Medical Humanities Commons^™

Three Essays In Hospital Financial Distress: Prediction, Antecedents And Organizational Response, Neeraj Avinash Puro

All ETDs from UAB

The following essays examine the financial distress in acute care hospitals in the United States. The first essay examines the accuracy of prediction models of financial distress, the second explores the factors associated with financial distress and the third essay examines organizational response to financial distress. The first essay compares the predictive ability of three financial distress prediction models: modified Altman Z score (1993), Ohlson O score (1980) and Zmijewski (1984) to more accurately predict financial distress in U.S acute care hospitals. Building on the first essay, the second essay uses the most accurate predictive model to examine acute care …

Insuring Graduation: An Analysis Of The Association Between Student Health Insurance And Graduation, John Robert Lovett

All ETDs from UAB

Most college students have access to basic health services through their campus’ college health program. Unfortunately, students who lack health insurance may be limited in their access to health services beyond the acute care provided, which may manifest in a myriad of adverse outcomes; ultimately resulting in withdrawal from college without graduating. Student health insurance plans (SHIPs) are high-quality, affordable insurance plans specially designed to meet this need. This study utilized survival analysis to examine the temporal nature of college graduation behavior, as it related to student health insurance status. The results of this study show no significant relationship between …

Healthcare Cybersecurity: Building A Cyber Vulnerability Profile For U.S. Hospitals, Gemini O. Majkowski

All ETDs from UAB

Digital transformation in healthcare has offered exponential advances in capabilities and efficiencies improving access, quality of care, chronic disease management, public health surveillance, and population health. However, the speed of change left security lagging, exposing cyber vulnerabilities that cost the U.S. $6.2 billion dollars annually, at an average cost of $2.2 million dollars, and 3,128 records breached per incident. Despite significant investments to close the gap on cyber vulnerabilities, cybersecurity remains a critical issue. Little research has been done to build a cyber vulnerability profile for U.S. hospitals. In this study, U.S. hospitals with reportable breach and without reportable breach …

Provider-Sponsored Health Plans In The Post-Reform Era, Katherine Ann Meese

All ETDs from UAB

The rise and fall of managed care in the 1980s and 1990s saw many hospitals and health systems in the United States enter and subsequently exit the health insurance market in the form of provider-sponsored health plans (PSHP). The passage and implementation of the legislation such as the Patient Protection and Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act (MACRA) has ushered in an era of value-based reimbursement methods and a heightened focus on population health management, which has stimulated health care organizations to contemplate health plan ownership as a logical strategy. This study examined market …

Reported Clinical And Financial Performance Of Hospitals With Physician Ceos Compared To Those With Nonphysician Ceos, Leon Moores

All ETDs from UAB

Leaders impact organizational behavior and performance, and CEOs may have greater impact via numerous proposed mechanisms. Because of this, organizations expend considerable resources recruiting and selecting CEOs and may benefit from information suggesting a positive impact on organizational performance based upon measurable CEO characteristics. Little work has been done comparing the performance of hospitals with physician CEOs versus non-physician CEOs, in spite of the ease of identification of this characteristic and extant leadership theories suggesting a relationship between technical expertise and success in leading highly technical organizations. We compared multiple measures of reported clinical and financial performance and our linear …

Effects Of Differential Fore Aft Resistance On Propulsive Force Generation During Walking In Nonimpaired And Poststroke Individuals, Avantika Naidu

All ETDs from UAB

Background: Impaired paretic limb-loading dynamics and force-generation ability due to hemiparesis are partially responsible for permanent locomotor deficits poststroke. During walking, inability of the paretic limb to generate sufficient propulsive-forces causes reliance on compensatory strategies, wherein the nonparetic limb generates the majority of propulsive-forces needed for forward progression and speed modulation. Purpose: To investigate factors that can improve paretic limb propulsion and walking function, I present four studies. The first pertains to a protocol for a poststroke body-weight-support treadmill-training (BWSTT) study, while the others concern a mechanistic exploration of propulsive-force generation during walking against combined and differential FA resistance. Methods: …

Exploring The Link Between Dietary Fiber, The Gut Microbiota And Estrogen Metabolism Among Women With Breast Cancer, Ayse G. Zengul

All ETDs from UAB

Breast cancer continues to be a very prevalent disease and impacts over 260,000 new patients per year in the United States. The gut microbiota composition may affect breast cancer risk by modulating various hormonal metabolites including endogenous estrogens. Dietary factors impact gut microbial ecology and influence the regulation of estrogen metabolism. Current evidence supports the potential role of dietary fiber in breast cancer prevention and its possible modulating influence on serum estrogen levels through the gut microbiota associated with β-glucuronidase activity. However, this mechanism is not clearly understood. In this study, we aimed to explore the associations between dietary fiber, …

Significance Of Acculturation, Assimilation, And Allostatic Load As Risk Factors For Obesity Among Hispanics, Yenni Elvia Cedillo Juare

All ETDs from UAB

Obesity has increased during the last two decades in the United States (U.S.) and is considered a major risk factor for chronic diseases within the Hispanic community. The burden of obesity in Hispanics is associated with higher rates of morbidity and mortality and an increase in healthcare costs. Hispanics’ challenges after migration extend to subsequent generations, putting the population at risk for disease development. Specifically, migration can lead to the adoption of health behaviors, beliefs, values, and language of the host country, a process known as acculturation, which has been associated with changes in health behaviors. Among the Hispanic population, …

The Strategy Of Federally Qualified Health Centers: The Influence Of Context And Performance Implications, Seongwon Choi

All ETDs from UAB

The three papers included in this dissertation attempt to provide empirical evidence on the relationship among strategies employed by Federally Qualified Health Centers (FQHCs), the contextual factors and consequent performance. The findings of these studies contribute to the existing body of literature on FQHC strategies and performance. In addition, the findings also provide key practical implications to FQHC managers as well as policymakers. Overall, the results of this dissertation suggest that the FQHC strategy on spatial differentiation is associated with a set of organizational and environmental factors. However, there was little support for the relationship between Medicaid expansion and FQHC …

Effects Of A Ketogenic Diet On Body Composition, Metabolic Health, And Quality Of Life In Ovarian And Endometrial Cancer Patients, Caroline Whitney Cohen

All ETDs from UAB

Ketogenic diets (KDs) have garnered considerable research attention in recent years, having been investigated as a therapy for neurologic, metabolic, and even dermatologic diseases. Recent research has also focused on KDs as a potential intervention for cancer, with preclinical studies demonstrating profound effects such as inhibiting tumor growth, enhancing the effects of radiation and chemotherapy, and prolonging survival. However, to date few studies have been conducted in cancer patients. In order to determine if KDs might augment existing cancer treatment protocols, additional research is needed. Accordingly, the objective of this project was to conduct the first randomized, controlled trial examining …

Obesity In People With Spinal Cord Injury: Secondary Data Analysis Of National Spinal Cord Injury Database, Huacong Wen

All ETDs from UAB

People with disabilities are 1.5-2.5 times more likely to be obese than those without disabling conditions. We have learned a lot about obesity in the general population. However, the neurological deficits of people with spinal cord injury (SCI) make it difficult to generalize the findings in the general population to the SCI population. Therefore, the purposes of this dissertation were to 1) assess racial differences in body mass index (BMI) change over 5 years; 2) evaluate the role of neighborhood in the relationship between race and obesity; 3) examine the impact of BMI at the time of injury on 1-year …

A Crisis In Care: Evaluating The Causes And Consequences Of Burnout Among Emergency Physicians, Michael Allyn Wiechart

All ETDs from UAB

For many physicians, the growing list of mandates and the unrelenting pace of change in today’s health care have taken a toll, leading to burnout. The consequences of burnout extend well beyond the impact on the individual provider, with physician burnout linked to a decrease in patient satisfaction, an increase in preventable medical errors, and increased levels of staff turnover. Consequently, the high rates of burnout reported among U.S. physicians might be considered not only as a symptom of dysfunction in the health care delivery system but also as a factor contributing to the dysfunction. While burnout exists to a …

[68ga] Labeled Radiopharmaceuticals For Diagnostic Applications Beyond Sstr And Psma Imaging, Abdullah Alosaimi

All ETDs from UAB

Imaging with radiolabelled peptides is an important technique used in medical imaging fields that can lead to significant advances in patient care. These tracers are utilized to target a variety of receptors, in particular, specific-receptors which are overexpressed on tumor cells. Recently, the application of Positron Emission Tomography (PET) radiotracers for medical imaging has grown significantly due to the high sensitivity and specificity of this technique. In particular, 68Ga is one of the most favorable PET radioisotopes, due to its short half-life, low radiation dose, generator production, and same day imaging procedures. [68Ga]-DOTATATE, which targets somatostatin receptors (SSTR) overexpressed on …

Postpartum Body Composition And Breast Milk Hormones, Camille Schneider

All ETDs from UAB

The prevalence of both adult and child obesity continues to rise. Children born to mothers with obesity have a greater risk for future obesity and chronic disease. There is an increasing body of literature suggesting that pregnancy and infancy are critical periods influencing the child’s risk for obesity. However, little is known about whether consumption of breast milk from an obese mother might influence the child’s metabolic programming and growth. The purpose of this dissertation was to examine the association of maternal adiposity with insulin and leptin in breast milk and, in turn, whether breast milk insulin, leptin, and glucose …

Physical Activity Promotion Among Adolescents With Pediatric Onset Multiple Sclerosis, Elizabeth Morghen Sikes

All ETDs from UAB

Pediatric onset multiple sclerosis (MS) is a chronic and disabling disease of the central nervous system with an onset before 18 years of age. Youth with pediatric onset MS may benefit from physical activity as evidenced by past research suggestsing higher levels of physical activity are associated with reduced physical and psychosocial disease manifestations. Unfortunately, published estimates of physical activity participation among those with pediatric onset MS are very low (<10 min/day). This dissertation aimed to describe the current literature regarding physical activity among youth with pediatric MS, and to further explore experiences, patterns, correlates, and potential confounders of physical activity for the ultimate purpose of informing future behavior change interventions. Results are presented through five single study chapters. Briefly, interventions developed to promote physical activity for adolescents with pediatric onset MS should be individually tailored, include a strong social component, aim to educate regarding safety and outcomes of physical activity, and differentially target weekday and weekend day activity and sedentary behavior. Social cognitive theory (SCT) is an appropriate method for promoting physical activity behavior change among youth with pediatric onset MS, and SCT constructs including exercise goal setting, barriers self-efficacy, outcome expectations, and social support should be incorporated in the intervention as appropriate. Further, physical activity is seemingly an appropriate method for the management of functional limitations for youth with pediatric onset MS. Clinicians and researchers seeking to promote physical activity among those with pediatric onset MS may find this dissertation especially useful in providing a framework for the development of behavior change interventions.

Embodied Transitions In Michel De Montaigne, Nora Martin Peterson, Peter Martin

Department of Modern Languages and Literatures: Faculty Publications

Sixteenth-century French philosopher Michel de Montaigne was one of the first writers to reflect on embodiment. “I am myself the matter of my book,” he proclaims in the introduction to his Essays. Montaigne writes about various moments of embodied transitions: a near-death experience, reflections on aging and cognitive decline, and a lengthy discussion of how to cope in the face of devastating loss. Taking an interdisciplinary perspective by analyzing the relationship between embodiment, health representations, and geropsychological themes, this chapter analyzes Montaigne’s in-between moments, arguing that Montaigne’s essays—innovative in their own time—remain important in discussing embodied transitions today.

How To Balance Intuitive And Analytical Functions Of Brain: A Neutrosophic Way Of Scientific Discovery Process, Florentin Smarandache, Victor Christianto, Robert Neil Boyd

Branch Mathematics and Statistics Faculty and Staff Publications

Initially this article stems from our discussion on math and mysticism, inspired by an article by Ralph Abraham. But it becomes a discussion on the role of intuition and inspiration in scientific discovery process. Hopefully this article will help anyone who aspires to be good scientists or engineers.

Need Of Professional Development And Ict Skills For Medical Library Professionals In Gujarat, S. D. Parmar Dr., Shishirkumar H. Mandalia Dr.

Library Philosophy and Practice (e-journal)

Professional development is the process where professionals stay up-to-date information, skills, and abilities which required working effectively in their profession. It is assumed that professionals have to maintain professional competency, involve in professional development and skill enhancement activities. The library professionals are catering library services to its users with growing demand of users; there are not enough studies are conducted about the need for professional development and ICT skills for medical library professionals in Gujarat. It is very much important to evaluate the needs of professional development and skills enhancement programme in medical educational institutions. The cross-sectional study was conducted …

3d Printing In Low Resource Healthcare Settings: Analysis Of Potential Implementations, Alenna Beroza

Dissertations, Master's Theses and Master's Reports

3D printing has gained significant momentum in the past ten years, and its unique advantages make it especially ideal for use in low resource healthcare settings, where many designs have already been successfully implemented. Yet, little has been studied on how 3D printing can be sustainably and functionally implemented in low resource healthcare systems as a manufacturing practice. In this report, three business models are proposed for this implementation: In-House Operator, Independent Operator, and Print Farm. These models were then tested over four months in Kisumu county, Kenya, at two workshops and seven public hospitals. I worked with local medical …

Development Of A Descriptive Model Of Flow Disruption Effect On Bypass Time In A Cardiovascular Operating Room, Timothy J. Disher

Doctoral Dissertations and Master's Theses

The current paper proposes utilizing extant flow disruption data, collected from two cardiovascular operating rooms, and utilizing that to develop a mathematical model. Of particular interest is bypass time which is a critical surgical phase, the length of which has been linked to post-operation complications such as hospital-borne infections and readmission. By developing a model that predicts bypass time, the present research can determine the impact by types of flow disruptions – coded based on the RIPCHORD-TWA taxonomy, team member disrupted, and where in the surgery the FD occurs.

After a review of literature, a variety of models were explored …

Language Of Disability, Language Of Disorder: An Investigation Of Lived Experiences And Perspectives Of Individuals On The Autism Spectrum With Respect To Communicative Interventions, Rebekah Burkhart

Senior Independent Study Theses

The primary purpose of this study was to investigate the lived experiences and first-person perspectives of individuals with Autism Spectrum Disorder (ASD) with respect to interventions for communicative differences and/or deficits characteristic of autism. This study extends limited research into autistic experiences of interventions in the domain of communication. Furthermore, by extending prior research into neurodiverse values among speech-language pathologists (SLPs), this research contributes to the body of professional literature through exploration of autistic voices as in-group sources of expertise on ASD. The researcher recruited participants online, utilizing mixed methods in the form of quantitative surveys and qualitative interviews to …