Medical Humanities Commons^™

The Relationship Between Emergency Department Wait Times And Inpatient Satisfaction, Polly Jean Davenport

All ETDs from UAB

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Development And Testing Of The Primary Care Homeless Organizational Assessment Tool (Pc-Hoat) To Evaluate Primary Care Services For The Homeless, Jocelyn Louise Steward

All ETDs from UAB

The purpose of this dissertation is to develop and test an organizational assessment tool that can used to evaluate primary care services for the homeless. The research evaluates the importance, feasibility, reliability, and validity of organizational processes and structures of primary care services for the homeless. The final product is the validated Primary Care Homeless Organizational Assessment Tool (PC-HOAT). This tool provides stakeholders with information regarding the organizational structures and processes associated with greater quality of primary care for the homeless. This tool will help managers better understand their organization's strengths and weaknesses, guide discussions regarding operations, and provide information …

Employer-Based Wellness Programs; Financial Value To The Organization, Ricky D. Wallace

All ETDs from UAB

The health and wellness of employees is of strategic importance for healthcare organizations to achieve leadership in accountable care and health reform. This study sought to discover whether an organizational program, focused on health promotion and wellness for employees, has a value to the organization. This quantitative evaluation study examines variables of a wellness program implemented at a medical facility in the United States by determining the medical costs among participants and non-participants of the facility sponsored wellness program. The results of the study provide valuation evidence concerning the program's value to the organization.

Syndecan Knockdown In The Insulin Producing Cells Of Drosophila Melanogaster Affects Energy Metabolism And Life Span, Jonathan Lund Warren

All ETDs from UAB

Drosophila melanogaster is a powerful model organism for studying human metabolic disease due to the conservation of various signaling processes and pathways. The insulin producing cells (IPCs) in the brain of adult flies sense circulating nutrients and respond by producing three insulin-like peptides (dILP2, dILP3, and dILP5). Several studies have shown that dILPs play a major role in Drosophila reproduction, metabolism, growth, and longevity. Previous data showed that flies homozygous for a hypomorphic mutation in the Drosophila syndecan (dSdc) gene had defects in energy metabolism and lower expression of brain dilp2-3 and dilp5 genes. Syndecan is a transmembrane proteoglycan that …

Employment Of Physician Administrators (Ceos) In Acute Care Hospitals And Their Impact On Hospital Performance, Muhammad H. Al-Midani

All ETDs from UAB

that arribada nesting enhances the survival of eggs and hatchlings through the confusing

Knowledge, Attitude, Lifestyle Practices, And Quality Of Life In Sporadic Lymphangioleiomyomatosis Patients, Shahpar Vafamand

Walden Dissertations and Doctoral Studies

Lymphangioleiomyomatosis (LAM) is a rare lung disease recognized by abnormal growth of smooth muscle cells proliferating in lungs parenchyma, developing benign tumors, migrating to the other organs, and ultimately leading to respiratory failure and death. Despite existing literature mainly on clinical aspects of LAM, there is a gap of literature in regards to the knowledge, attitude, and lifestyle practices (KAPs) of LAM patients and their effects on their quality of life. The purpose of this quantitative study was to investigate the KAPs of the sporadic LAM patients as measured by the Bristol Chronic Obstructive Pulmonary Disease Knowledge Questionnaire, Beliefs and …

Assessing System Congruence By Analyzing The Relationship Between Employee And Patient Driven Outputs, Timothy J. Harlin

All ETDs from UAB

Patients are at risk for employee driven preventable adverse events during hospital stays. These adverse events are varied and include such things as medication errors, pressure ulcers, hospital acquired infections, and falls. Preventable adverse events continue at alarming frequency despite significant academic, regulatory, and management attention to the topic over the past 14 years since the Institute of Medicine's (IOM) To Err is Human report. In addition to being at risk for preventable adverse events, patients experience aspects of the health care system such as ease of access, employee attitude, skill and efficiency of staff, and perceived value. Although purporting …

Assessing Patient Care Quality From Hospital Employed Physicians, Kerry Gil Gillihan

All ETDs from UAB

ASSESSING PATIENT CARE QUALITY FROM HOSPITAL EMPLOYED PHYSICIANS KERRY GILLIHAN ADMINISTRATION-HEALTH SERVICES ABSTRACT Background: Physician employment by hospitals and healthcare systems has become a growing phenomenon in America. Also the emphasis on improving patient care quality is receiving increasing attention. Moreover, recent changes in federal regulation and reimbursement have made improving patient care quality an imperative for hospitals and their medical staffs. The purpose of this study was to determine if there is a demonstrable relationship between hospital employed physicians and the quality of their patient care. Methods: Physician quality measurements were obtained from a prominent community hospital with roughly …

Risk Assessment And Staging Of Cardiometabolic Diseases, Fangjian Guo

All ETDs from UAB

Obesity is associated with elevated risk for morbidity and mortality and has become an epidemic both in the United States and around the world. Insulin resistance is essentially involved in the pathogenic process of cardiometabolic diseases in obese people, which involves defects in glucose production by the liver and insulin-stimulated glucose uptake and utilization by peripheral tissues. Insulin resistance appears at an early stage of life and is the first step in the development of cardiometabolic diseases. Long-term insulin resistance will induce metabolic syndrome and prediabetes and eventually will cause type 2 diabetes and cardiovascular diseases. Obesity may exacerbate insulin …

Measuring The Relationship Between Contextual Factors, Nurse Staffing Patterns, And Hospital Performance, Dong Yeong Shin

All ETDs from UAB

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Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

To Bear Witness: A Journey Of Healing And Solidarity, Updated, Revised, And Expanded Edition, Kevin M. Cahill, M.D.

International Affairs

For more than fifty years, Dr. Cahill has been helping to heal the world, as a leading specialist in tropical medicine and as a driving force in humanitarian assistance and relief efforts around the globe. In this revised and expanded edition, he chronicles extraordinary achievements of compassion and commitment. Bringing together a rich selection of writings, he crafts a fascinating memoir of a life devoted to others. The book includes front-line reports from places under siege—Lebanon, Somalia, Sudan, Nicaragua, Gaza, and Ireland; there are also visionary essays from the origins of the AIDS epidemic and landmine crises, and no less …

Interprofessional Roles Shoulder Dystocia: Maximizing Safety In Community Hospitals, Elizabeth Yznaga

Doctor of Nursing Practice (DNP) Projects

Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been …

Ability And Willingness To Change Among African Immigrant Patients At Akwaaba, Marianne Sarkis, Temitayo Akinbola, Charise Canales, Hana Chamoun, Jacqueline Leaf, Elisabeth Nebie

Local Knowledge: Worcester Area Community-Based Research

What are the challenges faced in treating Hypertension in the Worcester African Immigrant Community?

This study investigates the relationship between the understanding of high blood pressure, and the ability and willingness to modify behavior among African patients at Akwaaba, a free health clinic in Worcester, Massachusetts. In this research, our team specifically explores how the understanding of lifestyle risk factors of hypertension, such as diet, exercise, and levels of stress, influence the willingness and ability to modify behavior among African born patients at Akwaaba. What become clear was that language barriers, cultural differences, and approach to health care within the …

Information Sources In Relation To Information Quality, Information-Seeking, And Uncertainty In The Context Of Healthcare Reform, Jennifer L. Bevan

Communication Faculty Books and Book Chapters

This exploratory study examines information-seeking about the 2010 Patient Protection and Affordable Care Act (i.e. healthcare reform) in relation to the potential barriers of uncertainty,uncertainty discrepancy, and low health self-efficacy. Adult United States participants completed an anonymous online survey about their perceptions and understanding of healthcare reform. Results confirmed recent literature, suggesting a complex relationship between information-seeking and uncertainty. Specifically, for this sample, significant positive relationships were observed between information-seeking about healthcare reform and uncertainty, uncertainty discrepancy, health self-efficacy. Further, uncertainty discrepancy was the potential barrier that accounted for the most variance in predicting information-seeking.Implications of these findings for improving …

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 …

Acute Lung Injury And Acute Respiratory Distress Syndrome Requiring Tracheal Intubation And Mechanical Ventilation In The Intensive Care Unit: Impact On Managing Uncertainty For Patient-Centered Communication, Robert F. Johnson Jr., Jillian Gustin

Peer Reviewed Articles

A 56 year-old male presented with symptoms of pneumonia and findings consistent with acute lung injury (ALI). Deterioration of respiratory function occurred over the first 24 hours of hospitalization leading to placement in an intensive care unit (ICU) followed by tracheal intubation and mechanical ventilation (ETMV). At that time criteria defining acute respiratory distress syndrome (ARDS) were present. The palliative medicine service was asked to address concerns expressed by the patient’s spouse reflecting uncertainty regarding outcome expectations.

When interacting with families of incapacitated critically ill patients, clinicians are advised to employ a patient-centered communication process to alleviate family distress and …

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 …

The Relation Of Hospital Choices In It Infrastructure Spending And Deployment With Hit/Ehr Strategies And Operational Efficiency, Harold Neumeier

All ETDs from UAB

This study examined certain aspects of the association between information technology (IT) strategy and structure changes within hospitals, as well as the effects of IT infrastructure changes on measures of financial performance for these hospitals during the period of 2009-2011. Following the Process School of the Resource Based View, both internal and external information technology resources were examined to see how hospitals had responded to Federal policies related to the "meaningful use" of Health IT and Electronic Health records. Specifically, this study examined changes in information technology spending by hospitals based on size, hospital type, and percentage of revenue derived …

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., …