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Study Background: Researchers at ASU have determined that significant energy and environmental benefits are possible in the Phoenix metro area over the next 60 years from transit-oriented development along the current Valley Metro light rail line. The team evaluated infill densification outcomes when vacant lots and some dedicated surface parking

Study Background: Researchers at ASU have determined that significant energy and environmental benefits are possible in the Phoenix metro area over the next 60 years from transit-oriented development along the current Valley Metro light rail line. The team evaluated infill densification outcomes when vacant lots and some dedicated surface parking lots are repurposed for residential development. Life cycle building (construction, use, and energy production) and transportation (manufacturing, operation, and energy production) changes were included and energy use and greenhouse gas emissions were evaluated in addition to the potential for respiratory impacts and smog formation. All light rail infill scenarios are compared against new single family home construction in outlying areas.

Overview of Results: In the most conservative scenario, the Phoenix area can place 2,200 homes near light rail and achieve 9-15% reductions in energy use and emissions. By allowing multi-family apartments to fill vacant lots, 12,000 new dwelling units can be infilled achieving a 28-42% reduction. When surface lots are developed in addition to vacant lots then multi-family apartment buildings around light rail can deliver 30-46% energy and environmental reductions. These reductions occur even after new trains are put into operation to meet the increased demand.

Created2013
Description

Better methods are necessary to fully account for anthropogenic impacts on ecosystems and the essential services provided by ecosystems that sustain human life. Current methods for assessing sustainability, such as life cycle assessment (LCA), typically focus on easily quantifiable indicators such as air emissions with no accounting for the essential

Better methods are necessary to fully account for anthropogenic impacts on ecosystems and the essential services provided by ecosystems that sustain human life. Current methods for assessing sustainability, such as life cycle assessment (LCA), typically focus on easily quantifiable indicators such as air emissions with no accounting for the essential ecosystem benefits that support human or industrial processes. For this reason, more comprehensive, transparent, and robust methods are necessary for holistic understanding of urban technosphere and ecosphere systems, including their interfaces. Incorporating ecosystem service indicators into LCA is an important step in spanning this knowledge gap.

For urban systems, many built environment processes have been investigated but need to be expanded with life cycle assessment for understanding ecosphere impacts. To pilot these new methods, a material inventory of the building infrastructure of Phoenix, Arizona can be coupled with LCA to gain perspective on the impacts assessment for built structures in Phoenix. This inventory will identify the origins of materials stocks, and the solid and air emissions waste associated with their raw material extraction, processing, and construction and identify key areas of future research necessary to fully account for ecosystem services in urban sustainability assessments. Based on this preliminary study, the ecosystem service impacts of metropolitan Phoenix stretch far beyond the county boundaries. A life cycle accounting of the Phoenix’s embedded building materials will inform policy and decision makers, assist with community education, and inform the urban sustainability community of consequences.

Description

This study aims to quantify the environmental impacts of a hospital’s daily BMW disposal in the Phoenix, Arizona area. The sole option to dispose of BMW in Arizona is to sterilize the waste by sending it through an autoclave, and then dispose the sterilized waste in a landfill. This study

This study aims to quantify the environmental impacts of a hospital’s daily BMW disposal in the Phoenix, Arizona area. The sole option to dispose of BMW in Arizona is to sterilize the waste by sending it through an autoclave, and then dispose the sterilized waste in a landfill. This study used a Phoenix area hospital to create a start point for the waste and a general estimation of how much BMW the hospital disposes of. The system boundary for the LCA includes BMW generated at the Phoenix-area Hospital as it is travels to Stericycle, where it is autoclaved, and then transported to a landfill for disposal. The results of this retrospective, end-of-life LCA using this boundary enables hospital employees and policy makers to understand the environmental impact of placing items in the biohazardous waste bin.

Created2014-06-13
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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)
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Description
Purpose: Advance care planning (ACP) allows an individual to discuss and document their personal preferences at end-of-life. ACP has been shown to improve communication and reduce discomfort for patients and their families. The literature supports utilizing formalized, multimodality training programs for healthcare providers in order to increase their confidence in

Purpose: Advance care planning (ACP) allows an individual to discuss and document their personal preferences at end-of-life. ACP has been shown to improve communication and reduce discomfort for patients and their families. The literature supports utilizing formalized, multimodality training programs for healthcare providers in order to increase their confidence in initiating ACP discussions. These findings led to the initiation of an evidence-based practice project in a primary care setting with the purpose of increasing advance care planning discussions between providers and patients with the use of a standardized education tool.

Background and Significance: National regulations mandate that patients are provided information about advance directives in the healthcare setting, but completion rates are not monitored and continue to be low. ACP is now a billable service for healthcare providers, but it has not provided enough incentive to increase completion rates. Barriers for healthcare providers in the outpatient setting include lack of time, protocols, and lack of education on how to initiate and foster advance care planning discussions.

Methods: Healthcare providers in a primary care office attended a 15-minute structured educational session with and a toolkit was provided on the importance of ACP, how to initiate conversations with patients, and bill for the service. Participants completed a portion of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) survey assessing their confidence in ACP before and three months post intervention. Participant confidence (N = 6) in ACP was analyzed using the Wilcoxin test and descriptive statistics. The number of billed ACP services for the office was collected for four months post intervention and compared to the previous four months. Outcomes: A significant increase in provider confidence after participating in a multimodality education program was found in the results (Z = -2.21, p = .03). There was a 42.1% increase in the number of billed ACP discussions for the office in the four months post intervention.

Conclusion: The future desired state is that ACP discussions become standard practice in primary care leading to the completion of advance directives. This can be accomplished through formalized education sessions and resources for providers in order to increase their confidence in initiating ACP discussions with patients. The ultimate goal is to decrease unnecessary spending at end-of-life while improving patient and family satisfaction with the quality of care received at end-of-life.
ContributorsSmith, Arsena (Author) / Nunez, Diane (Thesis advisor)
Created2018-04-30