Mental and Social Health Commons^™

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 …

Freshman 15? Freshman 50?? The Reality Of Daily Life Habits Of A First Year College Student, Gregorio R. Salgado

Student Scholar Symposium Abstracts and Posters

This project presents a personal data tracking study in which I collected daily self-reported metrics over the course of the Spring semester using Excel. The variables tracked include sleep duration, caloric intake, screen time, social media usage, phone checks per day, family communication, and personal spending. The goal of this project is to identify meaningful patterns and correlations between daily habits and personal well-being.

Data was collected through a combination of manual logging and smartphone-generated daily reports. This study explores potential relationships between variables such as sleep duration and social media usage, as well as the association between family communication …

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, …

Applying User-Centered Design To Develop A Culturally Sensitive, Low-Calorie Meal Plan For Enhancing Dietary Behavioral Control In Masld, Maya Balakrishnan, Paola Martinez, Brett Deng, Ivonne Arguelles, Crystal Arguelles, Terri L Fletcher, Natalia I Heredia, Myriam Ibarra, Anna Christine Rome

Faculty, Staff and Students Publications

Background: Dietary changes are essential for managing metabolic dysfunction-associated steatotic liver disease (MASLD), yet patients often face barriers related to knowledge, skills, cost, time, and cultural fit.

Aims: The purpose of this paper is to report a process for culturally tailoring a dietary intervention and its application to create a calorie-restricted meal plan for Mexican and Central American patients with MASLD. Guided by the Theory of Planned Behavior and user-centered design, we produced a culturally tailored seven-day structured meal plan aligned with dietary guidelines for MASLD and weight loss.

Methods: We conducted a three-phase, mixed-methods process among Mexican/Central American patients …

Co-Active Therapeutic Filmmaking: A Methodology Pilot Project, Blair Webber

Expressive Therapies Theses

This pilot project examined the intersection of drama therapy and filmmaking. Drawing on the Co-Active Therapeutic Theater model from drama therapy and digital storytelling and participatory video methods from social work research, this methodology designed and delivered a co-created filmmaking intervention at a residential treatment center for adult men with co-occurring mental health and substance use disorder. Four participants made a seven-minute-long short fictional film based on their definition of active recovery and a theme of recovery they wished to share with an audience. It was screened at the treatment center for staff and their fellow residents. Data collection was …

Implementation Of Wellness Activities In An Experiential Rotation To Promote Pharmacy Student Well-Being, Neeloufar Fakourfar, Brenda Kilzi, Reza Taheri, Richard Beuttler, Hindu Rao

Pharmacy Faculty Articles and Research

Background

Educational activity

Harness The Darkness! Blackout Poetry And Drama Therapy For Systemic Existential Dread: A Proposed Methodology, Kerry Sullivan

Expressive Therapies Theses

This thesis explores the intersection of drama therapy and blackout poetry as a therapeutic intervention to address systemic existential dread (SED) among emerging adults. The proposed methodology is titled "Bringing Blackout Poetry to Life" and consists of five sessions designed to explore the participants’ SED and generate poetry, culminating in a public performance. By integrating elements from psychodrama and drama therapy with the therapeutic process of blackout poetry, the intervention intends to aid processing on all levels of the expressive therapies continuum (ETC), strengthen tolerance for uncertainty, and facilitate sustainable community action. This theoretical framework is supported by a wide-ranging …

Knowledge Of Advance Care Planning And Advance Directives Among Us Adults: Implications For Health Policy And Practice, Anisah Bagasra, Gretchen Agans

Faculty Articles

Background:

Objectives:

A Cross-Cultural Investigation Of Consumer Hoarding Behavior During Covid-19: Differences Between Sweden And The United States, Christy M. Cook, Pia A. Albinsson, James E. Stoddard

Atlantic Marketing Journal

This study is a cross-cultural exploration of consumer hoarding behavior during Covid-19; specifically, a comparison between Sweden and the United States. This research analyzes whether Swedish and American consumer hoarding behavior factors of prosocial orientation, consumer resilience and consumer risk-taking propensity reflect identical relationships during less predictable environmental forces (i.e., Covid-19 or global pandemic). Results from Partial Least Squares-Structural Equation Modeling (PLS-SEM) show that consumer prosocial orientation is negatively related to consumer hoarding and prosocial orientation is positively related to consumer resilience. In turn, both prosocial orientation and consumer resilience exhibit a positive relationship towards consumer hoarding. Consumer resilience is …

Understanding And Measuring Functional Communication In Adults Living With Alzheimer's Disease And Related Dementias, Sarah Toledo

Honors Capstones

Functional communication declines across all stages of dementia and directly affects quality of life, yet traditional standardized assessments may not fully capture everyday communication abilities. This capstone examines how functional communication in older adults living with dementia can be conceptualized and measured beyond standard tools. The study analyzes previously recorded video conversations between adults with dementia and student partners. Conversations are transcribed and coded using two observational measures: the Verbal and Nonverbal Interaction Scale–Care Recipient (VNVIS-CR) and the Adapted Measure of Participation in Conversation for Dementia (MPC-D). Gestures, facial expressions, responsiveness, and engagement are included in the analysis, and double …

A Retrospective Look At Self-Reported Mental Health Prevalence In Division Iii Student-Athletes, Jacob F. Neri

Masters Theses/Capstone Projects

Mental health concerns among collegiate athletes have gained increased attention, but there has been limited research focus on Division III student-athletes. This study aimed to examine the self-reported prevalence of anxiety, depression, anger, stalking/harassment, abuse/assault, alcohol/substance abuse, self-harm, suicide ideation, and suicide attempt to identify contributing factors amongst this population. A retrospective, cross-sectional study was conducted looking at data collected from the student-athlete mental health history & well-being questionnaire that was administered as part of their pre-participation exam (PPE) prior to the beginning of each academic year. A total of 554 Division III student-athletes were included in the study. Results …

Investigating The Prevalence Of Eating Disorder Risk And Body Image Dissatisfaction Among Division Iii Track And Field Athletes, Ravyn S. Goodson

Masters Theses/Capstone Projects

Context: Eating disorder (ED) risk, and body image dissatisfaction (BID) are increasingly recognized concerns in collegiate athletes due to sport-specific and sociocultural pressures. However, limited research has looked at these factors within NCAA Division III track and field athletes.

Objective: To examine the prevalence of eating disorder risk and body image dissatisfaction among division III track and field athletes and explore differences based on gender and event group Design A quantitative, cross-sectional survey design

Setting: NCAA division III athletic program within the Ohio Athletic Conference (OAC), during the 2025-2026 competitive season.

Participants: A total of 32 NCAA Division III track …

Exploring Identity Through Clay: A Humanistic Art Therapy Case Study With A Blind Chinese Adoptee, Virginia Jade Leicht

Expressive Therapies Theses

This qualitative case study explored how working with clay in art therapy can help support a blind man’s identity exploration. This paper addresses the problem of many traditional therapeutic approaches within the art therapy realm: They rely too heavily on visual engagement, which can limit the accessibility and opportunities for self-exploration and identity development for those who are blind. The study was grounded in current research and foundational theories based on the humanistic art therapy approach. Clay is considered an accessible medium that engages multiple senses and allows for emotional exploration and meaning making, specifically through tactile and sensory-based engagement …

How Nutrition And Physical Activity Shape Your Well-Being, Stacy Phillips

EFNEP

This publication will explore the link among nutrition, physical activity, physical health, and mental health and how it impacts whole-body well-being. Understanding how multiple aspects of a person's lifestyle can affect an individual's overall well-being is essential to providing better education on how to make better choices to improve their well-being.

A Pilot Study Of A Culturally Responsive Cognitive-Behavioral Intervention For Black American High School Students With Social Anxiety, Hannah Thomas

Theses, Dissertations and Culminating Projects

Cognitive-behavioral interventions have been shown to be effective for treating social anxiety, yet few have been evaluated for racially and ethnically minoritized youth, including Black American adolescents. These interventions also do not address sociocultural factors, including racial discrimination and mental health stigma, that may shape the experience of social anxiety among Black American youth and serve as barriers to care. Therefore, the aim of this study was to conduct a pilot evaluation of the feasibility, acceptability, and preliminary outcomes of Interacting and Changing Our Narratives (ICON), a culturally-responsive, school-based cognitive-behavioral group intervention for Black American high school students with social …