students and faculty throughout the state.

3.Highlight lessons learned and future directions for the M3I.

Virginianavigator/Gwep Community Outreach Training For Older Adults, Caregivers, And Service Programs, Adrienne Johnson, Kim Tarantino

Case Studies from Age in Action

Educational Objectives

1. Demonstrate how VirginiaNavigator (VN) can support self-care and connecting with community resources.

2. Discuss how VN can assist service providers who work with older adults and their families.

3. Explain how VN relates to six focus areas of the Geriatrics Workforce Enhancement Program (GWEP) to improve the well-being of older adults.

The Senior Mentoring Program At Vcu’S School Of Medicine, Leland H. Waters, Madeline Mcintyre

Case Studies from Age in Action

Educational Objectives

1. To demonstrate the value of senior mentoring in geriatrics education for medical students.

2. To provide a framework for positively influencing student attitudes toward older adults.

3. To describe the underlying human relationships that contribute to patient-centered care.

4. To describe effective verbal and non-verbal skills to establish and build relationships.

Care Transitions: Empowering Older Adults With Post-Hospital Interventions, Karen Moeller

Case Studies from Age in Action

Educational Objectives

1. Understand how Care Transitions Interventions® (CTI®) can decrease hospital readmission rates among older adults, ages 60 and over.

2. Recognize how CTI® services assist older adults to stay in their homes after hospitalization for 30 days or more without unnecessary readmissions.

3. Appreciate examples of ways Senior Connections, The Capital Area Agency on Aging, collaborates with community partners.

4. Identify how Senior Connections refers older adults and caregivers to community resources for effective utilization and outcomes.

To Repair Or Replace: That Is The Restorative Question, Juhstin M. Brown, Clement S. Augustus

Dental Hygiene Student Scholarship

Objective/Aims: During dental visits, patients spend the majority of their time with their dental hygienist. At these recall appointments the patient’s face-to-face time with the dentist may be short. At this part of the appointment the dentist may diagnose the need for restorative treatment for the patient. Part of the hygienist’s responsibility is to explain treatment options for teeth with restorative needs. The purpose of this review of literature is to provide both options for restoration of dentition to a functional/aesthetic state.

Methods: Studies pertaining to the topic were searched using PubMed database. Keywords used in the search were amalgam, …

Puberty: Is Your Gingiva Having Mood Swings?, Gabrielle R. Salvatore, Kendall A. Connerley

Dental Hygiene Student Scholarship

Objectives/aim: The purpose of this paper is to explore the effects on the different pathological changes in the oral cavity due to puberty, in both males and females. Hormonal changes caused by menstrual cycles, ovulation, the use contraceptives, and increased testosterone and estrogen levels.

Methods: This topic will be analyzed by thoroughly reviewing research on articles that relate to the oral health of individuals specifically between the ages of 12-18 years old.

Results: Research presents significant evidence that supports changes occurring in the oral cavity during an individual’s stage of puberty. These stages include ovulation, pre-menstruation, menstruation and males transitioning …

Acute Septic Shock From Routine Ureteroscopy With Laser Lithotripsy, Sameer Goel

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Time To Conversion Of Hemi/Total Shoulder Arthroplasty To Reverse Total Shoulder Arthroplasty; A Systematic Review Of Longevity And Factors Influencing Conversion, David Constantinescu, James Satalich, Kevin Lacy, Alexander Vap

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Background: The primary purpose of this study was to determine the average time from hemiarthoplasty (HA) or total shoulder arthroplasty (TSA) to conversion to reverse total shoulder arthroplasty (RTSA). The secondary purpose of this study was to determine the factors leading to conversion to RTSA.

Methods: A review of the literature regarding the existing evidence for conversion of HA/TSA to RTSA was performed using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980-present), and MEDLINE (1980-present). nclusion criteria were as follows: reporting of conversion of a HA or TSA to RTSA with a follow …

Comorbid Medical Conditions As Predictors Of Overall Survival In Glioblastoma Patients, Matthew T. Carr, Camille J. Hochheimer, Andrew K. Rock, Alper Dincer, Lakshmi Ravindra, Fan Lily Zhang, Charles F. Opalak, Nora Poulos, Adam P. Sima, William C. Broaddus

Neurosurgery Publications

Glioblastoma (GBM) is an aggressive central nervous system tumor with a poor prognosis. This study was conducted to determine any comorbid medical conditions that are associated with survival in GBM. Data were collected from medical records of all patients who presented to VCU Medical Center with GBM between January 2005 and February 2015. Patients who underwent surgery/biopsy were considered for inclusion. Cox proportional hazards regression modeling was performed to assess the relationship between survival and sex, race, and comorbid medical conditions. 163 patients met inclusion criteria. Comorbidities associated with survival on individual-characteristic analysis included: history of asthma (Hazard Ratio [HR]: …

Impact Of Use Of Optical Surface Imaging On Initial Patient Setup For Stereotactic Body Radiotherapy Treatments, Brian Leong, Laura Padilla

Radiation Oncology Publications

Purpose

To evaluate the effectiveness of surface image guidance (SG) for pre‐imaging setup of stereotactic body radiotherapy (SBRT) patients, and to investigate the impact of SG reference surface selection on this process.

Methods and materials

284 SBRT fractions (SG‐SBRT = 113, non‐SG‐SBRT = 171) were retrospectively evaluated. Differences between initial (pre‐imaging) and treatment couch positions were extracted from the record‐and‐verify system and compared for the two groups. Rotational setup discrepancies were also computed. The utility of orthogonal kVs in reducing CBCT shifts in the SG‐SBRT/non‐SG‐SBRT groups was also calculated. Additionally, the number of CBCTs acquired for setup was recorded and …

Radiotherapy-Compatible Robotic System For Multi-Landmark Positioning In Head And Neck Cancer Treatments, Mark Ostyn, Siqiu Wang, Yun-Soung Kim, Siyong Kim, Woon-Hong Yeo

Radiation Oncology Publications

The spine flexibility creates one of the most significant challenges to proper positioning in radiation therapy of head and neck cancers. Even though existing immobilization techniques can reduce the positioning uncertainty, residual errors (2–3 mm along the cervical spine) cannot be mitigated by single translation-based approaches. Here, we introduce a fully radiotherapy-compatible electro-mechanical robotic system, capable of positioning a patient’s head with submillimeter accuracy in clinically acceptable spatial constraints. Key mechanical components, designed by finite element analysis, are fabricated with 3D printing and a cyclic loading test of the printed materials captures a great mechanical robustness. Measured attenuation of most …

Metabolic Modulation Predicts Heart Failure Tests Performance, Daniel Contaifer Jr., Leo F. Buckley, George Wohlford, Naren G. Kumar, Joshua M. Morriss, Asanga D. Ranasinghe, Salvatore Carbone, Justin M. Canada, Cory Trankle, Antonio Abbate, Benjamin W. Van Tassell, Dayanjan S. Wijesinghe

Pharmacotherapy and Outcomes Science Publications

The metabolic changes that accompany changes in Cardiopulmonary testing (CPET) and heart failure biomarkers (HFbio) are not well known. We undertook metabolomic and lipidomic phenotyping of a cohort of heart failure (HF) patients and utilized Multiple Regression Analysis (MRA) to identify associations to CPET and HFBio test performance (peak oxygen consumption (Peak VO₂), oxygen uptake efficiency slope (OUES), exercise duration, and minute ventilation-carbon dioxide production slope (VE/VCO₂ slope), as well as the established HF biomarkers of inflammation C-reactive protein (CRP), beta-galactoside-binding protein (galectin-3), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP)). A cohort of 49 patients with …

A Preliminary Investigation Towards The Risk Stratification Of Allogeneic Stem Cell Recipients With Respect To The Potential For Development Of Gvhd Via Their Pre-Transplant Plasma Lipid And Metabolic Signature, Daniel Contaifer Jr., Catherine H. Roberts, Naren Gajenthra Kumar, Ramesh Natarajan, Bernard J. Fisher, Kevin Leslie, Jason Reed, Amir A. Toor, Dayanjan S. Wijesinghe

Pharmacotherapy and Outcomes Science Publications

The clinical outcome of allogeneic hematopoietic stem cell transplantation (SCT) may be influenced by the metabolic status of the recipient following conditioning, which in turn may enable risk stratification with respect to the development of transplant-associated complications such as graft vs. host disease (GVHD). To better understand the impact of the metabolic profile of transplant recipients on post-transplant alloreactivity, we investigated the metabolic signature of 14 patients undergoing myeloablative conditioning followed by either human leukocyte antigen (HLA)-matched related or unrelated donor SCT, or autologous SCT. Blood samples were taken following conditioning and prior to transplant on day 0 and the …

Creating A Clinical Ladder Education Program For Perioperative Surgical Services (Clepps), Velma Davis, Natalie Sorensen

VCU Health Nursing

Problem Statement:

Low participation in challenging the Clinical Ladder within the Perioperative Surgical Services was observed. The period 2016-2017, only five nurses from the department challenged and were successful on the ladder. As a process improvement initiative, the department implemented CLEPPS, using the organization’s clinical ladder program as a tool.

Background:

It is documented in the literature that a robust Clinical Ladder Program increases staff satisfaction, enhances professional development, and improve patient outcomes.

The Perioperative Surgical Services has a total of 102 Clinical Nurse II within the department who were eligible for advancement on the clinical ladder. An internal survey, …

Virginia Dental Journal (Vol. 96, No. 3, 2019)

Virginia Dental Journal

No abstract provided.

Using Er:Yag Laser To Remove Lithium Disilicate Crowns From Zirconia Implant Abutments: An In Vitro Study, Janina Golob Deeb, Sompop Bencharit, Nishchal Dalal, Aous Abdulmajeed, Kinga Grzech-Leśniak

Periodontics Publications

Background
When implants are restored with cement-retained restorations, prosthetic retrievability can be difficult and often requires sectioning using rotary instruments. Sometimes repeated removals of a cement-retained implant crown are needed such as for treatment of peri-implantitis or immediate implant provisionalization. The purpose of this study was to evaluate the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser as a non-invasive treatment modality to remove lithium disilicate crowns from zirconia implant abutments following long-term cementation, repetitive debonding and re-cementation, and short-term retrieval.

Material and methods
Twenty identical lithium disilicate crowns were cemented onto zirconia prefabricated abutments using composite resin cement. Ten …

Analysis Of Wind Instruments On Orofacial Anatomy: A Review Of Literature, Regina M. Dixon, Samantha Chavez

Dental Hygiene Student Scholarship

The focus of this review of literature is on orofacial anatomy and their association with the longevity of wind instrument use. The importance of how playing wind instruments creates a disadvantage for the oral cavity and therapeutic approaches to decrease the adverse effects. Using the university’s library database and PubMed, the authors performed a thorough search on the literature of our topic. Specific key terms such as wind instrumentalists, oral health, orofacial anatomy, and therapy were used to conduct our search. The searched was limited to the English language and within five years of publications. The findings acknowledged pathologically infectious …

The Effect Of Artificial Sweeteners In Chewing Gum, Helpful Or Harmful?, Taylor Rue, Emily Liebe

Dental Hygiene Student Scholarship

Objective/Aims: This review of literature was designed to analyze the effects of artificial sweeteners in chewing gum in the oral cavity. The intent was to recognize which formulations of artificial sweeteners in chewing gum lead to beneficial outcomes in the oral cavity and which formulations lead to harmful effects.

Methods: The review of literature analyzed the conclusions of primary and secondary resources accumulated from PubMed. Multiple scholarly studies were filtered based upon meta-analysis, cross-sectional, and cohort studies. The following key terms were used: artificial sweetener, chewing gum, plaque, saliva, microbes, and oral health. A summative report was created based upon …

Untapped Potential Of Clinical Text For Opioid Surveillance, Amy L. Olex, Tamas Gal, Majid Afshar, Dmitriy Dligach, Niranjan Karnik, Travis Oakes, Brihat Sharma, Meng Xie, Bridget T. Mcinnes, Julian Solway, Abel Kho, William Cramer, F. Gerard Moeller

Wright Center for Clinical and Translational Research Works

Accurate surveillance is needed to combat the growing opioid epidemic. To investigate the potential volume of missed opioid overdoses, we compare overdose encounters identified by ICD-10-CM codes and an NLP pipeline from two different medical systems. Our results show that the NLP pipeline identified a larger percentage of OOD encounters than ICD-10-CM codes. Thus, incorporating sophisticated NLP techniques into current diagnostic methods has the potential to improve surveillance on the incidence of opioid overdoses.

Identifying Attrition Phases In Survey Data: Applicability And Assessment Study, Camille J. Hochheimer, Roy T. Sabo, Robert A. Perera, Nitai Mukhopadhyay, Alex H. Krist

Biostatistics Publications

Background: Although Web-based questionnaires are an efficient, increasingly popular mode of data collection, their utility is often challenged by high participant dropout. Researchers can gain insight into potential causes of high participant dropout by analyzing the dropout patterns.

Objective: This study proposed the application of and assessed the use of user-specified and existing hypothesis testing methods in a novel setting—survey dropout data—to identify phases of higher or lower survey dropout.

Methods: First, we proposed the application of user-specified thresholds to identify abrupt differences in the dropout rate. Second, we proposed the application of 2 existing hypothesis testing methods to detect …

Virginia Dental Journal (Vol. 96, No. 2, 2019)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 96, No. 4, 2019)

Virginia Dental Journal

No abstract provided.

Patients’ Perceptions Of Relative Importance Of Discharge Elements (Pride) Study, Nargiza Kurbanova

Health Sciences Education Symposium

Background:

• Almost 20% of patients experience potentially preventable adverse events within 30 days of hospital discharge (Forster, et al, 2003).
• The Agency for Healthcare Research and Quality recommends structured and patient-centered discharge communication to prevent adverse events post-discharge (2018).
• The Joint Commission mandates information that must be included in all discharge communication including reason for hospitalization, significant findings, procedures and treatment provided, patient's discharge condition, patient and family instructions, and attending physician signature (Horwitz, et al, 2013).
• There is limited data suggesting how healthcare providers believe discharge communication should be prioritized.
• Blaine, et al, 2018 cites "Discharge Education/Teach-back" and "Involve …