IU Indianapolis ScholarWorks :: Browsing by Subject "Environment"

Browsing by Subject "Environment"

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Accommodating patients with obesity in ambulatory care: A clinical environment checklist
(Wiley, 2024-09-04) Boland, Wesley; Li, Wendy S.; Dilly, Christen K.; Surgery, School of Medicine
Objective: Individuals with obesity face unique challenges when visiting healthcare providers, including inadequate equipment. These negative care experiences, often exacerbated by weight stigma, frequently lead to mistrust and reluctance to seek future care. Currently, few instruments exist to ensure that an ambulatory clinic is welcoming to patients with obesity. The following clinical environment checklist was created with an aim to identify weaknesses in accommodating individuals of size. Methods: A checklist of equipment considered ideal for the care of patients with obesity was developed through a comprehensive review of the literature and feedback from office staff. Eight ambulatory clinics within an urban Midwest setting were assessed, focusing on their accommodations for patients with obesity. Feedback from clinic staff was incorporated to further refine the checklist. Results: Common equipment deficiencies included extra-large blood pressure cuffs, wheelchair-accessible scales, 2XL gowns, and adequate seat dimensions in the waiting area. Healthcare workers reported moral distress for their patients when unable to provide proper care due to these limitations. Newly constructed clinics exhibited better-equipped facilities for patients with obesity. Conclusions: Many clinics lack proper equipment to accommodate patients with obesity, resulting in negative care experiences. This clinical environment checklist can identify problem areas and provide solutions to create more welcoming environments, encouraging future care-seeking behaviors.
Addressing Pollution-Related Global Environmental Health Burdens
(AGU, 2018-02-19) Filippelli, Gabriel M.; Taylor, Mark P.; Earth Sciences, School of Science
New analyses are revealing the scale of pollution on global health, with a disproportionate share of the impact borne by lower‐income nations, minority and marginalized individuals. Common themes emerge on the drivers of this pollution impact, including a lack of regulation and its enforcement, research and expertise development, and innovative funding mechanisms for mitigation. Creative approaches need to be developed and applied to address and overcome these obstacles. The existing “business as usual” modus operandi continues to externalize human health costs related to pollution, which exerts a negative influence on global environmental health.
Assessing Individuals’ Exposure to Environmental Conditions Using Residence-Based Measures, Activity Location-Based Measures, and Activity Path-Based Measures
(Wolters Kluwer, 2019-03) Morrison, Christopher N.; Byrnes, Hilary F.; Miller, Brenda A.; Kaner, Emily; Wiehe, Sarah E.; Ponicki, William R.; Wiebe, Douglas J.; Pediatrics, School of Medicine
Background: Many approaches are available to researchers who wish to measure individuals' exposure to environmental conditions. Different approaches may yield different estimates of associations with health outcomes. Taking adolescents' exposure to alcohol outlets as an example, we aimed to (1) compare exposure measures and (2) assess whether exposure measures were differentially associated with alcohol consumption. Methods: We tracked 231 adolescents 14-16 years of age from the San Francisco Bay Area for 4 weeks in 2015/2016 using global positioning systems (GPS). Participants were texted ecologic momentary assessment surveys six times per week, including assessment of alcohol consumption. We used GPS data to calculate exposure to alcohol outlets using three approach types: residence-based (e.g., within the home census tract), activity location-based (e.g., within buffer distances of frequently attended places), and activity path-based (e.g., average outlets per hour within buffer distances of GPS route lines). Spearman correlations compared exposure measures, and separate Tobit models assessed associations with the proportion of ecologic momentary assessment responses positive for alcohol consumption. Results: Measures were mostly strongly correlated within approach types (ρ ≥ 0.7), but weakly (ρ < 0.3) to moderately (0.3 ≤ ρ < 0.7) correlated between approach types. Associations with alcohol consumption were mostly inconsistent within and between approach types. Some of the residence-based measures (e.g., census tract: β = 8.3, 95% CI = 2.8, 13.8), none of the activity location-based approaches, and most of the activity path-based approaches (e.g., outlet-hours per hour, 100 m buffer: β = 8.3, 95% CI = 3.3, 13.3) were associated with alcohol consumption. Conclusions: Methodologic decisions regarding measurement of exposure to environmental conditions may affect study results.
Association Between Residential Greenness and Cardiovascular Disease Risk
(American Heart Association, 2018-12-18) Yeager, Ray; Riggs, Daniel W.; DeJarnett, Natasha; Tollerud, David J.; Wilson, Jeffrey S.; Conklin, Daniel J.; O'Toole, Timothy E.; McCracken, James; Lorkiewicz, Pawel; Xie, Zhengzhi; Zafar, Nagma; Krishnasamy, Sathya S.; Srivastava, Sanjay; Finch, Jordan; Keith, Rachel J.; DeFilippis, Andrew; Rai, Shesh N.; Liu, Gilbert; Bhatnagar, Aruni; Geography, School of Liberal Arts
Background Exposure to green vegetation has been linked to positive health, but the pathophysiological processes affected by exposure to vegetation remain unclear. To study the relationship between greenness and cardiovascular disease, we examined the association between residential greenness and biomarkers of cardiovascular injury and disease risk in susceptible individuals. Methods and Results In this cross-sectional study of 408 individuals recruited from a preventive cardiology clinic, we measured biomarkers of cardiovascular injury and risk in participant blood and urine. We estimated greenness from satellite-derived normalized difference vegetation index ( NDVI ) in zones with radii of 250 m and 1 km surrounding the participants' residences. We used generalized estimating equations to examine associations between greenness and cardiovascular disease biomarkers. We adjusted for residential clustering, demographic, clinical, and environmental variables. In fully adjusted models, contemporaneous NDVI within 250 m of participant residence was inversely associated with urinary levels of epinephrine (-6.9%; 95% confidence interval, -11.5, -2.0/0.1 NDVI ) and F2-isoprostane (-9.0%; 95% confidence interval, -15.1, -2.5/0.1 NDVI ). We found stronger associations between NDVI and urinary epinephrine in women, those not on β-blockers, and those who had not previously experienced a myocardial infarction. Of the 15 subtypes of circulating angiogenic cells examined, 11 were inversely associated (8.0-15.6% decrease/0.1 NDVI ), whereas 2 were positively associated (37.6-45.8% increase/0.1 NDVI ) with contemporaneous NDVI . Conclusions Independent of age, sex, race, smoking status, neighborhood deprivation, statin use, and roadway exposure, residential greenness is associated with lower levels of sympathetic activation, reduced oxidative stress, and higher angiogenic capacity.
Associations Between the Built Environment in GPS-Derived Activity Spaces and Sedentary Behavior, Light Physical Activity, and Moderate-to-Vigorous Physical Activity
(MDPI, 2025-04-04) Vittor, Dante G.; Wilson, Jeffrey S.; Crouter, Scott E.; Ethier, Benjamin G.; Shi, Ling; Camhi, Sarah M.; Troped, Philip J.; Earth and Environmental Sciences, School of Science
Built environment and physical activity (PA) studies have predominantly used fixed or home-centric approaches to identify environmental exposures. In this study, GPS-derived daily activity spaces were used to examine the relationships between the built environment and sedentary behavior (SB), light PA (LPA), and moderate-to-vigorous PA (MVPA). Thirty-one adults were assessed with activity monitors and GPS units. Three types of activity spaces were created: 50 m buffered GPS tracks, minimum convex hulls (MCHs), and standard deviational ellipses (SDEs). The environmental variables included land use mix, greenness, and intersection, multi-use trail, bike infrastructure, and bike station densities. Repeated measures regression was used to test the associations for 141 person-days, controlling for age, gender, income, body mass index, crime, precipitation, and temperature. Greenness within MCH activity spaces was positively associated with LPA (p = 0.02). The bike infrastructure density within SDE spaces had a significant positive association with MVPA (p = 0.04). Multi-use trail, bike infrastructure, and bike station densities had significant negative associations with LPA (p ≤ 0.05). There were no significant adjusted associations with SB. The few significant associations in this study varied by outcome and type of activity space. Further studies are needed to determine optimal, yet flexible methods for activity spaces in built environment and PA research.
Decision 2020 Electing Indiana's Future: Addressing 21st Century Environmental Challenges
(2020-09) Kharbanda, Jesse; McCabe, Janet; Frank, Indra; Hoffman, Jill
Environmental risk factors are associated with autoimmune hepatitis
(Wiley, 2021) Lammert, Craig; Chalasani, Sai N.; Atkinson, Elizabeth J.; McCauley, Bryan M.; Lazaridis, Konstantinos N.; Medicine, School of Medicine
Background: Failure of immunologic homeostasis and resultant hepatocyte destruction in autoimmune hepatitis (AIH) is likely the result of environmental triggers within a permissive genetic architecture. Aims: We aimed to identify risk factors associated with AIH in a well-phenotyped AIH cohort. Methods: We prospectively collected environmental questionnaires from 358 AIH cases and 563 healthy controls. Response frequencies were compared using logistic regression, adjusting for age at recruitment, sex and education. Results: AIH cases were more likely to ever have a urinary tract infection (UTI) (53.6% vs 33.9%, P < .001) and recurrent UTI (more than 1 per year) (23.5% vs 15.9%, P = .002) compared to controls. Female cases more frequently had ever used oral contraceptives (83.0% vs 73.7%, P = .006), fewer pregnancies (median = 1 vs 3, P < .001) and less often used hormone replacement therapy compared to controls (28.5% vs 60.1%, P < .001). Current smoking was more prevalent in cases (18.9% vs 7.4%, P = .022), yet no difference according to historical smoking behaviours was observed. Finally, cases were less likely to have history of mumps (32.4% vs 53.1%, P = .011) and rheumatic fever (1.1% vs 4.4%, P = .028), but reported higher vaccination frequency to chicken pox (38% vs 28.1%), measles (66.5% vs 39.3%), mumps (58.7% vs 34.6%), rubella (55.3% vs 32.7%), pertussis (59.8% vs 40.1%) and pneumococcus (47.2% VS 39.4%) (P < .002). Conclusions: Environmental factors are important in AIH pathogenesis. Replication of these findings and prospective examination may provide new insight into AIH onset and outcomes.
Extinction
(2015) Eickhoff, Matthew; Petranek, Stefan
Four days before I began Herron’s graduate program, my close friend, and former boss, Ed Funk committed suicide. This event would forever influence my graduate research and my artwork. I began to search for a deeper understanding of life through the pursuit to tell a story and a desire to explore new materials. Up to this point, painting had primarily dominated my approach to art. The goal of my Master’s work was to break through the divisions of artistic medium and discover an overarching theme that would refine myself as an artist independent of medium.
Fort Benjamin Harrison: From Military Base to Indiana State Park
(2020-04) Hankins, Melanie Barbara; Scarpino, Philip V.; Shrum, Rebecca K.; Morgan, Anita
For nearly a hundred years, Fort Benjamin Harrison served as an epicenter of training and organization for United States Army in Indianapolis, Indiana. However, budget cuts pushed the U.S. Congress to close Fort Harrison under the Defense Base Re-Alignment and Closure Act of 1991. Over the following five years, the U.S. federal government, various Indiana state agencies, city governments of Indianapolis and Lawrence, and citizen advocacy groups worked together to develop a reuse plan for the former military base. Succinct planning and compromises allowed 70 percent of the former military base to be converted into an Indiana state park. Over the lifetime of the base a variety of factors resulted in the unintended creation of the largest noncontiguous forest in Central Indiana ---an area perfectly suited as an Indiana state park. As Fort Benjamin Harrison enters its second decade as a state park, park staff must reevaluate the park’s military past and its effects on the land as it is today. This thesis examines the transitional years between the closure of the base and opening of the park, analyzes current interpretive practices at the park, and provides new suggestions for future public programming and interpretive practices.
Fracked Prospects
(2017) Harney, Tarja; Setser, Meredith
My work is responding to social issues and their negative effects onto the environment. Bringing attention to the effects of hydraulic fracturing and other social issues I am voicing my concern and searching for a dialogue to emerge. I reveal the dangers hidden by the beauty of false truths of corporations that are the cause of environmental issues.

Browsing by Subject "Environment"

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