VCU researchers' impact
VCU receives $6 million from Department of Defense to study treatment for long-term concussion symptoms
James Burch, Ph.D., a professor in VCU’s School of Public Health, and William Walker, M.D., a professor in the School of Medicine, received a $6 million grant from the Department of Defense for a four-year study, named HERO (HRV Biofeedback for Enhancing Autonomic Resilience and mTBI Outcomes), focused on treating ongoing symptoms of mild traumatic brain injury (mTBI), or concussion. The research will specifically evaluate the effectiveness of Heart Rate Variability (HRV) biofeedback for veterans and service members who suffer from issues like poor sleep, fatigue, dizziness and trouble with memory or concentration after a concussion.
NEUROSCIENCE, PAIN, ADDICTION, AND MENTAL HEALTH
To combat sexual violence among college students, VCU researcher turns to video games
Adrienne Baldwin-White, Ph.D., assistant professor in VCU’s School of Social Work, is developing interactive training scenarios that could engage students more deeply to combat sexual violence than traditional formats.
Dr. Baldwin-White’s work stems from the finding that typical college sexual violence prevention trainings are often ineffective and fail to engage students. She believes that video games offer a more appealing and effective approach to educating vulnerable students about gender-based violence and promoting active intervention.
Her initial online game, “Once Upon a Party,” uses realistic, text-message-based scenarios, allowing players to practice appropriate bystander intervention by choosing how to respond to friends’ messages about sexual harassment or assault at a party. The narratives are drawn from actual conversations Dr. Baldwin-White had with college students to ensure realism and relatability.
Building on this, she is developing a second, animated game, “Student Body,” in collaboration with VCU computer science students. This game uses a “choose your own adventure” format and significantly expands representation to reflect campus diversity, incorporating narrative arcs featuring LGBTQ+ identities and people of color and also includes training on human trafficking.
Commercialized through her company, Noble Tech, the goal is to keep the games short, focused (about 30 minutes), and low-cost to ensure broad adoption across various institutions. Dr. Baldwin-White’s ultimate ambition is for these engaging tools to significantly reduce violence on campuses, thereby achieving positive academic and mental health impacts and reducing the institutional costs associated with responding to sexual violence.
HUMANITIES, CULTURE AND ETHICS
VCU-born startup Evizia lands $2.2M NIH grant for commercialization of advanced DNA sequencing microscope
Jason Reed, Ph.D., a physics professor in VCU’s College of Humanities and Sciences, developed an instrument that uses high-speed atomic force microscopy, a technology initially used in semiconductor manufacturing quality control.
Dr. Reed’s technology is the foundation for his VCU-born startup, Evizia. The company recently secured a $2.2 million Small Business Innovation Research grant from the National Institutes of Health, through the National Human Genome Research Institute, to optimize the manufacturing of its advanced microscope system. This platform, called PRECYSE, addresses critical shortcomings in next-generation DNA sequencing.
Current molecular sizing techniques, like electrophoresis, use indirect imaging, which is unreliable for larger molecules, can miss data and often leads to costly quality control issues in DNA sequencing. PRECYSE solves this by providing direct, high-resolution feedback on sample quality before sequencing begins.
The instrument uses a tiny, nanometer-sized probe to rapidly scan biomolecules, creating a three-dimensional topographical map. This map is then analyzed by machine learning software to obtain precise molecular sizing. This process offers a faster, more accurate alternative to older methods.
The PRECYSE platform is designed for wide adoption in bio-labs, being compact and featuring a built-in stability system to withstand standard lab environments. Furthermore, its sample preparation is simpler and eliminates the need for toxic consumables, reducing both complexity and cost. Evizia plans to use the grant to scale up production and is exploring future applications in genetic analysis, such as the detection of mutated inherited disease genes and cancer-related structural rearrangements. By eliminating “blind spots” in DNA visualization, PRECYSE aims to significantly increase the quality of next-generation sequencing and support the development of new diagnostics and therapeutics.
AI, QUANTUM TECHNOLOGIES AND CYBERSECURITY
Infant mortality rates declining, but Sudden Unexpected Infant Death is on the rise
New research from VCU and Children’s Hospital of Richmond at VCU shows SUID is increasing across the board, with the highest rates among Black, Native Hawaiian and Native American infants.
The study was led by Elizabeth Wolf, M.D., a pediatrician at Children’s Hospital of Richmond at VCU and an associate professor in the VCU School of Medicine’s Department of Pediatrics. Key contributors included Steven Woolf, M.D., director emeritus of the VCU Center on Society and Health, and Anabeel Sen, M.B.B.S., a student in Epidemiology from the VCU School of Public Health, among others.
Published in the Journal of the American Medical Association Pediatrics, the study found that while the overall U.S. infant mortality rate decreased by 24.2% between 1999 and 2022, mortality from SUID rose significantly by 11.8% from 2020 to 2022. A prior study had noted the rise primarily in Black infants, but this new data confirms the increase is now more generalized across infant populations.
The research highlights stark racial and ethnic disparities in SUID. The mortality rate for Black infants is 10 times higher than for Asian infants and three times higher than for white infants. These disparities may be linked to factors like unsafe sleep positioning, prematurity, tobacco exposure and infant feeding practices, which require further investigation.
Causes for the SUID increase are complex, but the authors suggest a possible link to the rise of COVID-19 and other respiratory viruses, increased parental opioid use and the negative influence of social media on infant sleep practices (e.g., showing infants in unsafe positions or environments like adult beds and swings).
To reduce the risk of SUID, Dr. Wolf and collaborators emphasize strengthening public health messaging on safe sleep and tightening regulations on unsafe infant products. They also advocate for broader strategies like expanding health insurance access, providing doulas for prenatal and postnatal support, supporting breastfeeding through lactation support and paid parental leave and ensuring infants receive all recommended vaccines on time.
COMMUNITY, POPULATION HEALTH AND PUBLIC POLICY
VCU-led research consortium identifies distinct long COVID symptoms in children and teens
Despite extensive research, there is still a significant lack of understanding on the impact long COVID has on children and adolescents. But a nationwide study with contributions made by nurse scientists at the Virginia Commonwealth University School of Nursing is helping to set new standards in diagnosing and treating this condition.
Patricia Kinser, Ph.D., interim dean of the School of Nursing and Amy Salisbury, Ph.D., associate dean of research, scholarship, and innovation at the School of Nursing, are leading a multi-institutional research consortium focused on long COVID pediatric patients as part of the Researching COVID to Enhance Recovery (RECOVER) initiative, a nationwide study funded by the National Institutes of Health.
The study, published in the Journal of the American Medical Association (JAMA), provides crucial insights after surveying over 5,000 participants aged 6 to 17, recruited from more than 60 U.S. health care and community settings. Researchers identified 14 symptoms that were significantly more prevalent in participants with a history of COVID-19 infection.
A key advancement was identifying distinct symptom patterns, or phenotypes, across age groups. School-age children primarily presented with neurocognitive problems, pain and gastrointestinal symptoms. In contrast, adolescents more frequently experienced changes in smell or taste, pain and fatigue or malaise.
These findings represent a significant leap forward, allowing researchers and clinicians to refine diagnostic tools and develop targeted management guidelines for pediatric long COVID. The guidelines help identify children and adolescents at high risk and address the resulting decline in their overall health and quality of life.
As the RECOVER-Pediatrics study continues, future work will explore the long-term progression of symptoms and their impact on quality of life. The initiative also plans to investigate potential genetic factors that may predispose individuals to more severe or persistent symptoms, ultimately driving the development of personalized treatment approaches tailored to the unique needs of young patients.
IMMUNOLOGY AND INFECTIOUS DISEASES
13% of patients with dementia may instead have cognitive decline from cirrhosis
Research team at VCU School of Medicine and Richmond VA Medical Center delve further into the connection between dementia and liver health.
A new analysis led by VCU and the Richmond VA Medical Center suggests that approximately 13% of individuals diagnosed with dementia may instead be suffering from a reversible cognitive decline caused by advanced liver disease, known as hepatic encephalopathy. This finding, recently published in the American Journal of Medicine, corroborates and extends the research group's earlier work which found a similar link in U.S. veterans.
Hepatic encephalopathy is a serious nervous system disorder triggered by cirrhosis, or the severe scarring of the liver. When the liver fails to properly filter the blood, toxins build up and travel to the brain, causing confusion and cognitive impairment that can be difficult to differentiate from true dementia.
The new study examined the health records of nearly 69,000 nonveteran patients diagnosed with dementia and found that almost 13% had high scores on the FIB-4 index, a noninvasive tool used to estimate the level of liver scarring.
Jasmohan Bajaj, M.D., a gastroenterologist with the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health and the Richmond VA Medical Center, was a contributing author and corresponding author on the study. Dr. Bajaj emphasized the importance of using simple screening tools: "This important link between dementia and liver health emphasizes the importance of screening patients for potentially treatable contributors to cognitive decline."
The research strongly recommends that clinicians treating patients with dementia, even those without a prior cirrhosis diagnosis, should assess them for liver disease using tools like the FIB-4 index. Early detection of cirrhosis and subsequent treatment can readily rid the body of toxins, potentially reversing or halting the cognitive impairment and improving patients' lives. Dr. Bajaj added, "Early detection of liver issues... could help ensure that patients get access to targeted and appropriate therapies."
CARDIOVASCULAR, LIVER, CHRONIC DISEASE AND METABOLIC HEALTH
Celebrity endorsements can drive advocacy by fans, VCU researcher finds
Baobao Song, Ph.D., assistant professor in VCU’s Richard T. Robertson School of Media and Culture in the College of Humanities and Sciences, found that endorsements and advocacy campaigns from the South Korean boy band, BTS, and other celebrities could change fans’ advocacy behavior, or willingness to take action as well as change their behaviors.
Dr. Song’s research investigates how celebrity endorsements and corporate social responsibility efforts can be translated into real-world action by dedicated fanbases. She focused on the BTS ARMY, an international fandom known for its high level of engagement and activism. For example, ARMY members quickly matched BTS’s $1 million donation to Black Lives Matter in 2020. This unique attachment drives fans to participate, believing, “I want to see them succeed. I want the fandom to succeed.”
The study specifically assessed how BTS’s ongoing partnership with the United Nations on Sustainable Development Goals influenced fans’ intentions to engage in related volunteering and advocacy work. Dr. Song and co-author Minhee Choi, Ph.D., conducted interviews and surveyed 424 Gen Z and millennial U.S. adults who self-identified as BTS fans.
The survey results strongly supported the idea that celebrity advocacy shapes fans’ behavioral intentions. This effect is driven by three key factors: Interdependence between fans and the celebrity; the fans’ individual identification within the fandom; and the fandom’s norms and participatory culture.
These findings offer valuable insights for organizations seeking to partner with celebrities to advance social causes. Dr. Song advises that the partnership’s success hinges on whether the celebrity has a strong personal connection and high interdependence with their fanbase, making fans genuinely motivated to follow the celebrity’s lead in taking actual behavioral action to support the cause. This research demonstrates the considerable influence highly engaged fandoms can wield in promoting social change.
PEDAGOGY, LEARNING AND COMMUNITY ADVANCEMENT
Genetic code deploys cancer mafia, new targeted drug gives them an offer they can’t refuse
A group of scientists at VCU Massey Comprehensive Cancer Center have revealed a new genetic code that acts like a cancer ringleader, recruiting and deploying a gang of tumor cells to incite a biological turf war by invading healthy organs and overpowering the normal cells. This discovery could unveil an entirely different understanding of the origins of cancer within the body, as well as offer groundbreaking insight into new treatment strategies that could target the growth of tumors in their earliest stages.
The research, published in Nature Biotechnology, was co-authored by Esha Madan, Ph.D., and Rajan Gogna, Ph.D., both assistant professors in the VCU School of Medicine. Dr. Madan explained that cancer cells "gaslight the human body," altering the host cell's genome to lower its fitness, giving the cancer a distinct advantage. The key lies in a previously unknown protein, the Flower gene, which expresses itself as two fitness codes: Flower-Win and Flower-Lose. Cancer cells overexpress the Flower-Win code, signaling their dominance and effectively acting as a "local bully" to overpower normal cells, which typically express Flower-Lose.
The VCU team has already patented a targeted solution: a monoclonal antibody administered intravenously. This drug works by masking the expression of the Flower-Lose code on healthy cells, enabling the body to resist the invaders and continue its "neighborhood watchdog routine." This treatment has already shown effectiveness in models of ovarian cancer, significantly reducing tumor growth and improving survival.
Study co-author Robert A. Winn, M.D., director of Massey Comprehensive Cancer Center, noted that these findings could "forge the path for new treatments that are able to target tumors in the first, most curable stages of disease." The ultimate goal is to investigate the efficacy of this antibody in clinical trials, with the hope that the implications will be universal to treating all cancer types.
CANCER BIOLOGY, PREVENTION AND CARE
AI method can help brands save time and money in refining their advertising
A new method using artificial intelligence can help businesses save time and money in refining their advertising visuals, according to César Zamudio, Ph.D., associate professor in the VCU School of Business and a specialist in marketing analytics. Visual stimuli, such as color and size, are fundamental to marketing experiments that reveal how consumers think and behave. However, Zamudio notes, "for decades, researchers have struggled to create high-quality ad images for experiments – they either looked unprofessional or were too expensive to make.”
In a recent Journal of Advertising article, Zamudio and co-authors explored the use of image generative AI (iGenAI) for faster and less costly production of visual stimuli. They introduced RAISE (Rapid Artificial Intelligence Stimuli for Experiments), a new methodology that requires no programming and relies on commercially available tools. Zamudio stated that RAISE generates ad images quickly, cheaply, and at the same quality as traditionally created ads. Five studies involving nearly 1,800 participants confirmed this, showing participants could not differentiate between the AI-generated and researcher-generated stimuli.
This innovation could help small businesses level the playing field. "Instead of spending weeks and thousands of dollars on ad visuals, managers can use AI to generate high-quality drafts in minutes, allowing teams to focus on what truly matters — strategy, storytelling and brand-building," Zamudio said. For consumers, this could result in more relevant, personalized ads that closely match their interests. As AI becomes a more prominent tool, the researchers also addressed ethical concerns, proposing four AI safeguards within the RAISE methodology to ensure content remains transparent, fair and responsible.
FINANCE, MARKETING AND SUPPLY CHAIN MANAGEMENT
VCU students embrace the call of the wild
Two new environmental studies field courses at VCU are showcasing the power of hands-on learning, reflecting the mission of the university’s new School of Life Sciences and Sustainability. These experiential courses took students far from campus to focus on crucial environmental issues and build professional skills.
The Buffalo National River seminar was co-led by James Vonesh, Ph.D., a professor and assistant director in the Center for Environmental Studies. Dr. Vonesh emphasized the course’s role in developing “the next generation of river stewards” as part of the River Management Society’s River Studies and Leadership Certificate program. Students on this hybrid online / field trip traveled to the Buffalo National River in Arkansas, where they developed outdoor leadership skills, including canoeing, rafting and river safety, while collecting data to compare the health of the Buffalo River with rivers in their home regions. This work contributed to student posters presented at national symposiums.
The Wilderness and Wildlife course was taught by avian ecologists Lesley Bulluck, Ph.D., an associate professor in the Center for Environmental Studies, and Dan Albrecht-Malinger. This course’s objective was to combine student learning in three distinct areas: natural history, human history and outdoor adventure. During a five-day trip to the South Carolina low country, students spotted 92 species of birds and camped in diverse ecosystems, including coastal marsh and longleaf pine savannas, to gain a “much more powerful and meaningful experience ecologically.” Dr. Bulluck highlighted that camping and enduring challenges also led to significant team building and the development of resilience both in the students and as a reflection on the regional ecosystems.
Both courses highlight VCU’s commitment to creating a pipeline for students interested in careers with federal agencies, nonprofits and park services.
ENERGY, ENVIRONMENT AND SUSTAINABILITY
Richmond’s historic Pump House ‘works’ again, thanks to VCU and VR
Richmond’s historic Pump House, a defunct utility building and event space in Byrd Park, is now “working” again thanks to a multi-year collaboration between VCU students and the Friends of Pump House nonprofit, which used virtual reality to transport visitors to the building’s heyday.
Since 2021, students from VCU’s College of Engineering and School of the Arts have been instrumental in this effort. The collaboration began with a College of Engineering capstone team that modeled and animated the pumps and conducted extensive archival work to determine the original machinery in use between 1905 and 1924, preserving and uncovering significant details about Richmond’s engineering history. Subsequent capstone groups modeled the generators and steam engine, and developed the final VR application using the Unity program. John Leonard, Ph.D., a computer science professor and faculty advisor for the project, noted the collaboration offers students “the perfect focal point for sharing their newly acquired skills and expertise with the community.”
The immersive VR tour, which features the basement pump room with its cranking pistons and spinning turbines, as well as the second-floor ballroom, allows visitors to experience the Gothic Revival structure as it operated a century ago. This project not only brings the past alive for visitors but provides VCU students with invaluable real-world client experience and team-based professional work, translating academic skills into a tangible community resource. The VR effort supports the nonprofit’s larger goal of fully restoring the 1883 building for future use within the James River Park System.
ROBOTICS, MACHINE LEARNING AND VIRTUAL REALITY
The van Gogh masterpiece ‘The Starry Night’ is more art than science, researchers report
Alongside colleagues at the University of Washington, Mohamed Gad-el-Hak, Ph.D., the Inez Caudill Eminent Professor in VCU’s Department of Mechanical and Nuclear Engineering, published a report, “Is There Hidden Turbulence in Vincent van Gogh’s ‘The Starry Night’?, asserting that the painting’s captivating swirls do not follow the rules of f low physics, despite recent claims to the contrary.
The report, which appeared in the Journal of Turbulence, was a rebuttal to a prior paper in Physics of Fluids that received considerable attention for positing that the eddies in Van Gogh’s 1889 masterpiece adhere to Kolmogorov’s theory of turbulent flow. This theory, developed by 20thcentury mathematician Andrey Kolmogorov, primarily applies to the velocity field in fluid flows and was later extended by Obukhov and Corrsin to scalar fields like fluid density or temperature.
Dr. Gad-el-Hak studied the nuances of this theory under Stanley Corrsin. Dr. Gad-el-Hak’s objection stems from a foundational error in the earlier study’s application of the theory to the painting. As outlined in the report, the assumed atmospheric flow field does not meet the theory’s required assumptions.
The impact of the research is to correct a flawed scientific conclusion that was widely publicized, ensuring that Van Gogh’s “The Starry Night” is understood as a fascinating and iconic work of abstract art rather than a hidden, perfectly rendered scientific model of turbulence. The VCU-led findings conclude that the previous claim that the painting accurately reproduces the size, distance and intensity of real-world turbulent whirls is “totally flawed.”
ART, DESIGN, COMMUNICATION AND MEDIA
Chatbots, avatars and more: VCU researchers delve into AI’s potential in public health
VCU researchers, led by Sunny Jung Kim, Ph.D., assistant professor of social and behavioral sciences in the VCU School of Public Health, conducted a systematic review examining how AI-powered interactive technologies can enhance public health, specifically in cancer prevention and control as well as substance use. The findings, published in Translational Behavioral Medicine, highlight both the promise and the critical concerns associated with the use of AI-Mediated Communications (AIMC) such as chatbots and virtual agents.
The review found that interventions using AIMC showed promise in improving health behaviors like substance use recovery, physical activity and dietary habits, often with high retention rates. From the patient perspective, these technologies offer instant, personalized support and information, thereby breaking down barriers to care such as high costs, social isolation and stigma. Fully developed, evidence-based AI has the potential to revolutionize public health by providing personalized messaging, scalable outreach and real-time feedback, ultimately fostering health equity.
However, the study identified critical concerns regarding the use of AI in this context. The most significant is the need to ensure AIMC systems are trained with clinically valid and accurate health information, as incorrect or misleading responses could be harmful. Researchers must also prioritize privacy, data safety and confidentiality when handling sensitive information exchanged with AI agents. To ensure equitable access and better represent diverse populations, future research needs to implement recruitment strategies that address the finding that participants in earlier studies were predominantly female. Dr. Kim’s team is currently building on these findings by developing an evidence-based chatbot prototype to support cancer survivors, with plans for a longitudinal clinical trial.
MATERIAL SCIENCES AND ADVANCED MANUFACTURING
Pre-med student Zachary Hodgen is examining what worms can tell us about the aging process
The rising third-year student at Virginia Commonwealth University is double-majoring in biology and political science in the College of Humanities and Sciences. As part of his pre-med studies, Hodgen is spending part of the summer in a research lab at the University of Virginia School of Medicine, where he has trained his eye on worms that might offer insight into human biology.
Hodgen is focusing on C. Elegans worms. Though too small to be seen without magnification, they are excellent research subjects because they share many similarities with humans and mature rapidly, growing from egg to adult in just three days, which makes their maturation process easy to study. In the lab, Hodgen isolates the worms’ ribosomes, or small protein factories in cells, and examines them under an electron microscope to observe how they change appearance in young versus old worms. This ribosomal appearance closely mirrors how human ribosomes look at the same ages.
Hodgen, who is also an Emergency Medical Technician with the Staunton-Augusta Rescue Squad, received support from VCU’s Internship Funding Program for his summer experience. He admitted he initially thought research would not be “his cup of tea,” but the internship has solidified his path toward medicine by providing a crucial perspective. He has gained valuable insights into the “behind the scenes” of research and development that precedes new drugs and patient solutions.
The research experience has also helped him develop crucial skills like being more detail-oriented and a better problem-solver. For Hodgen, understanding research is like “understanding the first leg of the race in helping patients,” making him grateful for the wealth of knowledge this experience has provided to him as an aspiring doctor.
AGING AND QUALITY OF LIFE
VCU startup wins $800k grant to propel its infection-fighting surgical gel
VCU startup Pascal Medical Corp., co-founded by Barbara Boyan, Ph.D., the Alice T. and William H. Goodwin Jr. Professor of Biomedical Engineering and former Dean of the College of Engineering, has been awarded an $800,000 Virginia Catalyst grant to propel the development of its infection-fighting surgical gel. Dr. Boyan, who is a National Academy of Inventors fellow and a serial entrepreneur, emphasized the innovation’s potential, “we have an opportunity to change the way surgeries are done. That’s what makes this work so exciting.”
Pascal’s core innovation is “ClickGel,” an antibiotic releasing hydrogel based on the principles of “click chemistry,” which won the 2022 Nobel Prize. The material is injected during surgery, where its molecules quickly “snap” together to form a strong, fast-setting and highly adaptable sealant. This is particularly crucial for delicate procedures like brain and spinal surgery, where a surgeon may cut the dura, the protective tissue layer, and where infections are notoriously difficult to treat.
The hydrogel’s ability to conform to the surgical site, not interfere with healing and deliver antibiotics directly to the wound is a major advancement over traditional surgical sealants. The company is collaborating with Monique van Hoek, Ph.D., a microbiology professor at George Mason University, to test ClickGel’s potential against difficult pathogens like MRSA (methicillin-resistant Staphylococcus aureus).
The new Virginia Catalyst funding is a “gamechanger” that provides validation of Pascal’s commercialization plan and will allow the company to complete crucial studies needed for submission to the Food and Drug Administration to approve clinical trials. This effort exemplifies VCU College of Engineering’s “Engineering for Humanity” mission to translate lab innovations into products that directly improve patient outcomes.
MEDICAL DEVICES AND DRUG DEVELOPMENT
VCU team has designs on a game-changer in women’s cancer treatment
A transdisciplinary team at VCU is developing a game-changing radiation device for treating uterine and cervical cancers, highlighting a major step toward customizable women’s health care. The idea was sparked by Navid Fallahi, M.D., a fourth-year clinical resident at the VCU School of Medicine, who recognized that rigid, existing brachytherapy devices often fail to account for the anatomical variations in women, leading to suboptimal radiation delivery.
Brachytherapy is an internal treatment where a radioactive source is placed directly on or near the cancerous area, but current devices’ “one-size-fits-all” design can increase radiation exposure to healthy tissues. Fallahi, advised by Emma Fields, M.D., a professor and the radiation oncology residency program director at the School of Medicine and Massey Comprehensive Cancer Center, developed the concept for a steerable tandem applicator. This innovative device features a flexible, jointed design that can be adjusted to each patient’s anatomy, ensuring precise placement and minimizing impact on surrounding tissues.
The project quickly gained momentum thanks to support from VCU’s innovation ecosystem, including a Commercialization Fund award from VCU’s TechTransfer and Ventures office that allowed the team to begin prototyping. The ultimate goal is to obtain Food and Drug Administration clearance and commercialize the device, which has strong market potential among universities, clinics and large radiation oncology companies. As Brittaney Ritchie, a licensing manager at TechTransfer and Ventures, noted, this represents a “huge step in a positive direction for women’s health” by moving away from standardized treatments toward highly tailored care delivery.
CHILDREN’S AND WOMEN’S HEALTH AND WELLBEING