Digital Commons Network^™

Exploring Medication Adherence In Children: A Survey-Based Approach To Addressing Disparities And Improving Treatment Outcomes., Rajat Sharma, Phuongloan Hoang, Drew Mccanless, Seana-Pierre Williams, Mariam-Sere Diaby, Lauren Callaway, Jihui Diaz, Xinyu Wang, Yujin Kim

Research Day

INTRODUCTION

Medication Therapy Management (MTM) aims to boost medication adherence, primarily focusing on seniors covered by Medicare and Medicaid. However, vulnerable populations like children with medical complexity or disabilities on medication (MCDM) lack access to this service. Previous research using the NHIS database identified disparities in medication adherence rates across socioeconomic levels, education, and ethnicity among caregivers. To investigate if these disparities persist in our community, we're developing a survey to assess medication adherence rates in children with MCDM. We conducted a literature review to create a questionnaire analyzing the impact of MTM services on children with MCDM.

METHODS

From …

Chest Binding Alters Thoracic Anatomy In Transmasculine Youth, Julienne Ryland, Jeannel Miclat, Diana Peterson

Research Day

Introduction:

With the recent legislation restricting gender-affirming care for minors, more mechanical means of gender-confirming methods are being used as a substitute. For adolescent transmasculine people, this includes chest binding, designed to flatten breast tissue and give a more streamlined masculine appearance. Chest binding is a relatively inexpensive and widely available technique to affirm gender identity without the need for healthcare professional involvement. Although chest binders are recommended to be worn for less than 8 hours daily, transmasculine youth have been documented wearing their chest binders for upwards of 18-21 hours a day. This consistent pressure on their chest essentially …

The Effect Of State And Trait Anxiety On Pain-Pressure Threshold, Scott Lowe, Christian T. Hughey, Kathryn E. Downing, Breana L. Fair

Research Day

Background:

The global burden of persistent pain is substantial, affecting up to 30% of the world's population. Despite growing awareness, challenges persist with accurate pain measurement, limiting research and clinical efforts. One method to assess pain perception is the Pain-Pressure Threshold (PPT), indicating the pressure at which pain is reported. Anxiety, comprising state and trait anxiety, has been suggested as a potential influencer of PPT, yet its precise impact remains uncertain. State anxiety is defined as a "transient state of arousal subjectively experienced as anxiety" Trait anxiety is “an individual's tendency to appraise situations as threatening, avoid anxiety-provoking situations, and …

Impact Of Covid-19 On Food Insecurity And Subsequent Consequences In Post-Secondary Students In The United States: A Systematic Review With Meta Analysis, Meshora Suthanthira, Valerie Cadet

Research Day

Introduction

Food insecurity is a prevalent problem in the United States that affects the livelihoods of many individuals and families. Food security is defined as “a situation that exists when all people, at all times, have physical and social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy lifestyle.” (Committee on World Food Security (CFS), 2012). The purpose of this systematic review is to compare food insecurity and its effects on mental health, physical health, and academics, prior to the start of the pandemic and after stay-at-home …

Improving Site-Specific Sti Screening In A Philadelphia-Based Academic Family Medicine Office, Brittany Macdonald, Md, Marie Ezran, Md, Haley Smallwood, Md, Gisel Garcia, Md, Maia Mandel, Md, Amaka Amobi, Md, Marshal Miller, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• In the last decade, rates of sexually transmitted infections (STIs) are rising both in Philadelphia and across the United States^{1, 2}
• STIs are often asymptomatic³
• Site-specific screening for gonorrhea and chlamydia (GC/CT) infections may increase STI detection o Genitourinary (GU), pharyngeal, and rectal sites o GU is the most common site tested, but GU-only testing may lead to missed diagnoses⁴

The Road To Equity: A Look At Medical School Interview Scores, Priyanga Selvakumar, Bs, Anjali Upadhyaya, Bs, Ashley B. Zhang, Bs, Ms, Alix Masters, Md, Bernard Lopez, Md, Alisa Losasso, Md

Health Equity and Quality Improvement (HEQI) Summit

Introduction and Objectives

• African Americans and other racial minorities remain underrepresented in medicine (UIM)¹, as do LGBTQ+ individuals.²
• Lack of physician diversity likely contributes to and exacerbates existing healthcare disparities.³
• Addressing medical school admissions is an appropriate target to improve overall physician diversity as the U.S. medical school populations critically lacks diversity which further perpetuates the problem.
• Few studies have focused on the medical school interview process as a potential site of bias, and there are no studies to date discussing the bias that may stem from faculty interview reports.

Objective

To investigate the medical school …

Resumption Of Anti-Platelet/Anticoagulation Therapy Following Lumbar Spine Surgery, Stephanie Serva, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

• No current guideline or protocol for AC/AP resumption in neurosurgical spine patients at TJUH
• There is difficulty in providing consistent perioperative anticoagulation recommendations to patients, as there remains no widely accepted, definitive literature of evidence or guidelines (Louie et al, 2020)

Project Aims:

• To determine standardized protocol for resuming antiplatelet/anticoagulation therapy following lumbar surgery
• To reduce combined postoperative cardiac/cerebrovascular/thrombotic events, and post-operative hematomas

Identifying Inappropriate Dual Anti-Platelet Therapy (Dapt) Utilization In The Outpatient Setting, Youssef Elfatatry, Julia Palecki, Nevin Varghese, Amry Majeed, Alexis Wickersham

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

• Dual anti-platelet therapy (DAPT) is a cornerstone in management of many cardiovascular and cerebrovascular conditions; however, inappropriate and prolonged use can lead to increased bleeding risk. Despite guidelines on optimal DAPT duration for various clinical scenarios, a proportion of patients receive inappropriately extended courses of therapy, exposing them to unnecessary risk.

Project AIM:

• We aim to (1) identify inappropriate DAPT use using established clinical guidelines at two academic primary care clinics and (2) develop and implement a targeted best practice advisory (BPA) in EPIC to address gaps in adherence to DAPT guidelines to enhance patient safety and …

Health Outcomes Of Hispanic Clients In A Community-Based Medically Tailored Meal Program, Victor Diaz, Jule Anne Henstenberg, Adrian Crafford

Health Equity and Quality Improvement (HEQI) Summit

Introduction and Objectives

• The Philadelphia-based Metropolitan Area Neighborhood Nutrition Alliance (MANNA) is a community-based organization that home delivers medically tailored meals (MTM) to local residents with serious illness andnutritional risk.
• Previous research has shown that in the U.S., Hispanics bear a disproportionate burden of major pathologies such as kidney disease [1] and experience lower rates of healthcare utilization [2].
• The objective of this project is to describe health outcomes of 258 Hispanic clients (mean age 57, 50% women) enrolled in MANNA’s program for 3-6 months between 2020-2022.

Importance Of The Assessment Of Left Ventricular Function Following A Diagnosis Of Left Bundle Branch Block, Samuel Dyer, Bs, Benjamin Mass, Bs, Alyson Owen, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Left bundle branch block (LBBB) is a diagnosis often encountered in clinical practice.
• It can be seen as a harbinger of decreased left ventricular function in the future. LBBB has been associated with new onset congestive heart failure (CHF) and death from cardiovascular diseases.¹

Problem Statement

• LBBB in and of itself is given inadequate follow-up and attention by clinicians. Project AIM: bring to light the delay in follow-up after diagnosis of LBBB.

Limited Education And Training For Inpatient Nurses Caring For Pregnant Women With Opioid Use Disorder, Jaime Tsao, Bs, Stephen Didonato, Phd, Lpc, Abby Adamczyk, Mlis, Ahip, Meghan Gannon, Phd Msph

Health Equity and Quality Improvement (HEQI) Summit

Background

• The opioid epidemic continues as a public health emergency
• Pregnant women with OUD face multiple forms of marginalization and stigma based on the complex interplay of their various social identities
• OUD education and training among healthcare providers, particularly nurses, who are frontline clinicians in treating perinatal OUD, are lacking and leave the workforce unprepared and under-resourced to effectively support pregnant persons with OUD

Complications Following Hemivertebrectomy For Congenital Scoliosis, Sanjana Davuluri, Taemin Oh, Kyrillos Akhnoukh, Zachary Weingrad, Michael Lesgart, Terrence Ishmael, Joshua Pahys, Amer Samdani, Steven Hwang

Rowan-Virtua Research Day

Introduction:

Hemivertebrae are rare congenital anomalies that can cause severe scoliosis requiring surgical correction. We aimed to determine whether severity of deformities is associated with more long-term surgical complications following surgical correction.

Methods:

We performed a retrospective, single-institution review on patients who underwent hemivertebrectomy and spinal fusion for congenital scoliosis between 2008-2020. We extracted pertinent data on demographics, radiographic parameters, operative details, and complication rates. Subgroup analyses were also done by complication severity, deformity complexity, and construct length.

Results:

In our series, 30 patients underwent hemivertebrectomy and fusion. Mean age was 9±4.2 years and there was 2:1 male preponderance, with …

The Effect Of Covid-19 Pandemic On Sanitation Practices And Anxiety In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: Illness anxiety and fear of contracting coronavirus increased considerably during the COVID-19 pandemic. The media, being in lockdown, and cyberchondria had the largest impact on the population’s anxiety surrounding illness. While this kind of reaction to illness is expected during the pandemic, there is limited data on post-pandemic illness anxiety levels in the general population. Patients’ perception of disease impacts medicine at every level; medical professionals need to understand the concerns and fears of their patients in order to treat the post-pandemic patient. We hypothesized that sanitation practices and anxiety surrounding illness have not returned to baseline pre-COVID-19 …

Investigating The Factors That Lead To Sports Related Injuries In Children, Kinjal Shah, Shawna Rotoli

Rowan-Virtua Research Day

This project’s focus is to investigate if playing contact versus non-contact sports at a young age leads to more sports related injuries and to identify which factors correlate with increased injury rate in order to develop the most effective prevention and treatment methods. Data was collected through a survey including questions that delve deeper to quantify the amount of strain being put on the youth athlete’s body such as hours played a week, level of competitiveness, weeks played in a year, contact versus non-contact sport, and number of sports played. The following set of questions then addressed the actual injury …

Exploring The Connection Between Diabetes Distress And Diabulimia, Stephen Poos, Misha Faerovitch, Celeste Pinto, Nima Jamalkhani, Fahad Chaudhri, Satara Khan, David F. Lo, Kaitlin Mcgowan, Ashaki Martin, Don D. Shamilov

Rowan-Virtua Research Day

Diabulimia is a disordered eating behavior that involves an individual with type 1 DM withholding insulin injection to lose weight. Diabetes distress, a term used to describe the psychological stress associated with managing diabetes, is believed to be the cause of this condition. This review aims to assess whether individuals with diabulimia have measurable evidence of diabetes distress. Studies that described patients qualitative experiences with Diabulimia were matched and compared to the criteria in the Diabetes Distress Scale. Over 40 of the 185 individuals across twelve studies were found to meet one or more criteria from the Diabetes Distress Scale. …

Gut Microbiome And Nutrition Interplay In Regulating And Improving Autism Spectrum Disorder Related Social Symptoms, Irenonsen Juliet Eigbe, Christian Moya Gamboa, Jana Gjini, Jaydeep Mukherjee, Susrut Dube

Rowan-Virtua Research Day

The composition of the gut microbiome has been shown to play a role in the onset of neurological disorders, including Autism Spectrum Disorder(ASD). A small variety of recent research articles identify a possible link between onset and severity of ASD related behaviors and the composition of the gut microbiome. The purpose of this review is to identify gaps in the current understanding of the role that nutrition plays in changing the gut microbiome and subsequently altering the onset and severity of behavioral phenotypes in children with ASD. Inclusion criteria comprises peer-reviewed publications relating to children with autism. Exclusion criteria consists …

Insurance Status And Its Effect On Mothers With Postpartum Depression In The United States, Sanjana Davuluri, Lillian J. Alonzo, Nikita Paranjape, Akshad Thirugnanam, Alexander Youssef

Rowan-Virtua Research Day

Postpartum depression (PPD) is a significant health issue in the US today: 1 in 8 new mothers experience symptoms of PPD. Understanding how social determinants of health impact the short and long-term health outcomes of patients with PPD is key to providing interventions that are effective, efficient, equitable, and patient-centered. In this literature review, we aimed to shed light on the association between discrepancies in health outcomes of mothers with PPD and their insurance status. A search was conducted across PubMed and ProQuest Central databases focusing on literature from 2014 onwards. Studies that explored factors contributing to PPD, the impact …

Improving Primary And Gynecological Care In Transmasculine Patients, Alison N. Mautner, Joanna Petrides

Rowan-Virtua Research Day

Introduction: This study aimed to assess the healthcare experiences of transmasculine individuals in primary and gynecological care settings. An online, anonymous survey was conducted to gather insights into positive and adverse encounters, factors influencing care-seeking behaviors, and strategies for improving care delivery in this population.

Methods: A survey was administered between June 1st and July 23rd, 2023, recruiting participants from three LGBTQ+ affirming healthcare offices in South Jersey and via Reddit. Data analysis involved SPSS to gain information from 499 valid responses.

Results: The majority of participants (55%) were aged 18-24, with 51% identifying as transgender men. Over two-thirds (68.5%) …

Spontaneous Intracranial Hemorrhage In A 29-Year-Old Male: A Case Report, Md Fateha, Caroline Nguyen, Michael A. Morris

Rowan-Virtua Research Day

Spontaneous intracranial hemorrhage is rare, especially in a young patient population. Signs and symptoms of intracranial hemorrhage include facial droop, vision loss, motor deficits with extraocular movements, deficits with tongue movement, weakness in the arms or legs, sensation loss, and mental status change. This is a case report of a 29-year-old male with no past medical history who presented for a spontaneous intracranial hemorrhage. This patient's only neurologic deficit was the loss of visual field on the left inferior quadrant of his field of vision. The patient obtained a CT head non-contrast which showed 21 mm acute right occipital hemorrhage …

Association Between Cultural Factors And Postpartum Depression, Usha Modukuru

Rowan-Virtua Research Day

Postpartum depression (PPD) is present in 17.22% of the world population. The negative physical and psychological impacts of PPD impact not only the mother, but also those around her. This raises the importance of identifying factors contributing to its onset. Studies have shown that PPD prevalence rates vary between non-Western and Western regions of the world. Cultural postpartum practices differed significantly region to region. Search terms including postpartum depression and cultures were used to find peer-reviewed articles, primary surveys, and patient interviews between 2013-2023. Qualitative analyses were performed on the results. Ethnokinship cultures, commonly present in non-Western countries, prioritized social …

Accessibility To Gender Affirming Treatments For Transgender Patients In New Jersey, Tara Young, Tara Pellegrino

Rowan-Virtua Research Day

Background: The literature clearly indicates that gender affirming treatments, such as gender reassignment surgery, counseling, exogenous hormones, and feminization/masculinization surgery, are highly effective and beneficial for transgender patients.

Purpose: The purpose of this review was to assess the barriers to accessing gender affirming treatments in New Jersey.

Methods: This review utilized the PubMed database and Google searches to gather information. The search terms included LGBTQ healthcare, LGBTQ Medicaid, transgender treatment, transgender healthcare, top surgery New Jersey, New Jersey Medicare and Medicaid, and transgender Health Insurance in New Jersey.

Results: New Jersey State Medicaid covers both gender affirming surgery and …

The Correlation Of Consistent Exercise With Depressive Symptoms, John Gericke, Tara Pellegrino, Robert Steer

Rowan-Virtua Research Day

Background: Depression is a major health issue that affects an estimated 350 million people worldwide. Typically, depression is associated with individuals who follow a poor diet and are physically inactive. Exercise is one form of treatment for depression and has been shown to reduce the risk of depression and protect against the onset of depression. The PHQ-9 Depression Score is a tool used to screen individuals for depression on a scale from 0-27. The goal of this study is to identify a relationship between consistent exercise and depression symptoms.

Methods: An original Qualtrics survey was created to be distributed with …

Effects Of Exercise On The Cardiovascular Health Of Adolescents And Young Adults With Down Syndrome, Samarth Gupta

Rowan-Virtua Research Day

Introduction: It is known that the incidence of Down Syndrome has increased over time and that this condition is associated with congenital heart defects, lower cardiorespiratory capacity, and increased rates of obesity and type 2 diabetes. It has been shown that individuals who have congenital heart defects but not Down Syndrome have increased cardiorespiratory function after engaging in exercise. Unfortunately, the role of exercise in improving cardiovascular health outcomes among individuals with DS is not yet fully understood.

Results: Exercise has been found to improve several health outcomes among individuals with Down Syndrome. For example, moderate to vigorous treadmill exercises …

Sex Differences In Outcomes Among Patients Undergoing Thoracic Endovascular Aortic Repair (Tevar) Procedure: A Retrospective Cohort Study, Dakota B. Pastore, Tony Elias, Rafail Beshai, Kyrillos Girgis, Maziyar Daneshvar, Keith Anacker

Rowan-Virtua Research Day

Introduction: There is limited data about sex differences in patients undergoing a thoracic endovascular aortic repair (TEVAR) procedure. This study sought to examine the national inpatient sample (NIS) database to describe in-hospital outcomes by gender.

Methods: The NIS was searched for hospitalizations of adult patients who underwent TEVAR in 2019 and 2020. For this cohort, female patients were identified, and pregnant patients were excluded. The primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS), and total hospital charges (TOTHCG).

Results: This study included 696 patients who underwent TEVAR. 255 (36.6%) females were identified, of which, 7 …

Factors Affecting Caregiver Burden In Informal Caregivers Of Patients With Autism Spectrum Disorder, Brian Joseph Mathew, Maduka Gunasinghe, Usmaan Al-Shehab, Samrat Gollapudi, Prince Patel, Maithri Goud

Rowan-Virtua Research Day

Individuals with Autism Spectrum Disorder (ASD) often require lifelong care to meet their daily needs, which is typically provided by informal sources like family members as well as formal caregivers from home health agencies. The persistent stress of raising a child with ASD can potentially lead to parental burnout, highlighting the importance of understanding the struggles faced by these caregivers. Clinicians must prioritize the well-being of both the individuals with ASD and their dedicated caregivers by gaining a comprehensive understanding of the challenges they encounter.

Our research aims to investigate and comprehend the specific challenges faced by caregivers of individuals …

Opioid Prescription Rates Before And After Alto Program And Various Factors Affecting Emergency Department Opioid Prescription Rates, Neel B. Patel, James F. Baird

Rowan-Virtua Research Day

Opioid prescription rates vary between patient population, diagnosis, location, and emergency department characteristics. High prescription rates offer an avenue for potential opioid addiction and overdoses. Alternatives to opioids (ALTO) is a new program already implemented in certain emergency departments to help change opioid prescription rates by introducing new protocols for first line treatments for pain management. With current trends still showing that South Jersey opioids prescription rates are the highest in the state of New Jersey, ALTO was introduced at Inspira Health Network located in South Jersey. This study retrospectively analyzed opioids prescription rates for abdominal pain, renal colic, migraines, …

Facial Skincare Routine Adherence In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: The COVID-19 pandemic sparked an interest in skincare with the closure of spas and salons. “Skincare”, one of the most popular dermatology related hashtags on TikTok in July 2020 received 378 million views. The American Academy of Dermatology (AAD) has shared facial cleansing recommendations; however, it is unclear how many people follow them. Studies have shown a good daily facial cleansing and moisturizing routine can increase microbiome diversity and skin hydration. This can be beneficial in conditions like psoriasis, eczema, and acne.

Purpose: The aim of the study is to assess how well people follow the AAD …

Colorblind Racial Attitudes And Emotion Dysregulation: Impact On White People’S Ethnocultural Empathy And Feelings Towards People Of Color, Vanessa L. Veltre, Alissa Hochman

Rowan-Virtua Research Day

Colorblind racial attitudes, which minimize the importance of race, have been identified as a barrier to understanding systemic racism and fostering empathy towards people of color (POC). This study aimed to examine the relationship between emotion dysregulation and White people's ethnocultural empathy and warmth towards people of color, and to explore the potential moderating role of colorblind racial attitudes.

The study utilized data from 511 White participants (ages 19-50) who completed the Difficulties in Emotion Regulation Scale (DERS), Colorblind Racial Attitudes Scale (CoBRAS), Scale of Ethnocultural Empathy (SEE), and a feeling thermometer scale measuring warmth towards POC. Participants were categorized …

Relationship Between Caregiver Burden And Socioeconomic Status, Nikitha Pappachen, Maithri Goud

Rowan-Virtua Research Day

In this study, caregiver burden measures the psychosocial strain a caregiver experiences as a result of caring for a person with autism. In addition, this study focuses on the effect of socioeconomic status on caregiver burden. A previous study found an association between lower primary caregiver education level and more sleep problems for children with autism³. Thus, the finding focuses on the child with autism as opposed to the caregiver burden. Other studies focus on elements that affect caregiver burden such as sleep quality, mental health, and cultural aspects. If it is known that socioeconomic status significantly affects …

Analyses Of The Correlation Of Hpv Vaccination And Oropharyngeal Cancer/Lesion In Men: From Allofus Research Database, Anna M. Terzian, Ahmad B. Cader, Qian Chen

Research Day

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. It is most well-known as the leading cause of cervical cancer. However, there is a rising prevalence of HPV-related oropharyngeal cancers, particularly in men from high-income countries. Therefore, it is urgent to advocate prevention. This study aims to understand the correlation between the HPV vaccination and reduced HPV-related oropharyngeal cancer development. Additionally, many factors, such as race, income, risky sexual behavior, smoking, and recreational drugs are worth analyzing to appreciate their role in cancer development. This study was conducted using the AllofUs research database. The keywords included …