Matching Items (13)
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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

Transitions towards sustainability are urgently needed to address the interconnected challenges of economic development, ecological integrity, and social justice, from local to global scales. Around the world, collaborative science-society initiatives are forming to conduct experiments in support of sustainability transitions. Such experiments, if carefully designed, provide significant learning opportunities for

Transitions towards sustainability are urgently needed to address the interconnected challenges of economic development, ecological integrity, and social justice, from local to global scales. Around the world, collaborative science-society initiatives are forming to conduct experiments in support of sustainability transitions. Such experiments, if carefully designed, provide significant learning opportunities for making progress on transition efforts. Yet, there is no broadly applicable evaluative scheme available to capture this critical information across a large number of cases, and to guide the design of transition experiments. To address this gap, the article develops such a scheme, in a tentative form, drawing on evaluative research and sustainability transitions scholarship, alongside insights from empirical cases. We critically discuss the scheme's key features of being generic, comprehensive, operational, and formative. Furthermore, we invite scholars and practitioners to apply, reflect and further develop the proposed tentative scheme – making evaluation and experiments objects of learning.

ContributorsLuederitz, Christopher (Author) / Schäpke, Niko (Author) / Wiek, Arnim (Author) / Lang, Daniel J. (Author) / Bergmann, Matthias (Author) / Bos, Joannette J (Author) / Burch, Sarah (Author) / Davies, Anna (Author) / Evans, James (Author) / König, Ariane (Author) / Farrelly, Megan A. (Author) / Forrest, Nigel (Author) / Frantzeskaki, Niki (Author) / Gibson, Robert B. (Author) / Kay, Braden (Author) / Loorbach, Derk (Author) / McCormick, Kes (Author) / Parodi, Oliver (Author) / Rauschmayer, Felix (Author) / Schneidewind, Uwe (Author) / Stauffacher, Michael (Author) / Stelzer, Franziska (Author) / Trencher, Gregory (Author) / Venjakob, Johannes (Author) / Vergragt, Philip J. (Author) / von Wehrden, Henrik (Author) / Westley, Frances R. (Author)
Created2016-09-03
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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

The relationship between the characteristics of the urban land system and land surface temperature (LST) has received increasing attention in urban heat island and sustainability research, especially for desert cities. This research generally employs medium or coarser spatial resolution data and primarily focuses on the effects of a few classes

The relationship between the characteristics of the urban land system and land surface temperature (LST) has received increasing attention in urban heat island and sustainability research, especially for desert cities. This research generally employs medium or coarser spatial resolution data and primarily focuses on the effects of a few classes of land-cover composition and pattern at the neighborhood or larger level using regression models. This study explores the effects of land system architecture—composition and configuration, both pattern and shape, of fine-grain land-cover classes—on LST of single family residential parcels in the Phoenix, Arizona (southwestern USA) metropolitan area. A 1 m resolution land-cover map is used to calculate land architecture metrics at the parcel level, and 6.8 m resolution MODIS/ASTER data are employed to retrieve LST. Linear mixed-effects models quantify the impacts of land configuration on LST at the parcel scale, controlling for the effects of land composition and neighborhood characteristics. Results indicate that parcel-level land-cover composition has the strongest association with daytime and nighttime LST, but the configuration of this cover, foremost compactness and concentration, also affects LST, with different associations between land architecture and LST at nighttime and daytime. Given information on land system architecture at the parcel level, additional information based on geographic and socioeconomic variables does not improve the generalization capability of the statistical models. The results point the way towards parcel-level land-cover design that helps to mitigate the urban heat island effect for warm desert cities, although tradeoffs with other sustainability indicators must be considered.

ContributorsLi, Xiaoxiao (Author) / Kamarianakis, Yiannis (Author) / Ouyang, Yun (Author) / Turner II, B. L. (Author) / Brazel, Anthony J. (Author)
Created2017-02-14
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Description

This study seeks to determine the role of land architecture—the composition and configuration of land cover—as well as cadastral/demographic/economic factors on land surface temperature (LST) and the surface urban heat island effect of Phoenix, Arizona. It employs 1 m National Agricultural Imagery Program data of land-cover with 120mLandsat-derived land surface

This study seeks to determine the role of land architecture—the composition and configuration of land cover—as well as cadastral/demographic/economic factors on land surface temperature (LST) and the surface urban heat island effect of Phoenix, Arizona. It employs 1 m National Agricultural Imagery Program data of land-cover with 120mLandsat-derived land surface temperature, decomposed to 30 m, a new measure of configuration, the normalized moment of inertia, and U.S. Census data to address the question for two randomly selected samples comprising 523 and 545 residential neighborhoods (census blocks) in the city. The results indicate that, contrary to most other studies, land configuration has a stronger influence on LST than land composition. In addition, both land configuration and architecture combined with cadastral, demographic, and economic variables, capture a significant amount of explained variance in LST. The results indicate that attention to land architecture in the development of or reshaping of neighborhoods may ameliorate the summer extremes in LST.

ContributorsLi, Xiaoxiao (Author) / Li, Wenwen (Author) / Middel, Ariane (Author) / Harlan, Sharon L. (Author) / Brazel, Anthony J. (Author) / Turner II, B. L. (Author)
Created2015-12-29
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Description
Evolving Earth observation and change detection techniques enable the automatic identification of Land Use and Land Cover Change (LULCC) over a large extent from massive amounts of remote sensing data. It at the same time poses a major challenge in effective organization, representation and modeling of such information. This study

Evolving Earth observation and change detection techniques enable the automatic identification of Land Use and Land Cover Change (LULCC) over a large extent from massive amounts of remote sensing data. It at the same time poses a major challenge in effective organization, representation and modeling of such information. This study proposes and implements an integrated computational framework to support the modeling, semantic and spatial reasoning of change information with regard to space, time and topology. We first proposed a conceptual model to formally represent the spatiotemporal variation of change data, which is essential knowledge to support various environmental and social studies, such as deforestation and urbanization studies. Then, a spatial ontology was created to encode these semantic spatiotemporal data in a machine-understandable format. Based on the knowledge defined in the ontology and related reasoning rules, a semantic platform was developed to support the semantic query and change trajectory reasoning of areas with LULCC. This semantic platform is innovative, as it integrates semantic and spatial reasoning into a coherent computational and operational software framework to support automated semantic analysis of time series data that can go beyond LULC datasets. In addition, this system scales well as the amount of data increases, validated by a number of experimental results. This work contributes significantly to both the geospatial Semantic Web and GIScience communities in terms of the establishment of the (web-based) semantic platform for collaborative question answering and decision-making.
Created2016-10-25
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Description
A large fraction of the world grasslands and savannas are undergoing a rapid shift from herbaceous to woody-plant dominance. This land-cover change is expected to lead to a loss in livestock production (LP), but the impacts of woody-plant encroachment on this crucial ecosystem service have not been assessed. We evaluate

A large fraction of the world grasslands and savannas are undergoing a rapid shift from herbaceous to woody-plant dominance. This land-cover change is expected to lead to a loss in livestock production (LP), but the impacts of woody-plant encroachment on this crucial ecosystem service have not been assessed. We evaluate how tree cover (TC) has affected LP at large spatial scales in rangelands of contrasting social–economic characteristics in the United States and Argentina. Our models indicate that in areas of high productivity, a 1% increase in TC results in a reduction in LP ranging from 0.6 to 1.6 reproductive cows (Rc) per km[superscript 2]. Mean LP in the United States is 27 Rc per km[superscript 2], so a 1% increase in TC results in a 2.5% decrease in mean LP. This effect is large considering that woody-plant cover has been described as increasing at 0.5% to 2% per y. On the contrary, in areas of low productivity, increased TC had a positive effect on LP. Our results also show that ecological factors account for a larger fraction of LP variability in Argentinean than in US rangelands. Differences in the relative importance of ecological versus nonecological drivers of LP in Argentina and the United States suggest that the valuation of ecosystem services between these two rangelands might be different. Current management strategies in Argentina are likely designed to maximize LP for various reasons we are unable to explore in this effort, whereas land managers in the United States may be optimizing multiple ecosystem services, including conservation or recreation, alongside LP.
Created2014-09-02
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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.

Created2015-07-28
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Description
Precipitation and temperature enact variable influences on vegetation, impacting the type and condition of land cover, as well as the assessment of change over broad landscapes. Separating the influence of vegetative variability independent and discrete land cover change remains a major challenge to landscape change assessments. The heterogeneous Lerma-Chapala-Santiago watershed

Precipitation and temperature enact variable influences on vegetation, impacting the type and condition of land cover, as well as the assessment of change over broad landscapes. Separating the influence of vegetative variability independent and discrete land cover change remains a major challenge to landscape change assessments. The heterogeneous Lerma-Chapala-Santiago watershed of central Mexico exemplifies both natural and anthropogenic forces enacting variability and change on the landscape. This study employed a time series of Enhanced Vegetation Index (EVI) composites from the Moderate Resolution Imaging Spectoradiometer (MODIS) for 2001–2007 and per-pixel multiple linear regressions in order to model changes in EVI as a function of precipitation, temperature, and elevation. Over the seven-year period, 59.1% of the variability in EVI was explained by variability in the independent variables, with highest model performance among changing and heterogeneous land cover types, while intact forest cover demonstrated the greatest resistance to changes in temperature and precipitation. Model results were compared to an independent change uncertainty assessment, and selected regional samples of change confusion and natural variability give insight to common problems afflicting land change analyses.
Created2016-06-07