Digital Commons Network^™

Interprofessional Curriculum Delivery: Experience Of A Primary Care Education Program, Jessica A Davila, Nancy D Harada, Kathryn Wirtz Rugen, Stuart C Gilman, Shubhada Sansgiry

Faculty, Staff and Students Publications

Few post-graduate training programs offer a comprehensive curriculum that includes structured clinical experiences to teach interprofessional care. To address this need, the United States Department of Veterans Affairs, Office of Academic Affiliations funded the Centers of Excellence in Primary Care Education (CoEPCE) from 2011-2019 to provide interprofessional curricula for health profession trainees (HPTs), including physician residents, nurse practitioner residents, pharmacy residents, and psychology residents. We examined changes over time in curricular domains, system impacts, and program practices based on HPT survey data and the qualitative evaluation of narrative feedback. An annual survey was administered to participants. Indirect standardized ratios were …

Mortality In Medicine, Maren Dougherty

Honors Projects

Practitioners in the medical field attend to health issues across one’s lifespan from birth to death and everything in between. A common conflict in today’s practice of medicine is establishing the true function of medicine. The complete reliance on medicine to ward off death proliferates the biomedicalization of natural life processes, like death. Biomedicalization is the process in which medical authority and its accompanying technology begin to control other aspects of daily life. With medicine’s ultimate goal being to cure disease and fight death, it interferes with the inevitability of human mortality. End-of-life treatment can be taken too far without …

Cognitive Control In Health And Disease: A Dynamic Approach To Mapping Oscillatory Activity Across The Lifespan, Mikki Schantell

Theses & Dissertations

Cognitive control is critical for flexibly adapting goal-directed behaviors to meet the demands of dynamically changing environments. The neural oscillatory dynamics serving cognitive control undergo changes across the lifespan, both in health and disease, with impairments in cognitive control functions being broadly implicated across a multitude of psychiatric disorders. Despite this, the trajectory of the population-level neural oscillatory dynamics supporting cognitive control across the lifespan remain poorly characterized, presenting challenges in fully understanding perturbations to these systems relative to one’s stage in neuronal maturation. Herein, we used the Eriksen flanker task during magnetoencephalographic (MEG) recording to map the neural oscillatory …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

From Survivors To Care Providers: A Multi-Dimensional Study On Physical Activity In Cancer Care, Gaurav Kumar

Theses & Dissertations

As the population of cancer survivors grows, understanding the dynamics of physical activity (PA) engagement is critical due to its potential benefits in reducing adverse health outcomes and mortality associated with cancer. Despite known benefits, both adherence to and promotion of PA among cancer survivors face significant challenges. This comprehensive study examines PA levels, barriers, facilitators, and perceptions among cancer survivors and oncology care providers over a ten-year period. The objectives are to assess adherence levels to PA among cancer survivors, explore the perceived barriers and facilitators to PA engagement from the survivors' perspectives, and understand the barriers, facilitators, and …

Virtual Support For Bereaved Parents: Acceptability, Feasibility, And Preliminary Efficacy Of Hope Group, Emma Archer, Bs, Amelia Hayes, Mpg Ccls, Kristin Drouin, Lcsw, Elissa G. Millier, Md, Aimee Hildenbrand, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

• Bereaved parents demonstrate increased risk for long-term psychological problems and poorer overall quality of life. Bereavement support programs can promote improved coping and are positively received by parents but remain underutilized.
• Virtual programs may help address barriers to accessing bereavement resources, such as families’ physical distance to the hospital and trauma reactions when exposed to a setting where the child received care.
• The objective of this quality improvement study is to examine caregivers’ bereavement experiences and perspectives on HOPE Group, a virtual group program for bereaved caregivers administered by the palliative care team at Nemours Children's Hospital, Delaware.

The Utility Of The Pap Nap For Increasing Patient Utilization Of Positive Airway Pressure Therapy, Erin Creighton, Md, Nicole Molin, Md, Dimitri Markov, Md, Ritu Grewal, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

• An estimated 9-38% of adults have obstructive sleep apnea (OSA), and about 80% is undiagnosed.
• OSA has been linked to excessive sleepiness, neurocognitive impairments, reduced quality of life, diabetes, heart disease, stroke, hypertension, and motor vehicle and workplace accidents
• Approximately85% of people with diagnosed OSA receive PAP and only 35-60% remain compliant long term
• Many factors impact CPAP use: disease and patient characteristics, titration procedures, device factors, side effects, psychological and social factors

Project AIM: Evaluate whether a daytime, abbreviated cardio-respiratory sleep study (AKA the PAP NAP -developed to help improve adherence in patients with OSA and …

Knowledge And Receptiveness Of Epidural Labor Analgesia By Parturients At Two Teaching Hospitals In Rwanda: A Cross-Sectional Study, Casey Fishman, Ba, Justin Do, Bs, Richita Bashyal, Mph, Fidele Hakorimana, Md

Health Equity and Quality Improvement (HEQI) Summit

Introduction

• Pain during labor can result in lasting psychological and physiological effects.¹ Although epidural analgesia is a first line pain management treatment and is used to reduce birth complications in many western countries, it is not commonly used in much of the world including Rwanda. The literature shows that African women have some of the lowest rates of pharmacological pain relief usage.
• Barriers to accessibility include; availability of equipment, staff with sufficient skills and monitoring, or myths and controversies surrounding labor.² Studies have found that some women believe that crying is a sign of weakness.³
• The aim …

Finding Ways To Decrease The Number Of Pediatric Type 1 Diabetes Patients With A Hba1c Over 8.5%, Abigayle Hoover, Bs, Ashley Medina, Dhsc, Kimberly Shoe Moyer, Apm, Evan G. Graber, Do, Patrick C. Hanley. Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

Hemoglobin A1c is the standard of care for monitoring the metabolic control of patients with Type 1 Diabetes.¹ Patients should have HbA1c checked every 3 months.

Higher HbA1cs are linked to higher morbidity and mortality in patients with diabetes.²

Project AIM:

Develop, implement, and evaluate different methods to engage patients with an

Implementation Of Pediatric Behavioral And Developmental Health Screening Tools At Student-Run Free Clinics In Philadelphia Shelters, Renee Li, Jasmine Miller, Martin Henry, Do, Bob Motley, Md, David Beckmann, Md, Mph

Health Equity and Quality Improvement (HEQI) Summit

Background & Project Aims

• Children experiencing homelessness (CEH) are at increased risk for behavioral health problems: 78% show behavioral problems, academic delays, or depression.¹

• Recent research suggests an increased prevalence of Autism Spectrum Disorder (ASD) among people experiencing homelessness.^2,3

• Psychosocial challenges are exacerbated by limited access to behavioral health and developmental disability screening, which is essential for early intervention.^4-6

• Recent studies have found that behavioral health screening in shelters is feasible, can generate a large number of referrals, and can be carried out by a student-run clinic without significantly disrupting workflow.^7,8

The Tensegrity Curriculum: A Comprehensive Curricular Structure Supporting Cultural Humility In Undergraduate Medical Education., Anne C Jones, Kristin N Bertsch, Deborah Williams, Millicent King Channell

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Due to growing health disparities in underserved communities, a comprehensive approach is needed to train physicians to work effectively with patients who have cultures and belief systems different from their own. To address these complex healthcare inequities, Rowan-Virtua SOM implemented a new curriculum, The Tensegrity Curriculum, designed to expand beyond just teaching skills of cultural competence to include trainees' exploration of cultural humility. The hypothesis is that this component of the curriculum will mitigate health inequity by training physicians to recognize and interrupt the bias within themselves and within systems. Early outcomes of this curricular renewal process reveal increased student …

Risk Of Meningomyelocele Mediated By The Common 22q112 Deletion, Keng Ioi Vong, Sangmoon Lee, Kit Sing Au, T Blaine Crowley, Valeria Capra, Jeremiah Martino, Meade Haller, Camila Araújo, Hélio R Machado, Renee George, Bryn Gerding, Kiely N James, Valentina Stanley, Nan Jiang, Kameron Alu, Naomi Meave, Anna S Nidhiry, Fiza Jiwani, Isaac Tang, Ashna Nisal, Ishani Jhamb, Arzoo Patel, Aakash Patel, Jennifer Mcevoy-Venneri, Chelsea Barrows, Celina Shen, Yoo-Jin Ha, Robyn Howarth, Madison Strain, Allison Elizabeth Ashley-Koch, Matloob Azam, Sara Mumtaz, Gyang Markus Bot, Richard H Finnell, Zoha Kibar, Ahmed I Marwan, Gia Melikishvili, Hal S Meltzer, Osvaldo M Mutchinick, David A Stevenson, Henry J Mroczkowski, Betsy Ostrander, Erica Schindewolf, Julie Moldenhauer, Elaine H Zackai, Beverly S Emanuel, Sixto Garcia-Minaur, Beata A Nowakowska, Roger E Stevenson, Maha S Zaki, Hope Northrup, Hanna K Mcnamara, Kimberly A Aldinger, Ian G Phelps, Mei Deng, Ian A Glass, Bernice Morrow, Donna M Mcdonald-Mcginn, Simone Sanna-Cherchi, Dolores J Lamb, Joseph G Gleeson

Faculty, Staff and Student Publications

Meningomyelocele is one of the most severe forms of neural tube defects (NTDs) and the most frequent structural birth defect of the central nervous system. We assembled the Spina Bifida Sequencing Consortium to identify causes. Exome and genome sequencing of 715 parent-offspring trios identified six patients with chromosomal 22q11.2 deletions, suggesting a 23-fold increased risk compared with the general population. Furthermore, analysis of a separate 22q11.2 deletion cohort suggested a 12- to 15-fold increased NTD risk of meningomyelocele. The loss of

Autologous Bone Marrow Mononuclear Cells To Treat Severe Traumatic Brain Injury In Children, Charles S Cox, David M Notrica, Jenifer Juranek, Jeffrey H Miller, Fabio Triolo, Steven Kosmach, Sean I Savitz, P David Adelson, Claudia Pedroza, Scott D Olson, Michael C Scott, Akshita Kumar, Benjamin M Aertker, Henry W Caplan, Margaret L Jackson, Brijesh S Gill, Robert A Hetz, Michael S Lavoie, Linda Ewing-Cobbs

Faculty, Staff and Student Publications

Autologous bone marrow mononuclear cells (BMMNCs) infused after severe traumatic brain injury have shown promise for treating the injury. We evaluated their impact in children, particularly their hypothesized ability to preserve the blood–brain barrier and diminish neuroinflammation, leading to structural CNS preservation with improved outcomes.

We performed a randomized, double-blind, placebo-sham-controlled Bayesian dose-escalation clinical trial at two children's hospitals in Houston, TX and Phoenix, AZ, USA (NCT01851083). Patients 5–17 years of age with severe traumatic brain injury (Glasgow Coma Scale score ≤ 8) were randomized to BMMNC or placebo (3:2). Bone marrow harvest, cell isolation and infusion were …

Unplanned Pregnancy As An Independent Risk Factor For Antepartum Si In A Post Roe Vs. Wade World, Rianna Mcnamee

Rowan-Virtua Research Day

Abstract: The objective of this literature review is to determine whether unplanned pregnancy is an independent risk factor for developing antepartum SI. Background: The Supreme Court of the United States of America recently ruled that the constitution of the United States does not confer a right to abortion to its citizens. As of October 2023, twenty-one states had developed full or partial bans on abortion, resulting in millions of Americans residing in areas where terminating unplanned pregnancy is not a viable option. There is evidence that indicates antepartum suicidal ideation (SI) is higher than that of the general population, however …

Evaluating The Effectiveness Of A School-Based Cognitive Behavioral Youth Depression Prevention Program In Improving Life Satisfaction, Roshani Patel, Steven M. Brunwasser, Alissa Hochman

Rowan-Virtua Research Day

Depression is the leading cause of disability worldwide, known as the global burden of disease. Incident cases from 1990 to 2017 have increased by 49.86%. Additionally, rates have been seen to dramatically rise in adolescents aged 18-25 (17%) compared to rates in individuals aged 10-14 (1.1%). This makes it beneficial to have prevention programs for middle school aged children. The Penn Resiliency Program (PRP) is a youth depression prevention program focused on cultivating healthy thinking styles and behavioral coping skills. In our study, we used archival data from a randomized control trial of PRP to evaluate whether the program led …

Impact Of Diabetic Education On Reducing Hospital Readmission Rates: A Literature Review Of Adults With Diabetes, Frank Camarda

Rowan-Virtua Research Day

According to 2018 data from the Diabetes Institute Foundation, adults in the U.S. diagnosed with diabetes accounted for 17 million emergency department visits. The readmission rate for patients with diabetes far exceeds the general readmission rates for hospitalized patients. While there is recognition of the need for diabetic education to reduce hospital readmissions, optimizing long-term self-management of diabetics remains a focus of ongoing research.

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 …

A Rare Intervention: Perimortem Hysterotomy In An Obstetric Emergency In A 32-Year-Old Female, Alec Mirchandani

Rowan-Virtua Research Day

In the realm of obstetric emergencies, perimortem hysterotomy stands as a rare but crucial intervention, employed in dire circumstances to salvage both maternal and fetal lives. This procedure, involving the surgical delivery of a fetus from a mother in cardiac arrest, presents a unique set of challenges and ethical considerations for healthcare providers. This case report delves into the intricate details surrounding a perimortem hysterotomy performed under emergent conditions, exploring the clinical decision-making process, procedural intricacies, and outcomes. Through this narrative, we aim to shed light on the complexities of managing obstetric emergencies, emphasizing the critical role of timely intervention …

Standardization Of Discharge Instructions For Mild Traumatic Brain Injury/Concussion In Children Presenting To Ed: A Qi Project, Niralee K. Rana, Nicole Gerber, Michael Alfonzo, Snezana Osorio, Deborah Levine

Rowan-Virtua Research Day

Background: Mild traumatic brain injuries (mTBI) or concussions account for high rates of emergency department (ED) visits. Concussion diagnoses are used less often in young children leading to a variability in parental education and discharge instructions. Lack of discharge guidance may increase parental anxiety, impact recovery, and increase ED visits.

Objectives: To increase the proportion of ED patients discharged with age-appropriate instructions for mTBI by 50% by June 1, 2024, and to determine the impact age-appropriate instructions have on decreasing parental anxiety.

Methods: This observational time series with planned sequential experimentation is in progress at a Pediatric ED affiliated 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 …

Over The Counter Overdose: A Case Of Tylenol Toxicity, Swet M. Patel, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 51-year-old man presenting to the Emergency Department (ED) with suicidal ideations (SI) endorsing an intentional overdose of acetaminophen. Just as important is the clinical presentation; it is equally important to obtain a detailed history of patient's presentation leading to the ED visit when evaluating a suicide attempt. Tylenol (acetaminophen) is a common over the counter (OTC) medication available to the public. Management of Tylenol overdose follows a standard outline of things to observe and intervene on. In this case, we discuss how Tylenol overdose is managed in a clinical setting through a patient who …

Interactive Distraction Techniques Versus Midazolam In Anxiolysis In Pediatric Patients: A Systematic Review And Meta-Analysis, Uzay Cagatay, Jon Elias, Alexander King

Rowan-Virtua Research Day

Background: Many pediatric patients experience high levels of anxiety prior to undergoing surgery. Midazolam is currently one of the most commonly used sedative drugs in the pediatric preoperative environment. A number of studies have evaluated the use of non-pharmacological methods of relaxing pediatric patients prior to surgery, known as ‘Interactive Distraction’. These techniques involve using various methods of distracting the child from the preoperative anesthetic procedures. Some examples of these methods involve giving the patient an iPad with which they can play video games. There have yet to be any systematic reviews comparing the usage of Midazolam alone against utilizing …

Investigation Of The Utility Of A Ptsd Coaching Mobile App To Address Mental Health Services Demand In A Primary Care Clinic: Analysis Of Caps-5 Measures, Sindhura Nemani, Danielle Rae Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

The COVID-19 pandemic affected countless people globally, resulting in a greater need for mental health professionals and resources¹. The demand for mental health care is soaring yet the limitation of resources has strained the healthcare system, making it challenging to help patients in a timely manner². This poster represents a snapshot of a larger project that is striving to investigate an intervention to help bridge the gap between patient need and prompt referral through a warm handoff approach and use of the PTSD Coach mobile application as well as exploring patients’ satisfaction^3,4,5,6,8,9. In this …

Using Fmri To Assess Effectiveness Of Olanzapine Treatment For Schizophrenia, William Kyle Copenhaver, David F. Lo, Hanna Rothenberg, Eeshan Khurana, Valerie Rome, Uzayr Wasif, Don D. Shamilov

Rowan-Virtua Research Day

Schizophrenia is a complex mental illness with neurobiological underpinnings and misconceptions about violence. Schizophrenia is associated with high levels of creativity and structural traits like fewer D2 receptors. Patients face reduced life expectancy due to cardiovascular diseases and cope through smoking and sedentariness. Treatment involves pharmacological antipsychotics like olanzapine and nonpharmacological approaches. Olanzapine works by antagonizing D2 receptors but has side effects like weight gain and diabetes risk. fMRI is used to study treatment mechanisms and predict response, but research on olanzapine's brain network effects is limited.

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …

The Efficacy Of Baricitinib As A Treatment Option For Alopecia, In Terms Of Promoting Hair Regrowth And Improving Patient Reported Outcomes, Bhaumik Patel, Abhiram Gollapudi, Samrat Gollapudi, Srinidhi Banala, Brian Joseph Mathew, Prince Patel

Rowan-Virtua Research Day

Background: Alopecia, an autoimmune condition characterized by hair loss, significantly impacts millions globally, often leading to psychological distress such as anxiety and depression. Current treatments are variably effective and frequently associated with adverse effects that restrict long-term use. This study evaluates the efficacy of Baricitinib, a Janus Kinase inhibitor, in treating severe alopecia, focusing on hair regrowth and patient-reported outcomes.

Methods: This research synthesized data from recent publications (2018-2023) including clinical trials, reviews, meta-analyses, and systematic reviews, sourced from databases such as PubMed, Springer, and Elsevier. The inclusion criteria focused on recent studies in English evaluating Baricitinib's effectiveness in severe …

Interprofessional Team Collaboration To Study Integrated Behavioral Health Services In Primary Care, Priya Srivastava, Sindhura Nemani, Danielle Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

• In Rowan Family Medicine (Sewell, NJ), an interprofessional team of medical and clinical psychology professionals and trainees collaborate to investigate the integration of behavioral health in patients’ primary care visits.

• We screen patients for PTSD symptoms using the DSM CAPS-5 during their primary care visits

• The PTSD Coach app is then encouraged to use 3x a day

• By making mental health care more accessible to patients, we strive to help meet the increased demand and alleviate the strain our healthcare system is currently experiencing.

• The team composed of Medicine and Clinical Psychology allows students to gain invaluable experience in interdisciplinary …

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Determinants Of Vaccine Hesitancy Among Parents And Caregivers, Priya Srivastava

Rowan-Virtua Research Day

•Vaccination efforts in the United States and globally are one of the largest contributors to pediatric preventative health

•Routine immunizations in the U.S for children ≤ 10 years old cover 14 vaccine-preventable diseases. As a result, an estimated 732,000 deaths, 21 million hospitalizations, and 322 diagnosed cases of diseases have been prevented between 1993 and 2013.

•Vaccines remain a point of contention with pediatricians and their patients' caregivers

•Many parents maintain hesitancy to give vaccines; to a number of reasons. Perceived risk and fear of side effects from vaccines more than the disease itself, can cause out-of-proportion concern

•Misinformation spread …

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 …

Efficacy Of Psilocybin In The Treatment Of Substance And Alcohol Use Disorders, Hanna Brancaccio

Rowan-Virtua Research Day

Introduction: Substance use disorder (SUD) and alcohol use disorder (AUD) are major public health crises, affecting millions of Americans. Current treatment options include behavioral therapies and medications. In this review, we explored psilocybin’s efficacy in treating SUD and AUD.

Methods: Key terms were used to search databases to identify articles that addressed psilocybin in the treatment of SUD. Included in the review were indexed, peer-reviewed, primary sources that were published within the last 10 years. Excluded studies were non-peer reviewed, not relevant to the thesis, and did not have an English translation.

Results: The psychodynamic antidepressant effects of psilocybin mark …