Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings.

BackgroundThis study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process.MethodsA mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives.DiscussionThe study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment

Two new submodels for the Modular Earth Submodel System (MESSy): New Aerosol Nucleation (NAN) and small ions (IONS) version 1.0

Abstract. Two new submodels for the Modular Earth Submodel System (MESSy) were developed. The New Aerosol Nucleation (NAN) submodel includes new parameterisations of aerosol particle formation rates published in recent years. These parameterisations include ion-induced nucleation and nucleation of pure organic species. NAN calculates the rate of new particle formation based on the aforementioned parameterisations for aerosol submodels in the ECHAM/MESSy Atmospheric Chemistry (EMAC) model. The ion pair production rate, needed to calculate the ion-induced or ion-mediated nucleation, is described using the new submodel IONS, which provides ion pair production rates for other submodels within the MESSy framework. Both new submodels were tested in EMAC simulations. These simulations showed good agreement with ground-based observations. </jats:p

Quantum Invariants, Modular Forms, and Lattice Points II

We study the SU(2) Witten--Reshetikhin--Turaev invariant for the Seifert fibered homology spheres with M-exceptional fibers. We show that the WRT invariant can be written in terms of (differential of) the Eichler integrals of modular forms with weight 1/2 and 3/2. By use of nearly modular property of the Eichler integrals we shall obtain asymptotic expansions of the WRT invariant in the large-N limit. We further reveal that the number of the gauge equivalent classes of flat connections, which dominate the asymptotics of the WRT invariant in N ->\infinity, is related to the number of integral lattice points inside the M-dimensional tetrahedron

Diffusion and jump-length distribution in liquid and amorphous Cu33_{33}Zr67_{67}

Using molecular dynamics simulation, we calculate the distribution of atomic jum ps in Cu$_{33}$Zr$_{67}$ in the liquid and glassy states. In both states the distribution of jump lengths can be described by a temperature independent exponential of the length and an effective activation energy plus a contribution of elastic displacements at short distances. Upon cooling the contribution of shorter jumps dominates. No indication of an enhanced probability to jump over a nearest neighbor distance was found. We find a smooth transition from flow in the liquid to jumps in the g lass. The correlation factor of the diffusion constant decreases with decreasing temperature, causing a drop of diffusion below the Arrhenius value, despite an apparent Arrhenius law for the jump probability

Eight Characteristics of Rigorous Multilevel Implementation Research: A Step-by-Step Guide

Background Although healthcare is delivered in inherently multilevel contexts, implementation science has no widely endorsed methodological standards defining the characteristics of rigorous, multilevel implementation research. We identify and describe eight characteristics of high-quality, multilevel implementation research to encourage discussion, spur debate, and guide decision-making around study design and methodological issues. Recommendations Implementation researchers who conduct rigorous multilevel implementation research demonstrate the following eight characteristics. First, they map and operationalize the specific multilevel context for defined populations and settings. Second, they define and state the level of each construct under study. Third, they describe how constructs relate to each other within and across levels. Fourth, they specify the temporal scope of each phenomenon at each relevant level. Fifth, they align measurement choices and construction of analytic variables with the levels of theories selected (and hypotheses generated, if applicable). Sixth, they use a sampling strategy consistent with the selected theories or research objectives and sufficiently large and variable to examine relationships at requisite levels. Seventh, they align analytic approaches with the chosen theories (and hypotheses, if applicable), ensuring that they account for measurement dependencies and nested data structures. Eighth, they ensure inferences are made at the appropriate level. To guide implementation researchers and encourage debate, we present the rationale for each characteristic, actionable recommendations for operationalizing the characteristics in implementation research, a range of examples, and references to make the characteristics more usable. Our recommendations apply to all types of multilevel implementation study designs and approaches, including randomized trials, quantitative and qualitative observational studies, and mixed methods. Conclusion These eight characteristics provide benchmarks for evaluating the quality and replicability of multilevel implementation research and promote a common language and reference points. This, in turn, facilitates knowledge generation across diverse multilevel settings and ensures that implementation research is consistent with (and appropriately leverages) what has already been learned in allied multilevel sciences. When a shared and integrated description of what constitutes rigor is defined and broadly communicated, implementation science is better positioned to innovate both methodologically and theoretically

A Generating Function for all Semi-Magic Squares and the Volume of the Birkhoff Polytope

We present a multivariate generating function for all n x n nonnegative integral matrices with all row and column sums equal to a positive integer t, the so called semi-magic squares. As a consequence we obtain formulas for all coefficients of the Ehrhart polynomial of the polytope B_n of n x n doubly-stochastic matrices, also known as the Birkhoff polytope. In particular we derive formulas for the volumes of B_n and any of its faces.Comment: 24 pages, 1 figure. To appear in Journal of Algebraic Combinatoric

Reactor process water (PW) piping inspections, 1984--1990

In July 1983, the NRC ordered the shutdown of five boiling water reactors (BWR's) because of concerns about reliability of ultrasonic examination for detecting intergranular stress corrosion cracking (IGSCC). These concerns arose because of leaking piping at Niagara Mohawk's Nine Mile Point which was attributed to IGSCC. The leaks were detected shortly after completion of ultrasonic examinations of the piping. At that time, the Dupont plant manager at Savannah River (SR) directed that investigations be performed to determine if similar problems could exist in SR reactors. Investigation determined that all conditions believed necessary for the initiation and propagation of IGSCC in austenitic stainless steel exist in SR reactor process water (PW) systems. Sensitized, high carbon, austenitic stainless steel, a high purity water system with high levels of dissolved oxygen, and the residual stresses associated with welding during construction combine to provide the necessary conditions. A periodic UT inspection program is now in place to monitor the condition of the reactor PW piping systems. The program is patterned after NRC NUREG 0313, i.e., welds are placed in categories based on their history. Welds in upgraded or replacement piping are examined on a standard schedule (at least every five years) while welds with evidence of IGSCC, evaluated as acceptable for service, are inspected at every extended outage (15 to 18 months). This includes all welds in PW systems three inches in diameter and above. Welds are replaced when MSCC exceeds the replacement criteria of more than twenty percent of pipe circumference of fifty percent of through-wall depth. In the future, we intend to perform flow sizing with automated UT techniques in addition to manual sizing to provide more information for comparison with future examinations

Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs

Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, “Improving Research of Employer Practices to Prevent Disability”, held October 14–16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences