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Articles 31 - 60 of 284
Full-Text Articles in Medical Humanities
Oxygen Cost Of Walking And Its Correlates In Multiple Sclerosis, Brenda Jeng
Oxygen Cost Of Walking And Its Correlates In Multiple Sclerosis, Brenda Jeng
All ETDs from UAB
Multiple sclerosis (MS) is a chronic, neurological disease characterized by demyelination and transection of axons as well as loss of neurons in the central nervous system that may result in poor walking efficiency, indicated by an increase in the oxygen cost of walking (Cw). The Cw is defined as the amount of oxygen consumed per kilogram of body weight per unit distance walked and reflects disability-related gait abnormalities and manifestations and its interaction with the environment. This dissertation involved four research projects. The first project provided an overview of existing research on the Cw in MS and established a research …
Nutrition Practices And Body Composition In Infants Born Preterm, Maggie Jerome
Nutrition Practices And Body Composition In Infants Born Preterm, Maggie Jerome
All ETDs from UAB
Adequate nutrition and optimal growth are critical goals of clinical care for premature infants in the NICU due to rapid brain growth and development that occur during this time. Emerging evidence suggests that body composition in preterm infants is predictive of neurodevelopmental and metabolic outcomes later in childhood. The objective of this dissertation is to investigate factors affecting premature infant growth and body composition, including high enteral protein supplementation, nutrition during the first two weeks of life, and race of infants born at 22-32 weeks gestational age admitted to the UAB NICU. In a pilot study, 56 preterm infants were …
Exploring The Influence Of Psychosocial Stress And Inflammatory Properties Of The Diet On Cardiometabolic Risk And Gut Microbiome Health Among Young Adult Women Of Birmingham, Alabama, Rachel Olivia Knight
Exploring The Influence Of Psychosocial Stress And Inflammatory Properties Of The Diet On Cardiometabolic Risk And Gut Microbiome Health Among Young Adult Women Of Birmingham, Alabama, Rachel Olivia Knight
All ETDs from UAB
Concerning trends for obesity, diabetes, heart attacks, and obesity-related cancers, or cardiometabolic disease (CMD), are developing within the emerging and young adult/adulthood (EYA) population. Evidence supports the concept that chronic stress leads to physiologic dysregulation, reduced mental health, chronic diseases, and reduced longevity; however, these are not inevitable outcomes, and resilience or vulnerability is determined by interacting environmental and biobehavioral factors. Although CMD manifests clinically in older adulthood, disease pathophysiology begins earlier, and thus, EYA is a critical time for observation and intervention. Growing evidence indicates inflammation is a major risk factor in CMD development and may be exacerbated by …
Unexpected And Usual Breaks' Impact On Body Composition In College Athletes, Aston Dommel
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 …
The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn
The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn
All ETDs from UAB
Hospital Acquired Infections (HAIs) are among the top five leading causes of death in the United States (Scott, 2009). Estimates of the annual direct medical costs of HAIs to U.S. hospitals have ranged from $28,400,000,000 to $33,800,000,000 (Scott, 2009). Many leading health care organizations have agreed that there is a link between infection prevention and the spread of HAIs (Allegranzi, 2009). This study explored health care workers’ hand hygiene compliance and whether automated compliance reporting improved compliance. A new system powered by technology called Near Field Magnetic Induction (NFMI) found a significant increase in compliance upon introduction of an automated …
The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris
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 …
Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber
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, …
An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge
An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge
All ETDs from UAB
Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …
The Effect Of Integrative Medicine Interventions On Patient Activation Measure, Rochelle F. Richards
The Effect Of Integrative Medicine Interventions On Patient Activation Measure, Rochelle F. Richards
All ETDs from UAB
Activated patients believe they have essential roles in achieving and maintaining their health. Patient activation is strongly related to improved clinical outcomes (Hibbard, 2017; Greene, 2013). The study’s primary purpose is to evaluate the use of Integrative Medicine Interventions (IMIs) and their relationship to patient activation levels; and to investigate the association between IMI protocols and patient activation levels on patient reported outcomes (PROs) for those with chronic diseases, specifically chronic fatigue and mental health-related conditions of anxiety and depression, using the principles of Integrative Medicine’s (IM) whole-person approach as the model of care in independent IM practices across the …
The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados
The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados
All ETDs from UAB
Two significant events transpired in Louisiana that had sweeping changes for the healthcare system between 2013 and 2016: (1) the privatization of the nation's only stateowned Charity Hospital System via cooperative endeavor agreements with local, private hospitals known as public-private-partnerships (PPP), and (2) the implementation of Medicaid expansion, referred to as implementation of the Affordable Care Act (ACA). Either event independently could have had significant utilization and financial implications for hospitals. This retrospective, quasi-experimental research implemented a generalized estimating equation (GEE) analysis to examine the effects of PPP and ACA on Medicaid patient emergency department utilization by PPP hospital designation, …
Assessing The Impact Of The Covid-19 Pandemic On Metastatic Lung Cancer Time To Treatment Initiation, Health Care Resource Utilization, And Costs In The United States, Teresa M. Zyczynski
Assessing The Impact Of The Covid-19 Pandemic On Metastatic Lung Cancer Time To Treatment Initiation, Health Care Resource Utilization, And Costs In The United States, Teresa M. Zyczynski
All ETDs from UAB
The COVID-19 pandemic has derailed normal operations in the health care delivery systems in the United States (US) and globally, providing prioritized care to patients seeking acute management of the novel coronavirus and its complications. Simultaneously, cancer screening tests have decreased, resulting in decreased rates of cancer diagnoses and referrals to oncologists. The purpose of this study was to assess time to treatment initiation (TTI) with systemic cancer therapy in patients with newly diagnosed metastatic lung cancer, metastatic lung cancer-related and total healthcare resource utilization (HCRU) and costs during the pandemic/post-pandemic period compared with the pre-pandemic period. The retrospective claims …
The Role Between Transactive Memory Systems In The Relationship Between Psychological Safety & Quality In Interprofessional Healthcare Teams, Tera L. Webb
All ETDs from UAB
During uncertainty, the optimum solution for work-related problems or patient care cases require the scopes of practice and competencies beyond a single profession. For this reason, the collaborative efforts of interprofessional teams are a widely used approach to patient care and medical decision making. The interdependency between healthcare professionals with varied expertise and input often lead to desired outcomes. Beyond the structure of the team, there are numerous cognitive processes at play that impact knowledge transfer in highly skilled teams that impact outcomes. Therefore, this dissertation will review relevant literature on two cognitive constructs – psychological safety and transactive memory …
The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley
The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley
All ETDs from UAB
Advancements in medical knowledge are producing significant improvements in medical technology, developing breakthrough drug therapies, advancing the practice of medicine, and improving outcomes for cancer patients. However, there are delays in getting new and improved therapies incorporated into routine clinical use, depriving cancer patients of valuable and potentially lifesaving treatments. The purpose of this study was to examine the rate of adoption of new cancer drug discoveries into routine clinical practice in non-academic cancer centers. The process of adoption takes a period of time to embrace new therapies, due in part to a prescriber’s need to gain greater comfort with …
The Role Of Alternative Payment Models In Pharmaceutical Services And Outcomes, Matthew G. Parker
The Role Of Alternative Payment Models In Pharmaceutical Services And Outcomes, Matthew G. Parker
All ETDs from UAB
A persistent challenge within the healthcare sector is balancing cost containment for health services and the quality of care associated with these services. This challenge has reinvigorated interest in alternative payment models (i.e., risk-sharing, shared savings, capitation), arrangements between payers and healthcare providers that structure reimbursement for services based on health outcomes. Although much research has assessed the association between these payment models and financial outcomes for medical services, there is a paucity of research that has likewise assessed pharmaceutical outcomes (i.e., electronic prescribing, evidence-based prescribing, medication adherence). The papers comprising this dissertation contribute to this limited body of research …
Health Disparities In Cardiometabolic Risk Among African American And European American Adults, Catharine A. Couch
Health Disparities In Cardiometabolic Risk Among African American And European American Adults, Catharine A. Couch
All ETDs from UAB
African American (AA) individuals are disproportionately burdened by cardiometabolic disease, including type 2 diabetes (T2D) and cardiovascular disease (CVD), and associated risk factors. The objective of this dissertation research was to investigate pathophysiological and lifestyle contributors to racial disparities in cardiometabolic disease including beta-cell dysfunction, ectopic fat, the natriuretic peptide system, and diet. These first three risk factors, beta-cell dysfunction, ectopic fat, and the natriuretic peptide system, were explored in a cross-sectional study of young AA and European American (EA) adults. The fourth risk factor, diet, was explored in a large, national cohort of black and white adults. First, we …
Changes In Pain Intensity And Physical Activity Levels In Individuals With Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Longitudinal Cohort Study, Naif Z. Alrashdi
Changes In Pain Intensity And Physical Activity Levels In Individuals With Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Longitudinal Cohort Study, Naif Z. Alrashdi
All ETDs from UAB
Acetabular dysplasia (AD) is a condition of the hip joint that is characterized by incomplete acetabulum development leading to lack of bony coverage of the femoral head. As a result of intra-articular injury from lack of bony congruency, often, individuals with AD report hip joint instability, pain, decreased hip-related function, and are at high risk for early development of hip osteoarthritis (OA). AD is primarily affects young-to-middle-aged adults, is more common in females and those with history of a breech birth position. Periacetabular osteotomy (PAO) is the currently-recommended surgical treatment for AD that aims to reposition the acetabulum to increase …
Embedding A Mixed Methods Process Evaluation In A Web-Based Diet And Exercise Program For Older Cancer Survivors, Jami Lee Anderson
Embedding A Mixed Methods Process Evaluation In A Web-Based Diet And Exercise Program For Older Cancer Survivors, Jami Lee Anderson
All ETDs from UAB
The purpose of this dissertation is to describe critical steps in designing a usercentered mixed methods process evaluation and implement the process evaluation within an existing program. Three objectives of this dissertation include: 1) develop a conceptual framework for conducting user-centered process evaluations of web-based diet and exercise programs for middle-aged and older cancer survivors; 2) inform the design of a user-centered process evaluation by leveraging insights from “think aloud” interviews collected during the beta-testing phase of the AMPLIFY program (a webbased diet and exercise program designed to support healthy lifestyle needs of older cancer survivors); and 3) present results …
Three Essays On Federally Qualified Health Centers: Competition, Patient-Centered Medical Home Adoption, Quality Quartiles Ranking And Financial Performance, Hani Al-Maliki
All ETDs from UAB
he following three essays examine the Federally Qualified Health Center (FQHC) industry. The first essay attempts to provide a description on what constitutes a competitive environment for FQHCs located in California, the second explores the impact of FQHC market competition on Patient Centered Medical Home (PCMH) adoption, and the third essay aims to test the relationship between the adoption of PCMH and FQHCs’ performance. The first essay utilizes Porter's Five Forces model to identify competitive forces in the FQHCs environment to fill a gap in the literature. Building on the first essay, the second essay using Porter’s generic strategies explores …
Exploring The Influence Of Family History Before And After Type 2 Diabetes Development Through Statistical Analysis Of Biomarkers And An Educational Intervention, Jessica Johnson Denton
Exploring The Influence Of Family History Before And After Type 2 Diabetes Development Through Statistical Analysis Of Biomarkers And An Educational Intervention, Jessica Johnson Denton
All ETDs from UAB
The prevalence of type 2 diabetes is increasing at an alarming rate in both children and adults worldwide. Timely identification of those at risk for type 2 diabetes is essential to reduce morbidity and mortality and to mitigate the toll on families and the healthcare system. Family history is an effective, universal tool that can be used to identify individuals at risk for type 2 diabetes before they acquire additional risk factors. Understanding how family history contributes to biomarkers associated with diabetes in healthy individuals could facilitate the creation of early screening and prevention strategies designed for this specific at-risk …
Effects Of Different Types Of Augmented Feedback On Spatiotemporal Gait Performance And Intrinsic Motivation With Individuals Post Stroke, Saleh M. Alhirsan
Effects Of Different Types Of Augmented Feedback On Spatiotemporal Gait Performance And Intrinsic Motivation With Individuals Post Stroke, Saleh M. Alhirsan
All ETDs from UAB
After a stroke, an individual can be left with physical and psychological deficits, including decreased walking speed, reduced step length, and reduced intrinsic motivation. These deficits affect their performance during rehabilitation sessions, limit daily activities such as walking and stepping, and restrict participation in social roles that involve mobility. Current clinical practice guidelines recommend providing augmented feedback using virtual reality (VR) to enhance walking outcomes after six months of stroke onset. This dissertation shows two novel VR applications designed, especially for individuals’ post-stroke, to induce their fast-walking speed and maximum step length performance, and intrinsic motivation. Three performance conditions were …
Mevisit: Value-Based Approach To Primary Care Delivery By Mtelemedicine Utilization Applied Through Lean Principles, Neil Coyer Thornbury
Mevisit: Value-Based Approach To Primary Care Delivery By Mtelemedicine Utilization Applied Through Lean Principles, Neil Coyer Thornbury
All ETDs from UAB
Background: Significant issues of inconsistent patient services in the U.S. health system impact health outcomes and create high cost. Limitations of immobility, inefficiency, and accessibility sacrifice patient treatment, delay recovery, and escalate health risks from the lack of primary care physicians. The primary purpose of this study was to examine meVisit, a connective mobile technology, as a feasible primary care solution to address escalating health costs by reducing emergency room (ER) visits and inpatient admissions (IA). Methods: The feasibility study applied descriptive and inferential statistics to secondary data (n=4,024) and compared the two independent patient groups from the same large …
The Relationship Between Nurse And Therapy Staffing Levels And The Medicare Patient-Driven Payment Model Reimbursement During The Covid-19 Pandemic, Roland T. Shapley
The Relationship Between Nurse And Therapy Staffing Levels And The Medicare Patient-Driven Payment Model Reimbursement During The Covid-19 Pandemic, Roland T. Shapley
All ETDs from UAB
The Patient Driven Payment Model (PDPM) brought about a paradigm shift in the way skilled nursing facilities are reimbursed, by linking complexity of care to beneficiary need, expanding case-mix adjusted components by including a non-therapy ancillary and speech language pathology component, and limiting the volume of therapy services provided. The COVID-19 pandemic wreaked havoc upon the nursing home industry that gave rise to high patient and staff infections and fatalities, declining occupancy rates, and nursing shortages, compelling the Department of Health and Human Services to provide $4.9 billion in CARES Funding to skilled nursing facilities (SNFs). Using Payroll Based Journal, …
Applying The Hospitalist Model Of Care To Cardiovascular Acute Care Delivery, Ginger K. Biesbrock
Applying The Hospitalist Model Of Care To Cardiovascular Acute Care Delivery, Ginger K. Biesbrock
All ETDs from UAB
The hospitalist model for managing patients in the hospital setting has been in existence for over 20 years. The hospitalist model for non-specialty care has been found to improve the efficiency of care, maintain quality of care, and support a higher degree of guideline adherence. However, there has been little research focusing on the use of the hospitalist model for specialty care. As cardiovascular programs have begun to adopt the hospitalist model, many are asking if this model is more effective than the traditional model. The main concern is the potential disruption to the patient-physician relationship that occurs with the …
Factors Influencing Balance And Muscle Tone In Adults With Attention-Deficit/Hyperactivity Disorder, Mansour M. Alotaibi
Factors Influencing Balance And Muscle Tone In Adults With Attention-Deficit/Hyperactivity Disorder, Mansour M. Alotaibi
All ETDs from UAB
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition prevalent in children globally and continues to persist into adulthood. Executive function (EF) impairments are core ADHD deficits, specifically response inhibition, and believed to drive ADHD symptoms. Psychostimulant medications (PS) is the first line treatment to manage ADHD symptoms. Overall, individuals with ADHD are at greater risk of falls and physical injuries compared to healthy individuals. Perhaps adults with ADHD balance impairments are secondary to ankle plantarflexor (PF) spasticity. Using psychostimulant medications (PS) improves PF spasticity and postural control in children with ADHD, but the effects on adults with ADHD are unclear. Furthermore, …
Alzheimer Disease Special Care Units And Nursing Homes' Organizational Performance, Giovanna Pilonieta Ortiz
Alzheimer Disease Special Care Units And Nursing Homes' Organizational Performance, Giovanna Pilonieta Ortiz
All ETDs from UAB
Alzheimer’s disease special care units (AD SCUs) have been adopted to provide specialized care for people with dementia in nursing homes. However, the effects of environmental and organizational factors on AD SCUs adoption by nursing homes and their influence on nursing homes' organizational performance remains unclear. Guided by Resource Dependence Theory, Donabedian’s Structure-Process-Outcome (SPO) framework and the Resource-Based View of Firms perspective, the purpose of the three papers included in this dissertation was to provide empirical evidence of the contextual and organizational factors that influence AD SCUs adoption among nursing homes and how the adoption of AD SCUs impact nursing …
Is There A Relationship Between Leadership Characteristics And Services Provided Among Ihs Urban Indian Health Programs?, George Grant Tribble
Is There A Relationship Between Leadership Characteristics And Services Provided Among Ihs Urban Indian Health Programs?, George Grant Tribble
All ETDs from UAB
IS THERE A RELATIONSHIP BETWEEN LEADERSHIP CHARACTERISTICS AND SERVICES PROVIDED AMONG IHS URBAN INDIAN HEALTH PROGRAMS?GEORGE G. TRIBBLE HEALTHCARE LEADERSHIP ABSTRACT The Native American population has faced and been impacted by a wide range of actions throughout the last few hundred years. The loss of cultural norms and way of life continues to manifest itself through various socioeconomic concerns. At the center of the Native American leadership model is a disciplined and culturally specific guidance structure. The Urban Indian Health Program (UIHP) was created by the Indian Health Service to establish a culturally appropriate health care delivery model for Native …
The Role Of Obesity, Gdm, And Lifestyle Factors On Metabolic Syndrome Scores In Mothers And Their Children 4-10 Years After Pregnancy, Makenzie Callahan
The Role Of Obesity, Gdm, And Lifestyle Factors On Metabolic Syndrome Scores In Mothers And Their Children 4-10 Years After Pregnancy, Makenzie Callahan
All ETDs from UAB
Metabolic syndrome (MetS) is a cluster of symptoms that increase risk for heart disease and type 2 diabetes. Therefore, early detection of MetS is vital for disease prevention. Gestational diabetes (GDM) and/or obesity during pregnancy are associated with a greater risk for MetS in mothers and their children compared to mothers with no GDM. However, little is known about how much a GDM history or in utero exposure to maternal GDM contributes to MetS risk years after that pregnancy in addition to risk attributable to obesity itself. Therefore, the overall objective of this dissertation was explore how a history of …
The Effect Of Medicaid Expansion On Hospitals Allowance For Bad Debt, Tara B. Dixon
The Effect Of Medicaid Expansion On Hospitals Allowance For Bad Debt, Tara B. Dixon
All ETDs from UAB
The management of bad debt is a complex issue for hospitals, and if mismanaged, can impact the organization's current and future financial stability. The expansion of Medicaid through the Patient and Affordable Care Act (ACA) was expected to lessen the bad debt reported by hospitals by increasing the number of insured lives. Hospital managers understand that a certain percentage from the accounts receivables will end up being uncollectable; however, strategically planning for bad debt and estimating a more accurate allowance requires a specific level of strategic planning. Allowance for bad debt should not be a guessing game but should be …
Pain-Related Injustice Appraisal And Chronic Low Back Pain Among Arabs In The United States, Albatool Homoud Alnojeidi
Pain-Related Injustice Appraisal And Chronic Low Back Pain Among Arabs In The United States, Albatool Homoud Alnojeidi
All ETDs from UAB
Pain-related injustice appraisal has emerged as a psychosocial predictor of deleterious chronic low back pain (CLBP) outcomes. The appraisal is defined as the individual’s perception regarding the magnitude and irreparability of pain-related loss and suffering, externalized blame, and unfairness. Research in diverse samples revealed racial differences in pain-related injustice appraisal, suggesting that it may reflect broader racial/ethnic, sociocultural, and socioeconomic factors. This agrees with theories recognizing the role of ethnic and cultural characteristics in ethnic minorities’ health. Despite global data showing that Arabs represent the population with the second-highest prevalence of CLBP worldwide, a reliable characterization of CLBP among Arabs …
Identifying Factors To Inform The Development Of Adaptive Interventions For Increasing Physical Activity Behavior Among People With Multiple Schlerosis, Yumi Kim
All ETDs from UAB
People with multiple sclerosis (MS) can benefit from physical activity, specifically exercise, for the management of disease symptoms, including walking impairments, fatigue, and depression, and improvements in quality of life. However, people with MS do not engage in adequate amounts of physical activity for the accrual of health benefits. Researchers have focused on the delivery of exercise training and behavioral interventions to improve levels of physical activity in MS. To date, there is an emerging body of research supporting the efficacy of these interventions for increasing and potentially sustaining physical activity behavior in people with MS. Yet, people with MS …