Enhancing Hiv Prevention: Implementation And Evaluation Of A Standardized Hiv Risk Assessment Screening In A Primary Care Setting, William Duckworth

Doctoral Dissertations

Background: HIV remains a persistent public health concern, with 1.3 million people affected worldwide. Although advances in treatment have improved long-term management, early prevention still relies on identifying individuals at elevated risk. In many primary care settings, routine HIV risk assessment is inconsistent or absent, resulting in missed opportunities to screen, educate and initiate prevention strategies such as pre-exposure prophylaxis (PrEP). This gap underscores the need for structured, evidence-based tools to improve early risk identification and strengthen HIV prevention efforts. Purpose: Implement and evaluate an evidence-based standardized screening process for HIV risk assessment to achieve early identification and enhance appropriate …

Enhancing Hpv Vaccination Engagement And Uptake Among Young Adults Aged 17 To 26 Through A Multilevel, Multicomponent Intervention, Sarah Dianne Girlinghouse

Doctoral Dissertations

Background: Human papillomavirus (HPV) remains one of the most common vaccine-preventable infections, with vaccination rates among young adults aged 17 to 26 remaining below Healthy People 2030 targets. University health settings represent a critical opportunity to improve vaccine uptake. Prior to this quality improvement (QI) initiative, student health services (SHS) at a public university in the southern United States did not routinely offer HPV vaccination, resulting in missed opportunities for prevention. Evidence supports provider recommendation, clinical decision support, and improved access as key drivers of HPV vaccination uptake. Purpose: The purpose of this QI project was to increase HPV vaccination …

Liver Injury From Medications Used For Treating Inflammatory Bowel Disease: The Drug-Induced Liver Injury Network Experience, Harish Gopalakrishna, Jiezhun Gu, Yi-Ju Li, Huiman Barnhart, Dina Halegoua-De Marzio, Herbert L. Bonkovsky, A. Sidney Barritt, Jean P. Molleston, Naga P. Chalasani, Marwan Ghabril

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: We aimed to investigate and characterise DILI due to approved therapies for inflammatory bowel disease (IBD).

METHODS: Using the Drug-Induced Liver Injury Network (DILIN) prospective study, we evaluated definite, highly likely, or probable DILI attributed to IBD therapies, including use for non-IBD indications (but excluding corticosteroids). HLA allele associations were investigated.

RESULTS: Among 1806 participants, 81 (4.5%) had IBD-agent DILI: 31 biologics (27 infliximab), 35 immunomodulators (31 azathioprine/mercaptopurine), 14 aminosalicylates (11 sulfasalazine) and 1 small molecule (tofacitinib). Median age was 45 years with 75% female and 78% White. Patients with biologic-DILI were younger, had longer latency (median 124 days), …

Evaluating Outcomes Of Alternative Pathologic Terminology In High-Grade Dysplastic Colorectal Lesions, Shaman Dalal, Aakash Desai, Nahel Tunio, Jacqueline Khalil, Devereaux Sellers, Marc Landsman

Division of Gastroenterology and Hepatology Faculty Papers

Background Pathologists occasionally classify colorectal adenomas with dysplastic mucosal invasion as intramucosal carcinoma (IMC), or carcinoma in situ (CIS), instead of high-grade dysplasia (HGD), potentially leading to earlier surveillance colonoscopies and inappropriate surgical referrals. We aimed to analyze differences in the management of patients with these diagnoses, and examined the factors that may lead to inappropriate early interval (IEI) follow-up recommendations for surveillance.

Methods We reviewed 870 colonoscopy and pathology reports from 2015-2022, excluding cases of colorectal cancer, inflammatory bowel disease, and lesions not amenable to endoscopic resection. Surveillance appropriateness was defined in accordance with the 2020 US Multi Society …

A Multi-Country Community Of Practice To Strengthen Quality Improvement In Low- And Middle-Income Countries: A Quality Improvement Program Description, Samhita Bhargava, Heather A Haq, Brodus A Franklin, Elizabeth Davis, Florence Anabwani-Richter, Thobile Bhembe, Lindokuhle P Dlamini, Makhosazana Dlamini, Andy Chapola, Nomsa Kafumba, Chisomo Mzandu Zinyemba, Menard Bvumbwe, Kyakuwa Richard Jjuuko, Jacqueline Balungi Kanywa, Dithan Kiragga, Andreas Boy Isaac, Esther Makhalanyane, Lwamba Nyembo, Retselisitoe Mahlaha, John T Farirai, Eunice W Ketang'enyi, Andrea E M Imsen, Iuliana Costas, Susan B Torrey

Faculty, Staff and Students Publications

Background/objectives: Quality improvement (QI) is widely used in global health to improve patient outcomes, reduce costs, and strengthen service delivery. The Texas Children's Global Health Network (TCGHN) includes nine independent non-governmental organizations supporting healthcare in low- and middle-income countries (LMICs), with pediatric HIV clinical centers of excellence in six countries in sub-Saharan Africa (SSA), supported technically by Baylor College of Medicine. We describe the development of a virtual QI Community of Practice (QICoP) to connect geographically dispersed teams and strengthen local QI capacity.

Methods: In 2022, QI and global health experts convened to design the QICoP and assess site readiness. …

Motivation And Leadership Development Among Federal Nurse Leaders, Sarah Davis-Arnold

Walden Dissertations and Doctoral Studies

No abstract provided.

New Applications Of Cardiopulmonary Exercise Testing Parameters Characterize Age-Related Changes In Exercise Performance During Adolescence, Katerina Kourpas, Takeshi Tsuda

Department of Pediatrics Faculty Papers

BACKGROUND: Age-related changes in exercise performance during adolescence are complex because of progressive physical and functional changes, in which multiple factors are involved.

METHODS: Peak and submaximal cardiopulmonary exercise testing (CPET) parameters were studied in healthy children and adolescents.

RESULTS: TTotal 303 subjects were divided into six groups by ages and sex: ≤11 years old (yo) (28/22 for males/females), 12–15 yo (61/98), and ≥16 yo (52/42). Rest and peak heart rate (HR) were comparable in all groups. Absolute peak values of oxygen consumption (˙ VO2), work rate (WR), and oxygen pulse (OP) were higher in older age groups in both …

Reducing Cardiovascular Disease Risk In Obesity: An Unexpected But Welcome Fourier Transformation, Layla A Abushamat, Arsalan Hamid, Vijay Nambi, Huaizhu Wu, Christie M Ballantyne

Faculty, Staff and Students Publications

No abstract provided.

A Cross-Sectional Analysis Of The Vaginal Microenvironment In Rheumatoid Arthritis, Marlyd E Mejia, Savannah Bowman, Jessica Lee, Ali El-Halwagi, Keshia Ferguson, Maryjo Maliekel, Yixuan Zhou, Camille Serchejian, Clare M Robertson, Mallory B Ballard, Lee B Lu, Sobia Khan, Olubunmi O Oladunjoye, Shixia Huang, Sandeep K Agarwal, Kathryn A Patras

Faculty, Staff and Students Publications

The human microbiota is implicated in the development and progression of rheumatoid arthritis (RA). Given the increased RA burden in women and well-known correlations between the vaginal microbiota and local inflammation, we seek to understand the vaginal microenvironment in the context of RA pathology. Self-collected vaginal swabs and questionnaires on dietary, menstrual, and health information were obtained from 36 RA and 50 demographically-matched control women, 18–63 years of age. Medication regimen, along with disease activity and severity, was captured for the RA cohort. Vaginal swabs were subjected to long-read 16S rRNA gene sequencing, multiplex cytokine analyses, and quantification of rheumatoid …

Nmda Receptor Subunit Nmr-2 Regulates Pathogen-Induced Immune Responses Via The Nervous System In C. Elegans, Benson Otarigho, Jonathan Lalsiamthara, Alejandro Aballay

Faculty, Staff and Student Publications

Neural control of innate immunity must balance restraint of basal immune activity with rapid activation upon pathogen encounter. Glutamate, the primary excitatory neurotransmitter in the nervous system, has been implicated in several neurological disorders associated with inflammation, suggesting a potential link to immune regulation. However, how glutamatergic signaling contributes to immune balance remains unknown. Here, we demonstrated that the NMDA-type ionotropic glutamate receptor subunit NMR-2, a component of the NMDA receptor complex, acts in the

An Exploration Of The Intersection Of Artificial Intelligence And Speech-Language Pathology -- Potential Impacts, Manish K. Rami

Internet Journal of Allied Health Sciences and Practice

Purpose: This paper explores the potential impact of Artificial Intelligence (AI) on the profession of Speech-Language Pathology (SLP). AI is widely recognized as a transformative force, presenting opportunities across both service delivery and professional practice in SLP. Method: The analysis employs the American Speech-Language-Hearing Association's  Scope of Practice in Speech-Language Pathology as an organizing framework to systematically evaluate AI applications across professional and service delivery domains. Within each domain, the study identifies emerging use cases, evaluates the capacity for AI technologies to automate or augment clinical processes, and examines broader implications for the profession, with particular attention to anticipated changes …

An Analysis Of Dei Preparation In Health Science Programs For Future Healthcare Providers, Michael Holik, Scott Heinerichs

Internet Journal of Allied Health Sciences and Practice

Purpose: Research has indicated patients have better outcomes when their healthcare providers are comprehensively trained in diversity, equity, and inclusion (DEI) related areas during their academic preparation. By understanding students’ perceptions of the DEI education, they receive and knowing how that training may impact future patient interactions, educators can allow educational programs to prepare health science students better. This study aimed to garner and examine the perceptions health science students have on the DEI education they receive as undergraduate and/or graduate students in a regional public comprehensive university. Methods: Upon approval of research from the Institutional Review Board, 2,700 health …

Postural Rehabilitation In The Management Of Chronic Neck Pain: A Comprehensive Literature Review, Yashfa Arman

Internet Journal of Allied Health Sciences and Practice

Purpose: This systematic review synthesizes current evidence on the efficacy of major postural rehabilitation techniques for chronic neck pain. Method: A systematic literature search was conducted in PubMed, Scopus, and PEDro databases up to May 2024. Randomized controlled trials and systematic reviews investigating posture-focused interventions for adults with non-specific chronic neck pain were included. Results: Seventeen studies met the inclusion criteria. Findings indicate that all techniques are effective, but each excels in distinct domains. Neck-specific exercises provided the most significant reduction in pain intensity (up to 58%) and functional disability. Global Postural Re-education (GPR) demonstrated superiority in improving objective measures …

Operational And Implementation Evaluation Of A Short-Term Medical Service Program In Rural Guatemala, Mitchell M. Michalak, Shamecka Douglas, Oscar Gonzalez, Giovanna Sanguinetti, Ashley Sweat

Internet Journal of Allied Health Sciences and Practice

Burnout And Professional Fulfillment Among Academic Faculty In U.S. Graduate Physical Therapy Programs: A Cross-Sectional Analysis, Joshua Cleland, Paul Mintken, Megan Donaldson

Internet Journal of Allied Health Sciences and Practice

Purpose: Burnout among academic faculty is a growing concern, particularly within health professions education. This study examines the prevalence of burnout, associated risk factors, and protective factors, including professional fulfillment, among faculty and leadership in U.S. graduate physical therapy (PT) programs. Methods: A cross-sectional survey was administered to program leaders in graduate PT programs for distribution. The survey included validated metrics from the Stanford Professional Fulfillment Index along with custom items assessing workload, institutional culture, mentorship, and wellness factors. Comparative analyses were conducted between individuals who reported burnout and those who did not. Results: A total of 152 responses were …

An Academic–Community Partnership: A Faculty-Student Collaborative Occupational Therapy Clinic For Health Equity And Experiential Learning, Jennifer Martin, Nancy Saucedo, Jazmine Jacobo, Monica Gendy, David John, Yolanda Escalante

Internet Journal of Allied Health Sciences and Practice

Purpose: This descriptive report outlines the development and operation of a faculty–student collaborative occupational therapy (OT) clinic embedded in a community-based primary care setting serving uninsured individuals. The clinic’s dual mission is (1) to reduce disparities in access to OT services and (2) to serve as an educational model for developing student competence, cultural humility, and advocacy skills. Description: Established in 2019 and relaunched in 2023, the clinic operates one day per week, providing consultative OT services primarily for musculoskeletal conditions, with additional referrals for neurological and systemic issues. Over two academic years, the clinic delivered 229 service hours across …

Dopamine-Endocannabinoid Crosstalk Drives Exercise-Induced Bidirectional Plasticity In Parkinson's Disease, Federica Campanelli, Gioia Marino, Giuseppina Natale, Maria De Carluccio, Tabitha N. Rodriguez, Michelle Smeyne, Richard Jay Smeyne, Veronica Ghiglieri, Paolo Calabresi

Department of Neuroscience Faculty Papers

Parkinson’s disease (PD) is a neurodegenerative disorder marked by loss of substantia nigra dopaminergic neurons. Epidemiological evidence indicates that lifelong physical activity reduces both PD incidence and slows disease progression. Here, we examine how voluntary exercise induces long-lasting neuroprotection of the corticostriatal function in a murine model of α-synuclein–driven nigrostriatal pathology. In preformed fibril (PFF)-injected mice, long-lasting voluntary wheel running prevents degeneration of nigrostriatal dopaminergic terminals and improves motor performances. Intensive exercise normalizes spontaneous glutamatergic transmission and preserves corticostriatal long-term potentiation (LTP) in striatal spiny projection neurons. Exercise-induced LTP is dependent on activation of dopamine (DA) DA1, GluN2B-expressing NMDA and …

Standardizing Tms Intensity Across Different Coils Using Individualized Electric Field Modeling, Evgenii Kim, Mohammad Daneshzand, Keren Zhu, Danyal Fareed Bhutto, Teresa Jacobson Kimberley, Dylan J. Edwards, Netri Pajankar, Parker Kotlarz, Tommi Raij, Sergey N. Makaroff, Aapo Nummenmaa

Moss-Magee Rehabilitation Papers

Quantitative measures for Transcranial Magnetic Stimulation (TMS) intensity are needed to ensure safe and consistent application in therapeutic and research settings. However, resting motor thresholds (rMTs), commonly used to determine stimulation intensity, depend on the coil used. Unless motor mapping and treatment coils are identical, re-thresholding is necessary, increasing patient discomfort and potentially introducing variability across studies. These considerations raise an unresolved fundamental question: does individual rMT reflect a consistent cortical electric field (E-field) magnitude independent of coil geometry? We tested the hypothesis that rMT corresponds to a coil-invariant cortical E-field magnitude and evaluated a computational method for predicting stimulator …

Articulator Volume 32, Issue 2

Metro Denver Dental Society Articulator Magazine

The 2nd Quarter 2026 issue of The Articulator explores the growing intersection between oral health and whole-body wellness, with a focus on oral-systemic health, interdisciplinary collaboration and the role of dentistry in preventive medicine. Articles include:

• A perspective from Dr. Brett Kessler examining what true medical-dental integration would require, including reimbursement reform, collaborative care models and expanded recognition of dentistry’s role in systemic health.
• An evidence-based article from Ms. Anne O. Rice exploring the connection between periodontal disease, inflammation and Alzheimer’s disease, including the role of dentistry in dementia risk reduction and preventive healthcare.
• Insights from Ms. Lani McBeth on …

A Systematic Review Of Intrusion Detection Systems For Internet Of Medical Things: Performance, Efficiency, Explainability, And Generalization, Oswald Adohinzin, Youssef Harrath

Research & Publications

The Internet of Medical Things (IoMT) has transformed health care delivery through medical devices, remote patient monitoring, and real-time clinical decision support. However, the proliferation of IoMT devices introduces security vulnerabilities that put patient safety and data privacy at risk. Intrusion Detection Systems (IDS) have emerged as essential components for protecting IoMT networks from cyberattacks. This article presents a systematic review of IoMT-IDS research, analyzing 53 high-quality papers published between 2020 and 2025, identified through database searches spanning 2016–2025 across IEEE Xplore, Springer, ScienceDirect, and ACM Digital Library. We organize the literature through a comprehensive taxonomy spanning classical machine learning …

Paidar: Private Sector Allied For Inclusive Delivery Of Accessible Reproductive Health, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face critical challenges in increasing contraceptive use and reducing the unmet need for family planning (FP). While public-sector facilities remain key providers, a substantial proportion of healthcare seekers rely on private family physicians as their initial point of contact.

Recognizing this strategic opportunity, the PAIDAR study was designed to strengthen the role of private- sector male family physicians in FP service delivery. Implemented across six diverse districts of Punjab, supported by Health Care Commission Punjab and Department of Health and Population Punjab, the intervention enhanced providers' capacity to deliver quality FP counselling, contraceptive services, structured referrals, and …

Making Better Use Of Data For Improved Health Service Delivery In Punjab: Transforming Data Into Action Evidence, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Strong health systems depend not only on collecting data, but on using it effectively for planning, monitoring, and decision-making. To strengthen evidence-based management across Punjab's health sector, the Population Council partnered with the Health and Population Department, Punjab, particularly the Health Information and Service Delivery Unit (HISDU), to improve the utilization of routine health information. This brief summarizes the collaboration's focus on three complementary areas: (1) Development of the ASET (Analytics for Service Efficiency and Tracking) platform to transform routine data into actionable information; (2) Strengthening the Capacity of Data Users through specialized training in data analytics, visualization, and use …

Social Media Is A Juggernaut: Lagged Correlation Analysis Using Ngram Data On “Internet” And “Social Media” With Amplification By The Advent Of The “Iphone”, William Zywiak, Gao Niu, Nicolas Petrell, Victoria Nichele, Kirsten Hokeness

Mathematics and Economics Faculty Journal Articles

The amount of new information transmitted per day can be overwhelming. The data available through Ngram Viewer allows statistical examination to determine the most salient topics, as well as lagged correlation and lagged variance to support possible causal connections between concepts. Using this database, we determined that COVID, crypto, microplastics, and especially social media are important topics of the last few years. We also present results that suggest the development of the internet and the iPhone fueled the prominence of social media, and the access of the iPhone also increased access to the internet.

Beyond The Mortality Paradox: Redesigning Uti Care For People Living With Dementia Through Diagnostic Stewardship, Rob E. Carpenter

Human Resource Development Faculty Publications and Presentations

Managing urinary tract infections (UTI) in people living with dementia presents a mortality paradox: clinicians must balance the risks of antibiotic overuse against the dangers of delayed treatment in high-risk phenotypes. Standard diagnostic criteria often rely on classic, localizing markers like fever and dysuria. However, these gatekeeper signs are frequently absent or blunted in dementia care due to age-associated immune dysregulation and immunosenescence. Consequently, infections often manifest as nonspecific neurobehavioral changes, leading to predictable misclassification and harmful diagnostic delays. This paper reframes UTI management in dementia as a clinical pathway and measurement architecture problem. We propose a verification-first service pathway …

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

The Impact Of Economic Stability On Diagnostic Timing Of Autism Spectrum Disorder In Children, Leslie Box Simms

ETDs from 2020-2029

Diagnosis of neurodevelopmental delays in children, including autism spectrum disorder, is an often lengthy and burdensome process, potentially placing children with economic instability at risk for diagnostic delay. The first aim of this dissertation was to explore the impact of economic stability on diagnostic timing of autism spectrum disorder via a scoping review of the literature. Papers were summarized by study design, data sourcing, handling of variables, statistical methodology, and the effect of economic stability factors on diagnostic timing of autism. Income and healthcare insurance were the most frequently employed measures of economic stability, with transportation, housing, and food security …

Advance Care Planning In Metastatic Lung Cancer Patients: A Quality Improvement Initiative, Khanh H. Thai

Student Theses

Background: Advance care planning (ACP) is essential in achieving goal-concordant care for patients with metastatic lung cancer (MLC), yet it remains underutilized.

Local problem: Despite its benefits, ACP has been inconsistently integrated into outpatient oncology settings, and a baseline evaluation at the project site revealed that only 11% of patients with MLC had ACP documented in the outpatient care clinic.

Methods: This Quality Improvement initiative implemented a formal, Nurse Practitioner (NP)-led intervention into routine oncology care. Using a quasi-experimental nonrandomized design, 13 eligible patients diagnosed with MLC without prior ACP documentation were enrolled in a four-week study. These participants were …

Assessing The Influence Of Disability Views On Perceptions Of Hearing Aids Among Older Korean Adults, Stasha Lee

Dissertations, Theses, and Capstone Projects

Background

Age-related hearing loss, also known as presbycusis, is highly prevalent among older adults, yet hearing aid adoption remains low, in part due to concerns about stigma and negative social perceptions. This study aimed to examine whether attitudes towards disabilities influence perceptions of individuals wearing hearing aids among older Korean adults. It also explored the potential effects of cultural identity and the age of the individual wearing the hearing aid on these perceptions.

Methods

Ten participants completed the Attitudes and Perspectives on Persons with Disabilities (APPD) questionnaire and rated 8 different images of individuals (one younger male and one older …

Clinical Presentations Of Pemphigus Vulgaris In Patients With Skin Of Color: A Systematic Literature Review, Haya Alkiswani, Simona Alomary, Jared Boetes, Nicole J. Baker, Susan C. Taylor

SKMC Student Presentations and Publications

Background: Pemphigus vulgaris (PV) is a rare, often severe autoimmune disease affecting skin and mucous membranes. Despite the scarce literature on PV in skin of color (SOC) populations (Fitzpatrick III-VI), existing studies suggest that there are misdiagnosis, delayed treatment, and recurrence of symptoms in SOC patients with PV. Objective: This review explores the clinical presentations of PV reported in patients with SOC, diagnostic challenges and delays, treatments, and patient outcomes to allow for an improved understanding of how PV manifests clinically in darker skin. Methods: A systematic literature review was conducted using articles found in PubMed and Embase. Two independent …

The Dermatologic Effects Of Climate Change On Skin Of Color Populations: A Comprehensive Review, Grace Ugwueke, Simona A. Alomary, Nicole J. Baker, Susan C. Taylor Md, Nada Elbuluk Md

Student Papers, Posters & Projects

Background: Climate change contributes to rising temperatures, worsening air pollution, increasing UV exposure, and more frequent extreme weather events with downstream consequences for dermatologic conditions. However, limited research has examined how these climate-related effects can impact skin of color (SOC) populations, who often face disproportionate environmental exposures and structural inequities. Objective: To summarize the dermatologic implications of climate and environmental stressors on SOC populations. Methods: A literature search of PubMed and Embase (2000-2025) identified studies assessing dermatologic outcomes related to climate change or environmental exposures. Of 1254 records screened, 133 duplicates were removed, leaving 1121 studies for evaluation. Twenty-three studies …