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The Prescription Drug Monitoring Program And Its Effect On Drug Overdose Mortalities, Charles Lee Jan 2024

The Prescription Drug Monitoring Program And Its Effect On Drug Overdose Mortalities, Charles Lee

All ETDs from UAB

The opioid epidemic is a growing concern, and the health and economic impacts on rural and urban counties are increasing. Between 1999 and 2019, approximately 841,000 people died from drug overdoses involving heroin, synthetic opioids, and prescribed opioids with 71,000 dying in 2019. This study examined the relationship between drug overdose mortalities and three independent variables, (a) Medicaid expansion, (b) Years PDMP active, and (c) Academic detailing engagement. Results of this study will contribute to the literature by determining if the Medicaid expansion, years prescription drug monitoring programs active, and academic detailing engagement decrease drug overdose mortalities. This study includes …


Insulin Responses, Diet Composition, And Fat Loss, Amanda Finn Jan 2024

Insulin Responses, Diet Composition, And Fat Loss, Amanda Finn

All ETDs from UAB

Some but not all studies show participants who have higher baseline insulin responses lose more weight on a low glycemic load compared to a high glycemic load diet. Most prior research tested the relationship between insulin and weight changes with only one insulin response variable, such as insulin from an orally or intravenously (IV) administered metabolic test. We tested whether insulin responses (IV or oral) predicted changes in body fat among participants undergoing diet-induced weight loss. This study was a secondary analysis of a clinical trial. In the parent study, participants were randomized to either a reduced carbohydrate (ReducedCHO) or …


Does Ceo Education Matter? The Relationship Between Doctoral-Educated Hospital Ceos And Organizational Performance, Kofi Ali Cash Jan 2024

Does Ceo Education Matter? The Relationship Between Doctoral-Educated Hospital Ceos And Organizational Performance, Kofi Ali Cash

All ETDs from UAB

One of the most pressing issues in healthcare strategic leadership research is identifying which hospital chief executive officer (CEO) characteristics possess a significant and favorable relationship to organizational performance. However, little is known about the relationship between hospitals led by doctoral-educated CEOs and organizational performance. This study adds to our knowledge by examining the relationship between doctoral-educated hospital CEOs and selected financial and patient safety outcomes. UET served as the theoretical framework and guided the examination of the relationship between the selected dependent and independent variables. This study’s population included 509 acute-care hospitals across nine states, requiring a minimum four-year …


Impact Of Federally Qualified Health Centers (Fqhc) And Look-Alikes (Fqhc Lal) Participating In The 340b Drug Pricing Program, Shannon Burger Jan 2024

Impact Of Federally Qualified Health Centers (Fqhc) And Look-Alikes (Fqhc Lal) Participating In The 340b Drug Pricing Program, Shannon Burger

All ETDs from UAB

The 340B Drug Pricing Program intends to enable community health providers to deliver care more easily to vulnerable populations. Safety net providers were designated as eligible entities through an act of Congress and were allowed access to prescription drug savings. Existing studies have focused on hospital participation in the program, overlooking the impact of Federally Qualified Health Centers (FQHC) and FQHC Look-alikes (FQHC LAL) and legislative intent. This study aimed to fill this gap by comparing the effectiveness of FQHCs and FQHC LALs participating in the 340B Drug Pricing Program. Specifically, the study examined the influence of the status of …


The Association Of Availability And Accessibility Of Federally Qualified Health Centers On Hospitals' Reported Charity Care, Philip Cendoma Jan 2023

The Association Of Availability And Accessibility Of Federally Qualified Health Centers On Hospitals' Reported Charity Care, Philip Cendoma

All ETDs from UAB

Hospitals are facing financially challenging times. Each year, billions of dollars are spent by hospitals to provide care to patients that, ultimately, will go unreimbursed. How to effectively provide accessible and affordable health care to the uninsured population continues to be a topic of discussion for policymakers, healthcare administrators, as well as healthcare-based consortiums, and consultant. The cost of charity care consists largely of the care provided to the uninsured population. Federally Qualified Health Centers (FQHCs) play an important role in providing primary care to the uninsured population, regardless of the patient’s ability to pay. Based on the 5 A’s …


Strategic Balance In Healthcare Organizations, Corey Spraberry Jan 2023

Strategic Balance In Healthcare Organizations, Corey Spraberry

All ETDs from UAB

The purpose of this dissertation was to assess the relationship between service mix offerings relative to competitors and firm performance. Specifically, this study explores if an optimal point of service offerings in the competitive market is associated with financial performance. This study is important to both researchers and healthcare leaders as it helps understand the relationship between optimal service mix and firm performance. The results find a relationship that suggests a differentiated service mix compared to a generalized service mix is associated with financial performance. Additionally, hospital characteristics are associated with service duplication and differentiation. The findings of this research …


Quantitative Analysis Of The Impact Of Automatically Generated Normal Tissue Contours On Knowledge-Based Planning Model Quality, Samuel Christopher Baker Arnold Jan 2023

Quantitative Analysis Of The Impact Of Automatically Generated Normal Tissue Contours On Knowledge-Based Planning Model Quality, Samuel Christopher Baker Arnold

All ETDs from UAB

While radiotherapy has become one of the primary standards of treatment for cancer in areas such as the brain, treatment plans are limited by the time it takes physicians to contour CT images used for dose distribution calculations. Automation of the contouring process can not only improve the rate of plan formation but establish an improved standard of care. With the development and implementation of knowledge-based planning (KBP) in radiation oncology, information derived from treatment plans provide machine learning models with years of experience to assess and create future treatment plans. Since KBP model quality rely on contouring from training …


I Would Be Shocked If Someone’S Not Depressed With That Diagnosis”: An In-Depth Exploration Of The Manifestation And Management Of Depression And Anxiety In Patients With Cancer, Carmen Rainey Brown Jan 2023

I Would Be Shocked If Someone’S Not Depressed With That Diagnosis”: An In-Depth Exploration Of The Manifestation And Management Of Depression And Anxiety In Patients With Cancer, Carmen Rainey Brown

All ETDs from UAB

Patients diagnosed with cancer experience depression and anxiety at higher rates compared to the general population. Most individuals diagnosed with cancer will experience symptoms of depression and anxiety at some point during their cancer trajectory and not seek care leaving their mental health conditions undiagnosed and untreated, which impact quality of life and cancer outcomes. Patient and providers perspectives are vital to understand the manifestation, care-seeking behaviors, and provider management of depression and anxiety in patients with cancer. This study sought to explore the manifestation of depression and anxiety among patients with cancer and their care seeking behaviors for mental …


Resilience And Vulnerability: The Impact Of Deprivation, Social Capital, And Distance Sensitivity On Mental Health In Covid-19 Vaccine Seekers, Cesar Ivan Landeros Jan 2023

Resilience And Vulnerability: The Impact Of Deprivation, Social Capital, And Distance Sensitivity On Mental Health In Covid-19 Vaccine Seekers, Cesar Ivan Landeros

All ETDs from UAB

The COVID-19 pandemic has inflicted profound challenges upon California, exacerbating disparities in care, access, and health outcomes within vulnerable and deprived communities. Especially, this crisis has led to a surge in mental health issues, with anxiety and depression emerging as predominant psychopathologies, and the rates of anxiety and depression are alarmingly high in disadvantaged communities. In California, the strikingly high prevalence of these symptoms at 31.7%, compared to the national average of 32.3%, sounds a critical alarm. Despite empirical investigations into anxiety and depression rates across a range of demographic groups worldwide—such as survivors, healthcare professionals, children, adolescents, and adults—the …


The Effects Of Mobile Shielding On Scatter Radiation In The Cardiac Catheterization Laboratory, Lancer Smith Jan 2023

The Effects Of Mobile Shielding On Scatter Radiation In The Cardiac Catheterization Laboratory, Lancer Smith

All ETDs from UAB

This research evaluates the effectiveness of a Specialized Cardiac Catheterization Laboratory Shielding Device (SCCLSD) compared to traditional shielding methods in reducing occupational exposure to scattered x-rays, contributing to the ongoing enhancement of radiation safety in the cardiac catheterization laboratory (CCL) setting. The upper component of the SCCLSD comprises a mobile, transparent barrier with lead-equivalent malleable drapes designed to conform to the patient's body contours. It is height-adjustable, creating a protective shield against scatter radiation generated during CCL procedures. The lower portion of the SCCLSD replaces traditional lead-lined drapes, extending further down the table and incorporating additional shielding for staff protection.An …


Senior Executive Experience And The Performance Of Healthcare Organizations, John Patrick Walsh Jan 2023

Senior Executive Experience And The Performance Of Healthcare Organizations, John Patrick Walsh

All ETDs from UAB

SENIOR EXECUTIVE EXPERIENCE AND THE PERFORMANCE OF HEALTHCARE ORGANIZATIONS JOHN P. WALSH HEALTH SERVICES ADMINISTRATION ABSTRACT The healthcare industry has become increasingly complex over the past two decades causing concern for stakeholders of hospitals and health systems regarding the future viability. Given the tumultuous times, understanding who is best suited to lead these organizations is essential. While some work has been done studying certain characteristics of the Senior Leaders of these organizations, none have looked at the relationship between the Senior Leader’s work experience comparing those with for-profit experience and those without and performance. Using Upper Echelon’s Theory as a …


The Influence Of A Low Glycemic Load Diet On Appetite In Women With Pcos, Sarah Et Hoover Jan 2023

The Influence Of A Low Glycemic Load Diet On Appetite In Women With Pcos, Sarah Et Hoover

All ETDs from UAB

Dysregulated appetite may contribute to weight gain and high prevalence of comorbid obesity in women with polycystic ovary syndrome (PCOS), yet dietary recommendations to promote satiety and facilitate weight maintenance in this population remain scarce. The objective of this dissertation was to determine if women with PCOS have alterations in appetite-regulating hormones that can be manipulated by low glycemic load diet habituation to improve satiety. This was tested by secondary analyses of two randomized controlled dietary intervention trials in women with and without PCOS. First, we explored differences in women with and without PCOS during a standardized liquid meal test …


Patient-Driven Payment Model And The Covid-19 Pandemic External Environment Impact On Nursing Home Industry In The Last 5 Years, Gregory N. Orewa Jan 2023

Patient-Driven Payment Model And The Covid-19 Pandemic External Environment Impact On Nursing Home Industry In The Last 5 Years, Gregory N. Orewa

All ETDs from UAB

Nursing homes face an ever-changing environment and must adapt to achieve organizational success. Recent events such as the COVID-19 pandemic and the implementation of the Patient-Driven Payment Model (PDPM) reimbursement policy have disrupted nursing homes. PDPM put pressure on nursing homes to change their operations and billing practices. The reimbursement policy changed from Resource Utilization Group (RUG) under the Prospective Payment Model (PPS), to PDPM. PDPM, which encourages more value in skilled nursing facility (SNF) spending, has been explored by various studies with respect to nursing home’s reaction in reducing therapy staffing. Three studies follow that examine PDPM and COVID-19 …


Understanding The Impact Of Hospital Price Transparency Initiatives On Consumer Decision-Making To Purchase Healthcare Services, Neel Pathak Jan 2023

Understanding The Impact Of Hospital Price Transparency Initiatives On Consumer Decision-Making To Purchase Healthcare Services, Neel Pathak

All ETDs from UAB

This study examined the influence of hospital list price information on individuals' decision-making to purchase healthcare services. The study collected quantitative data from 550 individuals by administering a hospital price transparency survey. Findings indicate that awareness of hospital list prices and quality outcomes metrics was high, but utilization rates were relatively low among survey participants. Demographic variations were explored with respect to the awareness and utilization of hospital list prices. Quality outcomes and recommendations from friends, family, and physicians emerged as the most important attributes influencing decision-making to purchase healthcare services whereas hospital list prices and social media had a …


Effects Of Dietary R, S-1, 3-Butanediol Diacetoacetate On Components Of Energy Balance And Hepatic Health, Kelsey A. Rushing Jan 2023

Effects Of Dietary R, S-1, 3-Butanediol Diacetoacetate On Components Of Energy Balance And Hepatic Health, Kelsey A. Rushing

All ETDs from UAB

Objective: Exogenous ketone administration presents a possible treatment strategy for obesity and obesity-related diseases. The exogenous ketone ester, R,S-1,3-butanediol diacetoacetate (BD-AcAc2) decreases adiposity and hepatic steatosis in high-fat dietinduced obese mice. In our previous work, carbohydrate energy was removed and replaced with the ketone ester to produce isocaloric diets. The current investigation aimed to determine whether BD-AcAc2 decreases markers of hepatic steatosis and inflammation in lean mice on a high-fat, high-sugar (HFHS) diet without removing carbohydrate energy. Methods: Sixteen 11-week-old male C57BL/6J mice were randomized to one of two groups for 9 weeks (n = 8 per group): 1) Control …


Evaluation Of A Hospital Pdmp Ehr-Integration Implementation: A Mixed, Heather D. Martin Jan 2023

Evaluation Of A Hospital Pdmp Ehr-Integration Implementation: A Mixed, Heather D. Martin

All ETDs from UAB

Background: Many providers continue to over prescribe opioids for pain, and Prescription Drug Monitoring Programs (PDMP) can be used as a tool to assist with appropriate opioid prescribing decisions. Despite mandates requiring opioid prescribers to review patients’ prescribing history in their state’s PDMP, barriers to PDMP success still exist such as a difficult PDMP logon process and having to log on to a separate PDMP system, which can cause access, workflow, time commitment, and ease of use issues and deter providers from using the PDMP. Some health care organizations have implemented PDMP electronic health record (EHR) integration (PDMP EHR-integration) to …


Physical Activity And Related Social Cognitive Theory Constructs By Major Depression Status In Persons With Multiple Sclerosis, Catherine Danielle Jones Jan 2023

Physical Activity And Related Social Cognitive Theory Constructs By Major Depression Status In Persons With Multiple Sclerosis, Catherine Danielle Jones

All ETDs from UAB

Major depressive disorder (MDD) is highly prevalent among the 1 million per-sons living with multiple sclerosis (MS) in the United States. The prevalence of MDD is nearly 1.7 times higher in persons with MS than in the general population. MDD is associated with negative outcomes in MS, including worse neuropsychological functioning, lower quality of life (QOL), and worse disability. Higher levels of physical activity (PA) are associated with lower depressive symptoms in MS and participation in moderate to vigorous physical activity (MVPA) has been recommended for managing depression se-verity in the general population. However, the rates, patterns, and behavioral correlates …


A Study To Examine The Relationship Between Ceo Characteristics And Organizational Performance In The Us Pharmaceutical And Biopharmaceutical Industries, Wafick K. Mohamed Jan 2023

A Study To Examine The Relationship Between Ceo Characteristics And Organizational Performance In The Us Pharmaceutical And Biopharmaceutical Industries, Wafick K. Mohamed

All ETDs from UAB

This study examined the relationship between CEO tenure, sex, level of education, and organizational performance across 229 U.S. publicly traded pharmaceutical and biopharmaceutical companies. The Upper Echelons Theory was used to guide this research on how CEO characteristics could impact organizational performance. Fifteen hypotheses were developed and tested to evaluate the statistically significant relationship between CEO tenure, sex, level of education, and the organizational performance demonstrated in the abnormal stock return valuation and the number of FDA-approved drug products in clinical trial phases (phases 1, 2, and 3) for each company. This quantitative, non-experimental, and cross-sectional study was completed by …


Assessing Visual Function In Young And Medically Complex Children With Cerebral Visual Impairment, Kathleen Mary Weden Jan 2023

Assessing Visual Function In Young And Medically Complex Children With Cerebral Visual Impairment, Kathleen Mary Weden

All ETDs from UAB

Cerebral Visual impairment (CVI) has become the leading cause of vision impairment in children worldwide. Early identification of CVI has been shown to improve visual function outcomes and improve developmental outcomes and quality of life. However, children with CVI are difficult to identify and assess because the medical conditions that cause CVI can also cause impairment across domains of function. A scoping review was first conducted on interventions and outcome measures used for children with CVI. The sources identified (n=20) were grouped into five types of interventions. The review confirmed the need for quantitative, standardized methods for measuring visual function …


Organizational Climate And Its Association With Eth Perceived Permanence Of An Evidence-Based Decision-Aid For Patients With Lupus, Aizhan Karabukayeva Jan 2023

Organizational Climate And Its Association With Eth Perceived Permanence Of An Evidence-Based Decision-Aid For Patients With Lupus, Aizhan Karabukayeva

All ETDs from UAB

It is increasingly evident that seemingly good ideas do not always result in changes in practice, and it is challenging to sustain evidence-based innovations, even if they are backed by substantial research. Long-term use of innovations seems more likely where favorable contextual conditions are in place, yet relatively little empirical research has taken up the question of how evidence-based practices are sustained and become established in day-to-day practice. This question of sustainability is crucial if the gains in patient care that derive from organizational innovations are to be maintained. The purpose of this dissertation was to examine the relationship between …


Physical Activity Promotion In Persons Newly Diagnosed With Multiple Sclerosis, Le Thao Trinh Huynh Jan 2023

Physical Activity Promotion In Persons Newly Diagnosed With Multiple Sclerosis, Le Thao Trinh Huynh

All ETDs from UAB

Multiple sclerosis (MS) is a prevalent immune-mediated, neurodegenerative disorder, affecting approximately 1 million people in the United States. MS onset is commonly between 20 and 40 years of age, and persons with MS often live a long life with the disease resulting from the early initiation of disease-modifying therapies and comorbidity-managing approaches. Notably, physical activity is promising for disease modification and symptoms and comorbidity management in MS. Yet, physical activity has been initiated quite late during the disease course. Further, early MS could be a “window of opportunity” for initiating physical activity to maximize its health benefits for symptom management …


Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas Jan 2023

Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas

All ETDs from UAB

Increasing competition in the healthcare industry is compelling organizations to adopt new strategies to obtain and/or maintain a competitive advantage. To obtain a competitive advantage, healthcare organizations may need either more efficient processes or offer new or improved products and services through the utilization of these strategies. In competitive market environments, technological innovations can be a key competitive advantage to reduce expenses, improve quality, attract more customers, or a combination of all. All healthcare organizations can benefit from technological innovations, especially those with limited resources. One type of healthcare organization that highlights the disparity in resources is the Federally Qualified …


Mechanisms Of Simulated-Spinal Manipulative Therapy In Animal Models Of Low Back Pain, Carla Rigo Lima Jan 2023

Mechanisms Of Simulated-Spinal Manipulative Therapy In Animal Models Of Low Back Pain, Carla Rigo Lima

All ETDs from UAB

Low back pain (LBP), a condition characterized by pain experienced between the 12th rib margin and gluteal folds, is a prevalent health problem that affects an ever-increasing population worldwide. First-line treatment for LBP often involves non-pharmacological approaches, including spinal manipulative therapy (SMT), which has demonstrated mild-to-moderate clinical efficacy. However, despite its therapeutic benefits, the physiological mechanisms underlying the analgesic effects of SMT in LBP are still not well understood. Recent evidence suggests that sensitization of peripheral and central nervous system structures contribute to the progression and maintenance of LBP with inflammatory cytokines, reactive glial cells, and/or aberrant muscle spindle activity …


Contributions Of Off-Season Training And Food Security Status On Body Composition And Performance In Collegiate Football Players, Kathryn Lee Stowers Jan 2023

Contributions Of Off-Season Training And Food Security Status On Body Composition And Performance In Collegiate Football Players, Kathryn Lee Stowers

All ETDs from UAB

Body composition measurements are collected periodically in the collegiate athletic setting to evaluate health and predict athletic performance of individual athletes. However, the effects of remote training and food insecurity on body composition have yet to be fully investigated in this population. The purpose of this research was to evaluate the influence of remote training and food security status on body composition and performance changes during off-season training. Aims 1 and 2 focus specifically on how factors affect body composition changes in collegiate football players during off-season training. Data were collected from routine body composition testing and food security screening …


An Examination Of The Relationship Between Mobile Apps And Healthcare Outcomes: A Patient Engagement And Patient Satisfaction Perspective, Khaled Hamad Alkhalifa Jan 2023

An Examination Of The Relationship Between Mobile Apps And Healthcare Outcomes: A Patient Engagement And Patient Satisfaction Perspective, Khaled Hamad Alkhalifa

All ETDs from UAB

Background: Mobile apps are rapidly becoming an essential tool for hospitals to be competitive in a rapidly evolving healthcare market driven by patient expectations. The effectiveness of mobile apps is not fully understood, and more research needs to be done to evaluate their impact on patient satisfaction. More specifically, the role of patient engagement in this relationship needs to be investigated, given the rapid improvement in health behavior-changing mobile apps.Objective: This study aimed to examine (1) whether hospitals providing mobile apps are associated with higher patient satisfaction and patient engagement scores, (2) whether mobile app usability impacts this relationship, and …


Weight Loss And Physical Activity For People With Physical Disabilities, Julianne Clina Jan 2023

Weight Loss And Physical Activity For People With Physical Disabilities, Julianne Clina

All ETDs from UAB

People with physical disabilities (PWD) are at higher risk of obesity than people with-out physical disability (PWoD). For PWD, obesity presents a greater risk of secondary conditions; preventable medical, emotional, or social problems resulting directly or in-directly from an initial disabling condition. There is incomplete information about how disability-specific concerns influence obesity treatment and weight management, in part because PWD have typically not been included in this research. Additionally, while studies exist examining weight loss in PWD, a dearth of research exists examining weight loss maintenance for this population. Previously, weight control registries have been a valuable tool in gaining …


Pathophysiological Metabolic Alteration In Lung Injury And Fibrosis, Samuel Robert Smith Jan 2023

Pathophysiological Metabolic Alteration In Lung Injury And Fibrosis, Samuel Robert Smith

All ETDs from UAB

Lung injury and lung repair are two sides of the same coin, for where injury occurs, repair must follow. Lung fibrosis occurs when this repair process is dysfunctional and becomes trapped in a chronically incomplete state. The studies described here examine each side of this coin to ask the question of whether metabolism has a role in the pathophysiology of acute lung damage following severe trauma or in the chronic progression of idiopathic pulmonary fibrosis (IPF). In the first half of this work, we investigated the impact that severe lung injury and infection exert on the flux of metabolites in …


Unexpected And Usual Breaks' Impact On Body Composition In College Athletes, Aston Dommel Jan 2022

Unexpected And Usual Breaks' Impact On Body Composition In College Athletes, Aston Dommel

All ETDs from UAB

Body composition is an important factor that determines athletic performance. At the elite level, margins of victory are narrow, with small changes in performance making the difference between victory and defeat. Changes in body composition affect performance, in both improvements and decrements. Athletes regularly experience breaks from structured activity and resources caused by expected circumstances (school breaks, off-season) and unexpected circumstances (injury, COVID-19). Due to differences in diet, physical activity, and other factors, breaks may cause changes in body composition that can hinder or help the athlete upon return to structured resources. Currently, there is a plethora of cross-sectional research …


Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber Jan 2022

Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber

All ETDs from UAB

Medical travel has been growing at a steady rate as global travel has also increased. However, with the advent of COVID-19, all global travel came to a screeching halt, including travel intended for medical purposes across borders. Now that travel is resuming worldwide, American hospital administrators are anxious to fill their beds with more profitable, international patients to make up for revenue losses incurred during the pandemic. Existing literature on the topic of medical tourism focuses on the role of patient initiative, choice, and risk-taking behaviors with little mention of hospital leadership’s ability or desire to construct a management strategy, …


The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris Jan 2022

The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris

All ETDs from UAB

Over the past two decades, uncompensated care in U.S. hospitals has grown at a staggering rate and reached $46.4 billion in 2013. It began to decline in 2014, due to the passage of the Patient Protection and Affordable Care Act (ACA), but is now on the rise again. Uncompensated care is typically affected by policy and market factors such as legislative changes and an increase in the number of uninsured. While hospitals continue to serve as critical safety net providers, they are often not the only or most appropriate facility to serve the indigent in U.S. communities. Instead, federally qualified …