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Articles 1921 - 1950 of 2055

Full-Text Articles in Medical Humanities

Effect Of A Faith-Based Initiative On Hospital Readmissions, Joseph Webb Jan 2013

Effect Of A Faith-Based Initiative On Hospital Readmissions, Joseph Webb

All ETDs from UAB

EFFECT OF A FAITH-BASED INITIATIVE ON HOSPITAL READMISSIONS JOSEPH WEBB ADMINISTRATION-HEALTH SERVICES ABSTRACT The purpose of this study was to examine the relationship between a faith-based initiative and hospital readmissions. The main data source used was the inpatient data-base of Methodist LeBonheur Healthcare System (MLH) in Memphis, TN. Data were collected from admissions that occurred during years 2008 through 2012 at four of MLH's five adult acute-care hospitals. Data from the U.S. Census Bureau's American Community Survey were also used in the study. This study uses theoretical tenets from the Social Justice and Equity Theory and the Chronic Care Model …

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Insulin Resistance, Lipids, And The Metabolic Syndrome Trait Cluster: Impact Of Race And Very Low Calorie Diet, Veeradej Pisprasert Jan 2013

Insulin Resistance, Lipids, And The Metabolic Syndrome Trait Cluster: Impact Of Race And Very Low Calorie Diet, Veeradej Pisprasert

All ETDs from UAB

Insulin resistance (IR) is central to the pathogenesis of cardiometabolic disorders. Early detection, along with appropriate interventions, is paramount to reduce the morbidity and mortality of IR-related diseases. The gold standard measurement for IR is the hyperinsulinemic-euglycemic clamp, which is markedly sophisticated for clinical evaluation but costly and invasive for clinical practice. Several alternative surrogate indicators of IR have been identified and used by clinicians, including insulin sensitivity indices derived from plasma glucose and insulin values, as well as other indicators that are independent of direct insulin measurements. In addition, lipid panel and lipoprotein subclass profile have emerged as markers …

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Impact Of Quality Performance On Financial Risk And Cost Of Capital In Hospitals, James D. Byrd Jan 2013

Impact Of Quality Performance On Financial Risk And Cost Of Capital In Hospitals, James D. Byrd

All ETDs from UAB

This study evaluated the relationship of hospital quality of care as measured by mortality scores to hospital cost of capital as represented by average cost of debt. A composite mortality score (weighted average of Hospital Compare's risk adjusted mortality rate for each hospital) was regressed against the hospitals' average cost of debt using OLS and the Stata 11 robust clustering function to adjust for repeated occurrences of hospitals across years. The data base consisted of acute care hospitals with interest expense observed over the three year period 2008 - 2010 (n=3420). Control variables included a number of hospital characteristic (e.g., …

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Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm Jan 2013

Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm

All ETDs from UAB

The purpose of this research was to examine the relationship between Patient-Centered Medical Homes (PCMH) practice capabilities and costs. Complexity science theory was used to develop a theoretical framework to address three primary and twelve secondary hypotheses. Secondary data from a consortium of physician organizations participating in Blue Cross Blue Shield of Michigan's Physician Group Incentive Program and Blue Cross Blue Shield of Michigan's administrative claims data were used to test hypothesized relationships using fixed effects panel regression models. It was found that higher levels of aggregated PCMH practice capabilities were negatively associated with certain costs, specifically average readmission costs. …

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High-Tech Services And Hospital Performance In The United States, Ferhat Devrim Zengul Jan 2013

High-Tech Services And Hospital Performance In The United States, Ferhat Devrim Zengul

All ETDs from UAB

This dissertation examined the relationship between high-technology medical services and hospital performance by focusing on financial and quality performance dimensions. An initial systematic review disclosed the paucity of research and mixed findings about the technology-performance relationship. The review indicated the need for further analyses by emphasizing some limitations of existing studies. The resource-based view (RBV) of a firm was used as a conceptual framework in examining the relationship between high-tech medical services and hospital financial performance. It was hypothesized that large breadth (number) of high-tech services and the use of rare high-tech services would be positively associated with hospitals' financial …

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Hospitalists And Organizational Performance, Josué Patien Epané Jan 2013

Hospitalists And Organizational Performance, Josué Patien Epané

All ETDs from UAB

Two decades ago, a group of hospital-based physicians (hospitalists) specializing in the practice of hospital medicine were introduced in the U.S. health care system. Since then, this group of physicians has experienced an unprecedented growth. Prior studies on hospitalists have focused on benefits associated with the use of hospitalists. Compared to non-hospitalists, these studies revealed that hospitalists are more efficient as they are able to reduce length of stay and costs while achieving similar or better quality of care. However, most of these studies have been cross-sectional, limited to few hospitals, and limited to pediatric and teaching hospitals. Very little …

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Prevalence Of Overweight And Obesity In Classic Rett Syndrome., Kathrine Clova Grigsby Jan 2013

Prevalence Of Overweight And Obesity In Classic Rett Syndrome., Kathrine Clova Grigsby

All ETDs from UAB

Introduction: Rett syndrome (RTT) is a genetic, neurodevelopmental disorder that displays high incidence of growth failure, variations in body composition, feeding/gastrointestinal complications, and undernutrition. The ongoing Rare Diseases Clinical Research Network (RDNCRN) Rett Syndrome Natural History Research Project has yielded observations regarding the less recognized occurrence of overnutrition in adult females with classic Rett syndrome. The purpose of this study was the determine the prevalence of overweight/obesity in children and young adults with classic Rett syndrome, the percent overweight and obese among adults with classic Rett syndrome, and to determine if the prevalence of overnutrition increases after the puberty years …

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The Burden Of Chronic Conditions On Self Reported Health Status In A Medicare Advantage Plan Population, Barbara Ann Guerard Jan 2013

The Burden Of Chronic Conditions On Self Reported Health Status In A Medicare Advantage Plan Population, Barbara Ann Guerard

All ETDs from UAB

THE BURDEN OF CHRONIC CONDITIONS ON SELF REPORTED HEALTH STATUS IN A MEDICARE ADVANTAGE PLAN POPULATION BARBARA GUERARD ADMINISTRATION-HEALTH SERVICES ABSTRACT This dissertation was a multi-staged research study with two goals. The first goal was to assess survey respondents' characteristics to better understand the influence of the characteristics on the validity of self-reported survey responses. Second, the study analyzed the relationship between certain chronic conditions and survey participants' responses to questions related to their overall physical health and mental health to further understand the burden of chronic conditions on self- reported survey responses. Secondary data derived from a patient satisfaction …

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Hospital Financial Performance: A Look At Governance And Hit Strategies, Taleah Collum Jan 2013

Hospital Financial Performance: A Look At Governance And Hit Strategies, Taleah Collum

All ETDs from UAB

Taken together, the purpose of the three papers included in this dissertation is to provide empirical evidence on the relationship between strategies employed by hospital managers and hospital financial performance. The findings of these studies are important to managers as they search for ways to sustain and improve hospital financial performance in light of environmental changes that have taken place over the last three decades. The results of this dissertation suggest that to improve financial performance hospital leaders (e.g. management, board of directors) should choose strategies that are more amenable to their control. Specifically, having BOD members that are independent …

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Understanding The Predictors Of Patient Trust And Its Role In Utilization And Outcomes, Sheikilya Lewis Thomas Jan 2013

Understanding The Predictors Of Patient Trust And Its Role In Utilization And Outcomes, Sheikilya Lewis Thomas

All ETDs from UAB

The purpose of this dissertation is to examine patient-related factors that predict trust in one's physician, and subsequently identify the role of patient trust in health care utilization and clinical outcomes among African Americans with hypertension. Three separate studies are conducted using an adapted version of the Interaction Model for Client Health Behavior (IMCHB). The first paper is a three-step review of quantitative studies investigating the (a) patient characteristics that influence trust; (b) impact of trust on health care utilization; and (c) impact of trust on outcomes. Based on the predictors identified, the second study examines the significance of these …

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Grave Robbing In Lexington And Elsewhere, Charles T. Ambrose Oct 2012

Grave Robbing In Lexington And Elsewhere, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

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Emmet F. Horine And Transylvania’S Special Collections, Charles T. Ambrose Jul 2012

Emmet F. Horine And Transylvania’S Special Collections, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

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A Unique Treasure: Transylvania's 1,760 Medical Theses From The Early Nineteenth Century--11 On Yellow Fever, Charles T. Ambrose Apr 2012

A Unique Treasure: Transylvania's 1,760 Medical Theses From The Early Nineteenth Century--11 On Yellow Fever, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

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Segmented Life Of Cf, Anna Novak Jan 2012

Segmented Life Of Cf, Anna Novak

English Student Work

No abstract provided.

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Hiv/Aids In The Muslim-Majority Countries: Formula For Low Prevalence, Kaoru Yamaguchi Jan 2012

Hiv/Aids In The Muslim-Majority Countries: Formula For Low Prevalence, Kaoru Yamaguchi

Political Science Theses and Capstones

The Muslim-majority countries long had been considered to be free of HIV/AIDS epidemic because of their strict religious and moral codes. However, the HIV prevalence rates are increasing in some Islamic states, and even more or so rapidly in a several cases that it is no longer valid to assume the Islamic religion protects its followers from the risks of contracting HIV. Contrary to the popular belief concerning the prevention of the HIV/AIDs epidemic, data collected from well-recognized international organizations such as the WHO and Freedom House indicate that democratization, strong government leadership, and wider and equal human rights for …

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Environmental And Organizational Characteristics Associated With A Critical Access Hospital Being Contract Managed Or Becoming Acquired, Virginia Anne Razo Jan 2012

Environmental And Organizational Characteristics Associated With A Critical Access Hospital Being Contract Managed Or Becoming Acquired, Virginia Anne Razo

All ETDs from UAB

The focus of this research is the relationship between environmental and organizational characteristics and critical access hospitals (CAHs) being contract managed or acquired. The resource dependence theory guided the methodology. Based on this theory, organizations prefer to remain autonomous until key resources become scarce. The scarcity of resources combined with a dynamic external environment causes environmental uncertainty that requires organizations to consider a variety of strategic responses in order to survive. Given the results of this study, contract managed CAHs were associated with markets that were less munificent and more dynamic with older facilities, relative to independent hospitals. Due to …

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Childhood Obesity: The Role Of Genetic Admixture, Parental Feeding Practices, And The School Food Environment, Michelle Cardel Jan 2012

Childhood Obesity: The Role Of Genetic Admixture, Parental Feeding Practices, And The School Food Environment, Michelle Cardel

All ETDs from UAB

Disentangling the etiology of pediatric obesity continues to challenge researchers due to the interconnecting of behavioral, physiological, environmental, and genetic factors. Studies have focused on the role of the obesogenic environment, characterized by excess energy intake and sedentary behavior, as it relates to weight and fat gain in children. Although these factors certainly have an impact on fat accumulation, increased energy intake and decreased physical activity do not solely account for the increasing trends in obesity prevalence. Less explored genetic and environmental factors may contribute independently and/or synergistically to the current obesity epidemic, and that, these factors could vary in …

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Apolipoprotein E Mimetic Peptide Improves Hdl Functionality And Inhibits Atherosclerosis Progression In Mouse Models Of Atherosclerosis, Gaurav Nayyar Jan 2012

Apolipoprotein E Mimetic Peptide Improves Hdl Functionality And Inhibits Atherosclerosis Progression In Mouse Models Of Atherosclerosis, Gaurav Nayyar

All ETDs from UAB

Despite major advances in diagnosis and treatment, coronary artery disease (CAD) is still the number one cause of morbidity and mortality in United States. An ideal treatment for lipid-mediated inflammatory disorders would not only reduce plasma cholesterol dramatically but also improve high density lipoproteins (HDL) function. Apolipoprotein E (apo E), a protein component of HDL and very low density lipoprotein (VLDL), is necessary for the receptor mediated hepatic uptake of apolipoprotein-B (apo B) containing remnant lipoproteins and also possesses strong anti-inflammatory properties. We hypothesized that a synthetic dual domain apo E mimetic peptide, Ac-hE18A-NH2 (a 28-residue peptide) containing receptor binding …

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Are Enabling Services In Federally Qualified Health Centers Associated With Women Receiving Prenatal Care In The First Trimester?, Forrest A. Daniels Jan 2012

Are Enabling Services In Federally Qualified Health Centers Associated With Women Receiving Prenatal Care In The First Trimester?, Forrest A. Daniels

All ETDs from UAB

The purpose of this study was to examine whether enabling services in federally qualified health centers (FQHCs) were associated with women receiving prenatal care services in the first trimester. The population for this study included FQHCs providing prenatal care services for the years 2008, 2009, and 2010. Data for this study were derived from two sources: Uniform Data System (UDS) and the Area Resource File (ARF). This study adopted the Andersen's (1973) Behavioral Model of Health Services Use. The study consisted of longitudinal panel data analysis. Univariate and bivariate statistics were calculated using PASW/SPSS statistical software, version 18. For the …

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Facilitating The Use Of Implicit Memory And Learning In The Physical Therapy Management Of Individuals With Alzheimer's Disease; A Case Series., Laura White Jan 2012

Facilitating The Use Of Implicit Memory And Learning In The Physical Therapy Management Of Individuals With Alzheimer's Disease; A Case Series., Laura White

All ETDs from UAB

Background and Purpose: Physical rehabilitation of individuals with Alzheimer's disease (AD) is often complicated by impairments in explicit memory and learning. Rehabilitation strategies that facilitate use of the preserved implicit memory system may be effective in treating patients with AD. The purpose of this case series is to describe the application of these strategies, including high-repetition practice, errorless learning (EL), and spaced retrieval (SR), to the physical therapy management of individuals with moderate AD. Case Description: Three women aged 89 to 95 years old with moderate AD who resided in an assisted living facility participated in physical therapy to address …

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The Antecedents And Consequences Of Public Hospital Privatization, Zo Harivololona Ramamonjiarivelo Jan 2012

The Antecedents And Consequences Of Public Hospital Privatization, Zo Harivololona Ramamonjiarivelo

All ETDs from UAB

ABSTRACT The purpose of this study was to explore the antecedents and consequences of public hospital privatization with special attention to financial distress and financial performance. A national sample of public hospitals using secondary longitudinal data from 1997 to 2009 was used in this study. Data set from the American Hospital Association, the Area Resource File, the Medicare Cost Report and the Local Area Unemployment Statistics were merged to test the hypotheses pertaining to each research question. Based on the resource dependence theory, both environmental variables and organizational variables were included in the analyses. This study adopted the Altman Z-score …

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Career Satisfaction Of Physicians Employed By Health Systems, Edward L. Heath Jan 2012

Career Satisfaction Of Physicians Employed By Health Systems, Edward L. Heath

All ETDs from UAB

CAREER SATISFACTION OF PHYSICIANS EMPLOYED BY HEALTH SYSTEMS EDWARD L HEATH, JR ADMINISTRATION-HEALTH SERVICES ABSTRACT Background:Higher career satisfaction has been shown to result in better patient outcomes, higher patient satisfaction and less turnover among physicians. The purpose of this study is to examine the relationship between physician employment and career satisfaction. Methods:Data from the Center for Studying Health System Change (HSC) 2008 Health Tracking Physician Survey was used in the study. The study is a cross sectional, quantitative study of the relationship between physician employment and career satisfaction. A total of 4,720 respondents responded to the survey, with a weighted …

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The Effect Of Liver X Receptor Α Deficiency In Skeletal Muscle On Lipid Content In Mice, Yishu Ding Jan 2012

The Effect Of Liver X Receptor Α Deficiency In Skeletal Muscle On Lipid Content In Mice, Yishu Ding

All ETDs from UAB

Liver X receptors (LXRs) are important regulators of cholesterol, fatty acid, and glucose homeostasis. Many researchs focus on the liver, but tissue-specific roles of LXRs in other tissues remain elusive. Based on in vitro studies on cultured cells, the roles of LXRs in skeletal muscle have been proposed. Nevertheless, the in vivo roles of LXRs in skeletal muscle remain lacking. Skeletal muscle is an important insulin targeting tissue, which plays a key role in regulating insulin sensitivity. Abnormal lipid metabolism and homeostasis have been demonstrated to play a crucial role in the development of insulin resistance in skeletal muscle. To …

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Development And Content Validity Of The Military Concussion Readiness Inventory For Service Members, Michelle L. Gutierrez Jan 2012

Development And Content Validity Of The Military Concussion Readiness Inventory For Service Members, Michelle L. Gutierrez

All ETDs from UAB

The aim of this study was to develop and establish content validity of a new questionnaire entitled the Military Concussion Readiness Inventory (MCRI). The MCRI was designed to identify functional impairments and predict readiness for return-to-duty in service members (SM) who experienced mild traumatic brain injury (mTBI) due to a blast. The items on the MCRI were linked to the The International Classification of Functioning, Disability and Health (ICF) classifications. Nineteen male SM participated in a nominal group technique process to generate items for the MCRI. The items were classified according to the ICF before sending items to the Delphi …

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The Relationship Between Hospitalists And Primary Care Physicians, James Robert Burkhart Jan 2012

The Relationship Between Hospitalists And Primary Care Physicians, James Robert Burkhart

All ETDs from UAB

THE RELATIONSHIP BETWEEN HOSPITALISTS AND PRIMARY CARE PHYSICIANS JAMES R. BURKHART EXECUTIVE DOCTOR OF SCIENCE IN ADMINISTRATION-HEALTH SERVICES ABSTRACT A study of the relationship between primary care physicians (PCPs) and hospitalists was conducted by surveying the Florida Academy of Family Physicians (FAFP) membership to determine whether they had an established relationship with a hospitalist or hospitalist group. The survey responses were then matched with Blue Cross and Blue Shield of Florida (BCBSF) administrative claims data to provide two groupings of study respondents with data regarding patients' average length-of-stay, average 30 day readmission rate, and average hospital claims payment. The survey …

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A Pilot Study To Determine The Effectiveness Of Bioelectrical Impedance Analysis As A Clinical Assessment Tool Of Nutrition Status In Glioblastoma Multiforme Patients (The Beam Study [Bia Effectiveness As Assessment Tool For Gbm Patients]), Rebecca V. Barnhill Jan 2012

A Pilot Study To Determine The Effectiveness Of Bioelectrical Impedance Analysis As A Clinical Assessment Tool Of Nutrition Status In Glioblastoma Multiforme Patients (The Beam Study [Bia Effectiveness As Assessment Tool For Gbm Patients]), Rebecca V. Barnhill

All ETDs from UAB

Glioblastoma multiforme (GBM) is a rare brain tumor, yet accounts for 80% of malignant brain tumors and has a five-year survival rate of < 5%. Few studies have evaluated nutrition recommendations and outcomes of this disease, including caloric needs. The purpose of this study was to find the best predictive equation for resting energy expenditure (REE) for GBM patients and evaluate bioelectrical impedance analysis (BIA) as a clinical tool for estimating REE and fat free mass (FFM) of GBM patients. REE was measured with indirect calorimetry. FFM was measured with DXA and estimated with BIA. Published predictive equations for REE were calculated to compare to measured REE. Six equations used variables easily attained in a clinical setting and three used FFM. Correlation analysis was used to evaluate the strength of the relationships between measured and predicted REE. Agreement between methods on the group level was assessed by comparing the group means of measured and predicted REE with paired t-tests. The Bland-Altman approach was used to find agreement between the methods on the individual level. Analysis included fifteen newly diagnosed GBM patients (7 male and 8 female; mean age 57.1±11.6 years) to evaluate equations using clinical variables and a subsample of eight to evaluate predictive equations using FFM. All the predictive equations overestimated measured REE. The Mifflin-St Jeor was the only equation using clinical variables which was not significantly different from measured REE (p=0.054) and had the lowest bias (73 kcal/day) and narrowest limits of agreement. Likewise, Cunningham and Wang equations using FFM from DXA were not significantly different from measured (p=0.261 and p=0.072, respectively). BIA overestimated FFM compared to DXA, 54.1 kg and 49.2 kg, respectively (p<0.001). More visits with both DXA and BIA measurements available are needed before predictive equations with clinical variables and predictive equations with FFM can be compared. Due to the ease of obtaining clinical variables and the low bias and narrow limits of agreement found for the Mifflin equation, at this time it appears to be the best predictive equation for individuals with GBM.

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Self-Organizing Biopsychosocial Dynamics And The Patient-Healer Relationship, David Pincus Jan 2012

Self-Organizing Biopsychosocial Dynamics And The Patient-Healer Relationship, David Pincus

Psychology Faculty Articles and Research

The patient-healer relationship has an increasing area of interest for complementary and alternative medicine (CAM) researchers. This focus on the interpersonal context of treatment is not surprising as dismantling studies, clinical trials and other linear research designs continually point toward the critical role of context and the broadband biopsychosocial nature of therapeutic responses to CAM. Unfortunately, the same traditional research models and methods that fail to find simple and specific treatment-outcome relations are similarly failing to find simple and specific mechanisms to explain how interpersonal processes influence patient outcomes. This paper presents an overview of some of the key models …

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Contracted Hospitalists And Non-Contracted Hospitalists: Impact On Hospital Cost And Quality Care Outcomes, Kathleen L. Adams Jan 2012

Contracted Hospitalists And Non-Contracted Hospitalists: Impact On Hospital Cost And Quality Care Outcomes, Kathleen L. Adams

All ETDs from UAB

Background Changes in the health care delivery and policy environment are creating increased need for attention to health care costs and efficiency. Hospitals need to develop and implement oversight processes to effectively control costs and provide quality services. It is common for hospitals to contract with physician groups to staff various departments throughout the facility. Hospitalists are the most recent addition to hospital rosters. While some hospitals hire hospitalists directly as employees, others contract with physician groups to provide hospitalist services. The purpose of this study was to compare the potential benefits for hospitals that contracted with a hospitalist group …

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Exploring Health Disparities For Children In The City Of Milwaukee, Mark Edwin Anderson Jan 2012

Exploring Health Disparities For Children In The City Of Milwaukee, Mark Edwin Anderson

All ETDs from UAB

This study investigated whether school-based oral health programs as a public policy intervention increased dental sealant applications among children from low-income families and minorities in public schools in inner city Milwaukee. By using a difference-in-differences analysis, we examined pre-post time frames, 2001-2003 and 2008-2009, to determine sealant application usage in public schools in nine inner city Milwaukee zip codes after the intervention of a public policy initiative to expand school-based oral health programs with the expressed intent of increasing placement of dental sealants in children at high risk for dental decay and disease. Results of a binary logistic regression revealed …

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Influences Of Habitual Diet, Ethnicity, And Age On Circulating Total Ghrelin, Amy Ellis Jan 2012

Influences Of Habitual Diet, Ethnicity, And Age On Circulating Total Ghrelin, Amy Ellis

All ETDs from UAB

Ghrelin is a hormone known to stimulate appetite and food intake. Although certain macronutrients differentially suppress ghrelin on an acute basis, it is unknown whether habitual macronutrient intake affects circulating ghrelin. Thus, the first experimental aim was to determine whether 8-week habituation to diets differing in carbohydrate or fat would affect fasting ghrelin or ghrelin response to a mixed meal. Recent reports also suggest that ghrelin regulation may relate to propensity for obesity. Obesity is more prevalent among AA compared to EA, with the highest rates among AA females. This disparity becomes apparent before puberty, and childhood obesity tends to …

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