Routine Actions Research Articles

The centrality of the nurse-patient relationship: A Scandinavian perspective.

To address aspects of importance in the nurse-patient relationship, as conceptualised within the Scandinavian healthcare context. An experiment in Beth Israel Hospital uncovered a set of core values (ontology) that were wiped away by stronger forces. Despite this, some of the ideas impacted the development of nursing thought and values in the Scandinavian countries, partly because they connected with deeper social values and also because investment was being put into explicitly identifying and understanding the core elements of nursing (ontology) and how to provide evidence that they found were important (epistemology). From that beginning and through the work of key thought leaders, Scandinavian nursing is ready to embark on a new phase, which could be helped by the Fundamentals of Care framework. This discursive position study offers insights from a public healthcare setting, influenced by values such as equal rights to equal care and/or cure. This study presents two complementing perspectives: an ontological and an epistemological, on establishing caring relationships. There are different pathways to follow in building person-oriented care; however, the nursing approach is both ontologically and epistemologically grounded and based on dialogue. Patients meet different nurses, the meeting may be short and, routine actions may be on the agenda. However, nurses must engage with patients' experiences and knowledge, in order to add to patients' present and future well-being with their person-oriented care.

A Proposed Amendment to the Foreign Corrupt Practices Act to Crack Down on Corruption in the Environmental Crime Scene

Corruption in the global, political and economic systems and the exploitation of natural resources account for many of the world’s most extreme cases of environmental injustice and human rights abuses. Corruption can be considered a catalyst for environmental crime because it plays an important role in signing and forging import and export certifications, unlawfully clearing customs, issuing licenses, facilitating fraudulent trade and the transportation of illicit goods and “turning a blind eye.” Environmental crime is one of the most profitable forms of criminal activity, generating profits in the amount of tens of billions of dollars for criminal enterprises each year, and it is vastly expanding. A disproportionately high percentage of environmental crime occurs in disadvantaged communities that lack sufficient resources to prevent the crime or impose penalties on the perpetrator. The FCPA contains an exception for “routine governmental action” — more commonly referred to as the “facilitating payments” or “grease payments” exception — which is a highly debated topic within FCPA law because it is difficult to distinguish an act that is “ordinarily and commonly performed” from an act that would be deemed “part of the decision-making processes.” This loophole has led to a “gray area of corruption” because it has effectively blurred the distinction between acceptable facilitating payments and illegal bribes. Environmental regulation in any country gives rise to opportunities for exchanges between government officials and individuals in the private sector, and each point of contact creates an opportunity to pay a bribe or seek improper influence. Many of the payments made to foreign officials throughout these standard regulatory processes or procedures fall within this “gray area of corruption.” This Article proffers a proposed amendment to the FCPA that repeals and replaces the facilitating payments exception and requires the DOJ’s Attorney General to develop a comprehensive strategy to combat corruption in the context of environmental crime.

When school-based, in-service teacher training sharpens pedagogical awareness

Research in the field of professional development (PD) stresses the importance of the development of professional learning communities (PLCs) designed to promote the process of inquiry in teaching. PLCs are of great importance with regard to both school improvement and in-service teacher training. This article shows that it is possible to teach teachers to reflect on their beliefs and actions, making them visible to teachers and their colleagues during a cooperative process of inquiry in the classroom. The empirical data stem from a 2-year, school-based, in-service teacher-training program involving 16 teachers at two Danish high schools. The research question is ‘how can teachers’ reflections, pedagogical awareness, and perspectives on their beliefs be sharpened by in-service teacher training?’ With regard to school improvement, two conclusions are drawn: (1) teachers’ pedagogical awareness is sharpened and their classroom behavior and educational thinking change when their routine actions and thinking are questioned and scrutinized; (2) teachers who experiment systematically with their own teaching alongside their colleagues find the process and product rewarding.

Formação para a prática docente especializada na educação inclusiva: o que dizem os educadores

Este trabalho faz parte de uma pesquisa, intitulada Formação continuada de professores: a pesquisa-ação colaborativa em contextos de práticas educativas inclusivas/2ª. Fase, financiada pelo Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Neste trabalho, exploramos uma das etapas do processo da pesquisa-ação, método que ampara a execução da pesquisa de um modo geral. Nesta etapa, já ao final da pesquisa, realizou-se um conjunto de entrevistas com educadores, procurando conhecer melhor suas aspirações e necessidades no campo da educação inclusiva. Estes educadores fazem parte de um Centro de Atendimento Educacional Especializado vinculado à rede pública municipal de ensino. Partimos da seguinte questão: Qual a importância da formação específica para atendimento especializado no âmbito da Educação inclusiva? Como apoio teórico, consideramos os estudos de Imbernón (2010), Nóvoa (2007; 2009) e Perrenoud (1997). Para o tratamento dos dados, recorreu-se às contribuições da análise de conteúdo (BARDIN, 2011). Observa-se um hiato entre os depoimentos oferecidos pelos educadores. De um lado, afirma-se a necessidade da formação específica, incluindo o conhecimento “médico” das síndromes e dificuldades, o que, segundo os educadores, permite uma melhor atuação pedagógica. Esta formação, na visão dos educadores, não é oferecida. De outro lado, encontra-se uma segunda afirmação em que as formações específicas se dão nas relações do próprio fazer cotidiano, ou seja, são os próprios educadores que vão se especializando a partir de suas buscas e ações rotineiras. Abre-se um campo de análise para proceder à reflexão sobre o lugar da formação específica.

Onset and Effect Duration of Intrabuccal Space and Intramuscular Ketamine in Pediatrics.

Background:Painful diagnostic and therapeutic procedures performed for children are routine actions. Opioids and nonsteroidal anti-inflammatory drugs such as acetaminophens are among medications that can be used for this purpose. This study aimed to compare the onset and duration of action of intrabuccal (IB, submucosal) space and intramuscular (IM) injection of ketamine in pediatrics.Materials and Methods:This clinical trial study was carried out on 126 children of 1–15 years old referred to the emergency room of Al-Zahra and Kashani Hospitals in Isfahan and divided into two 63 populated groups of IM and IB. For one group randomly, 3 mg/kg IB ketamine was administered, and for another group, ketamine was injected intramuscularly at the dose of 5 mg/kg. The drug effect, surgeon satisfaction, and complications were evaluated. Data were analyzed using SPSS software.Results:The mean of time between injection and onset of drug effect in IM group was 5.71 min, whereas in IB group, it was 4.14 min (P < 0.0001). The mean of the duration of drug effect in IM group was 45.54 min, whereas in IB group, it was 24.63 min (P < 0.0001). Complications in IM group were significantly more reported than IB group (33.3% versus 11.1%, respectively, P = 003). The median of surgeon satisfaction in IM group was 3 and in IB group was 4 which was statistically significant (P = 0.007).Conclusions:IB method is preferred over IM method, and hence, it is recommended to use.

How to Facilitate Routinized Reflection and Truly Dynamic Adaptation in an Ever-changing Business World

The paper at hand elaborates on two conceptual ambiguities inherent in the current state of development in the important research field of how individual thinking links with effective organizational action. In so doing the text firstly arguments why routinized reflection is needed to balance the danger of complacency on the individual level of analysis. Secondly, the paper gives a review of why existing writing on the key strategic management concept of dynamic capabilities is hitherto unclear about how exactly that pivotal theoretical concept can simultaneously safeguard both routinized replication and dynamic adaptation. The paper also provides evidence for that topic’s practical relevance in today’s increasingly knowledge-based business environment, as being simultaneously sensitive to weak signals of required changes while exploiting existing sources of revenue constitutes a key requirement for organizational longevity. The paper makes the conceptual proposition of a jester-like mindset to bridge the two outlined theoretical gaps. In a nutshell, this idea centers around the fact that individual organizational actors cannot stand the immense challenge of continually judging whether use of time-tested solutions or constructive challenging of routine action is required. This is the reason why the needed routinized reflection has to be transferred to the group-level of analysis by creating an attitude shared by all constituents, which makes it safe to trigger organizational adaptation. The paper sketches six fields of application, where the proposed mindset augments our understanding of how to create organizations prone to effective changeability. The paper ends with sketching avenues for further empirical research to inform the jester-mindset’s theoretical refinement.

Attentional Control in Accidents Involving Agricultural Tractor Operators

Feature at a glance: Although a lack of safety features is often reported as the most important factor in tractor accidents, an accident per se is the outcome of many elements, including the amount of attentional control operators exert over the driving task. The lack of active attentional control is sometimes referred as “absentmindedness,” and many studies have investigated this phenomenon as the expression of individual differences. The present retrospective study represents a first attempt at investigating the relation between lack of attention and tractor accidents in a large sample of operators. The results show that attentional control is involved in tractor accidents, which can be taken as evidence of habit effects in operating agricultural machinery: Lower attentional control is required in routine actions, which makes expert operators more exposed to the possibility of making (skill-based) errors. This finding leads to suggestions for the design of future systems.

Striatal fast-spiking interneurons selectively modulate circuit output and are required for habitual behavior.

Habit formation is a behavioral adaptation that automates routine actions. Habitual behavior correlates with broad reconfigurations of dorsolateral striatal (DLS) circuit properties that increase gain and shift pathway timing. The mechanism(s) for these circuit adaptations are unknown and could be responsible for habitual behavior. Here we find that a single class of interneuron, fast-spiking interneurons (FSIs), modulates all of these habit-predictive properties. Consistent with a role in habits, FSIs are more excitable in habitual mice compared to goal-directed and acute chemogenetic inhibition of FSIs in DLS prevents the expression of habitual lever pressing. In vivo recordings further reveal a previously unappreciated selective modulation of SPNs based on their firing patterns; FSIs inhibit most SPNs but paradoxically promote the activity of a subset displaying high fractions of gamma-frequency spiking. These results establish a microcircuit mechanism for habits and provide a new example of how interneurons mediate experience-dependent behavior.

Evolution of Agile Enterprise Architecture Innovation Practices: A Longitudinal Case Study

Agile Enterprise Architecture (EA) is the process of infusing and managing enterprise architecture modeling and redesign efforts with principles of agile methods such as iterations and lean thinking for faster development times (Bloomberg 2013). Although increasingly prevalent, little research has been done regarding how organizations adopt methodological innovations of integrating agile methods with enterprise architecture. While past studies on agile EA have provided insights on how organizations can build enterprise architecture in increments through institutionalization (Isham 2008; Ross et al. 2006), there is little emphasis on how organizations adopt agile EA and how they transition is being made (Laanti 2014; Leffingwell 2007). Recently scholars have suggested exploring temporal dimensions of adoption across multiple stages to track the divergences in routines that emerge due to situated local practices of actors and meanings that evolve during such routine actions (Dionysiou et al. 2013; Feldman et al. 2003; Karahanna et al. 1999; Russo et al. 1995). We follow this logic in addressing our research questions and use recent advances in sequence analysis and use theory of symbolic interactionism to position our case. To this end, we conducted a field study in a top railroad company based in the United States, referred to as “Alpha” (a pseudonym). During the time period from 2011-2014, Alpha transitioned from traditional EA to agile EA during a corporate initiative to modernize services for digital transformation. Our analysis shows how meanings of enterprise architecture routine changed over time to create new ostensive aspects. Further, we identify four stages that enabled the transition to agile EA.

Study of Effective Factors on the Lifestyle in Iran Rural Areas (Case Study: Rural Areas of Khaf and Roshtkhar Counties)

Study of Effective Factors on the Lifestyle in Iran Rural Areas (Case Study: Rural Areas of Khaf and Roshtkhar Counties)

When Is the State? Topology, Temporality, and the Navigation of Everyday State Space in Delhi

This article seeks to insert questions of temporality into the core of geographical analysis of the state. It does so by drawing on extended fieldwork in slums and so-called unauthorized colonies in Delhi, India, to describe how those who live on the margins of the state employ a topological sensibility in accessing, influencing, and “timing” the state. By attending to the temporal rhythms of these residents' everyday efforts to secure water, electricity, and building permission, the article proposes two topological figures that move beyond narrower spatial metaphors that read that state either as a fixed, hierarchically scaled entity or as a flat, wholly malleable assemblage without consequential spatial order or historicity. These are the topological state and the state outside itself. The analysis of the topological state centers on how real-time connections are forged between residents and key nodes in the bureaucracy, producing momentary reconfigurations of state form that allow low-level state actors to capture authority even as bureaucratic hierarchy is maintained. The analysis of the state outside itself focuses on how the routine actions of water engineers and municipal officers challenge the common conceptual mapping of the state as a surface with an inside and outside. Taken together, these figures reveal a temporally adept mode of political agency open to conjunctural possibilities and proximate connections but often dismissed as a near-sighted political disposition symptomatic of the poor and marginal classes' submission to clientalist politics.

ЗНАЧЕННЯ І ОСОБЛИВОСТІ ЗАСТОСУВАННЯ СУЧАСНИХ ІНФОРМАЦІЙНИХ СИСТЕМ В УПРАВЛІННІ ПІДПРИЄМСТВОМ

The questions of application of modern information systems in enterprises. The main factors that necessitated the use of information systems for effective administrative decisions in times of economic uncertainty, which include the desire to increase the performance of routine actions aimed at the analysis and processing of collected information, improve enterprise management system, reduce material, time and cost associated with the process of collecting primary data. Cutting values and features of information systems in the enterprise management. The main methods of implementation of information technology in local information structures are adapting new information technology to organizational structure and streamlining of the organizational structure. The characteristic trends of development and implementation of information systems in enterprises, fragmentary use of information systems to automate certain tasks; low level of information technology managers and business units; partial use ready solutions information problems. It is proved that the main factors affecting the process of implementation of information systems is the need of organizations and users, and the availability of appropriate tools for their formation.

Ravaisson, Simondon, and constitution of routine action: Organizational routines as habit and individuation

ABSTRACTOrganizational routines are increasingly theorized as recursively being constituted as structures that inform and influence human action while simultaneously being built from the bottom-up by individual activities. In such a view, agency is both the cause and effect of organizational routines. The concept of agency is still under-theorized as it is frequently assumed that the actor either benefits from adhering to prescribed scripted action or consciously respond to instructions, that is, agency precedes the actions that constitute routines. Drawing on the work of Félix Ravaisson and Gilbert Simondon, the article advocates a biophilosophical understanding of routine action as being co-constituted with agency in a specific domain wherein the individual agent accommodates information and uncertainty in the form of habit (Ravaisson) or in the process of individuating (Simondon). Recognizing the work of Ravaisson and Simondon thus provides new ways to theorize agency and routines in organizations.

Attention in words, not in deeds: Effects of attention dissonance on headquarters-subsidiary communication in multinational corporations

We introduce the notion of attention dissonance, where the subsidiary within a headquarter-subsidiary relationship feels that headquarters’ attention at the cognitive level, reflected in its strategic intentions (attention perspective), is not aligned with the routine actions the headquarters performs vis-à-vis the specific subsidiary (attention engagement). Using a comparative case study design, we investigate a European organization with subsidiaries located in both emerging and advanced markets. We show how subsidiaries in the emerging markets face attention dissonance, which impedes their ability to get business opportunities across to headquarters, thereby compromising a necessary condition for realizing economic potential in these emerging markets.

Ligonių, kuriems atlikta aortokoronarinių jungčių suformavimo operacija (AKJO), reabilitacijos efektyvumas

Kardiologinių ligonių reabilitacija yra koordinuotas derinys priemonių, garantuojančių geriausias fizines, psichologines ir socialines sąlygas, kurias pacientai, persirgę ūminėmis širdies ir kraujagyslių ligomis, gali savo pastangomis išsaugoti bei susigrąžinti optimalias funkcijas visuomenėje, gerinti sveiką elgseną, lėtinti ar išvengti ligos progresavimo (PSO). Gera fizinė būklė lemia ne tik žmogaus gyvenimo kiekybę (ilgaamžiškumą), bet ir kokybę (savarankiškumą darbe, buityje). Tyrimo tikslas – įvertinti ligonių, kuriems atlikta AKJO, antro reabilitacijos etapo efektyvumą remiantis šešių minučių ėjimo testo, objektyvių tyrimų (AKS, ŠSD) rezultatais, priklausomai nuo lyties, širdies nepakankamumo funkcinės klasės pagal Niujorko širdies asociaciją (NŠA). Tyrimo uždaviniai – nustatyti ligonių, kuriems atlikta AKJO, rizikos veiksnius, kiek suformuota aortokoronarinių jungčių, širdies nepakankamumo klasę pagal Niujorko širdies asociaciją (NŠA), AKS, ŠSD, ,,dvigubos sandaugos‘‘, šešių minučių ėjimo testo pokyčius reabilitacijos eigoje, kasdienių veikų galimybes (pagal MET ir nueitą atstumą per šešias minutes). Atlikta retrospektyvi pacientų duomenų analizė Lietuvos sveikatos mokslų universiteto Elgesio medicinos institute (II reabilitacijos etapas). Tiriamųjų grupę sudarė 85 ligoniai, kuriems buvo atlikta AKJO: 49 vyrai (57,6 proc.) ir 36 moterys (42,4 proc.). Tiriamųjų amžiaus vidurkis: moterų 64,31±2 m., vyrų 58,24±2 m. Šešių minučių ėjimo testas vertintas du kartus: reabilitacijos pradžioje ir pabaigoje. Rezultatai. Nustatėme, kad pagrindiniai ligonių, kuriems atlikta AKJO, rizikos veiksniai: moterims - dislipidemija, arterinė hipertenzija, rūkymas; vyrams - dislipidemija, arterinė hipertenzija, cukrinis diabetas. Viena aortokoronarinė jungtis buvo suformuota 10,6 proc. ligonių, 71,7 proc. – dvi jungtys, o 17,6 proc. suformuotos trys jungtys. Pagal NŠA I funkcinei klasei priklausė 8,3 proc. ligonių, 48,2 proc. – II, o 43,5 proc. – III funkcinei klasei. Reabilitacijos pabaigoje tarp skirtingų funkcinių klasių pagal NŠA ligonių AKS, ŠSD, ,,dvigubos sandaugos‘‘ reikšmingo pokyčių skirtumo nenustatyta. Lyginant šių rodiklių pokyčius tarp ligonių, kuriems suformuotas skirtingas jungčių skaičius, reikšmingai skyrėsi ligoniams, kuriems suformuotos trys aortokoronarinės jungtys. Išvados. Vertindami reabilitacijos efektyvumą pagal šešių minučių ėjimo testo rezultatus nustatėme, kad visų funkcinių klasių pagal NŠA ligoniams padidėjo nueitas atstumas (p&amp;lt;0,05). Nustatyta, jog ligoniams, priklausiusiems III funkcinei klasei pagal NŠA, reabilitacijos efektyvumas buvo vidutinis, o ligonių, priklausiusių I ir II funkcinėms klasėms pagal NŠA – didelis efektyvumas. Didžiausias nueito atstumo pokytis nustatytas vyrų, kurie priklausė I ir II funkcinėms klasėms pagal NŠA.

Reducing prospective memory error and costs in simulated air traffic control: External aids, extending practice, and removing perceived memory requirements.

In air traffic control (ATC), forgetting to perform deferred actions-prospective memory (PM) errors-can have severe consequences. PM demands can also interfere with ongoing tasks (costs). We examined the extent to which PM errors and costs were reduced in simulated ATC by providing extended practice, or by providing external aids combined with extended practice, or by providing external aids combined with instructions that removed perceived memory requirements. Participants accepted/handed-off aircraft and detected conflicts. For the PM task, participants were required to substitute alternative actions for routine actions when accepting aircraft. In Experiment 1, when no aids were provided, PM errors and costs were not reduced by practice. When aids were provided, costs observed early in practice were eliminated with practice, but residual PM errors remained. Experiment 2 provided more limited practice with aids, but instructions that did not frame the PM task as a "memory" task led to high PM accuracy without costs. Attention-allocation policies that participants set based on expected PM demands were modified as individuals were increasingly exposed to reliable aids, or were given instructions that removed perceived memory requirements. These findings have implications for the design of aids for individuals who monitor multi-item dynamic displays. (PsycINFO Database Record

Ravaisson, Simondon, and constitution of routine action: organizational routines as habit and individuation

Organizational routines are increasingly theorized as recursively being constituted as structures that inform and influence human action while simultaneously being built from the bottom-up by indiv...

Three performativities of innovation in public transport planning

ABSTRACTThe article scrutinizes planners’ stories of innovation in contemporary public transport planning in three Scandinavian contexts (Denmark, Sweden and Norway). This analysis is accomplished by adapting Judith Butler’s post-structural feminist critical theory on performativity to the planning context. This theoretical framework is used to illuminate how planning is dynamically renewed, revised and consolidated over time by the individual routine actions of planners. From this perspective, the research identifies a set of repetitive acts – as recognizing specific windows of opportunity, anticipate and respond to political signals and create arguments and means of communication and persuasion – that constitute the contemporary transformation of professional practice in relation to planning politics. This analytics of performativity reveals how professional planning practices engage with transformative capacities of reshaping, re-enacting and re-experiencing guidance for the future within a set of meanings and forms of legitimation. These findings are intended to contribute to present and future planning practice and education in Scandinavian countries and elsewhere.

Free Will as the Implied Negation of Our Conscious Physical Actions

In this paper, I have explained free will (classical libertarian version) as the implied negation of our conscious physical actions (routine actions). What we come across is liberty, which is purposive. The existence of free will, if possible, can only be traced in those states where our consciousness is in least connection with external world (eg. dreams or above). The spontaneity and absurdity of free will ensures that it will never accompany any purposive action. I have pointed out that it is important to proceed in the inverted direction (from determining free will in mind, to non-moral and then to moral conditions), rather than taking it for granted in morality. I have also tried to give an explanation for the illusion of free will during moral conditions. The major principles which I have used during this conversation are Anomalous Monism (Donald Davidson), Benjamin Libet’s ‘Half-second short delay’, Decision-making theories of Antonio Damasio and Daniel Dennett, Patricia Churchland’s notion of ‘Self-control’, Frankfurt’s ‘Theory of the Hierarchy of desires’ and occasional references to Freud’s and Jung’s psychoanalytic concepts, and Advaita Vedanta’s ‘states of consciousness’, etc.

Electronic Health Records and Clinical Routines: Convergence and Divergence

The article is based on the preliminary results of author’s current study of the implementation of electronic health records in one of Russian outpatient clinics. Interviews with doctors, developers, managers of the State Department of Healthcare, IT-specialists, and clinic’s head, as well as observations of doctors’ everyday work, show that one of the key problems in the transition from paper to electronic record-keeping is how new information system transforms (or fails to transform) doctors’ routine, habitual activities. The article suggests that the widespread view of habitual action as an action in accordance with a preliminary scheme – a view that forms a basis for the majority of medical information systems – does not describe the actual structure of healthcare activities. The analysis of how doctors perceive and use electronic health records in their daily practice demonstrates that a situational approach to routine actions is more adequate. For example, the use of so-called “templates” that are created by doctors within the electronic health records cannot be understood without reference to the situational context of professional activities. Doctors, creating and using various “templates,” do this in such ways that allow them to make these health records circumstantially understandable. The view of routine activities as situated, concerted achievements not only proves the possibility of a new approach to the description of habitual actions’ role and place in the structure of social action, but can be important for the design and evaluation of professional information systems.