Implementation Of Infrastructure Research Articles

Considering Equity in Green Infrastructure Using an Integrative Planning Framework for Green Infrastructure Implementation

In coastal communities, green infrastructure can be part of the infrastructure investment strategy to revitalize existing infrastructure and provide protection from flooding, erosion, and other coastal hazards. This article asks the question: What are key equity considerations related to green infrastructure planning for coastal resilience? We answer this question using the voices of research experts, practitioners, and community members who participated in a virtual workshop designed to identify key questions and concerns about coastal resilience and social equity. These research and practice perspectives are synthesized using an integrative planning framework for green infrastructure implementation that was developed to answer the research question. Our findings identify equity touchpoints as they relate to four cross-cutting themes: (1) stakeholder engagement and public participation, (2) trade-offs and multiple benefits, (3) resources and capacity, and (4) data, metrics, and analysis.

Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey.

Early detection, standardized therapy, adequate infrastructure and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute hospitals. A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives in hospitals. 1023 hospitals in 69 countries were included. Most of them, 835 (81.6%) were from Europe. Sepsis screening was used in 54.2% of emergency departments(EDs), 47.9% of wards, and 61.7% of intensive care units(ICUs). Sepsis management was standardized in 57.3% of EDs, 45.2% of wards and in 70.7% of ICUs. The implementation of comprehensive quality improvement initiatives(QIIs) was associated with increased screening (EDs +33.3%; wards +44.4%; ICUs +23.8% absolute difference) and increased standardized sepsis management (EDs +33.6%; wards +40.0%; ICUs: +17.7% absolute difference) compared to hospitals without QIIs. 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regards to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.

International investment as a factor of recovery and development of the post-war economy of Ukraine

Introduction: The relevance of the topic of studying international investment in the context of Ukraine's post-war reconstruction is due to the need for rapid economic recovery and sustainable development of our country in the context of global economic instability. Methods: Two types of research methods were used to achieve the main goal: general scientific and unique scientific methods. General scientific methods include analysis, synthesis, explanation and generalisation. Results: As a result of the study, the structure and dynamics of international investment in Ukraine's economy are examined. It is noted that the war in Ukraine has led to significant changes in the direction of international investment, with a decrease in investments in the agricultural sector and a reorientation towards public administration, defence and industry. These changes reflect the need to adapt investment strategies to new conditions and challenges. It is important to continue developing digital technologies and innovative industries, as they have significant potential for long-term economic growth. Conlcusions: The study concludes that international investment is a critical factor in recovering and developing Ukraine's post-war economy. They not only provide additional resources for the implementation of infrastructure and economic projects, but also facilitate technology transfer and the introduction of best management practices. New financial instruments, such as green bonds, will play a unique role in attracting international investments to the sustainable recovery of Ukraine. Ukraine needs to develop the green bond market to diversify investors and attract green investors.

Financial Evaluation of a Business Model for the Development of Advanced Measurement Electricity Infrastructure Projects in Colombia

The Colombian government’s plan aims to strengthen the electricity sector through the implementation of Advanced Measurement Infrastructure, network automation, distributed resources, and electric vehicles. These initiatives present both technological and economic challenges, given the current conditions in various Colombian municipalities, many of which will struggle to meet them. In response to this need, it is proposed to evaluate a business model to encourage the development of projects that facilitate the modernization of the distribution network, by supporting the network operator as a strategic partner. The distribution network of the municipality of San José de Guaviare in Colombia is used as a case study. The results indicate that this approach is attractive for the public service provider and demonstrate that continuous improvement in service quality indicators can be achieved without significantly impacting the local population’s economy.

Implementing integrated care infrastructure: A longitudinal study on the interplay of policies, interorganizational arrangements and interoperability in NHS England.

New models of care that integrate health and social care provision around the patient require a supportive infrastructure, including interorganizational arrangements and information systems. While public policies have been designed to facilitate visions of integrated care, these often neglect the implementation of effective and efficient delivery mechanisms. This study examines a decade of attempts to move from fragmented health and care delivery to integrated care at scale in NHS England by developing and implementing a support infrastructure. We undertook a longitudinal qualitative investigation -encompassing interviews and documentary analysis- of the implementation of interorganizational and digital interoperability infrastructures intended to support integrated care policies. Our findings underscore the long-term symbiotic relationship between institutional interorganizational frameworks and the construction of interoperability infrastructures, emphasizing how they mutually reinforce each other to support their ongoing evolution. Iterative, flexible, and experimental approaches to implementation provide opportunities to adapt to local realities while learning in the making. This study underlines the importance of adaptable, locally-informed implementation strategies in supporting the vision of integrated care, and the need to understand such development as a long-term, ongoing process of construction and learning.

Barriers to Sustainability: Reflections on Social and Environmental Dimensions

Objective: To address issues related to the impacts of development strategies on society and the environment based on the principles of sustainable development and public participation, as established in the Aahrus Convention in 1998. Theoretical framework: The importance of integrating concerns with ethical, social and environmental dimensions when planning and implementing infrastructure is addressed. Method: The methodology is based on bibliographical research to explore and combine the issues that represent mandatory requirements to meet the objectives of sustainable development, as well as to analyze the discrepancies between economic interests and the need to protect environmental and social values using water resources projects as an example. Results and conclusions: The fact that decision-making regarding the implementation of infrastructure is predominantly based on merely “technical-economic” aspects constitutes one of the barriers to sustainability. It is urgent to adopt feasible measures that aim to give due weight to environmental, social, cultural, ethical aspects and all those whose balance is likely to be affected by human interventions. Implications of the research: The research carried out highlights the relevance and urgency of integrating the ethical and social dimensions in the training of technicians (e.g., engineers whose activities raise significant environmental and social aspects) as a way of ensuring multidisciplinary content in their training and, thus, facilitating the understanding of the imperative nature of transdisciplinarity in the design and implementation of infrastructures that structure development. Originality/value: The work constitutes a reflection on the adaptations that urgently need to be implemented to enable territorial planning actions that holistically integrate the environmental, economic and social dimensions of sustainability.

Mobile Phone Data Transforming Casework in Asylum Decision-making: Insights from the Danish Case

The Danish Immigration Service estimates that approximately 20% of decisions in asylum cases are informed by data extracted from asylum seekers’ mobile phones, enabling more comprehensive constructions of data than passport or similar identification documents provide. Such data (e.g., from social media) feed into caseworker systems and inform decisions on whether to grant asylum to an applicant or not. During the asylum process both governmental authorities and non-governmental organizations (NGOs) have a formal role assisting individuals applying for asylum in understanding, intervening in, and participating in the socio-technical infrastructures through which data are produced and used, defined as data infrastructure literacy. In this article we ask: In the context of mobile phone data transforming asylum casework in Denmark, what characterizes data infrastructure literacy for different stakeholders in the asylum process, including those subjected to the asylum procedure? The research presented in this article is informed by qualitative data produced through semi-structured interviews ( N = 10), summaries of asylum cases from both a public and a non-public dataset, and 160 hours of observational studies. Our findings suggest that data obtained from mobile phones have become an integral part of asylum decision-making. Furthermore, our findings suggest that data infrastructure literacy is conditioned by stakeholders’ understanding of mobile phone data as assembled and utilized in the following ways: (1) through distributed, collaborative, and data-driven efforts, (2) at every stage of the asylum procedure and beyond, (3) as back-up data for credibility assessment, (4) in unequal power dynamics of consent, and (5) by practices that continue to transform by use of new types of data. This is crucial for ensuring that individuals seeking asylum receive basic legal support during and after the implementation of new data infrastructures.

Review of spatial layout planning methods for regional multi-station integration

In order to accelerate the high-quality development of China’s infrastructure, it is not only necessary to ensure the continuation and efficiency improvement of the original infrastructure, but also to promote the layout, implementation, improvement and quality improvement of new infrastructure. As an important part of the energy Internet and new power system, “multi-station integration” plays a role in strengthening digital transformation, intelligent upgrading, integration and innovation support, achieving the nearby integration of resources and the coordination and complementarity of operation, reducing redundant design, so that users, enterprises and industries in the region can reduce costs, energy saving and emission reduction, improve quality and efficiency. By combing the spatial layout planning methods, models and influencing factors of traditional single function station and multi-station integration in the region, the influences of the function station itself and other surrounding infrastructure on the function station are analyzed. Combined with the application scenario, load demand and integration mode of multi-station integration, it is proposed to combine common factors and characteristic factors. The objective evaluation method is introduced to improve the practicability and suitability of the layout location. Finally, the three-layer theoretical framework is proposed to improve and supplement the existing layout principles and methods, so as to provide reference suggestions for the scientific location selection and optimization of regional multi-station integration.

Vibrations induced by railway traffic: from environmental impact assessment to exploration in new railway projects

Prediction and control of ground-borne vibrations are one of the largest environmental challenges for railway exploration in urban areas. Nowadays, there is a shift at global level, in which investment in rail transport takes precedence over other transportation options, in a final attempt to drastically reduce CO2 emission. The expansion and improvement of the railway network, associated with the high standards of comfort required by modern societies, requires the assessment and mitigation of the environmental impact induced by the implementation of such infrastructures in nearby buildings, more specifically in their inhabitants and in the operation of sensitive equipment. Using a recently completed railway line in Porto, Portugal, as a case study, this paper aims to provide insights into the numerical studies conducted during the environmental impact assessment phase concerning vibrations induced by railway traffic. Additionally, it discusses the results from the experimental measurement campaign carried out after the line's construction to validate the assumptions made during the design phase regarding expected vibration levels.

A comprehensive risk management framework for NIMBY projects: Integrating social network analysis and risk transmission chains

Urban development projects often face local opposition, known as the NIMBY (Not in my back yard) effect, affecting infrastructure implementation and urban growth. This study aims to develop a systematic risk management approach for NIMBY projects. Employing grounded theory, 29 NIMBY cases in China were analyzed, identifying 17 risk factors across six categories. Social network analysis revealed risk interactions, highlighting four factors: government decision-making risk, government credibility risk, project completion risk, and online public opinion risk. Two risk transmission chains were delineated, each consisting of 4–5 interconnected risk factors, providing insights into risk propagation mechanisms. Simulation results indicated that targeted risk mitigation strategies based on these chains affected network efficiency differently compared to random approaches. The network efficiency reduced from 16.5% to 11.2% for the first chain-based strategy and to 13.4% for the second, while random interventions showed limited impact on network efficiency. Based on these findings, a NIMBY risk management system focusing on risk nodes and incorporating risk compensation mechanisms is proposed. This system addresses proactive governance, stakeholder engagement, and risk mitigation. The research contributes to the understanding and management of NIMBY risks, providing tools for policymakers and project managers. The findings suggest that this approach may affect NIMBY conflicts and community acceptance of urban development projects, potentially influencing urban development processes.

The Green Infrastructure Model Based On Waterlogging Mitigation In The Street Landscape Of Sungai Penuh City, Jambi Province

Background: In many cases, the planning of public and social space in Indonesia is not accompanied by the planning of green open space, which is their functions as a healthy environmental balancer. One of the public spaces is the street landscape. This results in to the impact of natural phenomena such as floods, waterlogging in the rainy season, and hot weather in summer. The purpose of this study is to provide an overview of the Green Infrastructure model of roads, can also function as a place to anticipate waterlogging, flooding, air quality improvement, and human-friendly designation. Materials and Methods: The methodology was carried out through field inventory, mapping based on Shp ArcGis data, and a modified literature study. The location of the research is on roads spread across 8 subdistricts of Sungai Penuh City, Jambi Province. Results: Based on government administration and axis content, the public roads of Sungai Penuh City are categorized into class III Provincial Roads. The number of road sections in Sungai Penuh City is 49 (forty-nine) road sections. The details are that the primary collector road landscape consists of 11 road sections, the secondary collector road landscape consists of 12 road sections, and the local road landscape is very dominant, which is as many as 26 roads. The total length of the entire Sungai Penuh City road section is 51.43 km with an average width of 6 meters. Based on the level of urgency, the results of the assessment of priority sub-districts determined 31 road sections spread across Sungai Penuh District, Sungai Bungkal District, and Pondok Tinggi District as priority sub-districts for the implementation of the Green Infrastructure system. Based on hydrological calculations of rainfall for the last 20 years (2003-2023). Conclusion: The Green Infrastructure Model is prioritized for 3 sub-districts. Based on the assessment of the Green Infrastructure Implementation Indicator, two green infrastructure concepts are applied, namely Green Stormwater Infrastructure 1 (GSI 1) and Green Stormwater Infrastructure 2 (GSI 2) which are equipped with the Complete Street concept. The GSI 1 system is applied on 24 roads in Sungai Penuh City using the Stormwater Tree Trench and planter. The GSI 2 system consisting of Stormwater Bump-Out, Stormwater Tree Trench, and Stormwater Planter and the Complete Street concept will be applied on 7 roads in Sungai Penuh City

Economic Feasibility Study of Deploying Green H2 Infrastructure at Los Angeles International Airport (LAX)

Air transportation is among the critically debated subjects, contributing to approximately 2.5% of global CO2 emissions 1. The main strategy for addressing environmental concerns related to aviation emissions is the shift to low-carbon propulsion technologies for aircraft. Hydrogen could be introduced to the aviation sector as a fuel for fuel cell-powered aircraft or for direct combustion jet engines, with anticipated zero- to low-carbon emissions 2. Moreover, the universe lightest element possesses a very high gravimetric energy density of 120 MJ/kg, which will be higher when stored in cryogenic hydrogen form3, making it an ideal alternative to conventional aviation fuels (for example, jet fuel). This study provides a techno-economic analysis of introducing green hydrogen infrastructure to Los Angeles International Airport (LAX) to promote its transition towards sustainability. Preliminary research showed that the largest uncertainty in economic projections for H2-powered aviation hinges on future H2 supply costs, rather than aircraft modifications4. Therefore, the costs of potential hydrogen implementation routes, including off-site production supplied by road tankers or pipelines to the airport, and on-site production, will be assessed. In summary, the implementation of a hydrogen infrastructure at LAX is not only an initiative to reduce its associated carbon footprint but also suggests a practical and environmentally sustainable paradigm for future upgrades to aviation fuel infrastructure.

Evaluating the implementations of big data analytics in academic libraries: a structural equation model-based approach

PurposeThe rapid evolution of technological infrastructure and analytical capabilities has facilitated the integration of big data analytics (BDA) across various sectors. This study aims to investigate the suitability of implementing BDA within academic libraries, addressing the demanding need for effective data utilization in contemporary educational environments.Design/methodology/approachThe research is grounded in five critical components: data-driven culture, organizational infrastructure, employee responsibilities, management capabilities and the successful deployment of technology for BDA. An extensive literature review led to the development of a Likert scale-based questionnaire distributed on social media to collect data from university librarians in Pakistan. The authors were able to collect the data from 211 librarians. Descriptive statistics were employed to analyze the variables, while confirmatory factor analysis (CFA) was conducted using the AMOS to validate the research model.FindingsThe findings from the measurement model reveal significant positive correlations among all five components, underscoring their collective importance in facilitating the implementation of BDA. This formation is essential for addressing the evolving needs and academic requirements of users in the context of big data in a digital environment.Research limitations/implicationsThe study acknowledges limitations about its focus on a single country’s perspective, which may affect the generalizability of the findings regarding the implementation process of BDA in academic libraries.Originality/valueThis research contributes to the existing body of knowledge by highlighting the practices and capabilities of librarians in the era of big data as well as the requisite organizational infrastructure for the effective implementation of analytics in academic libraries.

Shedding light on local development: Unveiling spatial dynamics from infrastructure implementation through nighttime lights in the Nacala corridor, Mozambique

The increased use of nighttime lights (NTL) to assess infrastructure implementation and socioeconomic development highlights the potential of this open data source, often used as a proxy indicator of economic dynamics. Many studies focus on supra-national levels and the quantification of light emissions, generating assumptions regarding development. However, fewer studies address the characterization of socio-spatial dynamics at the local level. This research analyses the Nacala corridor in Mozambique, aiming to challenge the assumption that increasing NTL levels equals local development. We qualify and contextualize the types of activities identified by nighttime light anomalies. Using data cubes with 10-year seasonal NTL emissions, we identified anomalies in the time series of 17 out of 74 settlements and subsequently analyzed them with very high-resolution images. Among these settlements, we identified soil extraction, quarrying, or industries in 13 cases. Finally, we compared the results with household surveys indicating that during the period, the population had no significant increase in access to energy. We conclude that the NTL time series can effectively portray infrastructure-driven activities, such as surface mining and industry, in the context of the Corridor. However, the assumption that local development is linked with an increase in NTL in non-urbanized areas can be misleading without qualitative analysis. The activities that are the source of radiance can be illicit, not socially adopted, economically concentrated, and/or environmentally harmful.

Professional nurses' perspectives on the implementation of integrated chronic disease management model.

The integrated chronic disease management (ICDM) model is seen to be a promising strategy as it is gaining global acceptance as an approach to enhance healthcare delivery. The study objectives were to explore and describe professional nurses' perspectives on the model, identify challenges experienced during implementation and identify factors that could improve the model implementation. An explorative, descriptive qualitative design was used, nine professional nurses from three selected facilities were interviewed. Data obtained from semi-structured individual interviews were analysed using thematic analysis and NVivo software. Three main themes emerged: the professional nurses' perceived benefits of the model, challenges experienced during implementation and recommendations to ensure effective implementation of the model. The perceived benefits of the model included the integration of care, adequate medication and the alleviation of stigma related to diseases. However, the challenges of the model included a shortage of staff, poor infrastructure and patients missing scheduled appointments. The study noted the need for adequate staff, infrastructure and ongoing training for the successful implementation of the model. Despite challenges in the South African healthcare system, professional nurses perceived the implementation of the model positively. The study highlighted the need for adequate staff, adequate infrastructure and ongoing training for staff.Contribution:This study outlined the challenges and recommendations identified, enabling healthcare organisations, policymakers and educators to develop targeted strategies for successful implementation. The findings will also inform future research focussed on optimising the utilisation of the model in the study setting and similar contexts.

Exploring experimental tests concerning liquid hydrogen releases

In recent years, the adoption of liquid hydrogen (LH2) has increased significantly in industrial and transport applications, driven by its low carbon footprint, thereby aiding the fight against global warming. Additionally, its high volumetric energy density, compared to gaseous or compressed hydrogen, enhances hydrogen storage capabilities. However, safety remains a major concern due to its physical-chemical properties and inherent hazardous characteristics, especially in the event of spillage scenarios. Therefore, to better understand the consequences of LH2 releases onto or into water, large-scale experimental tests were conducted by Bundesanstalt für Materialforschung und -prüfung (BAM) within the Safe Hydrogen Fuel Handling and Use for Efficient Implementation (SH2IFT) project at the Test Site Technical Safety of BAM, comprising 75 single spill events at varied release rates and orientations. While the rapid phase transition (RPT) phenomenon was not observed, self-ignition of the hydrogen-air cloud occurred, accompanied by blast wave overpressure and heat radiation, without a discernible ignition source. These findings emphasize the need for further investigation into LH2 safety. Leveraging experimental data for real-world applications provides insights into safe LH2 infrastructure implementation, laying foundational knowledge for addressing safety challenges and advancing LH2 technology.

Implementation of Sports Science and Technology Integration Infrastructure: A Case Study of Speed Skating Utilizing Web and Mobile Applications, and Information Visualization Technologies

In the field of sports, there is an active discussion on and an attempt to apply technologies that integrate sports with cutting-edge science and technology for the purpose of enhancing athletic performance. In line with this trend, South Korea is supporting research on the fusion of sports and science technology at an interdepartmental level. For the improvement of performance in elite sports, it is important to consider the athlete’s skills, the coach’s information analysis, the scientification of equipment, and the environmental optimization. Accordingly, this study aims to propose web and mobile app technologies to establish an integrated infrastructure of sports science and technology for the three factors of athletes, equipment, and environment to improve the performance of speed skating. Furthermore, it aims to make policy recommendations to activate this integration. The application of such technologies and policy recommendations can be transferred and organically integrated into other sports, including track and field, which are time-based competitions. Additionally, it is expected that this approach will lead to the formation of new theories that consider the emotional aspects occurring in sports situations.

AI-Driven Cardiomegaly Detection Using Cutting-Edge Chest X–ray imagery

This project aims to develop an innovative approach for detecting cardiomegaly, a condition characterized by an enlarged heart, using machine learning techniques, specifically Support Vector Machines (SVM), and state-of-the-art chest X-ray imagery. Cardiomegaly serves as a significant indicator of various cardiac diseases, and early detection through accurate imaging analysis can lead to timely intervention and improved patient outcomes. The proposed machine learning solution utilizes SVM algorithms trained on a diverse dataset of chest X-ray images to automatically identify signs of cardiomegaly with high precision and reliability. By harnessing the power of SVM, this system offers a non-invasive and cost-effective method for screening large populations for cardiac abnormalities, facilitating early diagnosis and appropriate medical management. Key features of the developed solution include robust feature extraction techniques, real-time analysis, and integration with existing healthcare infrastructure for seamless implementation in clinical settings. Moreover, the system prioritizes patient privacy and data security by adhering to relevant regulations and standards governing medical imaging and information management. Overall, this project represents a significant advancement in the field of cardiac health monitoring, providing healthcare professionals with a valuable tool for early detection and management of cardiomegaly, ultimately improving patient care and reducing the burden of cardio vascular disease

Design and implementation of blue-green infrastructure for socio-cultural benefits at community scales: The case of Wigram Basin in Ōtautahi Christchurch

Stormwater-related blue-green infrastructure (BGI) has been shown to play an important role in enhancing the socio-ecological-cultural resilience of communities under stress from climate change and in the wake of the COVID-19 pandemic. BGI has been defined as natural, semi-natural, and artificial spaces that deliver valued bio-physical and socio-cultural benefits to communities through the facilitation of natural processes, with a particular focus on stormwater management. While studies have identified a range of benefits associated with BGI, research has only partially examined their valuation, especially concerning socio-cultural outcomes. Research has also failed to consider the ways in which BGI operates at community scales, and how this may be influenced by the design process of individual projects. This study examines the range of socio-cultural benefits associated with BGI projects, alongside the design characteristics which may influence these outcomes using a mixed-methods case study of Wigram Basin. Results show that while a range of benefits were associated with the implementation of local BGI, broader socio-cultural outcomes such as social cohesion, the facilitation of a sense of place, and the ability to practice cultural values were infrequently identified by respondents. Results also demonstrated that the transdisciplinary design team, specific project priorities, and the approach taken to community and Indigenous engagement may have influenced the range of benefits achieved by Wigram Basin. As such, this research recommends that the design of BGI considers the range of disciplines required to be involved in project design, the pathways required to provide socio-cultural benefits, early, ongoing, and place-based community and Indigenous engagement and education, and the ongoing assessment and valuation of all project outcomes to maximize BGI implementation.

From plan to practice: A qualitative study of public mental health therapists' session-planning practices.

Therapists must dedicate considerable time to session plan to implement evidence-based practices (EBPs) flexibly and with fidelity. It is unclear whether public mental health settings offer the structural and organizational support for therapists to engage in session planning and, therefore, whether they provide the necessary infrastructure for EBP implementation. In Fall 2022, 18 therapists working in public mental health settings in New York City were recruited through snowball sampling to participate in 90-min semistructured qualitative interviews. Therapists were prompted to review their session-planning practices using a chart-stimulated recall strategy; to describe structural, organizational, and individual barriers and facilitators to session planning; and to generate recommendations to support their session planning. Qualitative data were analyzed using thematic analysis. A diverse group of therapists participated in the study-22% identified as Black; 22% as Asian; and 11% as Hispanic/Latinx. Seventy-eight percent of therapists were social workers; and they had on average 6.18 (SD = 5.70) years of clinical experience. The research team identified four multilevel session-planning barriers and three multilevel session-planning facilitators. Therapists proposed seven multilevel recommendations to support their session planning. Overall, therapists indicated that managing high productivity standards, severe clinical presentations, and clients' social needs often prevent them from having time to plan for sessions. Efforts to implement EBPs in public mental health settings cannot neglect the structural realities faced by agencies, therapists, and clients. Multilevel resources and reforms to support therapists' session planning are necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).