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An increase in population and need to protect the planet has created many initiatives and research goals in developing alternatives methods of fueling. Federal and state policies have provided a push for industries to find ways to of reducing their impact on the environment while maintaining competitiveness. In the sector

An increase in population and need to protect the planet has created many initiatives and research goals in developing alternatives methods of fueling. Federal and state policies have provided a push for industries to find ways to of reducing their impact on the environment while maintaining competitiveness. In the sector of alternative fuels, large policies such as the Renewable Fuel Standards (RFS) in the United States are making goals to reduce vehicular fuel from coal and oil, and focus on alternative fuels such as ethanol and biodiesel. Along with the RFS and other federal policies, states are introducing independent initiatives to promote the use of alternative fuels.

Research has shown that other crops besides corn can feasibly be used to produce ethanol for fuel use. One of the major crops of interest currently is switchgrass (Panicum Virgatum L.) because of its ability to grow under a variety of weather conditions and soil types. Switchgrass does not require as much maintenance as corn and is a perennial grass that can have high yielding fields for up to 9 years.

This report focuses on the impacts from using switchgrass-derived ethanol to meet the state of Arizona’s policy to have government fleet vehicles operating on alternative fuels. The study uses a life cycle assessment (LCA) approach to evaluate 22 million gallons of ethanol produced in Arizona and stored at fueling stations for use. Impacts in land use, global warming, and water quality are evaluated using software tools and databases in Ecoinvent and Simapro.

The results of the study indicate that the cultivation and harvest phase of the process will contribute the most to negative environmental impacts. According to the study, application of heavy nutrient fertilizer and the machinery needed for the additional agriculture have the potential to contribute over 36 million moles of hydrogen and 89 million CTU eq. to the air, soil, and water.

Created2013-05
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Description
Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a

Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a Federally Qualified Health Center (FQHC). The social cognitive theory underpins the project because patients' portal use behavior can change if changing their environmental factors in the clinic with educational videos. Methods: The Universities Institutional Review Board granted exempt approval to ensure human subject protection. The participants included bilingual adult patients in an FQHC who have access to the internet and email addresses who visited the center during the implementation period. The tablets in the patient rooms displayed the English and Spanish educational video on step-by-step instructions on accessing, using the patient portal, and the benefits of use. The information technology technician pulled aggregate data from the analytics component of the patient portal before and after the four-week implementation period. The data included total number of clinic patients, number of active portal users, number of monthly logins, and gender. The project facilitator used descriptive statistics to compare pre-and post-intervention analytics. Results: Active portal users increased by 0.22% and monthly logins increased by 390 logins. Only aggregate data was collected so the statistical significance was not calculated. Conclusion: This EBP project enhances knowledge on patient portal utilization's impact on patient engagement and may apply to current practice.
Created2022-04-29
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Description
Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in

Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in rural populations Study Design: A top priority of a rural federally qualified healthcare organization (FQHC) was to improve utilization of the AWV due to a patient response well below the national average. A six-week trial was conducted that examined a patient information campaign combined with a strategic workflow that encouraged interoffice collaboration. Methods: The office staff of a pilot medical clinic was selected by the FQHC quality improvement committee as the project site. A Relational Coordination survey (RC) was administered before and after the intervention to determine if the intervention improved interoffice collaboration regarding the AWV. Descriptive questions were used to determine which aspects of the intervention proved useful. Reliability of the survey results was verified by a Crohnbach’s ? > 0.08. An independent samples t test was used with p value < 0.05 to determine statistical significance and confidence intervals. Results: The patient information brochure demonstrated improved patient understanding of the AWV from the office staff perspective as demonstrated by an independent samples t test comparing pre and post survey responses (t(32) = -4.14, p < .001, CI 95%). The RC survey results identified an area for collaborative for improvement between the front office and medical staff.
Created2022-04-29
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Description
Background and Purpose: Across the United States, there are low adherence rates of prenatal care visits, primarily among the low-income and ethnic populations. Inadequate prenatal care education contributes to low appointment adherence and missed prenatal care during their first trimester. The project aim is to assess the current use of paper-based prenatal education

Background and Purpose: Across the United States, there are low adherence rates of prenatal care visits, primarily among the low-income and ethnic populations. Inadequate prenatal care education contributes to low appointment adherence and missed prenatal care during their first trimester. The project aim is to assess the current use of paper-based prenatal education in a Federally Qualified Health Center (FQHC) in southwestern Arizona and inquire if patients would elect to engage in a phone application for prenatal education with appointment reminders. Approach/Methods: The Theory of Planned Behavior was the theoretical framework utilized to guide this project. The Quality Improvement (QI) project gathered information regarding patient technology use and accessibility as well as utilization of FQHC prenatal booklet, collected with a 13-question survey. A non-identifying demographic questionnaire was also distributed during the prenatal visit. Results: Survey responses indicated that patients find utility in prenatal education and appointment reminders provided through a phone application. Out of the total participants (n=23), only 18 had received the prenatal care booklet and completed the entire survey. 80% of participants expressed they would use the phone application while 84% find prenatal education on the phone helpful. In comparison, less than 28% of respondents planned to continue to use the prenatal booklet they were provided at the clinic during their pregnancy. Outcomes: There is potential in utilizing digital platform and appointment reminders at FQHC to improve appointment adherence and early entry to prenatal care. The results will be used to inform FQHC on decisions regarding continuing prenatal booklet use and integration of techbased education formatting.
Created2022-05-02
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Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management. Objective: The purpose of this paper is to review the

Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management. Objective: The purpose of this paper is to review the outcomes of a diabetes education program offered to underserved women in the Southwestern United States. Methods: Four weekly nutrition classes were individualized and taught at a nonprofit organization in the southwest United States. Behavior change was measured using the Summary of Diabetes Self-Care Activities (SDSCA) tool. Classes were advertised via the center’s monthly class calendar and fliers. A total of nine participants (N=9) came to every class and took the SDSCA survey before and after class instruction. Results: Descriptive statistics and two 2-tailed t-tests with the critical value set at p<0.05 were used for data analysis. The participants were Hispanic women, most between the ages of 40-49, and had an income between $0-14,000. The mean difference between the variables of both general diet and specific diet pre and post-tests were significantly different from zero. The assumptions of normality and homogeneity were met. The results of both two-tailed paired sample t-tests were significant suggesting the means of general and specific diet pre-tests were significantly lower than the means of the general and specific diet post-tests. Discussion: The assumptions of normality and homogeneity were met and the results were significant. The pre-intervention scores for both categories were statistically significantly lower than the post-intervention scores for both categories. Thus, the desired outcome of helping clients within the organization modify, adapt, or change self-care behaviors related to diet was met.
Created2022-04-26
Description

The coronavirus (COVID-19) pandemic has affected employment and food security globally and in the United States. To understand the impacts of COVID-19 on food security in Arizona, a representative survey of Arizona households was launched online from July 1 to August 10, 2020. This brief provides an overview of changes

The coronavirus (COVID-19) pandemic has affected employment and food security globally and in the United States. To understand the impacts of COVID-19 on food security in Arizona, a representative survey of Arizona households was launched online from July 1 to August 10, 2020. This brief provides an overview of changes in food security rate, perceived worries and challenges about food security, as well as behavioral changes and strategies adopted since the pandemic. Additional briefs from the Arizona survey covering topics on economic consequences, food access, and participations in food assistance programs during the pandemic are also available.

ContributorsAcciai, Francesco (Author) / Yellow Horse, Aggie J. (Author) / Martinelli, Sarah (Author) / Josephson, Anna (Author) / Evans, Tom P. (Author) / Ohri-Vachaspati, Punam (Author)
Created2020-11
Description

The coronavirus (COVID-19) pandemic led to disruptions in the food supply and high rates of unemployment and under-employment, both in Arizona and nationally. These emergencies required food assistance programs to adapt quickly and in unprecedented ways by relaxing eligibility criteria, improvising on delivery modalities, and increasing benefits. To examine food assistance program

The coronavirus (COVID-19) pandemic led to disruptions in the food supply and high rates of unemployment and under-employment, both in Arizona and nationally. These emergencies required food assistance programs to adapt quickly and in unprecedented ways by relaxing eligibility criteria, improvising on delivery modalities, and increasing benefits. To examine food assistance program participation during the pandemic, we collected data from a representative sample of 620 Arizona households. The sample was drawn from across Arizona in July-August 2020 using an online survey. This brief provides the summary for participation in key food assistance programs, namely, the Supplementary Nutrition Assistance Program (SNAP), the Special Supplemental Program for Women Infants and Children (WIC), School Food Programs, and the emergency food assistance provided through food pantries.

ContributorsMartinelli, Sarah (Author) / Acciai, Francesco (Author) / Yellow Horse, Aggie J. (Author) / Josephson, Anna (Author) / Ohri-Vachaspati, Punam (Author)
Created2020-11
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With more than 19 million confirmed COVID-19 cases across the United States1 and over 500,000 in Arizona as of December 2020, the ongoing pandemic has had devastating impacts on local, national, and global economies. Prior to the pandemic (February 2020), based on U.S. Bureau of Labor Statistics data, the unemployment rate

With more than 19 million confirmed COVID-19 cases across the United States1 and over 500,000 in Arizona as of December 2020, the ongoing pandemic has had devastating impacts on local, national, and global economies. Prior to the pandemic (February 2020), based on U.S. Bureau of Labor Statistics data, the unemployment rate in Arizona was 6.5%, compared to 4.9% at the national level.3 Since the beginning of the COVID-19 pandemic (March 2020), the United States has experienced striking increases in the unemployment rate, reaching 13.2% in April. Similarly, in Arizona, the unemployment rate jumped to over 13.5% in April. The unemployment rates have since declined both nationally and in Arizona but remain higher compared to February 2020. In November 2020 (the most recent data available), the national unemployment rate was 6.7%, while in Arizona the rate was 7.8%—the 10th highest unemployment rate among all U.S. states.

Created2020-12
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Background: The cost of health care for end-stage kidney disease patients has exponentially increased over the years, costing 91,000 annually per patient. Peritoneal dialysis has proven to be a cost-effective renal replacement therapy compared to in-center hemodialysis. Quality evidence from a systematic literature review indicates that peritonitis is one of

Background: The cost of health care for end-stage kidney disease patients has exponentially increased over the years, costing 91,000 annually per patient. Peritoneal dialysis has proven to be a cost-effective renal replacement therapy compared to in-center hemodialysis. Quality evidence from a systematic literature review indicates that peritonitis is one of the leading causes of patients' ability to maintain peritoneal dialysis. Evidence suggests that enhanced patient education on infection control practices beyond standard education effectively reduces peritonitis incidents. Methods: Enhanced education on infection control practices was delivered to 18 peritoneal dialysis patients in Southern Arizona through the application of determinants of the Health Belief Model utilizing the principles of the ADKAR framework. Data analysis will be available through facility-specific quality metrics of decreased peritonitis and modality loss episodes. Each of these measures is to have data compared to pre/post-intervention. Results: All participants in the study were able to sustain peritoneal dialysis as their renal replacement therapy. Of the 18 participants, one patient episode of peritonitis occurred three months before the intervention, and zero episodes were reported during the first three months of monthly infection control education. Facility-specific peritonitis and modality loss measures are not available until after project publication. Conclusion: To decrease peritonitis rates and modality loss, the intervention will continue for eight to 12 months to determine success. More time is needed to determine if patients adhere to monthly infection control practices taught during enhanced education.
ContributorsSchneeweis, A. Danielle (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29
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Describes the LIHEAP benefits distributed to electric utilities companies in Arizona for fiscal year 2019.

Created2021-03