Routine Aspects Research Articles

Routine microprocesses and capability learning in international new ventures

Drawing on the distinction between the ostensive aspects (abstract patterns) and performative aspects (specific actions) of organizational routines, the paper offers a micro-level explanation of capability learning in international new ventures (INVs), that is, firms that internationalize actively from inception. The paper argues that variability in the performative aspects of internationalization routines is associated with improvisational learning and new capability development, whereas variability in the ostensive aspects is associated with trial-and-error learning and existing capability improvement. Furthermore, psychic distance moderates these relationships. Low psychic distance facilitates both improvisation and trial-and-error learning; high psychic distance frustrates learning of both types. Moderate psychic distance makes the success of both learning forms more likely – but only for more experienced INVs. The paper also argues that social capital may mitigate the negative effects of high psychic distance. It contributes to the extant literature by providing a micro-level explanation of how INVs accomplish capability learning and avoid wasteful learning efforts, and by theorizing the moderating effects of psychic distance on the relationships between routine microprocesses and capability learning.

Oncofertility and the Male Cancer Patient

Oncofertility as a discipline plays an important, adjunctive role in the treatment of male patients with cancer. Despite recommendations by the American Society of Clinical Oncology, many clinicians managing malignancies in males fail to consistently incorporate fertility preservation as a routine aspect of health care. Providers involved in the treatment of oncologic patients should have an awareness of the impact of their prescribed treatments on reproductive potential, just as they would be knowledgeable of the potential deleterious effects of cancer therapies on vital organs such as the kidneys, lungs, and liver. Providers should then have a discussion with their patients regarding these potential adverse therapeutic effects or consult a fertility preservation specialist to discuss these matters and fertility preservation options with the patient. Cryopreservation of sperm remains an excellent option for male fertility preservation as it is readily available and results in storage of viable gametes for future use in the event of post treatment infertility. With the use of assisted reproductive techniques (ART), cryopreserved sperm may ultimately result in successful paternity, even in the setting of very low numbers of stored sperm. While sperm cryopreservation is usually an option for adolescent and adult males, fertility preservation in pre-pubertal males presents a more challenging problem. To date, no clinically proven methods are available to preserve fertility in these males. However, some centers do offer experimental protocols under the oversight of an IRB, such as testicular tissue cryopreservation in these males. The hope is that one day science will provide a mechanism for immature germ cells from the testicular tissue of these patients to be used in vivo or in vitro to facilitate reproduction. In closing, studies have shown that the patient's regard for his provider is enhanced when the issue fertility preservation is raised. While oncologic care is often fraught with time constraints and acute medical concerns, fertility preservation care in the male can typically be administered quickly and without disruption of the overall plan of care.

An Innovative Use of Instant Messaging Technology to Support a Library's Single-Service Point

A library service model that provides reference and instructional services by summoning reference librarians from a single service point is described. The system utilizes Libraryh3lp, an open-source, multioperator instant messaging system. The selection and refinement of this solution and technical challenges encountered are explored, as is the design of public services around this technology, usage of the system, and best practices. This service model, while a major cultural and procedural change at first, is now a routine aspect of customer service for this library.

Shift Recording in Residential Child Care

Recording is a task often perceived by residential child care workers as boring or taking time away from the ‘real work’, direct engagement with young people. It is required by legislation and policy but has been undertheorized and treated as a technical/rational task. In this essay, Foucauldian and feminist perspectives are applied to shift recording, a routine aspect of residential practice, in order to problematize the positivist approach assumed in legislation and policy. The analysis suggests that this approach represses emotional aspects of care and subjugates particular forms of knowledge, such as young people’s experiences. Recording inevitably involves ethical choices and treating it as technical/rational task obscures its ethical implications. This essay concludes that greater attention needs to be given to the ethical aspects of shift recording in order to challenge practice that oppresses young people by failing to recognize their individuality and silencing their voices.

Organizational structure and processes in pediatric heart transplantation: A survey of practices

Despite emerging literature on pediatric heart transplantation, there continues to be variation in current practices. The degree of variability among heart transplant programs has not been previously characterized. The purpose of this study was to evaluate organizational structure and practices of pediatric heart transplant programs. The UNOS database was queried to identify institutions according to volume. Coordinators from 50 institutions were invited to participate with a 70% response rate. Centers were grouped by volume into four categories. Some institutional practices were dominated by clear volume trends. Ninety-five percent of larger centers routinely transplant patients with known antibody sensitization and report a broader range and acuity of recipients. Ninety-four percent report problems with non-adherence. Sixty-nine percent of centers routinely require prospective crossmatches. There was dramatic variation in the use of steroids across all centers. Sixty-five percent of centers transition adolescents to an adult program. Prophylaxis protocols were also highly inconsistent. This survey provided a comprehensive insight into current practices at pediatric heart transplant programs. The results delineated remarkably variable strategies for routine aspects of care. Analysis of divergence along with uniformity across protocols is a valuable exercise and may serve as a stepping-stone toward ongoing cooperation and clarity for evidence-based practice protocols.

Unpacking ostensive and performative aspects of organisational routines in the context of monitoring systems: A critical realist approach

Drawing on the theory of organisational routines as generative systems, we deploy a critical realist approach based on Searle's philosophy of language to analyse the generative mechanisms that specify the pre-conditions for recognisable, repetitive patterns of interdependent activities. Using the example of the organisational routines implemented in Germany to monitor the allocation and disbursement of the European Social Fund, we contend that constitutive rules of the type “X counts as Y in context C” are at the very centre of organisational routines. Such rules consist of generative mechanisms that account for the emergence of the ostensive aspects of organisational routines out of artefacts and/or procedures in a social structure of power relations. We further claim that, far from being proxies for the ostensive aspects of routines, artefacts whether tangible or intangible are instantiations of such ostensive aspects on a par with any other performative aspects of routines. On this basis, a re-conceptualisation and a re-labelling of the ostensive and performative aspects of routines are proposed. The former are the result of the activation of systems of constitutive rules, i.e. actual routines in critical realist terminology, the latter are patterns of interdependent activities instantiating the ostensive aspects of routines, i.e. empirical routines in critical realist terminology. Implications for theory and practice are discussed by developing a model of organisational routines that interweaves extant research streams.

A symptom-based approach to palliative care in cystic fibrosis

Cystic fibrosis (CF) has been transformed in the twentieth century from a fatal disease of infants to a chronic, life-limiting illness of children, adolescents, and adults. The increase in life expectancy has been accompanied by an increase in both chronic and acute physical and psychological symptoms. Careful attention to symptom assessment and treatment should now be a routine aspect of care for children and adults with CF. Although life expectancy has increased dramatically, children and adults with CF will still die before their unaffected peers, and careful attention to issues in end-of-life care is still a part of CF care, with the often complicating factor of lung transplantation as a relatively recent arrival. This review will focus on a symptom-based approach to CF care for children and adults throughout the lifespan.

Telling the CAQDAS code: Membership categorization and the accomplishment of ‘coding rules’ in research team talk

During the course of this article we examine data gathered from two research meetings in which coding issues and data organization are being discussed in relation to the use of the software package Atlas.ti. The meetings were concerned with the organization and coding of semi-structured interviews carried out by three different groups as part of a wider collaborative research project. A number of papers have considered aspects of coding practice in teams or small groups; however, little work exists on the analysis of first order collaborative CAQDAS coding interaction. In doing so, this article re-specifies formal coding and collaboration models through the examination of practical methods of situated interaction and data sense-making in the course of producing social scientific facts and explanation. In this sense, the analysis reveals the way in which the professional argot of social science codes can be understood to rely on everyday methods of sense-making within team based contexts. These methods can be understood to be realized through the fine-detailed ‘granular’ categorical and sequential specifics of talk-in-meetings where matters relating to social scientific reasoning, accountability, stakeholders’ interests, defeasible and defensible reasoning protocols, disciplinary rights and the ‘search for underlying patterns’ are salient features and recognizable and accountable concerns for team members as a routine aspect of doing qualitative social science.

Integrating intensified case finding of tuberculosis into HIV care: an evaluation from rural Swaziland

BackgroundSwaziland has the highest HIV prevalence in the world and the highest estimated tuberculosis incidence rate in the world. An estimated 80% of TB patients are also infected with HIV. TB detection through intensified case finding (ICF) has yet to become a routine aspect of integrated tuberculosis and HIV care. The purpose of this study was to evaluate implementation of ICF for TB into routine integrated tuberculosis and HIV care at 16 community clinics and one district hospital in Swaziland.MethodsNurses and lay counsellors conducted ICF using a TB screening tool and patient pathway at all HIV service entry points in clinics and the hospital. The patient pathway had three-stages; screening, sputum smear diagnosis and TB treatment initiation. Outcomes and losses to follow up were monitored at each stage. Patient demographics, access, and service feasibility and effectiveness were compared at hospital and clinic sites.Results1467 HIV patients at clinics and the hospital were screened over a 3 month period. Large losses to follow up occurred prior to the sputum diagnosis stage; only 47% (n = 172) of TB suspects provided a specimen. 28 cases of smear positive TB were diagnosed and 24 commenced treatment. People screened at clinics were significantly more likely to be female, older, and from rural or geographically remote areas (p < 0.001). There was no significant difference between the hospital and clinics sites in the proportion of all participants screened who were smear positive (x2 = 1.909; p = 0.16). The number needed to screen to detect one sputum positive TB case was 34 at clinics and 63 at the district hospital.ConclusionsICF was operationally feasible and became established as a routine aspect of tuberculosis and HIV integrated care. ICF in community clinics was potentially more accessible to an underserved, rural population and was as effective as the hospital service in detecting smear positive TB.

Ecotourism, social and human capitals, and identity valorization: the communities of Tapajós (PA), Brazil

This article deals with the role of community-based ecotourism for strengthening human and social capitals as well as for enhancing culture and forest livelihood of riverbank dwellers in the Tapajós region, in central Amazonia. The research was done based on the premise that ecotourism can be a potential avenue for putting in evidence local culture, identity and singular lifestyles as while it can contribute to strengthen the local networks which can result in collective material and immaterial advantages. The analysis examines the hypothesis that outsiders (the tourists) once they travel to and stay with local communities, they become the primary agents who are in a position to perceive the main aspects of values, beliefs and routines as particularities of an Amazonian livelihood. Even though the visitors usually stay a few days in a certain community, they end up paying enough attention to what the locals tell and do. This way, the tourists involuntarily put the locals at the centre of their visit, to the extent the locals start realizing how important their forest lifestyle is. This argument certainly does not aim at validating the “spetacularisation” of forest people, of their environment and of their culture. Instead, the authors are rather interested in the processes through which outsiders can direct or indirectly – as ecotourism participants - contribute to improve the quality of life and to raise self-esteem of riverbank dwellers. Some Amazonian peoples (of remote areas) usually have a feeling of periphery and of marginalization, because they do not take part in the ‘developed metropolitan world’. The self-esteem factor gets relevance in an academic debate, because the Amazonian peoples hold a feeling of being periphery and marginal in reason of not being part of a ‘developed metropolitan world’; and this may cause adverse effects on their attitude and expectations. The investigation has a qualitative approach in order to produce descriptive data. Open and semi-structured interviews and participant observation were the main methods used for getting information from the riverbank dwellers.

Understanding change and continuity in residential energy consumption

Practice theory has recently emerged within consumer studies as a promising approach that shifts focus from the individual consumer towards the collective aspects of consumption, and from spectacular and conspicuous dimensions of consumption towards routine and mundane aspects of consumption. Practice theory is, however, not a commonly agreed upon theory, but more like an approach, or a turn within contemporary social theory. When using practice theory in consumer studies, there are thus several conditions that need further clarification. The focus in this article is on how change and continuity in practices can be understood in practice theory. Discussions will include the balance between routinization and reflectivity as well as ways to understand the role of new technology in introducing change in consumer practices. One aspect of this is a discussion on how to include technologies and other types of material consumer goods in practice theory. Case studies on household energy consumption are used as an empirical basis for these discussions. Looking at household energy consumption through the theoretical lens of practice theory necessitates discussion on whether energy consumption should be viewed as one single practice or part of several different practices. The latter stimulates questioning on how these different consumer practices are related to each other horizontally and vertically, as parallel practices or as different levels of practices, and whether changes in one practice affect (or refrain from affecting) other related consumer practices, whether through reflexivity, routines or the materiality of consumer goods.

The association of psychosocial and diabetes factors to diabetes knowledge

Abstract Focal points

Capturing their dream: Video diaries and minority consumers

This paper describes the characteristics and benefits of a visual ethnography method called “video diary.” The authors illustrate the special features of the method based on their experiences in using it to understand consumer acculturation of Pacific Islanders in New Zealand. In brief, research participants benefit from the control and voice that video diaries give them. Researchers benefit from “saturated description” and collaborative analysis. The benefits of video diaries are particularly suited to ethnographic research with people from collectivist or vulnerable groups. Video diaries can be used alone or along with other ethnographic methods and the authors recommend them to consumer researchers, who want to understand routine and private aspects of consumers’ lives or any aspect of culture. Their range of use is limited only by one’s imagination.

Slowing Down to Stay Out of Trouble in the Operating Room: Remaining Attentive in Automaticity

Automaticity is integral to expert performance, but experts must be able to transition from an automatic mode into a more effortful state when required. In this study, the authors identified and characterized the manifestations of the phenomenon of "slowing down when you should" to stay out of trouble in operative practice. The authors interviewed 28 surgeons (60-minute, semistructured format) from various specialties at four academic medical centers and observed 5 hepatopancreatobiliary surgeons in the operating room (29 cases, 147 hours) during 2007-2009. Using a grounded theory qualitative methodology, they conducted a thematic analysis of transcripts and field notes in an iterative manner. Data collection continued until saturation. They adopted a reflexive approach throughout. Surgeons described and the authors observed four phenomenological manifestations of the transition to a more effortful state. In the most extreme manifestation, "stopping," surgeons actually stopped the procedure, whereas in the most subtle manifestation, "fine-tuning," surgeons were able to continue the procedure and focus on minor events simultaneously. A separate phenomenon of "drifting" represented surgeons' failure to transition out of the automatic mode when appropriate, resulting in surgical errors or near misses. The manifestations of the slowing down phenomenon represent acts of cognitive refocusing during the potentially more-critical moments of operative practice. Further, the authors challenge the conception of automaticity as effortless, arguing that automatic behavior can be attentive (fine-tuning) as well as inattentive (drifting).

Research News: Parental Understanding of Informed Consent

PARTICIPATION IN THE INFORMED CONSENT process for anesthetic and surgical procedures is one of the most routine aspects of perianesthesia nursing care. After preoperative visits and instructions, on-site teaching, and review of instructions, the perception is that ample education has occurred to establish informed consent. Of course, patients or their representatives must confirm that assumption and provide sufficient documentation toward that end. All else halts until this key piece of the patient’s medical record is on file.

Rubber Dam Use During Routine Operative Dentistry Procedures: Findings FromThe Dental PBRN

Rubber dam use during operative dentistry procedures has been quantified based on questionnaires completed by dentists. However, based on the knowledge of the authors of the current study, there are no reports based on use during actual clinical procedures other than in dental materials studies and none based on routine care. The objectives of the current study were to: 1) quantify how commonly the rubber dam is used during operative dentistry procedures; 2) test the hypothesis that certain dentist, restoration and patient-level factors are associated with its use. A total of 229 dentist practitioner-investigators in The Dental Practice-Based Research Network (DPBRN) participated. DPBRN comprises five regions of the USA: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates and Scandinavia. Practitioner-investigators collected data on 9,890 consecutive restorations done in previously unrestored tooth surfaces from 5,810 patients. Most dentists (63%) did not use a rubber dam for any restoration in this study. A rubber dam was used for only 12% of restorations, 83% of which were used in one DPBRN region. With regions accounted for, no other dentist characteristics were significant. A multi-level multiple logistic regression of rubber dam use was done with restoration and patient-level variables modeled simultaneously. In this multi-variable context, these restoration-level characteristics were statistically significant: tooth-arch type, restoration classification and reason for placing the restoration. These patient-level characteristics were statistically significant: ethnicity, dental insurance and age. These results, obtained from actual clinical procedures rather than questionnaires, document a low prevalence of usage of the rubber dam during operative dentistry procedures. Usage varied with certain dentist, restoration and patient-level characteristics.

THE MUSEUM AS METHOD

This speculative comment considers the potential worth of raising questions that appear simple but may be rewardingly complex. It asks whether routine aspects of curatorial work, such as captioning objects and juxtaposing them in displays, may not have more suggestive dimensions than has been recognized previously. It asks what the implications of a conception of “the museum as method” might have for current approaches to public exhibition.

Some remarks on determining short-period changes in glacier surface velocity using GPS technique - case study of Hans Glacier example

Movement is one of the most spectacular phenomena involving glaciers. Determining glacier surface velocity is now a routine aspect of glaciological studies. These are geodetic methods, especially satellite positioning, that most frequently is applied in such work. Using the Hans Glacier (SW Spitsbergen) as an example, the presented paper is an attempt at defining the time resolution limit of changes in the velocity determined using GPS positioning technology. A test network was established in the area of the examined glacier in order to define the size and variability of the main satellite positioning biases as well as to define their impact on determining position and the calculated velocity. A discussion relating to achieved accuracy (differentiated from measurement precision) for baselines of a length of several kilometres in the high latitudes has also been presented.

Of Arbitral Institutions and Provisional Determinations on Jurisdiction: The Global Gold Case

Among the administrative functions performed by an arbitral institution in the life of an arbitration – one of its earliest, and arguably most crucial, tasks – involves a preliminary determination by the institution in question on whether to accept or decline to administer an arbitration, either in whole or in part, after it has received and reviewed the request for arbitration. Such administrative determinations are an aspect of institutional work that until recently have received little attention. This case note examines the Global Gold decision rendered by the Southern District of New York federal court in 2008, in which a party sought to compel an arbitral institution, namely the ICC Court, to reverse its preliminary determination on jurisdiction with respect to a party named to the arbitration. Such an examination will hopefully provide some insight into the legal and practical ramifications of this routine aspect of institutional administration of international arbitrations on parties, arbitrators, institutions and national courts.

Inertia and management accounting change

PurposeThis paper aims to investigate ways in which inertia obstructs the adoption of new management accounting rules. Drawing on the view of management accounting as organisational rules and routines, it aims to suggest various ways in which inertia can become more pronounced when new accounting rules challenge existing routines.Design/methodology/approachA longitudinal case study was conducted at one of the largest banks in The Netherlands. This bank introduced a program called “Results Oriented Management”, which produced various new management accounting rules.FindingsThe paper identifies various ways in which inertia manifested itself when new management accounting rules were introduced. Moreover, the paper shows that ambiguity and contradictions play an important role in the presence of inertia.Research limitations/implicationsThe identification of individual‐level habits and scripts is a difficult undertaking. Through a focus on the performative and ostensive aspects of routines, some of the processes of inertia and change on an individual level are identified. This is a relevant method for students of management accounting change.Originality/valueAlthough it is well known that routines can produce inertia, the process by which this inertia is manifested and how this affects the adoption of new management accounting rules is still unclear. The paper aims to contribute to this understanding.