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Full-Text Articles in Medical Humanities
Organizational Climate And Its Association With Eth Perceived Permanence Of An Evidence-Based Decision-Aid For Patients With Lupus, Aizhan Karabukayeva
Organizational Climate And Its Association With Eth Perceived Permanence Of An Evidence-Based Decision-Aid For Patients With Lupus, Aizhan Karabukayeva
All ETDs from UAB
It is increasingly evident that seemingly good ideas do not always result in changes in practice, and it is challenging to sustain evidence-based innovations, even if they are backed by substantial research. Long-term use of innovations seems more likely where favorable contextual conditions are in place, yet relatively little empirical research has taken up the question of how evidence-based practices are sustained and become established in day-to-day practice. This question of sustainability is crucial if the gains in patient care that derive from organizational innovations are to be maintained. The purpose of this dissertation was to examine the relationship between …
The Association Of Availability And Accessibility Of Federally Qualified Health Centers On Hospitals' Reported Charity Care, Philip Cendoma
The Association Of Availability And Accessibility Of Federally Qualified Health Centers On Hospitals' Reported Charity Care, Philip Cendoma
All ETDs from UAB
Hospitals are facing financially challenging times. Each year, billions of dollars are spent by hospitals to provide care to patients that, ultimately, will go unreimbursed. How to effectively provide accessible and affordable health care to the uninsured population continues to be a topic of discussion for policymakers, healthcare administrators, as well as healthcare-based consortiums, and consultant. The cost of charity care consists largely of the care provided to the uninsured population. Federally Qualified Health Centers (FQHCs) play an important role in providing primary care to the uninsured population, regardless of the patient’s ability to pay. Based on the 5 A’s …
Mechanisms Of Simulated-Spinal Manipulative Therapy In Animal Models Of Low Back Pain, Carla Rigo Lima
Mechanisms Of Simulated-Spinal Manipulative Therapy In Animal Models Of Low Back Pain, Carla Rigo Lima
All ETDs from UAB
Low back pain (LBP), a condition characterized by pain experienced between the 12th rib margin and gluteal folds, is a prevalent health problem that affects an ever-increasing population worldwide. First-line treatment for LBP often involves non-pharmacological approaches, including spinal manipulative therapy (SMT), which has demonstrated mild-to-moderate clinical efficacy. However, despite its therapeutic benefits, the physiological mechanisms underlying the analgesic effects of SMT in LBP are still not well understood. Recent evidence suggests that sensitization of peripheral and central nervous system structures contribute to the progression and maintenance of LBP with inflammatory cytokines, reactive glial cells, and/or aberrant muscle spindle activity …
The Influence Of A Low Glycemic Load Diet On Appetite In Women With Pcos, Sarah Et Hoover
The Influence Of A Low Glycemic Load Diet On Appetite In Women With Pcos, Sarah Et Hoover
All ETDs from UAB
Dysregulated appetite may contribute to weight gain and high prevalence of comorbid obesity in women with polycystic ovary syndrome (PCOS), yet dietary recommendations to promote satiety and facilitate weight maintenance in this population remain scarce. The objective of this dissertation was to determine if women with PCOS have alterations in appetite-regulating hormones that can be manipulated by low glycemic load diet habituation to improve satiety. This was tested by secondary analyses of two randomized controlled dietary intervention trials in women with and without PCOS. First, we explored differences in women with and without PCOS during a standardized liquid meal test …
I Would Be Shocked If Someone’S Not Depressed With That Diagnosis”: An In-Depth Exploration Of The Manifestation And Management Of Depression And Anxiety In Patients With Cancer, Carmen Rainey Brown
I Would Be Shocked If Someone’S Not Depressed With That Diagnosis”: An In-Depth Exploration Of The Manifestation And Management Of Depression And Anxiety In Patients With Cancer, Carmen Rainey Brown
All ETDs from UAB
Patients diagnosed with cancer experience depression and anxiety at higher rates compared to the general population. Most individuals diagnosed with cancer will experience symptoms of depression and anxiety at some point during their cancer trajectory and not seek care leaving their mental health conditions undiagnosed and untreated, which impact quality of life and cancer outcomes. Patient and providers perspectives are vital to understand the manifestation, care-seeking behaviors, and provider management of depression and anxiety in patients with cancer. This study sought to explore the manifestation of depression and anxiety among patients with cancer and their care seeking behaviors for mental …
Evaluation Of A Hospital Pdmp Ehr-Integration Implementation: A Mixed, Heather D. Martin
Evaluation Of A Hospital Pdmp Ehr-Integration Implementation: A Mixed, Heather D. Martin
All ETDs from UAB
Background: Many providers continue to over prescribe opioids for pain, and Prescription Drug Monitoring Programs (PDMP) can be used as a tool to assist with appropriate opioid prescribing decisions. Despite mandates requiring opioid prescribers to review patients’ prescribing history in their state’s PDMP, barriers to PDMP success still exist such as a difficult PDMP logon process and having to log on to a separate PDMP system, which can cause access, workflow, time commitment, and ease of use issues and deter providers from using the PDMP. Some health care organizations have implemented PDMP electronic health record (EHR) integration (PDMP EHR-integration) to …
Weight Loss And Physical Activity For People With Physical Disabilities, Julianne Clina
Weight Loss And Physical Activity For People With Physical Disabilities, Julianne Clina
All ETDs from UAB
People with physical disabilities (PWD) are at higher risk of obesity than people with-out physical disability (PWoD). For PWD, obesity presents a greater risk of secondary conditions; preventable medical, emotional, or social problems resulting directly or in-directly from an initial disabling condition. There is incomplete information about how disability-specific concerns influence obesity treatment and weight management, in part because PWD have typically not been included in this research. Additionally, while studies exist examining weight loss in PWD, a dearth of research exists examining weight loss maintenance for this population. Previously, weight control registries have been a valuable tool in gaining …
Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas
Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas
All ETDs from UAB
Increasing competition in the healthcare industry is compelling organizations to adopt new strategies to obtain and/or maintain a competitive advantage. To obtain a competitive advantage, healthcare organizations may need either more efficient processes or offer new or improved products and services through the utilization of these strategies. In competitive market environments, technological innovations can be a key competitive advantage to reduce expenses, improve quality, attract more customers, or a combination of all. All healthcare organizations can benefit from technological innovations, especially those with limited resources. One type of healthcare organization that highlights the disparity in resources is the Federally Qualified …
Physical Activity Promotion In Persons Newly Diagnosed With Multiple Sclerosis, Le Thao Trinh Huynh
Physical Activity Promotion In Persons Newly Diagnosed With Multiple Sclerosis, Le Thao Trinh Huynh
All ETDs from UAB
Multiple sclerosis (MS) is a prevalent immune-mediated, neurodegenerative disorder, affecting approximately 1 million people in the United States. MS onset is commonly between 20 and 40 years of age, and persons with MS often live a long life with the disease resulting from the early initiation of disease-modifying therapies and comorbidity-managing approaches. Notably, physical activity is promising for disease modification and symptoms and comorbidity management in MS. Yet, physical activity has been initiated quite late during the disease course. Further, early MS could be a “window of opportunity” for initiating physical activity to maximize its health benefits for symptom management …
Physical Activity And Related Social Cognitive Theory Constructs By Major Depression Status In Persons With Multiple Sclerosis, Catherine Danielle Jones
Physical Activity And Related Social Cognitive Theory Constructs By Major Depression Status In Persons With Multiple Sclerosis, Catherine Danielle Jones
All ETDs from UAB
Major depressive disorder (MDD) is highly prevalent among the 1 million per-sons living with multiple sclerosis (MS) in the United States. The prevalence of MDD is nearly 1.7 times higher in persons with MS than in the general population. MDD is associated with negative outcomes in MS, including worse neuropsychological functioning, lower quality of life (QOL), and worse disability. Higher levels of physical activity (PA) are associated with lower depressive symptoms in MS and participation in moderate to vigorous physical activity (MVPA) has been recommended for managing depression se-verity in the general population. However, the rates, patterns, and behavioral correlates …
Patient-Driven Payment Model And The Covid-19 Pandemic External Environment Impact On Nursing Home Industry In The Last 5 Years, Gregory N. Orewa
Patient-Driven Payment Model And The Covid-19 Pandemic External Environment Impact On Nursing Home Industry In The Last 5 Years, Gregory N. Orewa
All ETDs from UAB
Nursing homes face an ever-changing environment and must adapt to achieve organizational success. Recent events such as the COVID-19 pandemic and the implementation of the Patient-Driven Payment Model (PDPM) reimbursement policy have disrupted nursing homes. PDPM put pressure on nursing homes to change their operations and billing practices. The reimbursement policy changed from Resource Utilization Group (RUG) under the Prospective Payment Model (PPS), to PDPM. PDPM, which encourages more value in skilled nursing facility (SNF) spending, has been explored by various studies with respect to nursing home’s reaction in reducing therapy staffing. Three studies follow that examine PDPM and COVID-19 …
Effects Of Dietary R, S-1, 3-Butanediol Diacetoacetate On Components Of Energy Balance And Hepatic Health, Kelsey A. Rushing
Effects Of Dietary R, S-1, 3-Butanediol Diacetoacetate On Components Of Energy Balance And Hepatic Health, Kelsey A. Rushing
All ETDs from UAB
Objective: Exogenous ketone administration presents a possible treatment strategy for obesity and obesity-related diseases. The exogenous ketone ester, R,S-1,3-butanediol diacetoacetate (BD-AcAc2) decreases adiposity and hepatic steatosis in high-fat dietinduced obese mice. In our previous work, carbohydrate energy was removed and replaced with the ketone ester to produce isocaloric diets. The current investigation aimed to determine whether BD-AcAc2 decreases markers of hepatic steatosis and inflammation in lean mice on a high-fat, high-sugar (HFHS) diet without removing carbohydrate energy. Methods: Sixteen 11-week-old male C57BL/6J mice were randomized to one of two groups for 9 weeks (n = 8 per group): 1) Control …
Contributions Of Off-Season Training And Food Security Status On Body Composition And Performance In Collegiate Football Players, Kathryn Lee Stowers
Contributions Of Off-Season Training And Food Security Status On Body Composition And Performance In Collegiate Football Players, Kathryn Lee Stowers
All ETDs from UAB
Body composition measurements are collected periodically in the collegiate athletic setting to evaluate health and predict athletic performance of individual athletes. However, the effects of remote training and food insecurity on body composition have yet to be fully investigated in this population. The purpose of this research was to evaluate the influence of remote training and food security status on body composition and performance changes during off-season training. Aims 1 and 2 focus specifically on how factors affect body composition changes in collegiate football players during off-season training. Data were collected from routine body composition testing and food security screening …
Assessing Visual Function In Young And Medically Complex Children With Cerebral Visual Impairment, Kathleen Mary Weden
Assessing Visual Function In Young And Medically Complex Children With Cerebral Visual Impairment, Kathleen Mary Weden
All ETDs from UAB
Cerebral Visual impairment (CVI) has become the leading cause of vision impairment in children worldwide. Early identification of CVI has been shown to improve visual function outcomes and improve developmental outcomes and quality of life. However, children with CVI are difficult to identify and assess because the medical conditions that cause CVI can also cause impairment across domains of function. A scoping review was first conducted on interventions and outcome measures used for children with CVI. The sources identified (n=20) were grouped into five types of interventions. The review confirmed the need for quantitative, standardized methods for measuring visual function …
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 …
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 …
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 …
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 …
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 …
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 …
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 …
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 …
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 …
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 …
Behavioral, Environmental, Social, Psychosocial, And Physiological Factors That Impact The Relationship Between Chronic Lung Disease Status And Susceptibility To Electronic Cigarette Use Or Actual Electronic Cigarette Use, Mohammed M. Alqahtani
All ETDs from UAB
There is surge increase in e-cigarettes among adult vulnerable population such as individuals with chronic lung disease (CLD). Currently, there is a lack of understanding of the factors that may lead to the increase use of e-cigarettes or susceptibility of ecigarette use among individuals who have a history of CLD. Thus, it is crucial to recognize the characteristics of the individuals with CLD and adults without CLD who are susceptible to using e-cigarettes because this may pave the way for the prevention and reduction of tobacco use by identifying the different factors and eventually targeting the related risk factors. In …
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, …
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 …
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 …
Joint Specificity Of Stretch-Shortening Cycle Potentiation, Marzouq Khalaf Almutairi
Joint Specificity Of Stretch-Shortening Cycle Potentiation, Marzouq Khalaf Almutairi
All ETDs from UAB
The stretch-shortening cycle (SSC) is a well-known phenomenon to enhance an individual’s muscular performance, and it is an area of active focus of research scientists for decades. However, it is not known whether SSC potentiation is a joint-specific event and shows a joint-specific temporal behavior. It is also unclear if constraints of joint and movement specificity of SSC potentiation can be captured via isokinetic dynamometer. Therefore, the purposes of this dissertation were to examine joint specificity of SSC potentiation via isokinetic dynamometer and kinetic-kinematic analysis of jump test performance and investigate joint-specific temporal behavior of SSC potentiation. My first study …
Evidence For A Bioelectrical Marker Of Insulin Resistance In Premenopausal Women: Membrane Capacitance, Valene E Garr Barry
Evidence For A Bioelectrical Marker Of Insulin Resistance In Premenopausal Women: Membrane Capacitance, Valene E Garr Barry
All ETDs from UAB
Insulin resistance (IR) is associated with poor metabolic and reproductive outcomes among premenopausal women. Early identification of women with IR might mitigate these outcomes. However, clinically suitable methods to identify women with IR are unavailable due to high cost, high patient burden, or limited reliability. The objective was to examine a bioimpedance-based approach to identifying women with IR using membrane capacitance (CM). CM is a measure of cell membrane health and function, which is independently associated with IR and may be a suitable predictor. We validated the association of CM with IR and established the clinical utility of CM as …