Arizona State University Open Curriculum project. Arizona State University, College of Nursing; Tempe, Arizona.
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Arizona↗
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College of Medicine--The University of Arizona. Department of Medicine. The University-V.A. Hospital Affiliated Program.
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Arizona↗
JUNE 1, 1958, PROGRESS report from the Arizona Poisoning Control Information Center at the University of Arizona College of Pharmacy; toxicity studies of Arizona ornamental plants.
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Arizona↗
Surveying University of Arizona students' health.
The authors sampled more than 600 University of Arizona students to determine how student attitudes, beliefs, and practices should be considered by healthcare personnel in planning campus health education programs. The survey found that students worried more about diet, exercise, and weight than they did about more serious health problems and that, although generally positive and optimistic, the students frequently felt anxious and overwhelmed. Two thirds of the students were sexually active, 74% of those who were active used various contraceptive methods. More than three quarters of those surveyed indicated they currently drank alcoholic beverages; one quarter of the drinkers said they frequently downed three or more drinks on one occasion, and 44% of the drinkers reported driving while under the influence of alcohol.
Arizona↗
Preventing alcohol-related problems at the University of Arizona's homecoming: an environmental management case study.
In 1995, the University of Arizona installed and publicized new policies to provide better alcohol control during its annual homecoming event. Systematic observation at pregame tents revealed that, compared to 1994, these policies led to a lower percentage of tents selling alcohol, elimination of beer kegs, greater availability of food and nonalcoholic beverages, the presence of hired bartenders to serve alcohol, and systems for identification checks. These changes were still in evidence through 1998. In 1995, campus police also saw a downward shift in the number of neighborhood calls for complaints related to homecoming activities, which was maintained through 1998. Statistics on law enforcement actions were inconsistent. There was a sharp drop in 1995, but 1996 and 1998 saw enforcement levels similar to what was seen prior to the new policies. This case study underscores the importance of environmental management strategies for campus-based alcohol and other drug prevention.
Alcoholic Intoxication↗
[Training and practice of neurosurgery in USA-personal experience after two-year fellowship in University of Arizona].
Author describes his observations from two-year neurosurgical fellowship in University of Arizona, USA. During the fellowship he underwent rotations to Pediatric Neurosurgery Department at Phoenix Children's Hospital for one year, Neurosurgery Department at University Medical Center for six months, Neurosurgery Department at Veterans Affairs Hospital for three months and private neurosurgery group based on three separate hospitals for three months. Work in the particular departments is described as well as process of fellowship position obtainment and statistical data regarding fellowships and residences in neurosurgery in USA.
Arizona↗
Interstitial thermoradiotherapy with ferromagnetic implants for locally advanced and recurrent neoplasms.
PURPOSE: The University of Arizona, University of California at San Francisco, City of Hope Medical Center, and University of Wisconsin participated in a Phase I/II protocol to assess the heating ability and the toxicity of interstitial thermoradiotherapy using ferromagnetic implantation. METHODS AND MATERIALS: Forty-four patients with advanced primary or recurrent extra-cranial solid malignancies were enrolled in this study. Fourteen gauge catheters were implanted into tumors and, once in the department of Radiation Oncology, loaded with ferromagnetic seeds to deliver a 60 min hyperthermia treatment. Multi-point thermometry was continuously used throughout the heating sessions for all patients, sampling the periphery as well as the core of the tumor. After 192Iridium brachytherapy, 18 patients then had an additional treatment. The mean radiation dose while on protocol was 50.0 Gy, with total doses (including prior radiotherapy) ranging from 20.3-151.8 Gy (median = 88.7 Gy). Response and toxicity were assessed by inspection, palpation, and/or radiologic studies. Forty-one patients were evaluable for response, and there were 55 analyzable hyperthermia treatment sessions. RESULTS: The complete response rate was 61% (25/41). The partial response rate was 31.7% and only 7.3% failed to respond. Median duration of local control has not yet been reached. The mean maximum, minimum, and mean time-averaged temperatures for all in-tissue sensors were 43.7 degrees C, 38.7 degrees C, and 41.0 degrees C, respectively. Tumor size was the only factor significantly correlated with temperatures or with complete response rate; larger tumors attained higher temperatures but smaller tumors had a higher response probability. Nineteen patients (43%) experienced toxicities, however there was only a 7% (3/44) rate of serious complications (Grade 3 or 4). Prior treatment with hyperthermia was the only factor significantly correlated with serious toxicity. CONCLUSION: These results, a 93% total response with only 7% serious toxicity, are encouraging especially in the context of the patient population treated. Phase II/III studies involving ferromagnetic implantation are warranted.
Adult↗
Digital imaging in dermatology.
In this article we discuss the recent surge in activity in digital imaging in dermatology. The key role of digital imaging as an adjunct to detection of early malignant melanoma, with application in following patients with the dysplastic nevus syndrome, is explored. Other current and future uses of digital imaging in image archiving, in clinical studies such as hair growth studies, and in telediagnosis are reviewed. We review the varying research activities of image analysis laboratories participating in the dermatology image researching group. Research laboratories included in this group are at Oregon Health Sciences University, Xerox Corporation, University of Arizona, University of Cincinnati, University of Munich, University of Wurzburg, University of Arkansas, Harvard University, Southern Illinois University-Edwardsville, Johns Hopkins University, National Institutes of Health, and University of Missouri at Columbia and Rolla. The role of new imaging devices in dermatology including the "nevoscope" and the dermatoscope is explored. Goals and challenges for the new technology are discussed.
Dermatology↗
Intermediate-term results of Phase I Food and Drug Administration Trials of buttoned device occlusion of secundum atrial septal defects.
OBJECTIVES: This study was conducted to evaluate the intermediate-term results of the multi-institutional U.S. trial of the buttoned device for transcatheter closure of atrial septal defects (ASDs). BACKGROUND: The trial was conducted in three centers (University of Arizona, University of Michigan and University of Wisconsin) under a Food and Drug Administration (FDA)-approved clinical trial with investigational device exemption. Only short-term follow-up is known. METHODS: All 46 patients who had successful implantation of the device were prospectively followed up. Patients were evaluated at 1, 6 and 12 months after device occlusion and yearly thereafter. RESULTS: This cohort was followed up from 51 to 68 months (mean 60.8, median 62). Patient ages ranged from 1 to 62 years (median 4); weights ranged from 10 to 105 kg (median 18); and stretched ASD sizes were 14 +/- 4 mm (left to right shunts) and 10 +/- 3 mm (right to left shunts). Of the 46 patients, 45 (98%) had effective occlusion of their ASD, and 34 (74%) had complete ASD closure. The incidence of residual shunts decreased from 65% (30 of 46 patients) at 1 month after device placement to 27% (12 of 45 patients) at last follow-up. All residual shunts were quantitated as trivial. Only two patients (4%) required reintervention for significant residual defects. There were no cases of endocarditis or thromboembolism in 224 patient-years of follow-up. CONCLUSIONS: In up to 5.5 years of follow-up, the buttoned device provided effective closure in 98% of patients in whom the device was successfully implanted. The incidence of residual shunts decreased during follow-up, and no instances of endocarditis or thromboembolism were observed.
Actuarial Analysis↗
Commitment to Underserved People (C.U.P.) program at the University of Arizona.
The C.U.P. (Commitment to Underserved People) Program was established at the University of Arizona College of Medicine to reinforce the commitment of a self-selected group of medical students to careers with medically underserved people and to help them acquire some of the special knowledge, skills, and attitudes essential to effective performance in such careers. The program brings together some preexisting curricular offerings and a number of additional extracurricular activities and experiences. The time demands on the participating students are significant, but not excessive. Support activities are an important aspect and include periodic group meetings, an annual retreat, faculty role models as students advisors, and personal counseling when needed. The program is coordinated by the Department of Family and Community Medicine, but relies on participation of faculty from other primary care departments and the cooperation of a number of community agencies and clinics. The C.U.P. Program was developed in response to an expressed student need, and students have continued to play an essential role in its design and direction.
Arizona↗
Phase II evaluation of amsacrine (m-AMSA) in solid tumors, myeloma, and lymphoma: a University of Arizona and Southwest Oncology Group Study.
A phase II trial was conducted to determine the clinical activity of amsacrine (m-AMSA) in patients with heavily pretreated solid tumors, myeloma, and lymphoma at the University of Arizona Cancer Center. Additionally, m-AMSA was evaluated at other Southwest Oncology Group institutions in breast cancer, myeloma, melanoma, and oat cell cancer of the lung. At a dose of 120 mg/m2 given iv every 28 days, 12 partial responses were observed in 221 patients evaluable for response. Some antitumor activity was observed in breast cancer (four responses of 65 patients), non-Hodgkin's lymphoma (three of nine), Hodgkin's disease (two of five), and sarcoma (two of 15). A partial response was also documented in one of two patients with cervical cancer. Among the 135 patients treated at the University of Arizona who were extensively evaluated for toxic effects, only myelosuppression and anemia were seen in a significant number of patients. At this dose and schedule, 29% of patients developed leukopenia of less than 3000 cells/mm3, 16% developed a thrombocytopenia of less than 100,000 cells/mm3, and 29% had an acute fall in hemoglobin of greater than or equal to 2 g/100 ml. In addition, two patients suffered grand mal seizures which were not clearly drug-related. These results suggest that further study of m-AMSA in lymphoma, sarcoma, and cervical cancer is warranted.
Adolescent↗
Reclassifying infusion therapy space at the University of Arizona: a case study.
This case study focused on reclassifying infusion therapy space at the University of Arizona Medical Center to a physician-based treatment setting. The study followed the managerial decision-making process as it described how the space reclassification was recommended, adopted, and implemented. A successful reclassification required close attention to organizational structure, administrative policies and responsibilities, and related work-flow processes.
Academic Medical Centers↗
A review of the first five years of the University of Arizona telepsychiatry programme.
We performed a retrospective review of the first five years of activity in the University of Arizona Telepsychiatry Programme. The programme began in 1998 as part of a telemedicine service for underserved rural areas. Over the first five years, 1086 teleconsultations were carried out for a total of 206 patients. There were 159 adult (77%) and 47 paediatric patients (23%). During the study period, the racial/ethnic diversity of the paediatric patients increased, as did the number of follow-up visits for adult patients (average 5.3/patient). These trends suggested that telepsychiatry became an integral part of the mental health service system at the six referring sites. Adult patients completed 81 satisfaction surveys (51%) and psychiatrists completed 47 (23%). The responses showed that providers and patients found telepsychiatry services satisfactory, although in a minority of teleconsultations (18% for providers and 17% for patients) equipment problems were distracting. The continued use of the services suggests that the telepsychiatry programme fills a service gap in rural areas of the state.
Adolescent↗
University of Arizona, Cardiac Transplantation: changing patterns in selection and outcomes.
Among 391 patients who received heart transplants at the University of Arizona since 1990, the percentage of bridge-to-transplant device patients receiving donor hearts has increased from 6.7% to 50%. Survival after transplantation in this-bridge-to transplant group and has been consistently 10-15% lower than patients who do not require a device. The result has been that our overall survival rate is beginning to fall. We have come to 2 major conclusions based on these results: First, the current UNOS system ranking candidates as Status 1A, 1B, and 2 may not identify those who are at higher risk for transplantation. It has failed to do so in our program. Rather, by grouping the potential recipients into patients with a device, Status 1 nondevice patients, and Status 2 patients, we have found a significantly lower survival rate after transplantation in the device group. This suggests that the problems shared by device patients such as being anticoagulated, having a difficult reoperation at the time of transplantation, and having increased inflammation and decreased immunity clearly place these patients in a very different risk group than other potential recipients. Second, these results lead us to believe that some high-risk device patients may not be suitable for transplantation and might be better if treated with devices as alternatives to transplantation.
Academic Medical Centers↗
The University of Arizona College of Medicine Optimal Aging Program: stepping in the shadows of successful aging.
The Optimal Aging Program (OAP) at the University of Arizona, College of Medicine is a longitudinal mentoring program that pairs students with older adults who are considered to be aging successfully. This credit-bearing elective was initially established in 2001 through a grant from the John A. Hartford Foundation, and aims to expand the concept of aging to include those of active, independently living, healthy older adults. The program goals are to provide students with the opportunity to develop a relationship with an older adult who continues to be active in her community and expand students' concepts of aging to include the increasing reality of healthy, active older adulthood. A review of students' journals, verbal feedback, and questionnaire surveys has been used to evaluate the OAP, and has resulted in minor modifications of the program since inception. These findings and the program modifications are described in the present study. "Success factors" are identified that may be employed by others attempting to develop such programs.
Adult↗
Clinical evaluation of hyperthermia equipment: the University of Arizona Institutional Report for the NCI Hyperthermia Equipment Evaluation Contract.
Two-hundred and fifteen independent sites in 203 patients were treated with hyperthermia at the University of Arizona from 10/81 through 3/86 under the auspices of this contract. In the head and neck, a site dominated by superficial tumors, air-coupled and water-coupled microwave applicators yielded the best results. Similarly in the thorax, also dominated by superficial tumors, water-coupled microwave applicators were best. In the abdomen and pelvis, sites dominated by deep tumors, only interstitial radiofrequency (RF) heating, an invasive technique useful only in selected cases, was capable of consistently producing therapeutic temperatures. Toxicity appeared to be site-related, and treatment discomfort was especially common in abdominal and pelvic sites. In conclusion, while superficial sites were readily heated using propagative electromagnetic devices, these devices were ineffective and poorly tolerated at deeper sites. Effective deep hyperthermia was best produced with interstitial techniques, and further development of these techniques using RF electrodes, implantable microwave antennas and thermoregulating ferromagnetic seeds, as well as scanned, focussed-ultrasound techniques, holds promise for effective heating of deep visceral sites.
Clinical Trials as Topic↗
Performances of underrepresented-minority students at the University of Arizona College of Medicine, 1987-1991.
PURPOSE: To compare the academic performances of underrepresented-minority (African American, Native American, and Hispanic) students and all other students at the University of Arizona College of Medicine. METHOD: The performances of 42 underrepresented-minority and 368 other students who graduated between 1987 and 1991 were compared using the following variables: undergraduate science, non-science, and overall grade-point average (GPA); scores on the Medical College Admission Test (MCAT); subtest and total scores on the National Board of Medical Examiners (NBME) Part I and Part II examinations; and three types of evaluations from a required family practice clerkship. In addition, a comparison was made of scores on an objective structured clinical examination (OSCE) taken in the fourth year by 25 underrepresented-minority and 165 other students. Data were analyzed using a three-way analysis of variance and Pearson correlation analysis. RESULTS: The underrepresented-minority students earned significantly lower GPAs and scored significantly lower on all standardized paper-and-pencil tests and the family practice clerkship final examination. There was no significant group difference in the family practice clerkship clinical evaluations or the majority of the OSCE scores. For both groups, overall GPAs and MCAT scores correlated equally well with NBME total scores but were not significantly corrected with OSCE scores or family practice clerkship clinical evaluations. CONCLUSION: While the underrepresented-minority students entered medical school with significant educational disadvantages and continued to score lower than the other students on paper-and-pencil tests, their clinical performances on the OSCE and family practice clerkship were nearly equivalent to those of the other students.
Black or African American↗
Integrative medical education: development and implementation of a comprehensive curriculum at the University of Arizona.
Dissatisfaction with the U.S. health care system is increasing despite impressive technologic advances. This dissatisfaction is one factor that has led patients to seek out complementary and alternative medicine (CAM) and led medical schools to start teaching CAM. This paper focuses on the University of Arizona's approach to developing and implementing a comprehensive curriculum in integrative medicine. Integrative medicine is defined much more broadly than CAM. It is healing-oriented medicine that reemphasizes the relationship between patient and physician, and integrates the best of complementary and alternative medicine with the best of conventional medicine. Since its inception in 1996, the Program in Integrative Medicine (PIM) has grown to include a two-year residential fellowship that educates four fellows each year, a distance learning associate fellowship that educates 50 physicians each year, medical student and resident rotations, continuing medical and professional education, an NIH-supported research department, and an active outreach program to facilitate the international development of integrative medicine. The paper describes the PIM curriculum, educational programs, clinical education, goals, and results. Future strategies for assessing competency and credentialing professionals are suggested.
Arizona↗