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The Germ Theory Of Dystopias: Fears Of Human Nature In 1984 And Brave New World, Clea D. Harris 2015 Scripps College

The Germ Theory Of Dystopias: Fears Of Human Nature In 1984 And Brave New World, Clea D. Harris

Scripps Senior Theses

This project is an exploration of 20th century dystopian literature through the lens of germ theory. This scientific principle, which emerged in the late 19th century, asserts that microorganisms pervade the world; these invisible and omnipresent germs cause specific diseases which are often life threatening. Additionally, germ theory states that vaccines and antiseptics can prevent some of these afflictions and that antibiotics can treat others. This concept of a pervasive, invisible, infection-causing other is not just a biological principle, though; in this paper, I argue that one can interpret it as an ideological framework for understanding human existence …


Do Patients With Long-Term Side Effects Of Cancer Treatment Benefit From General Practitioner Support? A Literature Review, Irene M. Ngune, Moyez Jiwa, Alexandra McManus, Jeff Hughes 2015 Edith Cowan University

Do Patients With Long-Term Side Effects Of Cancer Treatment Benefit From General Practitioner Support? A Literature Review, Irene M. Ngune, Moyez Jiwa, Alexandra Mcmanus, Jeff Hughes

Research outputs 2014 to 2021

Background: Alongside specialist cancer clinics, general practitioners have an important role in cancer patients ’ follow-up care, yet no literature summarises the nature, extent and impact of their involvement. This paper addresses this issue through a review of the literature. Methods: Studies were sourced from six academic databases - AustHealth ( n = 202), CINAHL ( n = 500), the Cochrane Library (reviews and trials; n = 200), Embase ( n = 368), PHCRIS ( n = 132) and PubMed/Medline ( n = 410). Studies that focused on interventions designed for patients receiving follow-up care and reported cancer care provided …


Hospital Community Orientation: Predictors And Performance Outcomes, J'Aime Jennings 2015 University of Alabama at Birmingham

Hospital Community Orientation: Predictors And Performance Outcomes, J'Aime Jennings

All ETDs from UAB

The three publishable manuscripts contained within this dissertation examine the predictors and performance outcomes of hospital community orientation. Community orientation is the customization of hospital services to meet identified community health needs. Together, these papers fill gaps in the literature regarding the factors that assist or hinder hospitals from being community-oriented, as well as the effects of community orientation. The first paper uses longitudinal data to examine the organizational and environmental factors that may influence how engaged hospitals are in a community orientation strategy based on the number of activities performed. The remaining papers consider the performance outcomes of community …


Towards An Understanding Of Patient Satisfaction In The Military Health System, Alan Alexander Jones 2015 University of Alabama at Birmingham

Towards An Understanding Of Patient Satisfaction In The Military Health System, Alan Alexander Jones

All ETDs from UAB

The Military Health System (MHS) is the most expansive health care system in the world. The MHS provides health care services to 9.7 million eligible beneficiaries spread across six continents. The MHS budget exceeded $52 billion in 2013 or 10 percent of the total 2013 Defense budget. The cost of health care in the MHS is of great concern to the Department of Defense and the US Congress. The MHS needs a strong framework to measure the value of the health care it provides. The purpose of this study was to develop a framework to better understand Patient Satisfaction in …


Examining The Interplay Of Diet Composition, Cardiometabolic Diseases, And Economics, Kenneth Patton Kell 2015 University of Alabama at Birmingham

Examining The Interplay Of Diet Composition, Cardiometabolic Diseases, And Economics, Kenneth Patton Kell

All ETDs from UAB

Despite the invaluable contributions that both randomized controlled trials and longitudinal studies have made to our understanding of the relationships between diet and cardiovascular disease (CVD), a comprehensive understanding of these relationships does not yet exist from birth to death. Furthermore, the longest running of these longitudinal studies have not included a representative portion of racial minority participants. Lastly, given the financial impacts of CVD, as well as how socioeconomic status (SES) can influence diet, the interplay between these three merits consideration. Therefore, the objective of this dissertation was to evaluate the associations between diet and cardiovascular disease (CVD): 1) …


The Impact Of Cultural Competency On Patient Experience Of Care, Emily Lane Koudelka 2015 University of Alabama at Birmingham

The Impact Of Cultural Competency On Patient Experience Of Care, Emily Lane Koudelka

All ETDs from UAB

The impact of hospitals’ cultural competency on inpatient experience of care will be examined. Enhanced patient experience of care may alter an individual’s willingness to use health services, thereby increasing access and decreasing health disparities. As a result, to the extent that cultural competency influences patient experience of care, the integration of cultural competency into healthcare organizations has emerged as a critical issue for researchers, industry leaders, and policymakers. Findings from this study will inform policies, practices, and processes across the broad spectrum of healthcare industry stakeholders.


Linking Adiponectin And Autophagy In The Regulation Of Breast Cancer Metastatic Potential, Emily Libby 2015 University of Alabama at Birmingham

Linking Adiponectin And Autophagy In The Regulation Of Breast Cancer Metastatic Potential, Emily Libby

All ETDs from UAB

Curative approaches for metastatic breast cancer remain elusive. Adiponectin is the most abundant of the adipocyte-secreted adipokines, and there is recent interest in development of adiponectin-based therapies for this disease. Yet, while multiple epidemiological studies have indicated that low levels of circulating plasma adiponectin portend poorer prognosis, recent work has reported that elevated adiponectin expression in breast tissue correlates with advanced disease. Further, isoform-specific roles of this molecule are not well understood. Thus, the overarching purpose of this work was to elucidate how adiponectin isoforms contribute to the microenvironmental regulation of the early steps of breast cancer metastasis. We show …


Intensivists And Organizational Performance, Glenn Barthwick Liddle 2015 University of Alabama at Birmingham

Intensivists And Organizational Performance, Glenn Barthwick Liddle

All ETDs from UAB

Because of the high intensity of care and the extremely complex medical conditions being treated, intensive care units (ICUs) represent one of the most significant units within a hospital. Despite the significance of the ICU, the majority of the care provided in the ICU has historically been managed and coordinated by referring or attending physicians, who often do not have the specialized training needed to effectively care for the exceedingly acute patients in the ICU. More recently, however, a growing number of hospitals have begun staffing the ICU with intensivists. Intensivists are uniquely trained physicians that specialize in providing care …


Patient Activation: An Examination Of The Relationship Between Care Management With Patient Activation-Customized Coaching And Patient Outcomes, Cindy L. Reistroffer 2015 University of Alabama at Birmingham

Patient Activation: An Examination Of The Relationship Between Care Management With Patient Activation-Customized Coaching And Patient Outcomes, Cindy L. Reistroffer

All ETDs from UAB

As part of healthcare reform, patient engagement is becoming an important area of focus. Most recently, patient activation, as part of engagement, has been studied; however, interventions to improve activation are not well identified. The purpose of this dissertation was to empirically examine whether enrollment in care management with patient activation (PA)-customized coaching was associated with patient outcomes of utilization, medication adherence, and clinical outcomes. The study utilized the chronic care model framework and theoretical insights from social cognitive theory to examine the relationships among three hypotheses. Secondary data related to commercially-insured enrollees in Priority Health were used to test …


Bioavailability Of Dietary Oxalate, Mary Catherine Robertson 2015 University of Alabama at Birmingham

Bioavailability Of Dietary Oxalate, Mary Catherine Robertson

All ETDs from UAB

Urolithiasis, or kidney stone disease, is a costly and painful health problem affecting about 8.8% of Americans with prevalence on the rise. Calcium oxalate stones account for about 80% of all stones. Increased urinary excretion of calcium and oxalate is a risk factor and central feature of such stones; dietary oxalate contributes up to 50% of urinary oxalate. The purpose of our research is to determine if physical manipulation such as chewing or blending prior to ingestion may render some oxalate more accessible for absorption in spinach, a high-oxalate food. In this crossover, controlled trial we enrolled six healthy, non-stone …


Emergency Department Wait Time Communication Strategies And Patient Throughput Efficiency, Tom R. McDougal 2015 University of Alabama at Birmingham

Emergency Department Wait Time Communication Strategies And Patient Throughput Efficiency, Tom R. Mcdougal

All ETDs from UAB

This study investigates hospital strategies used to inform patients of anticipated wait times in the Emergency Department (ED) and the association of such strategies with patient throughput efficiency. When hospitals are inefficient in ED patient throughput, conditions of overcrowding often occur. Overcrowding of the ED is a problem for many hospitals. When such conditions exist, there is evidence in the literature that it leads to lower patient satisfaction, care quality, and financial position of the hospital. Therefore, improving patient throughput efficiency is a priority for hospitals. To improve patient throughput efficiency, hospitals use a variety of strategies. This study focuses …


The Interrelationships Among Obesity, Insulin Sensitivity, And Bone Phenotype In Pre-Pubertal Girls, Anna L. Newton 2015 University of Alabama at Birmingham

The Interrelationships Among Obesity, Insulin Sensitivity, And Bone Phenotype In Pre-Pubertal Girls, Anna L. Newton

All ETDs from UAB

Impaired insulin sensitivity as a consequence of childhood obesity has been implicated as a contributor to skeletal fragility. There is a need to understand the interrelationships among insulin sensitivity and skeletal parameters (i.e. cortical, trabecular, marrow) in obesity during the pubertal transition. Further, calorie restricted weight loss to stabilize these relationships warrants investigation as well. The goal of this project was to examine the relationships among body composition, skeletal parameters, and insulin sensitivity. The first aim was to evaluate the relationships among total body fat, bone mineral content (BMC) and femoral bone marrow adipose tissue (BMAT) during childhood and underlying …


The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran 2015 University of Alabama at Birmingham

The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran

All ETDs from UAB

The rate of hospitals merging has increased significantly over the last few years. The number of hospital mergers between 2003 and 2009 averaged 55 per year, while mergers for 2010 and 2011 were 72 and 90, respectfully. This research moved beyond anecdotal reports and by using publicly reported data to not only evaluate the financial success of mergers, but also to look at other factors such as size, ownership, geography, environment (urban vs. rural), and market competitiveness to assess impacts on financial outcomes of mergers. This study examined the effect of joining a hospital system based on financial performance. Further, …


Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian 2015 University of Alabama at Birmingham

Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian

All ETDs from UAB

ABSTRACT Patient experience scores have become important indicators of value in healthcare. This study was the first of its kind to examine CEO gender, tenure, and education in relationship with patient experience scores and all other value based purchasing scores, such as outcome, efficiency, clinical process of care, and total performance scores. This study suggested that hospitals with certain types of CEOs may perform better with respect to patient experiences and other value based purchasing scores. The primary analysis of this study was to examine the impact of hospital CEO characteristics (tenure, education, gender) on patient experience scores. A supplementary …


Safety Culture And Patient Harm, Alfonso Gatmaitan 2015 University of Alabama at Birmingham

Safety Culture And Patient Harm, Alfonso Gatmaitan

All ETDs from UAB

SAFETY CULTURE AND PATIENT HARM EVENTS: A CONTINGENCY THEORY PERSPECTIVE IN THE CONTEXT OF COMPLEX ADAPTIVE SYSTEMS ALFONSO GATMAITAN ADMINISTRATION-HEALTH SERVICES ABSTRACT This study examines the correlation between a Culture of Patient Safety as measured by hospital staff surveys and actual patient harm attributed to hospital performance. It is generally accepted by health care management leaders that the presence of a strong culture of patient safety has become a critical component in reducing patient harm. However, little empirical evidence within multiple hospitals over time exists to support this belief. Healthcare managers can utilize this evidence in formulating patient safety improvement …


Hospital-Based Skilled Nursing Facilities: Predictors Of Survival And Performance, Shivani Gupta 2015 University of Alabama at Birmingham

Hospital-Based Skilled Nursing Facilities: Predictors Of Survival And Performance, Shivani Gupta

All ETDs from UAB

This three-paper dissertation examined the organizational and market factors predicting the response of hospital-based skilled nursing facilities (HBSNFs) to the changes in their environment such as the implementation of prospective payment system in 1998 and their role in coordination of care for patients in transition from acute care to home or a post-acute care facility. In the first study, population ecology of organizations framework was used to evaluate the organizational and market factors associated with HBSNFs’ closure after 1998. The event histories of all acute-care hospitals which had an open HBSNF in 1998 were examined across 15 years (1998-2012) to …


Associations Of Gestational Weight Gain And Breastfeeding With Postpartum Weight Change Among African American Women, Camille Schneider 2015 University of Alabama at Birmingham

Associations Of Gestational Weight Gain And Breastfeeding With Postpartum Weight Change Among African American Women, Camille Schneider

All ETDs from UAB

Objective: To examine the associations of gestational weight gain (GWG) and breastfeeding (BF) with postpartum (PP) weight change among African American women. Methods: Healthy, low-income African American women (n=32) were enrolled in a prospective observational cohort study of early life origins of obesity. GWG was calculated using data retrieved from medical records. Women were stratified according to the 2009 Institute of Medicine (IOM) GWG guidelines. Investigators measured maternal body weight at 2-weeks and 3-months PP, with the difference reflecting PP weight change. BF status at 2-weeks PP was self-reported. Analysis of covariance with Bonferroni post hoc testing was used to …


Difference In Recommended-To-Actual Nurse Staffing And Patient Falls, Shawn Ulreich 2015 University of Alabama at Birmingham

Difference In Recommended-To-Actual Nurse Staffing And Patient Falls, Shawn Ulreich

All ETDs from UAB

Patient falls are a serious safety concern in hospitals. Injuries from falls can be devastating to patients and are now subject to reimbursement penalties from the Center for Medicare and Medicaid Services. Patient falls have been identified by the American Nurses Association as a nursing sensitive indictor suggesting that improvements in the quality or quantity of nurses may impact this outcome. Moreover, the literature suggests that nurse staffing levels have an impact on various patient outcomes such as patient falls. Therefore, identifying appropriate nurse staffing levels to minimize patient falls is critically important to hospitals. A variety of staffing metrics …


Effectiveness Of Functional Electrical Stimulation Assisted Rowing To Improve Shoulder Pain And Aerobic Fitness In Manual Wheelchair Users With Spinal Cord Injury, Susan Wilbanks 2015 University of Alabama at Birmingham

Effectiveness Of Functional Electrical Stimulation Assisted Rowing To Improve Shoulder Pain And Aerobic Fitness In Manual Wheelchair Users With Spinal Cord Injury, Susan Wilbanks

All ETDs from UAB

Exercise is beneficial to adults with spinal cord injury (SCI) because of its ability to improve function and increase life expectancy. The goal of this dissertation was to determine an effective intervention for increasing aerobic fitness and decreasing shoulder pain in manual wheelchair users with SCI by identifying underlying mechanisms for shoulder pain, optimizing training and utilizing appropriate outcome measures. Three studies were conducted. The first study indicated that exercise interventions for adults with SCI are of low to moderate methodological quality, frequently using outcome measures associated with changes in body structures and functions, and not frequently examining effects on …


Impact Of Medicare Part D Coverage Gap On Medicare Beneficiaries With Copd: Adherence, Healthcare Resource Use, And Cost, Yanni Fan Yu 2015 University of Alabama at Birmingham

Impact Of Medicare Part D Coverage Gap On Medicare Beneficiaries With Copd: Adherence, Healthcare Resource Use, And Cost, Yanni Fan Yu

All ETDs from UAB

Medicare Part D provides prescription drug coverage for beneficiaries to support their pharmacological treatment; however, the complex deductible structure within benefit plans creates a major coverage gap and unexpected consequences. Some evidence has demonstrated reduced adherence resulting from the coverage gap; however, little research has evaluated the effect on healthcare resource use (HRU) and cost, and no studies have been conducted for beneficiaries with chronic obstructive pulmonary disease (COPD). This study examined the impact of the coverage gap on medication adherence as well as healthcare resource use and medical cost among beneficiaries with COPD. Claims data based on a 5% …


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