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Articles 121 - 150 of 284
Full-Text Articles in Medical Humanities
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 …
An Analysis Of The Relevance Of U.S. News And World Report Rankings On Admissions Outcomes And Student Placement Of Graduate Programs In Healthcare Management, William Alburn Tuttle
An Analysis Of The Relevance Of U.S. News And World Report Rankings On Admissions Outcomes And Student Placement Of Graduate Programs In Healthcare Management, William Alburn Tuttle
All ETDs from UAB
Social, economic and political influences are exerting considerable pressure on the development of universities and colleges. Such forces coupled with the growing influence of rankings are exerting a formidable impact upon higher education. The conceptual framework guiding this study was derived from the work of Spence and Signaling Theory (ST). This theory plays a vital role in societal interaction of individuals as well as how certain organizations carry out their mission. ST offers an opportunity and perspective to explore the relevance of signals associated with U.S. News and World Report (USNWR) rankings of graduate programs in healthcare management. Graduate programs …
Patient Safety: Organizations, Culture, And Information Technology, Soumya Upadhyay
Patient Safety: Organizations, Culture, And Information Technology, Soumya Upadhyay
All ETDs from UAB
The purpose of this dissertation is to explore factors that influence patient safety culture and patient safety outcomes, and whether patient safety culture affects hospital performance. The findings of these studies have important implications to hospital managers in the context of macro environmental changes regarding quality and safety. As managers look for ways to improve patient safety, results from this dissertation suggest strategies (for example, RN staffing; EHR presence) that may help improve safety culture and hospital performance. Specifically, having at least basic EHR as compared to not having any EHR supports safety culture to positively influence quality and financial …
The Effect Of Hospitalists On Hospital Length Of Stay, Khanhuyen Vinh
The Effect Of Hospitalists On Hospital Length Of Stay, Khanhuyen Vinh
All ETDs from UAB
Environmental pressures in the healthcare industry force hospitals to seek new innovations to become more efficient. Hospitals have entered into a partnership hospitalists in an effort to reduce their ALOS. The purposes of this study are to determine the impact of ALOS by hospitals using hospitalists, the sustainability of impact on ALOS over time, and whether hospitals that adopted the hospitalist innovation in the last five years experienced an impact on ALOS. The study investigated 26,527 observations of hospital-years of nonprofit and investor-owned hospitals from 2007-2015 that responded to the AHA Annual Survey and primarily provided general medical/surgical services. Case …
Acute And Chronic Regulation Of Skeletal Muscle Mitochondrial Function, Jonathan Lund Warren
Acute And Chronic Regulation Of Skeletal Muscle Mitochondrial Function, Jonathan Lund Warren
All ETDs from UAB
Obesity and type 2 diabetes (T2D) represent a growing global burden on healthcare and financial resources. One hypothesis for the onset and exacerbation of these diseases is related to the role of mitochondria as the end users of products of the metabolism of the nutrients we consume and in mediating the oxidative state of the body through the production of reactive oxygen species (ROS). In order to meet the demands of a metabolic challenge and prevent excessive ROS production, there appear to be adaptations to mitochondrial physiology and morphology that can occur and we hypothesize that the ability of the …
Type I Myofiber Grouping: Myofiber Phenotype And Implications For Muscle Performance In Older Adults And Parkinson Disease, Kelley Grace Hammond
Type I Myofiber Grouping: Myofiber Phenotype And Implications For Muscle Performance In Older Adults And Parkinson Disease, Kelley Grace Hammond
All ETDs from UAB
Neuromuscular morphology and function undergo changes with increasing age and Parkinson disease (PD) pathology. Motor unit reorganization occurs by denervation-reinnervation events which lead to diminishing random distribution of myofibers and type I myofiber grouping. Grouped type I myofibers maintain type II features such as hypertrophic capacity and myonuclear addition, sarco(endo)plasmic reticulum Ca2+ ATPase 1 expression, and lower capillarization. Though age-related type I myofiber grouping has been qualitatively described in the literature, this was the first study to characterize the phenotype of grouped type I myofibers in older adults. Furthermore, we identified a magnified degree of type I myofiber grouping in …
A Multilevel Perspective On Health Information Exchange, Claudia Guerrazzi
A Multilevel Perspective On Health Information Exchange, Claudia Guerrazzi
All ETDs from UAB
As the health care sector faces pressure to improve quality and contain costs, sharing information among the various care providers will become an essential practice among health care providers. Many countries are now adopting policies to foster Health Information Exchange (HIE), which is defined as the electronic transfer of data or information among health care organizations involved in the delivery of care. The literature about HIE reports contradictory evidence about the adoption and the use of HIE and more research is needed to understand this complex phenomenon. Specifically, HIE is a complex phenomenon that produces outcomes at different levels and …