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Full-Text Articles in Medical Humanities
The Antecedents And Consequences Of Public Hospital Privatization, Zo Harivololona Ramamonjiarivelo
The Antecedents And Consequences Of Public Hospital Privatization, Zo Harivololona Ramamonjiarivelo
All ETDs from UAB
ABSTRACT The purpose of this study was to explore the antecedents and consequences of public hospital privatization with special attention to financial distress and financial performance. A national sample of public hospitals using secondary longitudinal data from 1997 to 2009 was used in this study. Data set from the American Hospital Association, the Area Resource File, the Medicare Cost Report and the Local Area Unemployment Statistics were merged to test the hypotheses pertaining to each research question. Based on the resource dependence theory, both environmental variables and organizational variables were included in the analyses. This study adopted the Altman Z-score …
Exploring Health Disparities For Children In The City Of Milwaukee, Mark Edwin Anderson
Exploring Health Disparities For Children In The City Of Milwaukee, Mark Edwin Anderson
All ETDs from UAB
This study investigated whether school-based oral health programs as a public policy intervention increased dental sealant applications among children from low-income families and minorities in public schools in inner city Milwaukee. By using a difference-in-differences analysis, we examined pre-post time frames, 2001-2003 and 2008-2009, to determine sealant application usage in public schools in nine inner city Milwaukee zip codes after the intervention of a public policy initiative to expand school-based oral health programs with the expressed intent of increasing placement of dental sealants in children at high risk for dental decay and disease. Results of a binary logistic regression revealed …
The Effects Of Direct To Consumer Advertising On Healthcare Utilization Among Medicaid Children With Asthma, Luceta C. Mcroy
The Effects Of Direct To Consumer Advertising On Healthcare Utilization Among Medicaid Children With Asthma, Luceta C. Mcroy
All ETDs from UAB
National guidelines recommend treatment of asthma with preventive long term medication, but adherence remains low, resulting in high healthcare utilization among those affected by the chronic disease. The increase in DTCA since the easing of restrictions by the FDA in 1997 has prompted much debate on the effects of the DTCA, with critics arguing that it is harmful while proponents see many benefits such as increased medication adherence. This study examines the impact of DTCA on healthcare utilization and asthma medication use by combining Medicaid administrative data and a national advertising data set on asthma medication from 1999 to 2002. …
Fat Distribution And Metabolic Health: The Effects Of Macronutrient Manipulation On Fat Distribution, Weight Loss, And Glucose Metabolism, Amy Miskimon Goss
Fat Distribution And Metabolic Health: The Effects Of Macronutrient Manipulation On Fat Distribution, Weight Loss, And Glucose Metabolism, Amy Miskimon Goss
All ETDs from UAB
Fat distribution pattern may contribute to risk of development of metabolic diseases such and type 2 diabetes and cardiovascular disease. However, the precise nature of the relationships between adipose tissue depots and metabolic health remains controversial. Additionally, further research is needed to identify optimal dietary approaches to reduce disease risk and visceral adiposity among overweight and obese individuals, who may already be on a trajectory for development of metabolic disease. Therefore, the goal of this project was to examine relationships of adipose tissue depots with insulin sensitivity, and then to determine if diets differing in CHO and fat content can …
Childhood Obesity: The Role Of Genetic Admixture, Parental Feeding Practices, And The School Food Environment, Michelle Cardel
Childhood Obesity: The Role Of Genetic Admixture, Parental Feeding Practices, And The School Food Environment, Michelle Cardel
All ETDs from UAB
Disentangling the etiology of pediatric obesity continues to challenge researchers due to the interconnecting of behavioral, physiological, environmental, and genetic factors. Studies have focused on the role of the obesogenic environment, characterized by excess energy intake and sedentary behavior, as it relates to weight and fat gain in children. Although these factors certainly have an impact on fat accumulation, increased energy intake and decreased physical activity do not solely account for the increasing trends in obesity prevalence. Less explored genetic and environmental factors may contribute independently and/or synergistically to the current obesity epidemic, and that, these factors could vary in …
Vitamin D And Insulin Sensitivity Among African American And European American Adolescents And Adults, Jessica Alejandra Alvarez
Vitamin D And Insulin Sensitivity Among African American And European American Adolescents And Adults, Jessica Alejandra Alvarez
All ETDs from UAB
Adequate vitamin D status is associated with a reduced risk for type 2 diabetes (T2DM); the relationship may be mediated by insulin sensitizing effects of vitamin D. African Americans (AA) are at a greater risk for T2DM and insulin resistance, as well as vitamin D deficiency, compared to European Americans (EA). The primary objective of this dissertation was to investigate the independent relationships of vitamin D with various measures of insulin sensitivity. Investigations were performed in a series of studies involving adolescent and adult female cohorts. The intravenous glucose tolerance test-derived insulin sensitivity index (SI) or the oral glucose tolerance …
Role Of Nr4a3 Nuclear Receptor In Physiological Regulation Of Metabolism, Grace R. Walton
Role Of Nr4a3 Nuclear Receptor In Physiological Regulation Of Metabolism, Grace R. Walton
All ETDs from UAB
Nuclear receptor NR4A3 (NOR-1, MINOR) mediates transcriptional responses to ß-adrenergic signaling, is increased in insulin sensitive mice and humans, and enhances insulin-stimulated glucose transport in cultured adipocytes and myocytes. We therefore sought to determine the role of NR4A3 in in vivo adipose tissue and skeletal muscle physiology. Following adipose-specific NR4A3 over-expression in mice, we observed reduced circulating epinephrine due to enhanced catabolism of catecholamines in adipose tissue. Furthermore, this reduction in circulating epinephrine produced broad physiological consequences, including poor glucose tolerance, reduced insulin sensitivity, dyslipidemia, poor cardiac function, and behavioral alterations. In skeletal muscle, we show that NR4A3 protein associates …
Calciotropic Hormonal Influence On Energy Homeostasis, Lynae J. Hanks
Calciotropic Hormonal Influence On Energy Homeostasis, Lynae J. Hanks
All ETDs from UAB
Energy balance exists when intake is equivalent to expenditure. It has become evident that beyond quantitative aspects of intake, dietary components also have directive impact. On the expenditure side, an underappreciated yet key contributor is resting energy expenditure (REE). As the largest constituent of overall energy output, REE encompasses physiologic, dietary and genetic influence on body composition. While cellular and overall systemic contribution cannot be ignored, the relative proportion of adipose, bone and lean body tissue (i.e., body composition) represents the primary determinant underlying REE. It is possible that the mineral calcium is a common denominator encompassing energy balance influenced …
Organizational Configurations And Strategies Related To Financial Performance In Medical Group Practices: A Test Of Porter's Generic Strategies, Todd Brenton Smith
Organizational Configurations And Strategies Related To Financial Performance In Medical Group Practices: A Test Of Porter's Generic Strategies, Todd Brenton Smith
All ETDs from UAB
Research in the field of organizational configurations (OC) involves the formation of groups of firms that are similar to each other on certain characteristics, and dissimilar from other groups, and explores organizational performance differences between the groups (Ketchen & Shook, 1996; Short, Payne, and Ketchen, 2008). However, OC is replete with literature lacking in common key terms, measurement methods, and specification of variables, and too few empirical articles with a strong theoretical basis have been published (Short, Payne, & Ketchen, 2008). Porter's (1980, 1985) generic strategies are a specific typology within the field of OC that have been used extensively …
Altered Dna Methylation Of Repetitive Elements May Explain The Modified Risk Of Cervical Intraepithelial Neoplasia (Cin) Associated With Genetic Polymorphisms Of The Folate Metabolic Pathway In The Us Post Folic Acid Fortification Era, Suguna Badiga
All ETDs from UAB
Despite the controversy regarding the adverse effects of exposure to higher folate concentrations on health outcomes particularly cancer, there has been paucity of research to understand the biological mechanisms affected by such exposures in relation to the risk of developing pre-cancer or cancer. We have recently addressed this concern by demonstrating that higher plasma folate concentrations were not associated with greater risk of being diagnosed with higher grades of cervical intraepithelial neoplasia (CIN 2+) especially in women with sufficient plasma vitamin B12 concentrations. Higher plasma folate was also associated with a pre-cancer protective level of peripheral blood mononuclear cells (PBMC) …
The Association Between The Body Mass Index (Bmi) Of African American College Women And Their Exposure To Magazine Advertisements, Candice P. Prince
The Association Between The Body Mass Index (Bmi) Of African American College Women And Their Exposure To Magazine Advertisements, Candice P. Prince
All ETDs from UAB
The primary purpose of this study was to examine the association between body mass index (BMI) and exposure to magazine advertisements among African-American college women aged 19 to 29. This study also sought to determine how personal, behavioral, and environmental factors affect the BMI of African-American college women. A sample of 252 African-American college women enrolled in undergraduate degree programs in the Southeast United States completed a web-based survey on their weight-related health behaviors and magazine usage. Descriptive statistics, bivariate correlations, and multivariable regression analysis were used to analyze the data. Bivariate correlations showed significant associations between BMI and several …
Development And Validation Of A Palliative Care Needs Assessment Instrument-English/Arabic Versions (Pcna-Eav), For Use With Patients With Advanced Cancer, Susan Edith Volker
Development And Validation Of A Palliative Care Needs Assessment Instrument-English/Arabic Versions (Pcna-Eav), For Use With Patients With Advanced Cancer, Susan Edith Volker
All ETDs from UAB
The aim of this study was to develop and translate a psychometrically valid and reliable, population-based, needs assessment instrument, the PCNA-EAV, to measure the health care and support needs of patients with advanced cancer. The cross-sectional study design combined qualitative and quantitative methods, to test instrument reliability and validity, and to examine the association between sample characteristics and health care and support needs. The 116-item, PCNA-EAV, comprised 10 domains of need: physical/functional; social; psychological/emotional; information; communication; helpful resources; financial; religious/spiritual; priority of need; and preference for care The target population was all cancer patients in the department of oncology at …
Age Bias In Physicians' Recommendation For Physical Activity, Adherence, And Health Related Quality Of Life Among Individuals With Arthritis, Shamly Austin
All ETDs from UAB
The association between individuals' ages, physicians' recommendations for physical activity, adherence, and health related quality of life among individuals with arthritis was examined using the 2007 Behavioral Risk Factor Surveillance System. The sample included 33,071 individuals with self-reported, physician-diagnosed arthritis who were 45 years or older. To answer the research questions, three sets of data were created: a whole sample (n=33,071), those 45-64 years old (n=17,607), and those 65 years or older (n=15,464). The conceptual framework for the study was based on the Behavioral Model of Health Services Utilization. The variables of interests were physicians' recommendations for physical activity, adherence …
The Effects Of Weight Reduction On Obesity-Related Cancer Biomarkers And In Vitro Cancer Cell Growth, Maria Azrad
The Effects Of Weight Reduction On Obesity-Related Cancer Biomarkers And In Vitro Cancer Cell Growth, Maria Azrad
All ETDs from UAB
Obesity increases the risk for breast and endometrial cancers while weight loss reduces the risk for these cancers. One aim of this dissertation was to determine the effects of weight loss from an overweight state [body mass index (BMI) 27-30] to a normal weight state on several obesity-related cancer biomarkers in African-American (AA) and European-American (EA) premenopausal women. We also sought to determine whether the method of weight loss, caloric restriction alone (CR) or combined with exercise resulted in similar changes in cancer biomarkers. The biomarkers of interest were urinary estrogen metabolites, and serum adiponectin, leptin, insulin-like growth factor (IGF)-1, …
Characteristics Of Fundraising For Nonprofit Hospital Organizations, Cathleen Owens Erwin
Characteristics Of Fundraising For Nonprofit Hospital Organizations, Cathleen Owens Erwin
All ETDs from UAB
This study addresses a gap that has been noted in the charitable fundraising literature, which is a scarcity of theoretically-based studies of fundraising by nonprofit organizations and the need to study fundraising within sub-sectors of organizations rather than the full nonprofit sector. The study uses institutional theory and strategic management constructs to examine the characteristics of the fundraising operations of nonprofit organizations. A categorization scheme is created based on nonprofit organizational effectiveness and performance characteristics to analyze fundraising by nonprofit hospital organizations as an organizational field. The categorization scheme identifies distinct clusters of organizations that are then investigated to determine …
Maternal Gestational Glucose Concentration And Offspring Body Composition, Insulin Sensitivity, And Ss-Cell Function, Nikki C. Bush
Maternal Gestational Glucose Concentration And Offspring Body Composition, Insulin Sensitivity, And Ss-Cell Function, Nikki C. Bush
All ETDs from UAB
Background: Evidence suggests that intrauterine exposure to elevated glucose concentrations may be a mediating factor in prenatal programming of offspring disease risk. However, studies examining the effects of maternal glucose concentration on measures of body composition, insulin sensitivity, and ß-cell response in prepubertal children are limited. Therefore, the objective of this study was to determine the associations of maternal glucose concentration with children's fat mass, insulin sensitivity, and ß-cell response using robust and physiologic measures. Methods: Participants were 40 children aged 5-10 years. Children's insulin sensitivity index (SI) and measures of basal, static, dynamic, and total ß-cell response were determined …
Contributions Of The Atrial Natriuretic Peptide Gene System To The Relationship Between Pediatric Body Fat, Free Fatty Acids, And Blood Pressure, Amanda Willig
All ETDs from UAB
Elevated blood pressure and nonesterified fatty acids (NEFA) in children can lead to increased chronic disease risk during adulthood. The atrial natriuretic peptide precursor A (NPPA) and natiuretic peptide receptor A (NPR1) genes encode for atrial natriuretic peptide (ANP) and its cell receptor, respectively, and may influence levels of blood pressure and NEFA. Additionally, it is unclear how body composition, physical activity, physical fitness, and racial genetic ancestry influence pediatric NEFA and blood pressure. In order to understand the associations among these factors, five investigations were performed. For experimental aim 1, the association between blood pressure and body composition measures …
An Assessment Of The Factors That Affect The Self-Care Behaviors Of Diabetics, Gregory Ellis
An Assessment Of The Factors That Affect The Self-Care Behaviors Of Diabetics, Gregory Ellis
All ETDs from UAB
various heteroskedastic analysis of covariance (ANCOVA) models with orthogonal
Information Technology And Quality Of Care In Pediatric Hospitals, Gouri Gupte
Information Technology And Quality Of Care In Pediatric Hospitals, Gouri Gupte
All ETDs from UAB
The purpose of this dissertation is to examine the relationship between the adoption of information technology by pediatric hospitals and performance on several quality of care measures. This research is aimed at addressing a gap in literature by utilizing a relatively large sample size that examines health information technology adoption across institutions and utilizes validated quality indicators from Agency for Healthcare Research and Quality. The Donabedian evaluation model that encompasses "structure, process, and outcomes" provides the conceptual framework for the organization of this research, selection of variables, and analysis. Three secondary datasets were used, 2005 Information Technology Survey of the …
The Impact Of Ehr Systems On Physician Productivity And Performance, Anantachai Panjamapirom
The Impact Of Ehr Systems On Physician Productivity And Performance, Anantachai Panjamapirom
All ETDs from UAB
This study examines the relationship between electronic health record (EHR) adoption and physicians' operational productivity and financial performance. The resource-based view of the firm (RBV) was utilized as a theoretical framework to develop and address four hypotheses. Specifically, the first two hypotheses address the impact of EHR adoption status (i.e., electronic- vs. paper-based medical records), and the other two hypotheses focus on the length of EHR adoption (i.e., years of EHR adoption). This cross- sectional study used secondary data from the 2008 physician compensation and production survey conducted by the Medical Group Management Association (MGMA). Multiple linear regression analysis was …
A System Genetics Analysis Of Energy Metabolism Traits In Drosophila Melanogaster, Patricia Paola Jumbo-Lucioni
A System Genetics Analysis Of Energy Metabolism Traits In Drosophila Melanogaster, Patricia Paola Jumbo-Lucioni
All ETDs from UAB
Obesity is emerging as a global public health problem and it has shown to precede and predict the development of type 2 diabetes, a complex disease that has also reached epidemic proportions in the US and worldwide. Despite that obesity-related traits are highly heritable, the genetic basis underlying their natural variation and the loci playing pleiotropic roles among organismal traits have not been fully elucidated. The overall goals of these present studies were: to shed light on the architecture of the genetic co-expression networks regulating variations in obesity-related traits, elucidate the extent to which they are regulated by pleiotropic loci, …
The Antecedents And Consequences Of The Niche Approach To Healthcare Delivery, Lejon Poole
The Antecedents And Consequences Of The Niche Approach To Healthcare Delivery, Lejon Poole
All ETDs from UAB
ABSTRACT OBJECTIVE: Niche hospitals represent a growing segment in the health care industry. A niche strategy is an approach that focuses on a narrow market segment that its resources and capabilities can exploit (Porter, 1980; Powers and Khan, 2004). The purpose of the proposed study was to provide an understanding of the antecedents and consequences of the niche approach to healthcare delivery. The interaction of the niche strategy and the physician-owner as a unique bundle of resources was also examined. The subsequent model tested the relationships among generic strategies, market effects, firm effects, and financial performance. RESEARCH DESIGN AND METHODS: …
Impact Of An Electronic Medical Record On Adherence To Current Diabetes Guidelines In A Family Medicine Center, Thomas Macandrew English
Impact Of An Electronic Medical Record On Adherence To Current Diabetes Guidelines In A Family Medicine Center, Thomas Macandrew English
All ETDs from UAB
OBJECTIVE: Extensive research shows that diabetic care often falls below recommended guidelines. Many believe that Electronic Medical Records (EMR) have the ability to improve quality of care. The primary goal of this study is to evaluate the changes in diabetic care and outcomes pre and post EMR implementation. RESEARCH DESIGN AND METHODS: The study took place at the UAB Huntsville Family Medicine Center. A retrospective chart review was conducted in order to determine the impact of an EMR on diabetes care. This is a natural experiment that uses a pre post model in order to determine impact. Generalized Estimating Equations …
The Effects Of Maternal Prenatal Insults On The Bmi Growth Trajectory Of Children Between The Ages Of 5-12 Years, Anthony Goudie
The Effects Of Maternal Prenatal Insults On The Bmi Growth Trajectory Of Children Between The Ages Of 5-12 Years, Anthony Goudie
All ETDs from UAB
The level of childhood obesity in the United States is at epidemic proportions. Most population studies looking at the factors contributing to childhood obesity focus on obesity as a dichotomous outcome. The purpose of this study is to test for the effects of maternal prenatal insult behaviors on the growth trajectory of a sample of children 5-12 years of age in the United States. This is the first known study to use a latent growth curve model and a cohort-concurrent analytical design to test the association between maternal prenatal insult behaviors and the annual longitudinal increase in body mass index …
Lipomatous Tissue: Variation In Treatment Procedures, Comorbidities, And Outcomes, Theresa L. Keel
Lipomatous Tissue: Variation In Treatment Procedures, Comorbidities, And Outcomes, Theresa L. Keel
All ETDs from UAB
Benign lipomas are the most common soft tissue tumors. They exhibit great variation in severity and are associated with significant comorbidity. Advanced understanding of genetic and morphological aspects of benign lesions has revealed unexpected similarities to malignant lesions, but little work has addressed variation among benign lesions. There is a need for better understanding of the effects of variation in lipomas on comorbidity, treatment, and outcomes. Improved knowledge of the effects will clarify the extent of the health and economic burden that severe forms of benign lipomas present to patients and society and may add to understanding of malignant lesions. …
Determinants Of Hospital Affiliation With Health Care Networks, Ting-Huan Chang
Determinants Of Hospital Affiliation With Health Care Networks, Ting-Huan Chang
All ETDs from UAB
Since the 1990s, integrated health care delivery systems have proliferated rapidly in the U.S., but little research has been devoted to studying why hospitals decide to join such systems (e.g., health care networks or systems). The aim of this study was to identify environmental and organizational factors that encourage freestanding hospitals to affiliate with health care networks. Specifically, the relationships of hospital affiliation choice to environmental munificence, environmental uncertainty and organizational resources were examined. Additionally, the moderating effects of hospital setting on these relationships were also investigated. A nonexperimental, longitudinal design was used, with the individual hospital as the unit …
Factors Influencing The Adoption Of Administrative Innovations, Tom J. Sanders
Factors Influencing The Adoption Of Administrative Innovations, Tom J. Sanders
All ETDs from UAB
The purpose of this dissertation was to investigate the influence of selected environmental and organizational factors on the adoption of administrative innovations in order to better understand strategic adaptation by organizations. General systems theory, various organizational theories, strategic adaptation and management theories, and adoption and diffusion of innovation literature were used to develop a theoretical framework to address four primary and sixteen secondary hypotheses. The administrative innovation used for this study was the magnet hospital concept for enhancing attraction and retention of registered nurses in order to address a persistent workforce shortage in U.S. hospitals. Secondary data related to U.S. …
Importance Of Trnalys,3 Structure And Use In Gag Translation For Primer Selection Required For Replication Of Human Immunodeficiency Virus Type I, Wanfeng Yu
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The features of tRNALys,3 that dictate why human immunodeficiency virus exclu-sively selects this tRNA as the primer for initiation of reverse transcription is unknown. The post-transcriptional modification at nucleotide 58 in the TΨC stem-loop could play a role during plus-strand synthesis to stop reverse transcriptase from re-copying the tRNA primer. Nucleotides 53 and 54 within the TΨC stem loop of the tRNA have been shown to be important to form the complex between tRNA and the HIV-1 viral genome during initiation of reverse transcription. To further delineate the features of the TΨC stem loop in tRNALys,3 in reverse transcription, we …
Insulin Dynamics In African Americans And European Americans: Mechanistic Aspects, And Association With Inflammation, Radhika P. Phadke
Insulin Dynamics In African Americans And European Americans: Mechanistic Aspects, And Association With Inflammation, Radhika P. Phadke
All ETDs from UAB
Identification and characterization of ethnic differences in insulin dynamics, insulin sensitivity (SI), and inflammation may shed light on the greater risk for type 2 diabetes in African Americans (AA), relative to European Americans (EA). Ideally, such studies should take into account the potential confounding roles of adiposity, fat distribution, genetic background, and socioeconomic status (SES). The objectives of this study were, 1) to evaluate ethnic differences in insulin dynamics in AA and EA children and adults using robust measures of insulin secretion and clearance; 2) to identify the contributions of genetic admixture and SES to insulin dynamics; 3) to examine …
Ethnic Differences In Markers Of Inflammation With Weight Loss, Tanya C. Hyatt
Ethnic Differences In Markers Of Inflammation With Weight Loss, Tanya C. Hyatt
All ETDs from UAB
Chronic diseases such as type 2 Diabetes Mellitis (T2DM) and cardiovascular disease (CVD) are accompanied by chronic low-grade systemic inflammation and are related to obesity and ethnicity. For instance, African-Americans (AA) have increased risk for developing T2DM and are more likely to be overweight relative to Caucasians (C). However, C have more intra-abdominal adipose tissue (IAAT) and have higher risk for CVD than AA. The influence that ethnicity has on disease risk is obscured by ethnic differences in fat distribution and sensitivity to insulin. Ethnic differences in markers of inflammation (MOI) have not been investigated. It is also unclear if …