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Given experience in cluttered but stable visual environments, our eye‐movements form stereotyped routines that sample task‐relevant locations, while not mixing‐up routines between similar task‐settings. Both dopamine signaling and mindfulness have been posited as factors that influence the formation of such routines, yet quantification of their impact remains to be tested in healthy humans. Over two sessions, participants searched through grids of doors to find hidden targets, using a gaze‐contingent display. Within each session, door scenes appeared in either one of two colors, with each color signaling a differing set of likely target locations. We derived measures for how well target locations were learned (target‐accuracy), how routine were sets of eye‐movements (stereotypy), and the extent of interference between the two scenes (setting‐accuracy). Participants completed two sessions, where they were administered either levodopa (dopamine precursor) or placebo (vitamin C), under double‐blind counterbalanced conditions. Dopamine and trait mindfulness (assessed by questionnaire) interacted to influence both target‐accuracy and stereotypy. Increasing dopamine improved accuracy and reduced stereotypy for high mindfulness scorers, but induced the opposite pattern for low mindfulness scorers. Dopamine also disrupted setting‐accuracy invariant to mindfulness. Our findings show that mindfulness modulates the impact of dopamine on the target‐accuracy and stereotypy of eye‐movement routines, whereas increasing dopamine promotes interference between task‐settings, regardless of mindfulness. These findings provide a link between non‐human and human models regarding the influence of dopamine on the formation of task‐relevant eye‐movement routines and provide novel insights into behavior‐trait factors that modulate the use of experience when building adaptive repertoires. Using a double‐blind L‐Dopa intervention with healthy participants, we show that dopamine interacts with an individual's level of mindfulness to influence routine formation and cognitive control. These findings are the first empirical test of the theoretical suggestion that mindfulness and dopamine operate on the same underlying mechanisms that support task learning and habit formation. [ABSTRACT FROM AUTHOR]

Medical imaging diagnostic test accuracy research is strengthened by adhering to best practices for study design, data collection, data documentation, and study reporting. In this review, key elements of such research are discussed, and specific recommendations provided for optimizing diagnostic accuracy study execution to improve uniformity, minimize common sources of bias and avoid potential pitfalls. Examples are provided regarding study methodology and data collection practices based on insights gained by the liver imaging reporting and data system (LI‐RADS) individual participant data group, who have evaluated raw data from numerous MRI diagnostic accuracy studies for risk of bias and data integrity. The goal of this review is to outline strategies for investigators to improve research practices, and to help reviewers and readers better contextualize a study's findings while understanding its limitations. Level of Evidence: 5 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Temporal trajectories of health, illness and disability—from biographical change to micro‐embodied practices within social time—are important strands within medical sociology and disability studies. Drawing upon a UK‐based qualitative study using diaries and follow‐up interviews to explore everyday life with irritable bowel syndrome (IBS), this article explores routines when living with the condition. It focuses specifically on accounts of routines being anticipated, slowed down and stretched out to accommodate and/or care for bodies, with personal and social rhythms weaved in, out and with each other. Such reflections are told through participants' accounts of knowing routines and rhythms, stretching out and pacing morning routines to care for the body and how everyday practices are reimagined as the body and the social meet. Drawing upon the concept of 'Crip Time' where the social bends to meet with the body, this article seeks to illuminate important intersections between medical sociology and disability studies through accounts of living with IBS. This article demonstrates the entanglement of structural, disabling temporal rhythms and embodied temporalities, through an acknowledgement of routines reimagined. It offers a contribution to both medical sociology and disability studies in reimagining social lives with embodied temporalities in mind. [ABSTRACT FROM AUTHOR]

Aim: In‐hospital blood glucose testing is commonplace, particularly in acute care. In‐hospital screening for hyperglycaemia may present a valuable opportunity for early diabetes diagnosis by identifying at‐risk individuals. This systematic review investigates the extent to which random blood glucose testing in acute and inpatient hospital settings predicts undiagnosed diabetes. Methods: Two databases were systematically searched for studies in which adult patients received an in‐hospital random blood glucose test, followed by a diagnostic HbA1c test. The primary outcome was the proportion of hyperglycaemic individuals diagnosed with diabetes by HbA1c. Results: A total of 3245 unique citations were identified, and 12 were eligible for inclusion. Ten different blood glucose thresholds, ranging from 5.5 to 11.1 mmol/L, were used to detect hyperglycaemia, indicating that there is no consistent clinical definition for hyperglycaemia. The proportion of participants with hyperglycaemia in each study ranged from 3.3% to 62.1%, with a median (Q1, Q3) of 34.5% (5.95%, 61.1%). The proportion of hyperglycaemic participants found to have a diabetes‐range HbA1c varied from 4.1% to 90%, with a median (Q1, Q3) of 18.9% (11.5%, 61.1%). Meta‐analysis was not possible due to substantial heterogeneity between study protocols. Conclusions: All studies consistently identified a proportion of hyperglycaemic hospital patients as having a diabetes‐range HbA1c, showing that in‐hospital blood glucose screening can facilitate diabetes diagnosis. The proportion of hyperglycaemic participants with undiagnosed diabetes varied substantially, indicating a need for further research and consistency in defining in‐hospital hyperglycaemia. This may aid the development of a standardised screening protocol to identify people with possible undiagnosed diabetes. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the usefulness of a multiplex polymerase chain reaction (PCR) assay as a complementary tool in the diagnosis of prosthetic joint infections in the routine setting of a clinical microbiology laboratory, with a special focus on patients at high risk of culture‐negative infections and high suspicion of infection. Methods: The results obtained in the routine care setting with the use of the commercial multiplex PCR (Unyvero i60©, Curetis AG, Holzgerlingen, Germany) were retrospectively reviewed. The test was performed in samples of patients with suspected prosthetic joint infection, which were also processed for conventional diagnostic methods, including sonication of the implant when possible. Patients selected for the test were those with negative cultures after a 24‐h incubation period. Results: Ninety‐nine PCRs were performed, 57 of which were diagnostic of infection according to 2018 MSIS criteria. Nine patients received antibiotics within the 15 days prior to the diagnostic procedure. Tested samples included synovial fluid (33), sonication fluid (56) and tissue biopsies (10). The PCR test detected microorganisms in 26 samples: including two cases of polymicrobial infection. Eleven patients were diagnosed by using PCR only. The most frequently detected microorganism in PCR was Coagulase‐Negative Staphylococcus in 11 samples, followed by Staphylococcus aureus in five. One sample was positive for the bacteria universal primer, included in the 2.0 version of the kit. Only one discrepancy was detected between a negative PCR and a positive culture. One sample was also positive for a resistance marker (detection of mecA gene in a case of methicillin‐resistant S. aureus infection). Conclusion: The incorporation of the Unyvero ITI multiple PCR technique in patients selected by clinical experts is a useful tool for the diagnosis of bone and joint infections in a routine care setting. A close clinical‐microbiological collaboration improves the usefulness of this kit for the management of patients with these infections. [ABSTRACT FROM AUTHOR]

Several congenital heart diseases (CHD) are present in children with congenital anomalies of the kidney and the urinary tract (CAKUT) in syndromic or nonsyndromic patterns. The purpose of this study was to identify nonsyndromic children with CAKUT who required echocardiographic evaluation and to find the prevalence of CHD in these patients. Retrospective chart review of nonsyndromic patients with CAKUT between 2012 and 2018 was conducted. Types of congenital anomalies of the kidney and urinary tract and echocardiogram reports of the patients, age, gender, prematurity, prenatal diagnosis of CAKUT, and family history were noted. Among 806 children with CAKUT, 135 patients underwent transthoracic echocardiographic evaluation and CHD was detected in 91 (11.2%). The most common type of CHD was secundum type atrial septal defect that was found in 73 (80.2%) patients. On the other hand, the most frequent types of congenital anomalies of the kidney and the urinary tract were isolated hydronephrosis and primary vesicoureteral reflux (61.4% and 12.8%, respectively). Our results showed that 75.8% of the patients with congenital heart diseases had isolated hydronephrosis. Finally, only 18 (2.2%) cases out of 806 patients that were evaluated via transthoracic echocardiography due to the clinical findings and family history had a CHD that required close (<6 months) follow‐up. Congenital heart diseases that required close follow‐up are rarely observed in nonsyndromic patients with CAKUT. Therefore, we suggest echocardiography should be performed in cases of clinical suspicion and family history rather than routinely in this patient group. [ABSTRACT FROM AUTHOR]

The reduced physical activity of women when they become mothers is a public health priority. Existing studies show that mothers have little time for leisure, or time that is fragmented and requiring negotiation with others. However, the temporal features of mothering are undertheorised and qualitative studies tend to focus on how mothers can skilfully construct physically active identities and balance societal expectations about being a "good mother". In line with other research that focuses on the configuration of everyday practices that condition the "possibilities" for health‐related practices like physical activity, we shift our focus away from the resisting capacities of mothers to the temporal features of mothering practices. We interrogate the lived experiences of 15 mothers of preschool children in deprived urban areas and illuminate the inherent temporal dimensions, demands and dispositions of mothering practices that condition the possibility of leisure time physical activity being undertaken. Together, these temporal features mean mothering practices can readily work against leisure time physical activity. The focus on the mothering practices rather than mothers brings a novel perspective for developing public health policy designed to support mothers into regular leisure time physical activity. [ABSTRACT FROM AUTHOR]

This paper uses subject positioning theory to explore how conflicts between autonomy and protection are managed in the justification of controversial care arrangements for patients with mental/neurological illness. Its basic argument is twofold: firstly, to justify or propose care arrangements at strategic or contentious moments, actors position illness as an actant and make it present in talk‐in‐interaction, exploiting alignments and misalignments between the there and then of reported events and the above and beyond of shared societal discourses to say what matters and what's to be done here and now; secondly, the introduction of authoritative voices from elsewhere involves imbricating narrative and routine sequences in order to prioritise different subjectivities. Dilemmas opposing autonomy and protection may seem less intractable if we adopt a corresponding perspective interplay between narrative and routine situational readings. [ABSTRACT FROM AUTHOR]

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Objective: To determine whether restrictive or routine episiotomy in term pregnant Southeast Asian women results in fewer complications.Design: A multicentre randomised controlled trial.Setting: Two tertiary and two general hospitals in Thailand.Population: 3006 singleton pregnant women 18 years or older, ≥37 weeks of gestation, cephalic presentation and planned vaginal delivery.Methods: This randomised controlled trial compared routine versus restrictive episiotomies in Thai women giving birth vaginally. Participants were singleton, term pregnant women with cephalic presentation. Block randomisation was stratified by study site and parity. Risk ratios (RR) and 95% confidence intervals (CI) were calculated to indicate between-group differences.Main Outcome Measures: Primary outcome was severe perineal laceration. Secondary outcomes included vaginal laceration, cervical laceration, and pregnancy outcomes.Results: 3006 women were randomly assigned to restrictive (1502) and routine (1504) episiotomy. There was no difference in severe perineal laceration between the groups (RR 0.72, 95% CI 0.46-1.12). Restrictive episiotomy resulted in more intact perineums in multiparous women (RR 3.09, 95% CI 2.10-4.56). Restrictive episiotomy increased the risk of vaginal laceration in primiparous (RR 1.96, 95% CI 1.62-2.37) and multiparous women (RR 2.21, 95% CI 1.77-2.75) but did not lead to more suturing. There were comparable risks of cervical laceration, postpartum haemorrhage, wound complication, birth asphyxia, and admission to neonatal intensive care unit.Conclusions: Restrictive episiotomy results in more intact perineum in multiparous women. Risks of maternal and neonatal outcomes were comparable between the two practices. These results strengthen the certainty of the existing Cochrane review findings in supporting restrictive episiotomy.Tweetable Abstract: Restrictive episiotomy results in more intact perineums after vaginal birth in multiparous Southeast Asian women. [ABSTRACT FROM AUTHOR]

Background: Oral disease is one of the most prevalent chronic health conditions affecting children. Twice‐daily toothbrushing is recommended to promote good oral health; however, a large proportion of Australian families are not meeting this recommendation. Aim: This study aimed to identify important barriers to regular toothbrushing for young children. Design: In this study, 239 parents of 0‐ to 4‐year‐old children completed an online survey that investigated child, family, and parent factors associated with child toothbrushing. Hierarchical linear regression was used to identify predictors of toothbrushing frequency in children and perceived difficulty of the task by parents. Results: We found that parent factors, specifically oral health knowledge, were the most significant predictors of toothbrushing frequency. Conversely, parent factors did not contribute significantly to the prediction of perceived difficulty of toothbrushing once family and child factors were taken into account. Oral health knowledge and use of routines were identified as the most important predictors of toothbrushing frequency, whereas resistant child behaviour and household organisation were found to be the most important predictors of perceived difficulty of regular toothbrushing. Conclusions: The findings of the study have implications for behavioural interventions to support parents, as well as directions for future research. [ABSTRACT FROM AUTHOR]

Introduction: Conventional cytogenetics (CC) is important in diagnosis, therapy, monitoring of post‐transplant bone marrow, and prognosis assessment of acute lymphoblastic leukemia (ALL). However, due to the nature of ALL, CC often encounters difficulties of complex karyotype, poor chromosome morphology, low mitotic index, or normal cells dividing only. In contrast, chromosomal microarray analysis (CMA) showed a specificity >99% and a sensitivity of 100% in chronic lymphocytic leukemia (CLL) patients. Here, we report our experience with CMA on adult ALL patients. Methods: Thirty‐three bone marrow/blood samples from ALL patients (aged 18‐79 years, median 44) at diagnosis/relapse, analyzed by CC and/or fluorescence in situ hybridization (FISH), were recruited. Chromosomal microarray analysis results were compared with CC. Fluorescence in situ hybridization analysis, if available, was applied when there was a discrepancy. Results: Copy‐neutral loss‐of‐heterozygosity (CN‐LOH) was found in 8 cases (24.2%). Only CN‐LOH at 9p was recurrent (3 cases, 9.1%). Copy number alterations (CNAs) were detected in 6 of 9 cases (66.7%) with normal karyotypes, in 3 of 5 cases (60.0%) with sole "balanced" translocations, and in 18 of 19 cases (94.7%) with complex karyotypes. Common CNAs involved CDKN2A/2B (30.3%), IKZF1 (27.3%), PAX5 (9.1%), RB1 (9.1%), BTG1 (6.7%), and ETV6 (6.7%), which regulate cell cycle, B lymphopoiesis, or act as tumor suppressors in ALL. Copy number alteration detection rate by CMA was 81.8% (27 of 33 cases) as compared to 57.6% (19 of 33 cases) by CC. Conclusion: Incorporation of CMA as a routine clinical test at the time of diagnosis/relapse, in conjunction with CC and/or FISH, is highly recommended. [ABSTRACT FROM AUTHOR]

Tumour genetics is currently turning into a massive clinical approach. This paper is an enquiry into its practices as they expand beyond expert and experimental contexts and become routinised in clinical hospital settings. Studying a French university hospital, we unpack the content and everyday organization of diagnostic labour in this context. Exploring the sociotechnical frictions that arise in the process, we describe the ways in which they are collectively controlled, and stabilized through organizational fictions, that are instrumental in making tumour genetics doable in the hospital, at a large scale. We further show that the new role of external regulations in the production of clinical values for mutations has a strong impact on diagnostic work, making it possible to be performed locally without resorting to expert bioclinical collectives, and outside the professional jurisdiction of clinical geneticists. This division of labour appears as a necessary condition for the rise in clinical productivity required by a new function assigned to genetics: to guide the prescription of drugs for common diseases. This turn in the way genetics is embedded in the clinic calls for a thorough reassessment of its impacts on clinical discourses, practices and decisions. [ABSTRACT FROM AUTHOR]

Abstract: Certain experiments have shown that reasoning may weaken the stability of people's preferences, especially with regard to well‐learned perceptual judgment and decision‐making tasks, while learning has an opposite, consistency‐enhancing effect on preferences. We examined the effects of these factors in a visual multi‐attribute decision‐making task where reasoning, in contrast, has been found to benefit judgments by making them more stable. The initial assumption in this study was that this benefit would be typical for novel tasks, like the one employed here, and that it would decrease when the task is thoroughly learned. This assumption was examined in three experiments by contrasting it with an alternative assumption that this previously obtained beneficial effect is caused solely by learning, not by reasoning. It was found that learning indeed makes preferences more stable by consolidating the weights of the attributes. Reasoning, however, does not benefit this task when it is completely novel but facilitates learning and stability of the preferences long run, therefore increasing the consistency of the participants in the macrolevel. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives: To produce a summary of the published evidence of the barriers and facilitators for hospital‐based routine HIV testing in high‐income countries. Methods: Electronic databases were searched for studies, which described the offer of HIV testing to adults attending emergency departments (EDs) and acute medical units (AMUs) in the UK and US, published between 2006 and 2015. Other high‐income countries were not included, as their guidelines do not recommend routine testing for HIV. The main outcomes of interest were HIV testing uptake, HIV testing coverage, factors facilitating HIV screening and barriers to HIV testing. Fourteen studies met the pre‐defined inclusion criteria and critically appraised using mixed methods appraisal tool (MMAT). Results: HIV testing coverage ranged from 9.7% to 38.3% and 18.7% to 26% while uptake levels were high (70.1–84% and 53–75.4%) in the UK and US, respectively. Operational barriers such as lack of time, the need for training and concerns about giving results and follow‐up of HIV positive results, were reported. Patient‐specific factors including female sex, old age and low risk perception correlated with refusal of HIV testing. Factors that facilitated the offer of HIV testing were venous sampling (vs. point‐of‐care tests), commitment of medical staff to HIV testing policy and support from local HIV specialist providers. Conclusions: There are several barriers to routine HIV testing in EDs and AMUs. Many of these stem from staff fears about offering HIV testing due to the perceived lack of knowledge about HIV. Our systematic review highlights areas which can be targeted to increase coverage of routine HIV testing. [ABSTRACT FROM AUTHOR]

Temporomandibular disorders ( TMD) are common but seem to be largely undetected within general dental care. To improve dentists' awareness of these symptoms, three screening questions (3Q/ TMD) have been introduced. Our aim was to validate 3Q/ TMD in relation to the diagnostic criteria for TMD ( DC/ TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20-69 years old, who had their routine dental check-up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/ TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q-positives (at least one affirmative) were invited for examination in randomised order. For each 3Q-positive, a matched 3Q-negative was invited. In total, 152 3Q-positives and 148 3Q-negatives participated. At examination, participants answered 3Q/ TMD a second time, before they were examined and diagnosed according to DC/ TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale-20 ( JFLS-20) were used. In total, 74% of 3Q-positives and 16% of 3Q-negatives met the criteria for DC/ TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty-five per cent of 3Q-positives had a TMD diagnosis and CPI score ≥3 or a JFLS-20 score ≥5, compared to 4% of 3Q-negatives. The results show that the 3Q/ TMD is an applicable, cost-effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management. [ABSTRACT FROM AUTHOR]

Background Pharmacy fill data are a practical tool for assessing medication nonadherence. However, previous studies have not compared the accuracy of pharmacy fill data to measurement of plasma drug levels, or chemical adherence testing (CAT). Methods and Results We performed a cross-sectional study in patients with uncontrolled hypertension in outpatient clinics in a safety net health system. Plasma samples were obtained for measurement of common cardiovascular drugs, including calcium channel blockers, thiazide diuretics, beta blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and statins, using liquid chromatography mass spectrometry. Proportion of days covered (PDC), a method for tracking pharmacy fill data, was calculated via linkages with Surescripts, and its diagnostic test characteristics were compared with CAT. Among 77 patients with uncontrolled hypertension, 13 (17%) were nonadherent to at least 1 antihypertensive drug and 23 (37%) were nonadherent to statins by CAT. PDC was significantly lower in the nonadherent versus the adherent group by CAT only among patients prescribed an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or statin (all P <0.05) but not in patients prescribed other drug classes. The sensitivity and specificity of PDC in detecting nonadherence to angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and statin drugs by CAT were 75% to 82% and 56% to 79%, respectively. The positive predictive value of PDC in detecting nonadherence was only 11% to 27% for antihypertensive drugs and 45% for statins. Conclusions PDC is useful in detecting nonadherence to angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and statins but has limited usefulness in detecting nonadherence to calcium channel blockers, beta blockers, or thiazide diuretics and has a low positive predictive value for all drug classes.

Inconspicuous consumption, the habitual use of resources in daily routines, poses a challenge to sustainable consumption. For example, laundry is often the most environmentally demanding stage of clothing's life cycle, consuming significant quantities of water, energy and chemicals. Laundry thus provides a prime example of inconspicuous consumption, from which to consider sustainability transitions. However, because of the mundane nature of washing clothes, it is sometimes over looked in sustainable fashion literature. This paper presents the results of surveying 263 Australians about their jeans, laundry habits and resource consumption, to build a picture of the expectations and actions surrounding the performance of cleanliness in everyday life. These surveys are triangulated against in-depth interviews with people who had not washed their jeans for three months revealing qualitative insights into influences of laundry practice. This paper documents how and why people perform laundry. An interesting finding is that people can not wash and still be socially acceptable, suggesting that cleanliness is a cultural construct, the pursuit of which increases the use of water, energy and chemicals, in conflict with sustainable consumption goals. [ABSTRACT FROM AUTHOR]

Given the large number of food choices that consumers make each day it seems likely that they will adopt decision strategies that minimize cognitive effort. To examine this issue, we develop a conceptual and empirical model of habitual choice, and the factors that result in transitions to two strategies other than habitual selection: utility-maximizing choice and a variety-seeking strategy. Our approach provides an alternative to traditional state dependence methods used in this type of panel data. We apply this framework to the choice of two food products that illustrate the heterogeneity across types of products in decision strategies and routine choice patterns. [ABSTRACT FROM AUTHOR]

In recent debates on sustainable consumption, consumer's responsibility for the outcome of consumption has been outlined. Even though (co-)responsibilities have to be acknowledged, a general notion of responsibility is not unproblematic. Consequently, this article challenges conceptions of the responsible and thoughtful consumer. In providing a perspective on theorizing domestic consumption as social practice, the analysis of diary data encompassing a period of 20 years elucidates on the contours of routinized practices. The empirical material consists of diaries kept by a housewife during the years 1970-1990 in a mid-sized German town. In analysing the data, distinct features such as seasonality and constancy of routines in domestic practices become apparent. In this study, it is possible to stress the longevity of the repetitive and routine character of domestic practices and provide a perspective on often unrecognized and unaware aspects in routines. Assuming that routine consumption processes are taking place as moments in domestic practices, the data analysed here illustrate interesting directions for more sustainable consumption and further developments in home economics and consumer studies. [ABSTRACT FROM AUTHOR]

This study evaluates the effectiveness of the Municipal Emergency Consultation project in eight Israeli local authorities. The initiative centres on the appointment of independent emergency preparedness consultants entrusted with tailoring an emergency preparedness package to suit the specific needs of each locality. Regarding emergency preparedness improvements, in all of the municipalities examined, a concept of municipal emergency operation was consolidated and the derived emergency plan tested. Emergency work processes were structured and service-level agreements reached between municipality departments. Where necessary, a-linear patterns of municipal functioning in an emergency were established. Concerning a ‘spillover’ of emergency preparedness improvements into routine operations, and a ‘spillover’ of routine management improvements into local emergency preparedness, two municipalities near Gaza, which typically function in an emergency routine, saw a significant ‘spillover’ of emergency preparedness into routine functioning. In other localities, local managers chose to improve a number of municipal structures and procedures in times of routine functioning, which are also related to the functioning of the municipality during an emergency. [ABSTRACT FROM AUTHOR]

Title. Development and psychometric testing of the Scale of Older Adults’ Routine. Aim. This paper is a report of a study to develop, test the reliability, convergent and criterion-related validity of the Scale of Older Adults’ Routine, using measures of routinization and functional status. Background. The concept of routine needs a reliable and valid measure in order to allow for further expansion of research in this field. Methods. An instrument development procedure, followed by two studies, was conducted in 2004–2005. The validation study utilized a prospective, within-subject design. Testing took place in samples of independently dwelling residents in four retirement communities in an urban area in the Pacific Northwest of the United States of America (USA). A total of 90 participants took part in the studies. A pilot study ( n = 10) allowed for feasibility testing, and a prospective three-time point longitudinal study ( n = 80) assessed the instrument’s reliability and preliminary validity. Results. The 42-item scale describes various aspects of older adults’ routines and assesses routine stability across time. The scale has five dimensions (Basic, Instrumental, Social, Leisure and Rest Activities) and five scoring systems. The scale’s content validity and feasibility were high. Reliability indices were acceptable, ranging from 0·56 to 0·90 for the subscales. Validity tests showed moderate correlations with both functional indices ( r = 0·29–0·56; P < 0·01) and trait routinization ( r = 0·30–0·38; P < 0·01). Conclusions. Scale of Older Adults’ Routine demonstrated acceptable psychometric properties for most of its subscales and scores. Although further research is needed, it can be applied in both research and practice for evaluating routine among older adults and its associations with various outcome measures. [ABSTRACT FROM AUTHOR]

Objectives: The Centers for Disease Control and Prevention (CDC) recommends routine human immunodeficiency virus (HIV) screening of emergency department (ED) patients aged 13 to 64 years. The study objectives were to determine the accessibility of rapid HIV testing in academic EDs, to identify factors that influence an ED’s adoption of testing, and to describe current HIV testing practices. Methods: Online surveys were sent to EDs affiliated with emergency medicine (EM) residency programs ( n = 128), excluding federal hospitals and facilities in U.S. territories. Eighty percent ( n = 102) responded. Most e-mail recipients ( n = 121) were Emergency Medicine Network (EMNet) investigators; remaining contacts were obtained from residency-related Web sites. Results: Most academic EDs ( n = 58; 57%; 95% confidence interval (CI) = 47% to 66%) offer rapid HIV testing. Among this group, 26 (45%) allow providers to order tests without restrictions. Of the other 32 EDs, 100% have policies allowing for rapid HIV testing following occupational exposures, but less than 10% have guidelines for testing in other clinical situations. Forty-seven percent expect to routinely offer HIV testing in the next 2 to 3 years. Only 59% of the EDs that offered rapid tests in any situation could link an HIV-positive patient to subspecialty care. The facility characteristic most important to availability of rapid HIV testing was the presence of on-site HIV counselors. Conclusions: Most academic EDs now offer rapid HIV testing (57%), but few use it in situations other than occupational exposure. Less than half of academic EDs expect to implement CDC guidelines regarding routine screening within the next few years. The authors identified facility characteristics (e.g., counseling, ability to refer) that may influence adoption of rapid HIV testing. [ABSTRACT FROM AUTHOR]

In this article, we seek to apply the insights of recent research on routine to the context of repeated negotiations. To demonstrate the link between both concepts, we introduce an analytical framework in which we identify different negotiation situations in which routine can develop. We distinguish two dimensions of the negotiation process: a problem-solving dimension and a communication dimension. Our framework for analyzing the role of routine in negotiation is built around these two dimensions. We define those skills that we argue in repeated negotiations can help negotiators manage particular kinds of negotiations depending on the level and type of routinization that type of negotiation involves. Moreover, we demonstrate that our framework is inherently dynamic, which we illustrate with simplified business examples. [ABSTRACT FROM AUTHOR]

Purpose:To report on the usefulness of adding video recording to routine EEG studies of infants and children with frequent paroxysmal events.Methods:We analyzed the efficacy of this diagnostic means during a 4-year period. The decision whether to add video recording was made by the pediatric EEG interpreter at the time of the study. Studies were planned to last between 20 and 30 min, and, if needed, were extended by the EEG interpreter. For most studies, video recording was added from the beginning of EEG recording. In a minority of cases, the addition of video was implemented during the first part of the EEG test, as clinical events became obvious. In these cases, a new study (file) was begun. The success rate was analyzed according to the indications for the EEG study: paroxysmal eye movements, tremor, suspected seizures, myoclonus, staring episodes, suspected stereotypias and tics, absence epilepsy follow-up, cyanotic episodes, and suspected psychogenic nonepileptic events.Results:Video recording was added to 137 of 666 routine studies. Mean patient age was 4.8 years. The nature of the event was determined in 61 (45%) of the EEG studies. Twenty-eight percent were hospitalized patients. The average study duration was 26 min. This diagnostic means was particularly useful for paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and psychogenic nonepileptic events. About 46% of 116 patients for whom cognitive data were available were mentally retarded. EEG with added video recording was successfully performed in all 116 cases and provided useful information in 29 (55%) of these 53 patients.Conclusions:Adding video recording to routine EEG was helpful in 45% of cases referred for frequent paroxysmal events. This technique proved useful for hospitalized children as well as for outpatients. Moreover, it was successfully applied in cognitively impaired patients. Infants and children with paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and pseudoseizures especially benefited from this diagnostic means. Because of its low cost and the little discomfort imposed on the patient and his or her family, this technique should be considered as a first diagnostic step in children with frequent paroxysmal events. [ABSTRACT FROM AUTHOR]

Insomniacs report daytime functioning problems, but studies of neurobehavioral functioning in insomniacs have shown little objective evidence of impairment. In addition, very little is known about the influence of the circadian clock on performance in chronic insomniacs. In the present study, we investigated whether chronic insomnia is associated with an overall performance deficit, and what the effect is of circadian rhythmicity, under strictly controlled laboratory conditions. A 24-h experiment was carried out under constant routine conditions. Psychomotor performance, body temperature, and subjective functioning of 11 insomniacs and 13 healthy subjects were assessed. The insomniacs showed significant overall performance impairments in vigilance, working memory, and motor control. In addition, body temperature, performance and subjective functioning showed a circadian pattern similar to healthy subjects, with trough values in the late night/early morning and peak values in the early evening. Self-reported functioning among the insomniacs indicated mood disturbances, concentration problems, elevated fatigue and elevated sleepiness. The results indicated that chronic insomnia is associated with a substantial lowering of the 24-h level of performance and subjective functioning, irrespective of the type of task and/or the particular parameter, and without differential effects of circadian rhythmicity. Apparently, chronic insomnia has a negative impact upon performance as measured under strictly controlled, unmasked conditions. [ABSTRACT FROM AUTHOR]

Fornari D, Steven K, Hansen AB, Vibits H, Jepsen JV, Poulsen AL, Schwartz M, Horn T. Microsatellite analysis of urine sediment versus urine cytology for diagnosing transitional cell tumors of the urinary bladder. APMIS 2004;112:148–52. The aim was to evaluate microsatellite analysis of urine sediment (MAUS) as an alternative method to urine cytology for routine diagnosis of patients with transitional cell tumors (TCT) of the urinary bladder. Urine cytology has the advantage of being non-invasive, fast and cheap, but is of limited value because of its low sensitivity. MAUS has previously been found to be a successful alternative method. However, the experimental set-up of such investigations implied exclusion of samples with unfavorable characteristics and use of a large number of markers. In the present study, MAUS was tested on all samples routinely available and a small panel of markers was selected. The urine sediments of 66 TCT patients and 24 controls were analyzed by MAUS with 16 fluorescent markers and by urine cytology. All samples were analyzed, including the ones of later micturition, with gross hematuria, leukocyturia or absence of visible sediment. In patients with tumors of low grade (grades I–II), MAUS was significantly more sensitive than urine cytology. The two methods were of equivalent diagnostic power in high-grade (grades III–IV), high-stage (pT1-pT4) tumors. A panel of the six most informative markers for MAUS was selected. Although MAUS has an advantage over routine cytology in low-grade, low-stage tumors, an overall sensitivity of 45% is not sufficient for routine clinical use. [ABSTRACT FROM AUTHOR]

Objective.—To identify the relationship between headache severity, child coping, and quality of life (QoL) in the context of everyday family life. Background.—In the pediatric headache research only 3 studies have examined children's coping strategies and only 4 studies considered QoL. Methods.—A sample of 48 Italian families with children seeking treatment for primary headaches was interviewed using an adaptation of the Ecocultural Family Interview (EFI). The EFI is a parent interview that explores the daily routines of family life in which the child and parent participate and the main concerns regarding how that routine is organized. Results.—As expected the Lisrel analyses consistently showed that QoL is affected by a child's coping abilities in a causal direction. Headache frequency and duration have a significant impact on a child's QoL. The family daily routine influences significantly both the child's coping ability and QoL. Surprisingly enough, children's coping strategies are not related to headache severity. Conclusions.—More research is needed on the causal factors influencing child's ability to cope with pain, and in particular more attention should be devoted to the contextual and family factors related to pediatric headache. [ABSTRACT FROM AUTHOR]

Abstract The main ideas explored here include conceptualizing the patient, the idea of the unique patient and the use of theory, individual uniqueness and stereotype, and uniqueness embedded within routine. These ideas give direction to this paper and serve to raise ethical and epistemological questions about clinical nursing and nursing education. [ABSTRACT FROM AUTHOR]

Objectives UK guidelines recommend routine HIV testing for all medical admissions where the local prevalence exceeds 2 per 1000. We aimed to review uptake of HIV testing in the emergency department ( ED) of one of the country's major trauma centres in a 3-month pilot study ( March− June 2013). Methods ED attendees already having blood tests were routinely tested for HIV (based on the recommendation being made to all to test when having blood taken). Uptake was determined using the surrogate marker of ED attendees who had full blood counts ( FBCs) as the denominator. Newly diagnosed patients were linked to care and contacts tested. Staff completed an anonymous online survey to determine acceptability at the end of the pilot study. Results A total of 2828 patients were tested over 3 months. Nineteen HIV-positive individuals were identified. Eight were newly diagnosed, of whom two were thought to be seroconverting. The prevalence of new diagnoses was 8/2828 (0.28%); for comparison, the Public Health England ( PHE) actual prevalence for Tower Hamlets is 6.25/1000 (0.625%). Uptake for HIV testing was 30%, a significant increase from 72 tests performed in the 2 months prior ( P < 0.001). Ninety-five per cent of respondents to the staff survey agreed that routine HIV testing should be rolled out permanently in the ED. Conclusions Despite an average uptake rate, there were 19 positive tests: eight in patients who were newly diagnosed, six in patients who had been lost to follow-up, and five in patients who were known to be positive and linked to care. The staff survey indicated recognition of the importance of HIV testing in the ED. These persuasive data achieved short-term Clinical Commissioning Group ( CCG) funding for routine ED testing. [ABSTRACT FROM AUTHOR]

Arguments 'for' and 'against' ureteric stenting after ureteropyeloscopy are discussed. An individualised approach balancing renal function preservation, irritative lower urinary tract symptoms and emergent return to theatre needs to be adopted while being mindful of healthcare spending. [ABSTRACT FROM AUTHOR]