Medical Humanities Commons^™

Distributed Cognition In Cancer Treatment Decision Making: An Application Of The Decide Decision-Making Styles Typology, Janice L. Krieger, Jessica L. Krok-Schoen, Phokeng M. Dailey, Angela L. Palmer-Wackerly, Nancy Schoenberg, Electra D. Paskett, Mark Dignan

Department of Communication Studies: Faculty Publications

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript …

Decline In Ethical Concerns About Reproductive Technologies Among A Representative Sample Of Us Women, Arthur L. Greil, Kathleen S. Slauson-Blevins, Karina M. Shreffler, Katherine M. Johnson, Michele Lowry, Andrea R. Burch, Julia Mcquillan

Department of Sociology: Faculty Publications

Public awareness and utilization of assisted reproductive technology has been increasing, but little is known about changes in ethical concerns over time. The National Survey of Fertility Barriers, a national, probability-based sample of US women, asked 2031 women the same set of questions about ethical concerns regarding six reproductive technologies on two separate occasions approximately 3 years apart. At Wave 1 (2004–2007), women had more concerns about treatments entailing the involvement of a third party than about treatments that did not. Ethical concerns declined between Wave 1 and Wave 2, but they declined faster for treatments entailing the involvement of …

The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen

All ETDs from UAB

This study examined the potential relationship between interdepartmental transfers and perceptions of adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publically reported comparative data tool measuring hospital patient experiences. As consumers, patients are more informed about their own health and are challenging the quality and service of care provided by hospitals. The value-based purchasing reimbursement model has become a new challenge for hospitals. Historically, hospitals were reimbursed through a volume driven model. Comparatively, the value-based model focuses on …

Examining The Impact Of Emergency Department (Ed) Registered Nurse (Rn) Staffing On Ed Patient Experience, Deana L. Nelson

All ETDs from UAB

EXAMINING THE IMPACT OF EMERGENCY DEPARTMENT (ED) REGISTERED NURSE (RN) STAFFING ON ED PATIENT EXPERIENCE DEANA NELSON DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT Patient experience ratings are important to healthcare organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in the Emergency Department (ED). This study examined the relationships between ED RN staffing, patient expectations and patient experience ratings, using a conceptual framework adapted from Donabedian’s structure/process/outcome model, and expectancy disconfirmation …

Hospital-Physician Vertical Integration: The Effect Of Integration On Cardiology Compensation And Clinical Productivity, Vance Mcleod Chunn

All ETDs from UAB

HC2.

Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham

All ETDs from UAB

The study examined whether hospital implementation of cultural competence practices was influenced by the racial/ethnic composition of top management. With one-third of the U.S. population identifying with a racial or ethnic group other than non-Hispanic White, and that population continuing to grow increasingly diverse, racial and ethnic minorities are increasingly accessing health care services. Yet they represent less than 1% of the top management teams (TMT) of health care organizations. The study sought to determine the extent to which health care organizations with TMTs that are representative of the racial and ethnic compositions of the communities in which they serve …

Pay For Performance In Dentistry: Is It Worth It?, Andreea Voinea-Griffin

All ETDs from UAB

Introduction: The variability of dental care and the slow implementation of evidence-based dentistry point to the need for change. Pay for performance (P4P) programs may foster quality improvement if appropriately designed. This work demonstrates the use of modeling and simulation to evaluate such programs prior to deployment. An example is provided in the form of a P4P program for the treatment of occlusal early caries (EC) in permanent teeth. Research Design: The proposed P4P program evaluation consists of two steps. First step is to determine the optimal treatment. In this example, three non-invasive treatments (NTs), watchful-waiting (WW), sealants, and fluoride …

Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan

All ETDs from UAB

The purpose of this dissertation was to examine the antecedents and outcomes of hospital vertical integration into Sub-Acute Care (SAC). Using a sequential quanqual mixed methods design, we examined why hospitals adopt a vertical integration strategy and the relationship this strategy has to performance. Findings from this dissertation are important to hospital administrators as they seek to find ways to respond to the changing payment structures established during the Affordable Care Act. The results of this dissertation suggest that not all market and organizational factors are associated with vertical integration strategies toward SAC. They also suggest that vertical integration into …

The Role Of Ppar-Delta In Regulating Cardiomyocyte Proliferation And Angiogenesis In Post-Myocardial Infarction Adult Heart, Yishu Ding

All ETDs from UAB

immediately before, soon after, and one month after intervention. Average daily calcium

The Relationships Between Patient Satisfaction, Market Share, And Hospital Financial Performance, David W. Au

All ETDs from UAB

Quantitative scores enumerating patient experience with care have been introduced to healthcare via the Patient Protection and Affordable Care Act of 2010. Consumers can now compare with relative ease, different healthcare providers on the basis of standardized metrics. As government mandated transparency initiatives become commonplace as a result of the law, hospitals are more cognizant of how patient experience with care (operationalized using Hospital Consumer Assessment of Healthcare Providers and Systems: HCAHPS) has an impact on where patients decide to seek treatment. The proliferation of technological tools now enables patients to make meaningful quality and cost comparisons across providers. HCAHPS …

How Well Do Hospitals Budget Operating Results? The Relationship Between Budget Variances And Operating Margin, Mark F. Slyter

All ETDs from UAB

There is a near-universal assumption in both practice and literature that greater accuracy and management to the budget improves profitability (Libby & Lindsay, 2010; Umapathy, 1987). Prior to this study, this assumption has gone untested and we know little about the wisdom of such an assumption. The results of this study indicate greater accuracy in forecasting and/or tighter management to the budget, or favorably exceeding it, leads to improved profitability. More specifically, smaller unfavorable budget variances are associated with greater operating margins while greater favorable budget variances are associated with greater operating margins. A single standard deviation reduction in unfavorable …

Administrative Challenges In Pediatric Long-Term Care, Holly Elaine Jarek

All ETDs from UAB

ABSTRACT This research used a Delphi methodology to solicit challenges that significantly impact the operational success of pediatric long-term care facilities. Further, this study sought to understand the ability of pediatrics administrators to impact, affect, overcome, or resolve these challenges. Round 1 accomplished the desired goal of eliciting a substantial amount of new qualitative information regarding administrative challenges in pediatric long-term care, which previously had been extant in the literature. In Round 2, data were distilled into categories and unique exemplars which in turn were validated by participants. In Round 3, administrators ranked and rated categories and individual challenges in …

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

Undergraduate Research Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …

Patient Engagement Functionalities Facilitated By Health Information Technology: An Examination Of The Adoption Rate And Financial Performance Among U.S. Hospitals, Oghale Elijah Asagbra

All ETDs from UAB

The Centers for Medicare and Medicaid (CMS) meaningful use requirement, as well as documented evidence suggest that health information technology (HIT) has the potential to promote patient engagement and consequently improve quality and reduce cost. This prompts a better understanding of hospital adoption of HIT for patient engagement. The purpose of the three papers presented in this dissertation is to examine hospital adoption of health information technology (HIT) to facilitate patient engagement. Emphasis is placed on the functionalities (i.e., functions or capabilities) offered by these technologies that have been determined to allow patients be more involved in their care because …

Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste

All ETDs from UAB

Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …

Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay

All ETDs from UAB

RURAL HOSPITAL CLOSURES IN ALABAMA: POST ACA DENNIS O. MCCAY HEALTH SERVICES ADMINISTRATION ABSTRACT Rural hospitals differ from their urban counterparts with regard to two main areas. First, rural hospital patients are usually older, of lower income, and less healthy than those in urban areas. Second, their facilities tend to be smaller, older, and more prone to staff shortages than those in an urban environment. Rural hospitals have been closing at higher rates than their urban counterparts for a number of years, but more so since the implementation of the Affordable Care Act in 2010. The objective of this research …

Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson

All ETDs from UAB

As life expectancy continues to increase and the number of elderly Americans rises, public health initiatives are seeking to identify modifiable risk factors to preserve cognitive function and increase quality of life in advanced ages. The primary objective of this dissertation was to investigate dietary patterns, carbohydrate consumption, and insulin resistance as modifiable risk factors that may contribute to the development of cognitive impairment and cognitive decline. Three separate studies were performed in the REasons for Geographic And Racial Differences in Stroke study, a prospective cohort containing 30,239 black and white participants. Cognitive impairment was defined using the Six-Item Screener. …

Correlating High Reliability Organization Practices With Preventable Harms Across Children’S Hospitals Participating In The Children’S Hospitals’ Solutions For Patient Safety Collaborative, Kelly H. Randall

All ETDs from UAB

Background: Despite significant effort, focus, and resources dedicated to reducing patient safety risk, the healthcare system continues to have high error rates. Approaches and strategies implemented to decrease human error have been marginally successful in achieving sustainable reduction in patient harm. Purpose: The purpose of this study was to examine the association between high reliability and patient safety outcomes by testing the following hypotheses: Organizations exhibiting more advanced high reliability practice will have fewer hospital acquired conditions (as defined by the Serious Harm Event Index (SHE) than organizations exhibiting less advanced high reliability practices; and organizations exhibiting more advanced high …

High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley

All ETDs from UAB

Calorie restriction (CR) reduces body weight (BW) and adiposity, but is often less than expected due to hypometabolism produced by reductions in lean body mass (LBM). A comparable energy deficit created by combining CR and exercise energy expenditure (EE) has been shown to attenuate the reduction in EE produced by CR. Continuous moderate-intensity training (MIT) is commonly used to sustain energy balance or expedite weight loss, but high-intensity interval training (HIIT) may produce greater results. The purpose of this investigation was to determine if HIIT preserves LBM and improves energy metabolism to a greater extent than MIT in the presence …

Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman

All ETDs from UAB

Hospitals operate in turbulent and complex environments with limited resources. Consequently, administrators need to understand how to best use resources and improve a hospital’s positioning in a market. Surgical services is a key operational activity for hospitals, thus, a better understanding of how these services are organized by hospitals likely has important implications for a hospital’s performance and potentially survival. Given the potential importance of surgical services to hospitals, the purpose of this study was three-fold. First, the study identified different surgical profiles of hospitals based on the type and volume of surgical services provided by hospitals. Second, the study …