Digital Commons Network^™

Life After Ecmo: A Comprehensive Review Of Longterm Complications, Mia Olson Pa-C

Lynchburg Journal of Medical Science

Extracorporeal life support is the ability to temporarily supplement pulmonary and/or cardiac function in the setting of severe organ failure, with the most widely used version of this technology being extracorporeal membrane oxygenation (ECMO). While ECMO acutely improves outcomes in many patients with acute cardiopulmonary failure, evidence shows that survivors are at risk for long-term complications. These may include physical limitations, neurocognitive impairment, and psychological distress, all of which cumulate to impact a patient’s quality of life. The purpose of this research paper is to examine the literature on long-term complications associated with ECMO therapy and their impact on patient …

Prescribing In The Post-Black Box Era: Navigating Fda-Approved And Compounded Hormones For Menopause, Nicole Bray

Lynchburg Journal of Medical Science

This narrative review compares the safety, efficacy, and clinical utility of FDA-approved

versus compounded bioidentical hormone replacement therapies for women in

menopause. A comprehensive literature review was conducted using PubMed for

studies published between 2016 and 2026, with search terms including “bioidentical

hormone replacement therapy,” “compounded hormone replacement therapy,”

“menopause,” “menopausal,” “vasomotor,” “estradiol,” “progesterone,” and

“testosterone,” alongside an analysis of major medical societies' guidelines and leading

menopause telehealth platforms. The findings demonstrate that FDA-approved

bioidentical hormone therapies offer superior pharmacokinetic consistency, rigorous

regulatory oversight, and robust clinical evidence compared to compounded

alternatives, which lack standardized testing and regulatory oversight for …

Insomnia As A Risk Factor For Depression: Integrating Cognitive Behavioral Therapy For Insomnia, Derrick Bouldin

Lynchburg Journal of Medical Science

This review evaluates insomnia as an independent, modifiable risk factor for Major Depressive Disorder (MDD) within primary care, while assessing the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in improving outcomes, preventing onset, and reducing relapse risk of depression. A literature search conducted between January and April 2026 across PubMed, the Cochrane Library, and APA PsycINFO yielded 42 articles published between 2015 and 2026. Applying inclusion criteria focused on adult populations, comorbid insomnia and depression, and clinical outcomes of CBT-I, 26 articles were selected for synthesis. Findings demonstrate that insomnia is a predictive risk factor for MDD onset, persistence, …

Genitourinary Syndrome Of Menopause And Lower Urinary Tract Symptoms: A Primary Care Approach, Michelle Johnson

Lynchburg Journal of Medical Science

This literature synthesis reviewed current evidence on the pathophysiology, diagnosis, and management of genitourinary syndrome of menopause (GSM)-related lower urinary tract symptoms (LUTS) in postmenopausal persons, with implications for primary care. GSM is a chronic, progressive condition caused by estrogen deficiency affecting vaginal, urethral, and bladder tissues. An estimated 50% to 70% of postmenopausal persons experience symptoms, including urinary urgency, frequency, incontinence, and recurrent urinary tract infections. Despite its prevalence and effect on quality of life, GSM remains substantially underdiagnosed: fewer than half of symptomatic persons seek treatment, and clinicians often fail to screen proactively. Low-dose vaginal estrogen therapy remains …

Dengue: A Global And Emerging Health Challenge, Christopher Artigas

Lynchburg Journal of Medical Science

Dengue virus, a rapidly expanding tropical arbovirus with four distinct serotypes, poses a growing global public health threat—particularly in regions where healthcare systems are ill-equipped to diagnose, treat, and manage its severe manifestations. Transmitted primarily by Aedes mosquitoes, dengue typically manifests as an acute febrile illness characterized by severe myalgias ("bone-breaking fever"), arthralgias, gastrointestinal distress, and hemorrhagic tendencies. In severe cases, the infection can progress to life-threatening dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Because definitive antiviral therapeutics remain in development, supportive clinical care, with a critical focus on timely intravenous fluid resuscitation, is the cornerstone of management. …

Continuity Beyond Delivery: A Family Medicine Approach To Racial And Ethnic Equity In Postpartum Care, Dominique J. Tarrant

Lynchburg Journal of Medical Science

This narrative review examines interventions to improve postpartum care continuity, reduce disparities, and advance maternal health equity, emphasizing structured follow-up, care coordination, and family medicine integration. The postpartum period, often called the “fourth trimester,” should connect recovery with lifelong health. However, many women, particularly those from racially and ethnically minoritized populations, encounter missed screenings, inadequate support, and structural barriers that increase their risk of adverse maternal outcomes. Electronic searches of PubMed and Google Scholar were conducted from October 27 through November 7, 2025, using combinations of “postpartum care,” “family medicine integration,” “racial and ethnic disparities,” “health equity,” and “fourth trimester.” …

Multimodal Analgesia For Postoperative Pain Management In Total Shoulder Arthroplasty, Caroline Heramb

Lynchburg Journal of Medical Science

Total shoulder arthroplasty (TSA) is an increasingly common orthopedic procedure, yet postoperative pain management continues to rely heavily on opioid analgesics. Although multimodal analgesia (MMA) has become the standard of care in total hip and knee arthroplasty, consensus regarding the optimal multimodal approach for TSA remains limited. A comprehensive literature search was conducted using PubMed, CINAHL, the Cochrane Library, and Google Scholar. Following screening with inclusion and exclusion criteria, 42 articles were selected for review and synthesized. Current evidence supports MMA pathways incorporating regional anesthesia, non-opioid pharmacologic agents, perioperative corticosteroids, cryotherapy, and patient education to reduce postoperative opioid requirements without …

Sedation Minimization And Early Mobility To Prevent Intensive Care Unit Delirium, Alana M. Kugelard

Lynchburg Journal of Medical Science

The purpose of this paper is to synthesize current evidence on sedation minimization, early mobility, and multicomponent care bundles for the prevention of intensive care unit (ICU) delirium in critically ill adults. ICU delirium is a common and serious complication associated with increased mortality, prolonged mechanical ventilation, extended ICU and hospital length of stay, and long-term cognitive impairment, making it a significant safety and quality-of-care concern. A literature review was conducted using PubMed and the Cochrane Library, with search terms including “ICU delirium,” “sedation minimization,” “light sedation,” “early mobilization,” and “ABCDEF bundle.” Filters included adult populations, peer-reviewed studies, randomized controlled …

Microbiome-Modulating Dietary Interventions For The Treatment Of Insulin Resistance In Polyendocrine Metabolic Ovarian Syndrome (Pmos), Ashley Davis

Lynchburg Journal of Medical Science

No abstract provided.

Primary Treatment Of Congenital Aortic Stenosis In Infants: A Comparative Analysis Of Balloon Aortic Valvuloplasty And Surgical Aortic Commissurotomy, Kayumov Arabbek Ravshanovich, Sinelnikov Yuriy Semenovich, Amansakhatova Ekaterina Nazarovna, Nalimov Konstantin Aleksandrovich, Roseykin Evgeniy Vladimirovich, Manukian Serezha Nersesovich, Soynov Ilya Aleksandrovich

Journal of the Saudi Heart Association

Objective

To compare the efficacy and safety of balloon aortic valvuloplasty (BAV) and surgical aortic commissurotomy (SAC) as primary treatment strategies for congenital aortic stenosis in infants during the first year of life.

Methods

This retrospective two-center cohort study included 89 infants with congenital aortic stenosis treated between April 2015 and June 2025 at two tertiary centers. Patients were divided according to the initial intervention: BAV (n = 39) and SAC (n = 50). The primary endpoint was any repeat intervention on the aortic valve. Secondary endpoints included hospital and late mortality, recurrent hemodynamically significant aortic stenosis, and clinically significant …

Use Of The Well-Star Model And Well-Star Graphic In Healthcare, Fidan Korkut-Owen, Zubeyde Akpakir, Dean W. Owen

Journal of Wellness

No abstract provided.

Continuous Pacing During Lbbap With A Lumenless Lead: A Simplified, Zero-Cost Sliding-Contact Technique, Leonardo Marinaccio

Journal of the Saudi Heart Association

Left bundle branch pacing with lumenless leads usually requires disconnecting pacing cables during rotation, creating an electrical blind spot during septal advancement. We describe the "sliding-contact" technique, a zero-cost modification enabling continuous real-time monitoring. Retracting the rubber shroud of a standard sterile alligator pacing clip reduces jaw tension, allowing unrestricted lead pin rotation while preserving electrical continuity. In 42 consecutive cases, LBBAP was successfully performed without complications. Beat-to-beat feedback on QRS morphology, impedance, and injury current was maintained throughout rotation, improving procedural precision and safety without specialized equipment.

Inferior Vena Cava–Left Atrial Connection Hidden Beneath Large Secundum Defect. A Case Report, Alisia Yuana Putri, Muhammad Surya Tiyantara

Journal of the Saudi Heart Association

Inferior vena cava (IVC) drainage into left atrium is an exceptionally rare congenital anomaly and may remain unrecognized when associated with a large atrial septal defect (ASD). A 35-year-old-man presented with progressive exertional dyspnea and fatigue. Transthoracic echocardiography, transesophageal echocardiography, and cardiac catheterization demonstrated a large secundum ASD with severe septal malalignment, while systemic venous drainage was interpreted as normal. During surgical ASD repair, an unexpected IVC-to-left atrium connection was identified and redirected to right atrium. Careful assessment of IVC inflow is essential in patients with large malaligned ASD despite normal oxygen saturation.

Synthesizing Evidence Of Stress, Anxiety, Burnout, And Health Habits In Nursing Students Compared To Non-Nursing Students, Brooklyn Watson, Julie Harrison, Mariah Leopold, Nantz Kerry Fleurant

Best Integrated Writing

Nursing school is widely recognized as a demanding and stressful academic program, characterized by rigorous clinical and academic expectations. Elevated levels of stress among nursing students can contribute to negative academic, emotional, and professional outcomes. Through this project, the student team conducted an in-depth examination of nursing student stress and burnout to better understand its prevalence, contributing factors, and potential interventions. The team employed comprehensive search strategies to identify and evaluate relevant evidence. Multiple Johns Hopkins Evidence-Based Practice appraisal tools were used to critically assess the literature, synthesize findings, and determine the significance of the evidence in relation to the …

Contraception Or Complication: A Review Of Depo-Provera’S Pharmacology And Public Health Implication, Phylicia Carpenter

Best Integrated Writing

This review article explores the link between progestogens and meningioma risk and outlines the biological mechanisms that may contribute to tumorigenesis. Two progestogens are emphasized through the paper: cyproterone acetate and medroxyprogesterone acetate (Depo-Provera). An important French study examining the relationship between progestogens use and meningioma risk is discussed, along with the health risks associated with long-term use. Additionally, this review advocates for increased routine prescriber-patient consultations and stronger drug regulation to educate and protect patients, particularly those experiencing socioeconomic disadvantages. It is important to note that the FDA recently updated the label for injectable medroxyprogesterone acetate in December 2025 …

Best Integrated Writing Fall 2026 - Complete Edition, Wright State University School Of Humanities And Cultural Studies, Kristie Mckiernan

Best Integrated Writing

Best Integrated Writing includes excellent student writing from Integrated Writing courses taught at Wright State University.

The Potential Relationship Between Red Complex Tannerella Forsythia And Obstructive Sleep Apnea, Abby Dibble Ms, Kristi M. Soileau

New Orleans Dental Association News

The pathogenesis of periodontitis is no longer attributed to a single infectious organism but rather to a dysbiosis-affiliated microbial community that disrupts host immune response. Within this polymicrobial ecosystem, Tannerella forsythia has emerged as one of the principal periodontal pathogens because of its ability to evade host defenses, promote tissue destruction, and establish cooperative interactions with neighboring microorganisms. As a Gram-negative, obligate anaerobic bacterium belonging to the red complex group, T. forsythia is consistently associated with advanced periodontal disease and is increasingly recognized as an important contributor to both local periodontal destruction and systemic inflammation. A 2024 meta-analysis of ten …

Noda News October 2026

New Orleans Dental Association News

New Orleans Dental Association (NODA) News includes regular columns with regional news impacting the New Orleans membership including: columns from the President and Executive Director, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Did Statewide School Smoking Bans Reduce Smoking Rates?, Rachana Bhatt, Peter Hinrichs

Employment Research Newsletter

No abstract provided.

Key Drivers Of Revisit Intention In Dental And Oral Teaching Hospital, Mega Denada Aldila, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Digital transformation in dental and oral teaching hospitals demands strategies that not only ensure clinical quality but also sustain patient loyalty. This study examines the effects of digital storytelling and service quality on outpatient revisit intention at the Dental and Oral Hospital of Universitas Jenderal Soedirman (RSGMP Unsoed), with brand image and patient satisfaction as mediating variables. A quantitative cross-sectional design was applied to 115 outpatients aged ≥18 years who had completed one full episode of dental treatment. After exposure to a standardized digital storytelling video about RSGMP Unsoed, respondents completed a structured Likert-scale questionnaire. Data were analyzed using Partial …

Kepuasan Pasien Terhadap Pelayanan Di Rumah Sakit Pemerintah Dan Rumah Sakit Swasta: Tinjauan Literatur, Bahar Syah, Mardiati Nadjib

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient satisfaction is an important indicator for assessing the quality and performance of hospital services as it reflects patients’ experiences through the healthcare delivery process; this study explore how patient satisfaction toward hospital services in public and private hospitals by analyzing 23 selected scientific articles published between 2015 and 2024 and gathered from ProQuest, Scopus, PubMed, and ScienceDirect databases from an initial total of 176 articles founded based on inclusion and exclusion criteria, and the findings indicate that service quality has a significant impact toward patient satisfaction in both types of hospitals, with private hospitals generally demonstrating higher satisfaction levels …

Evaluasi Penerapan Rekam Medis Elektronik Terhadap Kinerja Perawat Di Unit Rawat Inap Rs Grha Permata Ibu Kota Depok Tahun 2025, Ratna Dian Andriani, Dicky Yulius Pangkey, Ahdun Trigono

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Electronic Medical Records (EMR) adoption aims to improve documentation efficiency and nurses’ performance; however, system instability and limited continuous training remain obstacles. This study examined the effects of EMR features and functionality, technical support and training, and users’ perceptions and attitudes on nurses’ performance at Grha Permata Ibu Hospital. This study employed an analytic observational design with a cross-sectional approach, using a quantitative survey conducted among 74 inpatient nurses through a Likert-scale questionnaire. Descriptive analysis, Spearman correlations, and multiple linear regression were employed. Results indicate that features and functionality (X1) have a strong positive association with performance (p = 0.652; …

Efektivitas Implementasi Raspro Terhadap Pola Resistensi Dan Biaya Antibiotik Di Rsud Kabupaten Bekasi, Irmawati Hasan, Helen Andriani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The increasing use of antibiotics over recent decades has significantly affected global public health, primarily through the emergence of antimicrobial resistance (AMR), which contributes to higher morbidity, mortality, and economic burden. As a regional referral hospital, Bekasi Regency General Hospital faces substantial challenges related to high resistance rates, with multidrug-resistant organisms (MDROs) showing MRSA at 22.22% and ESBL at 40% in 2024. This study evaluated the implementation of the Prospective System Antimicrobial Regulation Program (RASPRO) in relation to resistance patterns, antibiotic cost efficiency, and supporting roles of governance, human resources, and monitoring systems. A quantitative prospective cohort design was applied, …

Kualitas Hidup Pasien Penyakit Gagal Ginjal Kronik Dan Kepuasan Pelayanan Di Unit Hemodialisis Rumah Sakit Alia Depok: Studi Mixed-Methods, Bimo Kusumo, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The prevalence of chronic kidney disease (CKD) in Indonesia remains a high-incidence condition and most of it underwent hemodialysis in Hospital. This study aims to analyze the quality of life of patients with chronic kidney disease and satisfaction with services in the hemodialysis unit. This study is a mixed-methods study with a quantitative study using the World Health Organization Quality of Life (WHOQOL-BREF) and Service Quality (SERVQUAL) questionnaires, and a qualitative study with in-depth interviews related to hospital services from both service providers (healthcare professionals) and service recipients (patients). The study found predominantly moderate scores on the WHOQOL-BREF and poor …

Persepsi Dokter Terhadap Kompetensi Perawat Di Rsud Siti Aisyah Lubuklinggau: Analisis Domain Komunikasi, Profesionalisme, Dan Kolaborasi Tim, Novita Purnamasari, Wiku Bakti Bawono Adisasmito

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study analyzes doctors' perceptions of nurses' competencies at Siti Aisyah Regional Hospital in Lubuklinggau across three domains: communication, professionalism, and team collaboration. Doctors' perceptions are important for supporting interprofessional collaboration, quality of patient care, and patient outcomes. The study results are expected to identify competency gaps and provide an evidence-based foundation for developing measurable and effective nurse training programs. The study used a quantitative descriptive design with a cross-sectional approach, with a sample of 24 doctors who evaluated nurses' overall competencies in their work units. Data were collected through a structured questionnaire containing 11 Likert-scale items and were analyzed …

How Does Nurse-To-Patient Ratio Impact Patient Satisfaction?, Kathryn G. Courtney, Alexa Nicholson

Scholars Week

This evidence-based practice project examined the relationship between nurse-to-patient ratios and patient satisfaction. A review of current literature, guided by Jean Watson's Theory of Human Caring and the Plan-Do-Study-Act (PDSA) quality improvement framework, found that lower nurse-to-patient ratios are associated with improved communication, higher patient satisfaction, better patient outcomes, and increased patient safety. Based on these findings, recommendations and a Safe Nurse-to-Patient Staffing Policy were proposed to support acuity-based staffing, enhance quality of care, and improve both patient and nursing outcomes.

Implementation Of A Standardized, Multimodal Safe Sleep Education Policy For Newborns, Emma C. Cook, Anisa E. Toliver

Scholars Week

This evidence-based practice project proposes updating a regional hospital’s infant sleep policy to include standardized, multimodal safe sleep education. The goal is to improve adherence to safe sleep practices and reduce the risk of sleep-related infant death using interventions such as multiple forms of standardized parent education, consistent staff modeling of safe sleep practices, environmental modifications, and routine bassinet audits. This project uses Dorothea Orem’s Self-Care Deficit Nursing Theory to strengthen parental understanding and promote safe sleep environments during hospitalization and at home.

Developing An Emergency Department-Specific C. Difficile Infection-Prevention Policy, Katelyn M. Wuest, Chris Bray

Scholars Week

Our evidence-based practice project focuses on the need for an Emergency Department (ED)- specific Clostridioides difficile (C. difficile) infection-prevention policy that adapts the existing facility-wide guidelines to the unique workflow and environment of the ED. Using infection-prevention literature and environmental disinfection recommendations as a foundation, the project proposes the need for clearer guidance regarding applying precautions, managing shared equipment, and maintaining environmental cleanliness. Implementation and evaluation using a Plan-Do-Study-Act approach can help assess staff adherence and identify opportunities to improve consistency in infection-prevention practices.

Health Horizons Journal, Volume 1, Issue 1

Health Horizons Journal

The Health Horizons Journal was founded in the fall semester of 2025 at Clemson University in order to establish a student-led journal that connects the Clemson community with global health content and empowers student researchers. The mission of this journal is to provide students with an opportunity to publish their research and promote access to scholarly work through open-access publication. This journal is dedicated to publishing at no cost to authors and providing submitting authors from any institution at the undergraduate or graduate levels with equal consideration.

Improving health outcomes on a global scale begins with interdisciplinary collaboration and the …

The Commercialization Of Wellness: Gray Market Peptides & Cancer, Bryan M. Burt

Advances in Cancer Education and Quality Improvement

No abstract provided.