Matching Items (118)
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Description
Critical care environments are complex in nature. Fluctuating team dynamics and the plethora of technology and equipment create unforeseen demands on clinicians. Such environments become chaotic very quickly due to the chronic exposure to unpredictable clusters of events. In order to cope with this complexity, clinicians tend to develop ad-hoc

Critical care environments are complex in nature. Fluctuating team dynamics and the plethora of technology and equipment create unforeseen demands on clinicians. Such environments become chaotic very quickly due to the chronic exposure to unpredictable clusters of events. In order to cope with this complexity, clinicians tend to develop ad-hoc adaptations to function in an effective manner. It is these adaptations or "deviations" from expected behaviors that provide insight into the processes that shape the overall behavior of the complex system. The research described in this manuscript examines the cognitive basis of clinicians' adaptive mechanisms and presents a methodology for studying the same. Examining interactions in complex systems is difficult due to the disassociation between the nature of the environment and the tools available to analyze underlying processes. In this work, the use of a mixed methodology framework to study trauma critical care, a complex environment, is presented. The hybrid framework supplements existing methods of data collection (qualitative observations) with quantitative methods (use of electronic tags) to capture activities in the complex system. Quantitative models of activities (using Hidden Markov Modeling) and theoretical models of deviations were developed to support this mixed methodology framework. The quantitative activity models developed were tested with a set of fifteen simulated activities that represent workflow in trauma care. A mean recognition rate of 87.5% was obtained in automatically recognizing activities. Theoretical models, on the other hand, were developed using field observations of 30 trauma cases. The analysis of the classification schema (with substantial inter-rater reliability) and 161 deviations identified shows that expertise and role played by the clinician in the trauma team influences the nature of deviations made (p<0.01). The results shows that while expert clinicians deviate to innovate, deviations of novices often result in errors. Experts' flexibility and adaptiveness allow their deviations to generate innovative ideas, in particular when dynamic adjustments are required in complex situations. The findings suggest that while adherence to protocols and standards is important for novice practitioners to reduce medical errors and ensure patient safety, there is strong need for training novices in coping with complex situations as well.
ContributorsVankipuram, Mithra (Author) / Greenes, Robert A (Thesis advisor) / Patel, Vimla L. (Thesis advisor) / Petitti, Diana B. (Committee member) / Dinu, Valentin (Committee member) / Smith, Marshall L. (Committee member) / Arizona State University (Publisher)
Created2012
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Description

Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).

Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to

Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).

Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.

Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.

Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.

ContributorsHarlan, Sharon L. (Author) / Declet-Barreto, Juan H. (Author) / Stefanov, William L. (Author) / Petitti, Diana B. (Author)
Created2013-02-01
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Description

In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages

In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ≥65 during the months May–October for years 2000–2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90–97 °F; 32.2‒36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males <65 years (ATmax = 102 °F; 38.9 °C). Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

ContributorsHarlan, Sharon L. (Author) / Chowell, Gerardo (Author) / Yang, Shuo (Author) / Petitti, Diana B. (Author) / Morales Butler, Emmanuel J. (Author) / Ruddell, Benjamin L. (Author) / Ruddell, Darren M. (Author)
Created2014-05-20
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Description

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.

Objectives: This quantitative study was designed

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.

Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.

Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.

Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.

Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.

ContributorsPettiti, Diana B. (Author) / Hondula, David M. (Author) / Yang, Shuo (Author) / Harlan, Sharon L. (Author) / Chowell, Gerardo (Author)
Created2016-02-01
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Description

Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed

Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables.

Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983–2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (− 95%) to an increase of 339 deaths per year (+ 359%).

Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.

ContributorsHondula, David M. (Author) / Georgescu, Matei (Author) / Balling, Jr., Robert C. (Author)
Created2014-04-28
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Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53

Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53 cooling centers were evaluated to assess facility and visitor characteristics. Maricopa County staff collected data by directly observing daily operations and by surveying managers and visitors. The cooling centers in Maricopa County were often housed within community, senior, or religious centers, which offered various services for at least 1500 individuals daily. Many visitors were unemployed and/or homeless. Many learned about a cooling center by word of mouth or by having seen the cooling center’s location. The cooling centers provide a valuable service and reach some of the region’s most vulnerable populations. This project is among the first to systematically evaluate cooling centers from a public health perspective and provides helpful insight to community leaders who are implementing or improving their own network of cooling centers.

ContributorsBerisha, Vjollca (Author) / Hondula, David M. (Author) / Roach, Matthew (Author) / White, Jessica R. (Author) / McKinney, Benita (Author) / Bentz, Darcie (Author) / Mohamed, Ahmed (Author) / Uebelherr, Joshua (Author) / Goodin, Kate (Author)
Created2016-09-23
Description

For decades, women in the field of sports media have battled for equality with their male counterparts. In 1972, Title IX was passed, stating that “no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subject

For decades, women in the field of sports media have battled for equality with their male counterparts. In 1972, Title IX was passed, stating that “no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subject to discrimination under any educational program or activity receiving Federal financial assistance.” In 1978, the iconic court case, Melissa Ludtke and Time Inc., v. Bowie Kuhn, Commissioner of Baseball, confirmed that the Fourteenth Amendment guarantees that women should be given the same rights as men, specifically in regards to locker room access. Today, legally women and men in the field of sports media have the same rights. But many people would argue that is not the case. In the five decades succeeding these milestones, women have continued their fight for a more level playing field. Women in sports media are largely stereotyped, they are often judged based on their looks not their knowledge, they are underrepresented in a field that is male dominated. It could be assumed most women working in sports media have at least one instance where they have been judged on the basis of sex. And in 2021, sexual harassment allegations are still being made in the industry.. How will the events of this decade shape the future for women in this field? What strides are left to be made and how will they be achieved?

Created2021-05
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Description
On March 12, 2020, The Walt Disney Company announced that its U.S. Disney Parks, Disneyland and Walt Disney World, would close because of COVID-19. This study aims to determine how park annual passholders and frequent guests of the U.S. Disney Parks reacted to COVID-19 related news from The Walt Disney

On March 12, 2020, The Walt Disney Company announced that its U.S. Disney Parks, Disneyland and Walt Disney World, would close because of COVID-19. This study aims to determine how park annual passholders and frequent guests of the U.S. Disney Parks reacted to COVID-19 related news from The Walt Disney Company and if it impacts their decision to visit the parks. To determine this, five focus groups were conducted with annual passholders and frequent guests of the U.S. Disney Parks. Their social media habits, relationship with The Walt Disney Company, and reactions to COVID-19 related news was discussed. The results showed that while annual passholders and frequent guests may get their information from third party accounts, face confusion on some topics, and have reservations about COVID-19 during park reopenings, they still trust The Walt Disney Company and are eager to enter the parks again.
ContributorsHoldaway, Emily (Author) / Gilpin, Dawn (Thesis director) / Bovio, Sonia (Committee member) / School of Politics and Global Studies (Contributor) / Walter Cronkite School of Journalism & Mass Comm (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
Description
Fruit King a personal and historical audio narrative of a Sicilian immigrant turned American success completed in conjunction with the Walter Cronkite School of Journalism and Mass Communication and Barrett, The Honors College at Arizona State University. This project was completed with the guidance and support of thesis director, Dr.

Fruit King a personal and historical audio narrative of a Sicilian immigrant turned American success completed in conjunction with the Walter Cronkite School of Journalism and Mass Communication and Barrett, The Honors College at Arizona State University. This project was completed with the guidance and support of thesis director, Dr. Dawn Gilpin and thesis second-chair, Dr. John Craft. This thesis project has been executed in the form of a podcast, website and research report that recounts and relishes in the legacy and life of Joseph DiGiorgio, the once 14-year-old who immigrated from Cefalu, Sicily to Ellis Island, New York in 1888. He went from selling fruit in a cart and borrowing money from the bank to establishing the Baltimore Fruit exchange and becoming the director of the Maryland National Bank by 21 years old. His billion-dollar business, the DiGiorgio Fruit Corporation, became the world’s largest fruit grower of grapes, plums and pears in the 1940s, and he landed a feature story in Fortune Magazine in 1946. To me, he is my great-great-great-uncle Joe, but to the world, he is what the New York Times crowned him: the Fruit King.
ContributorsMorton, Julianna Lee (Author) / Gilpin, Dawn (Thesis director) / Craft, John (Committee member) / Walter Cronkite School of Journalism & Mass Comm (Contributor) / School of Community Resources and Development (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
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Description
Billions of people across the world use social media. Because a large portion of those users are college students between the ages of 20 and 22, this study sought to explore social media's effects on a female college student’s body image. The study’s research questions are: How does social media

Billions of people across the world use social media. Because a large portion of those users are college students between the ages of 20 and 22, this study sought to explore social media's effects on a female college student’s body image. The study’s research questions are: How does social media affect female college students’ feelings about their physical selves, and do such effects differ across platforms? Interview data are analyzed based on theories of social comparison, normative influence, narrative-induced transportation, media richness, and social presence. Results reveal that social media affects female college students' perceptions of physical images, and overall this effect is more often negative than positive. Also, Instagram offered a more perfectionist visual culture than Facebook and Twitter.
ContributorsEckstein, Susanna Marie (Author) / Kwon, Hazel (Thesis director) / Barrett, Marianne (Committee member) / Walter Cronkite School of Journalism & Mass Comm (Contributor) / School of Art (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12