Medical Humanities Commons^™

The Medicalisation Of Gender Nonconformity Through Language: A Keywords Analysis, Angelo Cosma Galluzzo

sprinkle: an undergraduate journal of feminist and queer studies

Language is an important part of the way gender nonconformity is legislated and medicalised. In 2012, the American Psychiatric Association (APA) changed the nomenclature of the ‘gender identity disorder’ (GID) to ‘gender dysphoria in the ‘Diagnostic and Statistical Manual of Mental Disorders (DSM) to reduce the social stigma attached to transgender identities. While the recognition of gender nonconformity by the medical authorities has led to some beneficial consequences, scholars have shown that the language of pathology has narrowed the definitions of gender nonconformity and has created social stigma. I use the web pages of five major health providers of English-speaking …

The Effect Of Medicaid Expansion On Hospitals Allowance For Bad Debt, Tara B. Dixon

All ETDs from UAB

The management of bad debt is a complex issue for hospitals, and if mismanaged, can impact the organization's current and future financial stability. The expansion of Medicaid through the Patient and Affordable Care Act (ACA) was expected to lessen the bad debt reported by hospitals by increasing the number of insured lives. Hospital managers understand that a certain percentage from the accounts receivables will end up being uncollectable; however, strategically planning for bad debt and estimating a more accurate allowance requires a specific level of strategic planning. Allowance for bad debt should not be a guessing game but should be …

Pain-Related Injustice Appraisal And Chronic Low Back Pain Among Arabs In The United States, Albatool Homoud Alnojeidi

All ETDs from UAB

Pain-related injustice appraisal has emerged as a psychosocial predictor of deleterious chronic low back pain (CLBP) outcomes. The appraisal is defined as the individual’s perception regarding the magnitude and irreparability of pain-related loss and suffering, externalized blame, and unfairness. Research in diverse samples revealed racial differences in pain-related injustice appraisal, suggesting that it may reflect broader racial/ethnic, sociocultural, and socioeconomic factors. This agrees with theories recognizing the role of ethnic and cultural characteristics in ethnic minorities’ health. Despite global data showing that Arabs represent the population with the second-highest prevalence of CLBP worldwide, a reliable characterization of CLBP among Arabs …

The Assessment Of Neuro-Mechanics Of Inspiratory Muscles During Mechanical Ventilation, Hassan Y. Abunurah

All ETDs from UAB

The decline in inspiratory muscles function for patients undergoing mechanical ventilation may further extend the duration of mechanical ventilation leading to lethal complications. Thus, the assessment of neuro-mechanics of inspiratory muscles may help us understand the pathophysiology for mechanical ventilation failure to avoid its complications. In this dissertation, we assessed the characteristics of inspiratory neuromechanics under different conditions. This dissertation is reported in three different papers. In the first paper, we sought to assess the quality of the available literate that used surface EMG of extra-diaphragmatic muscles during invasive mechanical ventilation. We demonstrated that the use of sEMG of extra-diaphragmatic …

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

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 …

Rural And Urban Differences In Vegetable And Fruit Consumption Among Older Cancer Survivors In The Deep South: An Exploratory Cross-Sectional Study, Harleen Kaur

All ETDs from UAB

Background: Rural Americans have poorer overall health and physical functioning than their urban counterparts. A varied diet, rich in vegetable and fruit (V&F) consumption may improve health; however, little is known about rural-urban differences in V&F consumption, especially in older cancer survivors. Objective: To assess differences in V&F consumption among older cancer survivors residing in urban- and rural-designated areas, and explore whether differences exist by sex, race, and cancer type. Design: This was a cross-sectional secondary analysis. Participants/setting: Screening data from the Harvest for Health trial was obtained on 731 Medicare-eligible cancer survivors across Alabama. Main outcome measures: V&F consumption …

Service Profiles In Substance Use Disorder Treatment: The Role Of Institutional And Organizational Factors, Reena Joseph Kelly

All ETDs from UAB

Substance use disorders (SUDs) are a growing crisis globally and in the US, and place an enormous health, social, and financial burden on the nation. To address the complex nature of SUDs, treatment typically involves a combination of different types of services to address the medical, behavioral and social needs of the patient and care is often delivered by specialized SUD treatment facilities. Despite recommendations for a broad suite of services, individual facilities vary in the specific services that they offer. This study examined whether and why systematic differences exist between treatment facilities based on their service mix and whether …

Actual And Perceived Balance Abilities While Performing Tasks That Challenge Balance In Older Adults And Individuals With Parkinson's Disease., Jutaluk Kongsuk

All ETDs from UAB

Walking is a fundamental activity for one to interact effectively with one’s environment. Walking in the community often requires both a wide range and constant modification of walking speed. Decreased walking capacity, that is the maximum speed that a person can physically achieve, results in a decline in both functional mobility and personal independence, contributing to decreased community participation among individuals whose walking is impaired. The most common test of walking speed (i.e., overground comfortable and maximum walking speed) may not reflect the full capacity of individuals to regulate gait control. Whereas walking with progressively increasing treadmill speeds allows researchers …

The Association Between Medicaid Expansion, Medicaid Disproportionate Share Payments And The Financial Performance Of Safety Net Hospitals, Jon Law

All ETDs from UAB

Safety Net Hospitals (SNHs) provide necessary emergency and acute care to all individuals, regardless of their ability to pay for health care. Medicaid Expansion and Disproportionate Share (DSH) payments are two Medicaid programs that may mitigate the financial vulnerability of SNH’s. Some assert that Medicaid Expansion, as part of the Patient and Affordable Care Act (ACA), may provide financial relief for SNHs. It offers payment mechanisms for millions of uninsured individuals. DSH expenditures per capita for each state vary widely. There is some likelihood that SNHs in some states may benefit greater than others. The study was framed within the …

Value Analysis Of Electronic Health Records, Shikha Shah Modi

All ETDs from UAB

The Electronic Health Record (EHR) is defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (HIMSS, 2011). EHRs have become an important part of the current health system as a result of government regulations, technology advancements, health care challenges, and market conditions. EHRs are considered an expensive investment; however, the complexity of adopting and implementing EHRs also demands attention. Given the complexity of health information technology (HIT) systems and the hefty investment that is required in the adoption of EHRs, a return on investment is expected, and it …

Is There A Relationship Between Leadership Characteristics And Services Provided Among Ihs Urban Indian Health Programs?, George Grant Tribble

All ETDs from UAB

IS THERE A RELATIONSHIP BETWEEN LEADERSHIP CHARACTERISTICS AND SERVICES PROVIDED AMONG IHS URBAN INDIAN HEALTH PROGRAMS?GEORGE G. TRIBBLE HEALTHCARE LEADERSHIP ABSTRACT The Native American population has faced and been impacted by a wide range of actions throughout the last few hundred years. The loss of cultural norms and way of life continues to manifest itself through various socioeconomic concerns. At the center of the Native American leadership model is a disciplined and culturally specific guidance structure. The Urban Indian Health Program (UIHP) was created by the Indian Health Service to establish a culturally appropriate health care delivery model for Native …

Disrupting The Perioperative Opioid Gateway: Identification Of Risk Factors For New Persistent Post-Surgical Opioid Use, Gia Marie Pittet

All ETDs from UAB

A large portion of the American Opioid Crisis is due to opioid naïve patients who become new persistent post-surgical opioid users, although the risk factors for the development of this addiction are not well studied. The objective of this study was to analyze multiple layers of pre-operative and procedural risk factors using an ecological perspective theoretical framework in adult patients undergoing invasive surgery. We performed a retrospective analysis of 13,970 opioid naïve adults in a mixed surgical cohort with data available at the University of California Los Angeles that was merged with narcotics data for the State of California (IRB#19-000625). …

Identifying Factors To Inform The Development Of Adaptive Interventions For Increasing Physical Activity Behavior Among People With Multiple Schlerosis, Yumi Kim

All ETDs from UAB

People with multiple sclerosis (MS) can benefit from physical activity, specifically exercise, for the management of disease symptoms, including walking impairments, fatigue, and depression, and improvements in quality of life. However, people with MS do not engage in adequate amounts of physical activity for the accrual of health benefits. Researchers have focused on the delivery of exercise training and behavioral interventions to improve levels of physical activity in MS. To date, there is an emerging body of research supporting the efficacy of these interventions for increasing and potentially sustaining physical activity behavior in people with MS. Yet, people with MS …

The Role Of Obesity, Gdm, And Lifestyle Factors On Metabolic Syndrome Scores In Mothers And Their Children 4-10 Years After Pregnancy, Makenzie Callahan

All ETDs from UAB

Metabolic syndrome (MetS) is a cluster of symptoms that increase risk for heart disease and type 2 diabetes. Therefore, early detection of MetS is vital for disease prevention. Gestational diabetes (GDM) and/or obesity during pregnancy are associated with a greater risk for MetS in mothers and their children compared to mothers with no GDM. However, little is known about how much a GDM history or in utero exposure to maternal GDM contributes to MetS risk years after that pregnancy in addition to risk attributable to obesity itself. Therefore, the overall objective of this dissertation was explore how a history of …

Do Outcomes From A Behavioral Weight Loss Intervention Differ In Alabama Vs Colorado?, Julianne Clina

All ETDs from UAB

There are well-established regional differences in obesity prevalence in the U.S., but relatively little is known about whether these differences impact efforts for weight loss. The objective of the study was to determine whether changes in body weight, engagement in physical activity (PA), and psychosocial factors differed in Colorado (CO) vs Alabama (AL) in response to a 16 week standardized behavioral weight management program. We hypothesized that weight loss would be greater in Colorado due to a more favorable physical and social environment.This is an ancillary study to a weight loss intervention being conducted simultaneously in AL and CO with …

Central Vestibular Integration In Concussion And Multiple Sclerosis, Graham Dean Cochrane

All ETDs from UAB

Dizziness and imbalance are commonly reported by people with concussion and people with multiple sclerosis (MS). Dysfunction of the vestibular system is likely a major cause of dizziness and imbalance in both diseases, but it is not well understood whether this dysfunction typically occurs in peripheral vestibular organs and pathways or higher-level central vestibular integration pathways. As these systems are assessed and targeted with rehabilitation differently, understanding how both are affected in these diseases will improve management of dizziness and imbalance. In addition, balance has been demonstrated to correlate with self-reported fatigue in people with MS, presumably through shared dysfunction …

Race, Feeding Practices And Infant Weight Gain During The First 6 Weeks Of Life, Alysha Breanne Everett

All ETDs from UAB

Background: Non-Hispanic black (NHB) infants are disproportionately affected by rapid weight gain compared to non-Hispanic white (NHW) infants, which in turn, is associated with future disparities including obesity and cardiometabolic disease. Feeding practices, such as the use of formula or bottles, differ by race and are associated with rate of weight gain. Data from the Pregnancy and Early Life in the South (PEARLS) birth-cohort study was used to test the hypotheses that change in body weight and weight-for-age z-scores (WAZ) from birth to 6 weeks would be greater for (1) NHB versus NHW infants; and (2) infants fed formula (exclusively …

Does Interdisciplinary Care Team Care Management Improve Health Quality And Demonstrate Cost Effectiveness?, F Cardwell Feagin

All ETDs from UAB

The U. S. healthcare system faces unsustainable rising healthcare costs. Health care cost as a percentage of gross domestic product is expected to rise to 19.4 percent by 2027 (Wilson, 2019). This unstainable rise in healthcare costs is creating a problem for consumers of healthcare. By 2030, the average annual healthcare spending per working household, including premium and out-of-pocket expenditures, is estimated to be 33.9 percent of median compensation (Girod et al., 2016). Also, lawmakers and policymakers face funding issues of healthcare. A key finding of this study is that field-based interdisciplinary care team care management, with an algorithm selecting …

Financial Performance Of Participating Hospitals In Accountable Care Organizations, Abdulrhman Alzhrani

All ETDs from UAB

The study examines the influence of accountable care organizations ACO participation on hospital financial performance. It poses two research questions: 1) how does ACO participation influence hospital financial performance? 2) How do organizational factors- hospital size, electronic health records (EHR) utilization, and ambulatory services- moderate the relationship between hospital ACO participation and financial performance? The study used longitudinal sample of general and surgical hospitals operating in United States from 2009 to 2017. The data were obtained from several sources including American Hospital Association (AHA), AHA survey of care system and payment, hospital cost reports, AHA information technology and Area Health …

Perception Of Stakeholders On Current Perfusion Education In Malaysia, Rafiq Sumardi Omar

Student Works (2020-2029)

Perfusionist is known as a certified medical technician liable for extracorporeal oxygenation of the blood during open-heart surgery. Current curriculum is believed to be at par and is aligned with the National Occupational Skills Standard, however, the scope of perfusion practice keeps changing with the advancement of technology and procedures, and there is a demand for specialty area such as extracorporeal membrane oxygenation (ECMO). Therefore, current curriculum should be re-evaluated by taking consideration from multiple stakeholders’ perception on current needs, content, educational strategies, teaching methods, assessment methods, and curriculum management. Hence, this study aimed to explore perception of stakeholders in …

Self-Directed Learning Readiness Of Recent Medical Graduates, Mohamad Nabil Mohd Noor

Student Works (2020-2029)

Self-directed learning occurs when teachers empower learners to take control of their learning. This method has been highlighted in medical education to promote lifelong learning for physicians to adapt to the ever-changing field of medicine. Past researchers have focused on undergraduate medical students' self-directed learning readiness and suggested further studies for the population after graduation. The present study aims to measure the level of self-directed learning readiness amongst recent medical graduates in Malaysia. 371 Malaysian doctors who recently graduated within the past 18 months participated in this study and completed Guglielmino’s Self-Directed Learning Readiness Scale. Mean score was computed to …

Revealing Meaning From Story: The Application Of Narrative Inquiry To Explore The Factors That Influence Decision Making In Relation To The Withdrawal Of Life-Sustaining Treatment In The Intensive Care Unit, Fiona Foxall, Deborah Sundin, Amanda Towell-Barnard Phd, Mnursing, Beverly Ewens, Vivien Kemp, Davina Porock

Research outputs 2014 to 2021

This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive sample of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story; the focus of analysis is the story, with the story …

Investigating The Development Of Perceptions And Behavioural Intentions Towards People Living With Hiv (Plhiv) Among Pre-Clinical Medical Students In The University Of Malaya, Calvin Christopher Willims Fernandez

Student Works (2020-2029)

Since the beginning of the HIV/AIDS epidemic in the 1980s, there has been a high prevalence of stigma and discrimination towards people living with HIV (PLHIV). They manifest in people’s attitudes and behaviour, and in various contexts including education, employment and healthcare. For the latter specifically, stigma-driven behaviours by healthcare practitioners have resulted in poorer health outcomes for PLHIV, where they are humiliated, isolated and in some cases, even refused treatment. This subsequently leads to an increase in mental health issues and other damaging health behaviours among PLHIV. Numerous studies have explored the manifestation of these stigmatizing attitudes and behaviours …

How Does Direct Volunteering Affect The Onset Of Alzheimer’S Dementia In Elderly Patients With Preexisting Cardiac Comorbidities?, Sneha R. Gade

Undergraduate Research Posters

Alzheimer's Dementia is a disease that affects memory, thinking, and behavior. The Alzheimer's Association reported Alzheimer's as the sixth-leading cause of death in the United States, and a cure does not exist. Donepezil, a cholinesterase inhibitor drug, is frequently prescribed to treat Alzheimer's disease. Still, patients must continuously take the medication for years to receive any measurable improvement in quality of life after developing Alzheimer's Dementia. Further, research shows prolonged use of Donepezil can lead to other health problems, such as QTc prolongation, for cardiac disease patients. Therefore, the effectiveness of non-drug interventions, such as volunteering to prevent the disease's …

We’Re All On This Spaceship Earth, Nancy Si

HCA Healthcare Journal of Medicine

The photo features the geodesic sphere at Epcot, Disney World in Orlando, FL. Inside the dome, there was an iconic ride called “Spaceship Earth”, which has since been shut down for refurbishment. This photo was taken November 2019, approximately 6 months before it was shut down. Much like how the ride emphasized the progress that human civilization has made in the last several hundred years and hopes to make in years to come, the current pandemic has shown us how far we have come in the medicine and other STEM fields. We hope only to do better and be better …

Still Learning: Covid Through The Eyes Of A Medical Student, Alexis Strahan

HCA Healthcare Journal of Medicine

As a first-year medical student when the COVID-19 pandemic found a foothold, I felt an overwhelming amount of emotions that accompanied the pandemic’s spread. Fear, although a reasonable choice, was not the first emotion that I experienced. In fact, it was a general feeling of paralysis. I had not six months prior taken an oath to commit my career and life to the service of the public’s health care needs, yet I could provide little more than the textbook knowledge of biochemistry or genetics from my first semester of learning. My hands felt unarmed and unskilled for the fight. What …

Cultural Competency Training For U.S. Army Security Force Assistance Brigade (Sfab) Brigade Medical Teams, Jacob Blount

Doctor of Nursing Practice Projects

The United States Army began standing up Security Force Assistance Brigades (SFAB) in February 2018. The Brigade Medical Team (BMT) is an 11-person, interdisciplinary Army National Guard team. National Guard Soldiers only have one weekend per month and two weeks of annual training per year to develop/maintain cultural competence. The researcher investigated the efficacy of the Cross-Cultural Competence Trainer (3CT) V2 course to develop and maintain cultural competency in BMT personnel. Pre-test results were obtained from three military medical personnel and a post-test immediately after the course. Participants completed a longitudinal test 28-31 days after the post-test. There was a …

The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz

Journal of Wellness

Introduction: Second Victim Syndrome (SVS) describes the phenomenon in which a caregiver experiences a traumatic psychological and emotional response to an adverse patient event or medical error. Using quantitative survey analysis, we aim to better understand the personal factors that affect SVS development and recovery.

Methods: Caregivers at a small urban academic medical center who had experienced an adverse patient event in the past six months were invited to take part in this institution-wide, voluntary, quantitative, cross-sectional study. Three surveys were administered; the Holmes-Rahe Life Stress Inventory (HRLSI) was used as a surrogate to measure stressful life events. The …

The Ethical Accountability Of Organizational Leadership To Communities Of Stakeholders In Healthcare, Lisa Martinelli

Electronic Theses and Dissertations

ABSTRACT

THE ETHICAL ACCOUNTABILITY OF ORGANIZATIONAL LEADERSHIP TO COMMUNITIES OF STAKEHOLDERS IN HEALTHCARE

By

Lisa A. Martinelli, JD, MA

October 2020

Dissertation supervised by Professor Gerard Magill

While much is written on organizational ethics in healthcare, this dissertation uniquely links organizational ethics and stakeholder theory to the ethical accountability of leadership to their distinct, vulnerable stakeholder communities. It does so by examining the healthcare organization’s moral agency in relation to stakeholder theory and applies those considerations to three major stakeholder categories: confidentiality and privacy of healthcare information, research and attention to specific pediatric populations, and ethics of care concerning the …