Digital Commons Network^™

Pangenome Analysis Of Proteus Mirabilis Reveals Lineage-Specific Antimicrobial Resistance Profiles And Discordant Genotype-Phenotype Correlations, Namrata Deka, Aimee L Brauer, Katherine Connerton, Blake M Hanson, Jennifer N Walker, Chelsie E Armbruster

Faculty, Staff and Student Publications

Urinary tract infections (UTIs) impose a large healthcare burden, with escalating antimicrobial resistance (AMR), and treatment failure. Proteus mirabilis is an undercharacterized and challenging UTI pathogen due to intrinsic resistance and biofilm formation. To understand P. mirabilis population genomics, we combined pangenome analysis, in silico AMR prediction, and phenotypic antimicrobial susceptibility testing (AST) across 1,027 P. mirabilis genomes derived from human urine specimens. This revealed a mosaic pangenome driven by extensive accessory genome plasticity. Multilocus sequence typing (MLST) identified 213 MLSTs, with only 7% having ≥10 genomes, highlighting strain diversity. AMR gene profiles were largely lineage-specific, with 25% of genomes …

Health Systems Interventions For Prevention Of Maternal Peripartum Infection In Low And Middle-Income Countries: A Systematic Review, Roseline Abwao, Job Mapesa, Wanja Tenambergen, David Odada, Nasra Gathoni, Felix Riunga

Internal Medicine, East Africa

Background Globally, there is growing recognition that a functional health system is key to improving maternal health and reducing maternal mortality. Maternal peripartum infection remains a major cause of maternal morbidity and mortality, particularly in low- and middle-income countries. This infection is a multifaceted problem with many players. Adopting a health systems approach could help avert this preventable infection by addressing the gaps across all the components of care.

Objective The aim of this systematic review was to identify and evaluate interventions to prevent maternal peripartum infection in LMICs.

Methods A systematic search was conducted in Cochrane Library, CINAHL, MEDLINE …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …

Mosaic Loss Of Y Chromosome Associates With Lung Function, Emphysema, And Epigenetic Aging, Woei-Yuh Saw, Kangjin Kim, Yichen Huang, Jeong H Yun, Xiaolong Ma, Jason Bacon, Yash Pershad, Daniel Levy, George T O'Connor, Eric Boerwinkle, R Graham Barr, Stephen S Rich, Jerome I Rotter, April P Carson, Laura M Raffield, Sina A Gharib, Traci M Bartz, Bruce M Psaty, Tamar Sofer, Kari E North, Robert C Kaplan, Elizabeth C Oelsner, Ani Manichaikul, Alexander G Bick, Paul Scheet, Alexander P Reiner, Nhlbi Trans-Omics For Precision Medicine Consortium, Yasminka A Jakubek, Paul L Auer, Michael H Cho, Dawn L Demeo

Faculty, Staff and Student Publications

Rationale: As the global population ages, identifying risk factors for age-related diseases, such as COPD, is crucial for public health. Mosaic loss of Y chromosome (mLOY) in blood cells is an age-related somatic mosaicism event, but its relationship with pulmonary health remains undercharacterized.

Objectives: To examine the association between mLOY and pulmonary outcomes in men.

Methods: Leveraging mLOY assessment (cell fraction ≥ 5%) in over 12 000 men, including 5097 from the COPDGene Study and 7235 from six additional cohorts in the Trans-Omics for Precision Medicine program, we investigated mLOY associations with respiratory outcomes and epigenetic aging using multivariable cross-sectional, …

Diversity And Inclusivity In Australian Dementia Prevention Research: A Mixed Methods Review, Olivia E. Giameos, Maddison L. Mellow, Diana Karamacoska, Aaron Davis, Paul A. Gardiner, Eddy Roccati, Kaarin J. Anstey, Nicolas Cherbuin, Jessica M. Adsett, Nikki Anne Wilson, Kylie Radford, Louise Lavrencic, Perminder S. Sachdev, Simone Reppermund, Suraj Samtani, Annabel P. Matison, Zara A. Page, Philip J. Batterham, Sophie C. Andrews, Alex Bahar-Fuchs, Michelle K. Lupton, Andrew Pipingas, Adrienne Withall, Belinda M. Brown, Helen Macpherson, Hannah A.D. Keage, Britt Burton, James C. Vickers, David W. Dunstan, Ashleigh E. Smith

Research outputs 2022 to 2026

Minoritized communities are disproportionately impacted by modifiable dementia risk factors but are underrepresented in dementia research globally. In Australia, the number of dementia prevention cohort and intervention studies has rapidly increased in the past two decades, yet the representation of minoritized groups has not been synthesized. The aims of this mixed-methods review were to summarize the demographic characteristics of participants involved in Australian dementia prevention-focused cohort and intervention studies. A systematic search of published literature, funded grant outcomes, and clinical trial registrations was conducted in October 2023 and updated in February 2025 to identify any Australia-based cohort or intervention studies …

The Effect Of Vaccine Mandates On Disease Spread: Evidence From College Covid-19 Mandates, Riley K. Acton, Wenjia Cao, Emily E. Cook, Scott A. Imberman, Michael F. Lovenheim

Research Collection School Of Economics

Nearly 700 4-year U.S. colleges mandated students receive COVID-19 vaccinations in fall 2021. Using data on college policies and county health, we estimate how mandates affect surrounding communities. Event studies from August to November 2021 show that mandates covering all colleges in a county reduced COVID-19 deaths by 5.6 per 100,000 persons, a 4.6% reduction in the U.S. total during this period. Mandates reduced COVID cases by 504 and ICU admissions by 16.2 per 100,000, though we see no statistically significant impact on hospitalizations. Impacts are larger in counties with larger college populations and low estimated ex-ante student vaccination rates.

Global Prevalence Of Internet Gaming Disorder: An Umbrella Review Of Meta-Analytic Evidence And Implications For Child And Adolescent Psychiatry, Elisabeth C. S. Poon, Xun Ci Soh, Trina J. H. Poh, Andre C. S. Tan, Andree Hartanto

Research Collection School of Social Sciences

Background/Objectives: Internet gaming has become a widespread global activity, raising concerns about the prevalence of Internet Gaming Disorder (IGD). However, existing meta-analyses report highly variable prevalence estimates. This umbrella review aims to clarify the prevalence and variability of IGD by synthesizing evidence from meta-analyses to provide a comprehensive overview of IGD prevalence across populations, age groups, and regions. Methods: Following PRISMA guidelines, systematic searches were carried out across five published literature databases and two supplementary search sources. Title and abstract screening, followed by full-text eligibility assessment, were conducted independently by three authors. The same three authors then performed data extraction …

Caregiver Health Literacy Is Associated With Pediatric Burn Recovery Outcomes, Ananya Sampathkumar, Anna Sabukurian, Erin M. Morris, Alyssa M. Griffith, Nicholas A. Long, Alexa Cumming, Macie Boden, Christina G. Morris, Lauren K. Mayon, Thian H. Nguyen, Allison L. Speer, Natalie A. Drucker

Summer Research Program Abstracts

No abstract provided.

Perceptions Of Research Participation Among Underrepresented Groups: Insights Using Freelisting Methodology, Tamar Klaiman, Jasmine Silvestri, Emma Britez Ferrante, Dorothy Sheu, Adina Lieberman, Erich Dress, Modele Ogunniyi, Neal Dickert, Meghan Lane-Fall, Rosemary Frasso, Rachel Kohn

College of Population Health Faculty Papers

BACKGROUND: Low enrollment and retention in clinical research disproportionately impact Black, Hispanic or Latinx, women, and rural populations, undermining generalizability and perpetuating health disparities. However, few studies have compared mechanisms driving underrepresentation across populations. Freelisting is a qualitative methodology that elicits lists of terms, explores perspectives about domains, and identifies common themes within groups with shared characteristics; however, it has not been systematically applied to understand research participation across underrepresented populations.

OBJECTIVE: To explore perspectives on clinical research participation across underrepresented populations using freelisting methodology to ultimately inform culturally-responsive recruitment strategies.

METHODS: We conducted a web-based freelisting survey among adults …

Association Of Household Economic Status And Birth Order With Stunting Among Children Aged 24-35 Months: Malawi Mics 2019–20, Sibongire B. Ngoma, Asri C. Adisasmita, Renti Mahkota, Septyana Choirunisa, Melisa Nyamukondiwa

Jurnal Epidemiologi Kesehatan Indonesia

Stunting remains a major public health concern in Malawi, with a national prevalence of 35.5% among children under five. However, evidence on the independent and combined effects of household economic status and birth order on stunting among Malawian children aged 24-35 months remains limited. This study aimed to examine the independent and combined association of household economic status and birth order with stunting among children aged 24-35 months in Malawi. A secondary data analysis of a cross-sectional 2019-20 Malawi Multiple Indicator Cluster Survey (MICS) was conducted, and the final sample comprised 2,764 children aged 24-35 months with complete data. Stunting …

Clinical Epidemiology Of Stroke In The Productive Age Population In Indonesia: A Scoping Review, Satria Akbar Putra Asmara, Ulil Albab Habibah

Jurnal Epidemiologi Kesehatan Indonesia

Data from the 2018 Indonesian Basic Health Research (Riskesdas) demonstrates a marked increase in stroke prevalence, rising from 7% in 2013 to 10% in 2018. This upward trend is accompanied by a notable epidemiological shift, with stroke no longer predominantly affecting older adults ≥65 years, but increasingly occurring among the productive-age population (15–64 years). This scoping review was conducted in February 2026 in accordance with the JBI methodological guidelines and PRISMA-ScR. Searches were conducted in Google Scholar, PubMed, Garuda, and ScienceDirect. Inclusion criteria include articles published within the last 10 years (2016–2026), articles discussing the characteristics of stroke patients in …

Application Of Toast Criteria, Comorbidities And Outcomes In Patients With Ischemic Stroke: Multicenter Collaboration In The Dominican Republic, Ryna Then, Maria Muñoz, Cristina Ramos, Marcos Mota, Priscilla Sepulveda, Lisa José, Luis Suazo, Francisco Mendez, Yahaira Franco, Cosme González Villamán, Acela Gonell, Violiza Inoa, Gillian Gordon Perue, Manuel Colomé-Hidalgo, Nadja García

Einstein Health Papers

INTRODUCTION: Stroke is a leading cause of neurological-related death in the Caribbean. The Dominican Republic has among the highest stroke-related mortality rates in the Americas. We aimed to determine ischemic stroke etiologies, characterize comorbidities, and describe outcomes in the Dominican Republic using the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.

METHODS: We analyzed a multicenter quality registry between January 2022 and October 2024. Statistical analyses included Mann–Whitney U and Kruskal–Wallis tests with Bonferroni correction, chi-square tests, and Spearman correlation.

RESULTS: The most common stroke subtype was undetermined etiology (54.8%), followed by large artery atherosclerosis (17.2%) and cardioembolism …

Workplace Environmental Exposures And Related Health Conditions Among Amish & Mennonite Women In Ohio, Lora Wyss, Ratchneewan Ross, Rosanna Hess

Journal of Amish and Plain Anabaptist Studies

Background: Although it is known that some plain (Amish and conservative Mennonite) women work in furniture finishing shops, commercial greenhouses, and on family farms, little is known about their exposure to harmful conditions and substances in those work environments and the incidence of any related illnesses. Aim: To assess the relationship between the exposure to potentially harmful environmental conditions and general health conditions, work-related illnesses, and work-related injuries, comparing adult plain women with adult women of the general population. Methods: Data in this exploratory, concurrent, mixed methods study were collected using a 24-item survey and semi-structured interviews. Descriptive and correlational …

Marshallese Female Caregivers’ Intention To Seek Pediatric Care For Their Children, Ages 2–5, With A Body Mass Index At Or Above The 95th Percentile, Living In Northwest Arkansas, Madicyn Huddleston Freeman

Walden Dissertations and Doctoral Studies

No abstract provided.

Racial Differences In Hiv Testing And Hiv Infection Among Adults With Seborrheic Dermatitis In Atlanta, Georgia, Olivia Elizabeth Collins

Walden Dissertations and Doctoral Studies

No abstract provided.

Online Rights Defense Among Chinese Americans Against Racial Aggression In The U.S. During The Covid-19, Fangzhu Lu, Wenshan Jia

Communication Faculty Articles and Research

Purpose

This study investigates how Chinese American communities responded to heightened racial discrimination during the COVID-19 pandemic by utilizing social media platforms to safeguard their civil rights, articulate collective concerns, and mobilize resistance against racial aggression.

Methodology

Through qualitative case study analysis, the research examines the social media activities of six advocacy organizations, including three X accounts (WashTheHate, Chinese for Affirmative Action, Asian Americans Advancing Justice) and three Instagram accounts (Stop AAPI Hate, Stop Asian Hate, Advancing Justice: AAJC). The analysis focuses on the content strategies and communication mechanisms employed to counteract racial hostility.

Findings

The selected organizations used social …

Exploring The Determinants Of Operating Room Utilization: A Scoping Review Of Influential Factors In Surgical Efficiency, Isma Sari Chumairah, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Optimal utilization of the operating room (OR) is a crucial element in improving the efficiency of surgical services and hospital performance. This scoping review aimed to identify and map the factors influencing OR utilization based on recent scientific literature. We conducted a scoping review using the Population–Concept–Context (PCC) framework and reported it according to the PRISMA-ScR guidelines. We systematically searched PubMed, Scopus, and ScienceDirect for articles published between 2015 and 2025. Eligible studies were screened, and information on study characteristics and reported determinants of OR utilization was extracted and summarized descriptively. Forty studies were included. The reported determinants clustered into …

Harmonizing Intervention, Context, And Implementation Strategies With Context-Driven Co-Design (Cd2), Sarah A Birken, Emily R Haines, Cheyenne R Wagi, Bonny B Morris, Kathryn E Weaver, Kathleen M Lisborg, Sara J Landes, Geoffrey M Curran, Miriam Bender, Maria E Fernandez, Ashley Strahley, Kimberly Wiseman, Kristie L Foley

Faculty, Staff and Student Publications

Background: Extant approaches to close the gap between implementation evidence and practice have been unsuccessful due in part to overreliance on researcher engagement. In practice, change is often driven by mid-level managers. We developed Context-Driven Co-Design (CD2) to equip mid-level managers with a theory- and evidence-based approach to implementation planning.

Methods: We used a two-pronged design. First, we engaged six established implementation researchers in a modified Delphi process, involving two hour-long meetings and asynchronous feedback to develop and refine a CD2 prototype. Second, we piloted an in-person CD2 training and conducted an hour-long focus group to solicit feedback from mid-level …

Bridging Gaps In Childhood Systemic Lupus Erythematosus Treated At An Outpatient Clinic, Allen M. Savedra

Walden Dissertations and Doctoral Studies

No abstract provided.

Qualitative Evaluation Of The Seated Physical Activity Intervention (Spin) Randomized Controlled Trial For Wheelchair Users With Multiple Sclerosis (Ms): Formative Feedback And Future Directions, Angela J Piasecki, Robert W Motl, Katherine Froehlich-Grobe, Stephanie L Silveira

Faculty, Staff and Student Publications

Background/objectives: Wheelchair users with multiple sclerosis (MS) often face barriers that restrict participation in physical activity and exercise training. This manuscript reports on participant feedback to guide evaluating and refining a novel exercise training program, Seated Physical activity INtervention (SPIN). SPIN was adapted from the Guidelines for Exercise in MS (GEMS) approach using a three-step community-engaged research framework based on meeting the needs of wheelchair users with MS.

Methods: Semi-structured interviews were conducted with 9 participants who completed the 16-week SPIN intervention. The key SPIN intervention components were the exercise prescription, exercise equipment, and behavioral coaching grounded in Social Cognitive …

Toolkit For Multistate Disease Progression Simulation And Treatment Decision-Making Aid, Can Xie, Ruosha Li, Wael Saber, Jorge E Cortes, Nicholas J Short, Xuelin Huang

Faculty, Staff and Student Publications

Background: The optimal timing of a treatment within therapy lines can maximize its benefit while minimizing risks and side effects. Because patients differ in clinical and biological characteristics, personalized treatment planning can support physicians' decision-making. However, multistate disease progression complicates the comparison of treatment strategies, motivating the development of a user-friendly web tool for multistate disease progression simulation and treatment decision support. Microsimulation is a natural approach for comparing prespecified treatment-timing strategies, where it generates disease trajectories for a large number of virtual patients matched to an individual patient's observed data. In our framework, microsimulation is performed using a multistate …

Enhancing Sleep Quality Through Sleep Hygiene Education Among Adults In A Faith-Based Community, Denielle Earle-Thompson

Doctor of Nursing Practice Projects

Background

Adults between 18 and 64 years of age require at least seven hours of sleep per night; however, many adults do not meet this recommendation, contributing to increased risks for chronic disease, impaired functioning, mood disturbances, and reduced quality of life. Poor sleep quality has been associated with weakened immunity, cardiovascular disease, diabetes, obesity, anxiety, depression, and decreased daytime performance. Obtaining adequate, good-quality sleep is essential for maintaining overall health and well-being. In faith-based communities, combining health education with spiritual support may provide a holistic approach that addresses both physical and emotional contributors to poor sleep.

Purpose

The purpose …

Disclosing Hunger: Predictors And Screening Strategies For Food Insecurity In Undergraduate University Students And Adults Contexts, Jocelyn Emily Jarvis

USF Tampa Graduate Theses and Dissertations

Food insecurity is a growing public health concern among college students in the United States, with prevalence estimates exceeding those of the general population. Despite the availability of campus, community, and federal food assistance resources, utilization remains low, suggesting that barriers extend beyond structural access. This dissertation examines the psychosocial, behavioral, and institutional factors that shape food insecurity disclosure and help-seeking behaviors among undergraduate students, guided by the Social Ecological Model (SEM).

This work includes three complementary studies. Study One presents a scoping review synthesizing 16 U.S.-based studies to identify psychosocial determinants of food assistance utilization among food-insecure adults. Findings …

A Scoping Review Of Preventive Interventions To Reduce Violence Against Women And Girls In The Islamic Republic Of Iran, Wahiba Abu-Ras, Leena Babiker Idris, Shahira Amin, Ashley Butler, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

In Iran, violence against women (VAWG) remains highly prevalent, with reported rates ranging from 22.9% to 66%, underscoring the need for effective, contextually grounded interventions.   This scoping review aimed to systematically identify, map, and critically appraise intervention strategies addressing VAWG in Iran.   Guided by PRISMA-ScR and the PICOS framework, comprehensive searches were conducted across nine databases from 2000 to September 2024. Eligible studies included intervention-based research conducted in Iran that reported outcomes related to violence reduction, psychological well-being, or empowerment. Thirteen studies met the inclusion criteria.   The included studies demonstrated heterogeneous designs, theoretical frameworks, and outcome measures. Four interventions targeted …

Quality Improvement Project: Implementation Of The Patient Health Questionnaire-9 Modified For Teens, Hedy Gerber, Leah Buchko, Jennifer Van Winkle

All Faculty and Staff Scholarship

Background: Adolescent depression is a prevalent and significant public health concern, strongly linked to increased suicidality, poor health outcomes, impaired psychosocial functioning, and substantial societal costs. Although measurement‑based care using validated screening instruments is recommended by clinical practice guidelines, routine use of standardized depression screening tools remains limited in mental health settings.

Objective: The purpose of this quality improvement project was to assess the impact of implementing the Patient Health Questionnaire-9 modified for teens (PHQ-9M) in depression screening rates among adolescents aged 11-17 years at an outpatient mental health clinic in Southern Colorado.

Methods: A quantitative, quasi‑experimental pre- and post-intervention …

Using United States Medicare Program Claims To Identify Reliable Measures Of Low Value Services Influenced By Primary Care Physician Decisions, Chris Fleming, Dmitriy Poznyak, Rhea E. Powell, Claire Erba, Eunhae Shin, Rui Wang, Claire Burkhart, Arkadipta Ghosh, Eugene C. Rich

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Low-value services (LVS) are those that “… provide little to no benefit to patients….”¹ Among an existing set of 31 LVS are invasive procedures not typically performed by primary care physicians (PCPs), and other LVS that may be commonly provided by specialists. To facilitate research on the role of primary care physicians in low-value care, we sought to identify the reliability of two subsets of LVS measures that are more directly subject to PCPs’ decisions. We refer to these as primary care adjacent (“PCA”) LVS measures.

METHODS: Retrospective observational cohort study to identify which of a 31-item LVS …

Culturally Informed Approaches To Support Perinatal Mental Health: Perceptions And Experiences Of Perinatal Depression And Support Systems Among Postpartum African-Born Women In The United States, Joyce O. Imafidon

ETDs from 2020-2029

Perinatal mental health (PMH) of African-born women (ABW) is underrepresented in research and practice in the United States (US) despite known consequences of poor mental wellbeing on one’s overall health, relationships and productivity. Beyond their fundamental role in family support, ABW contribute significantly to the US workforce, education sector, and economy. This three-paper dissertation enhances understanding on PMH outcomes, perception and experiences of ABW in the US. Perinatal depression (PD), one of the most common mood disorders affecting 1 in 8 women, is highlighted. The overarching question is to what extent does the US health system address PMH of ABW …

Psycho-Behavioral And Psychosocial Factors Influencing Childhood Obesity In The United States, Nadia Ntori Nkansah

Walden Dissertations and Doctoral Studies

No abstract provided.

Exploring Menstrual Cycle Experiences And Well-Being In Young Women With Type 1 Diabetes, Yolanda Rotzinger Ballesteros

USF Tampa Graduate Theses and Dissertations

Young women with type 1 diabetes (T1D) navigate complex physical, emotional, and social challenges, being at a higher risk for mental health concerns (e.g., depression), as well as physical (e.g., fatigue) and cognitive (e.g., focus) symptoms related to the management of their chronic health condition (Dantzer et al., 2003; Northam et al., 2005). About one-third of young women with T1D experience some form of menstrual dysfunction (Griffin et al., 1994; Schweiger et al., 2011), which is associated with lower quality of life across several domains, including the educational setting (Knox et al., 2015). Nevertheless, there is a gap in the …

Using In-Home Air Quality Monitoring To Reduce Cannabis Secondhand Smoke Exposure In Children: Quantitative Pilot Feasibility Study, Vincent Berardi, Bradley N. Collins, Laura M. Glynn, Eusabeia Silfanus, Darby G. Lyons, Stephen J. Lepore

Psychology Faculty Articles and Research

Background: An estimated 5 to 8 million US children live with a parent who uses cannabis, and most cannabis users report smoking cannabis inside their homes, placing children at risk for cannabis secondhand smoke (cSHS) exposure. Indoor air quality (IAQ) monitoring provides real-time feedback on airborne pollutants and has shown promise in reducing in-home tobacco secondhand smoke exposure, suggesting its potential as an effective harm reduction strategy for cSHS.

Objective: This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of using low-cost, off-the-shelf IAQ monitors to increase caregivers’ awareness of children’s cSHS exposure risk and to change …