Medical Humanities Commons^™

Knowledge, Attitude, Lifestyle Practices, And Quality Of Life In Sporadic Lymphangioleiomyomatosis Patients, Shahpar Vafamand

Walden Dissertations and Doctoral Studies

Lymphangioleiomyomatosis (LAM) is a rare lung disease recognized by abnormal growth of smooth muscle cells proliferating in lungs parenchyma, developing benign tumors, migrating to the other organs, and ultimately leading to respiratory failure and death. Despite existing literature mainly on clinical aspects of LAM, there is a gap of literature in regards to the knowledge, attitude, and lifestyle practices (KAPs) of LAM patients and their effects on their quality of life. The purpose of this quantitative study was to investigate the KAPs of the sporadic LAM patients as measured by the Bristol Chronic Obstructive Pulmonary Disease Knowledge Questionnaire, Beliefs and …

Community-Based Settings And Sampling Strategies: Implications For Reducing Racial Health Disparities Among Black Men, New York City, 2010–2013, Helen Cole, Antoinette Schoenthaler, Scott Braithwaite, Joseph Ladapo, Sherry Mentor, Jennifer Uyei, Chau Trinh-Shevrin

Publications and Research

Introduction Rates of screening colonoscopies, an effective method of preventing colorectal cancer, have increased in New York City over the past decade, and racial disparities in screening have declined. However, vulnerable subsets of the population may not be reached by traditional surveillance and intervention efforts to improve colorectal cancer screening rates.

Methods We compared rates of screening colonoscopies among black men aged 50 or older from a citywide random-digit–dial sample and a location-based sample focused on hard-to-reach populations to evaluate the representativeness of the random-digit–dial sample. The location-based sample (N = 5,568) was recruited from 2010 through 2013 from community-based …

Development And Testing Of The Primary Care Homeless Organizational Assessment Tool (Pc-Hoat) To Evaluate Primary Care Services For The Homeless, Jocelyn Louise Steward

All ETDs from UAB

The purpose of this dissertation is to develop and test an organizational assessment tool that can used to evaluate primary care services for the homeless. The research evaluates the importance, feasibility, reliability, and validity of organizational processes and structures of primary care services for the homeless. The final product is the validated Primary Care Homeless Organizational Assessment Tool (PC-HOAT). This tool provides stakeholders with information regarding the organizational structures and processes associated with greater quality of primary care for the homeless. This tool will help managers better understand their organization's strengths and weaknesses, guide discussions regarding operations, and provide information …

The Orphan Train Movement And Its Influence On Child Welfare Policy In Kansas, Robert Schremmer, Jane F. Knapp Md

Posters

The Orphan Train Movement was responsible for relocating thousands of children from large eastern cities to rural areas and can be seen as the forerunner to today's foster care system.

Ahead Of Their Time: The Story Of Alice Berry Graham And Katharine Berry Richardson, The Founders Of Children's Mercy Hospital In Kansas City, Jane F. Knapp Md, Robert Schremmer

Posters

Describes the founding of Children's Mercy Hospital through the story of its founders, Katharine Berry Richardson and Alice Berry Graham.

Syndecan Knockdown In The Insulin Producing Cells Of Drosophila Melanogaster Affects Energy Metabolism And Life Span, Jonathan Lund Warren

All ETDs from UAB

Drosophila melanogaster is a powerful model organism for studying human metabolic disease due to the conservation of various signaling processes and pathways. The insulin producing cells (IPCs) in the brain of adult flies sense circulating nutrients and respond by producing three insulin-like peptides (dILP2, dILP3, and dILP5). Several studies have shown that dILPs play a major role in Drosophila reproduction, metabolism, growth, and longevity. Previous data showed that flies homozygous for a hypomorphic mutation in the Drosophila syndecan (dSdc) gene had defects in energy metabolism and lower expression of brain dilp2-3 and dilp5 genes. Syndecan is a transmembrane proteoglycan that …

An Economic Evaluation Of A Peer Support Intervention For Diabetes Self-Management, Caresse Campbell

All ETDs from UAB

Appropriate management of diabetes has the potential to affect not only health outcomes associated with diabetes, but also its economic burden. Peer support has emerged as a promising intervention to improve diabetes self-management, with demonstrated effects on improving clinical outcomes. Whether the health improvements obtained with peer support are worth its implementation cost, has not been established. This dissertation sought to close the gap in the literature by conducting an economic evaluation of a peer support intervention for diabetes self-management. We conducted analyses of secondary data from Encourage, a randomized trial testing a peer advisor intervention conducted in rural Alabama. …

Freestanding Emergency Departments: Strategic And Policy Implications, Nitish Patidar

All ETDs from UAB

The dissertation examined the role of Freestanding Emergency Departments (FSEDs) in the current United State health care system. The study collected the primary data on FSEDs in the United States and analyzed the factors associated with the hospitals operating FSEDs and its effect on hospital financial performance. The relationship of presence of FSEDs in the market and Medicare expenditure per person was also studied. The Resource Dependency Theory was used to study the effect of market and organizational factors on the hospital decision to operate an FSED. Panel data from 2002 to 2011 was analyzed using logistic multivariate regression with …

Dietary Pattern Adherence Of Adults With Diabetes In The Reasons For Geographic And Racial Differences In Stroke (Regards) Study 2003-2007, Keith Pearson

All ETDs from UAB

The objective of this study was to determine if adults with diabetes engage in different dietary practices compared to adults without diabetes in a national cohort of adults 45 years of age or older. Dietary practices were evaluated using five dietary patterns derived previously using factor analysis in a sample of 21,636 African American and European American participants who completed the Block 98 Food Frequency Questionnaire in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) measuring dietary pattern adherence of adults with diabetes …

The Roles Of Mammalian Tribbles Homolog 3 (Trib3) In Coordinating Energy Metabolism And Development Of Insulin Resistance, Wei Zhang

All ETDs from UAB

Insulin resistance in diabetics comprises of a reversible component treatable with intensive glycemic control and a non-reversible component present in pre-diabetes that may lead to the development of overt diabetes. The reversible component is induced and exacerbated by hyperglycemia in both uncontrolled type 1 and type 2 diabetes, a process known as glucose-induced insulin resistance (GIIR) or glucose toxicity. The tribbles homolog 3 (TRIB3) has been identified as a pseudokinase that inhibits Akt activity by physically blocking its phosphorylation site. Expression of TRIB3 has been associated with various signals such as endoplasmic reticulum (ER) stress and nutrient availability in pancreatic …

Employment Of Physician Administrators (Ceos) In Acute Care Hospitals And Their Impact On Hospital Performance, Muhammad H. Al-Midani

All ETDs from UAB

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Assessing Patient Care Quality From Hospital Employed Physicians, Kerry Gil Gillihan

All ETDs from UAB

ASSESSING PATIENT CARE QUALITY FROM HOSPITAL EMPLOYED PHYSICIANS KERRY GILLIHAN ADMINISTRATION-HEALTH SERVICES ABSTRACT Background: Physician employment by hospitals and healthcare systems has become a growing phenomenon in America. Also the emphasis on improving patient care quality is receiving increasing attention. Moreover, recent changes in federal regulation and reimbursement have made improving patient care quality an imperative for hospitals and their medical staffs. The purpose of this study was to determine if there is a demonstrable relationship between hospital employed physicians and the quality of their patient care. Methods: Physician quality measurements were obtained from a prominent community hospital with roughly …

Glycine Supplementation To Improve Insulin Sensitivity In Humans, Marie-Hippolyte Boni Epse Attobla

All ETDs from UAB

The main purpose of this pilot study was to investigate the insulin sensitizing effect of glycine as a dietary supplement in insulin resistant (IR) normoglycemic subjects (N= 10), and to determine significant changes in insulin sensitivity and lipid profile after four weeks of glycine supplementation. Descriptive statistics were used to describe the basic characteristics of the study population. A paired t-test was used to determine differences between insulin sensitivity and lipid profile pre- and post- intervention, considering the estimation of HOMA-IR and Matsuda- index scores. Results showed that glycine supplementation might improve triglyceride (TG) levels in European Americans; and low-density …

Employer-Based Wellness Programs; Financial Value To The Organization, Ricky D. Wallace

All ETDs from UAB

The health and wellness of employees is of strategic importance for healthcare organizations to achieve leadership in accountable care and health reform. This study sought to discover whether an organizational program, focused on health promotion and wellness for employees, has a value to the organization. This quantitative evaluation study examines variables of a wellness program implemented at a medical facility in the United States by determining the medical costs among participants and non-participants of the facility sponsored wellness program. The results of the study provide valuation evidence concerning the program's value to the organization.

A Longitudinal Study Relating Patient Care Outcomes To Nurse Magnet Designation In United States Academic Medical Centers, Thomas R. Hunt

All ETDs from UAB

The purpose of this investigation is to determine whether the addition of the structural and process elements necessary for an academic medical center to garner its initial Magnet designation is associated with improved patient care. Donabedian's linear structure-process-outcome theory serves as the framework to empirically assess the relationship between Magnet status and patient care outcomes. The influence of such organizational factors as hospital size, clinical activity, and complexity of care is investigated. Secondary data from the American Nurse Credentialing Center (ANCC) and the University HealthSystem Consortium (UHC) is used as the basis of this empirical study. This investigation identified two …

The Relationship Between Patient Complaints And Surgical Complications, Joseph Francis John

All ETDs from UAB

THE RELATIONSHIP BETWEEN PATIENT COMPLAINTS AND SURGICAL COMPLICATIONS JOSEPH F. JOHN ADMINISTRATION - HEALTH SERVICES ABSTRACT Background: Patient complaints are viewed as indications of dissatisfaction with the service received or experience at a health care institution. The prediction of patient complaints is not clearly understood, and to date, very little quantitative research has evaluated the relationship between patient complaints and health care quality. Objective: The objective of this study was to examine whether (1) surgeons that operate on patients with higher perioperative surgical risk are associated with higher levels of patient complaints and (2) surgeons with higher levels of patient …

Gut Microbiome And Its Role In Obesity And Aging In C57bl/6j Mice, Yongbin Yang

All ETDs from UAB

turtles and its’ ecological and evolutionary significance regarding certain aspects of

Risk Assessment And Staging Of Cardiometabolic Diseases, Fangjian Guo

All ETDs from UAB

Obesity is associated with elevated risk for morbidity and mortality and has become an epidemic both in the United States and around the world. Insulin resistance is essentially involved in the pathogenic process of cardiometabolic diseases in obese people, which involves defects in glucose production by the liver and insulin-stimulated glucose uptake and utilization by peripheral tissues. Insulin resistance appears at an early stage of life and is the first step in the development of cardiometabolic diseases. Long-term insulin resistance will induce metabolic syndrome and prediabetes and eventually will cause type 2 diabetes and cardiovascular diseases. Obesity may exacerbate insulin …

The Relationship Between Emergency Department Wait Times And Inpatient Satisfaction, Polly Jean Davenport

All ETDs from UAB

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Assessing System Congruence By Analyzing The Relationship Between Employee And Patient Driven Outputs, Timothy J. Harlin

All ETDs from UAB

Patients are at risk for employee driven preventable adverse events during hospital stays. These adverse events are varied and include such things as medication errors, pressure ulcers, hospital acquired infections, and falls. Preventable adverse events continue at alarming frequency despite significant academic, regulatory, and management attention to the topic over the past 14 years since the Institute of Medicine's (IOM) To Err is Human report. In addition to being at risk for preventable adverse events, patients experience aspects of the health care system such as ease of access, employee attitude, skill and efficiency of staff, and perceived value. Although purporting …

Measuring The Relationship Between Contextual Factors, Nurse Staffing Patterns, And Hospital Performance, Dong Yeong Shin

All ETDs from UAB

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Cultural Factors Associated With Utilization Of Antenatal Care Services In Rural India, Anjali Om

Undergraduate Research Posters

Despite vast economic growth in developing countries in the past few years, infant mortality continues to plague underdeveloped regions, particularly rural regions of India. Many of these deaths are caused by a lack of education and motivation in regard to utilization of antenatal and neonatal care services to prevent and treat consequences of unhygienic umbilical cord care.

For years, high incidences of neonatal tetanus have plagued rural areas of India as a result of cultural practices that encourage topical applications of cow dung to cut umbilical stumps either directly or by using ghee heated with cow dung to warm umbilical …

Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

To Bear Witness: A Journey Of Healing And Solidarity, Updated, Revised, And Expanded Edition, Kevin M. Cahill, M.D.

International Affairs

For more than fifty years, Dr. Cahill has been helping to heal the world, as a leading specialist in tropical medicine and as a driving force in humanitarian assistance and relief efforts around the globe. In this revised and expanded edition, he chronicles extraordinary achievements of compassion and commitment. Bringing together a rich selection of writings, he crafts a fascinating memoir of a life devoted to others. The book includes front-line reports from places under siege—Lebanon, Somalia, Sudan, Nicaragua, Gaza, and Ireland; there are also visionary essays from the origins of the AIDS epidemic and landmine crises, and no less …

Interprofessional Roles Shoulder Dystocia: Maximizing Safety In Community Hospitals, Elizabeth Yznaga

Doctor of Nursing Practice (DNP) Projects

Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been …

Ability And Willingness To Change Among African Immigrant Patients At Akwaaba, Marianne Sarkis, Temitayo Akinbola, Charise Canales, Hana Chamoun, Jacqueline Leaf, Elisabeth Nebie

Local Knowledge: Worcester Area Community-Based Research

What are the challenges faced in treating Hypertension in the Worcester African Immigrant Community?

This study investigates the relationship between the understanding of high blood pressure, and the ability and willingness to modify behavior among African patients at Akwaaba, a free health clinic in Worcester, Massachusetts. In this research, our team specifically explores how the understanding of lifestyle risk factors of hypertension, such as diet, exercise, and levels of stress, influence the willingness and ability to modify behavior among African born patients at Akwaaba. What become clear was that language barriers, cultural differences, and approach to health care within the …

Acute Lung Injury And Acute Respiratory Distress Syndrome Requiring Tracheal Intubation And Mechanical Ventilation In The Intensive Care Unit: Impact On Managing Uncertainty For Patient-Centered Communication, Robert F. Johnson Jr., Jillian Gustin

Peer Reviewed Articles

A 56 year-old male presented with symptoms of pneumonia and findings consistent with acute lung injury (ALI). Deterioration of respiratory function occurred over the first 24 hours of hospitalization leading to placement in an intensive care unit (ICU) followed by tracheal intubation and mechanical ventilation (ETMV). At that time criteria defining acute respiratory distress syndrome (ARDS) were present. The palliative medicine service was asked to address concerns expressed by the patient’s spouse reflecting uncertainty regarding outcome expectations.

When interacting with families of incapacitated critically ill patients, clinicians are advised to employ a patient-centered communication process to alleviate family distress and …

Information Sources In Relation To Information Quality, Information-Seeking, And Uncertainty In The Context Of Healthcare Reform, Jennifer L. Bevan

Communication Faculty Books and Book Chapters

This exploratory study examines information-seeking about the 2010 Patient Protection and Affordable Care Act (i.e. healthcare reform) in relation to the potential barriers of uncertainty,uncertainty discrepancy, and low health self-efficacy. Adult United States participants completed an anonymous online survey about their perceptions and understanding of healthcare reform. Results confirmed recent literature, suggesting a complex relationship between information-seeking and uncertainty. Specifically, for this sample, significant positive relationships were observed between information-seeking about healthcare reform and uncertainty, uncertainty discrepancy, health self-efficacy. Further, uncertainty discrepancy was the potential barrier that accounted for the most variance in predicting information-seeking.Implications of these findings for improving …

The Contribution Of Intereim Executives To The Healthcare Industry, Ray Snead

All ETDs from UAB

This is the first research-based study of interim executive services in the US healthcare industry. It opens a new area of inquiry for academic investigation of the role of interim executive services in the healthcare industry. The study focused on Chief Executive Officer and Board of Directors leadership in acute care hospitals of all sizes across the United States. The research survey resulted in 443 responses to over seventy-five questions addressing interim executive services from the perspective of healthcare decision makers. Ninety five percent of the respondents were CEOs and the remainder were board members, primarily chairpersons. The research is …

The Relation Of Hospital Choices In It Infrastructure Spending And Deployment With Hit/Ehr Strategies And Operational Efficiency, Harold Neumeier

All ETDs from UAB

This study examined certain aspects of the association between information technology (IT) strategy and structure changes within hospitals, as well as the effects of IT infrastructure changes on measures of financial performance for these hospitals during the period of 2009-2011. Following the Process School of the Resource Based View, both internal and external information technology resources were examined to see how hospitals had responded to Federal policies related to the "meaningful use" of Health IT and Electronic Health records. Specifically, this study examined changes in information technology spending by hospitals based on size, hospital type, and percentage of revenue derived …