Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors

Implementation science is a quickly growing discipline. Lessons learned from business and medical settings are being applied but it is unclear how well they translate to settings with different historical origins and customs (e.g., public mental health, social service, alcohol/drug sectors). The purpose of this paper is to propose a multi-level, four phase model of the implementation process (i.e., Exploration, Adoption/Preparation, Implementation, Sustainment), derived from extant literature, and apply it to public sector services. We highlight features of the model likely to be particularly important in each phase, while considering the outer and inner contexts (i.e., levels) of public sector service systems

The immunobiology of primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease histologically characterized by the presence of intrahepatic and/or extrahepatic biliary duct concentric, obliterative fibrosis, eventually leading to cirrhosis. Approximately 75% of patients with PSC have inflammatory bowel disease. The male predominance of PSC, the lack of a defined, pathogenic autoantigen, and the potential role of the innate immune system suggest that it may be due to dysregulation of immunity rather than a classic autoimmune disease. However, PSC is associated with several classic autoimmune diseases, and the strongest genetic link to PSC identified to date is with the human leukocyte antigen DRB01*03 haplotype. The precise immunopathogenesis of PSC is largely unknown but likely involves activation of the innate immune system by bacterial components delivered to the liver via the portal vein. Induction of adhesion molecules and chemokines leads to the recruitment of intestinal lymphocytes. Bile duct injury results from the sustained inflammation and production of inflammatory cytokines. Biliary strictures may cause further damage as a result of bile stasis and recurrent secondary bacterial cholangitis. Currently, there is no effective therapy for PSC and developing a rational therapeutic strategy demands a better understanding of the disease

A scale-free network model for wireless sensor networks in 3d terrain

The building strategy of network topology in 3D space is important technology for wireless sensor networks (WSNs). It is often more complex to assess the detection area of sensor node in 3D terrain. The research on topological modeling method, which can withstand a certain amount of node failures and maintain work properly, has become the focus in recent years. In this paper, a 3D terrain with multi-peaks is defined by Gaussian distribution and a new scale-free wireless sensor network topology is modeled in 3D terrain. According to the improved growth and preferential attachment criteria in complex network theory and considering the limited communication radius and energy of sensor nodes, this model is tolerant against random attacks and apply to WSNs in 3D terrain

Reliability of Therapist Self-Report on Treatment Targets and Focus in Family-Based Intervention

Reliable therapist-report methods appear to be an essential component of quality assurance procedures to support adoption of evidence-based practices in usual care, but studies have found weak correspondence between therapist and observer ratings of treatment techniques. This study examined therapist reliability and accuracy in rating intervention target (i.e., session participants) and focus (i.e., session content) in a manual-guided, family-based preventive intervention implemented with 50 inner-city adolescents at risk for substance use. A total of 106 sessions selected from three phases of treatment were rated via post-session self-report by the participating therapist and also via videotape by nonparticipant coders. Both groups estimated the amount of session time devoted to model-prescribed treatment targets (adolescent, parent, conjoint) and foci (family, school, peer, prosocial, drugs). Therapists demonstrated excellent reliability with coders for treatment targets and moderate to high reliability for treatment foci across the sample and within each phase. Also, therapists did not consistently overestimate their degree of activity with targets or foci. Implications of study findings for fidelity assessment in routine settings are discussed