Choice and judgement in developing models for health technology assessment; a qualitative study

Introduction: The role of models in supporting health policy decisions is reliant on model credibility. Credibility is fundamentally determined by the choices and judgements that people make in the process of developing a model. However, the method of uncovering choices and making judgements in model development is largely unreported and is not addressed by modelling methods guidance. Methods: This qualitative study was part of a project examining errors in health technology assessment models. In-depth interviews with academic and commercial modellers were used to obtain descriptions of the model development process. Data were analysed using framework analysis and interpreted in the context of the methodological literature. Results: The activities involved in developing models were characterised according to the themes; understanding the decision problem, conceptual modelling, model implementation, model checking, and engaging with the decision maker. Finding and using evidence was frequently mentioned across these themes. There was marked variation between practitioners in the extent to which conceptual modelling was recognised as an activity distinct from model implementation. Discussion: Methodological approaches to addressing model credibility described in the wider modelling literature highlight the necessity to disentangle the conceptual modelling and implementation activities. Whilst interviewees talked of judgements and choice making throughout model development, discussion indicated that these were based upon skills and experience with no discussion of formal approaches. Methods are required that provide for a systematic approach to uncovering choices, to generating a shared view of consensus and divergence, and for making judgements and choices in model development

Innovative learning in action (ILIA) issue three: Employability, enterprise & entrepreneurship

The theme of the 3rd issue of ILIA is Employability, Enterprise and Entrepreneurship, reflecting the University of Salford’s Learning and Teaching Strategy and our Goal “To produce graduates with the skills, creativity, confidence and adaptability to succeed in the labour market and make a meaningful contribution to society”. The creativity, problem solving and change orientation this implies recognizes Salford’s distinctive strengths in this regard, and provides us with a conceptualization of employability which embraces enterprise and entrepreneurship, manifest in the form of selfemployment, but equally relevant to those working within organizations i.e. to intrapreneurship. The contributions to this edition provide us with examples of excellent practice demonstrating how practitioners at Salford have responded to the challenge of providing a quality learning experience for our students. Consideration of the papers and snapshots reveal how colleagues have embedded employability into teaching and learning and assessment strategies, and into frameworks of student support, in differing and innovative ways, across the institution. As this edition of ILIA goes to print work is underway to develop an Employability Policy and Strategy for the University. Designed to provide a coherent and progressive approach to Employability, Enterprise and Careers Education and Guidance, this Strategy will be able to build on the good practice evident both in this edition of ILIA and across the institution. ILIA therefore has once again provided us with a range of perspectives on a key area of curriculum design and development. It also has provided an opportunity to reflect on practice and student learning, to share experience and hopefully to identify future areas for collaboration

Studying complex interventions : reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco

Peer reviewedPublisher PD

An emerging user-led participatory methodology: Mapping impact pathways of urban food system sustainability innovations

This chapter presents an emerging effort to develop a participatory mapping methodology that will illuminate the pathways through which sustainable urban food systems achieve lasting impact. Carried out in collaboration with Està (Economia e Sostenibilità), the UNESCO Chair in World Food System (at Montpellier SupAgro), CIRAD (French Agricultural Research Centre for International Development) and the LCSFS (Laurier Center for Sustainable Food Systems), this initiative aims to provide an alternative to quantitative tools that lack precision at the local level, and to qualitative approaches holding a narrow focus that may obscure broader systemic dynamics. This URBAL project focuses on innovations in consumer practices, value-chains, and governance by examining 12 case studies in eight cities in the Global South and North

Shrinking the Malaria Map: A Prospectus on Malaria Elimination

\ud Thirty-nine countries across the world are making progress toward malaria elimination. Some are committed to nationwide elimination, while others are pursuing spatially progressive elimination within their borders. Influential donor and multilateral organizations are supporting their goals of achieving malaria-free status. With elimination back on the global agenda, countries face a myriad of questions. Should they change their programs to eliminate rather than control malaria? What tools are available? What policies need to be put into place? How will they benefit from elimination? Unfortunately, answers to these questions, and resources for agencies and country program managers considering or pursuing elimination, are scarce. The 39 eliminating countries are all positioned along the endemic margins of the disease, yet they naturally experience a variety of country characteristics and epidemiologies that make their malaria situations different from one another. The Malaria Elimination Group (MEG) and this Prospectus recognize\ud that there is no single solution, strategy, or time line that will be appropriate for every country, and each is encouraged to initiate a comprehensive evaluation of its readiness and strategy for elimination. The Prospectus is designed to guide countries in conducting these assessments. The Prospectus provides detailed and informed discussion on the practical means of achieving and sustaining zero transmission. It is designed as a road map, providing direction and options from which to choose an appropriate path. As on all maps, the destination is clearly marked, but the possible routes to reach it are numerous. The Prospectus is divided into two sections: Section 1 Eliminating Malaria comprises four chapters covering the strategic components important to the periods before, during, and after an elimination program. Section 2 Tools for the Job, comprises six chapters that outline basic information about how interventions in an elimination program will be different from those in a control setting. Chapter 1, Making the Decision, evaluates the issues that a country should consider when deciding whether or not to eliminate malaria. The chapter begins with a discussion about the quantitative and qualitative benefits that a country could expect from eliminating malaria and then recommends a thorough feasibility assessment. The feasibility assessment is based on three major components: operational, technical, and financial feasibility. Cross-border and regional collaboration is a key subject in this chapter. Chapter 2, Getting to Zero, describes changes that programs must consider when moving from sustained control to an elimination goal. The key strategic issues that must be addressed are considered, including supply chains, surveillance systems, intersectoral collaboration, political will, and legislative framework. Cross-border collaboration is again a key component in Getting to Zero. Chapter 3, Holding the Line, provides recommendations on how to conduct an assessment of two key factors that will affect preventing the reemergence of malaria once transmission is interrupted: outbreak risk and importation risk. The chapter emphasizes the need for a strong surveillance system in order to prevent and, if necessary, respond to imported cases. Chapter 4, Financing Elimination, reviews the cost-effectiveness of elimination as compared with sustained control and then presents the costs of selected elimination programs as examples. It evaluates four innovative financing mechanisms that must support elimination, emphasizing the need for predictable and stable financing. Case studies from Swaziland and two provinces in China are provided. Chapter 5, Understanding Malaria, considers malaria from the point of view of elimination and provides a concise overview of the current burden of the disease, malaria transmission, and the available interventions that can be used in an elimination program. Chapter 6, Learning from History, extracts important lessons from the Global Malaria Eradication Program and analyzes some elimination efforts that were successful and some that were unsuccessful. The chapter also reviews how the malaria map has been shrinking since 1900. xiv A Prosp ectus on Mala ria Elimi natio n\ud Chapter 7, Measuring Malaria for Elimination, provides a precise language for discussing malaria and gives the elimination discussion a quantitative structure. The chapter also describes the role of epidemiological theory and mathematical modeling in defining and updating an elimination agenda for malaria. Chapter 8, Killing the Parasite, outlines the importance of case detection and management in an elimination setting. Options for diagnosis, the hidden challenge of Plasmodium vivax in an elimination setting, and the impact of immunity are all discussed. Chapter 9, Suppressing the Vector, explores vector control, a necessary element of any malaria program. It considers optimal methods available to interrupt transmission and discusses potential changes, such as insecticide resistance, that may affect elimination efforts. Chapter 10, Identifying the Gaps — What We Need to Know, reviews the gaps in our understanding of what is required for elimination. The chapter outlines a short-term research agenda with a focus on the operational needs that countries are facing today. The Prospectus reviews the operational, technical, and financial feasibility for those working on the front lines and considers whether, when, and how to eliminate malaria. A companion document, A Guide on Malaria Elimination for Policy Makers, is provided for those countries or agencies whose responsibility is primarily to make the policy decisions on whether to pursue or support a malaria elimination strategy. The Guide is available at www.malaria eliminationgroup.org

An Evaluation of The Dove Project

The Dove Project is a partnership project run by Africans Unite Against Child Abuse (AFRUCA), Newham Children and Young People's Services (CYPS) and Newham Child and Adolescent Mental Health Services (CAMHS). The Project was launched in November 2012 as a 12 month pilot project funded by Trust for London. The Dove Project funding proposal states the project aim is to "strengthen psychological support for children and families affected by abuse linked to beliefs in witchcraft and spirit possession"i . Additional, intermediate aims of The Dove Project include i) increased awareness of witchcraft branding, ii) increased support to victims and their families and iii) increased access to a range of services.This document provides an evaluation of The Dove Project pilot from November 2012 to October 2013. TSIP agreed with Trust for London that this evaluation would focus on conducting a programme assessment of The Dove Project which assesses whether the Project was i) effectively designed (programme design) and ii) efficiently delivered (programme implementation)

A translational framework for public health research

<p><b>Background</b></p> <p>The paradigm of translational medicine that underpins frameworks such as the Cooksey report on the funding of health research does not adequately reflect the complex reality of the public health environment. We therefore outline a translational framework for public health research.</p> <p><b>Discussion</b></p> <p>Our framework redefines the objective of translation from that of institutionalising effective interventions to that of improving population health by influencing both individual and collective determinants of health. It incorporates epidemiological perspectives with those of the social sciences, recognising that many types of research may contribute to the shaping of policy, practice and future research. It also identifies a pivotal role for evidence synthesis and the importance of non-linear and intersectoral interfaces with the public realm.</p> <p><b>Summary</b></p> <p>We propose a research agenda to advance the field and argue that resources for 'applied' or 'translational' public health research should be deployed across the framework, not reserved for 'dissemination' or 'implementation'.</p&gt