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The concept of Service Model Fidelity is considered as a parallel process to Treatment Fidelity in evidence-based psychological therapies. NHS Talking Therapies (formerly IAPT) aimed to increase access to an expanded, upskilled workforce on a national scale. This included systematic training, supervision and front-line service delivery, emphasising treatment fidelity to evidence-based interventions. A further feature of NHS Talking Therapies was modernising and restructuring of the health system that housed these trained practitioners. The term ‘service model fidelity’ (Cromarty, 2016) was coined to emphasise service modernisation aspects as a distinct entity. A definition of the latter is included. Examples of service model fidelity and of service model drift, are outlined to distinguish these from therapist drift. This links to past literature recommending changes in traditional mental health service design and emergent evidence from NHS Talking Therapies. The latter examines publicly available data identifying characteristics of service design, which appear to be predictors of enhanced clinical outcome. Challenges in modernising health systems are discussed and conclusions are made highlighting the crucial role of service model when delivering evidence-based therapies. Suggestions for further research into service configuration to improve experiences of service users are considered. This includes ongoing exploration of service design being more than a qualitative feature, and increasingly appearing as a key factor in enhanced clinical outcome.
Key learning aims
(1) To identify service model fidelity as separate entity to treatment fidelity.
(2) To provide a clear definition of service model fidelity.
(3) To delineate therapist drift from service drift.
(4) To further examine the role of service model in delivering evidence-based interventions.
In this article, I argue, adverting to critical practices, that film adaptations are comparable with the comics that serve as their sources. The possibility of comparison presumes the existence of covering values according to which these comparisons are made. I raise four groupings of covering values for comics—narrative, pictorial, historical, and referential—and show how they apply to film adaptations as well, and argue that a fifth kind of value, fidelity, is relevant to comparisons of source comics to film adaptations. I close with a discussion of different types of fidelity that might be brought to bear in evaluation.
Edited by
Jeremy Koster, Max Planck Institute for Evolutionary Anthropology, Leipzig,Brooke Scelza, University of California, Los Angeles,Mary K. Shenk, Pennsylvania State University
Sexual selection theory has undergone both a theoretical and an empirical revolution over the last few decades. New understandings of female choice, partnership dynamics and the impact of sociodemographic factors on mating strategies have led to a flourishing of studies within human behavioral ecology and related evolutionary social sciences. Drawing from this literature, this chapter outlines how mating markets operate and the particular traits that are thought to be most important in human mate choice. Following this overview, the chapter examines how temporal and contextual facets of human partnerships affect mating decisions. Finally, the chapter shifts the focus to debates about the dual roles of fidelity and paternity and how these affect mating strategies. Throughout, the chapter focuses on data from non-WEIRD societies in order to highlight aspects of mating where universals are evident and where cross-cultural variation is important. In addition, the chapter highlights how studies of human mating by human behavioral ecologists offer a distinct and valuable perspective which cannot be found in other subfields of the evolutionary social sciences.
This chapter works through Romans 10 and Galatians 3:10–14 in conversation with other early Jewish evidence, arguing that Paul is participating in a long-standing Jewish debate about the relationship between repentance and Israel’s redemption. Specifically, will Israel’s repentance initiate the restoration or will God’s redemptive intervention produce Israel’s repentance? Paul comes down squarely on the latter side, arguing for a divinely-initiated redemption through the obedient fidelity of Jesus, whose status and authority as “the just one”—the figure divinely appointed to bring about redemption—was validated by the resurrection. In the process, this chapter provides an elegant solution for the longstanding problem of how to understand Paul’s citations of Lev 18:5 and Deut 30:12–14 in these passages.
Literary adaptions in comics are not a recent phenomenon, but until recently the cultural status of this kind of work has always been very low, and a certain distrust has dominated the debates for many decades, the main reason of this suspicion being the fear that “fidelity” to the adapted model might jeopardize the proper creative possibilities of the adapting medium. More and more recent examples from the graphic novel field, which aims at becoming a literary practice itself, do not only show that literary adaptations can be very valuable, they also demonstrate that it is possible to use the notion of fidelity itself in highly creative ways. Taking its departure from specific case studies, Olivier Deprez’s adaptation of Kafka’s The Castle (2003), Paul Karasik (script) and David Mazzuchelli’s adaptation of Paul Auster’s City of Glass (2005), Simon Grennan’s adaptation of Anthony Trollope’s John Caldigate (2015), and Sébastien Conard’s adaptation of Samuel Beckett’s Watt (2019), this chapter examines the most important techniques that can be used to transfer a novel into a visual narrative in print. It pays particular attention to the visuality of the text as it is transferred from one medium to another (typography, page layout, text as drawing).
Mixed Reality (MR) technologies are widely available and applied in a variety of design and engineering applications. MR prototypes capture the respective benefits of physical and digital prototypes by merging these domains saving the time and resources required to create them. This advantage is compelling in the context of design education where tight time and resource constraints exist. However, it is known that new digital prototyping tools can cause problems for students applying appropriate prototyping tools during practice-based studio design projects. Our paper contributes a systematic appraisal of MR prototyping's proposed dimensions value against constraints and issues in design studio education. This highlights MR Visualisation and Knowledge Management dimensions as most readily realised in education. Recommendations are then reflected on via an illustrative case study into the implementation of MR prototyping via these dimensions. Reflections corroborate the value proposition, but also highlight a need for further research exploring activities to scaffold MR prototyping to further support reflective design thinking.
Augmented reality offers the opportunity to increase the fidelity of training. This chapter describes three principles related to fidelity that augmented reality can effectively support in ways that are difficult for other training modalities. The first, the Sensory Fidelity Principle, describes how realistic cues are needed for perceptual skill development. Training designers often need to make decisions about which cues require high levels of fidelity; domain familiarization activities can help guide these decisions. According to the Scaling Fidelity Principle, virtual props should be represented close to their real-world size. This allows trainees to practice important physical skills, such as body positioning. The Assessment-Action Pairing Principle describes how being able to seamlessly assess a situation and act yields better transfer of training to on-the-job performance than part-task training approaches that separate assessment from acting.
This chapter provides a theoretical basis for examining the tension between scientific and lay rationality that continues to undermine attempts to address such vital healthcare issues as vaccine hesitancy or lack of compliance with regulations and test regimes during a pandemic. It outlines the main tenets of the narrative paradigm, acknowledges critical scholarship relating to its applicability in some cases and settings, and demonstrates its usefulness through a variety of examples from different cases of medical controversy relating to recent epidemics such as SARS and HIV. The chapters that follow do not only explain different antagonisms surrounding Covid-19 from the perspective of the narrative paradigm as elaborated by Walter Fisher, but also extend the framework and nuance it in the course of analysis, especially with reference to its application to medical narratives and its potential for offering a point of orientation for medical practitioners and policy makers in the healthcare sector.
No translation can ever be the same as its original, but rather than seeing this in terms of a loss, it makes far more sense to think in terms of gain, for once a translation enters the receiving culture it sets out on a new path. Never is this clearer than in the practice of retranslating classical texts. The Iliad may have begun as an oral poem, but over the ages it has become a source for writers, painters, sculptors, musicians, filmmakers, video game creators, graphic artists – in short for creative artists across the world – and has consequently acquired new life in new languages and new forms. In the great interconnectedness of global textuality, the role played by translation, however we choose to define that term, is infinite.
Lifestyle behaviours (e.g. physical activity and dietary habits) play a major role in the well-known premature mortality caused by poor physical health in people with mental illness. There is increasing evidence for the efficacy of lifestyle interventions on both physical and mental health, and consensus about important factors for success (e.g. targeting multiple lifestyle behaviours). However, implementation remains challenging and there is little change in clinical care. Studies that include measures of fidelity (the extent to which an intervention is implemented as intended) are able to gain insight in variations in actual implementation, which may affect intended health outcomes. However, there is currently no suitable fidelity tool for our lifestyle intervention.
Objectives
A pilot study to evaluate the feasibility of a tool that assesses and monitors the implementation fidelity of a multidisciplinary lifestyle focused approach (MULTI+).
Methods
MULTI+ can be tailored to various psychiatric wards and consists of 10 essential components based on scientific evidence, existing guidelines and consensus in the field of ‘lifestyle psychiatry’. We developed a tool to assess the 10 components and thereby the implementation fidelity of MULTI+. Qualitative observational data about compliance to these components are collected in 45 psychiatric wards. Adherence is converted to a gradual score (0-50). A higher score indicates higher fidelity.
Results
Preliminary results show that the tool is feasible for use in clinical practice. Scores give insight in how various wards have implemented MULTI+.
Conclusions
These outcomes can be used to further improve and understand the implementation and effectiveness of lifestyle interventions.
Coupled fire–atmosphere feedback is essential for modeling wildland fire spread, especially extreme fire phenomena. In this chapter, the suite of current and emerging tools capable of modeling this complexity is examined; these tools now dominate fundamental wildland fire research and are starting to be applied to fire operations, training, and planning. Some of the barriers to progress and challenges to validating these tools highlighted in this chapter suggest more emphasis on three areas: a scale-dependent and purposeful approach to comparing model results with appropriate observations, recognizing the limitations of each; the quantification of the errors and under-specifications in fuel properties and the impact of each; and assessing large-scale simulations and directing observations to address priority research gaps, from a position informed by the vast catalog of atmospheric scientific research.
Sustainment refers to continued intervention delivery over time, while continuing to produce intended outcomes, often with ongoing adaptations, which are purposeful changes to the design or delivery of an intervention to improve its fit or effectiveness. The Hispanic Kidney Transplant Program (HKTP), a complex, culturally competent intervention, was implemented in two transplant programs to reduce disparities in Hispanic/Latinx living donor kidney transplant rates. This study longitudinally examined the influence of adaptations on HKTP sustainment.
Methods:
Qualitative interviews, learning collaborative calls, and telephone meetings with physicians, administrators, and staff (n = 55) were conducted over three years of implementation to identify HKTP adaptations. The Framework for Reporting Adaptations and Modifications-Expanded was used to classify adaptation types and frequency, which were compared across sites over time.
Results:
Across sites, more adaptations were made in the first year (n = 47), then fell and plateaued in the two remaining years (n = 35). Adaptations at Site-A were consistent across years (2017: n = 18, 2018: n = 17, 2019: n = 14), while Site-B made considerably fewer adaptations after the first year (2017: n = 29, 2018: n = 18, 2019: n = 21). Both sites proportionally made mostly skipping (32%), adding (20%), tweaking (20%), and substituting (16%) adaptation types. Skipping- and substituting-type adaptations were made due to institutional structural characteristics and lack of available resources, respectively. However, Site-A’s greater proportion of skipping-type adaptations was attributed to greater system complexity, and Site-B’s greater proportion of adding-type adaptation was attributed to the egalitarian team-based culture.
Conclusion:
Our findings can help prepare implementers to expect certain context-specific adaptations and preemptively avoid those that hinder sustainment.
Building on positive research findings in Europe, Canada, and Australia over the past 30 years, the US National Institute of Mental Health (NIMH) funded two large trials of Coordinated Specialty Care (CSC) for first episode psychosis approximately 10 years ago. These studies found that participation in CSC, which includes both pharmacological and manualized psychosocial treatments, resulted in greater treatment retention, improved quality of life and work/school rates and reduced psychopathology among participants (Dixon et al., 2015; Kane et al., 2016). The authors of this chapter were intervention co-developers and trainers in the NIMH funded Recovery After an Initial Schizophrenia Episode (RAISE) national randomized controlled trial comparing CSC to customary care in 34 non-academic “real-world” community mental health clinics. The psychosocial components of the RAISE CSC intervention, entitled NAVIGATE, are manualized and available at navigateconsultants.org. The authors have now provided intensive onsite training and consultation in NAVIGATE in over 20 US states, typically to a combination of state and local community mental health agencies. In this chapter, they will present an overview of NAVIGATE and the national training effort, and then highlight both success and challenges in working to improve evidence-based first episode psychosis mental health treatment in the USA on a national and local level.
A belief is valuable when it “gets it right”. This “getting it right” is often understood solely as a matter of truth. But there is a second sense of “getting it right” worth exploring. According to this second sense, a belief “gets it right” when its concepts accurately match the way the world is objectively organized – that is, when its concepts are joint-carving, or have fidelity. In this paper, I explore the relationship between fidelity and epistemic value. While many philosophers (especially metaphysicians) acknowledge fidelity's value, they overlook just how much it might disrupt our understanding of epistemic value. To tease out this disruption, I draw on the Jamesian balance between seeking the truth and avoiding the false. A similar balance must be struck both within the pursuit of fidelity itself (“seeking the joints” and “avoiding the gruesome”) as well as between the pursuit of fidelity and the pursuit of truth. I then give an argument against the claim that truth is the higher epistemic good.
There has been an explosion in the uses of multimedia and their various platforms. The proliferation of different types of technology inclusion in education has become even greater due to the increased need for remote platforms for education globally. My focus in this paper is on providing a definition of multimedia learning with simulations. There are many types of simulations and this chapter presents a framework for understanding this diversity. In particular, I discuss the multimedia principles that inform the design of simulations along with research evidence of how simulations support learning. Future directions for this research are discussed.
Heaney’s translation work not only registered his engagement with literary history, and an evolving awareness of his position in the poetic world, but it was an intrinsic aspect of his poetics more generally. Specifically, Heaney spoke of how Frost’s notion of the ‘sound of sense’ lay at the root of both his poetry and his mode of ‘impure translation’. As a result, translational fidelity, for Heaney, privileged the uncovering of echoes that might capture and recreate the sound of the original text. This chapter charts how this conception of translation found expression in his renderings, in particular, of Sophocles, Dante, Virgil, Sweeney Astray and Beowulf. Focusing on the diverse dramas of fidelity these translations embody, this chapter explores how these texts assert his native soundscape’s ability to convey classics of world literature while, at the same time, they also defamiliarize and profitably disrupt Heaney’s domestic linguistic and cultural world.
Modern Greece offers us a distinctive example of the reception of ancient drama that testifies to the complications introduced by questions of national identity, vested ideological interests, and deep political divisions. On the modern Greek stage, the performance of ancient Greek drama has been characterised by an ongoing struggle between tradition and innovation. The traditional approach privileges ‘authenticity’, as part of a wider intellectual project that seeks to invest modern Greece with the glamour and cultural capital of ancient Greece. This chapter investigates the tension between this inherently conservative approach to performing ancient drama and freer, more innovative responses, as exemplified by the work of one of the country’s premier theatrical companies, the National Theatre of Greece. My analysis focuses on four representative case studies, two from 2000 and two from 2015–16, as a representative sample from the opposite ends of the tradition vs. innovation spectrum.
This chapter reviews the current status of implementation efforts in the field of family-based interventions for child and adolescent mental health. First, an overview of the implementation framework is provided, with an emphasis on the theoretical models that have previously been applied to family studies. Next, a comprehensive framework which integrates the common findings of individual models is introduced. Thereafter, specific research on the implementation of family-based intervention is reviewed. Strongest evidence exists for treatment fidelity and staff training as factors promoting successful implementation. Although some studies indicate that program fit with organizational characteristics is an important factor in both the adoption and sustainment phases, studies examining moderating effects between potential factors influencing the implementation process are lacking at this time. Future studies need to pursue implementation factors unique to family-based programs, as well as develop a consensus on the terminology and operational definitions of relevant constructs and sound methodology for measurement.
The Handbook of Behavior Change is the first wide-ranging compendium of theory- and evidence-based research and practice on behavior change. It provides scientists, students, and practitioners with the current evidence on behavior change and expert advice on how to develop, evaluate, and implement behavior change interventions. The handbook also sets an agenda for future research on behavior change theory and practice across multiple behaviors, contexts, and populations. This chapter outlines emerging issues and future research directions arising from the handbook. The chapter stresses the importance of theory development, including the need for greater emphasis on ecological and social theories; clearer descriptions and operationalizations of behavior change theories; and increased application of interdisciplinary approaches. Future research on intervention development should conduct more comprehensive intervention fidelity assessments; adopt novel means to improve the translation, feasibility, and optimization of interventions; ensure consideration of ethical issues in behavior change research; routinely evaluate mechanisms of action in behavior change interventions; and apply complex systems approaches to behavior change. “Best-practice” guidance on behavior change should consider emerging methods and approaches to behavior change; implement trials to evaluate the long-term maintenance of behavior change; and develop core curricula on behavior change to educate the next generation of scientists and practitioners.
Many people are unable or unwilling to participate in face-to-face interventions for functional behavior change, and existing services often have poor fidelity to evidence-based approaches. Pervasive ownership of digital devices may offer ways to supplement and increase the reach and impact of face-to-face care. Digital approaches to support behavioral change range from informational resources, through self-guided programs or apps, to digitally-delivered or guided human interventions. Online information is well accepted, and digital interventions are increasing in acceptability and use. Digital interventions also have strong research support. For example, coached web programs for some mental health conditions have equivalent effects to face-to-face treatment. However, many digital tools have no quality or efficacy data, and more agile ways to obtain data are needed. Threats to acceptance and use of digital interventions include concerns about data security, and difficulties deciding which resources and interventions to choose. What is promising is that sound assessment tools and initiatives to provide advice are emerging. Digital tools and resources have the potential to increase the reach, impact, and cost-effectiveness of existing behavior change initiatives, although they have yet to fully impact the way services are funded and delivered. That picture is likely to change rapidly in the coming decade.