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Articles 211 - 240 of 284
Full-Text Articles in Medical Humanities
The Relation Of Hospital Choices In It Infrastructure Spending And Deployment With Hit/Ehr Strategies And Operational Efficiency, Harold Neumeier
The Relation Of Hospital Choices In It Infrastructure Spending And Deployment With Hit/Ehr Strategies And Operational Efficiency, Harold Neumeier
All ETDs from UAB
This study examined certain aspects of the association between information technology (IT) strategy and structure changes within hospitals, as well as the effects of IT infrastructure changes on measures of financial performance for these hospitals during the period of 2009-2011. Following the Process School of the Resource Based View, both internal and external information technology resources were examined to see how hospitals had responded to Federal policies related to the "meaningful use" of Health IT and Electronic Health records. Specifically, this study examined changes in information technology spending by hospitals based on size, hospital type, and percentage of revenue derived …
Impact Of Quality Performance On Financial Risk And Cost Of Capital In Hospitals, James D. Byrd
Impact Of Quality Performance On Financial Risk And Cost Of Capital In Hospitals, James D. Byrd
All ETDs from UAB
This study evaluated the relationship of hospital quality of care as measured by mortality scores to hospital cost of capital as represented by average cost of debt. A composite mortality score (weighted average of Hospital Compare's risk adjusted mortality rate for each hospital) was regressed against the hospitals' average cost of debt using OLS and the Stata 11 robust clustering function to adjust for repeated occurrences of hospitals across years. The data base consisted of acute care hospitals with interest expense observed over the three year period 2008 - 2010 (n=3420). Control variables included a number of hospital characteristic (e.g., …
High-Tech Services And Hospital Performance In The United States, Ferhat Devrim Zengul
High-Tech Services And Hospital Performance In The United States, Ferhat Devrim Zengul
All ETDs from UAB
This dissertation examined the relationship between high-technology medical services and hospital performance by focusing on financial and quality performance dimensions. An initial systematic review disclosed the paucity of research and mixed findings about the technology-performance relationship. The review indicated the need for further analyses by emphasizing some limitations of existing studies. The resource-based view (RBV) of a firm was used as a conceptual framework in examining the relationship between high-tech medical services and hospital financial performance. It was hypothesized that large breadth (number) of high-tech services and the use of rare high-tech services would be positively associated with hospitals' financial …
Hospital Financial Performance: A Look At Governance And Hit Strategies, Taleah Collum
Hospital Financial Performance: A Look At Governance And Hit Strategies, Taleah Collum
All ETDs from UAB
Taken together, the purpose of the three papers included in this dissertation is to provide empirical evidence on the relationship between strategies employed by hospital managers and hospital financial performance. The findings of these studies are important to managers as they search for ways to sustain and improve hospital financial performance in light of environmental changes that have taken place over the last three decades. The results of this dissertation suggest that to improve financial performance hospital leaders (e.g. management, board of directors) should choose strategies that are more amenable to their control. Specifically, having BOD members that are independent …
Hospitalists And Organizational Performance, Josué Patien Epané
Hospitalists And Organizational Performance, Josué Patien Epané
All ETDs from UAB
Two decades ago, a group of hospital-based physicians (hospitalists) specializing in the practice of hospital medicine were introduced in the U.S. health care system. Since then, this group of physicians has experienced an unprecedented growth. Prior studies on hospitalists have focused on benefits associated with the use of hospitalists. Compared to non-hospitalists, these studies revealed that hospitalists are more efficient as they are able to reduce length of stay and costs while achieving similar or better quality of care. However, most of these studies have been cross-sectional, limited to few hospitals, and limited to pediatric and teaching hospitals. Very little …
The Contribution Of Intereim Executives To The Healthcare Industry, Ray Snead
The Contribution Of Intereim Executives To The Healthcare Industry, Ray Snead
All ETDs from UAB
This is the first research-based study of interim executive services in the US healthcare industry. It opens a new area of inquiry for academic investigation of the role of interim executive services in the healthcare industry. The study focused on Chief Executive Officer and Board of Directors leadership in acute care hospitals of all sizes across the United States. The research survey resulted in 443 responses to over seventy-five questions addressing interim executive services from the perspective of healthcare decision makers. Ninety five percent of the respondents were CEOs and the remainder were board members, primarily chairpersons. The research is …
Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm
Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm
All ETDs from UAB
The purpose of this research was to examine the relationship between Patient-Centered Medical Homes (PCMH) practice capabilities and costs. Complexity science theory was used to develop a theoretical framework to address three primary and twelve secondary hypotheses. Secondary data from a consortium of physician organizations participating in Blue Cross Blue Shield of Michigan's Physician Group Incentive Program and Blue Cross Blue Shield of Michigan's administrative claims data were used to test hypothesized relationships using fixed effects panel regression models. It was found that higher levels of aggregated PCMH practice capabilities were negatively associated with certain costs, specifically average readmission costs. …
Understanding The Predictors Of Patient Trust And Its Role In Utilization And Outcomes, Sheikilya Lewis Thomas
Understanding The Predictors Of Patient Trust And Its Role In Utilization And Outcomes, Sheikilya Lewis Thomas
All ETDs from UAB
The purpose of this dissertation is to examine patient-related factors that predict trust in one's physician, and subsequently identify the role of patient trust in health care utilization and clinical outcomes among African Americans with hypertension. Three separate studies are conducted using an adapted version of the Interaction Model for Client Health Behavior (IMCHB). The first paper is a three-step review of quantitative studies investigating the (a) patient characteristics that influence trust; (b) impact of trust on health care utilization; and (c) impact of trust on outcomes. Based on the predictors identified, the second study examines the significance of these …
Effect Of A Faith-Based Initiative On Hospital Readmissions, Joseph Webb
Effect Of A Faith-Based Initiative On Hospital Readmissions, Joseph Webb
All ETDs from UAB
EFFECT OF A FAITH-BASED INITIATIVE ON HOSPITAL READMISSIONS JOSEPH WEBB ADMINISTRATION-HEALTH SERVICES ABSTRACT The purpose of this study was to examine the relationship between a faith-based initiative and hospital readmissions. The main data source used was the inpatient data-base of Methodist LeBonheur Healthcare System (MLH) in Memphis, TN. Data were collected from admissions that occurred during years 2008 through 2012 at four of MLH's five adult acute-care hospitals. Data from the U.S. Census Bureau's American Community Survey were also used in the study. This study uses theoretical tenets from the Social Justice and Equity Theory and the Chronic Care Model …
Prevalence Of Overweight And Obesity In Classic Rett Syndrome., Kathrine Clova Grigsby
Prevalence Of Overweight And Obesity In Classic Rett Syndrome., Kathrine Clova Grigsby
All ETDs from UAB
Introduction: Rett syndrome (RTT) is a genetic, neurodevelopmental disorder that displays high incidence of growth failure, variations in body composition, feeding/gastrointestinal complications, and undernutrition. The ongoing Rare Diseases Clinical Research Network (RDNCRN) Rett Syndrome Natural History Research Project has yielded observations regarding the less recognized occurrence of overnutrition in adult females with classic Rett syndrome. The purpose of this study was the determine the prevalence of overweight/obesity in children and young adults with classic Rett syndrome, the percent overweight and obese among adults with classic Rett syndrome, and to determine if the prevalence of overnutrition increases after the puberty years …
Influences Of Habitual Diet, Ethnicity, And Age On Circulating Total Ghrelin, Amy Ellis
Influences Of Habitual Diet, Ethnicity, And Age On Circulating Total Ghrelin, Amy Ellis
All ETDs from UAB
Ghrelin is a hormone known to stimulate appetite and food intake. Although certain macronutrients differentially suppress ghrelin on an acute basis, it is unknown whether habitual macronutrient intake affects circulating ghrelin. Thus, the first experimental aim was to determine whether 8-week habituation to diets differing in carbohydrate or fat would affect fasting ghrelin or ghrelin response to a mixed meal. Recent reports also suggest that ghrelin regulation may relate to propensity for obesity. Obesity is more prevalent among AA compared to EA, with the highest rates among AA females. This disparity becomes apparent before puberty, and childhood obesity tends to …
Physical Activity Barriers Following Traumatic Brain Injury: A Cognitive Mapping Study, Anna De Joya
Physical Activity Barriers Following Traumatic Brain Injury: A Cognitive Mapping Study, Anna De Joya
All ETDs from UAB
Background: Despite the strong evidence indicating the benefits of regular physical activity (PA) for health and functioning, individuals with a traumatic brain injury (TBI) do not engage in PA at levels consistent with public health recommendations. To eliminate the health disparities and promote PA in this population, the barriers unique to individuals with TBI should be identified by different stakeholders to establish effective health promotion programs that have sustainable outcomes. There is limited evidence to guide the development and delivery of effective PA interventions in the TBI field. Objectives: The specific aims of this study are: 1) to identify the …
The Effects Of Direct To Consumer Advertising On Healthcare Utilization Among Medicaid Children With Asthma, Luceta C. Mcroy
The Effects Of Direct To Consumer Advertising On Healthcare Utilization Among Medicaid Children With Asthma, Luceta C. Mcroy
All ETDs from UAB
National guidelines recommend treatment of asthma with preventive long term medication, but adherence remains low, resulting in high healthcare utilization among those affected by the chronic disease. The increase in DTCA since the easing of restrictions by the FDA in 1997 has prompted much debate on the effects of the DTCA, with critics arguing that it is harmful while proponents see many benefits such as increased medication adherence. This study examines the impact of DTCA on healthcare utilization and asthma medication use by combining Medicaid administrative data and a national advertising data set on asthma medication from 1999 to 2002. …
Career Satisfaction Of Physicians Employed By Health Systems, Edward L. Heath
Career Satisfaction Of Physicians Employed By Health Systems, Edward L. Heath
All ETDs from UAB
CAREER SATISFACTION OF PHYSICIANS EMPLOYED BY HEALTH SYSTEMS EDWARD L HEATH, JR ADMINISTRATION-HEALTH SERVICES ABSTRACT Background:Higher career satisfaction has been shown to result in better patient outcomes, higher patient satisfaction and less turnover among physicians. The purpose of this study is to examine the relationship between physician employment and career satisfaction. Methods:Data from the Center for Studying Health System Change (HSC) 2008 Health Tracking Physician Survey was used in the study. The study is a cross sectional, quantitative study of the relationship between physician employment and career satisfaction. A total of 4,720 respondents responded to the survey, with a weighted …
Diagnostic Classifications For Bipedal Locomotion, Lois Deming Hedman
Diagnostic Classifications For Bipedal Locomotion, Lois Deming Hedman
All ETDs from UAB
Background: Analysis of and intervention for movement dysfunction, especially walking dysfunction, is the central expertise of physical therapists (PTs). PTs are called to establish a diagnosis prior to making patient management decisions yet no valid classification system for walking exists. Objectives: The purpose of this study was to determine if locomotor experts could arrive at consensus on the validity, mutual exclusivity and understandability of diagnostic classifications for bipedal locomotion. Methods: An electronic mail Delphi survey methodology was utilized. Experts were recruited purposefully through research and clinical leaders in the PT profession. Identified experts were then asked for their recommendations in …
The Antecedents And Consequences Of Public Hospital Privatization, Zo Harivololona Ramamonjiarivelo
The Antecedents And Consequences Of Public Hospital Privatization, Zo Harivololona Ramamonjiarivelo
All ETDs from UAB
ABSTRACT The purpose of this study was to explore the antecedents and consequences of public hospital privatization with special attention to financial distress and financial performance. A national sample of public hospitals using secondary longitudinal data from 1997 to 2009 was used in this study. Data set from the American Hospital Association, the Area Resource File, the Medicare Cost Report and the Local Area Unemployment Statistics were merged to test the hypotheses pertaining to each research question. Based on the resource dependence theory, both environmental variables and organizational variables were included in the analyses. This study adopted the Altman Z-score …
Environmental And Organizational Characteristics Associated With A Critical Access Hospital Being Contract Managed Or Becoming Acquired, Virginia Anne Razo
Environmental And Organizational Characteristics Associated With A Critical Access Hospital Being Contract Managed Or Becoming Acquired, Virginia Anne Razo
All ETDs from UAB
The focus of this research is the relationship between environmental and organizational characteristics and critical access hospitals (CAHs) being contract managed or acquired. The resource dependence theory guided the methodology. Based on this theory, organizations prefer to remain autonomous until key resources become scarce. The scarcity of resources combined with a dynamic external environment causes environmental uncertainty that requires organizations to consider a variety of strategic responses in order to survive. Given the results of this study, contract managed CAHs were associated with markets that were less munificent and more dynamic with older facilities, relative to independent hospitals. Due to …
An Examination Of The Relationship Between The External Environment And Care Coordination, Olena Mazurenko
An Examination Of The Relationship Between The External Environment And Care Coordination, Olena Mazurenko
All ETDs from UAB
This study addressed a gap in the care coordination literature by exploring the factors predictive of care coordination, with particular attention to the external environment. The first paper of this dissertation conducted a systematic review of empirical studies that looked at the predictors of care coordination. Based on the 22 papers that fulfilled the inclusion criteria, the evidence to support the relationships between care coordination and factors that are predictive of care coordination was shown to be weak to moderate depending on the types of factors you look at. This study has revealed a significant inconsistency in how predictors of …
A Study Of Early Adopters Of Innovation, John B. Mcwhorter
A Study Of Early Adopters Of Innovation, John B. Mcwhorter
All ETDs from UAB
This research study focused on identification of environmental and organizational variables that influence the rate of adoption of administrative innovation in organizations, and specifically hospitals that have adopted nurse magnet programs. The study identified both organizational and environmental factors as statistically significant among early adopters of magnet programs in hospitals, with organizational influences stronger than environmental influences in determining the rate of adoption of innovation. Organizational complexity, size, control of domain, presence of a competitor, and available resources were the factors identified as influencing the early adoption of innovation among hospitals.
Screening For Medical Referral: Determining Variables That Influence Accuracy, Heather Ellis Mount
Screening For Medical Referral: Determining Variables That Influence Accuracy, Heather Ellis Mount
All ETDs from UAB
SCREENING FOR MEDICAL REFERRAL: DETERMINING VARIABLES THAT INFLUENCE ACCURACY HEATHER E. MOUNT DOCTOR OF SCIENCE IN PHYSICAL THERAPY ABSTRACT Background: Screening for medical referral is essential to autonomous practice; however, no studies have examined the medical screening abilities of physical therapists in various settings. Objective: The purpose of this study was to determine if physical therapists in various practice settings could appropriately screen for medical referral, given brief clinical vignettes. Methods: A Delphi study was performed to enhance the content validity of the vignettes. After reviewing the vignettes, survey participants determined if they would provide intervention, provide intervention and refer, …
Apolipoprotein E Mimetic Peptide Improves Hdl Functionality And Inhibits Atherosclerosis Progression In Mouse Models Of Atherosclerosis, Gaurav Nayyar
Apolipoprotein E Mimetic Peptide Improves Hdl Functionality And Inhibits Atherosclerosis Progression In Mouse Models Of Atherosclerosis, Gaurav Nayyar
All ETDs from UAB
Despite major advances in diagnosis and treatment, coronary artery disease (CAD) is still the number one cause of morbidity and mortality in United States. An ideal treatment for lipid-mediated inflammatory disorders would not only reduce plasma cholesterol dramatically but also improve high density lipoproteins (HDL) function. Apolipoprotein E (apo E), a protein component of HDL and very low density lipoprotein (VLDL), is necessary for the receptor mediated hepatic uptake of apolipoprotein-B (apo B) containing remnant lipoproteins and also possesses strong anti-inflammatory properties. We hypothesized that a synthetic dual domain apo E mimetic peptide, Ac-hE18A-NH2 (a 28-residue peptide) containing receptor binding …
A Pilot Study To Determine The Effectiveness Of Bioelectrical Impedance Analysis As A Clinical Assessment Tool Of Nutrition Status In Glioblastoma Multiforme Patients (The Beam Study [Bia Effectiveness As Assessment Tool For Gbm Patients]), Rebecca V. Barnhill
All ETDs from UAB
Glioblastoma multiforme (GBM) is a rare brain tumor, yet accounts for 80% of malignant brain tumors and has a five-year survival rate of < 5%. Few studies have evaluated nutrition recommendations and outcomes of this disease, including caloric needs. The purpose of this study was to find the best predictive equation for resting energy expenditure (REE) for GBM patients and evaluate bioelectrical impedance analysis (BIA) as a clinical tool for estimating REE and fat free mass (FFM) of GBM patients. REE was measured with indirect calorimetry. FFM was measured with DXA and estimated with BIA. Published predictive equations for REE were calculated to compare to measured REE. Six equations used variables easily attained in a clinical setting and three used FFM. Correlation analysis was used to evaluate the strength of the relationships between measured and predicted REE. Agreement between methods on the group level was assessed by comparing the group means of measured and predicted REE with paired t-tests. The Bland-Altman approach was used to find agreement between the methods on the individual level. Analysis included fifteen newly diagnosed GBM patients (7 male and 8 female; mean age 57.1±11.6 years) to evaluate equations using clinical variables and a subsample of eight to evaluate predictive equations using FFM. All the predictive equations overestimated measured REE. The Mifflin-St Jeor was the only equation using clinical variables which was not significantly different from measured REE (p=0.054) and had the lowest bias (73 kcal/day) and narrowest limits of agreement. Likewise, Cunningham and Wang equations using FFM from DXA were not significantly different from measured (p=0.261 and p=0.072, respectively). BIA overestimated FFM compared to DXA, 54.1 kg and 49.2 kg, respectively (p<0.001). More visits with both DXA and BIA measurements available are needed before predictive equations with clinical variables and predictive equations with FFM can be compared. Due to the ease of obtaining clinical variables and the low bias and narrow limits of agreement found for the Mifflin equation, at this time it appears to be the best predictive equation for individuals with GBM.
The Relationship Between Hospitalists And Primary Care Physicians, James Robert Burkhart
The Relationship Between Hospitalists And Primary Care Physicians, James Robert Burkhart
All ETDs from UAB
THE RELATIONSHIP BETWEEN HOSPITALISTS AND PRIMARY CARE PHYSICIANS JAMES R. BURKHART EXECUTIVE DOCTOR OF SCIENCE IN ADMINISTRATION-HEALTH SERVICES ABSTRACT A study of the relationship between primary care physicians (PCPs) and hospitalists was conducted by surveying the Florida Academy of Family Physicians (FAFP) membership to determine whether they had an established relationship with a hospitalist or hospitalist group. The survey responses were then matched with Blue Cross and Blue Shield of Florida (BCBSF) administrative claims data to provide two groupings of study respondents with data regarding patients' average length-of-stay, average 30 day readmission rate, and average hospital claims payment. The survey …
Childhood Obesity: The Role Of Genetic Admixture, Parental Feeding Practices, And The School Food Environment, Michelle Cardel
Childhood Obesity: The Role Of Genetic Admixture, Parental Feeding Practices, And The School Food Environment, Michelle Cardel
All ETDs from UAB
Disentangling the etiology of pediatric obesity continues to challenge researchers due to the interconnecting of behavioral, physiological, environmental, and genetic factors. Studies have focused on the role of the obesogenic environment, characterized by excess energy intake and sedentary behavior, as it relates to weight and fat gain in children. Although these factors certainly have an impact on fat accumulation, increased energy intake and decreased physical activity do not solely account for the increasing trends in obesity prevalence. Less explored genetic and environmental factors may contribute independently and/or synergistically to the current obesity epidemic, and that, these factors could vary in …
Are Enabling Services In Federally Qualified Health Centers Associated With Women Receiving Prenatal Care In The First Trimester?, Forrest A. Daniels
Are Enabling Services In Federally Qualified Health Centers Associated With Women Receiving Prenatal Care In The First Trimester?, Forrest A. Daniels
All ETDs from UAB
The purpose of this study was to examine whether enabling services in federally qualified health centers (FQHCs) were associated with women receiving prenatal care services in the first trimester. The population for this study included FQHCs providing prenatal care services for the years 2008, 2009, and 2010. Data for this study were derived from two sources: Uniform Data System (UDS) and the Area Resource File (ARF). This study adopted the Andersen's (1973) Behavioral Model of Health Services Use. The study consisted of longitudinal panel data analysis. Univariate and bivariate statistics were calculated using PASW/SPSS statistical software, version 18. For the …
The Effect Of Liver X Receptor Α Deficiency In Skeletal Muscle On Lipid Content In Mice, Yishu Ding
The Effect Of Liver X Receptor Α Deficiency In Skeletal Muscle On Lipid Content In Mice, Yishu Ding
All ETDs from UAB
Liver X receptors (LXRs) are important regulators of cholesterol, fatty acid, and glucose homeostasis. Many researchs focus on the liver, but tissue-specific roles of LXRs in other tissues remain elusive. Based on in vitro studies on cultured cells, the roles of LXRs in skeletal muscle have been proposed. Nevertheless, the in vivo roles of LXRs in skeletal muscle remain lacking. Skeletal muscle is an important insulin targeting tissue, which plays a key role in regulating insulin sensitivity. Abnormal lipid metabolism and homeostasis have been demonstrated to play a crucial role in the development of insulin resistance in skeletal muscle. To …
Examining Spasticity After Spinal Cord Injury Using A Novel Robotic Assessment, Leslie R. Van Hiel
Examining Spasticity After Spinal Cord Injury Using A Novel Robotic Assessment, Leslie R. Van Hiel
All ETDs from UAB
This study investigated a novel robotic assessment of spasticity resulting from a spinal cord injury (SCI). Torque data was analyzed to provide a single measure spasticity score. Three participants with motor incomplete SCI and resultant spasticity were compared to three non-injured participants (NI) using three different angular velocities of passive lower extremity movement in the Lokomat gait orthosis. The mean spasticity scores (NI vs. SCI) at120°/s, 180°/s, and 240°/s were: 0.41 ± 0.30 vs. 3.70 ± 2.07; 0.65 ± 0.49 vs. 4.33 ± 3.57; and 1.55 ± 1.16 vs. 5.26 ± 3.99, respectively. Mean surface electrode electromyography measures (NI vs. …
Soy And Breast Cancer, Mandeep K. Virk-Baker
Soy And Breast Cancer, Mandeep K. Virk-Baker
All ETDs from UAB
The incidence of breast cancer is lower in Asia as compared to Western countries. However, the breast cancer risk among Asian immigrants living in Western countries reaches nearly as high as the Western country, suggesting environmental factors (e.g. diet and lifestyle) may be important for this geographical disparity. One dietary change of Asian immigrants is a reduction in soy consumption. Soy is rich in isoflavones, which compete with estrogen for receptor (ER) binding, and may protect against breast cancer. S-(-)equol, a metabolite of the soy isoflavone daidzein (DZ) has a higher bioavailability and greater affinity for ER than DZ. The …
Facilitating The Use Of Implicit Memory And Learning In The Physical Therapy Management Of Individuals With Alzheimer's Disease; A Case Series., Laura White
All ETDs from UAB
Background and Purpose: Physical rehabilitation of individuals with Alzheimer's disease (AD) is often complicated by impairments in explicit memory and learning. Rehabilitation strategies that facilitate use of the preserved implicit memory system may be effective in treating patients with AD. The purpose of this case series is to describe the application of these strategies, including high-repetition practice, errorless learning (EL), and spaced retrieval (SR), to the physical therapy management of individuals with moderate AD. Case Description: Three women aged 89 to 95 years old with moderate AD who resided in an assisted living facility participated in physical therapy to address …
Contracted Hospitalists And Non-Contracted Hospitalists: Impact On Hospital Cost And Quality Care Outcomes, Kathleen L. Adams
Contracted Hospitalists And Non-Contracted Hospitalists: Impact On Hospital Cost And Quality Care Outcomes, Kathleen L. Adams
All ETDs from UAB
Background Changes in the health care delivery and policy environment are creating increased need for attention to health care costs and efficiency. Hospitals need to develop and implement oversight processes to effectively control costs and provide quality services. It is common for hospitals to contract with physician groups to staff various departments throughout the facility. Hospitalists are the most recent addition to hospital rosters. While some hospitals hire hospitalists directly as employees, others contract with physician groups to provide hospitalist services. The purpose of this study was to compare the potential benefits for hospitals that contracted with a hospitalist group …