Medical Humanities Commons^™

Applying The Hospitalist Model Of Care To Cardiovascular Acute Care Delivery, Ginger K. Biesbrock

All ETDs from UAB

The hospitalist model for managing patients in the hospital setting has been in existence for over 20 years. The hospitalist model for non-specialty care has been found to improve the efficiency of care, maintain quality of care, and support a higher degree of guideline adherence. However, there has been little research focusing on the use of the hospitalist model for specialty care. As cardiovascular programs have begun to adopt the hospitalist model, many are asking if this model is more effective than the traditional model. The main concern is the potential disruption to the patient-physician relationship that occurs with the …

Behavioral, Environmental, Social, Psychosocial, And Physiological Factors That Impact The Relationship Between Chronic Lung Disease Status And Susceptibility To Electronic Cigarette Use Or Actual Electronic Cigarette Use, Mohammed M. Alqahtani

All ETDs from UAB

There is surge increase in e-cigarettes among adult vulnerable population such as individuals with chronic lung disease (CLD). Currently, there is a lack of understanding of the factors that may lead to the increase use of e-cigarettes or susceptibility of ecigarette use among individuals who have a history of CLD. Thus, it is crucial to recognize the characteristics of the individuals with CLD and adults without CLD who are susceptible to using e-cigarettes because this may pave the way for the prevention and reduction of tobacco use by identifying the different factors and eventually targeting the related risk factors. In …

Factors Influencing Balance And Muscle Tone In Adults With Attention-Deficit/Hyperactivity Disorder, Mansour M. Alotaibi

All ETDs from UAB

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition prevalent in children globally and continues to persist into adulthood. Executive function (EF) impairments are core ADHD deficits, specifically response inhibition, and believed to drive ADHD symptoms. Psychostimulant medications (PS) is the first line treatment to manage ADHD symptoms. Overall, individuals with ADHD are at greater risk of falls and physical injuries compared to healthy individuals. Perhaps adults with ADHD balance impairments are secondary to ankle plantarflexor (PF) spasticity. Using psychostimulant medications (PS) improves PF spasticity and postural control in children with ADHD, but the effects on adults with ADHD are unclear. Furthermore, …

Alzheimer Disease Special Care Units And Nursing Homes' Organizational Performance, Giovanna Pilonieta Ortiz

All ETDs from UAB

Alzheimer’s disease special care units (AD SCUs) have been adopted to provide specialized care for people with dementia in nursing homes. However, the effects of environmental and organizational factors on AD SCUs adoption by nursing homes and their influence on nursing homes' organizational performance remains unclear. Guided by Resource Dependence Theory, Donabedian’s Structure-Process-Outcome (SPO) framework and the Resource-Based View of Firms perspective, the purpose of the three papers included in this dissertation was to provide empirical evidence of the contextual and organizational factors that influence AD SCUs adoption among nursing homes and how the adoption of AD SCUs impact nursing …

Oxygen Cost Of Walking And Its Correlates In Multiple Sclerosis, Brenda Jeng

All ETDs from UAB

Multiple sclerosis (MS) is a chronic, neurological disease characterized by demyelination and transection of axons as well as loss of neurons in the central nervous system that may result in poor walking efficiency, indicated by an increase in the oxygen cost of walking (Cw). The Cw is defined as the amount of oxygen consumed per kilogram of body weight per unit distance walked and reflects disability-related gait abnormalities and manifestations and its interaction with the environment. This dissertation involved four research projects. The first project provided an overview of existing research on the Cw in MS and established a research …

The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn

All ETDs from UAB

Hospital Acquired Infections (HAIs) are among the top five leading causes of death in the United States (Scott, 2009). Estimates of the annual direct medical costs of HAIs to U.S. hospitals have ranged from $28,400,000,000 to $33,800,000,000 (Scott, 2009). Many leading health care organizations have agreed that there is a link between infection prevention and the spread of HAIs (Allegranzi, 2009). This study explored health care workers’ hand hygiene compliance and whether automated compliance reporting improved compliance. A new system powered by technology called Near Field Magnetic Induction (NFMI) found a significant increase in compliance upon introduction of an automated …

An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge

All ETDs from UAB

Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …

The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados

All ETDs from UAB

Two significant events transpired in Louisiana that had sweeping changes for the healthcare system between 2013 and 2016: (1) the privatization of the nation's only stateowned Charity Hospital System via cooperative endeavor agreements with local, private hospitals known as public-private-partnerships (PPP), and (2) the implementation of Medicaid expansion, referred to as implementation of the Affordable Care Act (ACA). Either event independently could have had significant utilization and financial implications for hospitals. This retrospective, quasi-experimental research implemented a generalized estimating equation (GEE) analysis to examine the effects of PPP and ACA on Medicaid patient emergency department utilization by PPP hospital designation, …

The Role Between Transactive Memory Systems In The Relationship Between Psychological Safety & Quality In Interprofessional Healthcare Teams, Tera L. Webb

All ETDs from UAB

During uncertainty, the optimum solution for work-related problems or patient care cases require the scopes of practice and competencies beyond a single profession. For this reason, the collaborative efforts of interprofessional teams are a widely used approach to patient care and medical decision making. The interdependency between healthcare professionals with varied expertise and input often lead to desired outcomes. Beyond the structure of the team, there are numerous cognitive processes at play that impact knowledge transfer in highly skilled teams that impact outcomes. Therefore, this dissertation will review relevant literature on two cognitive constructs – psychological safety and transactive memory …

The Role Of Alternative Payment Models In Pharmaceutical Services And Outcomes, Matthew G. Parker

All ETDs from UAB

A persistent challenge within the healthcare sector is balancing cost containment for health services and the quality of care associated with these services. This challenge has reinvigorated interest in alternative payment models (i.e., risk-sharing, shared savings, capitation), arrangements between payers and healthcare providers that structure reimbursement for services based on health outcomes. Although much research has assessed the association between these payment models and financial outcomes for medical services, there is a paucity of research that has likewise assessed pharmaceutical outcomes (i.e., electronic prescribing, evidence-based prescribing, medication adherence). The papers comprising this dissertation contribute to this limited body of research …

Nutrition Practices And Body Composition In Infants Born Preterm, Maggie Jerome

All ETDs from UAB

Adequate nutrition and optimal growth are critical goals of clinical care for premature infants in the NICU due to rapid brain growth and development that occur during this time. Emerging evidence suggests that body composition in preterm infants is predictive of neurodevelopmental and metabolic outcomes later in childhood. The objective of this dissertation is to investigate factors affecting premature infant growth and body composition, including high enteral protein supplementation, nutrition during the first two weeks of life, and race of infants born at 22-32 weeks gestational age admitted to the UAB NICU. In a pilot study, 56 preterm infants were …

Exploring The Influence Of Psychosocial Stress And Inflammatory Properties Of The Diet On Cardiometabolic Risk And Gut Microbiome Health Among Young Adult Women Of Birmingham, Alabama, Rachel Olivia Knight

All ETDs from UAB

Concerning trends for obesity, diabetes, heart attacks, and obesity-related cancers, or cardiometabolic disease (CMD), are developing within the emerging and young adult/adulthood (EYA) population. Evidence supports the concept that chronic stress leads to physiologic dysregulation, reduced mental health, chronic diseases, and reduced longevity; however, these are not inevitable outcomes, and resilience or vulnerability is determined by interacting environmental and biobehavioral factors. Although CMD manifests clinically in older adulthood, disease pathophysiology begins earlier, and thus, EYA is a critical time for observation and intervention. Growing evidence indicates inflammation is a major risk factor in CMD development and may be exacerbated by …

Health Disparities In Cardiometabolic Risk Among African American And European American Adults, Catharine A. Couch

All ETDs from UAB

African American (AA) individuals are disproportionately burdened by cardiometabolic disease, including type 2 diabetes (T2D) and cardiovascular disease (CVD), and associated risk factors. The objective of this dissertation research was to investigate pathophysiological and lifestyle contributors to racial disparities in cardiometabolic disease including beta-cell dysfunction, ectopic fat, the natriuretic peptide system, and diet. These first three risk factors, beta-cell dysfunction, ectopic fat, and the natriuretic peptide system, were explored in a cross-sectional study of young AA and European American (EA) adults. The fourth risk factor, diet, was explored in a large, national cohort of black and white adults. First, we …

Improving Empathy Of Occupational Therapy Students Through Reading Literary Narratives, Cavenaugh Kelly

Journal of Occupational Therapy Education

This study explored the impact of teaching empathy to occupational therapy students through the close reading of literary narratives. The study defined empathy as a dynamic process involving Theory of Mind (ToM), emotional resonance, and empathy as a willful act. Empathy is an espoused value of occupational therapy challenged by the modern demands of the market-driven health care system, and research suggests reading literary narratives, or stories with qualities of literature, facilitates greater empathy. Prior studies have also indicated that practicing with greater empathy improves health outcomes and makes occupational therapy sessions more client centered. In this study, a quasi-experimental …

Family Relationships And Academic Performance Via Belongingness Among Cuban Medical Students: Examining Family Legacy And Sex As Moderators, Maria J. Cisneros-Elias

Theses and Dissertations

Medical diplomacy is a foundational part of Cuban domestic and foreign policy (Feinsilver, 2010). Cuba has an abundance of doctors, encouraged by the country’s free medical education program (Hand et al., 2020), and has made a significant impact with its well-established healthcare system, provision of healthcare for all of its citizens, and healthcare support internationally. The current study aims to focus on processes underlying Cuban medical students’ academic performance, as they are a critical component of this successful system, and a population that has received limited empirical attention. Thus, the current study used path analyses to examine the relations between …

Locating Uncertainty In Hospital Leader Sensemaking And Sensegiving Of Organizational Change: A Single Case Study, Sara E. Barry

Antioch University Dissertations & Theses

Leaders planning strategic change face significant ambiguity and uncertainty due to the complex, fast-paced, and volatile nature of organizational life. What one leader sees as an opportunity, another may view as a threat depending on their past experiences, their existing mental models, and their perceptions of uncertainty. Sensemaking and sensegiving theories provide a framework for how leaders retrospectively make sense of new and disorienting information through recursive cycles of interpretation, action, and learning, and seek to influence the meaning-making of others towards a shared vision of the strategic change. Despite decades of research using these theories, studies have yet to …

A Vista Of Kahana Bay, Haryashpal Bhullar

HCA Healthcare Journal of Medicine

This is a picture of Kahana Bay in Honolulu, HI I took when I was visiting my friend stationed at Tripler Army Medical Center last year. Like me, he is a Psychiatry resident and I had not seen him in over a year, so meeting him was quite meaningful to me as we had so much more to talk about. Having this vista behind us while we climbed and shared stories made for one of the best hikes of my life. I often look at this photo and realize the freedom we had to fly to all sorts of beautiful …

Corona, Syed Anjum Khan

HCA Healthcare Journal of Medicine

We all are witnessing unprecedented pain and suffering, enduring unsurpassed tribulations. As a doctor working in an intensive care unit each day, I carry the burden of my patients and their families, my coworkers, my own family and friends. I never think about myself, the burden on my soul.

Yet I believe there will be a better tomorrow. A new day, where COVID times will be remembered with tears in our eyes yet a comfort in our smile that it’s past.

An Investigation Into The Prevalence Of Use And Availability Of Information On Contraception For Female Third Level Students Aged 18-24, Barbara Dymet, Jane Hyde, Chloe Madden, Ciara Walsh

International Undergraduate Journal of Health Sciences

Introduction:

The purpose of this investigation was to find out the amount of female students in third level institutions who use contraception as well as their attitude towards the availability of information about female birth control options in these institutions.

Materials and methods:

An online survey was created using Google Docs which was then sent out to undergraduate third level female students over the age of 18. All gathered data was analysed using Microsoft Excel.

Results:

The vast majority of the surveyed population was sexually active and used contraception with the most common form being a combination of the contraceptive …

A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry

English Theses

Florence Nightingale’s vision for nursing has changed greatly in the past one hundred and fifty years, with nursing’s identity replaced with an emphasis on science over caring. The fast-paced, technologically sophisticated environments, designed to meet the declining health of an American public, have resulted in nurses who are being pulled away from nurse-to-patient caring acts and the reasons they felt called to become nurses. These changes have had detrimental psychological and emotional effects on nurses and are especially evident in Intensive Care nurses. Expressive writing as poetry, autoethnography, and participation in vibrant writing communities offer nurses experiences for healing, voice, …