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Description
Advance care planning is a process that allows for patient autonomy at the end of life. Yet, less than 30% of Americans over the age of 65 have an advance care plan. Advance care planning has positive effects on patients, families and healthcare systems. However, both patients and healthcare providers

Advance care planning is a process that allows for patient autonomy at the end of life. Yet, less than 30% of Americans over the age of 65 have an advance care plan. Advance care planning has positive effects on patients, families and healthcare systems. However, both patients and healthcare providers report barriers to completing and discussing advance care planning. Many different interventions have been studied to increase advance care planning rates. Engaging patients and providers electronically before or during appointments in outpatient clinics and community settings has shown marked improvement in advance care plan discussions and documentation rates. To address this complex issue, two community-based seminars with electronic pre-engagement for adults has been proposed to improve advance care planning completion rates.
ContributorsCole, Alison (Author) / Nunez, Diane (Thesis advisor)
Created2020-04-24
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Description

Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to all Medicare patients. The healthcare staffs’ (n=7) commitment to 3-days of ACP training increase ACP rates in the primary care

Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to all Medicare patients. The healthcare staffs’ (n=7) commitment to 3-days of ACP training increase ACP rates in the primary care setting. The Medicare Incentive Program is the platform for this initiative. This quantitative project used a valid and reliable pre and posttest design that consisted of 27 items on a Likert-scale. A 3.5-month chart audit (n=91) was conducted to assess the completion rate. Descriptive statistics was used to describe the demographic data.

The results of the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -2.37, p = .018. There was a significant increase in the post-readiness to change average scores. A Mann Whitney test was used to analyze the statistically significant difference between the averages in two ACP types and electronic health record documentation (EHR). Staff did not always code (Mdn = 0.00) but they documented in the EHR (Mdn =1.00; 512.00, p = 0.003). ACP discussion was performed 63% of the time during Annual Wellness Visits (AWV), and there was a 49% increase in the EHR documentation. Trained staff are key stakeholders in guiding ACP conversations. They understand the barriers, impact, and consequences related to the lack of advance directives.

ContributorsBautista, Hija Mae (Author) / Johannah, Uriri-Glover (Thesis advisor)
Created2020-04-30
Description

Phoenix is the sixth most populated city in the United States and the 12th largest metropolitan area by population, with about 4.4 million people. As the region continues to grow, the demand for housing and jobs within the metropolitan area is projected to rise under uncertain climate conditions.

Undergraduate and graduate

Phoenix is the sixth most populated city in the United States and the 12th largest metropolitan area by population, with about 4.4 million people. As the region continues to grow, the demand for housing and jobs within the metropolitan area is projected to rise under uncertain climate conditions.

Undergraduate and graduate students from Engineering, Sustainability, and Urban Planning in ASU’s Urban Infrastructure Anatomy and Sustainable Development course evaluated the water, energy, and infrastructure changes that result from smart growth in Phoenix, Arizona. The Maricopa Association of Government's Sustainable Transportation and Land Use Integration Study identified a market for 485,000 residential dwelling units in the urban core. Household water and energy use changes, changes in infrastructure needs, and financial and economic savings are assessed along with associated energy use and greenhouse gas emissions.

The course project has produced data on sustainable development in Phoenix and the findings will be made available through ASU’s Urban Sustainability Lab.

ContributorsNahlik, Matthew (Author) / Chester, Mikhail Vin (Author) / Andrade, Luis (Author) / Archer, Melissa (Author) / Barnes, Elizabeth (Author) / Beguelin, Maria (Author) / Bonilla, Luis (Author) / Bubenheim, Stephanie (Author) / Burillo, Daniel (Author) / Cano, Alex (Author) / Guiley, Keith (Author) / Hamad, Moayyad (Author) / Heck, John (Author) / Helble, Parker (Author) / Hsu, Will (Author) / Jensen, Tate (Author) / Kannappan, Babu (Author) / Kirtley, Kelley (Author) / LaGrou, Nick (Author) / Loeber, Jessica (Author) / Mann, Chelsea (Author) / Monk, Shawn (Author) / Paniagua, Jaime (Author) / Prasad, Saransh (Author) / Stafford, Nicholas (Author) / Unger, Scott (Author) / Volo, Tom (Author) / Watson, Mathew (Author) / Woodruff, Abbie (Author) / Arizona State University. School of Sustainable Engineering and the Built Environment (Contributor) / Arizona State University. Center for Earth Systems Engineering and Management (Contributor)
Description

Hybrid system models - those devised from two or more disparate sub-system models - provide a number of benefits in terms of conceptualization, development, and assessment of dynamical systems. The decomposition approach helps to formulate complex interactions that are otherwise difficult or impractical to express. However, hybrid model development and

Hybrid system models - those devised from two or more disparate sub-system models - provide a number of benefits in terms of conceptualization, development, and assessment of dynamical systems. The decomposition approach helps to formulate complex interactions that are otherwise difficult or impractical to express. However, hybrid model development and usage can introduce complexity that emerges from the composition itself.

To improve assurance of model correctness, sub-systems using disparate modeling formalisms must be integrated above and beyond just the data and control level; their composition must have model specification and simulation execution aspects as well. Poly-formalism composition is one approach to composing models in this manner.

This dissertation describes a poly-formalism composition between a Discrete EVent System specification (DEVS) model and a Cellular Automata (CA) model types. These model specifications have been chosen for their broad applicability in important and emerging domains. An agent-environment domain exemplifies the composition approach. The inherent spatial relations within a CA make it well-suited for environmental representations. Similarly, the component-based nature of agents fits well within the hierarchical component structure of DEVS.

This composition employs the use of a third model, called an interaction model, that includes methods for integrating the two model types at a formalism level, at a systems architecture level, and at a model execution level. A prototype framework using DEVS for the agent model and GRASS for the environment has been developed and is described. Furthermore, this dissertation explains how the concepts of this composition approach are being applied to a real-world research project.

This dissertation expands the tool set modelers in computer science and other disciplines have in order to build hybrid system models, and provides an interaction model for an on-going research project. The concepts and models presented in this dissertation demonstrate the feasibility of composition between discrete-event agents and discrete-time cellular automata. Furthermore, it provides concepts and models that may be applied directly, or used by a modeler to devise compositions for other research efforts.

ContributorsMayer, Gary R. (Author)
Created2009
Description

In the spring of 2016, the City of Apache Junction partnered with the School of Geographical Sciences and Urban Planning at Arizona State University on three forward-thinking plans for development in Apache Junction. Graduate students in the Urban and Environmental Planning program worked alongside City staff, elected officials and the

In the spring of 2016, the City of Apache Junction partnered with the School of Geographical Sciences and Urban Planning at Arizona State University on three forward-thinking plans for development in Apache Junction. Graduate students in the Urban and Environmental Planning program worked alongside City staff, elected officials and the public to identify opportunities and visions for:
       1. Multi-modal access and connectivity improvements for City streets and open space.
       2. Downtown development.
       3. A master-planned community on state land south of the U.S. 60.

The following sections of the report present Apache Junction’s unique characteristics, current resident demographics, development needs and implementation strategies for each project:
       1. Community Profile
       2. Trail Connectivity Master Plan
       3. Downtown Visioning
       4. State Land Visioning

The Trail Connectivity Master Plan optimizes existing trails and wide road shoulders to improve multi-modal connections across the city. The proposed connections emphasize access to important recreation, education and other community facilities for pedestrians, equestrians and bicycles. Trail and lane designs recommend vegetated buffers, wherever possible, to improve traveler safety and comfort. The proposals also increase residents’ interaction with open space along urban-rural trails and park linkages to preserve opportunities to engage with nature. The objectives of the report are accomplished through three goals: connectivity, safety improvements and open space preservation.

Downtown Visioning builds on a large body of conceptual design work for Apache Junction’s downtown area along Idaho Road and Apache Trail. This report identifies three goals: to establish a town center, to reestablish the grid systems while maintaining a view of the Superstition Mountains, and to create an identity and sense of place for the downtown.

State Land Visioning addresses a tract of land, approximately 25 square miles in area, south of the U.S. 60. The main objective is to facilitate growth and proper development in accordance with existing goals in Apache Junction’s General Plan. This is accomplished through three goals:
       1. Develop a foundation for the creation of an economic corridor along US-60 through
           preliminary market research and land use planning.
       2. Create multi-modal connections between existing development north of US-60 and
           future recreational space northeast of US-60.
       3. Maintain a large ratio of open space to developed area that encompasses existing
           washes and floodplains using a master planned community framework to provide an
           example for future land use planning.