BackgroundAdvancing the description and conceptualisation of interventions in complex systems is necessary to support spread, evaluation, attribution and reproducibility. Improvement teams can provide unique insight into how interventions are operationalised in practice. Capturing this ‘insider knowledge’ has the potential to enhance intervention descriptions.ObjectivesThis exploratory study investigated the spread of a comprehensive medication review (CMR) intervention to (1) describe the work required from the improvement team perspective, (2) identify what stays the same and what changes between the different sites and why, and (3) critically appraise the ‘hard core’ and ‘soft periphery’ (HC/SP) construct as a way of conceptualising interventions.DesignA prospective case study of a CMR initiative across five sites. Data collection included: observations, document analysis and semistructured interviews. A facilitated workshop triangulated findings and measured perceived effort invested in activities. A qualitative database was developed to conduct thematic analysis.ResultsSites identified 16 intervention components. All were considered essential due to their interdependency. The function of components remained the same, but adaptations were made between and within sites. Components were categorised under four ‘spheres of operation’: Accessibility of evidence base; Process of enactment; Dependent processes and Dependent sociocultural issues. Participants reported most effort was invested on ‘dependent sociocultural issues’. None of the existing HC/SP definitions fit well with the empirical data, with inconsistent classifications of components as HC or SP.ConclusionsThis study advances the conceptualisation of interventions by explicitly considering how evidence-based practices are operationalised in complex systems. We propose a new conceptualisation of ‘interventions-in-systems’ which describes intervention components in relation to their: proximity to the evidence base; component interdependence; component function; component adaptation and effort.
Abstract-This research aims at finding how suspects in police interrogations express their interpersonal stance -in terms of T.Leary's interpersonal circumplex-through body postures and facial expressions and how this can be simulated by virtual humans. Therefore, four types of stances were acted by eight actors. To see if the resulted postures are valid, short recordings were shown online in a survey to subjects who were asked to describe them by a selection of a number of adjectives. Results of this annotation task show that some stance types are better recognized than others. Validity (recognizing the intended stance) and inter-rater agreement do not always go hand in hand. The body postures and facial expressions of the best recognized fragments are annotated so they can be implemented in the artificial agent. The results of this study are used in a serious game for police interrogation training where the role of the suspect is played by an artificial embodied conversational agent.
This paper reports on judgement studies regarding the perception of interpersonal stances taken by humans playing the role of a suspect in a police interrogation setting. Our project aims at building believable embodied conversational characters to play the role of suspects in a serious game for learning interrogation strategies. The main question we ask is: do human judges agree on the way they perceive the various aspects of stance taking, such as friendliness and dominance? Four types of stances were acted by eight amateur actors. Short recordings were shown in an online survey to subjects who were asked to describe them using a selection of a number of adjectives. Results of this annotation task are reported in this paper. We explain how we computed the interrater agreement with Krippendorff's alpha statistics using a set theoretical distance metric. Results show that for some of the stance types observers agreed more than for others. Some actors are better than others, but validity (recognizing the intended stance) and inter-rater agreement do not always go hand in hand. We further investigate the effect the expertise of actors has on the perception of the stance that is acted. We compare the fragments from amateur actors to fragments from professional actors taken from popular TV-shows.
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