Journals at the University of Arizona
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Assessing Participants’ Experiences in a Service-Learning Program: A Psychometric Evaluation
No full textThere is currently a gap in the literature regarding the creation of psychometrically sound measurement tools assessing service-learning programs in health-related fields. Without comprehension of a survey's psychometric properties, evaluators cannot ensure that survey instruments are reliable or valid. This study describes the psychometric evaluation of the Public Health Associate Program (PHAP) Service-Learning Scale (PSLS). PSLS assesses participant experience in PHAP, a Centers for Disease Control and Prevention program. This paper explains survey development, scale validity and reliability, and the internal factor structure of the PSLS. The final scale consisted of 22 items with a high internal consistency (Cronbach’s α=.90). Exploratory Factor Analysis (EFA) was used to determine the scale’s factor structure; five factors comprising of all 22 items were retained. The factors, or subscales, were Learning Outcomes, Mentoring, Experiential Assignment, Self-Efficacy in Program Competency Domains, and Program Satisfaction. All were also found to have adequate internal consistency (Cronbach’s α .70). Service-learning is vital in developing the next generation of the workforce. These study findings suggest the PSLS fills a critical gap in the literature by providing a valid and reliable instrument to evaluate experiences and satisfaction in service-learning programs and other fellowships
PRELIMINARY EVIDENCE OF EFFECTIVENESS OF TECAR IN LYMPHEDEMA
No full textLymphedema of the lower limbs often contributes to the mobility impairment of morbidly obese patients. Defining novel cost-effective protocols is important for reducing treatment costs. The study aimed to assess if Capacitive and Resistive Energy Transfer (TECAR) can reduce edema and the minimum number of sessions needed to observe volume reduction. Forty-eight severely obese subjects (age range: 46-78 years; BMI 40 kg/m2) with bilateral lower limb lymphedema were divided into three groups undergoing either manual lymphatic drainage, pressure therapy, or TECAR, in addition to a multidisciplinary rehabilitation program. They were compared to a control group composed by 12 women (age: 67.4 ± 8.9 years, BMI: 44.6 ± 4.1 Kg/m2) undergoing only the rehabilitation program. A handheld laser scanner 3D system was used for volume measurements. In addition, patients were evaluated with a Timed Up and Go (TUG) test and pain/heaviness of the lower limbs with a Visual Analog Scale (VAS). A significant volume reduction was observed after 6 sessions of TECAR: specifically, in the whole limb (PRE: 9.7+2.8 dm3; POST: 9.4+2.8 dm³; p0.05) and in the thigh (PRE: 3.5+1.3 dm3; POST: 3.3+1.2 dm3; p0.05). The TUG and VAS for pain showed a significant improvement in all groups. Our preliminary results suggest that TECAR can provide a relatively early reduction of lower limb edema with improvement of patients’ function and pain
PERCUTANEOUS FLUOROSCOPICALLY-GUIDED TRANSCERVICAL RETROGRADE ACCESS FACILITATES SUCCESSFUL THORACIC DUCT EMBOLIZATION AFTER FAILED ANTEGRADE TRANSABDOMINAL ACCESS
No full textThe purpose of this study was to demonstrate the feasibility of percutaneous fluoroscopically-guided transcervical retrograde access into the thoracic duct following unsuccessful transabdominal cisterna chyli cannulation to perform thoracic duct embolization for the treatment of chylothorax. Five patients, including three (60%) women and two (40%) men, with median age of 62 years, underwent percutaneous transcervical thoracic duct access and embolization after failed transabdominal cisterna chyli cannulation for the treatment of chylothorax. In all patients, fluoroscopically-guided percutaneous transcervical retrograde access into the distal thoracic duct was achieved using a 21-gauge needle and an 0.018-inch wire. Following advancement of a microcatheter, retrograde lymphangiography was performed to identify the location of thoracic duct injury. A combination of 2:1 ethiodized oil to cyanoacrylate mixtures, platinum microcoils, or stent-grafts were used to treat the chylous leaks. Technical successes, procedure durations, fluoroscopy times, blood losses, immediate adverse events, clinical successes, and follow-up durations were recorded. Technical success was defined as cannulation of the distal thoracic duct using a transcervical approach followed by treatment of the thoracic duct injury. Adverse events were classified according to the Society of Interventional Radiology guidelines. Clinical success was defined as resolution of the presenting chylothorax. Percutaneous transcervical retrograde thoracic duct access and treatment was technically successful in all patients (n=5). Median procedure duration was 173 minutes (range: 136-347 minutes) with a median fluoroscopy time of 94.7 minutes (range: 47-125 minutes). Median blood loss was 10 mL (range: 5-20 mL). No minor or major adverse occurred.Clinical success was achieved in all patients(n=5). Median follow-up was 372 days (range:67-661 days). Percutaneous fluoroscopicallyguided transcervical retrograde thoracic duct access is an effective and safe method to perform thoracic duct embolization following unsuccessful transabdominal cisterna chyli cannulation for the treatment of chylothorax
Trapped in nature: discourses on humanity in processes of environmental naturalization
No full textThe naturalization of protected areas is based on the discursive redefinition of both the environment and the social actors that inhabit it. This article studies how, within the processes associated with the creation and management of protected areas, discourses are generated that define humanity in relation to nature and its effects on access to resources and power relations. These processes are analyzed on the basis of a comparative ethnographic case study of El Manu National Park (Amazon, Peru) and the Galapagos National Park (Ecuador). Finally, it is concluded that discourses on humanity are instrumental in the processes for legitimizing or delegitimizing the role played by locals within protected areas, depending on attributed proximity or distance of humans to nature.Key words: nature, naturalization, humans, discourse, protected areas, Amazon, Galapagos
REDD+ as a tool for state territorialization: managing forests and people in Laos
No full textThis article analyzes the Reduction of Emissions from Deforestation and Forest Degradation (REDD+) policy process, through the lens of state territorialization in the Lao People's Democratic Republic (Laos). It explores the motivations, mechanisms and strategies that drive REDD+ policy design and its implementation in the country. The provinces selected for REDD+ activities within the Emission Reduction (ER) Program, as well as the various REDD+ pilot projects are located in the north, where shifting cultivation is widespread, but where the potential for REDD+ to address deforestation and carbon sequestration is not optimal. The provinces with high carbon sequestration potential and high rates of deforestation are not part of the ER Program due to development investment projects and political sensitivity in those areas. REDD+ acts as a tool for state territorialization in a number of ways, including: (i) by targeting the areas where shifting cultivation is widely practiced, aiming to regulate village forest uses and users, (ii) by protecting state political, economic and development goals and strategies, by leaving the profitable large-scale drivers of deforestation unaddressed, including large-scale land investments, hydropower, infrastructure and mining development, and finally (iii) by providing additional motives, tools and discourses for state territorialization, including funding, technologies and the narratives that support it. I highlight, however, that REDD+ is not the sole reason for state territorial politics and practices. Rather, the instrument is layered over previous histories of colonial and post-colonial territorialization processes, continuing a similar logic, rhetoric and management practices. The REDD+ design and its technical orientation, however, appear to provide additional motives, as well as a new pool of resources, technical assistance and modern technologies that intensify the practice and politics of state territoriality in Laos.Keywords: Laos, REDD+, state territorialization, forest politics, drivers of deforestatio
