Developing a Framework for Public Involvement in Mathematical and Economic Modelling: Bringing New Dynamism to Vaccination Policy Recommendations.

Objectives: The Mathematical and Economic Modelling for Vaccination and Immunisation Evaluation (MEMVIE) programme aimed to explore, capture and support the potential contribution of the public to mathematical and economic modelling, in order to identify the values that underpin public involvement (PI) in modelling and co-produce a framework that identifies the nature and type of PI in modelling and supports its implementation.

Methods: We established a PI Reference Group, who worked collaboratively with the academic contributors to create a deliberative knowledge space, which valued different forms of knowledge, expertise and evidence. Together, we explored the key steps of mathematical and economic methods in 21 meetings during 2015-2020.

Exploring the role of mass immunisation in influenza pandemic preparedness: A modelling study for the UK context.

The nature and timing of the next influenza pandemic is unknown. This makes it difficult for policy makers to assess whether spending money now to prepare for mass immunisation in the event of a pandemic is worthwhile. We used simple epidemiological modelling and health economic analysis to identify the range of pandemic and policy scenarios under which plans to immunise the general UK population would have net benefit if a stockpiled vaccine or, alternatively, a responsively purchased vaccine were used.

A method for evaluating the cost-benefit of different preparedness planning policies against pandemic influenza.

•Our work presents a unifying method to calculate the net-benefit of different preparedness policies against different pandemic influeunza strains. Unlike previous methods, which have focused on evaluating specific strategies against specific pandemics, our method allows assessment of mass immunisation strategies in presence and absence of antiviral drugs for a large range of pandemic influenza strain characteristics and programme features. Overall, the model described here combines two parts to evaluate different preparedness planning policies against pandemic influenza.

A method for evaluating and comparing immunisation schedules that cover multiple diseases: Illustrative application to the UK routine childhood vaccine schedule.

Background: In the UK, the childhood immunisation programme is given in the first 5 years of life and protects against 12 vaccine-preventable diseases. Recently, this programme has undergone changes with addition of vaccination against Meningitis B from September 2015 and the removal of the primary dose of protection against Meningitis C from July 2016. These hanges have direct impact on the associated diseases but in addition may induce indirect effects on the vaccines that are given simultaneously or later in the programme.

A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme.

Background: The availability of new vaccines can prompt policy makers to consider changes to the routine childhood immunisation programme in the UK. Alterations to one aspect of the schedule may have implications for other areas of the programme (e.g.

School closures during the 2009 influenza pandemic: national and local experiences.

Background: School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives.

A model to evaluate mass vaccination against pneumococcus as a countermeasure against pandemic influenza.

A mathematical model has been developed for the purpose of evaluating vaccination against pneumococcus as a countermeasure against pandemic influenza. As the characteristics of a future pandemic cannot be known in advance, three distinct pandemic scenarios were considered, corresponding to a 1918-like pandemic, a 1957/1968-like pandemic and a 2009-like pandemic. Model estimates for each of these pandemic scenarios are presented for two options of vaccination programme; universal vaccination of the entire UK population and vaccination only of those people considered to be at heightened risk of developing influenza complications.

The accuracy of external blood loss estimation by ambulance and hospital personnel.

Objective: To determine if emergency personnel, either ambulance or hospital based, can estimate the volume of external blood loss accurately enough to be of potential clinical use in guiding fluid resuscitation.

Methods: A total of 61 ambulance and 35 hospital personnel viewed nine scenarios consisting of volumes of blood (100 mL, 400 mL and 700 mL) spilt onto three surfaces--carpet, vinyl and a clothed manikin. They were asked to estimate the blood loss in each case.

The impact of trauma case management on patient outcomes.

Background: Previous investigations demonstrate that nursing case management in the acute care setting improves patient outcomes. However, these findings provide limited information specific to trauma patients.

Method: The effect of trauma case management (TCM) was measured using practice-specific variables such as in-hospital complications, missed injury rates, and length of stay.