The art and science of priority-setting: assessing the value of Public Health England’s Prioritization Framework

Background Findings are presented from the evaluation of Public Health England’s (PHE) Prioritization Framework (PF) aimed to assist local authority commissioners with their public health investment and disinvestment decisions. The study explored the take up of the PF in three early adopter local authority settings. Methods Semi-structured interviews (n = 30) across three local authorities supplemented by participant observation of workshops. Results Participants acknowledged that the PF provided a systematic means of guiding priority-setting and one that encouraged transparency over investment and disinvestment decisions. The role performed by PHE and its regional teams in facilitating the process was especially welcomed and considered critical to the adoption process. However, uptake of the PF required a significant investment of time and commitment from public health teams at a time when resources were stretched. The impact of the political environment in the local government was a major factor determining the likely uptake of the PF. Ensuring committed leadership and engagement from senior politicians and officers was regarded as critical to success. Conclusions The study assessed the value and impact of PHE’s PF tool in three early adopter local authorities. Further research could explore the value of the tool in aiding investment and disinvestment decisions and its impact on spending

Better estimates from binned income data: Interpolated CDFs and mean-matching

Researchers often estimate income statistics from summaries that report the number of incomes in bins such as \$0-10,000, \$10,001-20,000,...,\$200,000+. Some analysts assign incomes to bin midpoints, but this treats income as discrete. Other analysts fit a continuous parametric distribution, but the distribution may not fit well. We fit nonparametric continuous distributions that reproduce the bin counts perfectly by interpolating the cumulative distribution function (CDF). We also show how both midpoints and interpolated CDFs can be constrained to reproduce the mean of income when it is known. We compare the methods' accuracy in estimating the Gini coefficients of all 3,221 US counties. Fitting parametric distributions is very slow. Fitting interpolated CDFs is much faster and slightly more accurate. Both interpolated CDFs and midpoints give dramatically better estimates if constrained to match a known mean. We have implemented interpolated CDFs in the binsmooth package for R. We have implemented the midpoint method in the rpme command for Stata. Both implementations can be constrained to match a known mean.Comment: 20 pages (including Appendix), 3 tables, 2 figures (+2 in Appendix

Is a ‘strong leader’ really what the country needs?

Theresa May has repeatedly stated that what the country needs is ‘a strong and stable leader’. David J Hunter writes that the claim is too simplistic – political leadership in the modern era is multifaceted and, in this case, must be seen in the context of the UK system of government

Health Policy and Management: in praise of political science Comment on “On Health Policy and Management (HPAM): mind the theory-policy- practice gap”

Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems

Combustion synthesis of ceramic and metal-matrix composites

Combustion synthesis or self-propagating high temperature synthesis (SHS) is effected by heating a reactant mixture, to above the ignition temperature (Tig) whereupon an exothermic reaction is initiated which produces a maximum or combustion temperature, Tc. These SHS reactions are being used to produce ceramics, intermetallics, and composite materials. One of the major limitations of this process is that relatively high levels of porosity, e.g., 50 percent, remain in the product. Conducting these SHS reactions under adiabatic conditions, the maximum temperature is the adiabatic temperature, Tad, and delta H (Tad) = 0, Tad = Tc. If the reactants or products go through a phase change, the latent heat of transformation needs to be taken into account