Do pharmacy practice standards effectively describe behaviour? Reviewing practice standards using a behavioural specificity framework

Background Guidelines and practice standards exist to communicate the conduct and behaviour expected of health care professionals and ensure consistent quality practice. It is important that they describe behaviours explicitly so they can be interpreted, enacted and measured with ease. The AACTT framework specifies behaviour in terms of the: Action to be performed, Actor who performs the action, Context where the action occurs, Target who the action is performed with/for and Time when the action is performed (AACTT). It provides the most up to date framework for specifying behaviours and is particularly relevant to complex behavioural problems that involve sequences of behaviours performed by different people. Behavioural specificity within pharmacy practice standards has not been explored. Aim To determine if behaviours described in the Professional Practice Standards for Australian Pharmacists specify Action, Actor, Context, Target and Time. Methods Two researchers independently reviewed the scope and structure of the practice standards and one extracted action statements (behaviours) verbatim. Through an iterative process, the researchers modified and developed the existing AACTT definitions to operationalise them for application to review of the action statements in the practice standards. The operational definitions, decision criteria and curated examples were combined in a codebook. The definitions were consistently applied through a directed content analysis approach to evaluate all extracted action statements by one researcher. For consistency 20% was independently checked for agreement by a second researcher. Results A novel codebook to apply AACTT criteria to evaluate practice standards was developed. Application of this codebook identified 768 independent behaviours. Of these, 300 (39%) described at least one discrete observable action, none specified an actor, 25 (3%) specified context, 131 (17%) specified target and 88 (11%) specified time. Conclusion(s) The behaviours detailed in practice standards for Australian pharmacists do not consistently specify behaviours in terms of Action, Actor, Context, Target and Time. Developers in the pharmacy profession, and beyond, should consider the behavioural specificity of their documents to improve interpretability, usability and adherence to the behaviours detailed. This also has implications for the development and evaluation of interventions to change such behaviours and improve quality of care.

Deep-Breathing Biofeedback Trainability in a Virtual-Reality Action Game: A Single-Case Study with Police Trainers

It is widely recognized that police performance may be hindered by psychophysiological state changes during acute stress. To address the need for awareness and control of these physiological changes, police academies in many countries have implemented Heart-Rate Variability (HRV) biofeedback training. Despite these trainings now being widely delivered in classroom setups, they typically lack the arousing action context needed for successful transfer to the operational field, where officers must apply learned skills, particularly when stress levels rise. The study presented here aimed to address this gap by training physiological control skills in an arousing action context. We developed a Virtual-Reality (VR) breathing-based biofeedback training in which police officers perform deep and slow diaphragmatic breathing in an engaging game-like action context. This VR game consisted of a selective shoot/don’t shoot game designed to assess response inhibition, an impaired capacity in high arousal situations. Biofeedback was provided based on adherence to a slow breathing pace: the slower and deeper the breathing, the less constrained peripheral vision became, facilitating accurate responses to the in-game demands. A total of nine male police trainers completed 10 sessions over a 4-week period as part of a single-case experimental ABAB study-design (i.e., alternating sessions with and without biofeedback). Results showed that eight out of nine participants showed improved breathing control in action, with a positive effect on breathing-induced low frequency HRV, while also improving their in-game behavioral performance. Critically, the breathing-based skill learning transferred to subsequent sessions in which biofeedback was not presented. Importantly, all participants remained highly engaged throughout the training. Altogether, our study showed that our VR environment can be used to train breathing regulation in an arousing action context.

Machine Learning Model for Group Activity Recognition Based on Discriminative Interaction Contextual Relationship

This paper represents the recognition of group activity in public areas, considering personal actions and interactions between people from the field of computer vision. Modeling the interaction relationships between multiple people is essential for recognizing group activity in the video scene. In artificial intelligence applications, identifying group activities based on human interaction is often a challenging task. This paper proposed a model that formulates a group action context (GAC) descriptor. The descriptor was developed by integrating the focal person action descriptor and interaction joint context descriptor of nearby people in the video frame. The model used an efficient optimization principle based on machine learning to learn the discriminative interaction context relations between multiple persons. The proposed novel group action context descriptor is classified by support vector machine (SVM) to recognize group activity. The proposed technique effectiveness is evaluated for group activity recognition by performing experiments on a publicly available collective activity dataset. The proposed approach infers a group action class when multiple persons are together in the video sequence, especially when the interaction between people is confusing. The overall group action recognition model is interrelated with a baseline model to estimate the performance of interaction context information. The experimental result of the proposed group activity recognition model is comparable and outperforms the previous methods.

Lentius, profundius, suavius, tre coordinate dell'abitare contemporaneo

The aphorism lentius, profundius, suavius of Alexander Langer overturns the most famous citius, altius, fortius. It is both a program and a vision to face the most urgent challenges of our time. Outdoor is the priority action context to design possible ways of reconciliation with the environment, the only way to rediscover the balanced integration with nature that Adriano Olivetti indicated as an antidote to the harmfulness of the urban environment. Nature plays a decisive role in our society. According to the German philosopher Gernot Böhme, this general reference to nature on the one hand is indicative of a desire to compensate for a lifestyle that is increasingly distant from its rhythms and its essence, on the other it represents a profound and radical removal. The pandemic has definitively undermined some of the dominant paradigms, leading to the establishment of a new phenomenology of nature based on perception. The health issue has quickly, and perhaps irreversibly, changed our lifestyles and our relationships with nature. In high-altitude contexts, the archetypes of architecture become the concepts through which architecture redefines its dialogue with the landscape by innovating its grammar and semantic relationships. A complex dialogue that triggers new genealogies and belonging in which design solutions become an opportunity for experimenting and innovating processes, forms and technologies. The following projects address these issues with respect to two founding themes of architecture: the refuge and the threshold.

Defensive freezing and its relation to approach–avoidance decision-making under threat

Successful responding to acutely threatening situations requires adequate approach–avoidance decisions. However, it is unclear how threat-induced states—like freezing-related bradycardia—impact the weighing of the potential outcomes of such value-based decisions. Insight into the underlying computations is essential, not only to improve our models of decision-making but also to improve interventions for maladaptive decisions, for instance in anxiety patients and first-responders who frequently have to make decisions under acute threat. Forty-two participants made passive and active approach–avoidance decisions under threat-of-shock when confronted with mixed outcome-prospects (i.e., varying money and shock amounts). Choice behavior was best predicted by a model including individual action-tendencies and bradycardia, beyond the subjective value of the outcome. Moreover, threat-related bradycardia (high-vs-low threat) interacted with subjective value, depending on the action-context (passive-vs-active). Specifically, in action-contexts incongruent with participants’ intrinsic action-tendencies, stronger bradycardia related to diminished effects of subjective value on choice across participants. These findings illustrate the relevance of testing approach–avoidance decisions in relatively ecologically valid conditions of acute and primarily reinforced threat. These mechanistic insights into approach–avoidance conflict-resolution may inspire biofeedback-related techniques to optimize decision-making under threat. Critically, the findings demonstrate the relevance of incorporating internal psychophysiological states and external action-contexts into models of approach–avoidance decision-making.

Evidence Of We-Representation In Monkeys When Acting Together

A hallmark of successful evolution resides in the ability to adapt our actions to those of others, optimizing collective behaviour, so as to achieve goals otherwise unattainable by individuals acting alone. We have previously shown that macaques constitute a good model to analyse joint behavior, since they are able to coordinate their actions in a dyadic context. In the present work, we investigated whether monkeys can improve their joint-action performance, under special visuomotor conditions. The behavior of 5 monkeys was analyzed in isometric center-out tasks, requiring hand force application in different directions, either individually or together with a partner. Manipulating the presence or absence of a pre-instruction about the future action condition (SOLO or TOGETHER), allowed us to investigate on the existence of a "we-representation" in macaque monkeys. We found that pre-cueing the future action context increased the chances of dyadic success, also thanks to the emergence of an optimal kinematic setting, that ultimately facilitates inter-individual motor coordination. Our results offer empirical evidence in macaques of a "We-representation" during collective behavior, that once is cued in advance has an overall beneficial effect on joint performance.

Defensive freezing and its relation to approach-avoidance decision-making under threat

Successful responding to acutely threatening situations requires adequate approach-avoidance decisions. However, it is unclear how threat-induced states-like freezing-related bradycardia-impact the weighing of the potential outcomes of such value-based decisions. Insight into the underlying computations is essential, not only to improve our models of decision-making but also to improve interventions for maladaptive decisions, for instance in anxiety patients and first-responders who frequently have to make decisions under acute threat. Forty-two participants made passive and active approach-avoidance decisions under threat-of-shock when confronted with mixed outcome-prospects (i.e., varying money and shock amounts). Choice behavior was best predicted by a model including individual action-tendencies and bradycardia, beyond the subjective value of the outcome. Moreover, threat-related bradycardia interacted with subjective value, depending on the action-context (i.e., passive vs. active). Specifically, in action-contexts incongruent with participants’ intrinsic action-tendencies, strong freezers showed diminished effects of subjective value on choice. These findings illustrate the relevance of testing approach-avoidance decisions in relatively ecologically valid conditions of acute and primarily reinforced threat. These mechanistic insights into approach-avoidance conflict-resolution may inspire biofeedback-related techniques to optimize decision-making under threat. Critically, the findings demonstrate the relevance of incorporating internal psychophysiological states and external action-contexts into models of approach-avoidance decision-making.

Partnerships for the Sustainable Development Goals (SDGs)

In her dystopian novel The Handmaid’s Tale, Margaret Atwood gives voice to the importance of both context and experience in making sense of thought and action: “Context is all; or is it ripeness [...]