The role of teleoaffective profiles in practice adaptation

Consumer research is interested in the way consumers navigate consumption in the face of disruption, often using practice theory to focus on how practitioners creatively realign practice elements in order to carry on. Although recognising their significance, this research undertheorizes the significance, role and characteristics of 'meanings' in practice adaptation, presenting them as constraining and yet easy to adapt. We explore and theorize meanings in practice adaptation by mobilising the theoretical leverage of Schatzki’s (2002) concept of ‘teleoaffective structures’. Through our empirical material, we illuminate how multifaceted teleoaffective components constituent of teleoaffective structures are integrated differently into routinised practice performances in relatively stable ways; incorporated via ‘teleoaffective profiles’ that are unique to practitioners but properties of practices. Furthermore, we propose that teleoaffective profiles have different characteristics that condition practice adaptation, as teleological orientations and affective engagements afford different pathways towards integration with available materials and competences. We use our empirical material, based on interviews with loyal gym-based resistance training practitioners during COVID-19 gym closures, to illuminate our argument that practitioners can have ‘rigid’, ‘elastic’ or ‘fluid’ teleoaffective profiles. The characteristics of these profiles, which are unique but remain the properties of the practice, mean that adaptation processes and experiences unfold differently. This perspective advances from accounts of adaptation that are centred on binary outcomes of success or failure. Furthermore, our theorization advances from practice-oriented consumption adaptation research that foregrounds practitioner creativity and fails to adequately incorporate understandings of how practice elements condition adaptation processes. Yet, we retain practitioner experiences in our analysis. Teleoaffective components, profiles and properties provides further theoretical leverage to the practice turn in consumption research and advances the burgeoning focus on the significance of teleoaffective structures in the topographies of practices

Families and Collective Futures: Developing a Program Logic Model for Arts-Based Psychosocial Practice With South African Rural Communities

Aim: This aim of this study is to describe the development of a program logic model to guide arts-based psychosocial practice delivered in rural South African farming communities affected by transgenerational traumas.Background: The rationale for developing a program logic model for arts-based psychosocial practice in South Africa was based on the lack of evidence for effective community arts-based psychosocial interventions for collective trauma, unknown consensus about best practices and the need for developing cogent collective psychosocial practices. Further to this, the aims and benefits of the practice required clarity given the psychosocial complexity of the environment within which the practices for this population are being offered. The logic model offers a valuable resource for practitioners, participants and funders to understand the problem being addressed, how practice is defined, as well as the impact of practice and on intermediate and longer term goals.Methods: The authors used a systematic iterative approach to describe the operationalization of arts-based psychosocial practice. This resulted in the design of the logic model being informed by data from focus groups, an overview of the literature regarding transgerenational trauma in this population, operational policies and organizational documents. The development of the logic model involved actively investigating with practitioners their work with remote farming communities. We thematised practitioners practice constructs to identify salient practice elements and their relationship to perceived benefits and lastly feedback from practitioners and participants following implementation to make adjustments to the logic model.Results: The results were clearly identified in the form of visual mapping using the design of a program logic model. The logic model was divided into 5 parts and was verified by practitioners following implementation. The parts of the program logic model are (Part 1) main presenting problem, (Part 2) operational processes, (Part 3) practice elements, (Part 4) benefits, and impact and (Part 5) review.

Patient needs and resource intensity weighting in the ambulatory care unit

Across British Columbia Cancer (BC Cancer), oncology nurses work as part of an interdisciplinary team in the outpatient ambulatory care unit (ACU) and support patients across the trajectory of their cancer journey. Previous initiatives, which focused on identifying patient needs and nursing role optimization work, have enhanced role clarity, enabling nurses to articulate their scope of practice and specialty competencies required to best meet the needs of patients and families. However, while the patient needs and fundamental practice elements have been identified to optimize the ACU nursing role, a gap still exists in quantifying the staffing resources required to operationalize the current model of care. To address this gap, a quality improvement project was initiated to develop an internally validated ACU Nursing Resource Intensity Weighting (RIW) tool for projecting baseline staffing requirements. The tool can be utilized to inform strategic and operational planning discussions focused on improving the outpatient model of care in oncology.

The Impact of Quality Management Practices on Manufacturing Performance: An Empirical Study Based on System Theory

As one important part of core competitiveness of manufacturing enterprises, quality management practices have gradually received more attention. In many existing researches, quality management practices are regarded as a whole or categorized into two or four types of practice elements for discussions. There are less researches on the relationships among specific quality management practice elements and their impacts on manufacturing performance. This study analyzes quality management practices with the philosophical thinking of system theory, and deconstructs the mechanism of the mutual influences and synergies among various quality management practice elements and also their impacts on manufacturing performance, from an overall perspective through an empirical research. At last, a model of quality management practice synergies is built, as a theoretical support for manufacturing enterprises implementation of quality management practices.

Improving pediatric pharmacy services in a primarily adult emergency department

Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The American Society of Health-System Pharmacists (ASHP) and Pediatric Pharmacy Advocacy Group (PPAG) guidelines for providing pediatric pharmacy services in hospitals and health systems can be used to improve medication safety wherever pediatric patients receive care, including in the emergency department (ED). The purpose of this initiative was to improve compliance with these guidelines in a primarily adult ED. Methods This quality improvement initiative was conducted in a level 1 trauma center ED between October 2019 and March 2020. The ASHP-PPAG guidelines were used to create practice elements applicable to the ED. An initial compliance assessment defined elements as noncompliant, partially compliant, fully compliant, or not applicable. Investigators identified interventions to improve compliance for noncompliant or partially compliant elements and then reassessed compliance following implementation. Data were expressed using descriptive statistics. This initiative was exempt from institutional review board approval. Results Ninety-three ED practice elements were identified within the 9 standards of the ASHP-PPAG guidelines. At the initial compliance assessment, the majority (59.8%) of practice elements were fully compliant; however, various service gaps were identified in 8 of the standards, and 16 interventions were implemented to improve compliance. At the final compliance assessment, there was a 19.5% increase in full compliance. Barriers to achieving full compliance included technology restrictions, time constraints, financial limitations, and influences external to pharmacy. Conclusion This quality improvement initiative demonstrated that the ASHP-PPAG guidelines can be used to improve ED pediatric pharmacy services in a primarily adult institution. The initiative may serve as an example for other hospitals to improve compliance with the guidelines.

Interaction value formation spaces: configurations of practice-theory elements in service ecosystems

Purpose Contemporary service and marketing research on value co-creation and value co-destruction assume a one-dimensional view on value, ranging from positive value co-creation, alignment and high value to negative value co-destruction, misalignment and low value. This limitation has recently led researchers to conceptually develop more dynamic spatial-temporal models of how value is formed during the interaction, e.g. in terms of different relationships between practice elements (procedures, understandings and engagements) both within and between actors in “value formation spaces”. However, much of this research awaits validation and is in need of more details. This study aims to address this limitation with the purpose of detailing how and why the mechanisms in such spaces are formed. Design/methodology/approach Two different and interlinked typologies were analytically derived from previous research and applied on ethnographically-inspired multi-perspective empirical data from a service combining health care and transport service ecosystems, using a combination of interviews, observations and service design methodologies. The design in combination with a practice theory perspective was used to articulate crucial aspects related to understanding the dynamics of value co-formation for elaborative and illustrative purposes. Findings The study contributes to service theory by conceptualizing as follows: a typology consisting of nine different configurations of practice elements (within and between such elements) and eight possible directions that value formation can take, suggesting a theory that explains value co-creation, value co-destruction and mixed cases. Research limitations/implications Although the findings have been developed in a specific empirical context, they articulate a conceptualization applicable to many other service and marketing value co-formation settings. Practical implications The typologies are conceptual tools to be used in identifying and measuring the alignment/misalignment of practice elements in complex organizations. The empirical findings uncover service problems faced by disabled customers. Originality/value The suggested typologies can guide research and practitioners in understanding and analysing value co-formation mechanisms in complex service settings.

Exploring the effectiveness of dextroamphetamine for the treatment of stimulant use disorder: a qualitative study with patients receiving injectable opioid agonist treatment

Background A high proportion of people receiving both oral and injectable opioid agonist treatment report concurrent use of stimulants (i.e. cocaine and or amphetamines), which has been associated with higher rates of continued illicit opioid use and treatment dropout. A recent randomized controlled trial demonstrated the effectiveness of dextroamphetamine (a prescribed stimulant) at reducing craving for and use of cocaine among patients receiving injectable opioid agonist treatment. Following this evidence, dextroamphetamine has been prescribed to patients with stimulant use disorder at a clinic in Vancouver. This study investigates perceptions of the effectiveness of dextroamphetamine from the perspective of these patients. Methods Data were collected using small focus groups and one-on-one interviews with patients who were currently or formerly receiving dextroamphetamine (n = 20). Thematic analysis was conducted using an iterative approach, moving between data collection and analysis to search for patterns in the data across transcripts. This process led to the defining and naming of three central themes responding to the research question. Results Participants reported a range of stimulant use types, including cocaine (n = 8), methamphetamine (n = 8), or both (n = 4). Three central themes were identified as relating to participants’ perceptions of the effectiveness of the medication: 1) achieving a substitution effect (i.e. extent to which dextroamphetamine provided a substitution for the effect they received from use of illicit stimulants); 2) Reaching a preferred dose (i.e. speed of titration and effect of the dose received); and 3) Ease of medication access (i.e. preference for take home doses (i.e. carries) vs. medication integrated into care at the clinic). Conclusion In the context of continued investigation of pharmacological treatments for stimulant use disorder, the present study has highlighted how the study of clinical outcomes could be extended to account for factors that contribute to perceptions of effectiveness from the perspective of patients. In practice, elements of treatment delivery (e.g. dosing and dispensation protocols) can be adjusted to allow for various scenarios (e.g. on site vs. take home dosing) by which dextroamphetamine and other pharmacological stimulants could be implemented to provide “effective” treatment for people with a wide range of treatment goals and needs.

‘Almost Everything in the House Now Is Plastic’: Foregrounding Plastic Materiality in Household Routines and Practices

The impact of materials in disrupting routines and practices has recently become significant in scholarship and policymaking. This has motivated alternative social theories such as practice theory to look beyond the traditional human behavioural approaches into how objects exert their materiality in achieving daily activities. While there is a substantial theoretical body of work on materiality in practice theory, this study focuses on plastic and asks how plastic facilitates the reproduction of practices in households. To foreground plastic materiality, this study makes use of the data collected in the case studies of low-income households in a suburb in Lagos, Nigeria through a mixed-methods approach, including interviews, household tours, and directed photography. The data analysis combines inductive and deductive approaches to facilitate an iterative process of identifying and refining themes related to the research aim. As a ubiquitous material, plastic facilitates the performance of household practices related to hygiene, comfortability, storage, food, and child-rearing, among others. By interacting with other practice elements, plastic actively materialises household routines through its corporality or physical features, functionality, and spatiotemporal quality. The implication of these dimensions in enabling or disrupting household routines is further discussed. The findings present important lessons for advancing the corporal and relational dimensions of materiality in social theory and implementing sustainability policies.

The development of a novel supplemental coding system for investigating the practice elements of attachment-based interventions

While research generally demonstrates the efficacy of attachment-based interventions for supporting families and children, less is known about the constituent elements of these interventions and their effects. Existing tools for extracting information about these elements from psychosocial intervention studies do not differentiate between techniques used in attachment-based interventions. Therefore, a novel extension of the PracticeWise coding system was developed for attachment-based interventions. This paper describes the development of this new extension. A systematic literature search of randomized controlled trials of attachment-based interventions (1998-2018) identified 66 publications. This led to N = 49 unique attachment-based interventions. Study authors were requested to share the intervention manuals for these trials. Publications or, if available, manuals were initially coded using the standard PracticeWise coding system. Techniques falling under the general definition of a practice element, but not captured by the standard system, formed the basis for a novel set of subcategories. To identify and develop definitions for this novel subset of practice elements, the publications and manuals were carefully examined and initial codes were developed inductively for each intervention, and then discussed to reach consensus. These codes were then applied across all interventions. Through an iterative process, 16 unique practice elements were identified and defined, and clustered into five thematic groupings: Modelling; Parent-Child Interaction (Behavior-focused); Mental Representations (Representation-focused); Education & Guidance; Other. As an illustration, the Attachment and Biobehavioral Catch-up intervention is described using the novel supplemental practice elements coding system.