Medical Humanities Commons^™

A Multilevel Perspective On Health Information Exchange, Claudia Guerrazzi

All ETDs from UAB

As the health care sector faces pressure to improve quality and contain costs, sharing information among the various care providers will become an essential practice among health care providers. Many countries are now adopting policies to foster Health Information Exchange (HIE), which is defined as the electronic transfer of data or information among health care organizations involved in the delivery of care. The literature about HIE reports contradictory evidence about the adoption and the use of HIE and more research is needed to understand this complex phenomenon. Specifically, HIE is a complex phenomenon that produces outcomes at different levels and …

Hospital Purchasing Alliance: Contextual Factors And Financial Performance, William Opoku-Agyeman Opoku-Agyeman

All ETDs from UAB

Collectively, the purpose of the three papers included in this dissertation was to provide empirical evidence on the contextual factors that influence hospital utilization of services of group purchasing organizations and how utilization of group purchasing organizations impacts hospitals’ financial performance. The findings of these studies are important both to researchers and to managers as it sheds light on the relationship between hospitals and group purchasing organizations. The results of this dissertation suggest that better financial performance is associated with hospital utilization of group purchasing organizations. Additionally, some measures of environmental munificence and dynamism are associated with hospital utilization of …

The Dietary Context Of Nut Intake Among Overweight And Obese African-American Women Living In The Rural South: An Exploratory Study, Samara Sterling

All ETDs from UAB

Obesity has become a national epidemic over the last few decades, and lays its heaviest burden on certain populations (eg, rural residents, African-Americans, and African-American women in the Southeast). Obesity increases medical costs substantially, and is a significant risk factor for various chronic conditions, including certain cancers. There is a need to identify specific dietary behaviors that may contribute to obesity and obesity-related cancers among African-American women in the rural South, and to recommend dietary modifications that may alleviate those risks. Previous research has shown that nuts offer numerous health benefits, including weight loss and cancer protection. More research is …

Motor Abilities And Social Participation In Young Children With Autism Spectrum Disorder, Jamie M. Holloway

All ETDs from UAB

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that primarily affects social communication and behavior, however, a number of motor impairments have been identified in children with ASD. In children who are typically developing, the development of social, communication, and cognitive skills is thought to be influenced by motor development. However, the impact of these motor skill deficits on overall development in children with ASD is not yet known. The purpose of this dissertation was to explore the relationship between gross motor ability and social function and participation in young children with ASD. The first study described changes in peer …

Medical Humanities: Using Medhum To Promote The Goal Of Professional Identity In Ume, Michael P.H. Stanley

MaineHealth Maine Medical Center

No abstract provided.

Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans

All ETDs from UAB

This three-paper dissertation sought to examine the existence of strategic groups in the home health industry, the application of Porter’s generic strategies (cost leader, differentiator, “stuck-in-the-middle” and both cost leader/differentiator) in identifying these groups, and the association of group membership with agency performance. The findings of this study will provide researchers and managers with a highlight of the current strategic makeup of the home health industry and its relationship with quality and financial performance. The results of this dissertation provide some evidence that strategic groups do exist in the home health industry and can be described along the basis of …

The Effectiveness Of Clinical Integration: The Relationship Between Evidence-Based Clinical Processes, In-Network Utilization And Clinical, Service And Efficiency Outcomes, Patrick D. Falvey

All ETDs from UAB

THE EFFECTIVENESS OF CLINICAL INTEGRATION: THE RELATIONSHIP BETWEEN EVIDENCE-BASED CLINICAL PROCESSES, IN-NETWORK UTILIZATION AND CLINICAL, SERVICE AND EFFICIENCY OUTCOMES PATRICK D. FALVEY EXECUTIVE DOCTORAL PROGRAM – SCHOOL OF HEALTH PROFESSIONS ABSTRACT The evolving U.S. health care system continues to steer healthcare organizations and integrated healthcare delivery networks (IDNs) to function as population health networks and ACOs. Policymakers, payers, health care leaders and consumer groups are advocating that IDNs clinically integrate processes and structures under the assumption that they will improve the clinical outcomes for a population, reduce the health care spend, and enhance the patient experience. Relatively little research has …

Increasing The Accessibility Of A Falls Prevention Intervention For Community-Dwelling Older Adults With Low Vision, Sarah Blaylock

All ETDs from UAB

Falls remain a costly problem as a leading cause of injuries and fatalities for individuals over the age of 65. Older adults with low vision, or non-correctable visual impairment, are estimated to be two times more likely to fall than those without vision loss. There appear to be limited falls prevention interventions available for older adults that have been tested on or designed specifically for individuals with visual impairment. The goals of this dissertation were to learn more about the availability of visually accessible falls prevention interventions and to develop an intervention that can be used with veterans receiving services …

Diabetes Risk In Women: Pschosocial And Lifestyle Determinants, Sarah Katherine Sweatt

All ETDs from UAB

Type 2 diabetes (T2D) is a major public health concern. Physical inactivity, poor diet, and psychosocial distress have emerged as factors contributing to T2D. Women may be uniquely affected by these factors as obesity, physical inactivity, and the prevalence of psychosocial distress are higher in women. Additionally, polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women and increases the risk of both T2D and psychosocial distress. However, the relationship between physical activity (PA), psychosocial distress, and metabolic health is not fully understood, particularly in at risk populations such as minorities and women with PCOS. Therefore, the goal …

Acute And Chronic Regulation Of Skeletal Muscle Mitochondrial Function, Jonathan Lund Warren

All ETDs from UAB

Obesity and type 2 diabetes (T2D) represent a growing global burden on healthcare and financial resources. One hypothesis for the onset and exacerbation of these diseases is related to the role of mitochondria as the end users of products of the metabolism of the nutrients we consume and in mediating the oxidative state of the body through the production of reactive oxygen species (ROS). In order to meet the demands of a metabolic challenge and prevent excessive ROS production, there appear to be adaptations to mitochondrial physiology and morphology that can occur and we hypothesize that the ability of the …

Teleexercise For People With Disabilities, Byron Lai

All ETDs from UAB

Exercise is recognized as a method of improving health and function and preventing deconditioning for adults with neurological disabilities. However, they experience a multitude of barriers that prevent them from regular participation in exercise. To address these barriers, the goal of this dissertation was to explore the use of monitoring technology as a means for delivering exercise to adults with neurological disabilities at home. This pursuit involved three studies. The first study reviewed the extant literature for current trends in exercise interventions for people with disabilities. Regarding technology, the review indicated that technology is rarely used to deliver one-on-on supervised …

Circulating Mirnas And Human Insulin Resistance, Elizabeth Ma

All ETDs from UAB

Insulin resistance (IR) is central to the pathophysiology of Type 2 diabetes (T2DM), and is a risk factor for cardiovascular disease. The mechanisms behind IR are not clear, but microRNA (miR; short, non-coding RNA strands that base-pair with mRNA to modify gene expression) have garnered interest as potential contributors. miRs have recently been shown to be detectable in the circulation, and can be taken up and regulate target genes within recipient cells. Our primary objective was to identify circulating miRs (c-miRs) that play a role in regulating systemic metabolism and participate in the pathophysiology of IR and cardiometabolic disease. Three …

The Effects Of Nurse-Manager Relationships And Nurse-Physician Collaboration On Nurse Intent To Leave, Phillip John Mazzuca

All ETDs from UAB

ABSTRACT Aim. The aim of this study was to determine whether two relational aspects of the nurse work environment – perceived quality of the nurse-supervisor relationship and nurse-physician collaboration – might reduce nurse intent to leave the hospital. Background. There is a documented global shortage of nurses which is a pressing issue in U.S. hospitals. The nursing shortage has been exacerbated by a high rate of voluntary nursing turnover in U.S. hospitals which is costly and has previously been found to negatively impact patient care. Factors associated with the nursing work environment have been found to be important predictors of …

Type I Myofiber Grouping: Myofiber Phenotype And Implications For Muscle Performance In Older Adults And Parkinson Disease, Kelley Grace Hammond

All ETDs from UAB

Neuromuscular morphology and function undergo changes with increasing age and Parkinson disease (PD) pathology. Motor unit reorganization occurs by denervation-reinnervation events which lead to diminishing random distribution of myofibers and type I myofiber grouping. Grouped type I myofibers maintain type II features such as hypertrophic capacity and myonuclear addition, sarco(endo)plasmic reticulum Ca2+ ATPase 1 expression, and lower capillarization. Though age-related type I myofiber grouping has been qualitatively described in the literature, this was the first study to characterize the phenotype of grouped type I myofibers in older adults. Furthermore, we identified a magnified degree of type I myofiber grouping in …

Behavioral Markers Of Supraspinal Pain In Clinically Relevant Models Of Spinal Cord Injury, Kathryn Yamamoto Henley

All ETDs from UAB

The majority of people suffering from neuropathic pain as a result of a spinal cord injury (SCI) do not experience effective pain relief with currently available therapeutics. One aspect of preclinical studies that may be limiting the development of successful analgesics is the assessment of pain in animal models of SCI. Previous work has relied primarily on withdrawal reflexes to indicate pain; however, there is evidence that suggests this is an inadequate measure of pain sensation as spinal reflexes do not reflect the supraspinal processing of nociceptive information. The use of withdrawal responses is especially challenging in the context of …

The Effect Of Cultural Competency Training Programs On Expatriate Nurses' Levels Of Cultural Competence In Saudi Arabia As Measured By The Inventory For Assessing The Process Of Cultural Competence (Iapcc-R), Naof Faiz Saleem Al-Ansary

All ETDs from UAB

The study examined the relationship between cultural competence training programs and the levels of cultural competence among expatriate nurses in Saudi Arabia. Cultural competence training programs are believed to increase the awareness of expatriate nurses in Saudi Arabia in regards to issues that might arise from cultural differences between patients and healthcare providers. Healthcare professionals, and healthcare organizations, emphasize the importance of culturally competent healthcare environments in providing optimum healthcare services to individuals from different cultural backgrounds. Findings from the study suggested that participation in cultural competency training is associated to higher cultural competency scores. Additionally, age was positively associated …

Die Genveränderung Von Embryonen Bürdet Kindern Eine Unzumutbare Last Auf, Hille Haker

Theology: Faculty Publications and Other Works

Die Forschung an menschlichen Embryonen unterliegt in den meisten Staaten einer besonderen Kontrolle, die auch in den bestehenden internationalen Rechtsinstrumenten festgelegt ist. Angesichts der nun möglichen Keimbahnveränderungen durch das sogenannte «Gene Editing» oder «Genome Editing» ist eine öffentliche Diskussion aber nicht nur dringend notwendig, sondern überfällig. Die Wissenschaftsethik muss dabei eine grössere Rolle spielen, als dies derzeit der Fall ist. Meine Überlegungen in diesem Artikel betreffen ausschliesslich die reproduktive Anwendung, die ich einer ethischen Analyse unterziehe. Darüber hinaus steht jedoch eine Diskussion auch zu den anderen Anwendungsfeldern aus, so etwa zur Embryonenforschung insgesamt und zur embryonalen Stammzellforschung, zum Einsatz des …

Propiedad Intelectual Y Acceso A Medicamentos: El Caso De Lopinavir/Ritonavir En Guatemala, Luis Pablo Méndez-Alburez, Alejandro Cerón

Anthropology: Faculty Scholarship

No abstract provided.

Cultural Sensitivity In Healthcare: The New Modern Day Medicine, Daniel Dell'osso

Senior Theses

In healthcare facilities there are many factors that contribute to overall equity, efficiency, and quality of care which if addressed properly can promote justice for all. Patients relying on healthcare facilities come from a variety of races, ethnicities, and cultures as are the employees who provide care for the patients. Diversity is very widespread within the healthcare environment and tolerance as well as acceptance of others is necessary in conducting smooth and efficient care. However, cultural sensitivity and competency seems to continue to be an issue that has been neglected and has severely negatively impacted healthcare centers and its surrounding …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

Providers’ Perspectives On Inbound Medical Tourism In Central America And The Caribbean: Factors Driving And Inhibiting Sector Development And Their Health Equity Implications, Rory Johnston, Valorie A. Crooks, Alejandro Cerón, Ronald Labonté, Jeremy Snyder, Emanuel O. Núñez, Walter G. Flores

Anthropology: Faculty Scholarship

Background

Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector.

Objective

To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications.

Design

In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade …

Medicine Outside The Clinic: The Growing Need For Physicians In Sexual Education Policy, Zachary Sanford

Marshall Journal of Medicine

Sex and sexuality are both topics of immense social and personal importance, owing their openness or constraint in large part to the society in which they are discussed. In homogenous groups it may be possible to reach firm consensus on what is, or is not, appropriate to consider a sexual norm and use an overarching set of religious or spiritual morals to reaffirm this decision. However, in western society and specifically in the United States, a theme of integration and amalgamation of wildly different cultures has presented an interesting case study in searching for common ground on basic social issues. …

I Am Their Kin, Nihit N. Mehta

Akesis

In trying to answer the question, “what consumes me,” I was reminded of a question, one that has been asked of me over these past few years: “What do you want to be when you grow up?” It’s a question that I’ve encountered many a times along this journey of life. Yet, when I recently encountered this question, my answer was like a clarion call to the recesses of this heart. “I want to be a pediatrician. I was a really sick child, so the way I see it, I’m their family member, helping my kin feel …

Overgrowth, Samantha Stephen

Akesis

I often find myself consumed by a desire to better myself and my work.

This is true for both school and my art. It can be tricky trying to find a balance between the two.

This is a 5"x5" black and white print taken with a Holga 120 CFN Camera.

Compassionate Touch, Riddhi Daftary, Jessfor Baugh

Akesis

Artist Alex Rheault approached the College of Dental Medicine in the fall of 2015 about collaborating for UNE Interprofessional Art Exhibition: Wonder. Rheault’s idea was to create an artwork informed by CDM faculty and students that would explore the fear and anxiety many people associate with dental care. The artist connected with students Jessfor Baugh and Riddhi Daftary. Through meetings emphasizing free-form discussion—with Rheault often drawing as a part of the idea exchange—an interdisciplinary collaboration was born.

Baugh and Daftary identified five stages associated with anxious and fearful dental patients: Listen to Identify, Validation, Everyone has a Story, …

Facets Of Pain, Samantha J. Shepard

Akesis

Facets of Pain

By Samantha Shepard

This painting is a depiction of the emotions evoked by my journey with chronic pain. In the fall of 2009, I experienced an injury leaving me disabled for four years, I lost many things that day including my so-called identity as a young able bodied person. Though my journey with chronic pain was arduous, and at times, seemed endless, I continued to walk along my path to recovery, and today I am a successful premedical student at the University of New England working to pursue an education in osteopathy.

I often describe chronic pain …

“That’S Enough Patients For Everyone!”: Local Stakeholders’ Views On Attracting Patients Into Barbados And Guatemala’S Emerging Medical Tourism Sectors, Jeremy Snyder, Valorie A. Crooks, Rory Johnston, Alejandro Cerón, Ronald Labonte

Anthropology: Faculty Scholarship

Background

Medical tourism has attracted considerable interest within the Latin American and Caribbean (LAC) region. Governments in the region tout the economic potential of treating foreign patients while several new private hospitals primarily target international patients. This analysis explores the perspectives of a range of medical tourism sector stakeholders in two LAC countries, Guatemala and Barbados, which are beginning to develop their medical tourism sectors. These perspectives provide insights into how beliefs about international patients are shaping the expanding regional interest in medical tourism.

Methods

Structured around the comparative case study methodology, semi-structured interviews were conducted with 50 medical tourism …

The Importance Of Nature: An Investigation On How Geography Influences Well-Being, Christina Cobb

Independent Study Project (ISP) Collection

The objective of this community service project (CSP) was to study how a community’s location, specifically within nature, influences their well-being. I hoped to see how the community’s location, within Chapada Diamantina national park, influences the many ways health is promoted, and how these ways are affected by their location within nature. This project was built upon a review of the literature, which found that there is a theoretical basis for the notion that contact with nature is beneficial, a term deemed Biophilia. There is a robust body of academic research that highlights the health benefits deriving from contact …

Financial Hardship From Purchasing Medications For Senior Citizens Before And After The Medicare Modernization Act Of 2003 And The Patient Protection And Affordable Care Act Of 2010: Findings From 1998, 2001, And 2015, Anthony W. Olson, Jon C. Schommer, David A. Mott, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: The Medicare Modernization Act of 2003 (Medicare Part D) added prescription drug coverage for senior citizens aged 65 years and older and applied managed care approaches to contain costs. The Patient Protection and Affordable Care Act of 2010 (ACA) had the goals of expanding health care insurance coverage and slowing growth in health care expenditures.

OBJECTIVES: To (a) describe the proportion of senior citizens who had prescription drug insurance coverage and the proportion who experienced financial hardship from purchasing medications in 2015, and (b) compare the findings with those collected in 1998 and 2001.

METHODS: Data were obtained in …

Pathways To Positive Change: A People's Perspective Of Healthcare In Humla, Wensday Meyers Berman

Independent Study Project (ISP) Collection

The villagers of Humla have suffered from unreliable health services and unjust indifference from the Nepali government for too long. Many global health initiatives and international NGOs have tried and failed to step in and make an improvement of health within these villages, because they are lacking an understanding of how these villages are run, what villagers prioritize, and how to continue providing reliable, supervised support. Because of the remoteness of the Humla area, it is difficult for allopathic medicine to be sufficiently provided here, and access to emergency medical resources are limited. Global health organizations such as WHO and …