Matching Items (33)
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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
Description

Public transit systems are often accepted as energy and environmental improvements to automobile travel, however, few life cycle assessments exist to understand the effects of implementation of transit policy decisions. To better inform decision-makers, this project evaluates the decision to construct and operate public transportation systems and the expected energy

Public transit systems are often accepted as energy and environmental improvements to automobile travel, however, few life cycle assessments exist to understand the effects of implementation of transit policy decisions. To better inform decision-makers, this project evaluates the decision to construct and operate public transportation systems and the expected energy and environmental benefits over continued automobile use. The public transit systems are selected based on screening criteria. Initial screening included advanced implementation (5 to 10 years so change in ridership could be observed), similar geographic regions to ensure consistency of analysis parameters, common transit agencies or authorities to ensure a consistent management culture, and modes reflecting large infrastructure investments to provide an opportunity for robust life cycle assessment of large impact components. An in-depth screening process including consideration of data availability, project age, energy consumption, infrastructure information, access and egress information, and socio-demographic characteristics was used as the second filter. The results of this selection process led to Los Angeles Metro’s Orange and Gold lines.

In this study, the life cycle assessment framework is used to evaluate energy inputs and emissions of greenhouse gases, particulate matter (10 and 2.5 microns), sulfur dioxide, nitrogen oxides, volatile organic compounds, and carbon monoxide. For the Orange line, Gold line, and competing automobile trip, an analysis system boundary that includes vehicle, infrastructure, and energy production components is specified. Life cycle energy use and emissions inventories are developed for each mode considering direct (vehicle operation), ancillary (non-vehicle operation including vehicle maintenance, infrastructure construction, infrastructure operation, etc.), and supply chain processes and services. In addition to greenhouse gas emissions, the inventories are linked to their potential for respiratory impacts and smog formation, and the time it takes to payback in the lifetime of each transit system.

Results show that for energy use and greenhouse gas emissions, the inclusion of life cycle components increases the footprint between 42% and 91% from vehicle propulsion exclusively. Conventional air emissions show much more dramatic increases highlighting the effectiveness of “tailpipe” environmental policy. Within the life cycle, vehicle operation is often small compared to other components. Particulate matter emissions increase between 270% and 5400%. Sulfur dioxide emissions increase by several orders of magnitude for the on road modes due to electricity use throughout the life cycle. NOx emissions increase between 31% and 760% due to supply chain truck and rail transport. VOC emissions increase due to infrastructure material production and placement by 420% and 1500%. CO emissions increase by between 20% and 320%. The dominating contributions from life cycle components show that the decision to build an infrastructure and operate a transportation mode in Los Angeles has impacts far outside of the city and region. Life cycle results are initially compared at each system’s average occupancy and a breakeven analysis is performed to compare the range at which modes are energy and environmentally competitive.

The results show that including a broad suite of energy and environmental indicators produces potential tradeoffs that are critical to decision makers. While the Orange and Gold line require less energy and produce fewer greenhouse gas emissions per passenger mile traveled than the automobile, this ordering is not necessarily the case for the conventional air emissions. It is possible that a policy that focuses on one pollutant may increase another, highlighting the need for a broad set of indicators and life cycle thinking when making transportation infrastructure decisions.

Description

Public transportation systems are often part of strategies to reduce urban environmental impacts from passenger transportation, yet comprehensive energy and environmental life-cycle measures, including upfront infrastructure effects and indirect and supply chain processes, are rarely considered. Using the new bus rapid transit and light rail lines in Los Angeles, near-term

Public transportation systems are often part of strategies to reduce urban environmental impacts from passenger transportation, yet comprehensive energy and environmental life-cycle measures, including upfront infrastructure effects and indirect and supply chain processes, are rarely considered. Using the new bus rapid transit and light rail lines in Los Angeles, near-term and long-term life-cycle impact assessments are developed, including consideration of reduced automobile travel. Energy consumption and emissions of greenhouse gases and criteria pollutants are assessed, as well the potential for smog and respiratory impacts.

Results show that life-cycle infrastructure, vehicle, and energy production components significantly increase the footprint of each mode (by 48–100% for energy and greenhouse gases, and up to 6200% for environmental impacts), and emerging technologies and renewable electricity standards will significantly reduce impacts. Life-cycle results are identified as either local (in Los Angeles) or remote, and show how the decision to build and operate a transit system in a city produces environmental impacts far outside of geopolitical boundaries. Ensuring shifts of between 20–30% of transit riders from automobiles will result in passenger transportation greenhouse gas reductions for the city, and the larger the shift, the quicker the payback, which should be considered for time-specific environmental goals.

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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

In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and

In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and whether these relationships are sensitive to temperature. Using Poisson regression modeling with heat-related mortality as the outcome, we assessed the interaction of increasing temperature with social vulnerability, access to publicly available air conditioned space, home air conditioning and the thermal properties of residences. As temperatures increase, mortality from heat-related illness increases less in census tracts with more publicly accessible cooled spaces. Mortality from all internal causes of death did not have this association. Building thermal protection was not associated with mortality. Social vulnerability was still associated with mortality after adjusting for the infrastructure variables. To reduce heat-related mortality, the use of public cooled spaces might be expanded to target the most vulnerable.

ContributorsEisenman, David P. (Author) / Wilhalme, Holly (Author) / Tseng, Chi-Hong (Author) / Chester, Mikhail Vin (Author) / English, Paul (Author) / Pincetl, Stephanie Sabine, 1952- (Author) / Fraser, Andrew (Author) / Vangala, Sitaram (Author) / Dhaliwal, Satvinder K. (Author)
Created2016-08-03
Description

The intent of this study is to develop a new eco-cultural design model of development for the Salt River watershed and surrounding areas with renewed respect for the land in modern society. It includes both conceptual and practical community guides to facilitate and catalyze a new community-driven typology of planning

The intent of this study is to develop a new eco-cultural design model of development for the Salt River watershed and surrounding areas with renewed respect for the land in modern society. It includes both conceptual and practical community guides to facilitate and catalyze a new community-driven typology of planning prepared for rapid community change and climate challenges. This study includes the review of prominent existing projects, both regionally and globally, with expertise in the areas of urban development, culture and place keeping/making, ecology and water management. This study aims to exhibit the diverse components of urbanism and its effects on the Salt River corridor, surrounding urban ecosystems and climate. This thesis argues for simultaneous and codependent cultural and ecological growth and healing, and its necessity for sustainable urban development. Lastly, an urban revitalization framework is manifested in a community-oriented handbook based on key findings to produce a unified vision executed by watershed community co-design of the Phoenix metropolitan area.

ContributorsBascom, Erin Elizabeth (Author) / Coseo, Paul (Thesis director) / Underwood, Max (Thesis director) / Weisz, Claire (Committee member) / Dean, W.P. Carey School of Business (Contributor) / The Design School (Contributor, Contributor, Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Description

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
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Description
This project focuses on providing a series of Sensory Design Guidelines (SDG) for the creation of restorative environments for people and nature promoting cognitive health, motor skill development, and outdoor therapy for urban society’s most vulnerable. Although the project framework is structured around guidelines for the creation of spaces specifically

This project focuses on providing a series of Sensory Design Guidelines (SDG) for the creation of restorative environments for people and nature promoting cognitive health, motor skill development, and outdoor therapy for urban society’s most vulnerable. Although the project framework is structured around guidelines for the creation of spaces specifically designed for children with Sensory Processing Disorder, it is not restricted to that specific application. Guidelines are further developed structured around inclusive and universal design approaches.

The project is divided into four sections. The first section explores what Sensory Processing Disorder is, how Occupational Therapy with Sensory Integration positively impacts healing processes, and how designers can expand this processing into the natural healing environment of the great outdoors in a toxic and urbanized world. The second section discusses the vision, goals and objectives for implementation of Sensory Design Guidelines as discussed in the third section. And finally, the fourth section provides a conceptual example of what SDG would look like when applied to a physical site along a natural corridor in a densely urbanized landscape.

The final example of SDG implementation is applied to a site along the Salt River (Rio Salado) Corridor in Phoenix, Arizona. The Corridor is the subject of a coordinated inter-agency public/private restoration initiative spanning more than fifty-five miles along the Salt River that has been strongly supported by former U.S. Senator John McCain and greatly influenced by active involvement from Arizona State University students. The designated example site is designed as one site to be utilized in a larger network of easily accessible Sensory sites, each to be designed with a different approach to sensory development, as well as variation in challenges based on age and sensory abilities. Guidelines are intended to work in conjunction with future local projects promoting social and ecological growth and wellbeing, such as the Phoenix site is intended to work in conjunction with future Rio Re-imagined projects.

The findings, guidelines, and examples provided throughout the paper are focused on re-inventing the relationship between the built and natural environments in the urbanized landscape into one of daily nature-engagement and can be applied to any group living within an urban setting. By designing for society’s most vulnerable populations, design application benefits not only the individual, but creates a resilient, healthy environment for the entire urban population today, and for future generations.
ContributorsSquyres, Katryn O (Author) / Coseo, Paul (Thesis director) / Hargrove, Allyce (Committee member) / The Design School (Contributor) / Department of Finance (Contributor) / Dean, W.P. Carey School of Business (Contributor) / Department of Information Systems (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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Description
Following the prolific car-centric design of the twentieth century, many cities are grappling with increasing pedestrian deaths and greater vehicle congestion. To solve these problems, many of these cities are expressing a desire to create more effective and vibrant walkable places. Aside from safety, numerous benefits come from pedestrian friendly

Following the prolific car-centric design of the twentieth century, many cities are grappling with increasing pedestrian deaths and greater vehicle congestion. To solve these problems, many of these cities are expressing a desire to create more effective and vibrant walkable places. Aside from safety, numerous benefits come from pedestrian friendly communities, including greater economic activity, better health, greater social capital, and less environmental impact. Although there are several tools already available, evaluating an area’s current walkability situation is still varied, and evaluating a pedestrian’s thoughts on safety and enjoyability is also difficult. The benefits of walkability and past and present tools are summarized in this paper. The goal of this paper was to create a walkability evaluation tool that included smaller, often overlooked aspects of the sidewalk and site design that contribute to a pedestrian’s experience and safety. The author developed a tool containing 40 different measures of the sidewalk concerning safety, connectivity, enjoyment, and accessibility, as well as created methods for visualizing the data. The tool was then utilized to gather data at six Phoenix-metro area intersections using a combination of on street data collection and GIS software and Google Street View. The paper also details suggestions on how to act upon the data and improve walkability in an area, including minor street alterations and larger policy shifts in zoning codes. Although in preliminary data collection the tool provides a good snapshot of the data, further development of the tool and assessment of its reliability are needed, as well as greater data collection to compare evaluated areas to a larger region.
ContributorsLaufer, Daniel (Author) / King, David (Thesis director) / Coseo, Paul (Committee member) / School of Geographical Sciences and Urban Planning (Contributor) / Barrett, The Honors College (Contributor)
Created2019-12