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Articles 121 - 150 of 290
Full-Text Articles in Medical Humanities
Membrane Capacitance Derived From Bioimpedance Spectroscopy Is Associated With Insulin Resistance In Relatively Healthy U.S. Women, But Not Men, Valene Garr Barry
Membrane Capacitance Derived From Bioimpedance Spectroscopy Is Associated With Insulin Resistance In Relatively Healthy U.S. Women, But Not Men, Valene Garr Barry
All ETDs from UAB
Current screening methods have failed to detect more than 50% of the 120 million U.S. adults with insulin resistance and/or metabolic syndrome, conditions that substantially increase one’s risk for cardiometabolic disease (CMD).1 Evidence exists that metabolic health is associated with cell membrane composition, which is reflected in the electrical properties of the body cell mass. The objective of this study was to determine whether bioimpedance spectroscopy can identify insulin resistance and/or metabolic syndrome by evaluating membrane capacitance (CM). We hypothesized that CM would be higher in individuals with insulin resistance and/or metabolic syndrome when compared to healthy individuals. This cross-sectional …
The Association Between Designation As Leader In Lgbt Healthcare Equality And Hospitals' Patient Experience Scores, Rita Dileo
All ETDs from UAB
ABSTRACT There are an increasing number of LGBT individuals who openly acknowledge their sexuality and are visibly part of society. Unfortunately, a stigma remains among this group and a fear of discrimination that prevents many individuals from seeking healthcare. This is a long-standing issue and further challenged by lack of culturally competent LGBT healthcare providers. Using a conceptual framework based on the Resource Dependence and Resource-Based theories, the association between designation as a 2016 Leader in LGBT Healthcare Equality and patient experience scores are evaluated. Regression analyses were performed to assess the association between market factors, organizational characteristics, HCAHPS survey …
Examining The Relationship Between Operational And Clinical Performances Of Federally Qualified Community Health Centers, Ganisher K. Davlyatov
Examining The Relationship Between Operational And Clinical Performances Of Federally Qualified Community Health Centers, Ganisher K. Davlyatov
All ETDs from UAB
This dissertation studied the role of Health Information Technology (HIT) adoption on clinical performance; the effects of clinical performance on chief executive officer (CEO) compensation; and the association between CHC’s financial and clinical performances in Community Health Centers (CHC). Data from the Uniform Data System (UDS) and the Internal Revenue System (IRS) 990 Forms were extracted for the period 2011-2016. Generalized estimating equations models with state and year fixed effects were performed. To test the relationship between the age and extent of HIT adoption and clinical performance, Resource-Based View of the Firm constructs were used. The age of HIT adoption …
The Impact Of Hospital Change Of Ownership On Hospital Quality Of Care As Evidenced By Patient Satisfaction Scores And Readmission Rates, Ian Edward Mcfadden
The Impact Of Hospital Change Of Ownership On Hospital Quality Of Care As Evidenced By Patient Satisfaction Scores And Readmission Rates, Ian Edward Mcfadden
All ETDs from UAB
THE IMPACT OF HOSPITAL CHANGE OF OWNERSHIP ON HOSPITAL QUALITY OF CARE AS EVIDENCED BY PATIENT SATISFACTION SCORES AND READMISSION RATES IAN E. MCFADDEN DOCTOR OF SCIENCE IN ADMINISTRATION-HEALTH SERVICES ABSTRACT Much of the literature on current hospital consolidation activity reveals that hospitals and health systems are experiencing an inordinate amount of increased merger and acquisition activity due to the impact of healthcare reform legislation. The implementation of the Affordable Care Act of 2010 resulted in many hospital and health system providers seeking consolidation as a means to enhance resources and capital. These efforts have resulted in many hospitals changing …
Prenatal And Postnatal Factors Regulate Food Intake And Body Composition, Minsung Kang
Prenatal And Postnatal Factors Regulate Food Intake And Body Composition, Minsung Kang
All ETDs from UAB
This research sought to identify the effects of prenatal and postnatal factors on systemic metabolism and the regulation of food intake, weight, and body composition. It was found that the manipulation of maternal diets influenced the systemic metabolism of offspring. The offspring of dams fed an isocaloric, low protein diet were significantly smaller and consumed less food than offspring from dams fed a control diet. In the case of the offspring from dams fed a western diet, they were significantly heavier and consumed more food than offspring from dams fed a control diet. In addition, the offspring showed altered glucose …
The Effects Of Body Size, Growth, And History Of Diabetes On Glioma Risk, Rebecca Barnhill Little
The Effects Of Body Size, Growth, And History Of Diabetes On Glioma Risk, Rebecca Barnhill Little
All ETDs from UAB
Many dietary exposures have weak or null associations with glioma risk. As nutrition can affect growth rate in adolescence, body size throughout the lifespan, and the propensity for Type 2 diabetes, the goal of this project was to examine the relationships between these surrogates of nutritional states and the risk of glioma. The aims of this project were to examine the associations between glioma risk and 1) self-reported body measures; 2) age when full height was attained; 3) and a history of diabetes. To investigate the first aim, 1,111 glioma cases and 1,096 community controls completed a structured interview to …
Financial Distress – Causes And Consequences: An Examination Of The Nursing Home Industry, Justin Caleb Lord
Financial Distress – Causes And Consequences: An Examination Of The Nursing Home Industry, Justin Caleb Lord
All ETDs from UAB
Nursing homes operate in a tumultuous and changing environment and are under increasing financial pressure, risk of closure, and financial distress. The issue of financial distress has been explored tangentially within the nursing home industry. This study is the first to validate the Altman Z-Score, a financial distress prediction model, within the nursing home context. The Altman Z-Score model uses multiple discriminate analysis (MDA) to examine multiple financial ratios (liquidity, efficiency, profitability and net worth) simultaneously to predict the likelihood of a firm’s financial distress. After calculating the Z-Score, clustering was used to classify the observations into three groups, distressed, …
Diet, Physical Activity, And Healthy Aging In People Living With Hiv, Josh Newson Muhammad
Diet, Physical Activity, And Healthy Aging In People Living With Hiv, Josh Newson Muhammad
All ETDs from UAB
As life expectancy for people living with HIV (PLWH) has increased, healthy aging in this community has become an emerging public health concern. Although the benefits of adopting healthy diets and regular physical activity are well-documented, implementing strategies for lifestyle modifications among older PLWH remains a challenge. The complex milieu of social, physiological and economic burdens encountered by PLWH exposes this population to increased risk for adverse health outcomes, especially from preventable metabolic diseases. The interaction of diet, physical activity and social determinants of health in persons who are HIV positive is an understudied area. The aim of this dissertation …
A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery
A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery
All ETDs from UAB
Since 2009, the United States has experienced another wave of hospital mergers. Consequently, health systems are getting larger and increasing their market concentration. How patients benefit from hospital consolidation remains an open issue for policy-makers, economists, health care executives, community leaders, politicians, government agencies, and others. One measure of healthcare consolidation’s impact, and its potential benefit/detriment, is how mergers affect patient experience, which, since 2007, has been measured by the standardized HCAHPS instrument. Hundreds of studies conducted over the past 50 years have found mergers trigger an internal, socially-disruptive effect in the first 12 to 24 months following the event …
Effects Of Medicaid Expansion On The Financial Performance Of Rural Hospitals, Keith Darryl Brady
Effects Of Medicaid Expansion On The Financial Performance Of Rural Hospitals, Keith Darryl Brady
All ETDs from UAB
EFFECTS OF MEDICAID EXPANSION ON THE FINANCIAL PERFORMANCE OF RURAL HOSPITALS KEITH BRADY DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT The purpose of this research was to examine the effects of Medicaid expansion on the financial performance of rural hospitals. The analysis compares Medicaid revenue, uncompensated care cost and operating margins between rural hospitals in states that expanded Medicaid and rural hospitals in states that did not expand Medicaid. Strategic Management Theory was used to develop a theoretical framework to address three primary hypotheses. Secondary data from the Medicare Cost Report (MCR), the Agency for Healthcare Research and Quality …
An Analysis Of The Association Between An Established Chief Experience Officer Position And Hospital Patient Experience Scores Within Three States, William Robert Breen
An Analysis Of The Association Between An Established Chief Experience Officer Position And Hospital Patient Experience Scores Within Three States, William Robert Breen
All ETDs from UAB
Few industries operate with as much capacity to personally satisfy or disappoint, as does the U.S healthcare industry. Healthcare outcomes sought by society include wellness, safety, healing, and, ultimately, experiences. While healthcare involves complex relationships between patients, families, providers, payers, and regulators, the use of management theory can be insightful in studying and explaining the motivations and strategic decisions of healthcare managers. The healthcare industry is currently reacting to multiple stakeholders demanding improvements to the patient experience. New ways to measure patient experiences in healthcare are emerging. Some healthcare organizations are implementing new management structures, i.e., the role of Chief …
The Relationship Among Nurse-Physician Collaboration And Outcomes: Influence Of Nursing Leadership, Tiffany Lebano Cabibbo
The Relationship Among Nurse-Physician Collaboration And Outcomes: Influence Of Nursing Leadership, Tiffany Lebano Cabibbo
All ETDs from UAB
Background: Hospitalized patients outcomes are impacted by many professionals, with registered nurses and physicians being the most predominant. Nurses and physicians represent different autonomous professions, but their interdependent relationship effective collaboration for patients to receive high-quality and safe care. Nurse-physician collaboration is a key behavior that must be fostered by hospital leadership to meet or exceed value based outcomes (safety and quality). The purpose of this study was to examine the Chief Nursing Officer’s (CNO) perception of nurse-physician collaboration and its influence (mediating affect) on their direct reports (Nurse Directors). Furthermore, this study examining the relationship of this influence and …
Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd
Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd
All ETDs from UAB
African (Loxodonta africana) and Asian (Elephas maximus) elephant populations are rapidly declining due to poaching, and habitat fragmentation and loss. Due to the precarious situation elephants are facing worldwide, captive elephant populations are being viewed as an insurance policy against extinction. Unfortunately, captive elephant populations are not self-sustaining, in part because of reproductive and health issues. One hypothesis for the observed reproductive and health issues is zoo elephants are obese. The current method of assessing obesity in elephants is based on a qualitative visual tool, the body condition score, which does not quantify fat mass. The purpose of this dissertation …
Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen
Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen
All ETDs from UAB
INTERORGANIZATIONAL RELATIONSHIPS AND HOSPITAL ADOPTION OF SURGICAL ROBOTS STEPHEN G. CULLEN EXECUTIVE DOCTORIAL PROGRAM IN HEALTHCARE LEADERSHIP ABSTRACT The study investigates the relationship between interorganizational relationships (IORs) and hospital adoption of robotic surgery in the United States over a ten-year period. As a competitive strategy for hospitals, IORs should matter in a hospital’s decision to adopt a surgical robot given associated costs and risks. While literature exists on IORs and technical innovation, there is a gap in the literature on IORs and hospital adoption of surgical robots. This study explores four types of IORs (i.e., networks, systems, contract management, and …
Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis
Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis
All ETDs from UAB
Ketogenic diet (KD) has been used to attenuate the decline in energy expenditure occurring from calorie restriction-induced weight loss, but long-term adherence can be difficult due to the strict nature of the diet. The growing body of evidence supporting KD-treatment of neurologic and metabolic diseases, as well as obesity, has prompted interest in the ability to increase circulating ketones via exogenous delivery. Ketone esters (KE) can raise blood ketone concentrations similarly to fasting and appear to reduce food intake acutely, but studies assessing effects on energy balance are limited and provide a potentially promising direction for weight control. Previous investigations …
Constraint-Induced Movement Therapy To Improve Gait And Mobility Of People With Chronic Stroke: A Mixed Methods Study, Sarah Monteiro Dos Anjos
Constraint-Induced Movement Therapy To Improve Gait And Mobility Of People With Chronic Stroke: A Mixed Methods Study, Sarah Monteiro Dos Anjos
All ETDs from UAB
Walking impairment after stroke impacts on participation and quality of life. Different techniques have been developed in the last decades to overcome walking difficulties after stroke, however, few have been shown to be efficacious. Constraint-induced Movement Therapy (CIMT) is a family of techniques that has been reported as one the most effective intervention for improving functional use and motor skills of a more-affected upper extremity (UE). The intervention protocol includes: 1) intensive supervised training; 2) use of shaping as a strategy for the motor training, 3) a group of behavioral strategies called the transfer package, and 4) procedures to increase …
Culture And Patient Safety Outcomes: Examining The Impact Of The Departmental Work Environment On Outcomes, Dawn Ahner
Culture And Patient Safety Outcomes: Examining The Impact Of The Departmental Work Environment On Outcomes, Dawn Ahner
All ETDs from UAB
This study examined the relationship between the departmental work environment and patient safety outcomes to determine if there were particular subcomponents of a department’s work environment that had a more significant impact on patient safety outcomes. The work environment was defined as the culture of an individual nursing department which consisted of the employee’s perception of engagement and patient safety culture. The research was informed by the commitment-based theory. Based on this theory, it was predicted that a team-based approach in the work environment would lead to a learning and positive environment, which would be positively associated with quality of …
Vestibular And Oculomotor Function In Children With Cerebral Palsy, Anwar B. Almutairi
Vestibular And Oculomotor Function In Children With Cerebral Palsy, Anwar B. Almutairi
All ETDs from UAB
Cerebral palsy (CP) is the most common motor disability of childhood, caused by non-progressive permanent injury to the fetal or infant’s brain. Visual and balance impairments are prominent hallmarks of these disorders. Although musculoskeletal and neuromuscular causes are well established in the literature, the role of vestibular and oculomotor disabilities was not explored in this population. Because of that, this dissertation aims to describe the vestibular and oculomotor function in children with CP, aged 7-12years, GMFCS levels I-III, and to determine the feasibility, sensitivity, specificity and retest reliability of vestibular and oculomotor clinical tests in children with CP, compared to …
Interactions Between Posture And Locomotion In Nonimpaired And Poststroke Walking, Sarah Anne Graham
Interactions Between Posture And Locomotion In Nonimpaired And Poststroke Walking, Sarah Anne Graham
All ETDs from UAB
Background: Inappropriate paretic-limb force generation is a hallmark of impaired walking function poststroke. In addition to weakness, the paretic limb misdirects foot forces during stance, which may be due to inappropriate postural influence over weakened locomotor control. Purpose: Investigate neural control interactions between posture and locomotor functions by manipulating postural influence during walking of nonimpaired and individuals poststroke. I present four studies investigating measures associated with locomotor function and foot-force direction under varying postural demands during walking. Methods: Study 1 compared comfortable walking speed (CWS) outcomes following two body-weight-support (BWS) training protocols for N=29 participants with chronic (≥5 months) poststroke …
Diabetes Risk In Women: Pschosocial And Lifestyle Determinants, Sarah Katherine Sweatt
Diabetes Risk In Women: Pschosocial And Lifestyle Determinants, Sarah Katherine Sweatt
All ETDs from UAB
Type 2 diabetes (T2D) is a major public health concern. Physical inactivity, poor diet, and psychosocial distress have emerged as factors contributing to T2D. Women may be uniquely affected by these factors as obesity, physical inactivity, and the prevalence of psychosocial distress are higher in women. Additionally, polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women and increases the risk of both T2D and psychosocial distress. However, the relationship between physical activity (PA), psychosocial distress, and metabolic health is not fully understood, particularly in at risk populations such as minorities and women with PCOS. Therefore, the goal …
Circulating Mirnas And Human Insulin Resistance, Elizabeth Ma
Circulating Mirnas And Human Insulin Resistance, Elizabeth Ma
All ETDs from UAB
Insulin resistance (IR) is central to the pathophysiology of Type 2 diabetes (T2DM), and is a risk factor for cardiovascular disease. The mechanisms behind IR are not clear, but microRNA (miR; short, non-coding RNA strands that base-pair with mRNA to modify gene expression) have garnered interest as potential contributors. miRs have recently been shown to be detectable in the circulation, and can be taken up and regulate target genes within recipient cells. Our primary objective was to identify circulating miRs (c-miRs) that play a role in regulating systemic metabolism and participate in the pathophysiology of IR and cardiometabolic disease. Three …
Hospital Purchasing Alliance: Contextual Factors And Financial Performance, William Opoku-Agyeman Opoku-Agyeman
Hospital Purchasing Alliance: Contextual Factors And Financial Performance, William Opoku-Agyeman Opoku-Agyeman
All ETDs from UAB
Collectively, the purpose of the three papers included in this dissertation was to provide empirical evidence on the contextual factors that influence hospital utilization of services of group purchasing organizations and how utilization of group purchasing organizations impacts hospitals’ financial performance. The findings of these studies are important both to researchers and to managers as it sheds light on the relationship between hospitals and group purchasing organizations. The results of this dissertation suggest that better financial performance is associated with hospital utilization of group purchasing organizations. Additionally, some measures of environmental munificence and dynamism are associated with hospital utilization of …
Behavioral Markers Of Supraspinal Pain In Clinically Relevant Models Of Spinal Cord Injury, Kathryn Yamamoto Henley
Behavioral Markers Of Supraspinal Pain In Clinically Relevant Models Of Spinal Cord Injury, Kathryn Yamamoto Henley
All ETDs from UAB
The majority of people suffering from neuropathic pain as a result of a spinal cord injury (SCI) do not experience effective pain relief with currently available therapeutics. One aspect of preclinical studies that may be limiting the development of successful analgesics is the assessment of pain in animal models of SCI. Previous work has relied primarily on withdrawal reflexes to indicate pain; however, there is evidence that suggests this is an inadequate measure of pain sensation as spinal reflexes do not reflect the supraspinal processing of nociceptive information. The use of withdrawal responses is especially challenging in the context of …
Motor Abilities And Social Participation In Young Children With Autism Spectrum Disorder, Jamie M. Holloway
Motor Abilities And Social Participation In Young Children With Autism Spectrum Disorder, Jamie M. Holloway
All ETDs from UAB
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that primarily affects social communication and behavior, however, a number of motor impairments have been identified in children with ASD. In children who are typically developing, the development of social, communication, and cognitive skills is thought to be influenced by motor development. However, the impact of these motor skill deficits on overall development in children with ASD is not yet known. The purpose of this dissertation was to explore the relationship between gross motor ability and social function and participation in young children with ASD. The first study described changes in peer …
Teleexercise For People With Disabilities, Byron Lai
Teleexercise For People With Disabilities, Byron Lai
All ETDs from UAB
Exercise is recognized as a method of improving health and function and preventing deconditioning for adults with neurological disabilities. However, they experience a multitude of barriers that prevent them from regular participation in exercise. To address these barriers, the goal of this dissertation was to explore the use of monitoring technology as a means for delivering exercise to adults with neurological disabilities at home. This pursuit involved three studies. The first study reviewed the extant literature for current trends in exercise interventions for people with disabilities. Regarding technology, the review indicated that technology is rarely used to deliver one-on-on supervised …
The Effects Of Nurse-Manager Relationships And Nurse-Physician Collaboration On Nurse Intent To Leave, Phillip John Mazzuca
The Effects Of Nurse-Manager Relationships And Nurse-Physician Collaboration On Nurse Intent To Leave, Phillip John Mazzuca
All ETDs from UAB
ABSTRACT Aim. The aim of this study was to determine whether two relational aspects of the nurse work environment – perceived quality of the nurse-supervisor relationship and nurse-physician collaboration – might reduce nurse intent to leave the hospital. Background. There is a documented global shortage of nurses which is a pressing issue in U.S. hospitals. The nursing shortage has been exacerbated by a high rate of voluntary nursing turnover in U.S. hospitals which is costly and has previously been found to negatively impact patient care. Factors associated with the nursing work environment have been found to be important predictors of …
Increasing The Accessibility Of A Falls Prevention Intervention For Community-Dwelling Older Adults With Low Vision, Sarah Blaylock
Increasing The Accessibility Of A Falls Prevention Intervention For Community-Dwelling Older Adults With Low Vision, Sarah Blaylock
All ETDs from UAB
Falls remain a costly problem as a leading cause of injuries and fatalities for individuals over the age of 65. Older adults with low vision, or non-correctable visual impairment, are estimated to be two times more likely to fall than those without vision loss. There appear to be limited falls prevention interventions available for older adults that have been tested on or designed specifically for individuals with visual impairment. The goals of this dissertation were to learn more about the availability of visually accessible falls prevention interventions and to develop an intervention that can be used with veterans receiving services …
Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans
Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans
All ETDs from UAB
This three-paper dissertation sought to examine the existence of strategic groups in the home health industry, the application of Porter’s generic strategies (cost leader, differentiator, “stuck-in-the-middle” and both cost leader/differentiator) in identifying these groups, and the association of group membership with agency performance. The findings of this study will provide researchers and managers with a highlight of the current strategic makeup of the home health industry and its relationship with quality and financial performance. The results of this dissertation provide some evidence that strategic groups do exist in the home health industry and can be described along the basis of …
The Effectiveness Of Clinical Integration: The Relationship Between Evidence-Based Clinical Processes, In-Network Utilization And Clinical, Service And Efficiency Outcomes, Patrick D. Falvey
The Effectiveness Of Clinical Integration: The Relationship Between Evidence-Based Clinical Processes, In-Network Utilization And Clinical, Service And Efficiency Outcomes, Patrick D. Falvey
All ETDs from UAB
THE EFFECTIVENESS OF CLINICAL INTEGRATION: THE RELATIONSHIP BETWEEN EVIDENCE-BASED CLINICAL PROCESSES, IN-NETWORK UTILIZATION AND CLINICAL, SERVICE AND EFFICIENCY OUTCOMES PATRICK D. FALVEY EXECUTIVE DOCTORAL PROGRAM – SCHOOL OF HEALTH PROFESSIONS ABSTRACT The evolving U.S. health care system continues to steer healthcare organizations and integrated healthcare delivery networks (IDNs) to function as population health networks and ACOs. Policymakers, payers, health care leaders and consumer groups are advocating that IDNs clinically integrate processes and structures under the assumption that they will improve the clinical outcomes for a population, reduce the health care spend, and enhance the patient experience. Relatively little research has …
The Dietary Context Of Nut Intake Among Overweight And Obese African-American Women Living In The Rural South: An Exploratory Study, Samara Sterling
The Dietary Context Of Nut Intake Among Overweight And Obese African-American Women Living In The Rural South: An Exploratory Study, Samara Sterling
All ETDs from UAB
Obesity has become a national epidemic over the last few decades, and lays its heaviest burden on certain populations (eg, rural residents, African-Americans, and African-American women in the Southeast). Obesity increases medical costs substantially, and is a significant risk factor for various chronic conditions, including certain cancers. There is a need to identify specific dietary behaviors that may contribute to obesity and obesity-related cancers among African-American women in the rural South, and to recommend dietary modifications that may alleviate those risks. Previous research has shown that nuts offer numerous health benefits, including weight loss and cancer protection. More research is …