Browsing by Author "Schuler, Douglas A."
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Item A Shipping Container-Based Sterile Processing Unit for Low Resources Settings(Public Library of Science, 2016) Boubour, Jean; Jenson, Katherine; Richter, Hannah; Yarbrough, Josiah; Oden, Z. Maria; Schuler, Douglas A.; Rice 360 Institute of Global HealthDeficiencies in the sterile processing of medical instruments contribute to poor outcomes for patients, such as surgical site infections, longer hospital stays, and deaths. In low resources settings, such as some rural and semi-rural areas and secondary and tertiary cities of developing countries, deficiencies in sterile processing are accentuated due to the lack of access to sterilization equipment, improperly maintained and malfunctioning equipment, lack of power to operate equipment, poor protocols, and inadequate quality control over inventory. Inspired by our sterile processing fieldwork at a district hospital in Sierra Leone in 2013, we built an autonomous, shipping-container-based sterile processing unit to address these deficiencies. The sterile processing unit, dubbed “the sterile box,” is a full suite capable of handling instruments from the moment they leave the operating room to the point they are sterile and ready to be reused for the next surgery. The sterile processing unit is self-sufficient in power and water and features an intake for contaminated instruments, decontamination, sterilization via non-electric steam sterilizers, and secure inventory storage. To validate efficacy, we ran tests of decontamination and sterilization performance. Results of 61 trials validate convincingly that our sterile processing unit achieves satisfactory outcomes for decontamination and sterilization and as such holds promise to support healthcare facilities in low resources settings.Item Challenges of Social Sector Systemic Collaborations: What’s Cookin’ in Houston’s Food Insecurity Space?(Kinder Institute for Urban Research, 2019) Schuler, Douglas A.; Koka, Balaji R.In this study, we seek to understand the nature of collaborations between organizations working in the food insecurity and food desert1 social spaces in Houston, Texas. Within many neighborhoods, the lack of ready access to healthy foods such as fresh fruits, vegetables and whole grains combines with low incomes, and other factors related to transportation, time, ability and proclivity to cook to make food insecurity and food deserts a reality for many persons. An estimated 724,750 food insecure individuals live in the Greater Houston area with a food insecurity rate of 16.6 percent, about 4 percentage points above the national average. Over 500,000 Houston residents live in United States Department of Agriculture (USDA)-designated food desert areas. Food insecurity and food deserts have grave effects on individual and community health. According to the Harris County Healthcare Alliance’s 2015–2016 The State of Health report, about two-thirds of the area’s adult residents were overweight and about one-third was obese,2 with variation across ethnicity. In Harris County, about one in three children is likely to be obese and about one in three children born since 2000 is likely to develop diabetes. These health challenges result in additional health care costs of $3 billion in just Harris County.Item Ethics and Ecologies: Negotiating Responsible and Sustainable Business in Ireland(2012-09-05) Mc Carthy, Elise; Faubion, James D.; Ninetto, Amy; Schuler, Douglas A.This dissertation is about the development of corporate responsibility and sustainability advocacy in Ireland. It shows how the biopolitics of corporate responsibility (or CR) and sustainability was rendered—by CR advocates and interested companies—as an ethical ecology, not dissociated from the biopolitical but rooted in it. By ‘ecology’ I mean to refer to the growing consciousness and deliberate cultivation of the interconnections, dependencies and feedback as well as responsibilities between heretofore discreet parts of the social landscape—between business and employees for example. These nascent interconnections—between what we might think of as systems and their environment—were also being presented as compelling ethical striving and to an extent, facilitating it. Importantly this effort was to be directed towards what was coming to be understood by the terms ‘sustainability’ and ‘responsible business.’ Hence, I also used the word ‘ecology’ in the sense of how this argument for ethics had roots in concern for the planet itself and for the very survival of the human race. In a deeper sense then, the matrix or the features of biopower—“[1] one or more truth discourses about the ‘vital’ character of living human beings; [2] an array of authorities considered competent to speak that truth; [3] strategies for intervention upon collective existence in the name of life and health; [4] and modes of subjectification, in which individuals work on themselves in the name of individual or collective life or health” (Rabinow and Rose 2006, 195)—permeated this concern with sustainability (the ecology or the engagement of systems and environments in the name of ‘life’ as such) and certainly as it was rendered in this arena of business and all that surrounds it, sustainability weighed heavily on ethical quest or government of the self for its potential for success. Furthermore, these logics could be extended into the less biological concern with the sustainability of our ways of life—including communities, businesses and markets; as proxies for vital human bodies, they too were at risk and dependent on changed dispositions to action for their durability.Item The Construction of Sustainability in the Cement Industry: Audit Culture, Materiality and Affective Processes(2013-09-16) Resendez de Lozano, Laura; Faubion, James D.; Boyer, Dominic C.; Duenas-Osorio, Leonardo; Padgett, Jamie E.; Schuler, Douglas A.Introducing sustainability policies in the cement industry involves changing not only production technologies, but the organizational culture of a mature industry that is characterized by huge CO₂ emissions and significant environmental impacts. This research attempts to understand the transition process of the industry and its employees as the process is taking place. The actors involved are strongly influenced by often contradictory forces: On one hand the naturalized market dynamics in the context of the automobile dependent society and widespread networks of highways and other concrete structures, and on the other, the growing concern of preserving resources for future generations as a shared responsibility that raises awareness of the negative environmental impacts of cement production. The fieldwork component of the project was comprised of two complementary parts: First, an ethnographic study of how the abstract goal of becoming sustainable is given meaning as it is implemented in Cemex, one of the largest companies in the cement industry at the global level. Second, an analysis of the audit culture mechanisms present in the production of knowledge among experts involved in designing sustainability assessment mechanisms for infrastructure projects. The latter component took place among experts in the academy and in the Texas Department of Transportation, which represents at the same time a regulating force and a key client of the cement industry. To present the findings, I approach the subject of sustainability as a construction project where cement and sustainability act as boundary objects between multiple communities (Star and Griesemer 1989) at the same time that sustainability is being constructed. I attempt to present the interactions as an institutional ecology with multiple actors and layers of meaning which are interdependent. The work first describes the prevailing landscape of the urban environment pointing to the influence of aesthetic discourses through the course of history from modernism to brutalism and place-making as well as to the prevailing regulatory, geographic and cultural conditions. Here, the landscape is taken as the point of departure where the construction project of sustainability is to take place given that its characteristics allow certain constructions of sustainability while thwarting others. I consider the built environment to be the response to the surrounding conditions that constitute the landscape and to the prevailing preferences of key players. To follow, I describe the main actors who participate in the construction of sustainability including internal and external stakeholders. I take these groups as members of the construction crew of sustainability presenting their interests as they relate to the triple bottom line and to their affiliation to multiple publics (Warner 2002). Next, I turn to the accreditation mechanisms and the dynamics followed by experts and their interlocutors defining the blueprints which the cement industry must follow while sustainability is being constructed within the company and in dialogue with stakeholders. These blueprints are the result of negotiations between experts in industry, government and academy and portray the influence of audit culture, the widespread trust in quantification and the importance of the efficiency paradigm as described by informants. Afterwards, I focus on the construction of sustainability project that takes place within the cement company where multiple avenues are followed to complete the building of sustainability as a material object, combining the blueprints defined by experts as they are translated into concrete demonstrations of sustainability with the subjective interpretations of actors within the material constraints set by concrete and the plasticity of sustainability. While this is the institutional response to comply with sustainability expectations, the final construction of sustainability needs to include the construction of the sustainable subject where individuals incorporate into their mindset sustainability considerations. As the last part of the work, I discuss the emergence of sustainable subjectivities among key participating members of the construction crew of sustainability taken as employees and other stakeholders, presenting the distinct logics followed by individuals while becoming committed to sustainability. Finally, I present the conclusions of this constructive analysis. Foucault’s (Burchell, Gordon, and Miller 1991) concept of governmentality and Strathern’s (Strathern 2000b) analysis of audit culture frame this study, offering a common thread that transforms the need of corporate legitimacy into a process of accountability and transparency that resembles Rose and Miller’s (Rose and Miller 2008) description of the neoliberal rationalities of government. Paradoxically, sustainability as an ideal is transformed into an established system that tends to be mechanical. For this to occur, experts shape the meaning of sustainability and determine the parameters that must be met, creating metrics and certification processes that define a set of procedures that track and evaluate sustainability performance, hence defining what practices are selected by cement companies to demonstrate their sustainability credentials, and how these are implemented. Furthermore, both sustainability and cement are vibrant matters (Bennett 2010) with an agency of their own which introduces further constraints into the construction of sustainability process and influences the pace of change. However, the process of becoming sustainable is far from homogenous since each individual relates to sustainability according to the gamut of personal ethical convictions, affective needs, aesthetic preferences and gender perceptions which vary among many factors, including social class, geographic region, educational level and gender. Hence, it is not suitable for a single definition even when subjected to seemingly objective standards. In addition, in the case of employees, the interaction with different groups of stakeholders raises awareness about particular interests also influencing the meaning making process for each of them. Hence, the making of sustainable subjects not only involves the creation of specific regulatory practices tied to the emergence of a greater concern for social and environmental challenges but also the particular context of the individual. Even in this highly structured environment, the affect/emotion dynamic strongly shapes the interpretation and the weight that sustainability eventually gains. The material expressions of sustainability mediate the process and materialize morality at the same time (Verbeek 2006) given the underlying ethical position that sustainability as an idea conveys. As sustainability is becoming widely adopted and introduced into the conscience of more people, it is also being transformed into a numerical parameter that makes possible the perpetuation of market efficiency parameters. Capitalism is thus legitimated through the meta-narrative of sustainability as the triple bottom line that promises to fulfill the desire of progress for all while not really transforming the life-style and consumption patterns of today. As the concept of the triple bottom line enables sustainability to be adopted by key economic, governmental and NGO actors, it also contributes to the naturalization of market forces and profit oriented priorities making it difficult to re-orient human activities towards more environmentally friendly and socially inclusive models of community organization.