Programs and Communities
The collection collates collections by schools, centers, programs, and research groups.
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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 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.
Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.
This project evaluated an evidence-based intervention to increase cervical cancer screening among underserved women in a federally qualified health center (FQHC). Female patients ages 21 to 65 years without history of hysterectomy (n=1,710) were sent reminders to their phones through the electronic health record (EHR). The message included educational material about the screening process and an announcement regarding government aid for free or reduced cost screening.
The number of patients who made an appointment after receiving the message was assessed two months later. In total, 156 responses were collected, and 28 patients made an appointment for screening. The most frequently observed category of Ethnicity was Hispanic/Latina (n = 24, 86%). The most frequently observed category of Insurance was Title X (n = 13, 46%). The observations for Age had an average of 41.04 (SD = 9.93). Using an EHR communication function to send motivational reminders has shown some promise for increasing cervical cancer screening, thereby reducing cervical cancer mortality among the underserved.
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.
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.
Purpose: To collect and analyze participant demographic information and explore use of instruments to measure perceived social support and quality of life at a local cancer support program. Specific objectives included:
1. Gather and analyze participant demographic information and program utilization by participants for a non-profit cancer support agency.
2. Assess the extent to which those using the support programs experience perceived social support (PSS) and quality of life (QOL).
3. Assess the utility of the survey process and selected instruments to guide program planning.
Background: Obtaining the diagnosis of cancer is traumatic, but support groups assist in emotional healing among group members. There is strong evidence correlating support group participation with PSS and QOL. The Wilson and Cleary model of QOL clearly links social support and QOL and provided the conceptual framework for this project.
Methods: A survey for self-reported participant demographics, support activities, QOL scores, and PSS scores was implemented. Both online and pencil and paper surveys were available. Instruments included the Flanagan Quality of Life Scale (Cronbach’s α = .82 to .92) and the Multidimensional Scale of Perceived Social Support Scale (Cronbach’s α = 0.91) and a demographic survey created for this project.
Outcomes: All but one survey was completed online (n=48). Respondents were primarily white, female, cancer free at the time of the survey, and over the age of 55. QOL and PSS scores within this sample emulated previous research of correlations between instruments and people with chronic illnesses.
Conclusion: Correlations of sample demographics and instrument scores reflected current literature; this project validates an effective and affordable means to evaluate program effectiveness. Future use of the survey is to better tailor services to meet the objectives of the agency to improve QOL for all individuals affected by cancer.
Keywords: Cancer, support group, quality of life, perceived social support
Background and Significance: CRC is the second leading cause of cancer-related deaths in the United States among men and women. Current CRC screening rates remain low, even with advanced screening options available. Meaningful Use sets specific objectives for health care providers to achieve. Documenting CRC screening status and recommending CRC screenings to patients is one of the objectives of Meaningful Use and is considered a Clinical Quality Measure (HealthIT.gov). Factors that lead to CRC screening include primary care providers (PCPs) raising the topic, involving support staff, involving patients in the decision-making process, and setting alerts in electronic health records (EHRs).
Methods: The Health Belief Model and Ottawa Model of Research Use helped guide this project. The project took place at a private primary care practice. The focus was on patients between the ages of 50 and 75 years old meeting criteria for CRC. Five PCPS and five medical assistants (MAs) chose to participate in the study. Participants were given pre and post Practice Culture Assessment (PCA) surveys to measure perceptions of the practice culture. The project included a three-part practice change: PCP and MA education about CRC screening guidelines, EHR documentation and reminders, and a change of patient visit workflow which included having MAs review patient's CRC screening status before they were seen by the PCP and handing out CRC screening brochures when appropriate. PCPs then ordered the appropriate CRC screening, and the MA documented the screening in the EHR under a designated location. CRC Screening Project Evaluation Forms were completed by MAs after each patient visit.
Outcomes: No significant difference from pre to post survey satisfaction scores were found (t (8) = - 1.542, p= = .162). Means of quantitative data were reported from the CRC screening evaluation forms; N=91. The most common method of screening chosen was colonoscopy, 87%. A strong correlation was found (r (-.293) = .01, p<.05) between receiving a CRC brochure and choosing a form of screening. Meaningful Use scores pre and post project are pending.
Conclusion: Patients are more likely to choose a screening method when the topic is raised in a primary care setting. Continued staff education on workflow is important to sustain this change. Further research is needed to evaluate cost effectiveness and sustainability of this practice change.
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.
Approximately 15,270 children were diagnosed with cancer last year and a common treatment includes daily radiation therapy. Children must remain immobilized for the planning and treatment to ensure the radiation beam precisely delivers radiation to the tumor and reduces exposure to the normal surrounding tissue. Radiation therapy may last several weeks, which requires children to be put under daily anesthesia for an extended length of time to ensure immobilization. The risks for anesthesia include airway obstruction, broncho/laryngospasm, oxygen desaturation, apnea, nausea/vomiting, hypothermia, hypotension, hypoxia, cardiac arrest, sepsis due to central line access, and death. The relationship between daily anesthesia administration and neurotoxicity is currently unclear.
The purpose of audiovisual distraction (AVD) during radiation therapy was to decrease anesthesia exposure, improve quality of life, and decrease anxiety of patients and families. A plan to implement an AVD device at the time of radiation planning and during daily treatments was conducted in a large pediatric radiation oncology practice in Arizona. Inclusion criteria were children needing radiation, between the ages of 5 and 15, who do not have history or complaint of visual impairment, who have the ability to follow directions for AVD, and were deemed candidates by the Radiation Oncologist and Child Life Specialist through physical and mental assessment. Data collection included anesthesia requirements, heart rate, PedsQL Tool, and time in treatment room gathered at the planning session and at the end of treatment. Microsoft SPSS was used for data analysis. Descriptive statistics were used to describe the sample and outcome variables.
The aggregated data was analyzed to ascertain if the number of children in the inclusion age range had a decreased need for anesthesia, decreased anxiety, and increased quality of life. The primary outcome for the AVD was: all four children who participated were able to undergo radiation therapy without the need for anesthesia . The children were able to remain awake for treatment could attend school, as permissible, eat before treatment, and spend significantly less time at the treatment facility. The concern of repetitive anesthesia and neurotoxicity will not be a factor in the child’s long term late effects of treatment. The reduction of need on anesthesia staff and nursing staff was estimated to save over 500,000 dollars for the 89 treatments the four children underwent with the AVD. The benefits of the intervention not only provided a better treatment experience for all children, but it allowed the facility to utilize the treatment machine more efficiently, providing radiation therapy as an option to even more patients.
There is an increasing number of cancer patients outliving their diagnosis and treatment and requiring more support as they transition to cancer survivors. To bridge this gap, survivorship care plans should be provided to all cancer survivors to provide post treatment plans of care, recommendations, and resources (Commission on Cancer, 2016). A quality improvement project was implemented in the urology practice of a National Cancer Institute-designated, academic hospital in Phoenix, Arizona to provide survivorship care plans to prostate cancer patients with surgical intervention as their cancer treatment.
Through interprofessional collaboration, the process change was designed and implemented with the residents and Physician Assistants of the urology practice. There was a 93% adherence rate in delivering the survivorship care plans during the project. The “Confidence in Survivorship Information” questionnaire was used to measure the patients’ confidence in survivorship information prior to and after receiving a survivorship care plan. A paired t-test showed statistical significance in improvement in confidence in the knowledge of long-term physical effects of cancer treatment, strategies for preventing and treating long-term physical effects, and resources available for family members who may be at risk. The project will continue in order to meet requirements for cancer programs established by the Commission on Cancer (Commission on Cancer, 2016).