Availability Of Material Resources Research Articles

"When You Look at This Chart, That Is Not My Whole Life": Caregiver Perspectives to Inform Improved Primary Care Practice and Outcomes.

Worsening rates of infant and maternal mortality in the United States serve as an urgent call for multi-modal intervention. Infant Well Child Visits (WCVs) provide an opportunity for prevention, however not all infants receive the recommended schedule of visits, with infants of low-income and Black families missing a higher portion of WCVs. Due to diverse experiences and needs of under-resourced communities throughout the United States, caregiver voice is essential when designing improvement efforts. Purposeful sampling and interviewing of 10 caregivers in Cincinnati, OH was performed by community peer researchers. Interview transcripts were evaluated by the research team, with identification of several important themes. Nine out of 10 caregivers self-identified as Black. All young children of the interviewed caregivers had Medicaid as their insurance provider. All interviews highlighted rich perspectives on caregiver hopes for their child, family, and selves. Establishing trust through empathy, shared decision making, and the nurturing of interpersonal patient-practitioner relationships is crucial for fostering a positive healthcare experience. Levels of mistrust was perceptibly high across several interviews, with lack of racial concordance between medical provider and family exacerbating the issue for some caregivers. Caregivers voiced a tendency to rely on family and community members for when to seek out health care for their children, and additionally cited racism and perceptions of being rushed or judged as barriers to seeking further care. This study emphasizes the importance of being community-informed when considering interventions. Prior research on the topic of missed WCV's often focused on material resource availability and limitations. While that was commented on by caregivers in this study as well, equal-if not more-attention was directed toward interpersonal relationship formation, the presence or absence of trust between practitioner and caregiver, and the importance of social-emotional support for caregivers. We highlight several opportunities for systemic improvements as well as future directions for research.

Review of "lightened slipstraw ceilings" as a cultural practice in the vernacular roofing of Aymara houses in Arica and Parinacota, Chile

This article reviews the slipstraw ceiling technology known in the Aymara language as "caruna.” The study was made in Aymara homes at more than 4,000 meters above sea level in the town of Tacora, in the region of Arica and Parinacota, Chile, as part of project 49204, financed by the National Cultural Heritage Service. It aims to recover this vernacular technique as an alternative to industrialized materials that have modified Andean housing and the quality of life in extreme climates over the last 25 years. Samples of materials used in this technique, reproduced by a local craftsman, were collected and analyzed in the laboratory to determine their thermal properties and workability. The energy performance of three homes in Tacora was also monitored to compare the results obtained with those of the laboratories. The findings revealed that the mud mold used in this ceiling technique is predominantly made from clay with medium compressibility and low thermal conductivity, which makes it apt for insulation in cold desert climates. Lightened clay and straw ceilings stand out in the local culture thanks to the availability of material resources and ease of installation. This study highlights the importance of preserving traditional knowledge, respecting ancestral knowledge, and improving the thermal performance of homes in the northern mountain range of Chile, Peru, and Bolivia, highlighting its relevance for developing sustainable and culturally relevant housing solutions.

Resource Capacity Assessment of Lower-Tier Health Institutions and Delivery of Responsive Care-Given Within Ghana’s Decentralised Healthcare System

This study examined the capacity of decentralised health institutions at the Sunyani Municipality for responsive healthcare delivery, through the case study design. A sample size of 102 individuals comprising 60 household respondents and 42 healthcare staff were involved. Interviews and observations were used to collect data from the respondents. The human resource capacity of the health facilities was found to be adequate for responsive healthcare delivery; however, these successes were diminished by limited financial and material resource availability. The study concludes that disproportionate resource capacity is counterproductive; thus, the government should increase its health sector financial and material resource allocations.

The COVID-19 Pandemic's impact on sustainability and expansion of a Pediatric Early Warning System in resource-limited hospitals.

The COVID-19 pandemic impacted healthcare delivery worldwide, including pediatric cancer care, with a disproportionate effect in resource-limited settings. This study evaluates its impact on existing quality improvement (QI) programs. We conducted 71 semi-structured interviews of key stakeholders at five resource-limited pediatric oncology centers participating in a collaborative to implement Pediatric Early Warning System (PEWS). Interviews were conducted virtually using a structured interview guide, recorded, transcribed, and translated into English. Two coders developed a codebook of a priori and inductive codes and independently coded all transcripts, achieving a kappa of 0.8-0.9. Thematic analysis explored the impact of the pandemic on PEWS. All hospitals reported limitations in material resources, reduction in staffing, and impacts on patient care due to the pandemic. However, the impact on PEWS varied across centers. Identified factors that promoted or limited ongoing PEWS use included the availability of material resources needed for PEWS, staff turnover, PEWS training for staff, and the willingness of staff and hospital leaders to prioritize PEWS. Consequently, some hospitals were able to sustain PEWS; others halted or reduced PEWS use to prioritize other work. Similarly, the pandemic delayed plans at all hospitals to expand PEWS to other units. Several participants were hopeful for future expansion of PEWS post-pandemic. The COVID-19 pandemic created challenges for sustainability and scale of PEWS, an ongoing QI program, in these resource-limited pediatric oncology centers. Several factors mitigated these challenges and promoted ongoing PEWS use. These results can guide strategies to sustain effective QI interventions during future health crises.

Facades-as-a-Service

Facades-as-a-Service (FaaS) is a systemic innovation model aiming to accelerate and enhance the energy and comfort performance improvement of our buildings, while safeguarding the availability of material resources for future generations. The circular economy and clean energy transitions in the built environment have respectively dominated the academic dialogue in architecture, engineering, and real estate over the last decades. While significant progress has been made, and many fine examples of more sustainable architecture exist, the process has been hindered by traditional systemic models for the planning, contracting, financing, construction, and management of building projects. If we are to meet the ambitious climate-change mitigation goals and material resource preservation challenges of our generation, it is crucial to re-think the way in which we build, operate, and decommission the built environment. Product-service systems (PSS) are a promising model for realigning environmental risks and responsibilities with financial and business objectives, while promoting much deeper and long-lasting collaboration between all parties involved in a building’s life-cycle. This thesis focuses on the building envelope, as one of the most performance-determining systems in our buildings. It then questions the technological, managerial, financial, and legal contexts which often perpetuate unsustainable linear practices despite the urgency for - and technical feasibility of - more energy- and resource-efficient alternatives. Facades-as-a-Service is a topic that extends far beyond technological readiness and architectural engineering. It is rather a thesis about how we make façade construction and retrofitting decisions, the systemic parameters that determine and constraint these decisions, and whether – in the search for a more sustainable built environment – we should question the fundamental concepts behind these decisions. The results show that gradual and strategic development with a multi-disciplinary perspective can enable and facilitate the implementation of more efficient and sustainable building practices.

940. First situational diagnosis of the implementation of Antimicrobial Stewardship Programs in Mexican Hospitals, 2021

Abstract Background The development of antimicrobial stewardship programs (ASP) can help to improve the quality of care and contain the growing problem of antimicrobial resistance (AMR). In Mexico, there is little evidence on the design, implementation and evaluation of hospital ASP. The objective of this study is to present a situational diagnosis of the ASP structure, processes implemented and monitoring of results obtained in a sample of Mexican hospitals. Methods An online survey directed to ASP teams was applied to a purposive sample of 40 hospitals that perform regular antimicrobial stewardship activities in Mexico, during the last trimester of 2021. The survey was based on the ‘core elements’ instruments developed by the CDC and WHO. Results Forty hospitals (62% public and 38% private) were surveyed in 13 states in Mexico regarding ASP basic elements. Infrastructure and Organization elements: on average 52% of these hospitals carry basic actions that refer to: written ASP document and annual plan (46%); allocated human resources (68%); availability of material resources (59%) and use of technological platforms (37%). Processes: development of hospital treatment guidelines (49%); educational interventions (40%); persuasive and feedback interventions (42%); and in greater proportion, restrictive interventions (77%). Monitoring activities: interventions (25%); antimicrobial consumption (73%) and AMR (85%) Conclusion This first diagnosis serves as a baseline to determine the current state of ASP implementation per hospital and in the country. It also reflects on the ASP heterogeneity, that should be addressed by national policies. The greatest challenge lies in the program governance, and the systematic monitoring of the implementation of ASP interventions. Disclosures Anahí Dreser, PhD, MSD: Grant/Research Support.

Hand Hygiene in the Intensive Care Unit: Knowledge, Compliance and Factors Influencing Nursing Adherence, a Descriptive Study

Background: Nosocomial infections are particularly common among hospitalized patients who undergo resuscitation compared with other types of care. Hand hygiene remains the simplest and most effective measure to prevent and control the risk of infection. Objective: The main objectives are to evaluate hand hygiene compliance among nursing staff in the different intensive care units and to identify the factors influencing the adherence of nursing staff to the practice. Methods: It was a quantitative descriptive study using a questionnaire and an observation grid with all the nursing staff working in all the intensive care units of our university hospital. Results: The study showed a hand contamination rate of (80%), a hand hygiene compliance rate of (21.3%), it also showed the different factors explaining non-adherence, these are not necessarily related to training, nor to the availability of material resources but related to hidden reasons, non-apparent factors, which are often more important. (Workload and work environment) Conclusion: This study examined hand hygiene in the ICU setting, obtained data on overall compliance, which remains poor, and the various factors influencing nurses' adherence to the practice.

Does education protect families' well-being in times of crisis? Measurement issues and empirical findings from IT-SILC data

This study analyses the relationship between education and material well-being from a longitudinal perspective using the European Survey on Income and Living Conditions (EU-SILC) data collected in Italy in four waves (2009–2012). It has two main aims: (i) to measure household material well-being on the basis of householders’ responses to multiple survey items (addressed to gather information on the household availability of material resources) by advancing indexes, which can account for global and relative divergences in households’ material well-being across survey waves; (ii) to assess how education and other sociodemographic characteristics affect absolute well-being and its variation (i.e. relative well-being) in the time span considered. Both aims are pursued, combining measuring and explanatory modelling approaches. That is, the use of the Multilevel Item Response Theory model allows to measure the global household material well-being and its yearly variation (i.e. relative material well-being) in the four waves. Meanwhile, the use of a multivariate (and multivariate multilevel) regression model allows to assess the effects of education and other sociodemographic characteristics on both components (absolute and relative well-being), controlling for the relevant sources of heterogeneity in the data. The value added to using the proposed methodologies with the main findings and economic implications are discussed.

Organization of environmentally friendly production as the basis for the development of the municipal district

The concentration of means of production directly related to land largely determines the level of intensity of land use. The development of the territory is largely determined by the availability of material resources, they determine the structure of production activities and the level of well-being of the population. The article deals with the analysis of the development of the territory of the municipal district on the use of the land patent, the strategy of development of the territory.

Making Wine Without Grapes: The Case for Quality Teaching With Limited Resources

This article illustrates the significant role that creative, conscientious, dedicated, motivated, and committed teachers play in guiding, directing, and developing students' thinking, perspectives, and future lives. It highlights the importance of teacher agency in connecting learning to students' lives. It argues that good teachers can employ pedagogical practices that are not dependent on the availability of resources. It employs Pierre Bourdieu's theories of capital, field, and habitus to show how teachers can develop students' dispositions, consciousness, perceptions, perspectives, and lives. It also uses Nancy Fraser's theory of social justice to show how teachers can develop in working-class students, the essential knowledge, skills, and understandings that enable them to compete on a par with middle-class students. It uses life course theory to understand how the participants' schooling experiences, relationships, interconnectedness, and transitions influenced their thinking, doing, and lives. It employs a qualitative paradigm to explore five students' and one teacher's notions of how teaching and learning practices assisted the students to overcome the issue of inadequate resources. To locate the participants' perspectives and to analyse how their schooling experiences in the period 1968-1990 influenced their lives, the article uses the life history technique. The findings of the research stress that it is the inventiveness, competence, and attitude of the teacher that are the defining factors in the provision of quality education-not merely the availability of material resources.

COVID-19 shifts mortality salience, activities, and values in the United States: Big data analysis of online adaptation.

What is the effect of a life‐threatening pandemic at the societal level? An expanded Theory of Social Change, Cultural Evolution, and Human Development predicts that, during a period of increasing survival threat and decreasing prosperity, humans will shift toward the psychology and behavior typical of the small‐scale, collectivistic, and rural subsistence ecologies in which we evolved. In particular, subjective mortality salience, engagement in subsistence activities, and collectivism will all increase, while the aspiration to be wealthy will decrease. Because coronavirus has forced unprecedented proportions of human activity online, we tested hypotheses derived from the theory by analyzing big data samples for 70 days before and 70 days after the coronavirus pandemic stimulated President Trump to declare a national emergency. Google searches were used for an exploratory study; the exploratory study was followed by three independent replications on Twitter, internet forums, and blogs. Across all four internet platforms, terms related to subjective mortality salience, engagement in subsistence activities, and collectivism showed massive increases. These findings, coupled with prior research testing this theory, indicate that humans may have an evolutionarily conditioned response to the level of death and availability of material resources in society. More specifically, humans may shift their behavior and psychology toward that found in subsistence ecologies under conditions of high mortality and low prosperity or, conversely, toward behavior and psychology found in modern commercial ecologies under conditions of low mortality and high prosperity.

The ‘way of flowers’ and the care of patients with amyotrophic lateral sclerosis in Japan

Tracheostomy with invasive ventilation (TIV) may be required for the survival of patients at advanced stages of amyotrophic lateral sclerosis (ALS). In Japan it has been shown that a proactive approach toward TIV may prolong the survival of ALS patients by over 10 years by preventing the lethal respiratory failure that generally occurs within 3-5 years of the onset of the disease. Measures to prolong life expectancy without foregoing quality of life have produced better results in Japan than in other developed countries. This ‘Japanese bias’ has been attributed to socio-cultural and religious factors as well as to the availability of material resources in Japan. In this article, we use the concepts of onozukara in kadō (Japanese traditional flower art, also called ikebana) and amae (passive love) to illuminate features of patient care that may contribute to this ‘Japanese bias’.

Ayman al-Zawahiri and the Challenges of Succession in Terrorist Organizations

ABSTRACT What challenges do newly appointed terrorist leaders face? The paper proposes four primary needs all new leaders consider, including acceptance by the organization’s members, assuming control, maintaining organizational coherence and unity, and overcoming counterterrorism pressures. The magnitude of each challenge may differ depending on the predecessor’s character, the organization’s institutionalization level, the group’s ideological and strategic coherence, the availability of material resources, and communal support. This analytical framework is then used to assist the paper’s second objective: understanding how Ayman al-Zawahiri, who succeeded bin Laden, negotiated these challenges and the tradeoffs he made. Shifts in Al Qaeda’s operational environment required al-Zawahiri to confront challenges more complex than his predecessor had faced, even as he had fewer tools to solve them. Facing authority crisis, magnified by the incoherence between Al Qaeda’s central leadership and its branches and Al Qaeda’s inability to control its branches, al-Zawahiri increased decentralization, embraced affiliates’ local focus, promoted efforts to raise Al Qaeda’s local appeal, and sought to reduce U.S. interest in targeting the group. He kept Al Qaeda alive, but saw its stature shrink significantly.

How AI founders on adversarial landscapes of fog and friction

Formal analysis, based on the asymptotic limit theorems of control and information theories, uncovers sufficient conditions for punctuated failure across the full spectrum of real-time cognitive process – essentially a generalization of the Yerkes-Dodson law – challenging recent assertions that instabilities in AI deep learning paradigms can be easily remedied, permitting their use in real-world critical systems. A temperature analog for cognition that is itself an order parameter is determined by rates of internal information transmission, sensory or intelligence input, and material resource availability. Phase transitions driven by the synergisms of such parameters express symmetry-breaking changes in groupoids characteristic of cognition at and across scales and levels of organization, significantly extending models abducted from physical theory. No modifications of current – or future – AI or other cognitive systems can or will be immune to failure when facing sophisticated adversarial challenge under conditions of friction and the fog-of-war. We indicate how to reconfigure these results for study of long-term conflict on ‘Sun Zu Landscapes’ of deception, deceit, and subtle influence under Lamarckian selection.

Prática segura para partos em hospital universitário

Objetivo: identificar a aplicação das práticas essenciais da Lista de Verificação para Partos Seguros (LVPS) da Organização Mundial da Saúde realizadas em Hospital Universitário. Método: estudo transversal descritivo, realizado no período de janeiro a outubro de 2018, com 51 profissionais que assistem o trabalho de parto, parto e puerpério. Para identificar as práticas aplicadas, utilizou-se um questionário semiestruturado e análise estatística. Resultados: práticas relacionadas ao uso de fármacos, disponibilidade de recursos materiais, identificação de sangramento anormal, contato pele à pele, amamentação e planejamento reprodutivo estão conforme o preconizado. Contudo, não houve padronização quanto às avaliações no partograma e às orientações às mulheres e acompanhantes sobre os sinais de agravamento. Conclusões: a LVPS apresenta-se como uma ferramenta inovadora na assistência obstétrica. Oferece oportunidade de melhorias e qualificação dos cuidados, padronizando condutas essenciais, como as orientações sobre os sinais clínicos e registro no partograma, favorecendo a segurança do binômio mãe-bebê.

Analysis of The Mechanical Properties of Concrete Beams That Use Pumice as a Partial Substitution of Concrete Mixtures

One of the most common inhibiting factors in the archipelago is the lack of availability of material resources and human resources. One of the options is the use of lightweight concrete precast using materials around the islands. The local material which is widely distributed in North Maluku is pumice but it has not been used maximally because so far it has only been used as pile material. This study aims to analyze the effect of partial substitution of pumice on fine aggregate in a concrete mixture. This research was carried out experimentally in a laboratory using UTM and divided into 2 stages. Stage 1, designing and analyzing concrete mix using pumice compared without using pumice, Phase 2 testing using concrete beam dimensions of 600x150x100 mm with an inter load of 150 mm. Beam test results show that the limited use of pumice in a concrete mixture does not greatly affect the strength of normal concrete beams, as indicated by the deflection value and strength of concrete blocks that are almost as large.

Systematizing the impacts projection of complex decisions in work groups

Complex decisions can give rise to unexpected consequences from implemented actions. The main problem discussed by this research is the difficulty suffered by decision-makers in projecting impacts of a complex decision before the decision occurrence. Unexpected impacts of complex decisions demand mitigating action so that it is possible to intensify the positive aspects and neutralize the negatives. Dealing with unexpected impacts generates a cognitive overload on decision-makers and on the availability of material resources. To solve these problems, this research proposes the impact projection of complex decisions in a collaborative way, to be applied before the decision occurrence. The proposed solution considers a systematizing project impact of complex decisions inside work groups and delivers a framework and artefacts to support decision-makers in their decision impact tasks before the occurrence of a real decision scenario. This solution was evaluated by decision-making specialists and their goal was to investigate the applicability of this proposal to different teams. This is a qualitative research, and the method applied was the case study because we would like to deeply understand the behaviour of this approach in decision-makers team. The evaluation generated evidence on the feasibility of this approach, showing that the artefacts provide a systematic structure to orient what decision-makers must do to know and understand the impacts of decisions before their execution. This evidence is contribution for decision support field.

CRITICAL STRATEGIES FOR CONSTRUCTION PLAYERS IN THE ADOPTION OF BIOPHILIC CITY CONCEPT IN MALAYSIA

Around 2.5 billion individuals will be living in urban areas by 2050. Two out of three individuals are going to live in urban communities or other urban focuses, featuring sustainable urban planning and public services. A biophilic city concept which is a sister term of the green city innately affiliates human being to other living organisms. Apart from adhering to human needs, the concept is the economical among other green city concepts. However, biophilic city concept is still an alien term to construction players and the public. The paper aims to propose and evaluate the critical strategies for construction players in the adoption of the biophilic city concept in Malaysia. 173 respondents consisting of government agencies, developers, consultants and contractors were involved in a questionnaire survey. 81 out of 107 strategies were accepted as the critical strategies in adopting the biophilic city concept. Among the strongest strategies are (1) effective water conservation in biophilic city project; (2) acknowledging biophilic city concept adoption publicly; and (3) adequate material resource availability for the biophilic city project. These strategies fall under three different items, namely; (1) sustainability in the biophilic city project; (2) awards and recognition for biophilic city concept adoption; and (3) organisation in the biophilic city project, respectively. Commitment of all construction players are crucial crucial towards inclusive, sustainable urban planning and public services.

State‐targeted grievances and resources: Protest participation during economic downturns in Latin America

AbstractThis article analyzes the determinants of protest participation in Latin America. Whereas most research emphasizes grievances over resources, or vice versa, this article explains protest participation as the interaction between individuals' state‐targeted grievances and material resources. I argue that grievances and availability of material resources interact and fuel protest among individuals whose income falls close to the middle of the income distribution, but not among the poor or the rich. Whereas the scarcity of resources mitigates the politicization of grievances among the poor, the relative abundance of resources and alternative channels of political influence produces the same effect among the rich. Analysis of survey data from Latin American democracies provides strong support for these arguments.

The integration of pedagogical technologies as a condition for improving the quality of education

The article presents the results of a study of the activities of educational institutions to solve an actual problem - the problem of improving the quality of education. One of the promising ways to improve the quality of education in educational institutions is the integration of pedagogical technologies. The aim of the study is the development and theoretical substantiation of the system of integration of pedagogical technologies, the advantage of which is the sum of the advantages of the constituent technologies and focused on improving the quality of education. The model of flexible integrated technology of project-module training is proposed as an example. The developed models of flexible integral pedagogical technologies were experimentally tested and widely tested in the activities of Kazan Federal University, Kazan State Power Engineering University, Samara National Research University and several schools in Kazan (Republic of Tatarstan). This approbation led to the conclusion about the effectiveness of these models. The results of the study indicate the positive impact of these models on the main parameters characterizing the effectiveness and quality of the pedagogical process in the education system. The study confirmed that one of the important ways to increase the efficiency of the pedagogical process in education is the integration of pedagogical technologies, the implementation of flexible integrated pedagogical technologies capable adapt to different levels of complexity of pedagogical conditions and effectively solve modern problems of education. The integration of pedagogical technologies, the implementation of flexible pedagogical technologies in education allows not only to improve the quality, but also the efficiency of education, ensures the operational regulation of pedagogical technologies and the conditions of the educational process, considering the type and theme of the academic discipline, the level of students’ development, availability of material resources, tasks of education.