Routine Aspects Research Articles

Implementation of a case formulation to reduce restrictive interventions on a psychiatric intensive care unit: quasi-experimental single case evaluation.

Despite the use of case formulation being encouraged for in-patient psychiatric care, there have been no previous examples and evaluations of this type of work on a psychiatric intensive care unit (PICU). To evaluate whether a schema-informed formulation with a patient diagnosed with emotionally unstable personality disorder (EUPD), autism spectrum disorder (ASD) and mild learning difficulties was effective in reducing the use of restrictive interventions. A biphasic n = 1 quasi-experimental design with an 8-week baseline versus an 8-week intervention phase. The restrictive outcomes measured were use of physical restraint, seclusion, and intramuscular rapid tranquilisation. The formulation was developed through eight one-to-one sessions during the baseline period, and was implemented via six one-to-one sessions during the intervention phase and discussion at the ward reflective practice group. The intervention encouraged better communication of schema modes from the patient and for staff to then respond with bespoke mode support. Incidents involving need for seclusion, restraint and rapid tranquilisation extinguished. The need for making access to psychological input a routine aspect of the care in PICUs and the necessity for developing a methodologically more robust evidence base for psychological interventions on these wards.

KONSEP SYUKUR DALAM AL-QUR’AN DAN IMPLIKASINYA TERHADAP PENDIDIKAN ISLAM

Knowing the concept of gratitude for Islamic education is very important, that building the concept of gratitude for Islamic education is an effort to foster a mentality that excels in both the knowledge and routine aspects of Islamic Education and also gives a positive response to Islamic education, about how the concept of gratitude is needed to build and improve Islamic education that is noble, disciplined and has achievement motivation. This research focuses on the concept of gratitude in Surat al-Baqarah verse 172 and its implications for Islamic education. This research includeslibrary research by collecting data from literature. In analyzing the data using the methoddescriptive analysis. By using an interpretative and normative approach. The results of the study state that the implications of the concept of gratitude for Islamic education in the study of Surat al-Baqarah verse 172 include: 1. Humans are obliged to always be grateful at all times, especially when they get pleasure. 2. Gratitude in Islamic education is the most important thing that will create a sense of qana'ah, patience, and sincerity. So that it can build Islamic education to be more disciplined, achievement and noble. The research results stated; 1). In essence, a person always gets favors, so because of that someone must be grateful at all times. 2). The implications of gratitude for Islamic education include: implications for educators, implications for students, implications for institutions. The author hopes that this research will continue to be developed so that lessons can be learned in everyday life.

Emerging Role of Artificial Intelligence and Big Data in Spine Care.

The pace of US Food and Drug Administration-approved medical devices that incorporate artificial intelligence (AI) or machine learning as part of the device is accelerating. As of September 2021, 350 such devices have been approved for commercial sale in the United States. As much as AI has become ubiquitous in our lives-keeping our cars between the lines on the highway, converting speech to text on the fly, recommending movies, books, or restaurants, and so much more, AI also appears destined to become a routine aspect in daily spine surgery. Neural network types of AI programs have achieved extraordinary pattern recognition and predictive abilities-far surpassing human capabilities-and thus appears well suited to back pain and spine surgery diagnostic and treatment pattern recognition and prediction tasks. These AI programs are also data hungry. As luck would have it, surgery generates an estimated 80 MB per patient per day collected in a variety of datasets. When aggregated, this represents a 200+ billion patient record data ocean of diagnostic and treatment patterns. Such Big Data, when combined with a new generation of convolutional neural network (CNN) AI, set the stage for a cognitive revolution in spine surgery. However, there are important issues and concerns. Spine surgery is a mission-critical task. Because AI programs lack explainability and are absolutely reliant on correlative, not causative, data relationships, the emerging role of AI and Big Data in spine surgery will likely come first in productivity tools and later in narrowly defined spine surgery tasks. The purpose of this article is to review the emergence of AI in spine surgery applications and examine spine surgery heuristics and "expert" decision models within the context of AI and Big Data.

Distinguishing Household Groupings within a Precinct Based on Energy Usage Patterns Using Machine Learning Analysis

The home can be a complex environment to understand, as well as to model and predict, due to inherent variability between people’s routines and practices. A one-size-fits-all approach does not consider people’s contextual and institutional influences that contribute to their daily routines. These contextual and institutional factors relate to the household structure and relationship between occupants, as well as the working lifestyle of the occupants. One household can consume resources and live quite differently compared to a similar size household with the same number of occupants due to these factors. Predictive analysis of consumption data can identify this difference to create household-specific modelling to predict occupant routines and practices. Using post-occupancy data from the Fairwater Living Laboratory in Sydney that monitored 39 homes built in a green-star community, this research has utilised machine learning approaches and a K-Means clustering method complemented by t-distributed Stochastic Neighbour Embedding (t-SNE) to show how households follow different daily routines and activities resulting in resource consumption. This analysis has identified energy usage patterns and household groupings with each group following similar daily routines and consumption. The comparison between modelling the precinct as a whole and modelling households individually shows how detail can be lost when aggregating household data at a precinct/community level. This detail can explain why policies or technologies are not as effective as their design due to ignoring the delicate aspects of household routines and practices. These household groupings can provide insight for policymakers to help them understand the different profiles that may be present in the community. These findings are useful for net-zero developments and decarbonization of the built environment through modelling occupant behaviour accurately and developing policies and technologies to suit.

Supporting early childhood routines to promote cardiovascular health across the life course

Optimal cardiovascular health is an essential component of human health and well-being across the life course. Heart healthy practices around diet, physical activity, and sleep early in childhood have the potential to greatly improve lifespan and quality (Mehta et al., 2020). Early childhood routines, defined as functional practices that are predictable and repeatable, predict positive growth and development across the lifecourse (Fiese et al., 2002; Ferretti and Bub, 2017; Spagnola and Fiese, 2007). The American Heart Association has identified key heart healthy routines, such as daily regular activities including diet, physical activity, and sleep that promote cardiovascular health (Lloyd-Jones et al., 2022). Integrating the strength-based relational aspects of routines with the acquisition of cardiovascular health development capabilities allows children to establish their own optimal cardiovascular health trajectory early on. A systematic life course approach to supporting heart healthy routines in early childhood would inform clinical, research, and policy strategies to promote long-term cardiovascular health, and contribute to reducing inequalities in cardiovascular outcomes.

Risk assessment, surveillance, and nonpharmaceutical prevention of acute radiation dermatitis: results of amulticentric survey among the German-speaking radiation oncology community.

Radiation dermatitis (RD) represents one of the most frequent side effects in radiotherapy (RT). Despite technical progress, mild and moderate RD still affects major subsets of patients and identification and management of patients with ahigh risk of severe RD is essential. We sought to characterize surveillance and nonpharmaceutical preventive management of RD in German-speaking hospitals and private centers. We conducted asurvey on RD among German-speaking radiation oncologists inquiring for their evaluation of risk factors, assessment methods, and nonpharmaceutical preventive management of RD. Atotal of 244health professionals from public and private institutions in Germany, Austria, and Switzerland participated in the survey. RT-dependent factors were deemed most relevant for RD onset followed by lifestyle factors, emphasizing the impact of treatment conceptualization and patient education. While abroad majority of 92.8% assess RD at least once during RT, 59.0% of participants report RD at least partially arbitrarily and 17.4% stated to classify RD severity solely arbitrarily. 83.7% of all participants were unaware of patient-reported outcomes (PROs). Consensus exists on some lifestyle recommendations like avoidance of sun exposure (98.7%), hot baths (95.1%), and mechanical irritation (91.8%) under RT, while deodorant use (63.4% not at all, 22.1% with restrictions) or application of skin lotion (15.1% disapproval) remain controversial and are not recommended by guidelines or evidence-based practices. Identification of patients at an increased risk of RD and subsequent implementation of adequate preventive measures remain relevant and challenging aspects of clinical routines. Consensus exists on several risk factors and nonpharmaceutical prevention recommendations, while RT-dependent risk factors, e.g., the fractionation scheme, or hygienic measures like deodorant use remain controversial. Surveillance is widely lacking methodology and objectivity. Intensifying outreach in the radiation oncology community is needed to improve practice patterns.

The Role of Unpredictability in Maintaining Control of the Security Forces in the Gambia

ABSTRACT This research explores a classic predicament of authoritarian leaders—the need for a strong security force to deter opposition alongside a fear of the threats that a strong force could pose. By providing a unique view into the security services in The Gambia under President Jammeh (1994–2017), it argues that fostering uncertainty was the key tool in maintaining control of the armed forces. It situates this approach in the context of wider theories of institutional arbitrariness. The research demonstrates how unpredictability was operationalized through multiple, overlapping practices targeting both the structural level and routine aspects of military life. It also looks at international opportunities as an avenue to mitigate some of the negative effects of pervasive uncertainty in the forces. The research provides new insights into the internal dynamics of state security forces by drawing on data newly available after The Gambia’s democratic political transition of 2017. This includes interviews with members of the forces, testimonies from the Truth, Reconciliation, and Reparation Commission (TRRC), court martial transcripts, and other government reports.

CircRNA-sponging: a pipeline for extensive analysis of circRNA expression and their role in miRNA sponging.

Circular RNAs (circRNAs) are long noncoding RNAs (lncRNAs) often associated with diseases and considered potential biomarkers for diagnosis and treatment. Among other functions, circRNAs have been shown to act as microRNA (miRNA) sponges, preventing the role of miRNAs that repress their targets. However, there is no pipeline to systematically assess the sponging potential of circRNAs. We developed circRNA-sponging, a nextflow pipeline that (i) identifies circRNAs via backsplicing junctions detected in RNA-seq data, (ii) quantifies their expression values in relation to their linear counterparts spliced from the same gene, (iii) performs differential expression analysis, (iv) identifies and quantifies miRNA expression from miRNA-sequencing (miRNA-seq) data, (v) predicts miRNA binding sites on circRNAs, (vi) systematically investigates potential circRNA-miRNA sponging events, (vii) creates a network of competing endogenous RNAs and (viii) identifies potential circRNA biomarkers. We showed the functionality of the circRNA-sponging pipeline using RNA sequencing data from brain tissues, where we identified two distinct types of circRNAs characterized by a specific ratio of the number of the binding site to the length of the transcript. The circRNA-sponging pipeline is the first end-to-end pipeline to identify circRNAs and their sponging systematically with raw total RNA-seq and miRNA-seq files, allowing us to better indicate the functional impact of circRNAs as a routine aspect in transcriptomic research. https://github.com/biomedbigdata/circRNA-sponging. Supplementary data are available at Bioinformatics Advances online.

Bankers' job stress, job performance, and job commitment trajectories during the COVID-19 pandemic

PURPOSE: The global COVID-19 pandemic has profoundly impacted multiple sectors across industries and regions, including medical services, financial institutions, and others. The escalating global pandemic in both emerging and developed nations has resulted in the implementation of stringent lockdown measures and unparalleled disruptions to economic activities. Consequently, individuals have become accustomed to relying on banking operations as a routine aspect of their lives, regardless of the circumstances. Learning how bankers engage with customers in response to the given circumstances would be intriguing. Hence, the study aimed to unearth the relationship between bankers’ job stress, job performance, and job commitment, as well as the stress-based job performance and its impact on job commitment during the second to third wave of the COVID-19 pandemic in an emerging market. METHODOLOGY: A number of 287 data (response rate 71.75 percent) were collected by online platforms due to the COVID-19 pandemic through the simple random sampling technique. The exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were run to test the proposed research framework with the help of MS Excel 2007, SPSS 22.0, and AMOS 23.0. FINDINGS: The findings showed that bankers’ work-related stress has a positive impact on job performance but no relationship with job commitment; acute stress has a negative impact on job commitment but no significant relationship with job performance; and stress-based job performance has a significant positive impact on job commitment during the COVID-19 pandemic. IMPLICATIONS: The outcomes of this study provide value to the field of behavioral science by introducing the phenomena of COVID-19 in the context of bankers and emerging economies. The demographic variables and the revealed relationships of bankers’ job stress, job performance, and job commitment trajectories would help policymakers rethink stress management practices and policy building in the bank job and the long-term relationship building with their existing employees. ORIGINALITY AND VALUE: The novelty of the research is the COVID-19 phenomenon and an emerging economy’s bankers’ context.

Educator perceptions of free-flowing routines in early childhood education and care

There is ongoing interest in free-flowing routines in early childhood education and care settings (ECEC), however little is known about educators’ perceptions of free-flowing routines. Therefore, the aim of this study was to explore the perceptions of educators regarding free-flowing routines. A focus group and five semi-structured interviews were conducted. Four main themes were identified: learning outcomes, learning opportunities, team characteristics, and pedagogy and practice. Free-flowing routines may offer additional affordances for children’s learning compared to structured routines, such as greater independence and agency for children, sustained time to engage in child-led learning, and deeper engagement in learning. Quality pedagogical practice was perceived as being highly important in free-flowing routines. It is recommended that ECEC settings implement an aspect of free-flowing routines for part, or all of the day, and be open to the learning opportunities that this may present for children. With further research, there is potential to better understand routines that best support children’s learning and development in ECEC, as well as opportunities to influence national and international policy and curricula.

New prospects for harm reduction in the UK? A commentary on the new UK drug strategy.

The special section Practising recovery: New approaches and directions aims to shed light on the variety of epistemological, methodological and policy-making practices that emerge in empirical studies of recovery from the use of alcohol and other drugs (AOD). ‘Recovery’, as a concept and policy orientation, has received significant attention in sociological research and other disciplines. However, recovery understood as a practice that is crafted daily by service-users and workers reveals infinite manifestations that sociological research has yet to explore. Shifting from the study of recovery from AOD as a specific drug policy, to a practice-oriented study of recovery as a complex process of healing that unfolds in diverse social contexts, has the potential to advance the contribution of sociology to matters of illness and wellbeing. The articles collected for this special section begin to examine the complexity of recovery with a focus on the framing of recovery as a social, temporal, spatial and affective practice . In Practising Recovery, our aim is to focus on the routine aspects that accompany recovery as both a practice and policy object, emphasising the ambivalences, rather than the polemics of empirical engagements with recovery. In what follows, we describe our thinking about, in, and with the notion of ambivalence as an attempt to expand the meanings of recovery into unchartered terrain, before exploring some of the ways the articles in this special section serve to render visible the ambivalences that accompany the practice, as well as the methods, of researching recovery.

The perception of parents with a child with sickle cell disease in Ghana towards prenatal diagnosis.

Sickle cell disease is a global health concern. In the UK and USA, where the condition is common, prenatal testing is a routine aspect of antenatal care and offered on the basis of informed reproductive choice. Notwithstanding considerable advances in testing technologies, prenatal diagnosis for sickle cell disease is not common in Africa. There is a particular lack of research examining parental perceptions about the acceptability of antenatal screening. This qualitative paper explores the perceptions of parents, who had lived experiences of caring for a child with SCD, towards prenatal testing for sickle cell in Ghana. A purposive sample of 27 parents (four fathers and 23 mothers) was recruited via a sickle cell clinic in Accra, Ghana. Material was collected using semi-structured interview, using a topic guide that explored parental views on prenatal testing, along with factors influencing decision making about antenatal care. The findings shown that parents believed the decision to accept testing should be negotiated between both parents rather than the extended family. The decision to accept testing did not mean that parents would use the information to terminate the pregnancy of a child with SCD. They mentioned that they were more likely to use the test result to prepare themselves for the birth of their child. Parents accepted, however, that choice was important and that some parents may wish to terminate the pregnancy, given the impact of SCD on a person's quality of life. Parents lack awareness about prenatal testing because the procedure was not part of antenatal services in Ghana. However, the majority would accept testing should the process be available and affordable. The paper suggests that policy needs to establish and promote sickle cell prenatal testing/prenatal diagnosis and awareness among at-risk populations, bearing in mind the cost implication of the technology, equal access to healthcare, and the importance of informed reproductive decision making, which connects to the parents' experience of testing/screening.

Practising recovery: New approaches and directions.

The special section Practising recovery: New approaches and directions aims to shed light on the variety of epistemological, methodological and policy-making practices that emerge in empirical studies of recovery from the use of alcohol and other drugs (AOD). 'Recovery', as a concept and policy orientation, has received significant attention in sociological research and other disciplines. However, recovery understood as a practice that is crafted daily by service-users and workers reveals infinite manifestations that sociological research has yet to explore. Shifting from the study of recovery from AOD as a specific drug policy, to a practice-oriented study of recovery as a complex process of healing that unfolds in diverse social contexts, has the potential to advance the contribution of sociology to matters of illness and wellbeing. The articles collected for this special section begin to examine the complexity of recovery with a focus on the framing of recovery as a social, temporal, spatial and affective practice . In Practising Recovery, our aim is to focus on the routine aspects that accompany recovery as both a practice and policy object, emphasising the ambivalences, rather than the polemics of empirical engagements with recovery. In what follows, we describe our thinking about, in, and with the notion of ambivalence as an attempt to expand the meanings of recovery into unchartered terrain, before exploring some of the ways the articles in this special section serve to render visible the ambivalences that accompany the practice, as well as the methods, of researching recovery.

A review of EN 16907 on earthworks (extractive waste) in the context of South African mine residues

Rather quietly, a new generation of European norms dealing with earthworks has been developed over the past few years, in particular a part of EN 16907 pertaining to extractive waste. Whereas the majority of the parts deal with routine geotechnical aspects, one part deals specifically with tailings dams. The standard is currently in draft form but if this becomes a European Standard, members of the European Union are bound to comply with the regulations. As such, the standard has the capacity to influence mining in Europe and potentially in South Africa. In this paper we review the standard and compare it to the South African standard on mine residues and the recently published Global Industry Standard on Tailings Management (GISTM). We conclude found that although the European norm makes great strides towards increasing tailings dam safety, there is room for improvement. The current South African standard has served well since its inception, but can be improved by using concepts from the European and global tailings standards.

Conceptualizing Information Systems Development as an Organizational Routine

Research acknowledges that information systems development (ISD) teams experiment with, overlook, or adapt the methods that they purportedly use. Given this, one stream of research adopts a perspective focused on prescriptions based on the idea of a method. Another stream of research adopts a perspective anchored in the view that human agency plays a critical role in the unfolding of ISD projects. We suggest that our understanding of ISD can be enriched by mobilizing both perspectives. Specifically, we propose a conceptualization of ISD as an organizational routine based on the ontology developed by Feldman and Pentland. We build on the elements of this ontology- (1) the idea of a routine (the ostensive aspect) and (2) its enactment (the performative aspect) as the two mutually constitutive aspects of organizational routines; and (3) the role of artifacts as mediators of the relationship between actors and the ostensive and performative aspects of organizational routines - to develop theoretical arguments explaining the benefits of applying this ontology to the ISD phenomenon. Extending the contextual boundaries of Feldman and Pentland's ontology, we propose research avenues that have the potential to contribute to our understanding of this core phenomenon of the IS discipline.

Pathological processing of sentinel lymph nodes in endometrial carcinoma — routine aspects of grossing, ultra-staging, and surgico-pathological parameters in a series of 833 lymph nodes

Sentinel lymph nodes are widely accepted in the treatment of endometrial carcinoma. Whereas surgical aspects are well studied, the pathological work-up in terms of grossing, frozen section, and the so-called ultra-staging is still a matter of debate. This results in conflicting national or center-based recommendations. In a series of consecutive 833 sentinel lymph nodes from 206 patients in endometrial carcinomas, we compared three different grossing techniques and the use of frozen section in terms of anatomy, detection rates, and survival. In total, 42 macro-metastases, 6 micro-metastases, and 25 nodes with isolated tumor cells were found. Lymph nodes affected at least with micro-metastasis were about 0.5cm enlarged. Detection rates in lamellation technique increased with a step of 5.9% to 8.3% in comparison to bi-valved or complete embedding. The lamellation technique presented with a slight beneficial prognosis in pN0 subgroup (OS, p=0.05), which besides size effects might be attributed to trimming loss. In frozen section, this effect was less pronounced than expected (OS, p=0.56). Ultra-staging only revealed additional micro-metastases and isolated tumor cells. Exclusively, macro-metastases showed poor survival (p<0.001). In multivariate analysis, T-stage, subtype, and lympho-vascular invasion status outperformed this staging parameter significantly. Grossing of sentinel lymph nodes is the most essential step with evidence to prefer lamellation in 2 mm steps. Step sectioning should consider widely spaced protocols to exclude macro-metastases. Frozen sections might add value to the intra-operative assessment of endometrial carcinoma in selected cases. The excellent biological behavior of cases with isolated tumor cells might question the routine application of pan-cytokeratin as ultra-staging method.

Informed consent prior to nursing care: Nurses' use of information.

Informed consent prior to nursing care procedures is an established principle which acknowledges the right of the patient to authorise what is done to him or her; consent prior to nursing care should not be assumed. Nursing care procedures have the potential to be unwanted by the patient and hence require an appropriate form of authorisation that takes into consideration the relationship between the nurse and patient and the ongoing nature of care delivery. How do nurses obtain consent from patients prior to nursing care?. Critical incident technique and the collection of critical happenings. 17 participants who were all qualified nurses took part in in-depth interviews. Ethical approval was obtained from the university ethics committee. Information giving is a key component prior to nursing care procedures. Nurses provide information to patients as a routine aspect of care delivery, and do so even when the patient is unable to communicate themselves. Whilst some participants described how information giving might be rushed or overlooked at times, it is clearly an established part of nursing care and is provided to ensure the patient knows what to expect when care is delivered. What is less clear is the extent to which information is given in order to seek the consent - rather than merely inform the patient - about nursing care. Implied consent is often an appropriate way in which consent is obtained prior to nursing care procedures. It takes into account the ongoing care provision and the relationship that exists between the nurse and patient. However implied consent should not be assumed. Nurses need to ensure that information is given not only to inform the patient about a procedure but to enable the patient to give his or her consent and to find an alternative way forward if the patient withholds their consent.

Breast Medical Oncologists' Perspectives of Telemedicine for Breast Cancer Care: A Survey Study.

The COVID-19 pandemic forced rapid adoption of telemedicine (TM) for breast oncology visits in the United States, but the appropriate role of postpandemic TM is uncertain. We sought to understand physician and advance practice practitioner perspectives on the use of TM for outpatient breast cancer care through an electronically administered survey. Breast medical oncology clinicians at two academic cancer centers and five satellite locations affiliated with the Dana Farber Cancer Institute and the Massachusetts General Cancer Center were invited to respond to a 21-question survey administered in September 2021 about clinicians' perceptions and attitudes toward TM during the previous 12 months. Of the 71 survey invitations, 51 clinicians (36 physicians and 15 advance practice practitioners) provided survey responses (response rate = 72%). Ninety-two percent of respondents (n = 47) agreed that TM visits enhance patient care. Ninety-two percent of respondents (n = 46) also agreed that TM is valuable for early-stage breast cancer follow-up visits. Most respondents felt that there was no difference between TM and face-to-face (F2F) visits when it came to patient adherence, ease of ordering tests, ease of accessing patient records, and workflow outside of the visit (82%, 82%, 78%, and 53%, respectively). Fifty-one percent of respondents (n = 26) said that TM was better for timely access to follow-up appointments. Most respondents said that F2F visits were better for seeing physical problems, personal connection with patients, overall quality of visits, and patient-physician communication (100%, 75%, 65%, and 63%, respectively). Breast clinicians believe that TM is a valuable tool to enhance outpatient breast cancer care. TM was felt to be appropriate for routine follow-up visits and second opinion consultations and is as good as or better than F2F visits for several routine aspects of breast cancer care.

Using STAX data to predict IMS radioxenon concentrations

The noble gas collection and measurement stations in the International Monitoring System (IMS) are heavily influenced by releases from medical isotope production facilities. The ability to reliably model the movement of radioxenon from the points of release to these IMS samplers has improved enough that a routine aspect of the analysis of IMS radioxenon data should be the prediction of the effect of releases from industrial nuclear facilities on the sample concentrations. Predicted concentrations at IMS noble gas systems in Germany and Sweden based on measured releases from Institute for Radioelements (IRE) in Belgium and atmospheric transport modeling for a four-month period are presented and discussed.

Simulation process and data flow for a large system dynamics model

This paper documents the workflow and supporting technologies that a large system dynamics model, the biomass scenario model, employs to streamline the data preparation, simulation, quality control, and analysis process at the National Renewable Energy Laboratory. The workflow centers on automation of routine aspects of the flow of data between data stores, simulations, and visualizations. It enforces quality checks on data, reproducibility of computations, and traceability of results, while maintaining complete archives of modeling and analysis artifacts. The resulting frictionless simulation/analysis environment supports large-scale sensitivity analysis, interactive creation of ensembles of simulations, and rapid visualization-based exploration of simulation results.