Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts

Single-vortex-induced voltage steps in Josephson-junction arrays

We have numerically and analytically studied ac+dc driven Josephson-junction arrays with a single vortex or with a single vortex-antivortex pair present. We find single-vortex steps in the voltage versus current characteristics (I-V) of the array. They correspond microscopically to a single vortex phase-locked to move a fixed number of plaquettes per period of the ac driving current. In underdamped arrays we find vortex motion period doubling on the steps. We observe subharmonic steps in both underdamped and overdamped arrays. We successfully compare these results with a phenomenological model of vortex motion with a nonlinear viscosity. The I-V of an array with a vortex-antivortex pair displays fractional voltage steps. A possible connection of these results to present day experiments is also discussed.Comment: 10 pages double sided with figures included in the text. To appear in Journal of Physics, Condensed Matte

Dynamic Impedance of Two-Dimensional Superconducting Films Near the Superconducting Transition

The sheet impedances, Z(w,T), of several superconducting a-Mo77Ge23 films and one In/InOx film have been measured in zero field using a two-coil mutual inductance technique at frequencies from 100 Hz to 100 kHz. Z(w,T) is found to have three contributions: the inductive superfluid, renormalized by nonvortex phase fluctuations; conventional vortex-antivortex pairs, whose contribution turns on very rapidly just below the usual Kosterlitz-Thouless-Berezinskii unbinding temperature; and an anomalous contribution. The latter is predominantly resistive, persists well below the KTB temperature, and is weakly dependent on frequency down to remarkably low frequencies, at least 100 Hz. It increases with T as e-U'(T)/kT, where the activation energy, U'(T), is about half the energy to create a vortex-antivortex pair, indicating that the frequency dependence is that of individual excitations, rather than critical behavior.Comment: 10 pages, 10 figs; subm PR

Dynamic ordering and frustration of confined vortex rows studied by mode-locking experiments

The flow properties of confined vortex matter driven through disordered mesoscopic channels are investigated by mode locking (ML) experiments. The observed ML effects allow to trace the evolution of both the structure and the number of confined rows and their match to the channel width as function of magnetic field. From a detailed analysis of the ML behavior for the case of 3-rows we obtain ({\it i}) the pinning frequency $f_p$, ({\it ii}) the onset frequency $f_c$ for ML ($\propto$ ordering velocity) and ({\it iii}) the fraction $L_{ML}/L$ of coherently moving 3-row regions in the channel. The field dependence of these quantities shows that, at matching, where $L_{ML}$ is maximum, the pinning strength is small and the ordering velocity is low, while at mismatch, where $L_{ML}$ is small, both the pinning force and the ordering velocity are enhanced. Further, we find that $f_c \propto f_p^2$, consistent with the dynamic ordering theory of Koshelev and Vinokur. The microscopic nature of the flow and the ordering phenomena will also be discussed.Comment: 10 pages, 7 figure, submitted to PRB. Discussion has been improved and a figure has been adde

Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis

Background: Individuals with serious mental illness are at a higher risk of physical ill health. Mortality rates are at least twice those of the general population with higher levels of cardiovascular disease, metabolic disease, diabetes, and respiratory illness. Although genetics may have a role in the physical health problems of these patients, lifestyle and environmental factors such as levels of smoking, obesity, poor diet, and low levels of physical activity also play a prominent part.<p></p> Objective: To conduct a systematic review and meta-analysis of randomised controlled trials comparing the effect of exercise interventions on individuals with serious mental illness.<p></p> Methods: Searches were made in Ovid MEDLINE, Embase, CINAHL, PsycINFO, Biological Abstracts on Ovid, and The Cochrane Library (January 2009, repeated January 2013) through to February 2013.<p></p> Results: Eight RCTs were identified in the systematic search. Six compared exercise versus usual care. One study assessed the effect of a cycling programme versus muscle strengthening and toning exercises. The final study compared the effect of adding specific exercise advice and motivational skills to a simple walking programme. Exercise programmes were noted by their heterogeneity in terms of the type of exercise intervention, setting, and outcome measures. The review found that exercise improved levels of exercise activity (n=13, standard mean difference [SMD] 1.81, CI 0.44 to 3.18, p = 0.01). No beneficial effect was found on negative (n = 84, SMD = -0.54, CI -1.79 to 0.71, p = 0.40) or positive symptoms of schizophrenia (n = 84, SMD = -1.66, CI -3.78 to 0.45, p = 0.12). No change was found on body mass index compared with usual care (n= 151, SMD = -0.24, CI -0.56 to 0.08, p = 0.14), or body weight (n = 77, SMD = 0.13, CI -0.32 to 0.58, p = 0.57). No beneficial effect was found on anxiety and depressive symptoms (n = 94, SMD = -0.26, CI -0.91 to 0.39, p = 0.43), or quality of life in respect of physical and mental domains. One RCT measured the effect of exercise on exercise intensity, attendance, and persistence at a programme. No significant effect was found on these measures.<p></p> Conclusions: This systematic review showed that exercise therapies can lead to a modest increase in levels of exercise activity but overall there was no noticeable change for symptoms of mental health, body mass index, and body weight.<p></p&gt

AIMD - A validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies

Background: Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery]. Methods: Framework validity was evaluated against terminology schemas (n = 51); primary studies (n = 37); and reporting guidelines (n = 10). Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals. Results: There was variation in representativeness of the components across the three types of literature, in particular for the component 'causal mechanisms'. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1) Aims: what do you want your intervention to achieve and for whom? (2) Ingredients: what comprises the intervention? (3) Mechanisms: how do you propose the intervention will work? and (4) Delivery: how will you deliver the intervention? Conclusions: The draft simplified framework was validated with reference to a wide range of relevant literature and improvements have enhanced useability. The AIMD framework could aid in the promotion of evidence into practice, remove barriers to understanding how interventions work, enhance communication of interventions and support knowledge synthesis. Future work needs to focus on developing and testing resources and educational initiatives to optimize use of the AIMD framework in collaboration with relevant end-user groups

The Influence of Education and Socialization on Radicalization: An Exploration of Theoretical Presumptions and Empirical Research

Background and Objective: Research into radicalization does not pay much attention to education. This is remarkable and possibly misses an important influence on the process of radicalization. Therefore this article sets out to explore the relation between education on the one hand and the onset or prevention of radicalization on the other hand. Method: This article is a theoretical literature review. It has analyzed empirical studies-mainly from European countries-about the educational aims, content and style of Muslim parents and parents with (extreme) right-wing sympathies. Results: Research examining similarity in right-wing sympathies between parents and children yields mixed results, but studies among adolescents point to a significant concordance. Research also showed that authoritarian parenting may play a significant role. Similar research among Muslim families was not found. While raising children with distrust and an authoritarian style are prevalent, the impact on adolescents has not been investigated. The empirical literature we reviewed does not give sufficient evidence to conclude that democratic ideal in and an authoritative style of education are conducive to the development of a democratic attitude. Conclusion: There is a knowledge gap with regard to the influence of education on the onset or the prevention of radicalization. Schools and families are underappreciated sources of informal social control and social capital and therefore the gap should be closed. If there is a better understanding of the effect of education, policy as well as interventions can be developed to assist parents and teachers in preventing radicalization. © 2011 The Author(s)

Critical Exponents of the Fully Frustrated 2-D Xy Model

We present a detailed study of the critical properties of the 2-D XY model with maximal frustration in a square lattice. We use extensive Monte Carlo simulations to study the thermodynamics of the spin and chiral degrees of freedom, concentrating on their correlation functions. The gauge invariant spin-spin correlation functions are calculated close to the critical point for lattice sizes up to $240\times 240$; the chiral correlation functions are studied on lattices up to $96\times 96$. We find that the critical exponents of the spin phase transition are $\nu=0.3069$, and $\eta=0.1915$, which are to be compared with the unfrustrated XY model exponents $\nu=1/2$ and $\eta=0.25$. We also find that the critical exponents of the chiral transition are $\nu_{\chi}=0.875$, $2\beta=0.1936$, $2\gamma= 1.82$, and $2\gamma\>\prime=1.025$, which are different from the expected 2-D Ising critical exponents. The spin-phase transition occurs at $T_{U(1)}=0.446$ which is about 7\% above the estimated chiral critical temperature $T_{Z_{2}}= 0.4206$. However, because of the size of the statistical errors, it is difficult to decide with certainty whether the transitions occur at the same or at slightly different temperatures. Finally, the jump in the helicity modulus in the fully frustrated system is found to be about 23\% below the unfrustrated universal value. The most important consequence of these results is that the fully frustrated XY model appears to be in a novel universality class. Recent successful comparisons of some of these results with experimental data are also briefly discussed. (TO APPEAR IN PRB)Comment: 47 pages (PHYZZX

Transverse phase-locking in fully frustrated Josephson junction arrays: a new type of fractional giant steps

We study, analytically and numerically, phase locking of driven vortex lattices in fully-frustrated Josephson junction arrays at zero temperature. We consider the case when an ac current is applied {\it perpendicular} to a dc current. We observe phase locking, steps in the current-voltage characteristics, with a dependence on external ac-drive amplitude and frequency qualitatively different from the Shapiro steps, observed when the ac and dc currents are applied in parallel. Further, the critical current increases with increasing transverse ac-drive amplitude, while it decreases for longitudinal ac-drive. The critical current and the phase-locked current step width, increase quadratically with (small) amplitudes of the ac-drive. For larger amplitudes of the transverse ac-signal, we find windows where the critical current is hysteretic, and windows where phase locking is suppressed due to dynamical instabilities. We characterize the dynamical states around the phase-locking interference condition in the $IV$ curve with voltage noise, Lyapunov exponents and Poincar\'e sections. We find that zero temperature phase-locking behavior in large fully frustrated arrays is well described by an effective four plaquette model.Comment: 12 pages, 11 figure

What strategies are used to build practitioners’ capacity to implement community-based interventions and are they effective?: a systematic review

Abstract Background Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners’ capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wandersman et al. (Am J Community Psychol.50:445–59, 2102) proposed the Evidence-Based System of Innovation Support (EBSIS) as a framework to guide research and thereby strengthen the evidence base for building practitioners’ capacity. The purpose of this review was to contribute to further development of the EBSIS by systematically reviewing empirical studies of capacity-building interventions to identify (1) the range of strategies used, (2) variations in the way they were structured, and (3) evidence for their effectiveness at increasing practitioners’ capacity to use evidence-based prevention interventions. Methods PubMed, EMBASE, and CINAHL were searched for English-language articles reporting findings of empirical studies of capacity-building interventions that were published between January 2000 and January 2014 and were intended to increase use of evidence-based prevention interventions in non-clinical settings. To maximize review data, studies were not excluded a priori based on design or methodological quality. Using the EBSIS as a guide, two researchers independently extracted data from included studies. Vote counting and meta-summary methods were used to summarize findings. Results The review included 42 publications reporting findings from 29 studies. In addition to confirming the strategies and structures described in the EBSIS, the review identified two new strategies and two variations in structure. Capacity-building interventions were found to be effective at increasing practitioners’ adoption (n = 10 of 12 studies) and implementation (n = 9 of 10 studies) of evidence-based interventions. Findings were mixed for interventions’ effects on practitioners’ capacity or intervention planning behaviors. Both the type and structure of capacity-building strategies may have influenced effectiveness. The review also identified contextual factors that may require variations in the ways capacity-building interventions are designed. Conclusions Based on review findings, refinements are suggested to the EBSIS. The refined framework moves the field towards a more comprehensive and standardized approach to conceptualizing the types and structures of capacity-building strategies. This standardization will assist with synthesizing findings across studies and guide capacity-building practice and research