Practice Model Research Articles

National Identity and Foreign Borrowing in the Legal Forms of Personnel Management: History and Modernity

Relevance. The introduction of special rules for the use of foreign vocabulary in the texts of public acts, improving the form of a business letter, modifying the structure of documents in accordance with the powers of public authorities are trends in the current and past Russian administration experience. Both in the modern and historical and legal context of scientific research, it is relevant to consider state approaches in the field of regulating official paperwork, which are aimed at forming a stable management model in accordance with domestic national interests and values. The purpose of the study is to establish the relationship between elements of national identity and foreign models in the state personnel practice of document flow in Russia in the 18th century, which is useful for taking into account this experience in modern transformations of the foundations of legal and business writing.Objective: are to consider legislative innovations in terms of regulating the field of record keeping and personnel management; to identify forms of record keeping in the XVIII century and socio-political factors influencing their application; a retrospective assessment of the methodology for drafting texts of government acts.Methodology. The methodology is based on comparative legal, comparative historical, historical legal and systemic research methods.The results of the study indicate the improvement of grammatical, stylistic, translation and other business skills and competencies of personnel of public authorities. A historical and legal analysis of the directions of development of personnel management revealed an active borrowing of foreign vocabulary in the execution of administrative acts. The clerical mechanism of interdepartmental communication gradually became more complicated, and the procedure for receiving and responding to petitions from private individuals was regulated. Conclusion. The experience of forming the Russian management and personnel practice of paperwork, developing in conditions of value crises and political contradictions, is important for taking into account the political and legal measures carried out in the modern state.

Teachers’ perspectives of their development of culturally sustaining pedagogical practices: lessons for teacher learning

ABSTRACT This study explores factors that influence teachers’ development of culturally sustaining pedagogical practices. The research is guided by the question: How do teachers perceive their development of culturally sustaining pedagogical practices? Data collection occurred during the fall 2020 semester and involved five high school teachers. Given COVID-19 and the pervasiveness of online learning, interviews and observations occurred via Zoom. The data includes semi-structured interviews, fieldnotes, teaching artefacts, and questionnaires. This study found that all teachers employed dynamic support systems that significantly factored into their development as culturally sustaining educators. Due to the central role of communities of practice in participants’ development, a communities of practice model for culturally sustaining teacher development was created and illustrated in this paper. Social interaction played a significant role in developing educators’ critical stance towards teaching – demonstrating possibilities to productively relate culturally sustaining pedagogy and communities of practice for a critical communities of practice lens to teacher learning. This study suggests that a collective orientation should be central to the work of preservice and in-service teachers within teacher education programmes and PK-12 schools.

Tocilizumab Dose Tapering Based on a Model-Based Algorithm is Feasible in Clinical Practice: A Short Communication.

Tocilizumab in the treatment of rheumatoid arthritis (RA) is a potential candidate for concentration-guided tapering because the standard dose of tocilizumab results in a wide range of serum concentrations, usually above the presumed therapeutic window, and an exposure-response relationship has been described. However, no clinical trials have been published to date on this subject. Therefore, the objective of this study was to assess the feasibility of the tapering of intravenous (iv) tocilizumab with the use of a pharmacokinetic model-based algorithm in RA patients. A randomized controlled trial with a double-blind design and follow-up of 24 weeks was conducted. RA patients who received the standard of tocilizumab for at least the past 24 weeks, which is 8 mg/kg every 4 weeks, were included. Patients with a tocilizumab serum concentration above 5 mg/L at trough were randomized between concentration-guided dose tapering, referred to as therapeutic drug monitoring (TDM), or the standard 8 mg/kg dose. In the TDM group, the tocilizumab dose was tapered with a recently published model-based algorithm to achieve a target concentration of 4-6 mg/L after 20 weeks of dose tapering. Twelve RA patients were included and 10 were randomized between the TDM and standard dose group. The study was feasible regarding the predefined feasibility criteria and patients had a positive attitude toward therapeutic drug monitoring. In the TDM group, the tocilizumab trough concentration within patients decreased on average by 24.5 ± 18.3 mg/L compared with a decrease of 2.8 ± 12 mg/L in the standard dose group. None of the patients in the TDM group reached the drug range of 4-6 mg/L. Instead, tocilizumab concentrations of 1.6 and 1.5 mg/L were found for the 2 patients who completed follow-up on the tapered dose. No differences in RA disease activity were observed between the 2 study groups. This study was the first to show that it is feasible to apply a dose-reduction algorithm based on a pharmacokinetic model in clinical practice. However, the current algorithm needs to be optimized before it can be applied on a larger scale.

Glucose management in critically ill adults: A qualitative study from the experiences of health care providers

Aims and objectiveTo explain the components and elements of glucose management in critically ill adult patients from the healthcare providers’ experiences. BackgroundCritically ill adults are highly susceptible to stress-induced hyperglycaemia due to glucose metabolic disorders. Healthcare workers play a key role in the glycaemic management of critically ill patients. However, there is a lack of qualitative studies on the content and elements of glycaemic management and healthcare workers' perceptions about glycaemic management in China. DesignQualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. MethodsIndividual semi-structured interviews were conducted from January to April 2022. Fifteen physicians and nurses were recruited from ten hospitals in mainland China. Data were analysed using inductive thematic analysis. ResultsGlucose management in critically ill adult patients from their experiences included two parts: the inner ring (practice behaviours) and the external space (methods and drivers). The practice behaviours of glucose management include five elements, while the methods and drivers of glucose management focus on three elements. The content covered under each element was identified. ConclusionThis study developed a glycaemic management model for critically ill adult patients, clarified its elements based on the perceptions of healthcare providers and elaborated on the methods and drivers covered under each element to provide a reference for physicians and nurses to develop a comprehensive glycaemic management guideline for critically ill adult patients. Relevance to clinical practiceOur study proposed a glucose management practice model for critically ill adult patients, and the elements and components included in this model can provide a reference for physicians and nurses when performing glucose management in critically ill patients.

Uncovering Language Disparity of ChatGPT on Retinal Vascular Disease Classification: Cross-Sectional Study.

Benefiting from rich knowledge and the exceptional ability to understand text, large language models like ChatGPT have shown great potential in English clinical environments. However, the performance of ChatGPT in non-English clinical settings, as well as its reasoning, have not been explored in depth. This study aimed to evaluate ChatGPT's diagnostic performance and inference abilities for retinal vascular diseases in a non-English clinical environment. In this cross-sectional study, we collected 1226 fundus fluorescein angiography reports and corresponding diagnoses written in Chinese and tested ChatGPT with 4 prompting strategies (direct diagnosis or diagnosis with a step-by-step reasoning process and in Chinese or English). Compared with ChatGPT using Chinese prompts for direct diagnosis that achieved an F1-score of 70.47%, ChatGPT using English prompts for direct diagnosis achieved the best diagnostic performance (80.05%), which was inferior to ophthalmologists (89.35%) but close to ophthalmologist interns (82.69%). As for its inference abilities, although ChatGPT can derive a reasoning process with a low error rate (0.4 per report) for both Chinese and English prompts, ophthalmologists identified that the latter brought more reasoning steps with less incompleteness (44.31%), misinformation (1.96%), and hallucinations (0.59%) (all P<.001). Also, analysis of the robustness of ChatGPT with different language prompts indicated significant differences in the recall (P=.03) and F1-score (P=.04) between Chinese and English prompts. In short, when prompted in English, ChatGPT exhibited enhanced diagnostic and inference capabilities for retinal vascular disease classification based on Chinese fundus fluorescein angiography reports. ChatGPT can serve as a helpful medical assistant to provide diagnosis in non-English clinical environments, but there are still performance gaps, language disparities, and errors compared to professionals, which demonstrate the potential limitations and the need to continually explore more robust large language models in ophthalmology practice.

Characteristics of High School Physics Problem-Solving Skills and Integrating the PBL Model Assisted by E-Book

This research discusses the implementation of the Problem-Based Learning model assisted by E-Book to improve students' problem-solving skills on renewable energy materials. The purpose of this research is to identify the characteristics of physics problem-solving through the knowledge profile of students at the high school level as a consideration in the application of the PBL model and the use of E-Book assisted learning media to improve problem-solving skills. The research method used is a preliminary study with qualitative descriptive analysis. The instruments used include the problem-solving skills test, interview questionnaire, and student response questionnaire. The data analysis technique in this study used a problem-solving skills test questionnaire and a survey to get responses from students. The findings showed that students' problem-solving skills were generally in the low category. Of the total learners, 87 students were in the low category, 2 students in the medium category, and 1 student in the high category. Although students have been able to understand the problem, they still experience problems in providing answers and checking back due to lack of habit in working on problem-solving-based problems. Therefore, it is necessary to practice and use learning models, as well as E-Book technology, which can help in the process of teaching and learning activities and increase students' learning motivation. Thus, it is expected that students' problem-solving skills can be improved through the right learning approach and the use of relevant technology.

Development and validation of an individualized and weighted Myeloma Prognostic Score System (MPSS) in patients with newly diagnosed multiple myeloma.

Current standard predictive models of disease risk do not adequately account for the heterogeneity of survival outcomes in patients with new-diagnosed multiple myeloma (NDMM). In this retrospective, multicohort study, we collected clinical and genetic data from 1792 NDMM patients and identified the prognostic impact of all features. Using the top-ranked predictive features, a weighted Myeloma Prognostic Score System (MPSS) risk model was formulated and validated to predict overall survival (OS). In the training cohort, elevated lactate dehydrogenase level (LDH), International Staging System (ISS) Stage III, thrombocytopenia, and cumulative high-risk cytogenetic aberration (HRA) numbers were found to have independent prognostic significance. Each risk factor was defined as its weighted value respectively according to their hazard ratio for OS (thrombocytopenia 2, elevated LDH 1, ISS III 2, one HRA 1, and ≥2 HRA 2, points). Patients were further stratified into four risk groups: MPSS I (22.5%, 0 points), II (17.6%, 1 points), III (38.6%, 2-3 points), and IV (21.3%, 4-7 points). MPSS risk stratification showed optimal discrimination, as well as calibration, of four risk groups with median OS of 91.0, 69.8, 45.0, and 28.0 months, for patients in MPSS I to IV groups (p < .001), respectively. Importantly, the MPSS model retained its prognostic value in the internal validation cohort and an independent external validation cohort, and exhibited significant risk distribution compared with conventional prognostic models (R-ISS, R2-ISS, and MASS). Utilization of the MPSS model in clinical practice could improve risk estimation in NDMM patients, thus prompting individualized treatment strategies.

Utilizing a HRSA Training Grant to Promote PMHNP Student Resilience: Answering the Call to Enhance Trauma-Informed Teaching and Learning Practices in Nursing Education

Nursing burnout has reached a new level of prevalence among professionals and is rising among nursing students and can impact student success in the classroom and clinical areas. Among advanced practice nurses, psychiatric-mental health nurse practitioners have the least favorable combination of low compassion satisfaction and high secondary traumatic stress, placing them at even greater risk for burnout compared to other specialties. Trauma informed teaching and learning principles can serve to prevent burnout and have a positive impact on learning outcomes. Through these teaching methods, nurse educators have the opportunity to both support students during their nursing education and prepare students for the professional stressors that contribute to burnout. This quality improvement project involved implementation and evaluation of a HRSA funded program to train PMHNP students interested in working in rural and underserved areas. The training intervention included didactic curricular enhancements, a trauma resiliency training and a longitudinal clinical practicum. Qualitative program outcomes indicated that trainees were implementing trauma-informed principles and skills with patients and for self-care during their nursing training and at one year follow-up. The program may offer practical upstream solutions for nurse educators and future studies should explore concepts more formally to develop best practice models.

Telepharmacy knowledge, attitude, and experience among pharmacy students in Indonesia: A cross-sectional study

Background: The advancement of technology in healthcare services has given rise to telepharmacy. The success of telepharmacy depends on the knowledge, attitude, and experience of pharmacy students. However, telepharmacy is relatively new in the Indonesian pharmacy education system. Methods: This cross-sectional study was conducted using an online questionnaire to evaluate pharmacy students' knowledge, attitude, and experience related to telepharmacy. Results: The questionnaire was completed by 442 pharmacy students. Among them, 97.96% demonstrated a high level of knowledge about telepharmacy, and 96.60% had a positive attitude toward it. However, 85.97% of students had limited experience with telepharmacy. While there was a significant correlation between knowledge and attitude, no such correlation was observed between attitude and experience. Conclusion: The findings revealed that pharmacy students had high knowledge and attitude, but limited experience with telepharmacy. Additionally, there is a significant correlation between knowledge of telepharmacy and a positive attitude towards its use. To better prepare future pharmacists to provide effective telepharmacy services, it is essential to integrate telepharmacy practice models into the curriculum.

A Contextualized Reflective Practice Model: Responding to EFL Teachers’ Needs

A Contextualized Reflective Practice Model: Responding to EFL Teachers’ Needs

School Leadership Model in the Context of Autonomy and Accountability

The study explores the model of leadership in high schools with a focus on autonomy and accountability, aiming to analyze leadership factors and identify characteristics of leadership that align with the needs and context of high schools in Vietnam. The perspective of leadership models emphasizing autonomy and accountability helps enhance self-management, innovation, and development within schools. Additionally, the research recommends that school leaders increase accountability for the outcomes of school activities, ensuring sustainable development and meeting the needs of students and society. Researchers will propose solutions for implementing this model in practice, enabling schools to optimize leadership and enhance the quality of education.

Listening to children's voices: reflections on methods, practices and ethics in researching with children using zoom video interviews

PurposeThe purpose of this research was to reflect on the enablers, challenges and ethical considerations in conducting qualitative research with young children using online methods. The aim was to suggest recommended practices to be put in place for researchers conducting online focus groups and interviews with young children.Design/methodology/approachThis research article explores the use of Zoom video conferencing as a tool to collect qualitative data with young children in Singapore, as an alternative to face-to-face interviews. Taking a child-centred participatory approach, children shared their perspectives of their experiences of child agency in school and at home through their drawings, pictures and dialogue in online group interviews. Schon's model of reflective practice was used to guide the researchers' process of reflections during the research project.FindingsScreen sharing and real-time nature of interactions of Zoom video conferencing enabled building of rapport and children's narratives to be developed while group size and the effect of parental influence provided challenges and ethical issues that needed to be addressed in the research process. Researcher withitness emerged as an essential quality in successful engagement of children in an online focus group discussion.Research limitations/implicationsOnline video conferencing platforms like Zoom provide a powerful alternative tool for participatory research with children. It challenges researchers to share control of the interactions and data collection process with children. However, parental interference and effect on data may present itself as a research limitation if not navigated well.Practical implicationsGroup size of the focus group has an impact on children's engagement levels and wait time for their turn to speak during group interviews. While parents' presence during the online interview ensured child safety and a comforting presence for the child, parents should also understand their role in the study to avoid interfering with the data collection process.Social implicationsThe Zoom platform resembled onsite interviews' spontaneity of exchanges which allowed the researchers to build rapport with children through small-talk and icebreaker activities. Establishing personal connections and building of trust were essential elements in ensuring children were comfortable participating in the interviews. Observing real-time behaviour and body language of children also allowed for indication of withdrawal of consent and participation by the children.Originality/valueThis research adds new insights to the emerging discussions on collecting data from children via online video platforms with suggestions of new strategies and recommendations to overcome challenges, as well as future implications and potential of using Zoom as an alternative tool for participatory research with children. This research conducted in Singapore provides an Asian context and is different from current literature on this topic, largely focused on western countries' reports.

Pediatric consultative dermatology: A survey of the Society for Pediatric Dermatology workforce reveals shortcomings in existing practice models of pediatric dermatology consult services in the United States.

The rate of pediatric hospitalization for cutaneous pathology has been increasing in recent years, often requiring the expertise of consulting pediatric dermatologists; however, the infrastructure of inpatient pediatric dermatology consultative services remains poorly characterized. We sought to assess the structure, consult volume, physician compensation, and utilization of teledermatology in pediatric dermatology inpatient services to better understand the current care model. Our survey of 118 pediatric dermatologists revealed that 89% of respondents see between 1 and 10 new consults per week, 39% perform all inpatient consults including evening and weekends without assistance from other providers, 71% do not have protected time during the week to provide inpatient consultations, and only 10% receive financial compensation via stipend. By highlighting both the high demand for pediatric consultative dermatology as well as the significant burden placed on these providers by existing practice models, we hope to encourage a reappraisal of the current infrastructure of pediatric inpatient dermatology to increase structural and financial support for this vital service.

Post-traumatic stress and depression following disaster: examining the mediating role of disaster resilience.

The current study used structural equation modeling to examine the role of disaster resilience as a mediator between disaster exposure and post-traumatic stress and depressive symptoms among a sample of 625 U.S. adults who experienced a disaster event. Results found that disaster resilience mediated the relationship between disaster exposure as a predictor and depression and post-traumatic stress as dependent variables. These findings have important implications for understanding the mechanisms by which disaster resilience supports post-disaster mental health and can inform future disaster mental health interventions and practice models.

On Diagnostics in Bell--Touchard Regression Models

The Bell--Touchard regression model for count response variables was introduced recently in the statistical literature. This regression model for counts is, in some aspects, similar to the generalized linear model framework, and the mean response is related to covariates and unknown regression coefficients, which allows for parameter interpretation in terms of the response variable in its original scale. However, diagnostic methods for this class of regression models were not developed. In this paper, we fill this gap and propose a variety of diagnostic tools, such as leverage measures, global influence, normal curvatures of local influence under some perturbation schemes, and Pearson residuals. All diagnostic measures developed are applied in a real data set to analyze the fitted Bell--Touchard regression model in practice.

All creatures great and small: Faith, spirituality, environmental-animal rights activism and public relations as covenantal stewardship

This study extends the historical record of faith/spirituality-inspired social activism, an under-explored area of advocacy, by examining such campaigning for environmental and animal rights and the worldview and model of public relations that guide such efforts. A combination of qualitative methods was used to obtain data on public relations as conceptualized and practiced including a textual analysis of historical material and institutional media. Throughout history faith/spirituality has inspired Indigenous peoples, governments, and individuals to advocate for environmental and animal rights, playing a central role in the formation and practice of a worldview, caritas, embracing an approach to relationship-building – covenantal stewardship – that guides behavior in a pro-social manner toward an inclusive set of “publics” – humans living, unborn, and ancestral, animals, and the natural world as well as alternative views of public relations. Moreover, individuals of faith/spirituality have created NGOs to institutionalize such activism. The influence of faith/spirituality upon environmental and animal rights activism points toward a re-thinking of the nature of public relations and its “publics” given emerging sensitivities to the principles of inclusion necessary for the harmonious functioning of society and requires a new definition, worldview, and model of practice.

Reflection in Professional Practice and Education in Engineering, Nursing, and Teaching

Background: Critical reflection is an essential curricular component for learning from experience that determines placement quality in postsecondary experiential learning placements. However, there are poor empirical connections between the use of critically reflective processes and learning outcomes. Purpose: This research explored reflective processes professionals use in their practice and how these processes compare with the reflective activities postsecondary instructors in professional faculties use during experiential learning. Methodology/Approach: This collective case study used focus group interviews, field notes, and professional grey literature to examine the research questions. Findings/Conclusions: Professional training programs must align their reflective practices with more integrated and holistic models of reflective practice to better mirror the professional skills demanded in professional practice contexts. Professionals in context-laden professional environments should integrate reflective activities into their practice based on emergent, iterative, and cocreative models that are more like their lived realities at work. Reflective practices which better fit and mirror these lived realities may lead to better connections between reflective activities and work outcomes. Implications: Professional environments are complex, dynamic, and affected by contextual factors. New integrated and holistic models of reflective experience should replace the separated, stepwise, or automatic models that have guided reflective practices in the past.

Mapping clinical interactions in an Australian tertiary hospital emergency department for patients presenting with risk of suicide or self-harm: Network modeling from observational data.

Reliable assessment of suicide and self-harm risk in emergency medicine is critical for effective intervention and treatment of patients affected by mental health disorders. Teams of clinicians face the challenge of rapidly integrating medical history, wide-ranging psychosocial factors, and real-time patient observations to inform diagnosis, treatment, and referral decisions. Patient outcomes therefore depend on the reliable flow of information through networks of clinical staff and information systems. This study aimed to develop a quantitative data-driven research framework for the analysis of information flow in emergency healthcare settings to evaluate clinical practice and operational models for emergency psychiatric care. We deployed 2 observers in a tertiary hospital emergency department during 2018 for a total of 118.5 h to record clinical interactions along patient trajectories for presentations with risk of self-harm or suicide (n = 272 interactions for n = 43 patient trajectories). The study population was reflective of a naturalistic sample of patients presenting to a tertiary emergency department in a metropolitan Australian city. Using the observational data, we constructed a clinical interaction network to model the flow of clinical information at a systems level. Community detection via modularity maximization revealed communities in the network closely aligned with the underlying clinical team structure. The Psychiatric Liaison Nurse (PLN) was identified as the most important agent in the network as quantified by node degree, closeness centrality, and betweenness centrality. Betweenness centrality of the PLN was significantly higher than expected by chance (>95th percentile compared with randomly shuffled networks) and removing the PLN from the network reduced both the global efficiency of the model and the closeness centrality of all doctors. This indicated a potential vulnerability in the system that could negatively impact patient care if the function of the PLN was compromised. We developed an algorithmic strategy to mitigate this risk by targeted strengthening of links between clinical teams using greedy cumulative addition of network edges in the model. Finally, we identified specific interactions along patient trajectories which were most likely to precipitate a psychiatric referral using a machine learning model trained on features from dynamically constructed clinical interaction networks. The main limitation of this study is the use of nonclinical information only (i.e., modeling is based on timing of interactions and agents involved, but not the content or quantity of information transferred during interactions). This study demonstrates a data-driven research framework, new to the best of our knowledge, to assess and reinforce important information pathways that guide clinical decision processes and provide complementary insights for improving clinical practice and operational models in emergency medicine for patients at risk of suicide or self-harm. Our findings suggest that PLNs can play a crucial role in clinical communication, but overreliance on PLNs may pose risks to reliable information flow. Operational models that utilize PLNs may be made more robust to these risks by improving interdisciplinary communication between doctors. Our research framework could also be applied more broadly to investigate service delivery in different healthcare settings or for other medical specialties, patient groups, or demographics.

Remote Monitoring and Artificial Intelligence: Outlook for 2050.

Remote monitoring and artificial intelligence will become common and intertwined in anesthesiology by 2050. In the intraoperative period, technology will lead to the development of integrated monitoring systems that will integrate multiple data streams and allow anesthesiologists to track patients more effectively. This will free up anesthesiologists to focus on more complex tasks, such as managing risk and making value-based decisions. This will also enable the continued integration of remote monitoring and control towers having profound effects on coverage and practice models. In the PACU and ICU, the technology will lead to the development of early warning systems that can identify patients who are at risk of complications, enabling early interventions and more proactive care. The integration of augmented reality will allow for better integration of diverse types of data and better decision-making. Postoperatively, the proliferation of wearable devices that can monitor patient vital signs and track their progress will allow patients to be discharged from the hospital sooner and receive care at home. This will require increased use of telemedicine, which will allow patients to consult with doctors remotely. All of these advances will require changes to legal and regulatory frameworks that will enable new workflows that are different from those familiar to today's providers.

Proposing an integrative, dynamic and transdiagnostic model for addictions: dysregulation phenomena of the three main modes of the predostatic mind.

Several theories have been proposed to explain the complex diagnostic aspects related to addiction disorders and their development. Recent frameworks tend to focus on dimensional perspectives of symptoms rather than categorical systems, since substance use disorders are frequently comorbid with other psychiatric and especially personality disorders. However, useful transdiagnostic models that could integrate clinical evaluation derived from neuroscientific theories are lacking. In the present manuscript, the authors propose a model based on a new paradigm, in an attempt to better explain this complex, multifaceted phenomenon. The new paradigm presupposes that emotions and behavior are a response to risk prediction. Individuals make choices and engage in actions to manage potential risks/rewards in order to seek or maintain homeostasis in their internal and external environments - a mechanism that the authors call predostatic (predictive mechanism with homeostatic purpose). The model considers three main modes of the predostatic mind: (1) Alarm Mode, activated by high and/or imminent risk prediction; (2) Seek Mode, activated by long-term risk or reward prediction; and (3) Balance Mode, a self-regulating state of mind related to low risk prediction, a soothing system and a calm state. Addiction is seen as a chronic dysregulation of organism systems leading to internalizing or externalizing phenomena mainly related to the Seek and Alarm Modes, which are persistently activated by reward and risk prediction, respectively, thus hindering Balance. Addiction neuroscience research has shown that chronic drug use or engagement in addictive behaviors can lead to neuroadaptations in the brain reward circuitry, disrupting normal balance and the regulation of reward processes. This dysregulation can contribute to persistent drug-seeking/addictive behaviors despite negative consequences. This newly proposed dynamic and integrative model, named dysregulation based on externalizing and internalizing phenomena of the three main modes of the predostatic mind (DREXI3), proposes six dysregulation dimensions with basic emotional and behavioral symptoms, such as neurophysiological alterations, impulsivity, compulsion, cognitive impairment/psychosis, mood, and anxiety/anger. In this paper, the authors explain the rationale behind DREXI3 and present some hypothetical clinical examples to better illustrate the use of the model in clinical practice. The development of this innovative model could possibly guide tailored treatment interventions in the addiction field.