Good Value For Money Research Articles

Protecting Emergency Responders with Evidence-Based Interventions (PEREI): protocol for a randomized controlled trial for early career emergency responders, significant others, and supervisors

ABSTRACT Background: Emergency service personnel perform roles associated with high levels of trauma exposure and stress, and not surprisingly experience greater risk for poor mental health including posttraumatic stress disorder (PTSD), depression, anxiety, and substance use relative to the general population. Although programs exist to minimise the risk of developing mental health problems, their efficacy to date has been limited or untested. We will test the efficacy of the three programs which form PEREI: Protecting Emergency Responders with Evidence-Based Interventions. PEREI consists of modified versions of internet-delivered cognitive training in resilience (iCT-R) for early career first responders, PEREI-S for supervisors, and Be Well for Significant Others (BW-SO). Method: Up to 450 members in their first 5 years of service across multiple agencies will be recruited, with their adult supports (significant others, friends) invited to participate. Up to 180 supervisors in the agencies will be recruited. Participants will be randomized to their respective program or to receive the standard practice for mental health offered by the service (or usual mental health support for significant others). Assessments will be conducted pre- and post-program, and at 6- and 12-month follow-up. Primary outcome is PTSD and depression severity and probable-diagnosis. Secondary measures will index hypothesized mediators and moderators of outcome and determine whether the programs are cost-effective. Conclusions: The results will provide evidence as to efficacious methods for reducing risk of mental health problems in high-risk occupations, a better understanding of how such interventions may work, and whether they are good value for money. Trial registration: www.anzctr.org.au (ACTRN12622001267741)

Cost-effectiveness of falls prevention strategies for older adults: protocol for a living systematic review

IntroductionOne-third of adults aged 65+ fall annually. Injuries from falls can be devastating for individuals and account for 1.5% of annual healthcare spending. With the growing ageing population, falls place...

Xiaomi: An Analysis of Market Strategy under the High Cost-Performance Ratio

Abstract: Xiaomi Corporation, which was established in 2010 in Beijing, is well-known for its smartphones along with other smart hardware as well as IoT devices. It is the second-largest manufacturer of smartphones in the world, behind Samsung, with a market share of about 12%, most of which run on the MIUI (now HyperOS) operating system. It mainly focuses on providing products that are of excellent quality and performance but still maintain affordability which attracts customers from around the world. This research delves into Xiaomi's adaptive marketing tactics as a reaction to evolving market dynamics and changing consumer demands, and examines Xiaomis market plan by looking at three clear instances. The first is how Xiaomi keeps its strong position in the smartphone market by bringing out improved models every year with a steady price tag. This helps to maintain their image of being very good value for money. Second, the choice of the company to put $300,000 for three years into remaking its logo with Japanese designer Kenya Hara. This highlights how redesigning has a strategic effect on brand image and worldwide identification. Thirdly, this study talks about Xiaomis start in the car industry when it introduced the first car model called Xiaomi SU7 in month April. It shows a major shift from making only smartphones to also producing electric cars.

Lifetime engineering principles in highway asset management

Introduction. An important tendency of our time is sustainability, good value for money and long-term planning. These are also the goals of the recently developed discipline, lifetime engineering. Although the principles of the science were originally developed for buildings and engineering structures, they can also be adapted to public roads. The article — through a case study in Hungary — presents the applicability of life engineering science to public road asset management. Besides, examples of pavement structure design, durability, maintenance-operation and environmental protection are also presented. Problem Statement. The typical lifetime engineering science principles used in the presentation were: increasing (pavement) life cycle; complex, multi-disciplinary design methodology; modular design; effective, quality insurance methods; high level satisfaction of the customers’ needs; minimisation of lifetime costs; sustainable, end-of-life strategies. It is emphasized that lifetime engineering is based on specific basic principles that effectively promote an up-to-date approach to any discipline related to engineering infrastructure. The paper shows that the efficacy of a road asset management. can be considerably increased if some elements of lifetime engineering are utilized.

Analysis of public procurement characteristics in the Republic of Croatia

The issue of public procurement comes up from the very factthat in this process budgetary and other public funds are spent. This israther a significat amount of public funds - on the global level, publicprocurement reaches up to 12% of GDP and 29% of budget funds. Aseries of rules and regulations have to be applied, aiming to regulatepublic procurement procedures to make them transparent, efficient,and strictly formal and normatively regulated. Therefore, public bodiesare expected to effectively implement public procurement by applyingthe principle of ‘best value for money’ and with high standards ofethical and moral behavior. Croatia, like all countries in the world,faces a series of problems related to irregularity in public procurement,especially corruption as a general social problem. By becoming amember of the European Union, Croatia undertook to adapt itslegislation to the legislation of the European Union. The purpose ofthis paper is to present the effects of improving public procurementlegislation in Croatia by analysing available statistical data.

Estimating the Economically Justifiable Price of Limited-Duration Treatment with Donanemab for Early Symptomatic Alzheimer's Disease in the United States.

The goal of this economic model is to estimate an economically justifiable price (EJP) for using donanemab for the treatment of early symptomatic Alzheimer's disease (AD) in the United States based on clinical data from the phase 3 TRAILBLAZER-ALZ 2 trial (NCT04437511). We adapted an AD Markov state-transition model developed by the Institute for Clinical and Economic Review to estimate the EJP for donanemab at different willingness-to-pay (WTP) thresholds from the health care system perspective and the societal perspective as co-base cases. Assuming a WTP threshold of $150,000 per quality-adjusted life-year (QALY) gained, the model estimates a 1-year (13-dose) EJP for donanemab of $80,538 from the health care system perspective and $91,126 from the societal perspective; at a WTP threshold of $100,000 per QALY gained, the model estimates a 1-year (13-dose) EJP for donanemab of $44,691 from the health care system perspective and $55,419 from the societal perspective. Mean total treatment costs per patient at the $150,000 per QALY gained EJP derived from the health care system perspective were estimated at $77,812 based on the average number of doses of donanemab patients received in the co-base case analysis. One-way sensitivity analysis (OWSA) indicated that treatment efficacy, disease severity at the time of treatment initiation, and duration of treatment effect were the main drivers of the potential EJP. Results from this modeling simulation informed by the TRAILBLAZER-ALZ 2 study support an EJP for limited-duration treatment with donanemab that exceeds per-dose list prices for currently available amyloid-targeting therapies, implying potentially lower lifetime costs and better value for money.

Cost-effectiveness of blinatumomab for the treatment of B‑precursor acute lymphoblastic leukemia pediatric patients with high‑risk first‑relapse in Mexico

BackgroundBlinatumomab is a CD3/CD19-directed bispecific T-cell engager molecule that engages T cells to lyse CD19-expressing B cells. Based on a multicenter, open-label, phase 3, randomized clinical trial (Clinical Trials ID: NCT02393859), we aimed to evaluate the cost-effectiveness (CE) of blinatumomab compared to standard consolidation chemotherapy (SC) for the treatment of pediatric patients with high-risk first-relapsed Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia (B-ALL) from a Mexico healthcare payer perspective. MethodsA decision-analytic model, a partitioned survival model, was used to estimate the life-years (LYs) and costs over a lifetime horizon. We assumed that patients who remained alive beyond a 5-year period were cured. To account for the lingering impacts of cancer treatment, an excess mortality rate was incorporated into the model. Event-free survival (EFS) and overall survival (OS) were estimated by fitting mixture-cure and standard parametric survival distributions to the time-to-event data from the phase 3 trial. The model accounted for treatment costs, adverse event costs, follow-up costs, subsequent allogeneic hematopoietic stem cell transplantation (alloHSCT) costs, and subsequent treatment costs. ResultsBlinatumomab was associated with a lifetime gained of 5.11 years at an incremental cost of $621,111 MXN, relative to SC. The ICER for blinatumomab vs Standard of care was estimated to be $121,526 MXN/LY gained in the base case. Cost-effectiveness was sensitive to varying the time horizon. Blinatumomab had a probability of 99 % of being cost-effective, relative to SC, at the willingness to pay threshold defined in Mexico. LimitationsHealth-related quality of life values were not included in the analysis and therefore we did not estimate the quality-adjusted life-years gained. ConclusionsBlinatumomab was associated with greater benefit in terms of OS and EFS relative to SC. Probabilistic, deterministic, and scenario analyses indicate that blinatumomab represents the best value for money. Therefore, blinatumomab administered as part of consolidation therapy in B-ALL pediatric patients with high-risk first relapse is a cost-effective option.

Farmer‐led badger vaccination in Cornwall: Epidemiological patterns and social perspectives

Abstract In the United Kingdom, the management of bovine tuberculosis (bTB) challenges the coexistence of people and wildlife. Control of this cattle disease is hindered by transmission of its causative agent, Mycobacterium bovis, between cattle and badgers Meles meles. Badger culling has formed an element of bTB control policy for decades, but current government policy envisions expanding badger vaccination. Farming leaders are sceptical, citing concerns that badger vaccination would be impractical and potentially ineffective. We report on a 4‐year badger vaccination initiative in an 11 km2 area which, atypically, was initiated by local farmers, delivered by scientists and conservationists, and co‐funded by all three. Participating landholders cited controversies around culling and a desire to support neighbours as their primary reasons for adopting vaccination. The number of badgers vaccinated per km2 (5.6 km−2 in 2019) exceeded the number culled on nearby land (2.9 km−2 in 2019), and the estimated proportion vaccinated (74%, 95% confidence interval [CI] 40%–137%) exceeded the 30% threshold predicted by models to be necessary to control M. bovis. Farmers were content with how vaccination was delivered, and felt that it built trust with wildlife professionals. The percentage of badgers testing positive for M. bovis declined from 16.0% (95% CI 4.5%–36.1%) at the start of vaccination to 0% (95% CI 0%–9.7%) in the final year. With neither replication nor unvaccinated controls, this small‐scale case study does not demonstrate a causal link between badger vaccination and bTB epidemiology, but it does suggest that larger‐scale evaluation of badger vaccination would be warranted. Farmers reported that their enthusiasm for badger vaccination had increased after participating for 4 years. They considered vaccination to have been effective, and good value for money, and wished to continue with it. Synthesis and applications: Although small‐scale, this case study suggests that badger vaccination can be a technically effective and socially acceptable component of bTB control. A wider rollout of badger vaccination is more likely if it is led by the farming community, rather than by conservationists or government, and is combined with scientific monitoring. Read the free Plain Language Summary for this article on the Journal blog.

Value for money of reusable versus disposable ophthalmic instruments for intravitreal injections

aim: The aim of this study was to follow the instruments’ pathways and cost each segment to calculate whether reusable or disposable ophthalmic instruments offer better value for money for intravitreal injections. methods: The cycles and costs of reusable and single-use disposable instruments used for intravitreal injections were mapped out, including purchase costs, transport to and from the place of use, opening and disposal, sterilisation, replacement, salary costs of staff involved, etc. results: The cost of using reusable instruments for intravitreal injections (NZ$29.00) was lower than the cost of using disposable instruments ($30.51) by $1.51 per patient. conclusions: Intravitreal injections performed with reusable instruments offer better value for money than when performed with disposable instruments. This equates to a beneficial financial saving just for this one low-complexity case. Such savings can multiply significantly when considering the instruments used in a wider variety of ophthalmic procedures. There are of course trade-offs between safety, quality, cost and sustainability.

Dyadic capabilities in implementing performance-based public procurement

PurposeThis study aims to provide new understanding on operational and dynamic capabilities supportive to the implementation of performance-based public procurement by focusing on dyadic capabilities of a supplier and a buyer.Design/methodology/approachThe study is based on the qualitative analysis of 20 interviews with informants representing Finnish public organizations and their private sector suppliers. The analysis is aligned with a theoretical framework connecting the phases of procurement and the capability types studied.FindingsThe findings of the study present the role of operational and dynamic capabilities of a buyer and a supplier in the implementation of performance-based procurement at public procurement phases. Preprocurement phase is found to greatly benefit from all three dynamic capabilities, while operational capabilities suffice in the contracting phase.Social implicationsIncreased understanding on capabilities needed in performance-based procurement can increase the chances of success in reaching better value for money of public services and developing supplier markets.Originality/valueThe study contributes to the literature on performance-based public procurement and value-based selling by taking a dyadic approach to the operational and dynamic capabilities needed in business with an emphasis on performance. As the focus in public procurement shifts increasingly from resources to performance, involving a joint effort between buyer and supplier, the study provides insights into role of dyadic capabilities and explains how dynamic and operational capabilities together support the phases of performance-based procurement implementation in the public sector.

Young Consumers’ Price Perceptions in Purchasing Foods: Evidence from Greece

The recent consecutive economic and social crises impose sustainable “from farm to fork” food chain management to feed the global population. In this study, we investigated the price perceptions of young consumers (Gen Z) in purchasing foods in Greece to find out the determinants ensuring sustainable, future food consumption. We used eight overall price perception determinants, five with negative roles, namely value and price consciousness, coupon and sales proneness, and price mavenism, and three with positive roles, namely price–quality, price–value, and prestige–sensitivity for the formation of the study’s questionnaire. A total of 514 students (Gen Z, 85%) answered the questionnaire, promoted through the Google platform during September and October 2023. The data were analyzed with statistical tools, combining cross and chi-square tests. Between the negative determinants, the “value consciousness” price perceptions (71.02%) were the most important parameters in purchasing food, followed by “price consciousness” (55.02%) parameters. “Coupon proneness”, 48.4%, and “sales proneness”, 49%, were equally lower, while “price mavenism” parameters were minimally preferred by only 26.4% of the participants. Participants exhibited a major preference for the “value to price” interconnection (66.7%), such as good value for money, value exceeding a product’s price, and overvalued low-priced foods, while their preference for the “quality to price” interconnection was significantly lower (48.8%), such as in terms of getting what you pay for, more money for better quality, and priced, quality foods. The “prestige–sensitivity” price perception was outside of their preferences in terms of food purchasing (only 7.1%). Our findings indicate that young consumers (Gen Z) pay more attention to the values of negative and positive parameters concerning price perceptions when purchasing food rather than quality, coupons and sales, low prices, and mavenism, or even the prestige of the foods. This means that value issues such as the perceived environmental impact (green value), the climate crisis, the social signaling potential, and others are significant concerns, including their price perceptions for food purchases.

기술융합형 웹툰 서비스의 지속적 사용에 영향을 미치는 요인 연구

This study aims to identify the factors influencing the continuous use of technology-converged webtoons by users through the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2). The influence of webtoons as a media form is increasing, and they are evolving into technology-converged webtoons, such as smarttoons optimized for mobile environments and cuttoons designed for sharing on social media. The study investigated the factors influencing the continued use of technology -converged webtoons by categorizing them into technical attributes (effort expectancy, social influence, facilitating conditions, recommendation services) and psychological factors (hedonic motivation, price value, habit). The research findings revealed that, within the technical attributes, effort expectancy positively impacted the sustained use of technology-converged webtoons. Furthermore, within the psychological factors, hedonic motivation, price value, facilitating conditions, and habit were found to have a positive influence on the continuous use of technology-converged webtoons. Through this study, it was determined that users of technology-converged webtoons are more likely to continue using webtoons due to psychological factors rather than technical attributes. Additionally, the study highlighted the importance of the price value factor, noting that users perceive the price of technology -converged webtoons as “reasonable,” offering “good value for money” and providing “utility.” Based on these findings, it is expected that this study will serve as valuable data for the future developmental growth of the webtoon industry.

Cost-effectiveness of enoxaparin versus aspirin in the prevention of venous thromboembolism after total hip or knee arthroplasty: an analysis from the CRISTAL cluster-randomized trial.

The aim of this study was to evaluate the healthcare costs and benefits of enoxaparin compared to aspirin in the prevention of symptomatic venous thromboembolism (VTE) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) using data from the CRISTAL trial. This trial-based economic analysis reports value for money as incremental cost per quality-adjusted life-year (QALY) gained in 2022 Australian dollars, compared to a single threshold value of AUD$70,000 per QALY. Event costs were estimated based on occurrence of VTEs and bleeds, and on published guidelines for treatment. Unit costs were taken from Australian sources. QALYs were estimated using CRISTAL six-month follow-up data. Sensitivity analyses are presented that vary the cost of VTE treatment, and extend the analyses to two years. The CRISTAL trial found that enoxaparin was more effective than aspirin in preventing symptomatic VTE within 90 days of THA or TKA (risk difference 1.97% (95% confidence interval (CI) 0.54% to 3.41%; p = 0.007)). The additional cost after a THA or TKA was AUD$83 (95% CI 68 to 97) for enoxaparin, and enoxaparin resulted in an additional 0.002 QALYs (95% CI -0.002 to 0.005). Incremental cost per QALY gained was AUD$50,567 (95% CI 15,513, dominated) for enoxaparin. We can be 60% confident that the incremental cost per QALY does not exceed the willingness-to-pay threshold of AUD$70,000. Increasing the cost of VTE treatment and extension of costs and consequences to two years suggested greater confidence that enoxaparin is good value for money (70% and 63% confidence, respectively). This analysis provides strong evidence that enoxaparin thromboprophylaxis following THA or TKA reduced VTEs, but weak evidence of net economic benefits over aspirin. If the value of avoiding VTEs is high, and there is a strong likelihood of VTE-related health impairments, we can be more confident that enoxaparin is cost-effective compared to aspirin.

PHYSICOCHEMICAL ANALYSIS OF MURCHHITA YASHTYADI GHRITA

Background: According to the WHO, malnutrition is estimated to contribute to more than one-third of all child deaths, although most often, it is not listed as the direct cause. Nutrition-specific interventions, which address the immediate causes of undernutrition, have been proven to deliver among the best value for money of all development interventions. Ayurvedic literature has numerous herbal preparations in the form of medicines that need validation in today’s perspectives; Yashtyadi ghrita is one of those classical herbal formulations used in the management of Balsosha, mentioned in the famous textbook Ashtanga Samgraha Uttarasthan under the Balaupcharaniya chapter. Yashtyadi ghrita was prepared as per textual reference under the heading of sneha kalpana in Sharangdhara Samhita. To date, no research has been carried out on Yashtyadi ghrita. Therefore, the present study was planned to evaluate the physiochemical analysis of Yashtyadi ghrita. Aims and objectives: The aim was to prepare Yashtyadi ghrita and evaluate its pharmaceutical and analytical parameters. Materials and methods: Yashtyadi ghrita was prepared as per Sharangdhara Samhita, while murchhana of ghrita was done as per API and. Result: All the physicochemical parameters of Yashtyadi ghrita are found within the reference range explained in API for ghrita kalpana. Conclusion: Physiochemical parameters of Yashtyadi ghrita explained that no heavy metals, aflatoxins, or active microbes were detected. Therefore, it was a safe preparation for internal administration.

Cost-effectiveness of weight-management pharmacotherapies in Canada: a societal perspective

ObjectivesThis study aimed to assess the cost-effectiveness of weight-management pharmacotherapies approved by Canada Health, i.e., orlistat, naltrexone 32 mg/bupropion 360 mg (NB-32), liraglutide 3.0 mg and semaglutide 2.4 mg as compared to the current standard of care (SoC).MethodsAnalyses were conducted using a cohort with a mean starting age 50 years, body mass index (BMI) 37.5 kg/m2, and 27.6% having type 2 diabetes. Using treatment-specific changes in surrogate endpoints from the STEP trials (BMI, glycemic, blood pressure, lipids), besides a network meta-analysis, the occurrence of weight-related complications, costs, and quality-adjusted life-years (QALYs) were projected over lifetime.ResultsFrom a societal perspective, at a willingness-to-pay (WTP) threshold of CAD 50 000 per QALY, semaglutide 2.4 mg was the most cost-effective treatment, at an incremental cost-utility ratio (ICUR) of CAD 31 243 and CAD 29 014 per QALY gained versus the next best alternative, i.e., orlistat, and SoC, respectively. Semaglutide 2.4 mg extendedly dominated other pharmacotherapies such as NB-32 or liraglutide 3.0 mg and remained cost-effective both under a public and private payer perspective. Results were robust to sensitivity analyses varying post-treatment catch-up rates, longer treatment durations and using real-world cohort characteristics. Semaglutide 2.4 mg was the preferred intervention, with a likelihood of 70% at a WTP threshold of CAD 50 000 per QALY gained. However, when the modeled benefits of weight-loss on cancer, mortality, cardiovascular disease (CVD) or osteoarthritis surgeries were removed simultaneously, orlistat emerged as the best value for money compared with SoC, with an ICUR of CAD 35 723 per QALY gained.ConclusionSemaglutide 2.4 mg was the most cost-effective treatment alternative compared with D&E or orlistat alone, and extendedly dominated other pharmacotherapies such as NB-32 or liraglutide 3.0 mg. Results were sensitive to the inclusion of the combined benefits of mortality, cancer, CVD, and knee osteoarthritis.

RCT-based Social Return on Investment (SROI) of a Home Exercise Program for People With Early Dementia Comparing In-Person and Blended Delivery Before and During the COVID-19 Pandemic.

Regular exercise and community engagement may slow the rate of function loss for people with dementia. However, the evidence is uncertain regarding the cost-effectiveness and social return on investment (SROI) of home exercise with community referral for people with dementia. This study aimed to compare the social value generated from the in-person PrAISED program delivered before March 2020 with a blended PrAISED program delivered after March 2020. SROI methodology compared in-person and blended delivery formats of a home exercise program. Stakeholders were identified, a logic model was developed, outcomes were evidenced and valued, costs were calculated, and SROI ratios were estimated. Five relevant and material outcomes were identified: 3 outcomes for patient participants (fear of falling, health-related quality of life, and social connection); 1 outcome for carer participants (carer strain), and 1 outcome for the National Health Service (NHS) (health service resource use). Data were collected at baseline and at 12-month follow-up. The in-person PrAISED program generated SROI ratios ranging from £0.58 to £2.33 for every £1 invested. In-person PrAISED patient participants gained social value from improved health-related quality of life, social connection, and less fear of falling. In-person PrAISED carer participants acquired social value from less carer strain. The NHS gained benefit from less health care service resource use. However, the blended PrAISED program generated lower SROI ratios ranging from a negative ratio to £0.08:£1. Compared with the blended program, the PrAISED in-person program generated higher SROI ratios for people with early dementia. An in-person PrAISED intervention with community referral is likely to provide better value for money than a blended one with limited community referral, despite the greater costs of the former.Trial registration: ISRCTN Registry ISRCTN15320670.

Circular economy a push and pull mechanism - Recycling starts before purchasing

Public procurement is a mechanism through which the public sector can benefit from the latest technological processes and assistance from the private sector, while retaining its position as the main decision-maker in setting and implementing investment policies. This paper aims to make a quantitative analysis in an attempt to identify, to what extend, the contracting authorities in Romania, given the increased demand for the purchase of IT equipment caused by the emergence of the COVID-19 pandemic, as well as the recommendations of the European Commission in this field, have used, in their tender documents, evaluation criteria/factors specific to circular purchasing. In addition, the analysis aims to establish how the recycling and circularity process can be determined from the early stage of the tender documents, when establishing the evaluation factors that will directly impact the contract winner. Using principal component analysis and the Cronbach coefficient alpha combined with “the Varimax” method, the nature and the weight of the evaluation factors have been identified in a circular procurement process, considering the best value for money. The final findings represent a mix of criteria for IT circular procurement to be used to push the suppliers to clean/green production and to pull the market to a circular economy sales and consumption paradigm.

A53Simulation equipment - What do you have? What do you do with it?

Educators and workforce planners appreciate that clinical skills development and simulation-based learning are key strategic responses to safe and effective service provision and a sustainable workforce. However, some simulation-based experiences require simulators costing tens of thousands of pounds. In order to promote a ‘Once for Scotland’ approach, collaboration is essential to encourage sustainability by enabling sharing of equipment, training materials, processes, procedures and faculty between boards. Although there have been other scoping exercises [1], we believe that this the first to take place at a national level. This scoping exercise aimed to: Establish what equipment is available in the territorial health boards; Clarify the types of skills-based courses being run across NHS Scotland; Connect and encourage collaboration between simulation providers Information was gathered via Teams discussions and questionnaires. The responses were collated into Excel spreadsheets. These have been linked into an application to present the data in a more user-friendly manner online ( Interactive map of simulation resources in Scotland Responses reveal that: All health boards in Scotland have invested in simulation-based learning. There is pioneering work with the establishment of medical and surgical bootcamps as well as national pharmacy simulation. Additional work needs to be carried out to ensure that resources are invested wisely to areas of greatest need and that resources are shared within and between health boards. It is clear where abundant simulation activities are taking place, as well as where there are gaps in equipment and faculty. Distribution of the information gathered will reduce duplication of effort, increase collaboration and encourage the sharing of equipment between health and social care workers across Scotland. It is hoped that this scoping project will support the creation of new relationships between people, not just for their mutual benefit, but for the benefit of the people of Scotland. The results are a first step to providing a detailed inventory of the resources available to help ensure best value for money. We hope to see an increase in the sharing of equipment across Scotland similar to the use of the NES surgical cut suit which was purchased by the Scottish Centre for Simulation and Clinical Human Factors and recently used by the simulation team at NHS Lothian to provide a multi-professional immersive paediatric training session. The plan is to update this database on a regular basis and to widen the results to incorporate all health boards as well as universities. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

DESIGN, INSTALLATION, CAPACITIES AND EXPENSES OF AN INDOOR MULTIPURPOSE MODULAR 2D WAVE FLUME AND CIRCULATING WATER CHANNEL

In this article all the details related to the design, installation process, working capacities and expenses of a modular indoor laboratory flume are presented. The facility is able to work as wave flume or circulating water channel. Flume structure design distributes appropriately the load, to ensure the structural safety of the building. The length of the wave flume depends on the number of these structures, 2.5 m each, which are attached one to each other. Presented cases are 12.5 m and 25 m length. Width is 600 mm and can be filled up to 700 mm water depth. In this work, a multipurpose 50 m3 underground water storage tank is used to feed the flume through three centrifugal pump pressure group equipped with a variable frequency drive. Main structure is made of a welded stainless steel square-tubular frame. Seabed is flat, made from a folded stainless steel 5 mm sheet metal and a sandwich-type assembly system allows the fitting of the lateral glasses to the seabed frame. A fine-tuning regulation system allows a perfect alignment of each of the modules with the adjacent. This manufacturing and assembly strategy avoids undesirable whirls effects. Two types of wave generators have been tested, an in-house developed one for regular waves and an externally manufactured one with added options: irregular waves, and active absorption system of reflected waves. At the end of the flume, a parabolic beach has been installed as wave energy dissipation system. An in-house developed regulation system sets the optimal position of this device. Several dissipation options have been tested: height, slopes and perforated surfaces. A foldable wave generator paddle and a set of pipes and valves, allows working as water channel by recirculating water to the underground storage tank, and therefore, increasing flume research versatility. In the upper part, there have been mounted guides along the whole facility so that different ad-hoc devices can be attached onto it, such as testing models or necessary instrumentation. Among this, we can mention wave gauge module together with resistive wave gauges; digital, ultra-low pressure sensor that is fully conditioned and temperature compensated; CompactRIO controller as data acquisition system (National Instruments, cRIO-9063 model) with an inputs voltage module (National Instruments-9205, C-series). A computer with a Labview program that has been developed specifically for that purpose controls all data recording. In addition, the expenses of the main components are also presented, which demonstrate the cost effective of this indoor laboratories where small scale models can be tested. In this work the design characteristics and operation of the main components of the wave flume, such as the wave-maker, wave absorber, wave probes and data acquisition system are reported in detail together with the full range of wave parameters achievable in any experimental campaign in the Le Méhauté chart. This technical recommendations provides any research group with useful guidelines and details necessary to construct their own domestic wave flume being good value for money and unachievable otherwise.

Is extending eligibility for adult social care better than investing more in existing users in England? A cross-sectional evidence for multiple financial years

ObjectivesPublicly funded adult social care (ASC) in England aims to improve quality of life through the provision of services for individuals with care needs due to physical and/or mental impairment...