Medical Humanities Commons^™

Provider-Sponsored Health Plans In The Post-Reform Era, Katherine Ann Meese

All ETDs from UAB

The rise and fall of managed care in the 1980s and 1990s saw many hospitals and health systems in the United States enter and subsequently exit the health insurance market in the form of provider-sponsored health plans (PSHP). The passage and implementation of the legislation such as the Patient Protection and Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act (MACRA) has ushered in an era of value-based reimbursement methods and a heightened focus on population health management, which has stimulated health care organizations to contemplate health plan ownership as a logical strategy. This study examined market …

Reported Clinical And Financial Performance Of Hospitals With Physician Ceos Compared To Those With Nonphysician Ceos, Leon Moores

All ETDs from UAB

Leaders impact organizational behavior and performance, and CEOs may have greater impact via numerous proposed mechanisms. Because of this, organizations expend considerable resources recruiting and selecting CEOs and may benefit from information suggesting a positive impact on organizational performance based upon measurable CEO characteristics. Little work has been done comparing the performance of hospitals with physician CEOs versus non-physician CEOs, in spite of the ease of identification of this characteristic and extant leadership theories suggesting a relationship between technical expertise and success in leading highly technical organizations. We compared multiple measures of reported clinical and financial performance and our linear …

Organizational Characteristics And Environmental Factors Associated With Hospitals Identified As Consolidation Targets, Christi Pierce

All ETDs from UAB

In today’s dynamic healthcare landscape, hospitals face uncertainty and pressure from changing reimbursement schemas, intense government regulation, technological advances, consumer demand and workforce scarcity. These increased pressures have led to an acceleration of consolidation activities as hospitals position themselves to cope with a dynamic and complex external environment by maximizing resources, creating economies of scale and expanding access to care. Despite increased hospital consolidation activity, little is known about what makes a hospital attractive as a consolidation target to an acquiring hospital, particularly post-ACA. The purpose of this study was to evaluate the organizational characteristics and environmental factors associated with …

Three Essays In Hospital Financial Distress: Prediction, Antecedents And Organizational Response, Neeraj Avinash Puro

All ETDs from UAB

The following essays examine the financial distress in acute care hospitals in the United States. The first essay examines the accuracy of prediction models of financial distress, the second explores the factors associated with financial distress and the third essay examines organizational response to financial distress. The first essay compares the predictive ability of three financial distress prediction models: modified Altman Z score (1993), Ohlson O score (1980) and Zmijewski (1984) to more accurately predict financial distress in U.S acute care hospitals. Building on the first essay, the second essay uses the most accurate predictive model to examine acute care …

Postpartum Body Composition And Breast Milk Hormones, Camille Schneider

All ETDs from UAB

The prevalence of both adult and child obesity continues to rise. Children born to mothers with obesity have a greater risk for future obesity and chronic disease. There is an increasing body of literature suggesting that pregnancy and infancy are critical periods influencing the child’s risk for obesity. However, little is known about whether consumption of breast milk from an obese mother might influence the child’s metabolic programming and growth. The purpose of this dissertation was to examine the association of maternal adiposity with insulin and leptin in breast milk and, in turn, whether breast milk insulin, leptin, and glucose …

Effects Of Differential Fore Aft Resistance On Propulsive Force Generation During Walking In Nonimpaired And Poststroke Individuals, Avantika Naidu

All ETDs from UAB

Background: Impaired paretic limb-loading dynamics and force-generation ability due to hemiparesis are partially responsible for permanent locomotor deficits poststroke. During walking, inability of the paretic limb to generate sufficient propulsive-forces causes reliance on compensatory strategies, wherein the nonparetic limb generates the majority of propulsive-forces needed for forward progression and speed modulation. Purpose: To investigate factors that can improve paretic limb propulsion and walking function, I present four studies. The first pertains to a protocol for a poststroke body-weight-support treadmill-training (BWSTT) study, while the others concern a mechanistic exploration of propulsive-force generation during walking against combined and differential FA resistance. Methods: …

Language Of Disability, Language Of Disorder: An Investigation Of Lived Experiences And Perspectives Of Individuals On The Autism Spectrum With Respect To Communicative Interventions, Rebekah Burkhart

Senior Independent Study Theses

The primary purpose of this study was to investigate the lived experiences and first-person perspectives of individuals with Autism Spectrum Disorder (ASD) with respect to interventions for communicative differences and/or deficits characteristic of autism. This study extends limited research into autistic experiences of interventions in the domain of communication. Furthermore, by extending prior research into neurodiverse values among speech-language pathologists (SLPs), this research contributes to the body of professional literature through exploration of autistic voices as in-group sources of expertise on ASD. The researcher recruited participants online, utilizing mixed methods in the form of quantitative surveys and qualitative interviews to …

Development Of A Descriptive Model Of Flow Disruption Effect On Bypass Time In A Cardiovascular Operating Room, Timothy J. Disher

Doctoral Dissertations and Master's Theses

The current paper proposes utilizing extant flow disruption data, collected from two cardiovascular operating rooms, and utilizing that to develop a mathematical model. Of particular interest is bypass time which is a critical surgical phase, the length of which has been linked to post-operation complications such as hospital-borne infections and readmission. By developing a model that predicts bypass time, the present research can determine the impact by types of flow disruptions – coded based on the RIPCHORD-TWA taxonomy, team member disrupted, and where in the surgery the FD occurs.

After a review of literature, a variety of models were explored …

3d Printing In Low Resource Healthcare Settings: Analysis Of Potential Implementations, Alenna Beroza

Dissertations, Master's Theses and Master's Reports

3D printing has gained significant momentum in the past ten years, and its unique advantages make it especially ideal for use in low resource healthcare settings, where many designs have already been successfully implemented. Yet, little has been studied on how 3D printing can be sustainably and functionally implemented in low resource healthcare systems as a manufacturing practice. In this report, three business models are proposed for this implementation: In-House Operator, Independent Operator, and Print Farm. These models were then tested over four months in Kisumu county, Kenya, at two workshops and seven public hospitals. I worked with local medical …

Physical Therapist Views And Experiences With Patient Use Of Marijuana, Arturo De La O Basurto Jr.

Cal Poly Humboldt theses and projects

Conditions seen within physical therapy settings overlap with reasons that patients seek marijuana. For this reason, information about these professionals’ outlooks on patients’ marijuana use in prime. Purpose: Gain current views and experiences of physical therapists (PTs)/physical therapist assistants (PTAs) on their patients’ use of marijuana in the physical therapy field. Methods: PTs/PTAs were invited to complete an anonymous survey asking relative PT/PTA views, experiences, and understanding of patients’ marijuana use. Results: PTs/PTAs who have had experience (did not have experience) with patients who use marijuana received information about marijuana from news media - 61% (60%), patients …

Blended With The Savior: Gregory Of Nyssa's Eucharistic Pharmacology In The Catechetical Oration, John David Penniman

Faculty Journal Articles

Humankind, for Gregory of Nyssa, was poisoned through a primordial act of eating the forbidden fruit from the Garden of Eden. As a result, the toxin of sin and death has been blended into the body and soul of each person, dispersing itself throughout the component parts of their nature. If eating and drinking initiated the spiritual and physical degradation of humanity, Gregory argues, then it must also be through eating and drinking—namely, through the Eucharist—that humanity will be healed. This article proposes that Gregory's instruction on the Eucharist in his Catechetical Oration should be understood as more than merely …

Gender, Gender Roles And Academic Success In Diverse College Students, Noelle Rowe

Renée Crown University Honors Thesis Projects - All

More than ever before, college serves as an important entity to further an individual’s personal and professional goals. An interesting pattern has emerged: women are outpacing men in college enrollment, as well as in degree attainment. Hegemonic masculinity serves as one of many theories to explain this gender gap. Additionally, little research has focused on the topic of hegemonic masculinity exhibited by men of color. Thus, this study had three purposes: to understand the academic behavior and achievement of racially diverse college students, understand how hegemonic masculinity contributes to decreased academic achievement among males, and how hegemonic masculinity differs across …

Gender Differences In First Authors, Peer Reviewers, And Grand Rounds Presenters In Medicine, Parisa Mortaji

Shared Knowledge Conference

Women are underrepresented in senior academic positions that depend on accomplishments like presentations and publications, and gender bias has shown to be a factor. We studied whether gender differences existed in multiple internal medicine venues: first authorship in a national trainee poster competition; first authorship in a national specialty-specific poster competition; peer reviewer-ship in three prestigious medical journals; and in presentations at UNM grand rounds. We found some progress in gender parity overall, but not yet enough. We first studied gender differences in authorship among residents in a 2015 national internal medicine resident poster competition; we found more authors were …

Tell Me More: Promoting Compassionate Patient Care Through Conversations With Medical Students, Danielle Qing, Anjali Narayan, Kristin Reese, Sarah Hartman, Taranjeet Ahuja, Alice Fornari

Patient Experience Journal

Tell Me More^® (TMM) is a medical student driven project that represents a movement amongst the rising generation of physicians to practice humanistic, patient-centered medicine through a collaborative approach. Students interviewed patients to create individualized posters designed to build rapport and trust between patients and clinicians, remind patients of their special strengths by highlighting their unique interests and qualities, and encourage more personal and compassionate patient-clinician interactions in order to enhance the patient experience. Students asked each patient three questions: 1. “How would your friends describe you?” 2. “What are your strengths?” 3. “What has been most meaningful to …

Euthanasia, Assisted-Suicide, And Palliative Sedation: A Brief Clarification And Reinforcement Of The Moral Logic, Peter A. Depergola Ii

Journal of Health Ethics

A persistent misunderstanding of the moral distinctions between the practices of euthanasia, assisted suicide, and palliative sedation suggests a critical need to revisit the relationship each shares with licit medical practice in the context of palliative care. To that end, this essay grounds its arguments in two, straightforward premises: (i) the licitness of medical practice is largely determined by the balance between (a) good ends, (b) proportionate means, (c) appropriate circumstances, and (d) benevolent intentions; and (ii) whereas palliative sedation employs criteria A-D (above), both euthanasia and assisted suicide fail to secure criteria A-C. Drawing from this syllogism, the aim …

Oh Bother!, Jack Williams Phd, Med

Akesis

I often ponder those wonderful days of innocence, and I long to return there as I remember those magical places and things. What imaginations and lightness we had in those times! And our worries, when and if they existed, were like wisps of the wind. We would fall down, cry perhaps a little, then return again and again to the wondrous realities of play. As I have become "a senior citizen" in our often stodgy culture, I have come to realize that we never really lose those wondrous gifts....We just have to remember and work to remind ourselves of those …

Refill, Humza Ahmed

Akesis

The experiences we carry with us play a role in how we see the world. At times, those experiences are accompanied by the negativity, self judgement, and regret that can weigh us down and prevent us from becoming the strongest versions of our selves.

Sometimes, the solution involves finding an environment in which we can pour out our poisons, forgive ourselves for being human, and refill ourselves with positivity and hope.

The defining moment comes when you stare at the puddle of poison before you, and reflect on what you see staring back at you, behind the ripples of self …

Re-Purpose, Jordan Morrison-Nozik

Akesis

I would often take breaks from studying by walking along the beach, collecting any good seashells I would find. I started using them as plant holders, and enjoyed the hermit crab-like appearance.

Refrigerate, Alay P. Nanavati

Akesis

I just wanted to share my experience of burnout since beginning medical school. Given how widespread and common burnout is in the medical field, I felt like there would be many people who could relate to my experience. If my experience could help or even comfort anyone by the fact that they are not alone in the feelings that arise from burnout, it would make this piece worth the effort of writing for me. If anything else, I hope any readers can enjoy reading about the experience of a brand new medical student.

Fiqws 10113 Composition For Creative Expression- Narrative Medicine, Julia R. Brown

Open Educational Resources

No abstract provided.