Perspectives on program mis-implementation among U.S. local public health departments

BACKGROUND: Public health resources are limited and best used for effective programs. This study explores associations of mis-implementation in public health (ending effective programs or continuing ineffective programs) with organizational supports for evidence-based decision making among U.S. local health departments. METHODS: The national U.S. sample for this cross-sectional study was stratified by local health department jurisdiction population size. One person was invited from each randomly selected local health department: the leader in chronic disease, or the director. Of 600 selected, 579 had valid email addresses; 376 completed the survey (64.9% response). Survey items assessed frequency of and reasons for mis-implementation. Participants indicated agreement with statements on organizational supports for evidence-based decision making (7-point Likert). RESULTS: Thirty percent (30.0%) reported programs often or always ended that should have continued (inappropriate termination); organizational supports for evidence-based decision making were not associated with the frequency of programs ending. The main reason given for inappropriate termination was grant funding ended (86.0%). Fewer (16.4%) reported programs often or always continued that should have ended (inappropriate continuation). Higher perceived organizational supports for evidence-based decision making were associated with less frequent inappropriate continuation (odds ratio = 0.86, 95% confidence interval 0.79, 0.94). All organizational support factors were negatively associated with inappropriate continuation. Top reasons were sustained funding (55.6%) and support from policymakers (34.0%). CONCLUSIONS: Organizational supports for evidence-based decision making may help local health departments avoid continuing programs that should end. Creative mechanisms of support are needed to avoid inappropriate termination. Understanding what influences mis-implementation can help identify supports for de-implementation of ineffective programs so resources can go towards evidence-based programs

European energy poverty metrics:Scales, prospects and limits

ENGAGER 2017–2021, CA16232Energy poverty, a condition whereby people cannot secure adequate home energy services, is gaining prominence in public discourse and on political and policy agendas. As its measurement is operationalised, metrical developments are being socially shaped. A European Union mandate for biennial reporting on energy poverty presents an opportunity to institutionalise new metrics and thus privilege certain measurements as standards. While combining indicators at multiple scales is desirable to measure multi-dimensional aspects, it entails challenges such as database availability, coverage and limited disaggregated resolution. This article converges scholarship on metrics e which problematises the act of measurement e and on energy poverty e which apprehends socio-political and techno-economic particulars. Scholarship on metrics suggests that any basket of indicators risks silencing significant but hard to measure aspects, or unwarrantedly privileging others. State-of-the-art energy poverty scholarship calls for indicators that represent contextualised energy use issues, including energy access and quality, expenditure in relation to income, built environment related aspects and thermal comfort levels, while retaining simplicity and comparability for policy traction. We frame energy poverty metrology as the socially shaped measurement of a varied, multi-dimensional phenomenon within historically bureaucratic and publicly distant energy sectors, and assess the risks and opportunities that must be negotiated. To generate actionable knowledge, we propose an analytical framework with five dimensions of energy poverty metrology, and illustrate it using multi-scalar cases from three European countries. Dimensions include historical trajectories, data flattening, contextualised identification, new representation and policy uptake. We argue that the measurement of energy poverty must be informed by the politics of data and scale in order to institutionalise emerging metrics, while safeguarding against their co-optation for purposes other than the deep and rapid alleviation of energy poverty. This ‘dimensioned’ understanding of metrology can provide leverage to push for decisive action to address the structural underpinnings of domestic energy deprivation.publishersversionpublishe

Detector or System? Extending the Concept of Detective Quantum Efficiency to Characterize the Performance of Digital Radiographic Imaging Systems

Purpose: To develop an experimental method for measuring the effective detective quantum efficiency (eDQE) of digital radiographic imaging systems and evaluate its use in select imaging systems

Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA

During August 1, 2014–July 31, 2015, in 2 counties in Minnesota, USA, incidence of invasive methicillin-susceptible Staphylococcus aureus (MSSA) (27.1 cases/100,000 persons) was twice that of invasive methicillin-resistant S. aureus (13.1 cases/100,000 persons). MSSA isolates were more genetically diverse and susceptible to more antimicrobial drugs than methicillin-resistant S. aureus isolates