Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project

BACKGROUND: The Evidence-Based Practice (EBP) Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project. METHODS: Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002 – Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation. RESULTS: One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation. CONCLUSION: Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a stronger evidence-base from which to plan, implement and sustain such efforts. This paper offers a classification scheme and list of innovative implementation activities and strategies. The classification scheme offers potential value for future studies that seek to assess the effects of various implementation processes, and helps establish widely accepted standards and criteria that can be used to assess the value of innovative activities and strategies

X-ray-imaging spectrometer (XRIS) for studies of residual kinetic energy and low-mode asymmetries in inertial confinement fusion implosions at OMEGA (invited)

A system of x-ray imaging spectrometer (XRIS) has been implemented at the OMEGA Laser Facility and is capable of spatially and spectrally resolving x-ray self-emission from 5 to 40 keV. The system consists of three independent imagers with nearly orthogonal lines of sight for 3D reconstructions of the x-ray emission region. The distinct advantage of the XRIS system is its large dynamic range, which is enabled by the use of tantalum apertures with radii ranging from 50 μm to 1 mm, magnifications of 4 to 35×, and image plates with any filtration level. In addition, XRIS is capable of recording 1–100’s images along a single line of sight, facilitating advanced statistical inference on the detailed structure of the x-ray emitting regions. Properties such as P0 and P2 of an implosion are measured to 1% and 10% precision, respectively. Furthermore, T e can be determined with 5% accuracy. </jats:p

Strong law of large numbers for pairwise positive quadrant dependent random variables

Associated random variables, Markov chain, Positive quadrant dependence, Rate of convergence, Stochastic equicontinuity, 60F15,