Medical Humanities Commons^™

Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste

All ETDs from UAB

Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …

Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay

All ETDs from UAB

RURAL HOSPITAL CLOSURES IN ALABAMA: POST ACA DENNIS O. MCCAY HEALTH SERVICES ADMINISTRATION ABSTRACT Rural hospitals differ from their urban counterparts with regard to two main areas. First, rural hospital patients are usually older, of lower income, and less healthy than those in urban areas. Second, their facilities tend to be smaller, older, and more prone to staff shortages than those in an urban environment. Rural hospitals have been closing at higher rates than their urban counterparts for a number of years, but more so since the implementation of the Affordable Care Act in 2010. The objective of this research …

Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson

All ETDs from UAB

As life expectancy continues to increase and the number of elderly Americans rises, public health initiatives are seeking to identify modifiable risk factors to preserve cognitive function and increase quality of life in advanced ages. The primary objective of this dissertation was to investigate dietary patterns, carbohydrate consumption, and insulin resistance as modifiable risk factors that may contribute to the development of cognitive impairment and cognitive decline. Three separate studies were performed in the REasons for Geographic And Racial Differences in Stroke study, a prospective cohort containing 30,239 black and white participants. Cognitive impairment was defined using the Six-Item Screener. …

Correlating High Reliability Organization Practices With Preventable Harms Across Children’S Hospitals Participating In The Children’S Hospitals’ Solutions For Patient Safety Collaborative, Kelly H. Randall

All ETDs from UAB

Background: Despite significant effort, focus, and resources dedicated to reducing patient safety risk, the healthcare system continues to have high error rates. Approaches and strategies implemented to decrease human error have been marginally successful in achieving sustainable reduction in patient harm. Purpose: The purpose of this study was to examine the association between high reliability and patient safety outcomes by testing the following hypotheses: Organizations exhibiting more advanced high reliability practice will have fewer hospital acquired conditions (as defined by the Serious Harm Event Index (SHE) than organizations exhibiting less advanced high reliability practices; and organizations exhibiting more advanced high …

High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley

All ETDs from UAB

Calorie restriction (CR) reduces body weight (BW) and adiposity, but is often less than expected due to hypometabolism produced by reductions in lean body mass (LBM). A comparable energy deficit created by combining CR and exercise energy expenditure (EE) has been shown to attenuate the reduction in EE produced by CR. Continuous moderate-intensity training (MIT) is commonly used to sustain energy balance or expedite weight loss, but high-intensity interval training (HIIT) may produce greater results. The purpose of this investigation was to determine if HIIT preserves LBM and improves energy metabolism to a greater extent than MIT in the presence …

Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman

All ETDs from UAB

Hospitals operate in turbulent and complex environments with limited resources. Consequently, administrators need to understand how to best use resources and improve a hospital’s positioning in a market. Surgical services is a key operational activity for hospitals, thus, a better understanding of how these services are organized by hospitals likely has important implications for a hospital’s performance and potentially survival. Given the potential importance of surgical services to hospitals, the purpose of this study was three-fold. First, the study identified different surgical profiles of hospitals based on the type and volume of surgical services provided by hospitals. Second, the study …

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

Undergraduate Research Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …

Written On By Experience, Akesis Anonymous Author

Akesis

This poem is about a conversation I had with a friend about beginnings, and how any given experience has no intrinsic good or bad qualities, but rather holds whatever we imbibe it with.

What Is My Beginning?, Stephanie Braunthal

Akesis

I find that when we ask about beginnings, we are really asking about the present. How did a person come to be who he or she is today? As I try to answer this question about myself, I am finding it easier to express myself in diagrams (pen on scratch paper) than in words. Perhaps this is a product of being a medical student; or perhaps it is because beginnings are a complex amalgam of static forces and fluid experiences that cannot be expressed linearly through prose...Enjoy!

To Care Is To Treat, Himanshu Malhotra

Akesis

To Care is to Treat is a reflection of a few experiences from my second and third year that have inspired me to become a palliative care physician.

The Narrative Of My Childhood, Nihit N. Mehta

Akesis

I was a weak child from early on, never able to run or play as much as the other kids in my block. Each month I'd visit doctors, trying my best to recover from common colds and coughs. Luckily, all this changed as I matured and in a way I almost began living a "normal life".

However, when it came to deciding what I wanted to be as an adult, I remembered the sick kid I was and how my doctors were always there for me, helping me "find health." This made me realize that I too, could someday be …

The Descent Down The Step One Rabbit Hole, Katelyn A. Hanson

Akesis

At the start of my second year of medical school I was ecstatic to move away from the study of the normal, healthy human body and to begin to immerse myself in the complex mechanisms behind the pathophysiology of disease. I drew this illustration to connect aspects of my personality with the aspects of medicine I was most excited about exploring deeper. This image was drawn with permanent markers on the cover of a binder dedicated solely to preparing for the first part of the medical licensing exam; I looked at this drawing every day as I drove myself closer …

Laurie's Greenhouse, Elizabeth G. Mcandrew, Kelsey Albert

Akesis

Pottery by: Elizabeth McAndrew

Photography by: Kelsey Albert and Elizabeth McAndrew

Modeling: Laurie the Bird

Materials: Wheel thrown pottery - Cone 10 white clay and dipped glaze (cobalt blue and mossy green). Philodendron Heartleaf Plant. Laurie is a parrotlet, which is the second smallest species of parrot. Photo editing was done directly on the iPhone photo application.

This photo represents beginnings because it includes many elements of my life that I drew toward me in the year that I began my medical career. Living alone for the first time, I bought plants so that I wasn't the only living thing …

Beginnings, Nehal J. Shah

Akesis

The beginning of one thing signifies the end of another – for one to start, another must end. With that said, under karmic and Hindu belief, we are constantly in a cycle of beginnings, and endings, until we achieve “moksha” – true oneness with God. Furthermore, within each cycle, there are four stages of life that one hopes to go through, carrying out the ideal goals and progress of each existence. Therefore, this life ultimately is a new beginning to an old soul – a soul that has traveled and journeyed upon eons of time to find happiness, spirituality, completeness …

Beginnings: A Letter From The Editors, Akesis Editors

Akesis

The editors would like to welcome you to the inaugural issue of Akesis.

Street Drug Markets Beyond Favelas In Belo Horizonte, Brazil, Elenice De Souza Oliveira, Braulio Figueiredo Alves Silva, Marcos Oliveira Prates

Department of Justice Studies Faculty Scholarship and Creative Works

This study examines whether social disorganization mechanisms that explain clusters of street drug markets in socially disorganized neighborhoods in developed countries can also help explain geographical patterns of drug dealing across neighborhoods in Belo Horizonte, Brazil. Data for this study includes drug arrests from 2007 to 2011 and socio demographic data from the 2010 Census. To examine the influence of exploratory variables on drug market locations, the Negative Binominal regression model was used at two levels of analysis—the Belo Horizonte city center and other neighborhoods including favelas. The findings show that a high hot spot of street drug markets located …

The Transformative And Healing Powers Of Compassion, Forgiveness, And Wonder, Anna C. Eriksson-Marty

Senior Theses

Since time immemorial, humankind has struggled to coexist peacefully together. As human beings, we strive on our relationships with each other and, yet, with actions of hatred and prejudice, we seem to consistently destroy those very relationships we value so deeply. Our current society is plagued by fear, which seems to run more rampant now – more than ever – with assistance of our rapidly evolving communication technology. The question must be asked, “How can we end this madness and heal ourselves into a kinder and more fulfilling future?” By providing up-to-date scientific research on the human emotions of compassion, …

The Pedagogy Of Medical Humanities : Using Literature And The Visual Arts To Help Future Caregivers Maintain Their Compassion And Resilience., Lisa Higgins Shugoll

Electronic Theses and Dissertations

This dissertation argues that medical humanities education for students considering careers in healthcare should begin at the general undergraduate level and should have two primary objectives, (1) providing tools that will help students foster therapeutic, compassionate relationships with their patients, and (2) providing strategies that will help students maintain healthy habits of mind that afford resilience against compassion fatigue. I assert that in order for students to practice compassion for themselves and others three core objectives must be met. (1) Students must be exposed to the fundamentals of bioethics in order to understand the virtue of compassion itself, (2) they …

Maternal Intuition Of Fetal Gender, Michael P. Mcfadzen, David P. Dielentheis, Ronda Kasten

Journal of Patient-Centered Research and Reviews

Background: Many pregnant mothers feel they have a perception or intuition as to the gender of their unborn baby. There is very little published scientific literature regarding this topic. The study’s goal is to determine accuracy of mothers’ perceptions as to gender of their unborn babies. Many scientists believe a pregnant woman could not determine her baby’s gender by intuition, with a 50% probability of correctly determining the gender. This study should be considered fun science.

Purpose: To objectively measure a pregnant mother’s perception as to the gender of her unborn baby and compare to sonographically proved gender. The study …

Incidence Of Breast, Colorectal And Lung Cancers And Mortality Among Women Within Midwestern States, Ruth M. Perez, Matthew Rappelt, Kathryn Kossow, Maharaj Singh

Journal of Patient-Centered Research and Reviews

Background: Breast, colorectal and lung cancers have been shown to be the most common cancers as well as the leading causes of cancer death among women. Previous studies suggest that the Northeast had significantly higher rates in incidence and mortality than the Midwest, South and Western regions. However, new data indicates that the Midwest now harbors the highest mortality rates. In Wisconsin, the sixth largest state in the Midwest, cancer is the leading cause of death. Differences in incidence and mortality of breast, colorectal and lung cancers have been observed between Wisconsin, other Midwestern states and national data, warranting further …

Irish Gms Cost Projections And Its Implications Between 2016 And 2026, Aisling Conway Lenihan, Noel Woods

Dept. of Management & Enterprise Publications

Introduction: Ireland had one of the highest pharmaceutical spends per capita in the EU in 2012. The General Medical Services (GMS) scheme is the largest community drug scheme in Ireland with approximately 40% of the population eligible for free drugs and appliances in 2012. The total cost of GMS prescriptions increased by 414% between 1998 and 2012. This paper projects Irish GMS cost from 2016 to 2026 and examines the implications of the estimated impact on GMS expenditure.

Method: Central Statistics Office (CSO) population projections (2013) and HSE-PCRS GMS population prescription data (2012) were used to develop four variables; population, …

Predictive Factors Of Patient Satisfaction With Pharmacy Services In South Korea: A Cross-Sectional Study Of National Level Data, Sunkyung Lee, Onyeka P. Godwin, Kyungah Kim, Euni Lee

Pharmacy Faculty Articles and Research

Objectives
Patient satisfaction has emerged as a prerequisite to improving patients’ health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.

Methods
A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES) data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.

Results
A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom …

“Inhumanly Beautiful”: The Aesthetics Of The Nineteenth-Century Deathbed Scene, Margo Masur

English Theses

Death today is hidden from our everyday lives so it cannot intermingle with the general public. So when a family member dies, their body becomes an object in need of disposal; no longer can they be recognized as the familiar person they once were. To witness death is to force individuals to confront the truths of human existence, and for most of us seeing such a sight would fill us with an emotion of disgust. Yet during the nineteenth century, the burden of care towards the sick or dying was shared by a community of family, neighbors, and friends; the …

Reproductive Rights In Latin America: A Case Study Of Guatemala And Nicaragua, Katherine W. Bogen

Scholarly Undergraduate Research Journal at Clark (SURJ)

A lack of access to contraceptives and legal abortion for women throughout the nations of Nicaragua and Guatemala creates critical health care problems. Moreover, rural and underprivileged women in Guatemala and Nicaragua are facing greater limitations to birth control access, demonstrating a classist aspect in the global struggle for female reproductive rights. Although some efforts have been made over the past half-century to initiate a dialogue on the failure of medical care in these nations to adequately address issues of maternal mortality and reproductive rights, the women's reproductive health movements of Nicaragua and Guatemala have struggled to reach an effective …

El Impacto De Los Lazos Familiares En La Salud Física, Emocional Y Espiritual En Cuidados Paliativos: Un Estudio De La Clínica Familia, Max Meyerhoff

Independent Study Project (ISP) Collection

Research Question: How do Chilean family ties impact the physical, emotional and spiritual health of patients in a palliative care facility?

Objective: Understand the role that the tight-knit Chilean family structure plays during the palliative care process and how these family ties affect the physical, emotional and spiritual well being of the patient.

Background: Chile has recently gone through an epidemiological transition. Due to improved access to primary care fewer people are dying from infectious diseases. However, because they are now living longer, more Chileans are now dying from slow-acting noncommunicable diseases. Due to these slower acting …

Smartphone Mobile Application To Enhance Diagnosis Of Skin Cancer: A Guide For The Rural Practitioner, Shane E. Cook, Louis C. Palmer Md, Franklin D. Shuler Md, Phd

MIIR Faculty Research

Primary care physicians occupy a vital position to impact many devastating conditions, especially those dependent upon early diagnosis, such as skin cancer. Skin cancer is the most common cancer in the United States and despite improvements in skin cancer therapy, patients with a delay in diagnosis and advanced disease continue to have a grave prognosis. Due to a variety of barriers, advanced stages of skin cancer are more prominent in rural populations. In order to improve early diagnosis four things are paramount: increased patient participation in prevention methods, establishment of screening guidelines, increased diagnostic accuracy of malignant lesions, and easier …

The Intersection Of Art And Medicine: Tanya Sheehan Breaks Down The Boundaries Between Disciplines, Gerry Boyle

Colby Magazine

Tanya Sheehan arrived at Georgetown University intending to become a medical doctor. She aced her organic chemistry lab section, eventually was turned off by the rote memorization the program emphasized, and then discovered art history and film studies. "That changed everything," she said, "but I never forgot about science and medicine."

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

World Sepsis Day In Pakistan, Madiha Hashmi

Department of Anaesthesia

Celebration of World Sepsis Day at a global level started just three years back, and the immense importance of this celebration was not lost to Pakistan Society of Anaesthesiologists (PSA) and Pakistan Society of Critical Care Medicine (PSCCM). Both these organizations were quick to grasp the opportunity to use it to achieve the common goal of enhancing the level of awareness about sepsis and prevention of sepsis among the healthcare professionals as well as higher authorities. The result was multiple international academic events being organized regularly across the country as well as the adoption of National Sepsis Guidelines. The struggle …