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1.
Chem Rev ; 119(19): 10856-10915, 2019 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-31469277

RESUMO

Practical challenges in simulating quantum systems on classical computers have been widely recognized in the quantum physics and quantum chemistry communities over the past century. Although many approximation methods have been introduced, the complexity of quantum mechanics remains hard to appease. The advent of quantum computation brings new pathways to navigate this challenging and complex landscape. By manipulating quantum states of matter and taking advantage of their unique features such as superposition and entanglement, quantum computers promise to efficiently deliver accurate results for many important problems in quantum chemistry, such as the electronic structure of molecules. In the past two decades, significant advances have been made in developing algorithms and physical hardware for quantum computing, heralding a revolution in simulation of quantum systems. This Review provides an overview of the algorithms and results that are relevant for quantum chemistry. The intended audience is both quantum chemists who seek to learn more about quantum computing and quantum computing researchers who would like to explore applications in quantum chemistry.


Assuntos
Modelos Químicos , Teoria Quântica , Algoritmos , Metodologias Computacionais , Simulação de Dinâmica Molecular
2.
J Bacteriol ; 200(21)2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30150230

RESUMO

Copper is both a required micronutrient and a source of toxicity in most organisms, including Campylobacter jejuni Two proteins expressed in C. jejuni (termed CopA and CueO) have been shown to be a copper transporter and multicopper oxidase, respectively. We have isolated strains with mutations in these genes, and here we report that they were more susceptible to both the addition of copper in the growth media and to induced oxidative stress. Both mutant strains were defective in colonization of an avian host, and copper in the feed exacerbated the colonization deficiency. Overexpression of a cytoplasmic peptide derived from the normally periplasmic copper-binding region of CueO also caused copper intolerance compared to nonexpressing strains or strains expressing the non-copper-binding versions of the peptide. Taken together, the results indicate that copper toxicity in C. jejuni is due to a failure to effectively sequester cytoplasmic copper, resulting in an increase in copper-mediated oxidative damage.IMPORTANCE Copper is a required micronutrient for most aerobic organisms, but it is universally toxic at elevated levels. These organisms use homeostatic mechanisms that allow for cells to acquire enough of the element to sustain metabolic requirements while ensuring that lethal levels cannot build up in the cell. Campylobacter jejuni is an important foodborne pathogen that typically makes its way into the food chain through contaminated poultry. C. jejuni has a metabolic requirement for copper and encodes a copper detoxification system. In the course of studying this system, we have learned that it is important for avian colonization. We have also gained insight into how copper exerts its toxic effects in C. jejuni by promoting oxidative stress.


Assuntos
Campylobacter jejuni/efeitos dos fármacos , Campylobacter jejuni/metabolismo , Sulfato de Cobre/toxicidade , Cobre/toxicidade , Estresse Oxidativo , Ração Animal/análise , Ração Animal/toxicidade , Animais , Proteínas de Bactérias/genética , Campylobacter jejuni/genética , Galinhas , Mutação , Oxirredução , Oxirredutases/genética
3.
Prev Sci ; 19(2): 250-259, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28677088

RESUMO

The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5 years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.


Assuntos
Redes Comunitárias , Comportamento Cooperativo , Assistência Técnica ao Planejamento em Saúde , Serviços Preventivos de Saúde , Adulto , Feminino , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
5.
Youth Soc ; 48(6): 739-762, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28042180

RESUMO

The present study uses an ecological systems perspective to examine how parental involvement in school-related activities in sixth grade influences early adolescents' school bonding and academic achievement in eighth grade. Results of multilevel models of multiple data sources (i.e., adolescents, parents, and principals) suggested that parents' involvement in school, as reported by the adolescent in sixth grade, was a significant predictor of school bonding and academic grades in eighth grade. Furthermore, parent reports of guidance, support, and involvement in school and non-school activities were unrelated to their adolescents' grades and school bonding. Finally, schools' efforts to engage parents did not consistently predict an association between parental involvement and adolescent outcomes.

7.
Appl Environ Microbiol ; 81(13): 4507-16, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25911479

RESUMO

The diazotroph Azotobacter vinelandii possesses three distinct nitrogenase isoenzymes, all of which produce molecular hydrogen as a by-product. In batch cultures, A. vinelandii strain CA6, a mutant of strain CA, displays multiple phenotypes distinct from its parent: tolerance to tungstate, impaired growth and molybdate transport, and increased hydrogen evolution. Determining and comparing the genomic sequences of strains CA and CA6 revealed a large deletion in CA6's genome, encompassing genes related to molybdate and iron transport and hydrogen reoxidation. A series of iron uptake analyses and chemostat culture experiments confirmed iron transport impairment and showed that the addition of fixed nitrogen (ammonia) resulted in cessation of hydrogen production. Additional chemostat experiments compared the hydrogen-producing parameters of different strains: in iron-sufficient, tungstate-free conditions, strain CA6's yields were identical to those of a strain lacking only a single hydrogenase gene. However, in the presence of tungstate, CA6 produced several times more hydrogen. A. vinelandii may hold promise for developing a novel strategy for production of hydrogen as an energy compound.


Assuntos
Aerobiose , Azotobacter vinelandii/enzimologia , Azotobacter vinelandii/metabolismo , Hidrogênio/metabolismo , Nitrogenase/metabolismo , Azotobacter vinelandii/genética , Genoma Bacteriano , Ferro/metabolismo , Redes e Vias Metabólicas/genética , Compostos de Tungstênio/metabolismo
8.
Phys Rev Lett ; 114(17): 170802, 2015 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25978219

RESUMO

Quantum number-path entanglement is a resource for supersensitive quantum metrology and in particular provides for sub-shot-noise or even Heisenberg-limited sensitivity. However, such number-path entanglement has been thought to be resource intensive to create in the first place--typically requiring either very strong nonlinearities, or nondeterministic preparation schemes with feedforward, which are difficult to implement. Very recently, arising from the study of quantum random walks with multiphoton walkers, as well as the study of the computational complexity of passive linear optical interferometers fed with single-photon inputs, it has been shown that such passive linear optical devices generate a superexponentially large amount of number-path entanglement. A logical question to ask is whether this entanglement may be exploited for quantum metrology. We answer that question here in the affirmative by showing that a simple, passive, linear-optical interferometer--fed with only uncorrelated, single-photon inputs, coupled with simple, single-mode, disjoint photodetection--is capable of significantly beating the shot-noise limit. Our result implies a pathway forward to practical quantum metrology with readily available technology.

9.
Am J Dermatopathol ; 37(6): 495-8, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24999549

RESUMO

Cutaneous squamous cell carcinoma with perineural invasion (PNI) is an important inconspicuous finding. We report a case of a common tumor with an uncommon finding. A 57-year-old white man presented with paresthesias and a new lesion at the site of a previously resected squamous cell carcinoma. At the time of case review, present deep in the dermis, were large hyalinized tumor nodules. These nodules could have easily have been dismissed as sclerotic tumor nodules or fibrotic in-transit metastases. With the clinical history in mind, these nodules were further investigated by immunohistochemistry and reviewed in conjunction with the Mohs frozen section slides. These nodules were subsequently diagnosed as significant peri- and intraneural invasion. This extremely unusual presentation of PNI is a potential diagnostic pitfall that is potentially under-recognized by dermatopathologists but crucial for determining patient management.


Assuntos
Carcinoma de Células Escamosas/patologia , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Nervos Periféricos/patologia , Neoplasias Cutâneas/patologia , Humanos , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/patologia , Transplante de Órgãos
10.
Am J Community Psychol ; 56(1-2): 69-78, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26148977

RESUMO

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.


Assuntos
Depressão/psicologia , Ajustamento Emocional , Satisfação no Emprego , Militares/psicologia , Ajustamento Social , Apoio Social , Adulto , Feminino , Humanos , Masculino , Satisfação Pessoal , Análise de Regressão , Fatores Sexuais
11.
Eval Health Prof ; 47(2): 178-191, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38790111

RESUMO

Recent implementation science frameworks highlight the role of training and technical assistance (TTA) in building workforce capacity to implement evidence-based practices (EBPs). However, evaluation of TTA is limited. We describe three case examples that highlight TTA by three regional centers in the national Mental Health Technology Transfer Center (MHTTC) network. Each MHTTC formed Learning Communities (LCs) to facilitate connections among behavioral health professionals with the goals of sharing implementation strategies, discussing best-practices, and developing problem solving techniques. Data on outcomes were collected through a combination of self-report surveys and qualitative interviews. LC participants reported strong connectedness, gains in knowledge and skills, improvements in implementation capacity, and intentions to advocate for organizational and systems-level change. Furthermore, across the case examples, we identified LC characteristics that are associated with participant perceptions of outcomes, including tailoring LC content to workforce needs, providing culturally relevant information, engaging leaders, forming connections among participants and trainers, and challenging participants' current workplace practices. These findings are interpreted through the lens of the Interactive Systems Framework, which focuses on how TTA, such as LCs, can facilitate connections between the theoretical and empirical foundations of interventions and the practices of implementing interventions in real-world settings to advance workforce capacity.


Assuntos
Prática Clínica Baseada em Evidências , Humanos , Prática Clínica Baseada em Evidências/organização & administração , Feminino , Masculino , Pessoal de Saúde/educação , Fortalecimento Institucional/organização & administração , Ciência da Implementação , Adulto , Pesquisa Qualitativa , Aprendizagem , Internet , Educação a Distância/organização & administração
12.
Psychiatr Serv ; : appips20230602, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39257311

RESUMO

OBJECTIVE: This report summarizes results from a national survey that aimed to assess the training and technical assistance needs of individuals who work in mental health. METHODS: A survey was distributed to mental health workers by 10 regional centers of a large, nationwide, federally funded training and technical assistance network during January-October 2021. RESULTS: A total of 2,321 individuals from 58 states and territories responded to the survey. The three training and technical assistance needs they indicated most frequently were equitable and culturally responsive services, co-occurring mental and substance use disorders, and mental health awareness and literacy. CONCLUSIONS: The survey findings reflect the continued need to address inequities in mental health services, particularly for communities of color. In addition, a cluster of topics (i.e., mental health awareness and literacy, trauma-informed care, crisis services, grief, and provider well-being) stemmed from the COVID-19 pandemic and its effects on the nation's mental health.

13.
J Am Acad Psychiatry Law ; 51(2): 247-254, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36931714

RESUMO

Behavioral health professionals are charged with providing effective outpatient services while addressing patient and public safety, yet training in empirically-informed violence risk assessment strategies remains inaccessible. The authors developed and evaluated an online distance learning (ODL) course on clinical risk assessment targeting frontline providers and trainees in the United States. The ODL consisted of three modules: confidentiality, duty to third parties, and clinical assessment of violence risk. We evaluated the response characteristics and reach among different disciplines, as well as training satisfaction, change in knowledge, self-perceived competence, and self-reported impact on practice at six-week follow-up among 221 learners. Self-perceptions of competence and knowledge in the focal areas increased immediately after completing the training; self-perceived competence increased again by a significant margin at six-week follow-up. Participants reported a moderate-high positive impact of the training on practice.


Assuntos
Educação a Distância , Humanos , Estados Unidos , Pessoal de Saúde/educação , Autorrelato , Violência/prevenção & controle , Competência Clínica
14.
Commun Biol ; 6(1): 341, 2023 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-36991092

RESUMO

Hyperspectral imaging and spectral analysis quantifies fluorophore concentration during fluorescence-guided surgery1-6. However, acquisition of the multiple wavelengths required to implement these methods can be time-consuming and hinder surgical workflow. To this end, a snapshot hyperspectral imaging system capable of acquiring 64 channels of spectral data simultaneously was developed for rapid hyperspectral imaging during neurosurgery. The system uses a birefringent spectral demultiplexer to split incoming light and redirect wavelengths to different sections of a large format microscope sensor. Its configuration achieves high optical throughput, accepts unpolarized input light and exceeds channel count of prior image-replicating imaging spectrometers by 4-fold. Tissue-simulating phantoms consisting of serial dilutions of the fluorescent agent characterize system linearity and sensitivity, and comparisons to performance of a liquid crystal tunable filter based hyperspectral imaging device are favorable. The new instrument showed comparable, if not improved, sensitivity at low fluorophore concentrations; yet, acquired wide-field images at more than 70-fold increase in frame rate. Image data acquired in the operating room during human brain tumor resection confirm these findings. The new device is an important advance in achieving real-time quantitative imaging of fluorophore concentration for guiding surgery.


Assuntos
Neoplasias Encefálicas , Neurocirurgia , Humanos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Protoporfirinas , Imagem Óptica/métodos , Corantes Fluorescentes
15.
BMC Microbiol ; 12: 258, 2012 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-23148765

RESUMO

BACKGROUND: The genetic features that facilitate Campylobacter jejuni's adaptation to a wide range of environments are not completely defined. However, whole genome expression studies showed that respiratory proteins (RPs) were differentially expressed under varying conditions and stresses, suggesting further unidentified roles for RPs in C. jejuni's adaptation. Therefore, our objectives were to characterize the contributions of selected RPs to C. jejuni's i- key survival phenotypes under different temperature (37°C vs. 42°C) and oxygen (microaerobic, ambient, and oxygen-limited/anaerobic) conditions and ii- its interactions with intestinal epithelial cells from disparate hosts (human vs. chickens). RESULTS: C. jejuni mutant strains with individual deletions that targeted five RPs; nitrate reductase (ΔnapA), nitrite reductase (ΔnrfA), formate dehydrogenase (ΔfdhA), hydrogenase (ΔhydB), and methylmenaquinol:fumarate reductase (ΔmfrA) were used in this study. We show that only the ΔfdhA exhibited a decrease in motility; however, incubation at 42°C significantly reduced the deficiency in the ΔfdhA's motility as compared to 37°C. Under all tested conditions, the ΔmfrA showed a decreased susceptibility to hydrogen peroxide (H(2)O(2)), while the ΔnapA and the ΔfdhA showed significantly increased susceptibility to the oxidant as compared to the wildtype. Further, the susceptibility of the ΔnapA to H(2)O(2) was significantly more pronounced at 37°C. The biofilm formation capability of individual RP mutants varied as compared to the wildtype. However, the impact of the deletion of certain RPs affected biofilm formation in a manner that was dependent on temperature and/or oxygen concentration. For example, the ΔmfrA displayed significantly deficient and increased biofilm formation under microaerobic conditions at 37°C and 42°C, respectively. However, under anaerobic conditions, the ΔmfrA was only significantly impaired in biofilm formation at 42°C. Additionally, the RPs mutants showed differential ability for infecting and surviving in human intestinal cell lines (INT-407) and primary chicken intestinal epithelial cells, respectively. Notably, the ΔfdhA and the ΔhydB were deficient in interacting with both cell types, while the ΔmfrA displayed impairments only in adherence to and invasion of INT-407. Scanning electron microscopy showed that the ΔhydB and the ΔfdhA exhibited filamentous and bulging (almost spherical) cell shapes, respectively, which might be indicative of defects in cell division. CONCLUSIONS: We conclude that the RPs contribute to C. jejuni's motility, H(2)O(2) resistance, biofilm formation, and in vitro interactions with hosts' intestinal cells. Further, the impact of certain RPs varied in response to incubation temperature and/or oxygen concentration. Therefore, RPs may facilitate the prevalence of C. jejuni in a variety of niches, contributing to the pathogen's remarkable potential for adaptation.


Assuntos
Aderência Bacteriana , Proteínas de Bactérias/metabolismo , Campylobacter jejuni/fisiologia , Células Epiteliais/microbiologia , Viabilidade Microbiana , Oxirredutases/metabolismo , Fatores de Virulência/metabolismo , Animais , Biofilmes/crescimento & desenvolvimento , Campylobacter jejuni/efeitos dos fármacos , Campylobacter jejuni/patogenicidade , Campylobacter jejuni/efeitos da radiação , Galinhas , Deleção de Genes , Humanos , Peróxido de Hidrogênio/toxicidade , Locomoção , Microscopia Eletrônica de Varredura , Oxirredutases/genética , Temperatura
16.
Adv Appl Microbiol ; 79: 19-42, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22569516

RESUMO

Campylobacter jejuni is among the most frequent agent of foodborne gastroenteritis in the world, but its physiology and pathogenesis is less well understood than other bacterial enteric pathogens. This is due in part to the incompatibility of the molecular tools that have enabled advances in the characterization of other bacterial species. Most notably, the dearth of plasmid-based complementation, reporter assays, and plasmid-based unmarked mutagenesis procedures in many of the type strains has hindered research progress. The techniques themselves are not inadequate in Campylobacter species, but rather the barrier to genetic transfer of these genetic constructs from non-Campylobacter cloning stains such as Escherichia coli. Here, we review the modes of genetic transfer in C. jejuni and review the current state of research into the mechanism of each. Also reviewed are two systems (CRISPR-Cas and restriction modification) that are common to many strains of C. jejuni and are at least partly responsible for these barriers.


Assuntos
Campylobacter jejuni , Transferência Genética Horizontal , Campylobacter , Escherichia coli/genética , Plasmídeos
17.
Bioprocess Biosyst Eng ; 35(9): 1591-602, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22592649

RESUMO

This research focused on optimizing the upstream process time for production of polyhydroxybutyrate (PHB) from sucrose by two-stage batch and fed-batch fermentation with Alcaligenes latus ATCC 29714. The study included selection of strain, two-stage batch fermentations with different time points for switching to nitrogen limited media (14, 16 or 18 h) and fed-batch fermentations with varied time points (similar to two stage) for introducing nitrogen limited media. The optimal strain to produce PHB using sucrose as carbon source was A. latus ATCC 29714 with maximum-specific growth rate of 0.38 ± 0.01 h(-1) and doubling time of 1.80 ± 0.05 h. Inducing nitrogen limitation at 16 h and ending second stage at 26 h gave optimal performance for PHB production, resulting in a PHB content of 46.7 ± 12.2 % (g PHB per g dry cell weight) at the end of fermentation. This was significantly higher (P ≤ 0.05) (approximately 7 %) than the corresponding fed batch run in which nitrogen limitation was initiated at 16 h.


Assuntos
Alcaligenes/crescimento & desenvolvimento , Meios de Cultura/farmacologia , Poliésteres/metabolismo , Sacarose/farmacologia , Edulcorantes/farmacologia
18.
Eval Program Plann ; 92: 102059, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35218986

RESUMO

The National Technical Assistance Network for Children's Behavioral Health (TA Network) supports the development and implementation of Systems of Care (SOC) for youth with serious emotional disorders and their families in states, tribes, territories, and communities throughout the United States. The purpose of the current research was to conduct an evaluation of the TA Network to assess: The degree to which it has deployed research-based elements of TA; levels of participant satisfaction; types and scope of TA services provided; and systems-level outcomes. Study participants were drawn from a stratified random sample of SOC grant recipients who received technical support from the TA Network between 2013 and 2017. Results suggest that the TA Network has encompassed research-based elements of effective TA. Participants rated their interactions with the network very highly, and they accessed a wide variety of resources from the network. Finally, participants reported a variety of systems-level outcomes associated with TA Network support. Together, these findings underscore the importance of structuring TA systems to tailor support to fit with recipients' needs, build positive, proactive relationships, and offer services of sufficient dosage. Given the lack of rigorous evaluations on provision of TA, future studies can confirm the degree to which such tailored approaches to TA result in increased satisfaction, more effective implementation of SOC principles, and ultimately improved outcomes for youth and families.


Assuntos
Avaliação de Programas e Projetos de Saúde , Adolescente , Criança , Humanos , Avaliação de Programas e Projetos de Saúde/métodos , Estados Unidos
19.
Microorganisms ; 10(6)2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35744712

RESUMO

Campylobacter jejuni and Campylobacter coli are leading zoonotic foodborne pathogens, and the drugs of choice for human campylobacteriosis are macrolides (e.g., erythromycin) and fluoroquinolones. C. jejuni and C. coli are naturally competent for transformation via naked DNA uptake, but potential differences in transformation frequency (TF) for different antimicrobial resistance (AMR) markers remain poorly understood. We determined TFs for resistance to different antibiotics using as recipient a derivative of C. jejuni NCTC 11168 (strain SN:CM) with donor DNA from multidrug-resistant C. jejuni or C. coli. TF for nalidixic acid resistance ranked significantly highest (~1.4 × 10-3), followed by resistance to streptomycin and gentamicin. Tetracycline resistance via chromosomal tet(O) was less commonly transferred (~7.6 × 10-7), while transformation to erythromycin resistance was rare (≤4.7 × 10-8). We also determined TFs with the contemporary poultry-derived strains C. jejuni FSIS 11810577 and C. coli FSIS 1710488 as recipients. TFs to nalidixic acid and streptomycin resistance remained the highest (~7 × 10-4). However, TF for gentamicin resistance was remarkably low in certain recipient-donor combinations, while average TF for erythromycin resistance was noticeably higher (~3 × 10-6) than with SN:CM. Findings from this experimental model provide insights into factors that may impact transformation-mediated transfer of AMR leading to AMR dissemination in the agricultural ecosystem.

20.
Gen Hosp Psychiatry ; 75: 1-9, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35078020

RESUMO

OBJECTIVE: Critical gaps exist between implementation of effective interventions and the actual services delivered to people living with mental disorders. Many technical assistance (TA) efforts rely on one-time trainings of clinical staff and printed guidelines that alone are not effective in changing clinical practice. The Mental Health Technology Transfer Center (MHTTC) Network uses implementation science to accelerate the use of evidence-based practices (EBPs), improve performance, and bring about systems-level change. METHOD: Four case examples illustrate how MHTTCs employ the Exploration-Preparation-Implementation-Sustainment (EPIS) implementation framework and intensive implementation strategies to educate clinicians, manage change, and improve processes. These examples include implementing motivational interviewing, cognitive-behavioral therapy for people with psychosis, strategies to decrease the no show rate for virtual appointments, and school mental health systems development. RESULTS: From Preparation through Sustainment, MHTTCs successfully employed implementation strategies including learning communities, audit and feedback, and coaching to bring about change. Each project attended to inner and outer contexts to eliminate barriers. The examples also show the benefit of integrating process improvement alongside implementation. CONCLUSIONS: The MHTTCs are a model for using implementation science to design technical assistance that leads to more successful practical execution of EBPs; thus reducing the gap between research and practice.


Assuntos
Ciência da Implementação , Serviços de Saúde Mental , Prática Clínica Baseada em Evidências , Humanos , Saúde Mental , Transferência de Tecnologia
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