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The purpose of this research was to evaluate the impact of glycemic measures, and changes in identified risk factors (BMI, waist circumference, lipids, blood pressure) on follow-up glycemia, in Pima children at high risk for type two diabetes (type 2 DM).I computed incidence and cumulative incidence of type 2 DM in Pima children 5-19 years of age between 1983 and 2004. Cox proportional hazards rates for development of type 2 DM were calculated by glycemic measure (HbA1C, 20PG, FPG) controlling for confounding factors (age, sex, BMI, blood pressure, and cholesterol). Diabetes was defined by the presence of at least one of four criteria: 1) 20PG of >200 mg/dl, 2) FPG of >126 mg/dl, 3) HbA1C > 8.0%, or 4) hypoglycemic treatment. Linear regression models were computed to identify the impact of changes in risk factors on changes in HbA1C. Only exams performed in non-diabetic children during childhood were included in the regression models.Among 2658 non-diabetic children, 258 cases of diabetes occurred during mean 9.1 years of follow-up (1.5 - 21.7). The age-sex adjusted incident rate of diabetes was 19.0 cases per 1000 person-years, and cumulative incidence was 54% by age 40. Incidence rates increased with increasing baseline values of 20PG, and FPG, but not for HbA1C. For HbA1C the relationship was u-shaped with the lowest and highest quartiles having the highest DM rates. After adjustment for confounding risk factors using Cox proportional hazards analysis, the risk for diabetes increased 2-fold for every 10 mg/dl increase in FPG. Changes in waist circumference best predicted changes in HbA1C (R2 = 0.48, Ï <0.001). However, the ability of waist circumference to predict change is limited due to the powerful effect of regression to the mean, suggesting that these risk factors contribute very little to changes in HbA1C, at least in childhood.Childhood levels of glycemia predict development of type 2 DM later in life. While changes in waist circumference are associated with only moderate changes in HbA1C, this does not refute the significant contribution of adiposity in childhood to the development of type 2 DM.

The Cienega Gap area, located about 27 miles southeast of Tucson, Arizona, has long been noted for its structural complexity. Discordances between sedimentary rocks of Paleozoic, Mesozoic, and Cenozoic age and between these rocks and their granitic basement have led previous workers to propose large -scale northward thrusting in an effort to explain the complex structures observed. An alternative hypothesis invoking southward gliding has been considered by several authors but has been assigned a subordinate role in explaining the deformation. The present study was undertaken in an effort to evaluate the relative suitability of dominantly northward versus dominantly southward movement. In the course of this study nine separate localities were examined and mapped in detail in an effort to evaluate movement direction. Evidence of displacement on low -angle faults or glide surfaces was found in each of the areas examined, and definite evidence of movement direction was recognized in five of these. Large-scale recumbent folding, previously unrecognized in the Colossal Cave and Agua Verde Wash areas, was found to be closely related to local uplift. The asymmetry of the folds, plus a very few observed offsets marginal to the uplifts, were the only criteria found for determining the direction of movement. Evidence of northward, southward, and nearly westward movement was found in the course of the study. Areas in the northern Empire Mountains south of Cienega Gap gave evidence of west – northwestward and northward movement. Areas in the southern Rincon Mountains north of Cienega Gap were found to have undergone dominantly southward movement. Involvement of the Pantano Formation in several of the localities suggests that deformation occurred at least as late as early Oligocene time and probably after middle Miocene time. Cienega Gap was therefore the focus of movement for material which was moving laterally away from areas undergoing uplift in Tertiary time.

Recent genetic studies have confirmed that there was admixture between African early modern humans and archaic populations throughout the Old World. In this dissertation, I examine European early modern human dental morphology to assess the evidence for Neandertal-human admixture. The focus of this study is not on the question of taxonomic designations of Late Pleistocene Homo, but rather on the interactions of these populations in Europe. This focus on gene flow itself redefines the Neandertal question. Rather than asking if Neandertals are a different species from H. sapiens, I focus on the nature of the interactions between archaic and modern populations, which is essential to understanding the history of modern H. sapiens regardless of species definitions. I recorded dental metric measurements and morphology observations on 85 fossil Neandertals and early modern humans and a recent modern human comparative sample of 330 Native Americans and Spaniards. I examined each trait distribution individually and through the use of Mahalanobis D2, mean measure of divergence, principle components analysis, discriminant function analysis, k-means cluster analysis, and a population genetics program, structure. Through these methods, I found evidence of admixture in the dental trait distributions of European early modern humans. However, it is not evident in traditional distance measures or cluster analyses. The earliest European modern humans do not follow the trend of dental reduction found throughout the Pleistocene and into the Holocene and do not uniformly classify with any fossil population in discriminant function analysis of metric traits. The non-metric trait sample size is too small to make any definitive conclusions, but a mosaic pattern of trait frequencies also suggests admixture. The recent modern human sample shows that while increased variation and a mosaic of non-metric traits persist through many generations after admixture has ceased, traditional methods of distance analysis cannot detect low levels of admixture within 200 years. The program structure is effective in finding patterns of variation within and among populations using morphological data. It will be useful for future analyses of dental traits and other fossil data, given the ability to use it with an incomplete data set.

Thesis (Ed. D.)--Northern Arizona University, 1996. / "This study involved ... investigation at a single large multi-campus urban community college ... Pima Community College in Tucson, Arizona."--Leaf 7. Includes vita. Includes bibliographical references (leaves 123-133).

Class of 2014 Abstract / Specific Aims: Assess the change in efficiency and accuracy of healthcare in provider access to HIE for medication profiles at the PCADC. Methods: Adults detainees admitted from October 22, 2012 to July 31, 2013 were enrolled in this study. A completed Intake Medical Screening form with self-reported/correction facility staff verified medication list will (the old method) be compared to the medication list obtained by querying the medication HIE (the new method). Descriptive statistics will describe the patients. Statistical significance will be calculated using the McNemar chi-square test for comparing the proportions of omissions (medications and strengths) on the 765PI to the HIE with an a priori alpha of 0.05. Main Results: In progress. Conclusion: HIE has the potential to be a valuable tool for healthcare providers operating at an adult detention facility.

Class of 2016 Abstract and Report / Objectives: To evaluate the successes and failures of the recent implementation of the Arizona Health-e Connection (AzHeC) health information exchange (HIE) at the Pima County Adult Detention Center (PCADC); to identify a generalized infrastructure and draft recommendations for implementing HIE at other correctional facilities. Methods: Participants pertinent to the implementation by current staff at the PCADC were identified through snowball sampling. Interviews were conducted in-person or by telephone using a semi-structured interview guide. Demographics regarding roles and responsibilities during implementation were collected during each interview. Participants were asked for input regarding key aspects and lessons learned from the implementation. Interviews were audio-recorded, transcribed verbatim, and then analyzed with Atlas.ti software for common themes. Results: A total of 12 individuals were interviewed, providing a comprehensive set of perspectives. Six common themes were identified: impact of being a novel implementer; challenges surrounding implementation; problems during implementation; what was done well; benefits of the system; and communication during implementation. Potential barriers that were successfully anticipated were establishing the value of the HIE through pilot studies to obtain early stakeholder buy-in, and addressing legal/privacy issues for the at-risk population in the corrections system. Problems that arose during implementation often involved information technology issues. Conclusions: Despite challenges faced throughout the HIE implementation, improvements in patient care, workflow, and time-savings made a tremendous impact for those involved. The lessons learned and advice given by the participants of this study can provide guidance for other correctional health systems wishing to implement a HIE at their facility.

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