Matching Items (43,913)
Description
Overcrowding of Emergency Departments (EDs) put the safety of patients at risk. Decision makers implement Ambulance Diversion (AD) as a way to relieve congestion and ensure timely treatment delivery. However, ineffective design of AD policies reduces the accessibility to emergency care and adverse events may arise. The objective of this dissertation is to propose methods to design and analyze effective AD policies that consider performance measures that are related to patient safety. First, a simulation-based methodology is proposed to evaluate the mean performance and variability of single-factor AD policies in a single hospital environment considering the trade-off between average waiting time and percentage of time spent on diversion. Regression equations are proposed to obtain parameters of AD policies that yield desired performance level. The results suggest that policies based on the total number of patients waiting are more consistent and provide a high precision in predicting policy performance. Then, a Markov Decision Process model is proposed to obtain the optimal AD policy assuming that information to start treatment in a neighboring hospital is available. The model is designed to minimize the average tardiness per patient in the long run. Tardiness is defined as the time that patients have to wait beyond a safety time threshold to start receiving treatment. Theoretical and computational analyses show that there exists an optimal policy that is of threshold type, and diversion can be a good alternative to decrease tardiness when ambulance patients cause excessive congestion in the ED. Furthermore, implementation of AD policies in a simulation model that accounts for several relaxations of the assumptions suggests that the model provides consistent policies under multiple scenarios. Finally, a genetic algorithm is combined with simulation to design effective policies for multiple hospitals simultaneously. The model has the objective of minimizing the time that patients spend in non-value added activities, including transportation, waiting and boarding in the ED. Moreover, the AD policies are combined with simple ambulance destination policies to create ambulance flow control mechanisms. Results show that effective ambulance management can significantly reduce the time that patients have to wait to receive appropriate level of care.
ContributorsRamirez Nafarrate, Adrian (Author) / Fowler, John W. (Thesis advisor) / Wu, Teresa (Thesis advisor) / Gel, Esma S. (Committee member) / Limon, Jorge (Committee member) / Arizona State University (Publisher)
Created2011
Description
Lots of previous studies have analyzed human tutoring at great depths and have shown expert human tutors to produce effect sizes, which is twice of that produced by an intelligent tutoring system (ITS). However, there has been no consensus on which factor makes them so effective. It is important to know this, so that same phenomena can be replicated in an ITS in order to achieve the same level of proficiency as expert human tutors. Also, to the best of my knowledge no one has looked at student reactions when they are working with a computer based tutor. The answers to both these questions are needed in order to build a highly effective computer-based tutor. My research focuses on the second question. In the first phase of my thesis, I analyzed the behavior of students when they were working with a step-based tutor Andes, using verbal-protocol analysis. The accomplishment of doing this was that I got to know of some ways in which students use a step-based tutor which can pave way for the creation of more effective computer-based tutors. I found from the first phase of the research that students often keep trying to fix errors by guessing repeatedly instead of asking for help by clicking the hint button. This phenomenon is known as hint refusal. Surprisingly, a large portion of the student's foundering was due to hint refusal. The hypothesis tested in the second phase of the research is that hint refusal can be significantly reduced and learning can be significantly increased if Andes uses more unsolicited hints and meta hints. An unsolicited hint is a hint that is given without the student asking for one. A meta-hint is like an unsolicited hint in that it is given without the student asking for it, but it just prompts the student to click on the hint button. Two versions of Andes were compared: the original version and a new version that gave more unsolicited and meta-hints. During a two-hour experiment, there were large, statistically reliable differences in several performance measures suggesting that the new policy was more effective.
ContributorsRanganathan, Rajagopalan (Author) / VanLehn, Kurt (Thesis advisor) / Atkinson, Robert (Committee member) / Burleson, Winslow (Committee member) / Arizona State University (Publisher)
Created2011
Description
Regional differences of inventive activity and economic growth are important in economic geography. These differences are generally explained by the theory of localized knowledge spillovers, which argues that geographical proximity among economic actors fosters invention and innovation. However, knowledge production involves an increasing number of actors connecting to non-local partners. The space of knowledge flows is not tightly bounded in a given territory, but functions as a network-based system where knowledge flows circulate around alignments of actors in different and distant places. The purpose of this dissertation is to understand the dynamics of network aspects of knowledge flows in American biotechnology. The first research task assesses both spatial and network-based dependencies of biotechnology co-invention across 150 large U.S. metropolitan areas over four decades (1979, 1989, 1999, and 2009). An integrated methodology including both spatial and social network analyses are explicitly applied and compared. Results show that the network-based proximity better defines the U.S. biotechnology co-invention urban system in recent years. Co-patenting relationships of major biotechnology centers has demonstrated national and regional association since the 1990s. Associations retain features of spatial proximity especially in some Midwestern and Northeastern cities, but these are no longer the strongest features affecting co-inventive links. The second research task examines how biotechnology knowledge flows circulate over space by focusing on the structural properties of intermetropolitan co-invention networks. All analyses in this task are conducted using social network analysis. Evidence shows that the architecture of the U.S. co-invention networks reveals a trend toward more organized structures and less fragmentation over the four years of analysis. Metropolitan areas are increasingly interconnected into a large web of networked environment. Knowledge flows are less likely to be controlled by a small number of intermediaries. San Francisco, New York, Boston, and San Diego monopolize the central positions of the intermetropolitan co-invention network as major American biotechnology concentrations. The overall network-based system comes close to a relational core/periphery structure where core metropolitan areas are strongly connected to one another and to some peripheral areas. Peripheral metropolitan areas are loosely connected or even disconnected with each other. This dissertation provides empirical evidence to support the argument that technological collaboration reveals a network-based system associated with different or even distant geographical places, which is somewhat different from the conventional theory of localized knowledge spillovers that once dominated understanding of the role of geography in technological advance.
ContributorsLee, Der-Shiuan (Author) / Ó Huallacháin, Breandán (Thesis advisor) / Anselin, Luc (Committee member) / Kuby, Michael (Committee member) / Lobo, Jose (Committee member) / Arizona State University (Publisher)
Created2011
Description
Vitamin C is a micronutrient with many important physiological roles. It can function as a reducing agent, a free radical scavenger, and an enzyme cofactor. Much research has examined the potential of vitamin C supplements to enhance exercise capacity in trained athletes; however, little is known regarding the effects of vitamin C supplements on the promotion of leisure-time physical activity in the general population. This area deserves attention since 1/3 of Americans have below adequate vitamin C status, and since aversion to exercise, fatigue, and altered mood states are the earliest signs of poor vitamin C status. This study analyzed the effect of supplementing 500 mg twice daily of vitamin C on self-reported leisure-time activity levels and mood states in young men. Twenty-nine healthy, young men, aged 18-35 years, were stratified by age, BMI, smoking status, and plasma vitamin C concentrations and assigned to either a control (CON) or experimental group (VTC) for the 8-week randomized, double-blinded, parallel arm trial. Subjects were instructed to keep track of their leisure-time physical activity by filling out the validated Godin Leisure-Time Exercise Questionnaire weekly for the entire study. In addition, subjects took the self-administered Profile of Mood States (POMS) at baseline, week 4, and week 8 to observe mood states. Plasma vitamin C concentrations were analyzed at the initial screening, week 4, and week 8 of the study. Plasma vitamin C concentrations significantly differed by group at week 4 and week 8. Furthermore, vitamin C supplementation significantly increased self-reported mild, moderate, and strenuous activity levels during the 8-week trial. Overall, total physical activity scores increased nearly 50% in the VTC group as compared to 18% in the CON group (p=0.001). However, mood states were not significantly impacted by vitamin C supplementation during the trial. This study provides the first experimental evidence that supplementing 500 mg of vitamin C twice daily can be effective in increasing leisure-time physical activity in healthy young men. This study, however, was unable to link improvements in physical activity rates to improved mood states. Since sedentary behaviors have been implicated in the rise of obesity in the U.S., further research should be conducted to substantiate the finding that vitamin C supplementation increases physical activity.
ContributorsSchumacher, Sarah (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2012
ContributorsCarlisi, Daniel (Performer) / ASU Library. Music Library (Publisher)
Created2018-04-07
Description
Research on psychological help seeking has continued to grow as the field of psychology has expanded. Much of the research is often variable driven and assumes this construct is a global construct. The current study used the Theory of Planned Behavior to provide a theory based approach to understanding psychological help seeking intention. Also, the theory was tested for three common presenting concerns: Anxiety or Depression, Career Choice Concerns, and Alcohol or Substance Use. Two samples of over 400 university students completed surveys for all three concerns. Results produced invariance across path loadings for the concerns being compared. When thinking about seeking psychological help, university students do not appear to consider the type of concern but do rely on attitude, stigma, and how much control and efficacy they have to address their problems on their own. Mean differences emerged for some variables in the model, but no meaningful mean differences were noted for gender. Overall, the variables used in the decision making process do not appear to consider concern when seeking help, but the beliefs about seeking help differ some. These results extend the Theory of Planned Behavior to consider the importance of an individual's ability to address their problem on their own. When considering psychological help seeking, college students have similar attitudes and beliefs about their ability to access mental health resources, their beliefs about stigma, ability to address their problems on their own, and their intention to seek help vary more by concern. The specific concerns being addressed does not appear to impact the weight each variable is given in the decision making process; attitude, stigma, and ability to solve the problem on their own appear to be the variables given greatest consideration.
ContributorsHess, Timothy Robert (Author) / Tracey, Terence J. G. (Thesis advisor) / Claiborn, Charles (Committee member) / Sheu, Hung-Bin (Committee member) / Arizona State University (Publisher)
Created2011
Description
It is crucial for counselors to be aware of their own attitudes and beliefs and to prevent them from influencing the counseling process. The prevalence of obesity is growing and biases against obese people are becoming more apparent. Counselors must become aware of the potential weight bias and what factors influence it. The purpose of the current study was to examine whether counselors- in-training hold negative attitudes toward obese clients and whether the career status of the client affects these perceptions. Seventy-six students in graduate level counseling programs at Arizona State University were randomly assigned one of four vignettes describing either an obese bookkeeper, a normal weight bookkeeper, an obese executive, or a normal weight executive. Negative attitudes were measured using two scales; one evaluating perceived personal characteristics of the client and one evaluating the perceived work efficacy. Results indicated that counselors-in-training perceived the client with more negative characteristics when the client was described as obese rather than normal weight, and also when she was described as having a low status job compared to a high status job. The perceived work efficacy of the presented client was not affected by the client’s weight or job status. It is important for students in counseling programs to receive training regarding weight biases and job status biases.
ContributorsPascal, Brittani (Author) / Robinson Kurpius, Sharon E (Thesis advisor) / Homer, Judith (Committee member) / Horan, John J (Committee member) / Arizona State University (Publisher)
Created2011
Description
Photovoltaic (PV) systems are one of the next generation's renewable energy sources for our world energy demand. PV modules are highly reliable. However, in polluted environments, over time, they will collect grime and dust. There are also limited field data studies about soiling losses on PV modules. The study showed how important it is to investigate the effect of tilt angle on soiling. The study includes two sets of mini-modules. Each set has 9 PV modules tilted at 0, 5, 10, 15, 20, 23, 30, 33 and 40°. The first set called "Cleaned" was cleaned every other day. The second set called "Soiled" was never cleaned after the first day. The short circuit current, a measure of irradiance, and module temperature was monitored and recorded every two minutes over three months (January-March 2011). The data were analyzed to investigate the effect of tilt angle on daily and monthly soiling, and hence transmitted solar insolation and energy production by PV modules. The study shows that during the period of January through March 2011 there was an average loss due to soiling of approximately 2.02% for 0° tilt angle. Modules at tilt anlges 23° and 33° also have some insolation losses but do not come close to the module at 0° tilt angle. Tilt anlge 23° has approximately 1.05% monthly insolation loss, and 33° tilt angle has an insolation loss of approximately 0.96%. The soiling effect is present at any tilt angle, but the magnitude is evident: the flatter the solar module is placed the more energy it will lose.
ContributorsCano Valero, José (Author) / Tamizhmani, Govindasamy (Thesis advisor) / Madakannan, Arunachalanadar (Committee member) / Macia, Narciso (Committee member) / Arizona State University (Publisher)
Created2011
Description
Power relations among cultural, socio-economic, and political groups have been dynamic forces shaping American history. Within that changing world, relations between indigenous and non-indigenous groups have been complicated by a fundamental difference often ascribed to Western philosophy versus Native American spiritual traditions. In 1990, Congress codified that difference when it passed the Native American Graves Protection and Repatriation Act (NAGPRA) stipulating that Indian tribes and Native Hawaiians are unique among United States cultural groups. At the same time, NAGPRA began breaking down the Western vs. indigenous paradigm. The legislative process of NAGPRA strongly encouraged cooperation among indigenous peoples and the non-indigenous peoples who had collected their bones and belongings under earlier policies. NAGPRA required museums and other agencies accepting federal monies to inventory any collections of Native American items with the intent of giving control to tribes over the disposition of culturally affiliated human remains and certain classes of objects. In the rearranging power relations NAGPRA instigated, people maneuvered for power over the "truth," over whose memory, meaning, and spiritual worldview held authenticity. This dissertation considers cases that pushed or broke the limits of cooperation fostered by NAGPRA. Ignoring the bones and related funerary objects, Tangled Truths analyzes repatriation disputes over cultural artifacts to illuminate changing power relations among cultural groups in the United States. The repatriation negotiations in which people would not compromise were cases in which there existed strong differences in spiritual worldviews, cultural memories, or material interests. Congress could encourage cooperation, but it could not legislate acceptance of others' spiritual worldviews, nor could it persuade people to relinquish engrained cultural memories. And without solid enforcement, the NAGPRA process could be outmaneuvered by those intent on pursuing their own material interests.
ContributorsBiggs, Patricia Allyn (Author) / Fixico, Donald L (Thesis advisor) / Kintigh, Keith W. (Committee member) / Thoompson, Victoria E (Committee member) / Arizona State University (Publisher)
Created2011
Description
Programmable metallization cell (PMC) technology is based on an electrochemical phenomenon in which a metallic electrodeposit can be grown or dissolved between two electrodes depending on the voltage applied between them. Devices based on this phenomenon exhibit a unique, self-healing property, as a broken metallic structure can be healed by applying an appropriate voltage between the two broken ends. This work explores methods of fabricating interconnects and switches based on PMC technology on flexible substrates. The objective was the evaluation of the feasibility of using this technology in flexible electronics applications in which reliability is a primary concern. The re-healable property of the interconnect is characterized for the silver doped germanium selenide (Ag-Ge-Se) solid electrolyte system. This property was evaluated by measuring the resistances of the healed interconnect structures and comparing these to the resistances of the unbroken structures. The reliability of the interconnects in both unbroken and healed states is studied by investigating the resistances of the structures to DC voltages, AC voltages and different temperatures as a function of time. This work also explores replacing silver with copper for these interconnects to enhance their reliability. A model for PMC-based switches on flexible substrates is proposed and compared to the observed device behavior with the objective of developing a formal design methodology for these devices. The switches were subjected to voltage sweeps and their resistance was investigated as a function of sweep voltage. The resistance of the switches as a function of voltage pulse magnitude when placed in series with a resistance was also investigated. A model was then developed to explain the behavior of these devices. All observations were based on statistical measurements to account for random errors. The results of this work demonstrate that solid electrolyte based interconnects display self-healing capability, which depends on the applied healing voltage and the current limit. However, they fail at lower current densities than metal interconnects due to an ion-drift induced failure mechanism. The results on the PMC based switches demonstrate that a model comprising a Schottky diode in parallel with a variable resistor predicts the behavior of the device.
ContributorsBaliga, Sunil Ravindranath (Author) / Kozicki, Michael N (Thesis advisor) / Schroder, Dieter K. (Committee member) / Chae, Junseok (Committee member) / Alford, Terry L. (Committee member) / Arizona State University (Publisher)
Created2011