Medicine and Health Sciences Commons^™

Staphylococcus Aureus Urease Is Controlled By A Complex Regulatory Network To Promote Dissemination During Cauti, Jana Gomez, Jesus Duran-Ramirez, Maristhela Alvarez, Shane Cristy, Jennifer N Walker

Faculty, Staff and Student Publications

Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-associated infections in the United States, accounting for >1 million cases annually. One CAUTI pathogen, Staphylococcus aureus, is commonly found persisting asymptomatically in the bladder of catheterized individuals, increasing these individuals' risk of developing infection. Importantly, S. aureus is not only associated with severe symptoms during CAUTI, including bacteremia and septic shock, but it also produces a common uropathogen-associated virulence factor, urease. Despite its importance, urease has only been well-studied in another uropathogen, Proteus mirabilis. While previous studies identified three S. aureus urease regulators, including CodY, …

An Online Epilepsy Self-Management Tool For Patients With Epilepsy: A Formative Usability Study, Katarzyna Czerniak, Ross Shegog, Refugio Sepulveda, Robert Addy, Youngran Kim, Sahiti Myneni, Alejandra Garcia-Quintana, Kimberly Martin, David M Labiner

Faculty, Staff and Student Publications

Background: Epilepsy is a serious chronic neurological condition with no permanent cure. Continual self-management is important to mitigate seizure frequency and optimize quality of life in people with epilepsy who have greater disparities in accessing epilepsy care. The Management Information & Decision Support Epilepsy Tool (MINDSET [UTHealth, University of Arizona, and Radiant Digital]) was developed to enhance accessibility to epilepsy self-management (ESM) assessment and treatment. The purpose of this formative usability pilot study was to assess the user experience and functionality of MINDSET 2.0, an enhanced cross-platform online version of MINDSET, among a sample of patients with epilepsy prior to …

Differences In Response Rates To A Previsit Electronic Portal Questionnaire In Outpatient Clinics: A Retrospective Observational Study Of The Standard Dermatology Outcome Measures, Rene F. Chen, Udeyvir S. Cheema, Beiyu Liu, Cynthia L. Green, Matilda W. Nicholas, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Larotrectinib In Trk Fusion Differentiated Thyroid Carcinoma: Updated Trial Data, Steven Waguespack, Marcia Brose, Jessica J Lin, Ray Mcdermott, Mohammed Almubarak, Jessica Bauman, Michela Casanova, Shivaani Kummar, Se-Hoon Lee, Damian Rieke, Do-Youn Oh, Changsong Qi, Natascha Neu, Domnita-Ileana Burcoveanu, Chiara Mussi, Alexander Drilon, David Hong, Maria Cabanillas

Department of Medical Oncology Faculty Papers

Larotrectinib is a first-in-class, highly selective, central nervous system-active tropomyosin receptor kinase (TRK) inhibitor approved for tumour-agnostic use in TRK fusion cancer. It has previously demonstrated rapid and durable disease control and favourable safety in patients with advanced TRK fusion thyroid carcinoma (TC). After an additional 4 years of follow-up with the inclusion of two additional patients, and utilising an independent review committee (IRC) to assess overall response rate (ORR), we report updated pooled analyses from three phase 1-2 larotrectinib clinical trials, focusing only on patients with TRK fusion differentiated TC (DTC). The primary endpoint was the IRC-determined ORR per …

Prescription Opioid Misuse Among High School Athletes During The Opioid Prescribing Limit Law Era: Yrbss 2017-2023, Francine R Vega, Andrea J Yatsco, Audrey Sarah Cohen, James R Langabeer, Tiffany Champagne-Langabeer, Rakshitha Vijendra, Christine Bakos-Block

Faculty, Staff and Student Publications

Background/Objectives: School-age athletes occupy a paradoxical position in the adolescent opioid crisis, combining health-oriented activity with elevated risk of sports-related injury and prescription opioid exposure. In response to the opioid epidemic, states enacted opioid prescribing limit laws (OPLLs) beginning in 2016-2017, yet whether these supply-side policies reached high-risk youth subgroups remains unclear. This study evaluated national temporal trends in prescription opioid misuse among U.S. high school students during the period of OPLL implementation and examined differences across athletic participation, concussion history, sex, grade, race/ethnicity, and substance-use profiles.

Methods: Using four biennial waves of the Youth Risk Behavior Surveillance System with …

The 2025 Measles Outbreak In Texas, Tamer Oraby, Martial L. Ndeffo-Mbah

School of Mathematical & Statistical Sciences Faculty Publications

Background

In 2025, Texas experienced its largest measles outbreak in decades, reporting 762 cases by mid-August. Measles is a highly contagious but vaccine-preventable infection transmitted mainly among unvaccinated individuals and capable of causing severe outcomes.

Methods

We investigate counterfactual measles control scenarios based on daycare and school closures and reactive vaccination of infants and children, including mixed interventions. We analyze the 2025 Texas outbreak using an age-structured multi-stage SEIR model formulated as a system of ordinary differential equations. The model is fit to case data using Bayesian inference to estimate the effective reproduction number and generate posterior predictive trajectories under …

Conceptual Framework And Key Considerations For Field-Based Infrastructure In Food Is Medicine Research, Shreela V Sharma, Colleen Tewksbury, Christopher R Long, Colleen Spees, Ronit A Ridberg, Reshma Gupta, Erin P Ferranti, Naomi Tice, Eric Peterson, Brian Levine

Faculty, Staff and Student Publications

In 2023, the American Heart Association launched the Healthcare by Food (HCXF) initiative to establish a rigorous evidence base for Food Is Medicine (FIM) programs, so that patients with acute or chronic disease could access FIM programs as a covered benefit under their health insurance. The HCXF initiative is engaging in research, advocacy, and education to support the development and testing of interventions that improve health outcomes. The HCXF initiative launched 9 task forces aligned with research progress, including the Field-Based Infrastructure task force designed to examine broader questions to help support either earlier or later stages of the HCXF …

Reply To “Comment On Primary Care Providers' Perspectives On Telehealth Medicare Annual Wellness Visits For Older Adults In Midwestern Health System”, Vaibhavi Mone, Jungyoon Kim

Health Services and Informatics Research

No abstract provided.

Reducing The Readmission Rate In Adult Psychiatric Patients With Bipolar Disorder, Jessica Nwokocha

Doctor of Nursing Practice Final Project Abstract

Purpose: 

The goal of this project was to reduce the readmission rate among patients by improving attendance to the post-hospitalization program through phone call reminders.

Background: 

Review of baseline data at the project site showed a 60% increase in the readmission rate among adult patients with bipolar disorder in May 2025. This analysis demonstrates that the readmission rate in psychiatric hospitals continues to be an issue.

Methodology: 

The project utilized the Plan-Do-Study-Act (PDSA) framework to guide implementation over a six-week period, with readmission rates monitored for a 30-day period. Data collected and tracked included patient attendance, completed phone calls, and …

A Topology-Aware Extension Of Guttae Area Ratio In Fuchs Endothelial Corneal Dystrophy, Molly Orlick, Henry Bair

Wills Eye Hospital Papers

No abstract provided.

Non-Enzymatic Hepatic Abhd6 Interacts With Akt-Foxo1 Axis To Regulate Metabolic Health, Guannan Li, Laurence T Maeyens, Jiyuan Yin, Jan-Bernd Funcke, Chanmin Joung, Ruizhen Li, Ziying Xu, Ting Wu, Xin Li, Nisi Jiang, Mbolle Ekane, Maria Paula Lopez, Pengju Cao, Sijia He, Adam B Salmon, S R Murthy Madiraju, Marc Prentki, Juli Bai, James F Nelson, Xianlin Han, Yi Zhu, Shangang Zhao

Children’s Nutrition Research Center Staff Publications

The enzymatic role of ABHD6 in insulin secretion and resistance is well documented. However, its non-enzymatic function, especially its effects on metabolic health, including selective hepatic insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), is poorly understood. To define the role of ABHD6 in liver physiology, we generated liver-specific ABHD6 knockout mice, as well as liver-specific native and enzymatically inactive mutant ABHD6 overexpression mouse models. We demonstrate that non-enzymatic ABHD6 contributes to the regulation of selective hepatic insulin resistance and MASLD progression. Mechanistically, we show that ABHD6 localizes to the nucleus and interacts with Akt/FoxO1 axis to regulate insulin …

Clinical Utility Of An Fda-Authorized Artificial Intelligence Imaging Platform In Interstitial Lung Disease Diagnosis, Arjun Prakash Tambe, Ryan Boente, Gautam George, Fayez Kheir, Omid Tahamtani Omran, Kavitha Selvan

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background/Objectives: The diagnosis of interstitial lung disease (ILD) is challenging and frequently delayed. Clinically accessible and minimally invasive diagnostic tools are needed to expedite the diagnosis of ILD while minimizing risk to patients. Fibresolve is an imaging artificial intelligence (AI) tool recently approved by the Food and Drug Administration (FDA) for use in ILD diagnosis and made available to clinicians. The objective of this study was to describe its utility in clinical practice. Methods: We conducted a prospective, observational study of patients across the United States (US) in whom Fibresolve was utilized during routine clinical practice between July 2024 and …

Sex-Aware Causal Inference Assessment Of The Immune System In Complex Neurodegenerative Diseases, Frida Lona-Durazo, Ross P Byrne, Marc-Olivier Pilon, Michael D Greicius, Marie-Pierre Dubé, Michael E Belloy, Russell L Mclaughlin, Sarah A Gagliano Taliun

2020-Current year OA Pubs

Sex differences, in terms of prevalence, symptoms and disease progression, are established in the aetiology of complex neurodegenerative diseases, including amyotrophic lateral sclerosis, Parkinson's disease and Alzheimer's disease, but the underlying biology driving these differences remains poorly understood. There is emerging evidence from genetic and functional analyses affirming the role of the immune system in such diseases, but a thorough assessment of sex differences in the link between the immune system and neurodegenerative diseases remains lacking. Here, we applied a robust causal inference approach, two-sample Mendelian randomization, to evaluate the causal effect of immune-related protein levels on three neurodegenerative diseases …

A Poetic Call For And A Reflection And Commentary On Clarity, Understanding, Hope, Courage, And Compassion, Carroy U. Ferguson

Psychology Faculty Publication Series

Finding a published poem I had written as a teenager, titled “The Heavens Weep.” this article uses that poem as the basis for a commentary that reflects on the state of the world today (2026),  As a commentary, the article uses the poetic and metaphoric words in the poem as a relevant "reality check" for what is still going on today.  In essence, the commentary is about a call for Clarity, Understanding, Hope, Courage, and Compassion, or what I call Archetypal Energies, Higher Vibrational Energies that operate deep within our individual and collective psyches to creatively urge us to "see" …

Improving Patient Satisfaction Through Post-Urgent Care Visit Follow-Up Calls: A Quality Improvement Project, Lindsay Boyer

Doctor of Nursing Practice Final Project Abstract

Purpose This quality improvement project aimed to determine whether implementing standardized post-visit follow-up calls within 24–48 hours of urgent care visits would improve patient satisfaction by increasing the clinic’s Net Promoter Score (NPS) from a baseline of 62. Background Declining NPS scores during peak clinic seasons suggested a gap in post-visit communication and follow-up, highlighting the need for a standardized nursing intervention to better support patients after discharge.

Methodology Guided by the AIDET communication framework and the Plan-Do-Study-Act cycle, scripted follow-up calls were implemented across five cycles from February to April 2026 to assess recovery, reinforce discharge instructions, answer questions, …

Remote Assessment And Management Of Physical Function In Older Adults (Ramp): An International Expert Delphi Process, Jack Dalla Via, Hurst, Elsa Dent, Jackson J. Fyfe, Paul Jansons, Eleanor J. Hayes, Marc Sim, Mylene Aubertin-Leheudre, Alex Barreto De Lima, Lucimere Bohn, Sabine Britting, Fanny Buckinx, Gavin Connolly, Lora Giangregorio, Duarte Henriques-Neto, Jennifer R.A. Jones, Robert Kob, Suzanne N. Morin, Girish N, Lucas B.R. Orssatto, Maria Pearson, Daniel Pinto, Esmee M. Reijnierse, Catherine M. Said, Mohamed Salem, Gary Skinner

Research outputs 2022 to 2026

Background: Remote methods may help older adults improve their physical function, but understanding the perspectives of experts who deliver this care is critical. This modified Delphi process aimed to develop expert consensus on effectiveness, feasibility and implementation of remote assessment and management of physical function in older adults. Methods: This online Delphi process included experts involved in supporting older adults to maintain or improve their health. The Round 1 survey presented 33 Delphi statements assessed using an 11-point Likert scale (0–10; ≥7 indicated agreement). Statements with strong (≥80 %), moderate (50–<80 %) and low (<50 %) agreement were accepted, revised, or rejected, respectively. Revised statements were presented in Round 2, and accepted statements were consolidated into key messages. Results: In total, 108 respondents (67 % female; mean [SD] age 41.4 [10.9] years) from 16 countries (five continents) completed Round 1. Fourteen statements were accepted (88–100 % agreement) and 10 were rejected (8–39 % agreement). The remaining nine statements (52–69 % agreement) were revised, and two new statements were developed for Round 2, which was completed by 89 (82 %) respondents. Five Round 2 statements were accepted (82–93 % agreement). Seven key messages were developed from 19 accepted statements, highlighting that remote care should be accessible to older adults with requisite capabilities, is feasible for older adults and health professionals with adequate support and training, and requires guidelines, policies, and further research to support wider adoption. Conclusions: The findings of this Delphi process can inform the implementation of remote care approaches for assessing and managing physical function in older adults.

Characterising Manual Dexterity, Motor Cortex Neuroplasticity, And Intracortical Inhibition Long After Burn Injury, Grant S. Rowe, Alecia Wood, Mark Fear, Dale W. Edgar, Aleksandra Miljevic, Tyler Osborne, Natalie Morellini, Merrilee Needham, Ann Maree Vallence, Fiona Wood

Research outputs 2022 to 2026

Purpose: Persistent motor dysfunction after burn injury may be due to altered motor cortex and corticospinal tract function. This study examined manual dexterity, motor cortex neuroplasticity, and intracortical inhibition in former burn patients 1–3 years after minor injury (<10% TBSA). Method: Thirty former burn patients (TBSA: 0.78 ± 1.08%) and 30 non-injured controls participated. Manual dexterity was assessed using the Purdue Pegboard. Transcranial magnetic stimulation (TMS) was used to measure motor cortex excitability (motor evoked potential [MEP] amplitude) and short- and long-interval intracortical inhibition (SICI, LICI) before and after paired-associative stimulation (PAS) to induce neuroplasticity. Results: Former burn patients performed worse than controls on the bimanual assembly subtest of the Purdue Pegboard. PAS did not induce changes in MEP amplitude but increased LICI in both burn patients and control participants. In burn patients, baseline LICI was related to bimanual performance differently than controls. Conclusions: These findings suggest poorer bimanual motor function persists after minor burns, and differences in the association between inhibition and bimanual dexterity between burn and control groups. Further research should explore whether targeting motor cortex inhibitory circuits can improve motor performance following burn injury

Yap1-Dependent Regulation Of Cell Size In Bcam-Positive Limbal Corneal Progenitor Cells, Kosei Suzuki, Shinri Sato, Markus H. Frank, Natasha Y. Frank, Yuzuru Sasamoto

Research outputs 2022 to 2026

Cell size has been associated with stem and progenitor cell states across multiple tissues, yet its regulation in the human corneal epithelium remains incompletely understood. This study aimed to characterize cell-size differences among limbal and corneal epithelial cell populations defined by the limbal stem cell (LSC) marker ABCB5 and the transit-amplifying cell (TAC) marker BCAM, and to investigate the molecular regulators of progenitor cell size. ABCB5-positive LSCs and BCAM-positive TACs were identified and isolated by flow cytometry, and the mean cell size was estimated using forward scatter (FSC). As a result, ABCB5-positive LSCs were significantly smaller than ABCB5-negative limbal epithelial …

Differential Effects Of Physical Activity Interventions On Gross And Fine Motor Difficulties In Children With Autism Spectrum Disorder: Insights From A Multilevel Meta-Analysis With Moderator Analyses, Changhui Peng, Jinrong He, Kai Xu, Xueping Wu, Dandan Wang, Lei Zhang

Research outputs 2022 to 2026

Background Difficulties in gross and fine motor skills negatively affect the healthy development of children with autism spectrum disorder (ASD), yet evidence for physical activity interventions (PAIs) remains limited and inconsistent. Therefore, this study aimed to investigate the differential effects of PAIs on gross and fine motor difficulties in children with ASD and to explore potential moderators. Methods Following PRISMA guidelines, empirical studies published from inception to April 21, 2026 were systematically searched across PubMed, Web of Science, Embase, the Cochrane Library, and SPORTDiscus. Effect sizes were synthesized using a three-level random-effects model and were expressed as Hedges’ g (g). …

Genai-Assisted Podcasts To Support Nursing Students’ Research Literacy And Evidence-Based Practice: A Feasibility Study, Jennifer Hamilton, Lesley Barr, Martina Costello, Lukman Thalib, Martin Jones

Research outputs 2022 to 2026

Background: Nursing students often report difficulty understanding and applying research evidence, limiting evidence-based practice capability. Podcasts are an accessible method for research dissemination, and generative artificial intelligence (GenAI) may offer a scalable approach to developing research-focused podcasts within curricula. Aims: To assess the feasibility of integrating GenAI-assisted research podcasts into nursing curricula as supplementary learning resources. A secondary objective examined associations in students’ self-reported competencies. Methods: A nonrandomised pre-post study was conducted in two entry-to-practice nursing programs at one Australian university. Episodes were released weekly as additional resources. Students completed the Student Evidence-Based Practice Questionnaire at semester commencement and completion. …

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training (Dsmt) To The Fee-For-Service Medicare Population, 2017–2024, Wanying Zhu, Aleksandr Taraskin, Jeffrerey Talbert

Rural & Underserved Health Research Center Publications

Key Report Highlights

• A significant rural DSMT access gap exists. Rural beneficiaries accounted for 20.1% of Medicare beneficiaries with diabetes but only 7.8% of DSMT participants.

• Geographic availability remains limited. Only 16.8% of counties with DSMT utilization were rural.

• Access, not demand, appears to be the primary challenge. Rural counties offering DSMT achieved utilization rates more than twice those observed in urban counties (6.0% vs. 2.5%).

• Expanding rural DSMT capacity may represent a high-impact opportunity to improve diabetes self-management support among underserved Medicare beneficiaries.

Non-Metropolitan Vs. Metropolitan Variations In Alcohol, Illicit Drug, And Prescription Therapeutic Drug Misuse, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

Alcohol Use. The prevalence of past year and past 30-day drinking was lower among non-metropolitan (non-metro) than metropolitan (metro) residents. However, non-metro drinkers engaged in more frequent binge drinking than metro drinkers. Drinking 3-5, 6-19, and 20-30 days over the past 30 days were higher among non-metro than metro residents.

Illicit Drug Use. Hallucinogens were the mostly commonly used illicit drugs among non-metro as well as metro residents. Methamphetamine use was significantly higher among non-metro than metro residents.

Prescription Pain Reliever Use. The misuse of prescription pain killers, primarily prescription opioids, was higher among non-metro than …

High-Deductible Health Plans In Rural And Urban Populations: Outpatient Utilization And Out-Of-Pocket Costs, Aaron P. Smith, Jefferey Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings This policy brief explores rural-urban differences in High-Deductible Health Plan (HDHP) enrollment, subsequent healthcare utilization, and out-of-pocket (OOP) costs. ▪ HDHP enrollment was uncommon. Rural residents were slightly less likely to enroll than urban residents across all demographic groups. ▪ Switching plans influenced utilization. Compared to those who did not change healthcare plans, switching from a Traditional plan to a HDHP was associated with a larger reduction in 2022 outpatient visits for both rural and urban residents. Moving from a HDHP to a Traditional plan was associated with a smaller reduction in 2022 outpatient visits for …

Nurse Manager Perceptions Of Strategies To Overcome The Underutilization Of Nonpharmacological Pain Control Methods In Adult Acute Care, Landen M. Bonnell

Undergraduate Honors Theses

A basic patient right is to have pain adequately managed. However, research consistently indicates that many adult patients in acute care experience inadequately managed pain, which may contribute to adverse patient outcomes. Studies have shown that nonpharmacological pain management can lead to increased patient satisfaction, shorter hospital stays, and better patient outcomes. However, many barriers exist to nurses providing effective nonpharmacological pain control therapy, primarily including heavy workload and a lack of education and support. Currently, there is insufficient research on how to overcome these barriers. Four nurse managers with experience in nursing leadership were interviewed using a qualitative descriptive …

Early Radiographic And Patient-Reported Outcomes Of Percutaneous Distal Metatarsal Osteotomy In Adolescent Hallux Valgus., David Cieremans, Sara Ruzzi, Matthew Titus, Susan Dubowy, Reid Nichols, Joseph Rosenblatt

PCOM Scholarly Works

BACKGROUND: Percutaneous osteotomy for adolescent hallux valgus has become an increasingly popular technique due to its quick recovery time and effectiveness. Few studies have assessed both the radiographic and clinical outcomes of percutaneous osteotomy. We present a series that demonstrates adequate radiographic correction and favorable postoperative patient-reported outcomes.

METHODS: A retrospective review of 27 percutaneous distal metatarsal osteotomies for adolescent hallux valgus performed by two surgeons was conducted at two urban, tertiary children's hospitals. Cases were excluded if radiographic imaging information was not available. Pre- and postoperative radiographic measurements, including hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal …

A Word From The Writing Team (August 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

What Drives Schoolchildren's Food Choices? Insights From A Gamified Stated-Preference Choice Experiment In Tunisia, Ali Chalak, Christelle Akl, Joanne Haddad, Nehmat El Helou, Sonia Sassi, Houda Ben Gharbia, Rawan Traboulsi, Marc Haber, Jalila El Ati, Hala Ghattas Ph.D.

Faculty Publications

This paper models the drivers of schoolchildren's food choices in urban Tunisia using a gamified Stated-Preference Choice Experiment (SPCE), which includes scenario attributes (food placement, preparation, and price) and contextual factors (parental/peer modeling eating behaviors). A representative sample of 2465 schoolchildren aged 8 to 12 years in Greater Tunis participated in a SPCE, which simulates real-life food choice scenarios on a typical school day. The game includes six nodes (breakfast, recess, lunch, snack on the road to/from school, afternoon snack, dinner) in various locations (home, school, neighborhood). Each choice task includes nine items to choose from (3 beverages, 3 side-meals, …

Impact Of Media Guidelines On Suicide-Related Reporting Quality And Suicides: A Systematic Review And Meta-Analysis, Simone Scotti Requena, Vikas Arya, Thomas Niederkrotenthaler, Mark Sinyor, Michiko Ueda, Matthew J. Spittal, Jane Pirkis

Center for Policy Design and Governance

This brief summarizes "Impact of media guidelines on suicide-related reporting quality and suicides: A systematic review and meta-analysis," co-authored by Simone Scotti Requena, Vikas Arya, Thomas Niederkrotenthaler, Mark Sinyor, Michiko Ueda, Matthew J. Spittal, and Jane Pirkis in Crisis.

August 2026, Swosu Rural Health Center

RURAL ROCKS

It's been an exciting season at the SWOSU Rural Health Center!

We are thrilled to share that SWOSU Rural Health has been awarded a second grant through Oklahoma's Rural Health Transformation Program (RHTP), building on the momentum of our Community-Led Wellness Microgrant. This week, we also have the privilege of welcoming representatives from the Centers for Medicare & Medicaid Services (CMS) and the Oklahoma Rural Health Transformation Program to SWOSU as they visit our Jerry & Margaret Hodge College of Pharmacy and Rural Health Center to highlight the innovative work happening across our region.

• Feds push back HIPAA security rule …

Attrition Of The Midwifery Workforce: Understanding Factors Associated With Leaving The Profession, E. Brie Thumm, Amy H. Goh, Elizabeth G. Phillips, Zachary Giano

College of Health Professions Faculty Papers

OBJECTIVE: To understand why advanced practice midwives (certified nurse-midwives and certified midwives) leave the workforce.

STUDY SETTING AND DESIGN: A multi-method, multi-source investigation included secondary analysis of certification data of advanced practice midwives and a cross-sectional online survey with closed- and open-ended items. Advanced practice midwives' active certification data were used to compare self-reported demographic characteristics of advanced practice midwives who reported working in the discipline of midwifery to those who did not (n = 9704). A survey was conducted in 2022 with individuals who allowed their certification to lapse between 2017 and 2021 (n = 303) and individuals who …