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Rationale: The positive reinforcing effects of alcohol (ethanol) drive repetitive use and contribute to alcohol use disorder (AUD). Ethanol alters the expression of glutamate AMPA receptor (AMPAR) subunits in reward-related brain regions, but the extent to which this effect regulates ethanol's reinforcing properties is unclear., Objective: This study investigates whether ethanol self-administration changes AMPAR subunit expression and synaptic activity in the nucleus accumbens core (AcbC) to regulate ethanol's reinforcing effects in male C57BL/6 J mice., Results: Sucrose-sweetened ethanol self-administration (0.81 g/kg/day) increased AMPAR GluA2 protein expression in the AcbC, without effect on GluA1, compared to sucrose-only controls. Infusion of myristoylated Pep2m in the AcbC, which blocks GluA2 binding to N-ethylmaleimide-sensitive fusion protein (NSF) and reduces GluA2-containing AMPAR activity, reduced ethanol-reinforced responding without affecting sucrose-only self-administration or motor activity. Antagonizing GluA2-lacking AMPARs, through AcbC infusion of NASPM, had no effect on ethanol self-administration. AcbC neurons receiving projections from the basolateral amygdala (BLA) showed increased sEPSC area under the curve (a measurement of charge transfer) and slower decay kinetics in ethanol self-administering mice as compared to sucrose. Optogenetic activation of these neurons revealed an ethanol-enhanced AMPA/NMDA ratio and significantly reduced paired-pulse ratio, suggesting elevated GluA2 contributions specifically within the BLA➔AcbC pathway., Conclusions: Ethanol use upregulates GluA2 protein expression in the AcbC and AMPAR synaptic activity in AcbC neurons receiving BLA projections and enhances synaptic plasticity directly within the BLA➔AcbC circuit. GluA2-containing AMPAR activity in the AcbC regulates the positive reinforcing effects of ethanol through an NSF-dependent mechanism, highlighting a potential therapeutic target in AUD., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflicts of interest., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Rationale : The positive reinforcing effects of alcohol (ethanol) drive its repetitive use and contribute to alcohol use disorder (AUD). Ethanol alters the expression of glutamate AMPA receptor (AMPAR) subunits in reward-related brain regions, but the extent to which this effect regulates ethanol's reinforcing properties is unclear. Objective: This study investigates whether ethanol self-administration changes AMPAR subunit expression and synaptic activity in the nucleus accumbens core (AcbC) to regulate ethanol's reinforcing effects in male C57BL/6J mice. Results: Sucrose-sweetened ethanol self-administration (0.81 g/kg/day) increased AMPAR GluA2 protein expression in the AcbC, without effect on GluA1, compared to sucrose-only controls. Infusion of myristoylated Pep2m in the AcbC, which blocks GluA2 binding to N-ethylmaleimide-sensitive fusion protein (NSF) and reduces GluA2-containing AMPAR activity, reduced ethanol-reinforced responding without affecting sucrose-only self-administration or motor activity. Antagonizing GluA2-lacking AMPARs, through AcbC infusion of NASPM, had no effect on ethanol self-administration. AcbC neurons receiving projections from the basolateral amygdala (BLA) showed increased sEPSC area under the curve (a measurement of charge transfer) and slower decay kinetics in ethanol self-administering mice as compared to sucrose. Optogenetic activation of these neurons revealed an ethanol-enhanced AMPA/NMDA ratio and significantly reduced paired-pulse ratio, suggesting elevated GluA2 contributions specifically within the BLA→AcbC pathway. Conclusions: Ethanol use upregulates GluA2 protein expression in the AcbC and AMPAR synaptic activity in AcbC neurons receiving BLA projections and enhances synaptic plasticity directly within the BLA→AcbC circuit. GluA2-containing AMPAR activity in the AcbC regulates the positive reinforcing effects of ethanol through an NSF-dependent mechanism, highlighting a potential therapeutic target in AUD.

Background: Community health workers (CHWs) connect individuals to community resources and build individual competence in an effort to improve overall community/public health. There is a need for more research on how community health nurse (CHN)-led training programs are needed to help train and support CHWs., Purpose: The purpose was to describe the development and evaluation of a series of CHN-led CHW trainings on CHW role, boundaries, and motivational interviewing; diabetes; mental health and long COVID; sexually transmitted infections; and lead poisoning prevention and treatment., Design: This study utilized a one-group pretest-posttest design in which quantitative and qualitative data were collected., Methods: The sample consisted of CHWs representing White/Caucasian, Black/African American, Hispanic/Latinx, and Asian American populations who for each topic, completed a pretest one week prior to the training, the training, and a posttest one week after the training. The quantitative and qualitative data collected during winter and spring/summer 2023 underwent statistical and thematic analysis, respectively., Findings: The results suggest that the CHW trainings were effective overall at increasing participants' knowledge and confidence in their knowledge levels, as well as comfort with educating community members on various public health topics. Information learned and found most helpful, and application and utilization plans for this knowledge in their work were revealed., Conclusions: CHWs are important for disseminating health communication and education among members of their communities, and play a key role in reducing health disparities among at-risk populations., Clinical Evidence: CHN-led educational intervention is a strategy to improve CHWs' knowledge, confidence, and comfort.

Psychedelics have experienced renewed interest following positive clinical effects, however the neurobiological mechanisms underlying effects remain unclear. The paraventricular nucleus of the hypothalamus (PVN) plays an integral role in stress response, autonomic function, social behavior, and other affective processes. We investigated the effect of psilocin, the psychoactive metabolite of psilocybin, on PVN reactivity in Sprague Dawley rats. Psilocin increased stimulus-independent PVN activity as measured by c-Fos expression in male and female rats. Psilocin increased PVN reactivity to an aversive air-puff stimulus in males but not females. Reactivity was restored at 2- and 7-days post-injection with no group differences. Additionally, prior psilocin injection did not affect PVN reactivity following acute restraint stress. Experimental groups sub-classified by baseline threat responding indicate that increased male PVN reactivity is driven by active threat responders. These findings identify the PVN as a significant site of psychedelic drug action with implications for threat responding behavior., (© 2024. The Author(s).)

Background: The American Heart Association has a call to action to reduce hospital acquired venous thromboembolism (HA-VTE) by 20% by the year 2030. There is increasing recognition that quality improvement initiatives for VTE reduction should focus on reducing potentially preventable HA-VTE. The objective of our study was to determine what proportion of HA-VTE events are potentially preventable. Methods: This was a retrospective, single center pilot study of 50 patients with HA-VTE. Seven preventability factors were identified with a focus on VTE prescription and administration. Data were extracted through chart review using a systematic data collection form. The primary endpoint was the proportion of patients with potentially preventable HA-VTE. Descriptive statistics were used. Results: The median age was 66 years with an admission VTE risk level of moderate-high in 94%. Potentially preventable HA-VTE was found in 40% of cases. Missed doses occurred in 29.8% with a median of 2 missed doses and a range of 1 to 20. Patient refusal was the most common reason for missed doses in 71%. Delays in initiation occurred in 12.7%. Sixty percent of those on mechanical prophylaxis only had nonadherence. Conclusion: Forty percent of HA-VTE cases were potentially preventable. Missed doses was the most common preventability factor identified with patient refusal accounting for most missed doses., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Purpose: The purpose of this research study was to determine the effectiveness of an innovative online COVID-19 educational module among community health nursing students., Design: Mixed-methods study., Methods: The sample ( N  = 86) consisted of prelicensure and postlicensure community health nursing students, who completed a pretest, COVID-19 educational intervention, and posttest., Findings: The majority of participants' scores increased from pretest to posttest, and most participants strongly agreed that the COVID-19 educational module was effective. Strategies to address vaccine hesitancy, information learned and found most helpful, and plans for application and utilization of this knowledge were revealed., Conclusions: An online COVID-19 community health nursing educational intervention was effective at improving participants' knowledge, confidence, and attitudes regarding COVID-19., Clinical Evidence: Online COVID-19 community health nursing education was an effective strategy for increasing preparation for this pandemic and the format can be useful to utilize for future public health emergencies.

Background: Virtual reality (VR) simulation in nursing education, especially about non-acute care including community health, is an emerging learning strategy; more research is needed about its effectiveness. Purpose: This study aimed to evaluate the effectiveness of an innovative community health nursing VR simulation on prelicensure students' knowledge about social determinants of health and cultural competence, with a goal of enhancing students' preparation for practice. Methods: In a convergent mixed methods study, 100 prelicensure nursing students in a community health nursing course at a Midwestern U.S., urban, public university completed a pretest, a VR simulation, a posttest, and an evaluation. Pre- and posttests containing content questions adapted from leading community health nursing text faculty resources were used to assess learning, and the Simulation Effectiveness Tool-Modified (SET-M) was used to assess perceived effectiveness of the intervention. Results: The majority of participants' posttest scores were higher than their pretest scores. Most participants strongly agreed that the VR simulation was effective, and reported on new knowledge/skills learned, material found most helpful, and benefit to their nursing practice. Conclusions: The community health nursing VR simulation was effective at increasing participants' knowledge and their confidence in their knowledge and abilities.

Rationale: The development and progression of alcohol use disorder (AUD) are widely viewed as maladaptive neuroplasticity. The transmembrane alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) regulatory protein γ8 (TARP γ-8) is a molecular mechanism of neuroplasticity that has not been evaluated in AUD or other addictions., Objective: To address this gap in knowledge, we evaluated the mechanistic role of TARP γ-8 bound AMPAR activity in the basolateral amygdala (BLA) and ventral hippocampus (vHPC) in the positive reinforcing effects of alcohol, which drive repetitive alcohol use throughout the course of AUD, in male C57BL/6 J mice. These brain regions were selected because they exhibit high levels of TARP γ-8 expression and send glutamate projections to the nucleus accumbens (NAc), which is a key nucleus in the brain reward pathway., Methods and Results: Site-specific pharmacological inhibition of AMPARs bound to TARP γ-8 in the BLA via bilateral infusion of the selective negative modulator JNJ-55511118 (0-2 µg/µl/side) significantly decreased operant alcohol self-administration with no effect on sucrose self-administration in behavior-matched controls. Temporal analysis showed that reductions in alcohol-reinforced response rate occurred > 25 min after the onset of responding, consistent with a blunting of the positive reinforcing effects of alcohol in the absence of nonspecific behavioral effects. In contrast, inhibition of TARP γ-8 bound AMPARs in the vHPC selectively decreased sucrose self-administration with no effect on alcohol., Conclusions: This study reveals a novel brain region-specific role of TARP γ-8 bound AMPARs as a molecular mechanism of the positive reinforcing effects of alcohol and non-drug rewards., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Virtual reality simulation in postlicensure nursing education, including community health, is an emerging instructional approach, and more research is needed on its effectiveness. The goal of this study was to evaluate the effectiveness of an innovative, computer-based community health nursing virtual reality simulation among postlicensure nursing students., Method: This mixed methods study consisted of 67 postlicensure community health nursing students who completed a pretest, computer-based virtual reality simulation, and a posttest and evaluation., Results: The majority of participant scores increased from pretest to posttest, and most participants agreed that the computer-based virtual reality simulation was effective; new knowledge and skills learned, the material that was found to be most helpful, and benefits to nursing practice were identified., Conclusion: This community health nursing computer-based virtual reality simulation was effective at increasing participants' knowledge and confidence with learning. [ J Contin Educ Nurs. 2023;54(3):109-116.] .

Of 65 cases during a human immunodeficiency virus (HIV) outbreak among persons who inject drugs (PWID) in West Virginia (2019-2021), 61 (94%) had hepatitis C diagnosed a median of 46 months prior to HIV diagnosis. Hepatitis C diagnosis among PWID should trigger improved access to prevention and treatment services., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.)

Aim: To describe the process of engaging underserved communities of color that designs, conducts, and evaluates community-engaged COVID-19 Community Health Navigator training on COVID-19: Vaccination, Prevention, and Contact Tracing., Subject and Methods: The project used a mixed-methods design; 18 community health navigators (CHNs) representing Asian American, Arab American, Black/African American, and Hispanic/Latinx communities completed the pretest, training, and post-test. Demographic characteristics, along with knowledge and confidence level questions regarding COVID-19 issues, were gathered in pre- and post-tests. Qualitative data were collected via open-ended questions in post-tests., Results: Findings suggest that the community health navigator training successfully increased participants' knowledge of COVID-19-related topic areas and confidence in educating community members regarding COVID-19 vaccination and prevention. Qualitative evaluation contained information learned and found most helpful, and application and utilization plans for CHNs' follow-up work., Conclusion: The process of community health navigator training and evaluation results adds important insights to the current COVID-19 pandemic workforce literature and can inform future trainings., Competing Interests: Conflicts of interest/competing interestsThe authors declare that they have no conflicts of interest/competing interests., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Purpose: To evaluate the effectiveness of an online human trafficking awareness program for healthcare providers., Design: Mixed-methods study., Methods: Sample ( N =141) consisted of community health nursing students, who completed a pretest, watched one three-minute video a day for 20 days, and completed a posttest., Findings: Participants indicated their knowledge of human trafficking increased, attitudes toward victims improved, and competence and confidence engaging with victims increased. Satisfaction with program, and information utilization plans for practice were revealed., Conclusions: Human trafficking awareness program was effective in increasing participants' knowledge, competence and confidence, and improving attitudes., Clinical Evidence: Educational intervention is a strategy to improve students' knowledge of human trafficking.