BackgroundSchool 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.MethodsData were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data.ResultsOur review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area.ConclusionsThe single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries.

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. These deliberations generated rich discussion, through which we identified potential points of public contribution and the values that underpin PI in modelling. We iteratively developed a framework to guide future practice of PI in modelling. Results We present the MEMVIE Public Involvement Framework in two forms: a short form to summarise key elements, and a long form framework to provide a detailed description of each potential type of public contribution at each stage of the modelling process. At a macro level, the public can contribute to reviewing context, reviewing relevance, assessing data and justifying model choice, troubleshooting, and interpreting and reviewing outcomes and decision making. The underpinning values that drive involvement include the public contributing to the validity of the model, potentially enhancing its relevance, utility and transparency through diverse inputs, and enhancing the credibility, consistency and continuous development through scrutiny, in addition to contextualising the model within a wider societal view. Discussion and Conclusion PI in modelling is in its infancy. The MEMVIE Framework is the first attempt to identify potential points of collaborative public contribution to modelling, but it requires further evaluation and refinement that we are undertaking in a subsequent study.

Changes in medical practice, demographic shifts and financial pressures are all examples of factors that may contribute to demand for periodic changes in the configuration of health services. When reconfiguring a service, health planners often take into account projected demand for services, patient access criteria and budgetary constraints (amongst other things), but typically give little consideration regarding its resilience to deliver services during and after external disruptions to its capability to deliver. In this paper we discuss a study conducted in response to a direct request from the National Health Service (NHS) Resilience Project within the Department of Health to explore the feasibility of assessing resilience across local services within the NHS and developing a computer software tool to assess resilience of different service reconfigurations. We give an account of the modelling process used, including the analytical framework we developed using both optimisation and heuristic methods, and an illustrative example of usage of a prototype software tool. We also highlight the key lessons that emerged during this project, which may be helpful to OR analysts working on similar projects regarding resilience in the public sector. KeywordsPractice of OR, Health service, Optimization. IntroductionEmergency preparedness can help reduce the impact to society and the economy of major disruptions such as fuel shortages, an influenza pandemic or widespread flooding. Preparing for such events may comprise a range of measures and is often required to be co-ordinated across local, regional, national and sometimes international borders. In this paper, we focus on emergency preparedness in health care and, in particular, those aspects that are related to resilience. In the context of this work and as defined by the project's client, we use the term resilience to mean the 2 capability of a health system to mitigate the impact of major external disruptions on its ability to meet the needs of the population during the disruption. Considerations of health system resilience may include strategic decisions, such as the allocation of health service provision across different sites, as well as operational decisions, such as the design of robust stock management for essential health care supplies. In this work we focus on the former.Periodic alterations in the configuration of health services arise as a result of political cycles, changes in medical practice, demographic shifts and financial pressures amongst other things. The decision-making behind reconfiguration is complicated and multifaceted, with health planners taking into account factors such as budgetary constraints, projected demand for services, the accessibility of services to patients, economies of scale and quality of service provision (Imison, 2010; Fulop et al., 2010).The configuration of a health system can affect its resilience. For example, reconfiguration often involves the concentration of services to enhance safety, effectiveness and efficienc...

Hub and spoke networks imply a tradeoff between congestion and service levels, and are important to understanding the nature of the contemporary airline industry. Further, the hub and spoke network is emerging as the central component of airline network planning and since such a strategy promises to channel a greater proportion of flights to a smaller number of major airports, it follows that the potential for air system congestion will continue to rise. In this paper, the relationship between hub and spoke networks and congestion is analyzed.