Digital Commons Network^™

Training Apart, Together: Team Dynamics In Individual Sports And Surgical Residency, W. Jack Palmer, Dylan Bertoni, Elizabeth E. Cottrill, Colin T. Huntley

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery …

Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey

Department of Surgery Faculty Papers

Objective: Early surgical exposure may potentially influence medical students' decision to pursue a surgical career. At our urban, academic medical school, senior medical students developed a Surgical Externship Program (SEP) to provide first-years with hands-on OR experience. This program is a structured 1- to 2-week immersive experience in which first-year students scrubbed into operations, participated in rounds, and engaged with surgical teams under resident and attending supervision. This study evaluates the SEP's impact on surgical interest, OR confidence, and clinical exposure.

Setting: Academic tertiary care hospital.

Participants: First-year medical students.

Design: First-year students participated in a 1- or 2-week SEP …

Shsp Dean's Newsletter, Fall 2026, Brian J. Nickerson

SHSP Dean’s Newsletter

No abstract provided.

Implementing A Fall-Prevention Bundle To Reduce Falls In A Skilled Nursing Facility, Ginette Lubin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are a persistent patient-safety concern in skilled nursing facilities (SNFs), contributing to injury, functional decline, reduced quality of life, healthcare utilization, and costs. At the project site, a short-term rehabilitation unit in an urban SNF, 13 resident falls occurred during the baseline period, with 23% resulting in injury, and prevention relied on routine risk assessments, environmental checks, and post-fall reporting rather than proactive strategies.

Aim: To decrease the overall fall rate by 20%, reduce fall-associated injuries from 23% to 15% or less, and raise staff adherence to evidence-based fall-prevention interventions to 90% or higher within 12 weeks.

Evidence: …

A Profile Of Assisted Living Direct Care Workforce Training Requirements Across The United States, Erh-Chi Hsu, Paula Carder, Lindsey Smith, Zhiqing E. Zhou, Olga Yakusheva, Anna S. Beeber, Eric Jutkowitz, Kali Thomas

Institute on Aging Publications

Objectives

To characterize assisted living (AL) direct care worker (DCW) training requirements across the United States and how these regulations have changed over time. Specifically, we examine state-level profiles of training regulations, including duration, frequency, content, source of materials, evaluation, and changes in regulatory coverage.

Design

Cross-sectional and longitudinal descriptive study using state policy data and AL directories from 2019, 2021, and 2023.

Setting and Participants

All US states' AL training–related regulations; all ALs and AL beds governed by those regulations.

Methods

We used a mixed-methods approach with an explanatory sequential design (QUAN → qual), first conducting health services regulatory …

Caribbean Hearing Health Readiness: A Data-Guided Method For Doctor Of Audiology Study-Abroad And Service Learning, Chelsea Tynes, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Access to audiology care is essential, as unmanaged hearing loss carries significant communicative, social, and health consequences. Across many Caribbean nations, access to audiologic care remains limited, with substantial variation in workforce, diagnostic services, hearing-health infrastructure, and system readiness. The Caribbean Audiology Research Project (CARP), established by the Hearing Loss Prevention Laboratory, characterized hearing-health capacity across eight Caribbean countries: Antigua and Barbuda, Barbados, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, and The Bahamas. Publicly available data on the audiology workforce, healthcare infrastructure, diagnostic and rehabilitative services, public-health programs, demographic indicators, and logistical factors were …

Loma Linda Nurse - Vol. 35, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | From Behind the Lens to by the Bedside—Nicole Mackey

6 | Coming Home— CRNA Alumni Faculty Feature

8 | From NICU Miracle Baby to Nurse—Nito Gil

10 | Change the Game— Miguel Aguayo

12 | Standing in the Shadow of a Miracle—Joyce Rusch

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-29 | ACADEMICS

30-33 | HOMECOMING

34-38 | FACULTY UPDATES

Strengthening Post-Fall Huddle Practices In Long-Term Care, Janette Perry

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: High resident fall rates and repeat falls caused by an unreliable nurse-only post-fall huddle (PFH) process that lacked structure, interdisciplinary participation, and timely root-cause analysis.

Aim of the Project: To reduce falls and fall-related injuries in long-term care units by implementing a standardized, evidence-based PFH workflow that strengthens root-cause analysis, improves interdisciplinary communication, and increases PFH reliability.

Review of the Evidence: Evidence from fourteen high-quality, peer-reviewed studies demonstrates that structured, interdisciplinary post-fall huddles are more effective than informal, nurse-only approaches in improving fall analysis and reducing repeat falls in long-term care settings. Structured PFHs strengthen root-cause analysis; interdisciplinary participation …

Examining The Impact Of Supramaximal Eccentric And Long-Lever Isometric Training Protocols On Isometric Hamstring Strength, Nordic Hamstring Performance, And Sprint Speed, Adam E. Sundh, Devin S. Vervoort, Nicholas J. Ripley, A. J. Lamb, Paul Comfort

Research outputs 2022 to 2026

The aim of this study was to compare the effects of a 6-week higher-volume eccentric training protocol with a combined lower-volume eccentric and long-lever isometric protocol on posterior chain strength and sprint performance. Thirty-three NCAA Division II soccer players (men: n = 17, age = 19.7 ± 1.2 years, height = 178.9 ± 6.6 cm, body mass 79.8 ± 8.1 kg; women: n = 16, age = 20.1 ± 0.9 years, height = 166.7 ± 5.2 cm, body mass = 67.0 ± 12.1 kg) were allocated to either group via exhaustive minimization. Nordic hamstring exercise break-point angle (NBPA), rapid isometric …

Flourishing Childhood Frameworks: A Scoping Review, Jacqueline A. Davis, Zenobia Talati, Lisa Y. Gibson, Jack Kennare, Christina Bethell, Christina Hinton, Hannah Block, Tara D'Silva, Desiree Silva, Susan L. Prescott

Research outputs 2022 to 2026

Objectives: Experiences in early life impact childhood, lifelong flourishing, and overall well-being. Yet a framework to guide promoting and measuring flourishing in early childhood has not emerged. The objective of this study was to identify frameworks and measures related to promoting and assessing early-childhood flourishing (0-5 years) to build on a preexisting, community-informed framework.

Methods: A systematic search was conducted across electronic databases and the gray literature for articles published between 2014-2026. Of 13 902 total references, 8592 were eligible for screening. A machine learning-assisted tool (Research Screener) was used to streamline screening of the abstracts against the inclusion criteria. …

Enantioselectivity Of The Photochemical Continuous-Flow Isomerization Of Humulones, Gregory M. Giovine, Trevor Smith, Bruce Hamper

Undergraduate Research Symposium

Humulones, the primary natural product present in the historically significant hop flower, represent a largely unexplored candidate for structure-based pharmaceutical design.  Showing promising biological activity as an anti-bacterial and anti-inflammatory agent, humulones are of interest both for their bioactive properties and for their long-established tolerability and natural abundance.  Humulones undergo a characteristic isomerization reaction, where the six-membered substituted phloroglucinol ring contracts to a five-membered ring isohumulone, under a variety of conditions, including those enabled by brewing conditions (thermal, metal-catalyzed) and by exposure to UV light.  Optimization of the photocatalyzed isomerization of n-humulone to n-isohumulone in flow conditions resulted in a …

Exploring The Contextual Relationships Between Match Day Load And Recovery Biomarkers In Professional Soccer Players, Carina Hanson-Evans, Ryland Morgans, Rafael Oliveira, Jule Scholten, Roi Gil, Ben Ryan, Jon Oliver, Piotr Żmijewski, Michael G. Hughes

Baltic Journal of Health and Physical Activity

Background: This study examined the relationship between match-day (MD) load and contextual factors on recovery biomarkers in professional soccer players across the 2024/2025 competitive season. Materials and Methods: Twenty-six male professional soccer players provided blood samples following 38 competitive matches. High-sensitivity C-Reactive Protein (hs-CRP), Free-Oxygen Radicals Test (FORT), Free-Oxygen Radicals Defence Test (FORD) and Oxidative Stress Index (OSI) were analyzed. Physical MD load was measured via a Global Positioning System (GPS). Results: Differences in High-Load vs Low-Load matches did not significantly influence post-match levels of hs-CRP, FORD, FORT or OSI. Increased high-intensity running and elevated inflammation, with non-significant moderate-to-large effects …

Bacterial Biomass As A Versatile Platform For Functional Materials: Structural Insights And Sustainable Applications, Hasan M. Agha

AUIQ Complementary Biological System

Bacterial biomass has emerged as a versatile material with strong potential in environmental, material, and biotechnological applications, as well as broader uses such as bioplastics, packaging materials, and agricultural systems, owing to its rapid growth, controllable production, and surface chemistry enriched with carboxyl, hydroxyl, amino, phosphate, sulfate, and sulfhydryl groups. These features enable multiple interaction mechanisms, including electrostatic attraction, ion exchange, surface complexation, hydrogen bonding, and π –π interactions, supporting applications in pollutant removal, wastewater treatment, composite development, and bioenergy systems. Bacterial biomass can be sourced from natural environments, industrial fermentation, and waste streams, particularly activated sludge, making it compatible …

Effectiveness Of An Integrated Activity-Based And Tele-Monitoring Intervention On Mental Health Literacy And Resilience Among Urban Older Adults In Thailand: A Quasi-Experimental Study, Khunatpakorn Makkabphalanon, Pramote Thangkratok, Jutamast Wongjan, Natchaya Palacheewa

Journal of Health Research

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes …

The Impact Of Evidence-Based Benzodiazepine Tapering Guidelines In An Outpatient Psychiatric Setting: A Quality Improvement Project, Addeh Tosin

Doctor of Nursing Practice Projects

Long-term benzodiazepine use is associated with dependence, withdrawal, cognitive impairment, falls, and overdose, yet tapering practices remain inconsistent in outpatient psychiatric care. This quality improvement project examined whether evidence-based deprescribing education improved psychiatric mental health nurse practitioners' (PMHNPs) self-efficacy, adherence to benzodiazepine tapering guidelines, and active prescription outcomes. The Plan-Do-Study-Act cycle guided implementation, the ADKAR Model guided change, Bandura’s Self-Efficacy Theory provided the theoretical framework, and the Stetler Model supported evidence translation. The project employed a quantitative, quasi-experimental, single-group pretest-posttest design and involved three PMHNPs from one outpatient psychiatric practice. Participants received one 20-minute educational session based on American Society …

Improving Provider Confidence In Suicide-Risk Screening Through Training On A Safe-T-Guided Pathway At Intake, Shukairo Mack Baker

Doctor of Nursing Practice Projects

Evidence supports structured suicide-prevention education, but inconsistent pathway use at outpatient intake prompted this quality improvement project to evaluate provider confidence. The aim was increased confidence after training on a Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) guided pathway. Donabedian's structure, process, and outcome model and the Awareness, Desire, Knowledge, Ability, and Reinforcement change model guided implementation through one Plan, Do, Study, Act cycle. A single-group pre-test and post-test design involved seven clinicians at one hybrid outpatient behavioral health clinic. All available eligible staff (100%) completed a 2.5-hour training and both surveys. The Suicide Risk Assessment Confidence Scale was administered …

Modelling Acute Haemorrhagic Conjunctivitis In East Africa: An Integrated Approach To Transmission Dynamics And Outbreak Response Strategies, Geofrey Wingi Sikazwe

Tanzania Journal of Science

Acute hemorrhagic conjunctivitis (AHC) poses a significant global health risk, with the potential for rapid spread during outbreaks. For instance, a localized outbreak in Yunnan Province, China, recorded infection rates of up to 48%, illustrating how transmission can intensify under favourable epidemiological and environmental conditions. Existing mathematical models of AHC transmission overlook seasonal variations, a critical factor in epidemic spread. This study combines species distribution models (SDMs) and epidemiological modelling to analyse key drivers of AHC in East Africa. We use the SEIR type (Susceptible-Exposed-Infected-Recovered - incorporating waning immunity) framework with temperature-dependent infectivity rate as the key driver of an …

Building Health Resilience Against The Threat Of “Jakarta Sinking”: A Scoping Review, Risky Kusuma Hartono, Dewi Shinta

Journal of Indonesian Health Policy and Administration

In Jakarta, land subsidence amplifies flood risks—often described as the city “sinking”—which increases exposure to waterborne and vector-borne diseases, disrupts essential health services, and undermines health system resilience. This review examines how subsidence-induced flood amplification impacts health and its implications for system resilience. This study employs a literature review approach that combines narrative synthesis with scoping-oriented evidence mapping. Peer-reviewed articles in English or Indonesian (2015–2025) were searched across PubMed, Scopus, ScienceDirect, Google Scholar, and Portal Garuda using the following terms: flooding, Jakarta land subsidence, health impacts, and health system resilience. Data on hazards, populations, health outcomes, and resilience functions were …

Biosensor Development In East Africa: A Systematic Review Of Technologies, Applications, Challenges, And Future Directions, Ally Mahadhy

Tanzania Journal of Science

Biosensors integrate biological recognition elements with signal transduction systems to generate quantitative or semi-quantitative analytical information and have applications across healthcare, food safety, agriculture, environmental monitoring, and wildlife health. Despite substantial global advances, biosensor development in East Africa remains poorly characterized. This systematic review, conducted according to PRISMA 2020 guidelines, evaluated published evidence from 1995 to 2025 within a predefined East African Community geographical scope. Eligibility was based on IUPAC-aligned operational criteria requiring an integrated biological recognition element, transduction mechanism, and quantitative or semi-quantitative signal output. Three locally developed biosensors met the criteria: an electrochemical nano-biosensor for schistosomiasis diagnosis in …

Korelasi Indeks Massa Tubuh Dengan Kekuatan Otot Dan Performa Fisik Pada Lansia Sarkopenia Di Posyandu Lansia Palembang, A. Deza Farista, Nur Riviati, Ridzqie Dibyantari, Erial Bahar, Taufik Indrajaya, Melani Melani, Michael Jonathan Tan, Crisnah Indah, Indah Aprilia

Jurnal Penyakit Dalam Indonesia

Introduction. The number of older adults in Indonesia continues to increase, and so does the number of older adults with sarcopenia. The decline in muscle mass, muscle strength, and physical performance can reduce quality of life. Body Mass Index (BMI) is easy to measure at community health posts, but it is unclear whether BMI reflects muscle strength and physical performance in older adults who already have sarcopenia. This study aimed to analyze the correlation between BMI and muscle strength and physical performance in older adults with sarcopenia.

Methods. This analytical observational cross-sectional study was conducted from September to …

Antiplasmodial Activity Of Detarium Senegalense J.F.Gmel. (Fabaceae) Stembark Ethanol Extract, Cletus Anes Ukwubile, Hananiya Hamza Milagawanda

Journal of Bioresource Management

Malaria is a persistent public health impediment in sub-Saharan Africa, necessitating an incessant search for new, effective, and low-cost antimalarial agents from medicinal plants. This study was designed to evaluate the antiplasmodial efficacy of the ethanol crude extract of the stembark of Detarium senegalense. Standard methods were employed to identify the major secondary metabolites. In vivo antiplasmodial activity of the extract in Plasmodium berghei-infected mice was carried out as per the standard suppression test. The LD₅₀ was elicited in mice using a standard procedure. Phytochemical analysis revealed the presence of important bioactive components such as alkaloids, flavonoids, …

Descriptive Epidemiology Of Tuberculosis Case With Diabetes Mellitus Identified Through Screening Activities In Indonesia, 2024, Chrisshanti Putri Pasaribu

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major public health problem, particularly among individuals with diabetes mellitus (DM), who are at an increased risk of developing TB disease. Screening activities conducted through health facility-based screening and active case finding (ACF) provide opportunities to identify TB cases with DM comorbidity. This study aimed to describe the epidemiological characteristics of TB-DM cases identified through screening activities in Indonesia in 2024. This descriptive study used routine secondary program data obtained from the Tuberculosis Information System (SITB). The source population consisted of 615,357 individuals screened for TB in 2024, among whom 14,727 TB cases were identified. Of …

Situational Analysis Of Maternal And Child Health Problems In Dki Jakarta Province In 2024, Jennifer Irene Amorita Hadiono, Helda Helda, Tri Yunis Miko Wahyono, Inggariwati Inggariwati

Jurnal Epidemiologi Kesehatan Indonesia

Maternal and child health (MCH) is a critical indicator of national health development aligned with SDGs targets. DKI Jakarta, as a densely populated capital city, faces unique challenges in providing equitable MCH services. This study aims to analyze the situational status of MCH problems in DKI Jakarta Province in 2024 and to determine health priorities using the PAHO-adopted Hanlon method. A descriptive study using quantitative and qualitative approaches was conducted at the DKI Jakarta Provincial Health Office from October 2024 to January 2025. Primary data were collected through structured interviews, while secondary data were sourced from reports of the Nutrition …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

Overview Of Glp-1ra Medications, Thomas A.F. Cordaro Pharmd, Sumaiya A. Difaa Pharmd, Amel J. Basil Pharmd

Transformative Medicine

GLP-1 is an incretin hormone that is naturally produced in the body that regulates blood glucose and appetite. The first GLP-1RA that was FDA approved, exenatide, in 2005, originated from the Gila monster and beaded lizard, via the discovery of the exendin-4 peptide. GLP-1RAs function by mimicking endogenous GLP-1 incretin hormone, leading to an increase in glucose-dependent insulin release from beta-cells of the pancreas, decrease in glucagon release, delayed gastric emptying, and satiety. Due to the benefits seen from initiating GLP-1RAs in the market, it sparked interest in numerous studies which proved that certain GLP-1RAs can provide cardiorenal protection. The …

Wolff-Parkinson-White Pattern: Recognition Of Ventricular Pre-Excitation And Risk Stratification, Devi Parvathy Jyothi Ramachandran Nair, Badri Aryal

Transformative Medicine

Background: Wolff-Parkinson-White (WPW) pattern is characterized by ventricular pre-excitation through an accessory atrioventricular pathway. Although often asymptomatic, some pathways carry a risk of tachyarrhythmia and sudden cardiac death.

Case Description: A 45-year-old man with hypertension, polysubstance use, and bipolar disorder presented with altered mental status following suspected substance intoxication. His course was complicated by hypoxic respiratory failure requiring intubation and a large right basal ganglia hemorrhage requiring surgical evacuation. During hospitalization, an abnormal ECG prompted Cardiology consultation. The ECG demonstrated sinus rhythm with a short PR interval, delta wave, and widened QRS complex, consistent with ventricular pre-excitation. He had …

Elite Esports Players And Their Physical Health: A Systematic Review Of Injuries, Musculoskeletal Pain, And Fitness-Related Factors, Michal Steffl, Daniel Opelik, Vladimir Hlinka, Grzegorz Mikrut, Petra Hospodkova

Baltic Journal of Health and Physical Activity

Background: The rapid rise of competitive esports has sparked concerns over the physical health of elite players. Prolonged sedentary behaviour, repetitive movements, and poor ergonomic practices may predispose these athletes to injuries, musculoskeletal pain, and unfavourable body composition. Materials and methods: A systematic review following PRISMA guidelines was conducted by searching Pub-Med, Scopus, EBSCOhost, and Web of Science for cross-sectional studies on physical activity (PA), body composition, physical fitness, and musculoskeletal health in elite esports players. Data from 22 peer-reviewed studies involving 5,035 participants aged 16 to 35 were synthesized. Results: Findings consistently show that esports players engage in lower …

Beyond Electromyography: A Systematic Review And Meta-Analysis Of Ai Enabled Wearables For Neuromuscular Assessment In Sports Medicine And Rehabilitation, Dariusz T. Skalski, Michał Spieszny, Łukasz Jaworski, Marcin Żak, Artur Terbalyan, Marlena Stawiarska, Wirginia Likus, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Conventional laboratory based EMG systems constrain neuromuscular assessment to controlled environments, limiting ecological validity in sport and rehabilitation. While AI enabled wearable sensor systems, including surface EMG (sEMG), high density EMG (HD-EMG), inertial measurement units (IMUs), and multimodal configurations, have expanded ambulatory monitoring capabilities, no prior meta-analysis has quantitatively synthesized their agreement with laboratory grade comparators or examined the moderating roles of sensor class and task domain. Objective: To determine the overall agreement between AI enabled wearable neuromuscular systems and laboratory benchmarks; to examine sensor class and task domain as moderators of measurement fidelity; to evaluate multimodal gain over …

Quality Improvement Project: Improving Nurse Confidence In Managing Patient Aggression Using The Brøset Violence Checklist And Team-Based Strategies, Grace Amakulor

Doctor of Nursing Practice Projects

Workplace violence remains a concern in psychiatric nursing, particularly when changes in patient behavior are not recognized early or communicated consistently. This quality improvement (QI) project was conducted at a psychiatric recovery center in Central Ohio after identifying a practice gap in aggression risk assessment and response. The purpose was to implement and evaluate a multicomponent aggression-management approach using the Brøset Violence Checklist (BVC), structured team huddles, and individualized aggression care plans. The aim was to improve nurse confidence (primary outcome) and reduce aggressive behavioral incidents (secondary outcome) over four weeks. Bandura’s Social Cognitive Theory and Lewin’s Change Theory guided …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …