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Articles 1 - 21 of 21
Full-Text Articles in Medical Humanities
The 340b Drug Pricing Program: Are 340b Covered Entities Providing More Services And More Uncompensated Care?, Isabell M. Pacheco
The 340b Drug Pricing Program: Are 340b Covered Entities Providing More Services And More Uncompensated Care?, Isabell M. Pacheco
All ETDs from UAB
The 340B Drug Pricing Program enacted in 1992 requires pharmaceutical manufacturers participating in the Medicaid program to provide statutorily defined discounts on "covered outpatient drugs" purchased by government-supported facilities, known as covered entities, that are expected to serve the nation's most vulnerable patient populations. The Program has been under copious scrutiny by industry stakeholders and Presidential Executive Orders that threaten its macrocosm. While previous research suggests that health systems with a mix of 340B participating and non-participating locations are not associated with expanded access to care, additional research is needed to determine if entities participating in the 340B Drug Pricing …
The Effect Of Medicaid Expansion On Hospitals Allowance For Bad Debt, Tara B. Dixon
The Effect Of Medicaid Expansion On Hospitals Allowance For Bad Debt, Tara B. Dixon
All ETDs from UAB
The management of bad debt is a complex issue for hospitals, and if mismanaged, can impact the organization's current and future financial stability. The expansion of Medicaid through the Patient and Affordable Care Act (ACA) was expected to lessen the bad debt reported by hospitals by increasing the number of insured lives. Hospital managers understand that a certain percentage from the accounts receivables will end up being uncollectable; however, strategically planning for bad debt and estimating a more accurate allowance requires a specific level of strategic planning. Allowance for bad debt should not be a guessing game but should be …
Pain-Related Injustice Appraisal And Chronic Low Back Pain Among Arabs In The United States, Albatool Homoud Alnojeidi
Pain-Related Injustice Appraisal And Chronic Low Back Pain Among Arabs In The United States, Albatool Homoud Alnojeidi
All ETDs from UAB
Pain-related injustice appraisal has emerged as a psychosocial predictor of deleterious chronic low back pain (CLBP) outcomes. The appraisal is defined as the individual’s perception regarding the magnitude and irreparability of pain-related loss and suffering, externalized blame, and unfairness. Research in diverse samples revealed racial differences in pain-related injustice appraisal, suggesting that it may reflect broader racial/ethnic, sociocultural, and socioeconomic factors. This agrees with theories recognizing the role of ethnic and cultural characteristics in ethnic minorities’ health. Despite global data showing that Arabs represent the population with the second-highest prevalence of CLBP worldwide, a reliable characterization of CLBP among Arabs …
Identifying Factors To Inform The Development Of Adaptive Interventions For Increasing Physical Activity Behavior Among People With Multiple Schlerosis, Yumi Kim
All ETDs from UAB
People with multiple sclerosis (MS) can benefit from physical activity, specifically exercise, for the management of disease symptoms, including walking impairments, fatigue, and depression, and improvements in quality of life. However, people with MS do not engage in adequate amounts of physical activity for the accrual of health benefits. Researchers have focused on the delivery of exercise training and behavioral interventions to improve levels of physical activity in MS. To date, there is an emerging body of research supporting the efficacy of these interventions for increasing and potentially sustaining physical activity behavior in people with MS. Yet, people with MS …
The Assessment Of Neuro-Mechanics Of Inspiratory Muscles During Mechanical Ventilation, Hassan Y. Abunurah
The Assessment Of Neuro-Mechanics Of Inspiratory Muscles During Mechanical Ventilation, Hassan Y. Abunurah
All ETDs from UAB
The decline in inspiratory muscles function for patients undergoing mechanical ventilation may further extend the duration of mechanical ventilation leading to lethal complications. Thus, the assessment of neuro-mechanics of inspiratory muscles may help us understand the pathophysiology for mechanical ventilation failure to avoid its complications. In this dissertation, we assessed the characteristics of inspiratory neuromechanics under different conditions. This dissertation is reported in three different papers. In the first paper, we sought to assess the quality of the available literate that used surface EMG of extra-diaphragmatic muscles during invasive mechanical ventilation. We demonstrated that the use of sEMG of extra-diaphragmatic …
Rural And Urban Differences In Vegetable And Fruit Consumption Among Older Cancer Survivors In The Deep South: An Exploratory Cross-Sectional Study, Harleen Kaur
All ETDs from UAB
Background: Rural Americans have poorer overall health and physical functioning than their urban counterparts. A varied diet, rich in vegetable and fruit (V&F) consumption may improve health; however, little is known about rural-urban differences in V&F consumption, especially in older cancer survivors. Objective: To assess differences in V&F consumption among older cancer survivors residing in urban- and rural-designated areas, and explore whether differences exist by sex, race, and cancer type. Design: This was a cross-sectional secondary analysis. Participants/setting: Screening data from the Harvest for Health trial was obtained on 731 Medicare-eligible cancer survivors across Alabama. Main outcome measures: V&F consumption …
The Relationship Of Debt Ratio And Financial Performance For Large Nfp Health Systems, Mark Lombardi
The Relationship Of Debt Ratio And Financial Performance For Large Nfp Health Systems, Mark Lombardi
All ETDs from UAB
This dissertation was a quasi-experimental research study exploring the relationship between long-term to debt capitalization ratio and financial performance in an environment where interest rates remained historically low and stable, while investment returns in the U.S. equity markets increased year over year. The study reviewed 142 not for profit health systems and examined total and non-operating margins along with long-term debt to capitalization ratio to determine if margins increased as long-term debt increased. Researchers have discussed the opportunity that not for profit health systems have to utilize low cost, tax-exempt debt to maintain or grow their endowments and in turn …
Joint Specificity Of Stretch-Shortening Cycle Potentiation, Marzouq Khalaf Almutairi
Joint Specificity Of Stretch-Shortening Cycle Potentiation, Marzouq Khalaf Almutairi
All ETDs from UAB
The stretch-shortening cycle (SSC) is a well-known phenomenon to enhance an individual’s muscular performance, and it is an area of active focus of research scientists for decades. However, it is not known whether SSC potentiation is a joint-specific event and shows a joint-specific temporal behavior. It is also unclear if constraints of joint and movement specificity of SSC potentiation can be captured via isokinetic dynamometer. Therefore, the purposes of this dissertation were to examine joint specificity of SSC potentiation via isokinetic dynamometer and kinetic-kinematic analysis of jump test performance and investigate joint-specific temporal behavior of SSC potentiation. My first study …
Fqhcs, Health Center Controlled Network Affiliation And Performance, Armika Jessica Berkley
Fqhcs, Health Center Controlled Network Affiliation And Performance, Armika Jessica Berkley
All ETDs from UAB
Since the mid-1960s, Federally Qualified Health Centers (FQHCs) have been funded by the U.S. federal government to provide access to preventative and primary care for medically underserved communities. The federal government’s involvement in the funding of FQHCs was a response to extreme poverty, economic instability, and civil unrest related to the Civil Rights movement. Adoption of value-based care delivery practices to improve clinical and financial performances among FQHCs has been slow. This slow adoption has been attributable to cost, lack of expertise, and support. Since August 1994, the Department of Health Resources and Services Administration (HRSA), the funding source for …
The Role Of Obesity, Gdm, And Lifestyle Factors On Metabolic Syndrome Scores In Mothers And Their Children 4-10 Years After Pregnancy, Makenzie Callahan
The Role Of Obesity, Gdm, And Lifestyle Factors On Metabolic Syndrome Scores In Mothers And Their Children 4-10 Years After Pregnancy, Makenzie Callahan
All ETDs from UAB
Metabolic syndrome (MetS) is a cluster of symptoms that increase risk for heart disease and type 2 diabetes. Therefore, early detection of MetS is vital for disease prevention. Gestational diabetes (GDM) and/or obesity during pregnancy are associated with a greater risk for MetS in mothers and their children compared to mothers with no GDM. However, little is known about how much a GDM history or in utero exposure to maternal GDM contributes to MetS risk years after that pregnancy in addition to risk attributable to obesity itself. Therefore, the overall objective of this dissertation was explore how a history of …
Central Vestibular Integration In Concussion And Multiple Sclerosis, Graham Dean Cochrane
Central Vestibular Integration In Concussion And Multiple Sclerosis, Graham Dean Cochrane
All ETDs from UAB
Dizziness and imbalance are commonly reported by people with concussion and people with multiple sclerosis (MS). Dysfunction of the vestibular system is likely a major cause of dizziness and imbalance in both diseases, but it is not well understood whether this dysfunction typically occurs in peripheral vestibular organs and pathways or higher-level central vestibular integration pathways. As these systems are assessed and targeted with rehabilitation differently, understanding how both are affected in these diseases will improve management of dizziness and imbalance. In addition, balance has been demonstrated to correlate with self-reported fatigue in people with MS, presumably through shared dysfunction …
Evidence For A Bioelectrical Marker Of Insulin Resistance In Premenopausal Women: Membrane Capacitance, Valene E. Garr Barry
Evidence For A Bioelectrical Marker Of Insulin Resistance In Premenopausal Women: Membrane Capacitance, Valene E. Garr Barry
All ETDs from UAB
Insulin resistance (IR) is associated with poor metabolic and reproductive outcomes among premenopausal women. Early identification of women with IR might mitigate these outcomes. However, clinically suitable methods to identify women with IR are unavailable due to high cost, high patient burden, or limited reliability. The objective was to examine a bioimpedance-based approach to identifying women with IR using membrane capacitance (CM). CM is a measure of cell membrane health and function, which is independently associated with IR and may be a suitable predictor. We validated the association of CM with IR and established the clinical utility of CM as …
Does Interdisciplinary Care Team Care Management Improve Health Quality And Demonstrate Cost Effectiveness?, F Cardwell Feagin Jr
Does Interdisciplinary Care Team Care Management Improve Health Quality And Demonstrate Cost Effectiveness?, F Cardwell Feagin Jr
All ETDs from UAB
The U. S. healthcare system faces unsustainable rising healthcare costs. Health care cost as a percentage of gross domestic product is expected to rise to 19.4 percent by 2027 (Wilson, 2019). This unstainable rise in healthcare costs is creating a problem for consumers of healthcare. By 2030, the average annual healthcare spending per working household, including premium and out-of-pocket expenditures, is estimated to be 33.9 percent of median compensation (Girod et al., 2016). Also, lawmakers and policymakers face funding issues of healthcare. A key finding of this study is that field-based interdisciplinary care team care management, with an algorithm selecting …
Actual And Perceived Balance Abilities While Performing Tasks That Challenge Balance In Older Adults And Individuals With Parkinson's Disease., Jutaluk Kongsuk
Actual And Perceived Balance Abilities While Performing Tasks That Challenge Balance In Older Adults And Individuals With Parkinson's Disease., Jutaluk Kongsuk
All ETDs from UAB
Walking is a fundamental activity for one to interact effectively with one’s environment. Walking in the community often requires both a wide range and constant modification of walking speed. Decreased walking capacity, that is the maximum speed that a person can physically achieve, results in a decline in both functional mobility and personal independence, contributing to decreased community participation among individuals whose walking is impaired. The most common test of walking speed (i.e., overground comfortable and maximum walking speed) may not reflect the full capacity of individuals to regulate gait control. Whereas walking with progressively increasing treadmill speeds allows researchers …
The Association Between Medicaid Expansion, Medicaid Disproportionate Share Payments And The Financial Performance Of Safety Net Hospitals, Jon Law
All ETDs from UAB
Safety Net Hospitals (SNHs) provide necessary emergency and acute care to all individuals, regardless of their ability to pay for health care. Medicaid Expansion and Disproportionate Share (DSH) payments are two Medicaid programs that may mitigate the financial vulnerability of SNH’s. Some assert that Medicaid Expansion, as part of the Patient and Affordable Care Act (ACA), may provide financial relief for SNHs. It offers payment mechanisms for millions of uninsured individuals. DSH expenditures per capita for each state vary widely. There is some likelihood that SNHs in some states may benefit greater than others. The study was framed within the …
Service Profiles In Substance Use Disorder Treatment: The Role Of Institutional And Organizational Factors, Reena Joseph Kelly
Service Profiles In Substance Use Disorder Treatment: The Role Of Institutional And Organizational Factors, Reena Joseph Kelly
All ETDs from UAB
Substance use disorders (SUDs) are a growing crisis globally and in the US, and place an enormous health, social, and financial burden on the nation. To address the complex nature of SUDs, treatment typically involves a combination of different types of services to address the medical, behavioral and social needs of the patient and care is often delivered by specialized SUD treatment facilities. Despite recommendations for a broad suite of services, individual facilities vary in the specific services that they offer. This study examined whether and why systematic differences exist between treatment facilities based on their service mix and whether …
Value Analysis Of Electronic Health Records, Shikha Shah Modi
Value Analysis Of Electronic Health Records, Shikha Shah Modi
All ETDs from UAB
The Electronic Health Record (EHR) is defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (HIMSS, 2011). EHRs have become an important part of the current health system as a result of government regulations, technology advancements, health care challenges, and market conditions. EHRs are considered an expensive investment; however, the complexity of adopting and implementing EHRs also demands attention. Given the complexity of health information technology (HIT) systems and the hefty investment that is required in the adoption of EHRs, a return on investment is expected, and it …
Is There A Relationship Between Leadership Characteristics And Services Provided Among Ihs Urban Indian Health Programs?, George Grant Tribble
Is There A Relationship Between Leadership Characteristics And Services Provided Among Ihs Urban Indian Health Programs?, George Grant Tribble
All ETDs from UAB
IS THERE A RELATIONSHIP BETWEEN LEADERSHIP CHARACTERISTICS AND SERVICES PROVIDED AMONG IHS URBAN INDIAN HEALTH PROGRAMS?GEORGE G. TRIBBLE HEALTHCARE LEADERSHIP ABSTRACT The Native American population has faced and been impacted by a wide range of actions throughout the last few hundred years. The loss of cultural norms and way of life continues to manifest itself through various socioeconomic concerns. At the center of the Native American leadership model is a disciplined and culturally specific guidance structure. The Urban Indian Health Program (UIHP) was created by the Indian Health Service to establish a culturally appropriate health care delivery model for Native …
Disrupting The Perioperative Opioid Gateway: Identification Of Risk Factors For New Persistent Post-Surgical Opioid Use, Gia Marie Pittet
Disrupting The Perioperative Opioid Gateway: Identification Of Risk Factors For New Persistent Post-Surgical Opioid Use, Gia Marie Pittet
All ETDs from UAB
A large portion of the American Opioid Crisis is due to opioid naïve patients who become new persistent post-surgical opioid users, although the risk factors for the development of this addiction are not well studied. The objective of this study was to analyze multiple layers of pre-operative and procedural risk factors using an ecological perspective theoretical framework in adult patients undergoing invasive surgery. We performed a retrospective analysis of 13,970 opioid naïve adults in a mixed surgical cohort with data available at the University of California Los Angeles that was merged with narcotics data for the State of California (IRB#19-000625). …
Race, Feeding Practices And Infant Weight Gain During The First 6 Weeks Of Life, Alysha Breanne Everett
Race, Feeding Practices And Infant Weight Gain During The First 6 Weeks Of Life, Alysha Breanne Everett
All ETDs from UAB
Background: Non-Hispanic black (NHB) infants are disproportionately affected by rapid weight gain compared to non-Hispanic white (NHW) infants, which in turn, is associated with future disparities including obesity and cardiometabolic disease. Feeding practices, such as the use of formula or bottles, differ by race and are associated with rate of weight gain. Data from the Pregnancy and Early Life in the South (PEARLS) birth-cohort study was used to test the hypotheses that change in body weight and weight-for-age z-scores (WAZ) from birth to 6 weeks would be greater for (1) NHB versus NHW infants; and (2) infants fed formula (exclusively …
Do Outcomes From A Behavioral Weight Loss Intervention Differ In Alabama Vs Colorado?, Julianne Clina
Do Outcomes From A Behavioral Weight Loss Intervention Differ In Alabama Vs Colorado?, Julianne Clina
All ETDs from UAB
There are well-established regional differences in obesity prevalence in the U.S., but relatively little is known about whether these differences impact efforts for weight loss. The objective of the study was to determine whether changes in body weight, engagement in physical activity (PA), and psychosocial factors differed in Colorado (CO) vs Alabama (AL) in response to a 16 week standardized behavioral weight management program. We hypothesized that weight loss would be greater in Colorado due to a more favorable physical and social environment.This is an ancillary study to a weight loss intervention being conducted simultaneously in AL and CO with …