Medical Humanities Commons^™

Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

To Bear Witness: A Journey Of Healing And Solidarity, Updated, Revised, And Expanded Edition, Kevin M. Cahill, M.D.

International Affairs

For more than fifty years, Dr. Cahill has been helping to heal the world, as a leading specialist in tropical medicine and as a driving force in humanitarian assistance and relief efforts around the globe. In this revised and expanded edition, he chronicles extraordinary achievements of compassion and commitment. Bringing together a rich selection of writings, he crafts a fascinating memoir of a life devoted to others. The book includes front-line reports from places under siege—Lebanon, Somalia, Sudan, Nicaragua, Gaza, and Ireland; there are also visionary essays from the origins of the AIDS epidemic and landmine crises, and no less …

Interprofessional Roles Shoulder Dystocia: Maximizing Safety In Community Hospitals, Elizabeth Yznaga

Doctor of Nursing Practice (DNP) Projects

Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been …

Ability And Willingness To Change Among African Immigrant Patients At Akwaaba, Marianne Sarkis, Temitayo Akinbola, Charise Canales, Hana Chamoun, Jacqueline Leaf, Elisabeth Nebie

Local Knowledge: Worcester Area Community-Based Research

What are the challenges faced in treating Hypertension in the Worcester African Immigrant Community?

This study investigates the relationship between the understanding of high blood pressure, and the ability and willingness to modify behavior among African patients at Akwaaba, a free health clinic in Worcester, Massachusetts. In this research, our team specifically explores how the understanding of lifestyle risk factors of hypertension, such as diet, exercise, and levels of stress, influence the willingness and ability to modify behavior among African born patients at Akwaaba. What become clear was that language barriers, cultural differences, and approach to health care within the …

Information Sources In Relation To Information Quality, Information-Seeking, And Uncertainty In The Context Of Healthcare Reform, Jennifer L. Bevan

Communication Faculty Books and Book Chapters

This exploratory study examines information-seeking about the 2010 Patient Protection and Affordable Care Act (i.e. healthcare reform) in relation to the potential barriers of uncertainty,uncertainty discrepancy, and low health self-efficacy. Adult United States participants completed an anonymous online survey about their perceptions and understanding of healthcare reform. Results confirmed recent literature, suggesting a complex relationship between information-seeking and uncertainty. Specifically, for this sample, significant positive relationships were observed between information-seeking about healthcare reform and uncertainty, uncertainty discrepancy, health self-efficacy. Further, uncertainty discrepancy was the potential barrier that accounted for the most variance in predicting information-seeking.Implications of these findings for improving …

Acute Lung Injury And Acute Respiratory Distress Syndrome Requiring Tracheal Intubation And Mechanical Ventilation In The Intensive Care Unit: Impact On Managing Uncertainty For Patient-Centered Communication, Robert F. Johnson Jr., Jillian Gustin

Peer Reviewed Articles

A 56 year-old male presented with symptoms of pneumonia and findings consistent with acute lung injury (ALI). Deterioration of respiratory function occurred over the first 24 hours of hospitalization leading to placement in an intensive care unit (ICU) followed by tracheal intubation and mechanical ventilation (ETMV). At that time criteria defining acute respiratory distress syndrome (ARDS) were present. The palliative medicine service was asked to address concerns expressed by the patient’s spouse reflecting uncertainty regarding outcome expectations.

When interacting with families of incapacitated critically ill patients, clinicians are advised to employ a patient-centered communication process to alleviate family distress and …

Impact Of Quality Performance On Financial Risk And Cost Of Capital In Hospitals, James D. Byrd Jr

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., …

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 …

The Burden Of Chronic Conditions On Self Reported Health Status In A Medicare Advantage Plan Population, Barbara Ann Guerard

All ETDs from UAB

THE BURDEN OF CHRONIC CONDITIONS ON SELF REPORTED HEALTH STATUS IN A MEDICARE ADVANTAGE PLAN POPULATION BARBARA GUERARD ADMINISTRATION-HEALTH SERVICES ABSTRACT This dissertation was a multi-staged research study with two goals. The first goal was to assess survey respondents' characteristics to better understand the influence of the characteristics on the validity of self-reported survey responses. Second, the study analyzed the relationship between certain chronic conditions and survey participants' responses to questions related to their overall physical health and mental health to further understand the burden of chronic conditions on self- reported survey responses. Secondary data derived from a patient satisfaction …

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 …

Insulin Resistance, Lipids, And The Metabolic Syndrome Trait Cluster: Impact Of Race And Very Low Calorie Diet, Veeradej Pisprasert

All ETDs from UAB

Insulin resistance (IR) is central to the pathogenesis of cardiometabolic disorders. Early detection, along with appropriate interventions, is paramount to reduce the morbidity and mortality of IR-related diseases. The gold standard measurement for IR is the hyperinsulinemic-euglycemic clamp, which is markedly sophisticated for clinical evaluation but costly and invasive for clinical practice. Several alternative surrogate indicators of IR have been identified and used by clinicians, including insulin sensitivity indices derived from plasma glucose and insulin values, as well as other indicators that are independent of direct insulin measurements. In addition, lipid panel and lipoprotein subclass profile have emerged as markers …

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 …

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. …

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 …

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 …

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 …

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 …

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 …