Mental and Social Health Commons^™

Behind The Screen: The Effect Of Screen Time On The Pediatric Population, Arthi Rameshkumar, Tanvi Shah, Liam Courtney, Talia Hartman, Tanya Kadrmas-Iannuzzi

Rowan-Virtua Research Day

No abstract provided.

Evaluation Of Possible Suicide Attempt And Treatment Of Chronic Serotonin Syndrome: A Case Report, Lalitya Karra, Colin Villarin

Rowan-Virtua Research Day

No abstract provided.

Enhancing Wellness And Healthcare Support For Medical Students At Rowan-Virtua Som: A Comprehensive Needs Assessment, Han Jie Liu, Karen Welding-Brown, Joanne Kaiser Smith

Rowan-Virtua Research Day

Introduction: While the rigors of medical education are well-documented, high stress levels have been shown to negatively impact academic performance. Despite this, Rowan-Virtua SOM currently lacks structured programs that address students’ unique healthcare and wellness needs. This study evaluates the wellness challenges and healthcare barriers faced by pre-clinical students (classes of 2028 and 2029) to inform targeted institutional support.   Methods: A descriptive survey-based study was distributed to all pre-clinical students at Rowan-Virtua SOM. The IRB-expempt (PRO-2025-114) Qualtrics survey assessed four domains: 1) demographics, 2) mental and physical wellness, 3) lifestyle patterns, and 4) access to healthcare and barriers.   Results: Fifty-four …

Methadone-Associated Qt Prolongation: The Importance Of Early Recognition And Monitoring In The Emergency Department, Uma Murrugappan, Kelsey Murray, James Espinosa Md, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 43-year-old female with cervical cancer and bilateral percutaneous nephrostomy tubes receiving high-dose methadone maintenance therapy who presented to the emergency department with bilateral flank and abdominal pain. She denied cardiac symptoms. Electrocardiogram obtained during evaluation revealed marked QT prolongation (QTc 596 ms) following recent methadone dose escalation. The patient was placed on continuous cardiac monitoring and intravenous magnesium was ordered. While intravenous access was being obtained, she developed polymorphic ventricular tachycardia consistent with torsades de pointes and became pulseless. Advanced cardiac life support was initiated including defibrillation and magnesium administration, with return of spontaneous …

Medical Clearance For Behavioral Health Patients In The Emergency Department: A Conceptual Overview Of Practice Variability, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Patients presenting to the emergency department (ED) with behavioral health complaints frequently undergo medical clearance prior to behavioral health evaluation or admission. Substantial variability appears to be found in laboratory utilization, documentation language, and interdepartmental workflow.

Objective: To provide a conceptual overview of variability in medical clearance practices and to synthesize existing guideline recommendations and literature regarding routine laboratory testing in low-risk psychiatric patients.

Methods: Narrative review of professional policy statements, selected peer-reviewed studies, and operational considerations influencing emergency physician practice patterns.

Results: Evidence suggests that routine laboratory testing in psychiatric patients has low diagnostic yield and rarely changes …

Protecting The Protectors: Supporting Emergency Department Security Officer Wellness: A Brief Conceptual Review And Research Agenda, James A. Espinosa Md, Paul Sarnese, Alan Lucerna

Rowan-Virtua Research Day

Background: Workplace violence in emergency departments (EDs) has been widely studied, yet the occupational wellness of ED security officers has received comparatively limited focused attention in emergency medicine literature.

Objective: To conceptually examine the role of ED security personnel within the emergency care environment and outline a research agenda addressing their wellness.

Discussion: Security officers frequently respond to behavioral crises, assist with restraint events, and help maintain safety for patients, visitors, and staff. These duties include vigilance between events, sudden physical exertion, and exposure to aggression. ED security work often follows a recognizable rhythm: baseline vigilance, rapid escalation response, physical …

Schizophrenia And Multiple Dka Episodes Leading To Neurocognitive Deficits In A 37yo Patient, Andrew Harmon D.O.

Rowan-Virtua Research Day

Patient is a 37 year old female with a PPHx of schizoaffective disorder and PMH of type 1 Diabetes who has had numerous admissions to the ICU due to uncontrolled blood sugars in the setting of continued delusions and medication noncompliance. With continued episodes of DKA, patient continued to psychiatrically decline over the course of multiple years. Studies have shown that anti-psychotic treatment in schizophrenia can help improve cognitive functioning.

Mental Health Comorbidities And Ibd Outcomes In Patients Treated With Anti–Il-23 Therapy, Jashanveer S. Johal, Archana Salek, Mahmoud Al-Bataineh, Bianca Patel, Om Patel, Yecheskel Schneider, Jason Hyman, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely influence outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti–IL-23 agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti–IL-23 agent were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to treatment initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 3,546 patients per cohort. Primary outcomes included inpatient/ED encounters, abscess/fistula, …

Cannabis Use Disorder And Executive Function - A Literature Review, Jonathan Perumpail

Rowan-Virtua Research Day

Cannabis use disorder (CUD) is recognized as a psychiatric condition characterized by persistent and problematic cannabis consumption that leads to marked functional impairment. Growing evidence suggests that chronic CUD exerts significant effects on executive functions such as inhibitory control, cognitive flexibility, goal-directed behavior, and decision-making. This literature review integrates findings from 25 studies focusing specifically on individuals with objectively diagnosed CUD to explore the effects on cognition in this patient population. Across studies, deficits in executive function are consistently observed, with adolescents and early-onset users demonstrating increased vulnerability. Neuroimaging studies reveal structural and functional alterations in the prefrontal cortex and …

Unmasking Neurosyphilis: A Psychotic Presentation With A Hidden Cause, Fazal Choudhary Do, Lalitya Karra Do

Rowan-Virtua Research Day

No abstract provided.

Reframing Emergency Medicine (And Healthcare) Wellness Measures: The Case For Adding Measures Of Physiological Sustainability, Exercise, Restoration, And Meaning, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Physician wellness measurement in Emergency Medicine (EM) in particular and in healthcare in general has largely focused on identifying distress states such as emotional exhaustion and depersonalization. Instruments such as the Maslach Burnout Inventory and related derivative surveys have been well-validated and  have played a central role in identifying the scope of burnout across healthcare systems.

Conceptual Framing

While current measures of distress are essential, they may not fully characterize the spectrum of clinician health. In many fields outside healthcare—including occupational health, resilience research, and positive psychology—assessment of well-being includes behaviors and experiences associated with sustained health, such as …

Case Study: 46-Year-Old Female With Auditory Hallucinations, Ahmed Aly, Tayeb Ahamed, Chien Y. Cepeda, Apn

Rowan-Virtua Research Day

The case study discusses a patient seen at a voluntary psychiatric unit. Patient has been prescribed benzodiazepine and bupropion; she became dependent on the benzodiazepine due to social difficulties that have not been addressed by her prescriber. The study highlights the dependency of benzodiazepine while being offered bupropion (which lowers seizure threshold), which can be deadly if accompanied with benzodiazepine withdrawal

Comparative Efficacy Of Cognitive Behavioral Therapy And Intranasal Oxytocin In Adolescent Anorexia Nervosa, Nikhila P. Archakam, Akhila P. Archakam, Wesley A. Kim, Harshal Parmar, Iram Fatima

Rowan-Virtua Research Day

Anorexia nervosa (AN) is a severe and potentially life-threatening psychiatric disorder with the highest mortality rate among psychiatric illnesses affecting adolescents.¹ It is characterized by extreme restriction of caloric intake driven by an intense fear of weight gain or negative body image perception.¹ Mortality results from medical complications of starvation and an increased prevalence of suicide risk.¹ Although AN can occur at any point across the lifespan, it most commonly first presents during adolescence.¹ This developmental period is marked by significant hormonal, biological, and psychosocial changes. Early-onset AN is associated with stunted growth, pubertal delay, and long-term cognitive and emotional …

Mental Health Vs Substance Misuse: Predicting Restraint Use In The Emergency Department, Chloe Lafosse Bs, Michael Witt Md, Mph

Rowan-Virtua Research Day

Introduction: Violence in the emergency department affects approximately 30% of hospital staff every 6 months. Presenting complaints may contribute to violence risk, particularly in those with mental health or substance misuse issue where there are heightened risks of cognitive impairment and involuntary holds.

Methods: We conducted a systematic review of literature published between 1957-2025 using multiple databases, identifying studies that observed physical restraint use on adult emergency department patients. All relevant data was recorded and imputed into SPSS for a chi-square test.

Results: Thirteen studies (2019-2025) met inclusion criteria, with sample sizes ranging from 58 to 1,035,522 participants. All studies …

What Are The Effects Of Exposure To Green Spaces On Attention, Adhd Symptoms, Depression, And Overall Mental Health?, Emily Marie Hackett

Rowan-Virtua Research Day

This poster is a literature review examining the relationship between green space exposure and mental health outcomes. Examples of green spaces include nature, hiking trails, city parks, tree cover, and gardens. This literature review finds that green space exposure has positive effects on the symptoms of ADHD, depression, and anxiety. Nature exposure may serve as a complementary intervention to improve patient well-being.

Septic Pulmonary Emboli Revealing Tricuspid Valve Endocarditis In A Patient Presenting With Opioid Withdrawal Symptoms, Dong Shin, Dhara Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Septic embolism is a serious complication of systemic infection, most commonly arising from infective endocarditis. In patients with intravenous drug use (IVDU), right-sided endocarditis may lead to septic pulmonary emboli, often presenting with nonspecific or misleading symptoms. A 36-year-old female with recent intravenous fentanyl use presented with presumed opioid withdrawal, along with chest pain, dyspnea, and systemic symptoms. Initial evaluation revealed leukocytosis and bilateral pulmonary nodules on imaging. Computed tomography angiography demonstrated multiple cavitary and non-cavitary nodules consistent with septic pulmonary emboli. Blood cultures grew Staphylococcus aureus, and echocardiography revealed tricuspid valve vegetations with severe regurgitation. The patient required escalation …

Refeeding Syndrome In A Person Experiencing Homelessness: A Case Report, James Espinosa, Jose Gerald Aragon, Md Fateha, Alan Lucerna

Rowan-Virtua Research Day

Refeeding syndrome (RFS) is a potentially life-threatening metabolic disturbance that occurs following nutritional reintroduction in severely malnourished individuals. It is characterized by rapid intracellular shifts of electrolytes—most notably hypophosphatemia—driven by insulin-mediated metabolic changes. Although commonly associated with eating disorders and chronic illness, RFS may also occur in socially vulnerable populations.

We report the case of a 64-year-old male experiencing homelessness who presented to the emergency department with weakness, muscle cramps, and confusion after resuming regular meals at a local shelter following prolonged minimal intake. Laboratory evaluation revealed severe hypophosphatemia (0.7 mg/dL), hypokalemia (3.0 mmol/L), and hypomagnesemia (1.2 mg/dL). Electrocardiogram demonstrated …

Impostor Phenomenon In Healthcare: Prevalence, Implications, And Educational Responses, James Espinosa, Robin Lahr, Sergey Medlenov, Swet Patel, Nicholas Tomasello, James Lee, Neel Parikh, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

The impostor phenomenon describes persistent self-doubt and fear of being exposed as a fraud despite objective evidence of competence. The term 'impostor phenomenon' is preferred over the term "imposter syndrome" because it is not a psychiatric diagnosis and avoids pathologizing normal developmental uncertainty. The original authors used the term 'phenomenon' (Clance & Imes, 1978), and contemporary scholarship increasingly adopts this terminology.

First described by Clance and Imes (1978), the construct has since been studied across diverse professional domains, including medicine, nursing, and academic leadership. Subsequent research demonstrates that impostor experiences occur across genders, training levels, and healthcare roles (Bravata et …

Designing For Difference: A Systems Approach To Sensory-Adaptive Care In The Emergency Department, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Children with genetic syndromes and other neurodevelopmental conditions frequently present to the Emergency Department (ED) with sensory vulnerabilities that complicate evaluation and treatment in high-stimulus environments. While experienced clinicians often adapt instinctively to meet these needs, such adaptations may be inconsistently applied and may also be highly individual provider dependent. We present a case involving a child with a genetic syndrome affecting auditory and visual systems to illustrate how small environmental, relational, temporal, and cognitive adjustments can prevent escalation and enable routine care delivery without specialized resources.

We propose reframing sensory-adaptive care not as an exceptional accommodation but as a …

When Individual Implicit Bias Meets Ed System Turbulence: Expanding The Implicit Bias And Cultural Bias Conceptual Frame To Support Reflective Decision Making Through Both Individual Bias Reduction Strategies As Well As System-Level Design Approaches, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Cultural and implicit bias have been widely studied as contributors to disparities in healthcare delivery. Prior literature has largely conceptualized bias as an individual-level cognitive phenomenon occurring within clinician–patient interactions. However, emergency departments (EDs) function as complex adaptive systems (CAS), characterized by time pressure, uncertainty, cognitive load, and environmental noise. These conditions may contribute to the expression of implicit bias in clinical care.

Objective

To reframe cultural and implicit bias in the ED as both an individual cognitive property as well as a system-dependent and modulated  phenomenon and to propose that the operational state of the ED influences the …

Demographic Disparities In Contraceptive Use: Insights From Female Nsfg Respondents, 2015–2023, Adira Brenner

Rowan-Virtua Research Day

Disparities in contraceptive use persist in the United States despite expanded access to family planning services. Historical policies and ongoing social determinants of health (SDOH) are significant drivers of the continued inequality in reproductive healthcare access and utilization. This study examines demographic trends in contraceptive use using data from the National Survey of Family Growth (NSFG) between 2015 and 2023.

Data were obtained from the NSFG and the National Center for Health Statistics (NCHS) datasets. A cross-comparison was conducted, focusing on variables such as age, race/ethnicity, and educational attainment.

The consensus was that contraceptive use increased to approximately 65% in …

Preliminary Results From Assessing Medical Students’ Familiarity With Adverse Childhood Experiences (Aces) And Trauma-Informed Care (Tic), Kaylea Shoulders, Portia Tasnim Shaheed, Kartik Kannan, Rachel Silliman Cohen, Beth Cooper, Christine Schroeder, Yahaira Márquez

Rowan-Virtua Research Day

Adverse childhood experiences (ACEs) are highly prevalent and associated with significant long-term health outcomes1; however, physicians often report feeling underprepared to address trauma in clinical care. While medical education increasingly includes exposure to ACEs and trauma-informed care (TIC), limited research has examined how these topics are integrated and experienced within osteopathic medical education (OME). This project aims to assess medical students’ familiarity with ACEs and TIC at Rowan-Virtua School of Osteopathic Medicine and to potentially help inform curricular improvement efforts. This study adapts and extends prior research2 using an anonymous survey administered via Qualtrics. Recruitment targeted medical students across years …

In School Age Children With Autism Spectrum Disorder, Does Academic Achievement And Social Development Improve In Inclusive Classroom Environments?, Ashley A. Macquaid

Rowan-Virtua Research Day

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulties in social skills, communication, and sensory processing 1. ASD affects approximately 1 in 100 children internationally 2. With the growing prevalence, classroom inclusivity of individuals with autism has emerged as a priority in education. However, current literature presents a range of positive and negative factors without clear indication of effective classroom placement for students' specific needs. This research aims to determine if inclusive classroom environments improve academic achievement and social development for school-age children with ASD. A systematic search on PubMed, Embase, and Cochrane databases yielded studies published between …

Mental Health Comorbidities And Ibd Outcomes On Anti-Tnf Therapy, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes …

Effect Of Pcos Treatment On Mental Health Outcomes, Audriti Mazumder, Aubrey Olson

Rowan-Virtua Research Day

Abstract (250 words)

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with a range of physical symptoms, including hirsutism, acne, weight gain, insulin resistance, and infertility. While its metabolic and reproductive manifestations are well characterized, the impact of PCOS on mental health remains underexplored. This study aims to evaluate the relationship between PCOS and mental health outcomes, with a particular focus on changes in symptoms following treatment and the influence of demographic factors.

A survey-based study was conducted using a Qualtrics questionnaire distributed via QR code and social media platforms. Questions were modeled after validated screening tools, including …

Impact Of A Caregiver Wellness Workshop On Well-Being And Mental Health, Keertana Jonnalagadda, Morgan Yacoe

Rowan-Virtua Research Day

Family caregivers provide care for loved ones by addressing their activities of daily living (ADLs), instrumental activities of daily living (IADLs), and psychological needs. These demands impact a caregiver’s time and overall well-being. To address burnout and improve education regarding caregiver wellness, a workshop was created to build an effective support system for caregivers and teach them practical self-care strategies. Activities using visual art were designed to reduce caregiver anxiety and stress. Results from validated scales such as Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), WHO-5 Well-Being Index (WHO-5), and a unique caregiver wellness survey (CWS) in a small sample showed …

Barriers To Accessing Mental Healthcare Among Refugee Populations In Southern New Jersey, Paul Cardillo, Hijab Zaidi, Jacob Trainer, Alison Mancuso Do, Facofp

Rowan-Virtua Research Day

This project examines barriers to accessing mental healthcare among refugee populations in Southern New Jersey, with a focus on individuals with limited English proficiency (LEP). Using a narrative review of peer reviewed studies and government reports, key challenges were identified, including language barriers, cultural stigma, and limited familiarity with the U.S. healthcare system. Findings show that refugee populations experience significantly higher rates of mental health disorders, including PTSD and depression, driven by trauma, structural inequities, and social disadvantage. Effective interventions emphasize culturally competent care, integration of bicultural staff, and community based approaches. Addressing these barriers is essential to improving equitable …

Cultural Influences In Psychiatry, Kavita Bhavsar, Mayuri Patel

Rowan-Virtua Research Day

The patient is a 26-year-old female presenting with unspecified hallucinations, delusional thinking, concerns for catatonia and potential sex-trafficking. This case study highlights the importance of approaching each patient through their unique cultural lens while examining and minimizing our own biases while navigating each patient holistically and individually.

Adolescent Opioid Use And Prefrontal Cortex Development - A Systematic Review, Jonathan Perumpail, Liam Kerrick, Shreya Kadi

Rowan-Virtua Research Day

Adolescence represents a critical period of neurodevelopment characterized by ongoing maturation of the prefrontal cortex (PFC), a brain region essential for executive function, impulse control, and behavioral regulation. Exposure to opioids during this vulnerable window may disrupt neural development and lead to long-term consequences. This review synthesizes current preclinical and human evidence examining the effects of adolescent opioid exposure on PFC development. Across rodent models, opioid exposure is associated with impaired synaptogenesis, altered dopaminergic signaling, and dysregulation of the prefrontal-mesolimbic circuits involved in decision making. Human studies showed reduced functional connectivity and white matter changes in those with opioid use …

Challenges Of Weight Management In A Transgender Woman Veteran, Emily Sarett, Wilmington Va Medical Center

Rowan-Virtua Research Day

Case Report

Title: Challenges of Weight Management in a Transgender Woman Veteran

Authors/Institutions: Emily Sarett, OMS-II1; Heather Dixon, PharmD2

Abstract:

Introduction: Obesity is a growing concern among transgender individuals, influenced by hormone therapy and social determinants of health. Bariatric surgery is effective, but weight regain is common and understudied in this population. Case: A transgender woman with prior sleeve gastrectomy presented with weight regain despite multiple pharmacologic trials. Her Gender-affirming hormone therapy included estrogen and androgen suppression. Results: Following the initiation of tirzepatide, the patient achieved clinically meaningful weight loss (8.4% total body weight reduction) with normalization of hemoglobin A1c …