Medical Humanities Commons^™

Hospital Community Orientation: Predictors And Performance Outcomes, J'Aime Jennings

All ETDs from UAB

The three publishable manuscripts contained within this dissertation examine the predictors and performance outcomes of hospital community orientation. Community orientation is the customization of hospital services to meet identified community health needs. Together, these papers fill gaps in the literature regarding the factors that assist or hinder hospitals from being community-oriented, as well as the effects of community orientation. The first paper uses longitudinal data to examine the organizational and environmental factors that may influence how engaged hospitals are in a community orientation strategy based on the number of activities performed. The remaining papers consider the performance outcomes of community …

Towards An Understanding Of Patient Satisfaction In The Military Health System, Alan Alexander Jones

All ETDs from UAB

The Military Health System (MHS) is the most expansive health care system in the world. The MHS provides health care services to 9.7 million eligible beneficiaries spread across six continents. The MHS budget exceeded $52 billion in 2013 or 10 percent of the total 2013 Defense budget. The cost of health care in the MHS is of great concern to the Department of Defense and the US Congress. The MHS needs a strong framework to measure the value of the health care it provides. The purpose of this study was to develop a framework to better understand Patient Satisfaction in …

Examining The Interplay Of Diet Composition, Cardiometabolic Diseases, And Economics, Kenneth Patton Kell

All ETDs from UAB

Despite the invaluable contributions that both randomized controlled trials and longitudinal studies have made to our understanding of the relationships between diet and cardiovascular disease (CVD), a comprehensive understanding of these relationships does not yet exist from birth to death. Furthermore, the longest running of these longitudinal studies have not included a representative portion of racial minority participants. Lastly, given the financial impacts of CVD, as well as how socioeconomic status (SES) can influence diet, the interplay between these three merits consideration. Therefore, the objective of this dissertation was to evaluate the associations between diet and cardiovascular disease (CVD): 1) …

The Impact Of Cultural Competency On Patient Experience Of Care, Emily Lane Koudelka

All ETDs from UAB

The impact of hospitals’ cultural competency on inpatient experience of care will be examined. Enhanced patient experience of care may alter an individual’s willingness to use health services, thereby increasing access and decreasing health disparities. As a result, to the extent that cultural competency influences patient experience of care, the integration of cultural competency into healthcare organizations has emerged as a critical issue for researchers, industry leaders, and policymakers. Findings from this study will inform policies, practices, and processes across the broad spectrum of healthcare industry stakeholders.

Linking Adiponectin And Autophagy In The Regulation Of Breast Cancer Metastatic Potential, Emily Libby

All ETDs from UAB

Curative approaches for metastatic breast cancer remain elusive. Adiponectin is the most abundant of the adipocyte-secreted adipokines, and there is recent interest in development of adiponectin-based therapies for this disease. Yet, while multiple epidemiological studies have indicated that low levels of circulating plasma adiponectin portend poorer prognosis, recent work has reported that elevated adiponectin expression in breast tissue correlates with advanced disease. Further, isoform-specific roles of this molecule are not well understood. Thus, the overarching purpose of this work was to elucidate how adiponectin isoforms contribute to the microenvironmental regulation of the early steps of breast cancer metastasis. We show …

Emergency Department Wait Time Communication Strategies And Patient Throughput Efficiency, Tom R. Mcdougal

All ETDs from UAB

This study investigates hospital strategies used to inform patients of anticipated wait times in the Emergency Department (ED) and the association of such strategies with patient throughput efficiency. When hospitals are inefficient in ED patient throughput, conditions of overcrowding often occur. Overcrowding of the ED is a problem for many hospitals. When such conditions exist, there is evidence in the literature that it leads to lower patient satisfaction, care quality, and financial position of the hospital. Therefore, improving patient throughput efficiency is a priority for hospitals. To improve patient throughput efficiency, hospitals use a variety of strategies. This study focuses …

Patient Activation: An Examination Of The Relationship Between Care Management With Patient Activation-Customized Coaching And Patient Outcomes, Cindy L. Reistroffer

All ETDs from UAB

As part of healthcare reform, patient engagement is becoming an important area of focus. Most recently, patient activation, as part of engagement, has been studied; however, interventions to improve activation are not well identified. The purpose of this dissertation was to empirically examine whether enrollment in care management with patient activation (PA)-customized coaching was associated with patient outcomes of utilization, medication adherence, and clinical outcomes. The study utilized the chronic care model framework and theoretical insights from social cognitive theory to examine the relationships among three hypotheses. Secondary data related to commercially-insured enrollees in Priority Health were used to test …

Impact Of Medicare Part D Coverage Gap On Medicare Beneficiaries With Copd: Adherence, Healthcare Resource Use, And Cost, Yanni Fan Yu

All ETDs from UAB

Medicare Part D provides prescription drug coverage for beneficiaries to support their pharmacological treatment; however, the complex deductible structure within benefit plans creates a major coverage gap and unexpected consequences. Some evidence has demonstrated reduced adherence resulting from the coverage gap; however, little research has evaluated the effect on healthcare resource use (HRU) and cost, and no studies have been conducted for beneficiaries with chronic obstructive pulmonary disease (COPD). This study examined the impact of the coverage gap on medication adherence as well as healthcare resource use and medical cost among beneficiaries with COPD. Claims data based on a 5% …

Hospital-Based Skilled Nursing Facilities: Predictors Of Survival And Performance, Shivani Gupta

All ETDs from UAB

This three-paper dissertation examined the organizational and market factors predicting the response of hospital-based skilled nursing facilities (HBSNFs) to the changes in their environment such as the implementation of prospective payment system in 1998 and their role in coordination of care for patients in transition from acute care to home or a post-acute care facility. In the first study, population ecology of organizations framework was used to evaluate the organizational and market factors associated with HBSNFs’ closure after 1998. The event histories of all acute-care hospitals which had an open HBSNF in 1998 were examined across 15 years (1998-2012) to …

Drivers Of Inter-Organizational Network Participation, Kimberly S. Davey

All ETDs from UAB

The purpose of this dissertation was to study market and organizational drivers associated with inter-organizational network participation. Inter-organizational networks are increasingly emerging across industries as a strategy for adapting to fundamental changes in competitive market environments. Specifically, this study empirically examined the association between market and organizational drivers for a sample of U.S. hospitals relative to their participation or non-participation in Medicare ACOs as a newly emergent inter-organizational network in the healthcare sector. This was a cross-sectional study of U.S. hospitals participating in Centers for Medicare and Medicaid Services (CMS) designated ACOs as of January 1, 2014 and hospitals not …

Utilization Of Anc And Pnc Services In Nepal : A Multivariate Analysis Based On Nepal Demographic Health Survey 2001 And 2006, Gehendra Mahara, Collins Asweto, Kai Cao, Ali M. Alzain, Andrea Sebastian, Jill Barr, Xiuhua Guo, Wei Wang

Research outputs 2014 to 2021

Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health sevices such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken f …

Do Patients With Long-Term Side Effects Of Cancer Treatment Benefit From General Practitioner Support? A Literature Review, Irene M. Ngune, Moyez Jiwa, Alexandra Mcmanus, Jeff Hughes

Research outputs 2014 to 2021

Background: Alongside specialist cancer clinics, general practitioners have an important role in cancer patients ’ follow-up care, yet no literature summarises the nature, extent and impact of their involvement. This paper addresses this issue through a review of the literature. Methods: Studies were sourced from six academic databases - AustHealth ( n = 202), CINAHL ( n = 500), the Cochrane Library (reviews and trials; n = 200), Embase ( n = 368), PHCRIS ( n = 132) and PubMed/Medline ( n = 410). Studies that focused on interventions designed for patients receiving follow-up care and reported cancer care provided …

Disproportion Of Women In General Surgery And Obstetrics-Gynecology Professions, Nidhi H. Patel

Undergraduate Research Posters

An increasingly number of women have been enrolling in U.S. medical schools recently and the field of obstetrics-gynecology has become predominantly female, but the profession of general surgery still remains largely unequal between the two genders. There is an observable pattern of gender inequality in both of these specialties, which is a result of several different factors which affect all women regardless of their profession. I studied how the stark difference in the percentages of female surgeons versus the percentages of female obstetricians-gynecologists compared to men has been created due to the prescribed gender roles of women in society. I …

Journal Cover And Front Matter

Journal of Clinical Art Therapy

No abstract provided.

Wellness And Food Preferences Among Children Of Latino Immigrant Families In The Arcadia Community Of Spartanburg County, Sarah Grace Keaveny

Student Scholarship

The topic of this capstone is the result of my synthesis across disciplines. As a student with majors in Biology and Spanish with a concentration in Medical Humanities, I wanted to research a topic that would include my disciplines in a way that would meaningfully prepare me to leave my undergraduate years for medical school. This project seeks to generate an understanding of the culturally created eating habits and perceptions of wellness in Latino children living in the Arcadia Community, as told by their mothers. By seeking this understanding, I hope that this project may serve as a tool to …

H.E.A.P.S. In Advances Towards A Healthier Samoa The Health Education And Promotions Section’S Role In Combating Non-Communicable Diseases, Kara Le

Independent Study Project (ISP) Collection

With an increase in the number of health issues within Samoa, specifically in relation to non-communicable diseases (NCDs), it is important to examine the efforts being made by government health officials to improve Samoa’s overall health status. This study explores the role of the Health Education and Promotion Section (H.E.A.P.S.) of the Ministry of Health in establishing and promoting healthier standards within the Samoan community. The current efforts of H.E.A.P.S. in combating NCDs through recently introduced projects and programs were explored in-depth. Further analysis of the design and effectiveness of these programs in changing the unhealthy habits of Samoan people …

La Psiquiatría Comunitaria En La Corporación Bresky / Community Psychiatry In The Bresky Corporation, Connery O’Brien

Independent Study Project (ISP) Collection

The purpose of this paper is to provide insight on the community model of rehabilitation for individuals with mental health disorders in Chile with a specific focus on schizophrenia. Stigmas surrounding mental health are still very prevalent in this society. These stigmas make it difficult for patients to integrate themselves into society, and in turn, add stress to the patients’ families, who must support and care for them. The community model of mental health rehabilitation is important to consider in the efforts to re-integrate these patients into society. La Corporación Bresky, a rehabilitation center in Peñablanca, will be used as …

Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin

Independent Study Project (ISP) Collection

Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …

Andreas Vesalius (1514-1564)–An Unfinished Life, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The fame of Andreas Vesalius (1514-1564) rests on his anatomy text, De humani corporis fabrica, regarded as a seminal book in modern medicine. It was compiled while he taught anatomy at Padua, 1537-1543. Some of his findings challenged Galen’s writings of the 2c AD, and caused De fabrica to be rejected immediately by classically trained anatomists. At age 29, Vesalius abandoned his studies and over the next two decades served as physician to Emperor Charles V of the Holy Roman Empire (HRE) and later to King Philip II of Spain in Madrid. In 1564, he sought to resume teaching anatomy …

La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins

Independent Study Project (ISP) Collection

Background: In Argentina, abortion is illegal under all circumstances except for when a woman has been raped, has a mental disability or her life is in danger. There are approximately 500,000 abortions practiced each year in Argentina, and the majority is performed in an unsafe manner, which can result in complications that require medical attention. In 2010, over 50,000 women were hospitalized because of complications post-abortion. These complications can include hemorrhages, infections, or other toxic illnesses. After the International Conference on Population and Development in 1994 they identified post-abortion care as a worldwide problem. Subsequently, Argentina created a guide for …

In A Bind: Artificial Cranial Deformation In The Americas, Aaron Fehir

Laurier Undergraduate Journal of the Arts

No abstract provided.

Human Papillomavirus And The Gardasil Vaccine: Medicalization And The Gendering Of Bodies And Bodily Risk, Lauren Camara

Laurier Undergraduate Journal of the Arts

No abstract provided.

Negotiating Masculinity: How Infertility Impacts Hegemonic Masculinity, Myscha Burton

Laurier Undergraduate Journal of the Arts

No abstract provided.

Neglected Or Non-Compliant? Assessing The Difficulties Of Tuberculosis Patients In Salvador-Ba, Brazil, Erin Slatery

Independent Study Project (ISP) Collection

Objective: The aim of this study is to analyze how Instituto Brasileiro para Investigação da Tuberculose (IBIT), a philanthropic tuberculosis clinic in Salvador, Brazil, maintains treatment abandonment rates much lower than those of surrounding public clinics. This study also aims to evaluate how professionals conceptualize and address the difficulties faced by patients.

Methods: Interviews were conducted with 8 IBIT professionals and 16 patients in treatment for tuberculosis in the aforementioned institution via semi-structured and structured questionnaires, respectively. Participant observation guided the analysis of relationships between patients and professionals.

Results: Patients found varying aspects of treatment difficult depending on personal circumstances, …

Surgeon Practices And Attitudes Toward The Control Of Surgical-Site Infections In Jordan, Sara Ali Mater

Independent Study Project (ISP) Collection

The purpose of this study was to determine the attitudes and practices of Jordanian surgeons on the control of surgical-site infections, evaluated by the Center of Disease Control’s guidelines toward the prevention of surgical-site infections, in addition to gaining respondents opinions on infection control in Jordan. This study was conducted through the distribution of 75 questionnaires given to surgeons at five hospitals in Jordan. Additional insight on SSI infection control was gained through interviews with two cardiac surgeons and three infection control directors. The results of the survey were compared with the Center for Disease Control’s guide to surgical-site infection …

Assessing Health Conditions And Medication Use Among The Homeless Community In Long Beach, California, Mok Thoong Chong, Jason Yamaki, Megan Harwood, Richard D'Assalenaux, Ettie Rosenberg, Okezie Aruoma, Anupam Bishayee

Pharmacy Faculty Articles and Research

Objective: Persons experiencing homelessness are a vulnerable population and are at increased risk for morbidity and all-cause mortality compared to the general population. This study sought to evaluate medication use, regular physician visits, and identify health conditions among the homeless population of Long Beach, California.

Methods: Two "brown bag" medication review events were held at homeless shelters in the Long Beach area. Demographic information, medication use, and comorbid disease states were obtained through surveys.

Findings: Three-fourths of the cohort (95 participants) consisted of males, and the average age of participants was 48 years. Psychiatric disorders and cardiovascular disease were the …

Review Of "Truly Human Enhancement: A Philosophical Defense Of Limits ", James Mcbain

Faculty Submissions

Review of "Truly Human Enhancement: A Philosophical Defense of Limits" by Nicholas Agar.

Reporting Risk, Producing Prejudice How News Reporting On Obesity Shapes Attitudes About Health Risk, Policy, And Prejudice, Abigail C. Saguy, David Frederick, Kjerstin Gruys

Psychology Faculty Articles and Research

News reporting on research studies may influence attitudes about health risk, support for public health policies, or attitudes towards people labeled as unhealthy or at risk for disease. Across five experiments (N = 2123) we examined how different news framings of obesity research influence these attitudes. We exposed participants to either a control condition, a news report on a study portraying obesity as a public health crisis, a news report on a study suggesting that obesity may not be as much of a problem as previously thought, or an article discussing weight-based discrimination. Compared to controls, exposure to the public …

Mainecare Stage A Health Homes Year 1 Report: Implementation Findings And Baseline Analysis, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana, Deborah A. Thayer Mba

Population Health & Health Policy

In January 2013, Maine established Health Homes under federal authority pursuant to Section 2703 of the Affordable Care Act to improve care coordination for MaineCare members with chronic conditions. Stage A of the Health Homes initiative focuses on members with complex medical chronic conditions. Stage B, planned for early 2014, will focus on persons with severe and persistent mental health conditions and children with serious emotional disturbances. The Stage A demonstration builds off the State’s existing Maine multi-payer Patient Centered Medical Home (PCMH) Pilot project and Maine’s Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary …

Review Of Manon Parry, Broadcasting Birth Control: Mass Media And Family Planning, Rose Holz

Women's and Gender Studies Program: Faculty Publications

As Manon Parry explains in her interesting new book, ‘Many of the women who wrote [to the Birth Control Review] noted that they had read about [Margaret] Sanger’s work in the press, confirming the important role of the mass media in publicizing and building support for the movement’ (p. 13). Therein lies the crux of Parry’s project: the use of publicity was central to the family planning movement and a sustained analysis of its use over time is long overdue. To that end, she challenges several long-standing historiographic assumptions and unearths more than a few fascinating stories. For example, …