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Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste 2016 University of Alabama at Birmingham

Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste

All ETDs from UAB

Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …


Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto McCay 2016 University of Alabama at Birmingham

Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay

All ETDs from UAB

RURAL HOSPITAL CLOSURES IN ALABAMA: POST ACA DENNIS O. MCCAY HEALTH SERVICES ADMINISTRATION ABSTRACT Rural hospitals differ from their urban counterparts with regard to two main areas. First, rural hospital patients are usually older, of lower income, and less healthy than those in urban areas. Second, their facilities tend to be smaller, older, and more prone to staff shortages than those in an urban environment. Rural hospitals have been closing at higher rates than their urban counterparts for a number of years, but more so since the implementation of the Affordable Care Act in 2010. The objective of this research …


Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson 2016 University of Alabama at Birmingham

Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson

All ETDs from UAB

As life expectancy continues to increase and the number of elderly Americans rises, public health initiatives are seeking to identify modifiable risk factors to preserve cognitive function and increase quality of life in advanced ages. The primary objective of this dissertation was to investigate dietary patterns, carbohydrate consumption, and insulin resistance as modifiable risk factors that may contribute to the development of cognitive impairment and cognitive decline. Three separate studies were performed in the REasons for Geographic And Racial Differences in Stroke study, a prospective cohort containing 30,239 black and white participants. Cognitive impairment was defined using the Six-Item Screener. …


Correlating High Reliability Organization Practices With Preventable Harms Across Children’S Hospitals Participating In The Children’S Hospitals’ Solutions For Patient Safety Collaborative, Kelly H. Randall 2016 University of Alabama at Birmingham

Correlating High Reliability Organization Practices With Preventable Harms Across Children’S Hospitals Participating In The Children’S Hospitals’ Solutions For Patient Safety Collaborative, Kelly H. Randall

All ETDs from UAB

Background: Despite significant effort, focus, and resources dedicated to reducing patient safety risk, the healthcare system continues to have high error rates. Approaches and strategies implemented to decrease human error have been marginally successful in achieving sustainable reduction in patient harm. Purpose: The purpose of this study was to examine the association between high reliability and patient safety outcomes by testing the following hypotheses: Organizations exhibiting more advanced high reliability practice will have fewer hospital acquired conditions (as defined by the Serious Harm Event Index (SHE) than organizations exhibiting less advanced high reliability practices; and organizations exhibiting more advanced high …


High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley 2016 University of Alabama at Birmingham

High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley

All ETDs from UAB

Calorie restriction (CR) reduces body weight (BW) and adiposity, but is often less than expected due to hypometabolism produced by reductions in lean body mass (LBM). A comparable energy deficit created by combining CR and exercise energy expenditure (EE) has been shown to attenuate the reduction in EE produced by CR. Continuous moderate-intensity training (MIT) is commonly used to sustain energy balance or expedite weight loss, but high-intensity interval training (HIIT) may produce greater results. The purpose of this investigation was to determine if HIIT preserves LBM and improves energy metabolism to a greater extent than MIT in the presence …


Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman 2016 University of Alabama at Birmingham

Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman

All ETDs from UAB

Hospitals operate in turbulent and complex environments with limited resources. Consequently, administrators need to understand how to best use resources and improve a hospital’s positioning in a market. Surgical services is a key operational activity for hospitals, thus, a better understanding of how these services are organized by hospitals likely has important implications for a hospital’s performance and potentially survival. Given the potential importance of surgical services to hospitals, the purpose of this study was three-fold. First, the study identified different surgical profiles of hospitals based on the type and volume of surgical services provided by hospitals. Second, the study …


Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353 2016 Virginia Commonwealth University Honors College

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

Undergraduate Research Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …


Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos MSN RN 2015 University of San Francisco

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …


Written On By Experience, Akesis Anonymous Author 2015 University of New England

Written On By Experience, Akesis Anonymous Author

Akesis

This poem is about a conversation I had with a friend about beginnings, and how any given experience has no intrinsic good or bad qualities, but rather holds whatever we imbibe it with.


What Is My Beginning?, Stephanie Braunthal 2015 University of New England

What Is My Beginning?, Stephanie Braunthal

Akesis

I find that when we ask about beginnings, we are really asking about the present. How did a person come to be who he or she is today? As I try to answer this question about myself, I am finding it easier to express myself in diagrams (pen on scratch paper) than in words. Perhaps this is a product of being a medical student; or perhaps it is because beginnings are a complex amalgam of static forces and fluid experiences that cannot be expressed linearly through prose...Enjoy!


To Care Is To Treat, Himanshu Malhotra 2015 University of New England

To Care Is To Treat, Himanshu Malhotra

Akesis

To Care is to Treat is a reflection of a few experiences from my second and third year that have inspired me to become a palliative care physician.


The Narrative Of My Childhood, Nihit N. Mehta 2015 University of New England, College of Osteopathic Medicine

The Narrative Of My Childhood, Nihit N. Mehta

Akesis

I was a weak child from early on, never able to run or play as much as the other kids in my block. Each month I'd visit doctors, trying my best to recover from common colds and coughs. Luckily, all this changed as I matured and in a way I almost began living a "normal life".

However, when it came to deciding what I wanted to be as an adult, I remembered the sick kid I was and how my doctors were always there for me, helping me "find health." This made me realize that I too, could someday be …


The Descent Down The Step One Rabbit Hole, Katelyn A. Hanson 2015 University of New England

The Descent Down The Step One Rabbit Hole, Katelyn A. Hanson

Akesis

At the start of my second year of medical school I was ecstatic to move away from the study of the normal, healthy human body and to begin to immerse myself in the complex mechanisms behind the pathophysiology of disease. I drew this illustration to connect aspects of my personality with the aspects of medicine I was most excited about exploring deeper. This image was drawn with permanent markers on the cover of a binder dedicated solely to preparing for the first part of the medical licensing exam; I looked at this drawing every day as I drove myself closer …


Laurie's Greenhouse, Elizabeth G. McAndrew, Kelsey Albert 2015 University of New England

Laurie's Greenhouse, Elizabeth G. Mcandrew, Kelsey Albert

Akesis

Pottery by: Elizabeth McAndrew

Photography by: Kelsey Albert and Elizabeth McAndrew

Modeling: Laurie the Bird

Materials: Wheel thrown pottery - Cone 10 white clay and dipped glaze (cobalt blue and mossy green). Philodendron Heartleaf Plant. Laurie is a parrotlet, which is the second smallest species of parrot. Photo editing was done directly on the iPhone photo application.

This photo represents beginnings because it includes many elements of my life that I drew toward me in the year that I began my medical career. Living alone for the first time, I bought plants so that I wasn't the only living thing …


Beginnings, Nehal J. Shah 2015 University of New England

Beginnings, Nehal J. Shah

Akesis

The beginning of one thing signifies the end of another – for one to start, another must end. With that said, under karmic and Hindu belief, we are constantly in a cycle of beginnings, and endings, until we achieve “moksha” – true oneness with God. Furthermore, within each cycle, there are four stages of life that one hopes to go through, carrying out the ideal goals and progress of each existence. Therefore, this life ultimately is a new beginning to an old soul – a soul that has traveled and journeyed upon eons of time to find happiness, spirituality, completeness …


Beginnings: A Letter From The Editors, Akesis Editors 2015 University of New England

Beginnings: A Letter From The Editors, Akesis Editors

Akesis

The editors would like to welcome you to the inaugural issue of Akesis.


Street Drug Markets Beyond Favelas In Belo Horizonte, Brazil, Elenice De Souza Oliveira, Braulio Figueiredo Alves Silva, Marcos Oliveira Prates 2015 Montclair State University

Street Drug Markets Beyond Favelas In Belo Horizonte, Brazil, Elenice De Souza Oliveira, Braulio Figueiredo Alves Silva, Marcos Oliveira Prates

Department of Justice Studies Faculty Scholarship and Creative Works

This study examines whether social disorganization mechanisms that explain clusters of street drug markets in socially disorganized neighborhoods in developed countries can also help explain geographical patterns of drug dealing across neighborhoods in Belo Horizonte, Brazil. Data for this study includes drug arrests from 2007 to 2011 and socio demographic data from the 2010 Census. To examine the influence of exploratory variables on drug market locations, the Negative Binominal regression model was used at two levels of analysis—the Belo Horizonte city center and other neighborhoods including favelas. The findings show that a high hot spot of street drug markets located …


The Transformative And Healing Powers Of Compassion, Forgiveness, And Wonder, Anna C. Eriksson-Marty 2015 Dominican University of California

The Transformative And Healing Powers Of Compassion, Forgiveness, And Wonder, Anna C. Eriksson-Marty

Senior Theses

Since time immemorial, humankind has struggled to coexist peacefully together. As human beings, we strive on our relationships with each other and, yet, with actions of hatred and prejudice, we seem to consistently destroy those very relationships we value so deeply. Our current society is plagued by fear, which seems to run more rampant now – more than ever – with assistance of our rapidly evolving communication technology. The question must be asked, “How can we end this madness and heal ourselves into a kinder and more fulfilling future?” By providing up-to-date scientific research on the human emotions of compassion, …


The Pedagogy Of Medical Humanities : Using Literature And The Visual Arts To Help Future Caregivers Maintain Their Compassion And Resilience., Lisa Higgins Shugoll 2015 University of Louisville

The Pedagogy Of Medical Humanities : Using Literature And The Visual Arts To Help Future Caregivers Maintain Their Compassion And Resilience., Lisa Higgins Shugoll

Electronic Theses and Dissertations

This dissertation argues that medical humanities education for students considering careers in healthcare should begin at the general undergraduate level and should have two primary objectives, (1) providing tools that will help students foster therapeutic, compassionate relationships with their patients, and (2) providing strategies that will help students maintain healthy habits of mind that afford resilience against compassion fatigue. I assert that in order for students to practice compassion for themselves and others three core objectives must be met. (1) Students must be exposed to the fundamentals of bioethics in order to understand the virtue of compassion itself, (2) they …


Maternal Intuition Of Fetal Gender, Michael P. McFadzen, David P. Dielentheis, Ronda Kasten 2015 Department of Obstetrics, Aurora Sheboygan Clinic

Maternal Intuition Of Fetal Gender, Michael P. Mcfadzen, David P. Dielentheis, Ronda Kasten

Journal of Patient-Centered Research and Reviews

Background: Many pregnant mothers feel they have a perception or intuition as to the gender of their unborn baby. There is very little published scientific literature regarding this topic. The study’s goal is to determine accuracy of mothers’ perceptions as to gender of their unborn babies. Many scientists believe a pregnant woman could not determine her baby’s gender by intuition, with a 50% probability of correctly determining the gender. This study should be considered fun science.

Purpose: To objectively measure a pregnant mother’s perception as to the gender of her unborn baby and compare to sonographically proved gender. The study …


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