Primary Care Commons^™

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Prediction Of Lung Vital Capacity Value From Thoracoabdominal Expansion In Young Adults, Aung Myo Htun, Aung Aung Nwe, Chatchaya Jaimanee, Thiwaphon Chatprem, Saowanee Nakmaroeng, Chatchai Phimphasak

Journal of Health Research

Background: Vital capacity (VC) is a fundamental indicator of pulmonary health, but its routine assessment often depends on spirometry devices that may be unavailable (i.e. because of access, cost) in many clinical or community settings. In contrast, lower costal (LC) and upper abdominal (AB) expansions are simple, equipment-free methods commonly used in physiotherapy.

Method: This cross-sectional study was aimed at developing prediction equations for VC using LC or upper AB expansion alongside demographic and anthropometric variables. The study involved 116 healthy nonsmokers (53 male and 63 female individuals) aged 18–39 years. VC was measured via spirometry using a …

Comparing Lower Extremity Kinematics Using Trazer And Inertial Motion Capture Systems, Gabriella Juoza-Clark Spt, Joellen Carter Spt, Nikki Stam Spt, Kevin Robinson Pt, Dsc, Ocs

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: This study assessed the validity of a non-immersive body motion tracking system (TRAZER) as an alternative to using Inertial Measurement Units (IMU)-based motion capture (MyoMotion) for lower extremity kinematic analysis. Methods: Twenty healthy participants (10 females, 10 males) with a mean age of 24.03 years (range: 20-33 years) and a mean BMI of 25.15 kg/m² (range: 18.45-32.23 kg/m²) performed double and single-leg squats. Data Analysis: Kinematic data from TRAZER and MyoMotion IMUs were compared using a mixed two-way ANOVA. Results: No significant differences were observed in knee flexion data across all movements (p > 0.05) and knee abduction during the …

Comparison Of Patient Retention Of Pcl-5 Vs. Caps-5 In A Study On Tracking Ptsd Symptoms After A Mobile App Intervention, Kaylea Shoulders, Deep Patel, Muntaha Rana, Anne C. Jones

Rowan-Virtua Research Day

Background: Due to mental health provider shortages, primary care providers are seeing more patients with mental health concerns.1 Due to the COVID-19 pandemic, mental health concerns increased requiring primary care to adapt new multidisciplinary interventions to assist patients.2 When assessing patients for PTSD, either the CAPS-5 or PCL-5 can be used, but they have different qualities that may affect retention.

Hypothesis: The PCL-5 will have a higher retention due to the ease of administration.

Methods: Providers identified eligible patients at the Rowan-Virtua family medicine office in Sewell. Upon consent, the CAPS-5 or PCL-5 was administered, and then the PTSD Coach …

Exploring The Effects Of Target Race, Gender, And Weight On Pain Perception, Catherine Awad, Theresa Miller, Azer Tuerxuntuoheti, Peter Mende-Siedlecki

Rowan-Virtua Research Day

Healthcare equity is an essential right, and while the quality of care is assumed to be uniform, notable disparities in care are associated with factors of race, gender, and weight-particularly in the domain of pain evaluation and care. In experimental work, target race and gender have varying, and interacting effects on visual thresholds for perceiving painful expressions. Racial bias in pain perception is well established as participants see pain on black faces less readily than pain on white faces; gender also impacts pain treatment, where women are susceptible to having their pain discredited. Across two experiments, the influence of weight …

Cardiovascular Effects Of Glp-1 Receptor Agonists In Non-Diabetic Adults With Obesity: A Systematic Literature Review, Mariam Abdeen

Rowan-Virtua Research Day

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with obesity. GLP-1 receptor agonists, initially developed for glycemic control in diabetes, are now approved for weight loss in non-diabetic populations. Recent clinical trials suggest these agents may also offer direct cardiovascular benefits.

Objective: This literature review aims to evaluate the cardiovascular effects of GLP-1 receptor agonists, specifically semaglutide, liraglutide, and tirzepatide, in non-diabetic adults with overweight or obesity.

Methods: A systematic search was conducted in January 2025 using PubMed as the primary database, supplemented by Google Scholar and Embase. Clinical trials were selected based on …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Off-Label Long-Term Use Of Phentermine For Weight Management, Monique Morin, Yamini Pandey, Sarah Bdeir, Rumyah Rafique, Taim-Allah Al-Jarrah, Ali Farhat

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Hendricks EJ, Greenway FL, Westman EC, Gupta AK. Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity. 2011;19(12):2351-2360 https://doi.org/10.1038/oby.2011.94

for a patient struggling at the intersection of weight loss and financial instability.

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Barriers To Health Care Among Adults With Disabilities In Connecticut, Mary Beth Bruder Phd, Tara M. Lutz Phd, Kelly E. Ferreira Phd

Developmental Disabilities Network Journal

It is estimated that 25% of adults in the US are living with one or more disabilities. Persons with disabilities (PWD) have unmet health care needs, experience health disparities compared to those without disabilities. Barriers to quality health care include structural barriers such as access to transportation, physical access to facilities, and lack of accessible medical equipment. Other barriers include the knowledge, skills, beliefs, and attitudes of health care providers to meet the needs of PWD. To examine the barriers to health care experienced by adults with disabilities in Connecticut, the University of Connecticut Center for Excellence in Developmental Disabilities …

Addressing Gaps In Care Through A Medical Student-Led Cancer Screening Project, Matthew Green, Hannah Ngo, Dakota B. Pastore, Jenna Zappetti, Olivia Siciliano, Meghan Mcquade, John Sauer, Anne Jones

Rowan-Virtua Research Day

Background: Colorectal cancer (CRC), breast cancer (BrCa), and cervical cancer are three of the most preventable cancers. Despite the known significance for early detection and treatment, barriers to screening remain. We developed a medical student-led project to improve adherence to national cancer screening guidelines in patients across Rowan-Virtua Family Medicine (FM) practices. This study assesses the initiative’s efficacy in improving adherence to CRC, BrCa, and cervical cancer screenings.

Methods: Rowan-Virtua FM patients between the ages of 21-75 (n=735) were identified as due or up-to-date on cancer screenings based on chart review. Student volunteers were trained to contact patients to discuss …

Can Nutritional Supplements Benefit Patients Receiving Treatment For Neurodegenerative Disorders?, Russell Levi, Saad Ahmed, Zachary Harris

Rowan-Virtua Research Day

As the prevalence of neurocognitive disorders rises globally, developing new methodologies of prevention and treatment is crucial. This literature review examines the efficacy of adding nutritional supplements, specifically nootropics, with traditional pharmacological regimens on various neurocognitive and neurodegenerative disorders. Primary, peer-reviewed research, including both human and animal studies, was assesed to determine if there was a benefifical, minimal, or detrimental effect on symptom progression. The inclusion criteria focused on studies that evaluated the reduction in disease markers or symptoms following supplement use. The findings reveal that natural supplements generally support disease management. Significant improvements were noted with specific combinations like …

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 …

A Systematic Review On Belimumab’S Effectiveness, Improved Health Outcomes And Quality Of Life In Patients With Lupus Syndromes, Emily Meale, Alexandra Fontaine

Rowan-Virtua Research Day

Autoimmune diseases are prevalent disorders that many individuals within the United States suffer from. Systemic lupus erythematosus (SLE) is a common autoimmune disease that has a high incidence in women of child-bearing age. Management for lupus depends on the anatomical location SLE manifests, the severity of disease, and the tolerance that one has for certain adverse effects. Glucocorticoids are commonly used to manage lupus. Currently, long term glucocorticoid usage is associated with devastating adverse effects, so current treatment options aim to mitigate corticosteroids use to improve quality of life while maintaining favorable health outcomes. New management for SLE include biologics …

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 …

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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Health Disparities Among Adults With Disabilities, Kirsten Carlberg, Madison Plone, Chrismely Castro, Nayarith Lopez

Rowan-Virtua Research Day

Background: According to the Centers for Disease Control (CDC), 27% of adults in the United States (US) live with a disability. These disabilities are often accompanied by poorer health outcomes with adults with disabilities reporting higher rates of obesity, diabetes, and cardiovascular disease. This review aims to characterize rates of disability among young adults in Camden County, New Jersey.

Methods: Data was collected from the CDC and United States Census and analyzed using Microsoft Excel 365.

Results: In 2022, 9.7% of residents of Camden County aged 18-34 were reported as disabled while the rate was 8.3% of US residents nationwide. …

Physical Medicine & Rehabilitation Referrals In Cancer Patients, Bhumik Patel, Venkateswar Venkataraman, Deanna Janora, Jack Goldberg

Rowan-Virtua Research Day

Physical Medicine and Rehabilitation (PM&R) can address functional limitations in various conditions, including cancer. Cancer rehabilitation aims to address functional impairments resulting from both the disease itself and its treatments, striving to optimize physical, social, psychological, and vocational functioning. Existing literature indicates that PM&R services significantly benefit cancer patients by improving their overall quality of life. Studies have found that optimal utilization of PM&R services can increase the Functional Independence Measure (FIM) in cancer patients. Current National Comprehensive Cancer Network and American Cancer Society guidelines emphasize the importance of incorporating PM&R services into oncology care to enhance the function and …

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 …

Exploring Geriatric Self Management Of Type 2 Dm: A Systematic Review, Ahmed Gawash, David F. Lo, Kunal P. Shah, Jasmine Emanuel, Brandon Goodwin, Don D. Shamilov, Gaurav Kumar, Nathan Jean, Christian P. White

Rowan-Virtua Research Day

This review explores diabetic self-management in geriatric individuals, focusing on positive attitudes and support from family/friends as crucial for self-care optimization. A comprehensive search in health databases was conducted, which involved screening 248 participants across eight qualitative research studies. Themes emphasizing the importance of listening to one’s body, acknowledging hidden issues, and recognizing the impact of various factors on diabetes self-care were established. A holistic approach to self management, emphasizing the significance of positive attitudes, cultural sensitivity, and individual values in healthcare practices is recommended. Embracing cultural diversity and addressing barriers can enhance self-management and quality of life for geriatric …

A Review Of Risk Factors, Adverse Outcomes, And Counseling Strategies Among Pregnant Individuals With Eating Disorders, Alexandra Fontaine, Emily Meale

Rowan-Virtua Research Day

Background: Eating disorders (EDs) among women of childbearing age have become more prevalent on the global level. Identifying at-risk populations of women having EDs before, during, or after pregnancy is essential for clinicians to improve treatment and decrease the likelihood of negative maternal and/or fetal outcomes. Purpose: The purpose is to determine risk factors for women who have EDs throughout pregnancy, to identify negative pregnancy outcomes of women suffering from EDs, and to explore treatment and counseling options through the postpartum period. Methods: This literature review mainly utilizes sources from PubMed and the National Institute of Health databases. An expansive …

What Stigmas Still Exist For Weight Loss Medications?, Abdullah Panah, Philip Collins Do

Rowan-Virtua Research Day

Background and Hypothesis:

Medications for weight loss are becoming far more common as more tolerable formulas have come to the market with some medications offering results almost on par with bariatric surgery. However, studies show a stigma still persists around the discussion and perception around using weight loss medications. The authors of this study hypothesized that one of the biggest hurdles patients face for weight loss medications are the stigmas associated with taking these medicines and approaching the topic.

Methods:

This was a survey-based project that consisted of an anonymous, voluntary questionnaire which was provided to patients during their regular …

Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov

Rowan-Virtua Research Day

Ms. R, a 32-year-old Hispanic female, suffers from severe anxiety exacerbated by a car accident and past struggles with depression and substance use. Evaluation reveals hypothyroidism, mild anemia, and GAD as the primary diagnosis. Factors contributing to her condition include genetic predispositions, medical issues, and social stressors. Treatment involves pharmacotherapy, psychotherapy, and monitoring her physiological health. Research on wearable data for GAD severity offers potential insights for her treatment. A holistic approach, considering biological, psychological, and social factors, guides her tailored treatment plan for overall well-being.

Case Report: Babesiosis Presenting To The Emergency Department, Daniel M. Zaayenga, Daniel A. Weeks

Rowan-Virtua Research Day

Babesiosis is a tick-borne illness caused by the parasitic protozoa Babesia transmitted by the Ixodes tick. Babesia infect the red blood cell of its host and requires the cell for its replication. It is a disease process that can range from asymptomatic infection to organ failure and death. This case presentation reviews a 68-year-old male who presented to the emergency department with flu like symptoms and was found to have babesiosis.

A True Bloody Emergency: An Unusual Case Of Thrombotic Thrombocytopenic Purpura, Joshua M. Ninan

Research Symposium

Background: Thrombotic thrombocytopenic purpura (TTP) is a primary thrombotic microangiopathy that is classically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Although rare with an annual incidence of 3.7 cases per one million adults, it is considered a true hematological emergency due to its fatality rate of almost 100% if appropriate treatment is not initiated immediately. This makes it vitally important to identify and treat patients with TTP, a task that becomes unusually challenging in the absence of the disorder’s other characteristically diagnostic clinical features such as mucosal bleeding, fever, or presence of schistocytes.

Case Presentation: A 30-year-old gentleman with …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …