The importance of strategic financial leadership in the UK public sector in a time of financial austerity

Given the severity of financial pressures on public authorities, this report is concerned with how finance managers in public services are coping with the demands placed on them and how they can demonstrate improved value by providing more effective strategic financial leadership. It considers how they are applying managerial approaches and solutions to the challenges of austerity and the role that the public sector finance function can play in this process

Evaluation of Phase 2 of the early discharge project of the ‘ASSIST’ team at Mansfield District Council

Project Objective: To provide a longer term independent appraisal of the business case for the continuation of the ASSIST early discharge scheme in Mansfiel

Evaluation of an early discharge from hospital scheme focussing on patients' housing needs: the ASSIST Project

This study calculated a return on investment of an early discharge from hospital scheme focusing on improved responses to patients’ housing needs. The study identified critical success factors of the scheme that will inform potential spread of the intervention to other localities. Financial return on investment based on service costs and benefits were calculated and the critical success factors were identified through interviews with key stakeholders

Analysis of gas constituents from sealed containers of plutonium oxide materials.

The safe storage of pure and impure plutonium oxide materials in sealed containers is a current Department of Energy (DOE) concern. Plutonium oxides sorb moisture from the atmosphere, and the subsequent radiolytic and/or chemical decomposition of the water has been thought to generate excessive hydrogen pressures inside sealed containers. Eleven sealed containers with ten grams each of plutonium oxide materials have been studied for up to four years. The sealed materials were representative materials from the DOE complex and contain less than 0.5 weight percent water. The samples were kept at ambient conditions. We report the final gas analysis of the headspace gas of these containers using gas chromatography, mass spectrometry and Raman spectroscopy. The results show that none of the containers have pressurized significantly, and that hydrogen was not generated in significant quantities

Gas generation over plutonium oxides in the 94-1 shelf-life surveillance program.

The Department of Energy (DOE) is embarking upon a program to store large quantities of plutonium-bearing materials for up to fifty years. The Los Alamos National Laboratory Shelf Life Project was established to bound the behavior of plutonium-bearing material meeting the DOE 3013 Standard. The shelf life study monitors temperature, pressure and gas composition over oxide materials in a limited number of large-scale 3013 inner containers and in many small-scale containers. For the large-scale study, baseline plutonium oxides, oxides exposed to high-humidity atmospheres, and oxides containing chloride salt impurities are planned. The first large-scale container represents a baseline and contains dry plutonium oxide prepared according to the 3013 Standard. This container has been observed for pressure, temperature and gas compositional changes for less than a year. Results indicate that no detectable changes in pressure and gas composition are observed

A case-series study to explore the efficacy of foot orthoses in treating first metatarsophalangeal joint pain

Background: First metatarsophalangeal (MTP) joint pain is a common foot complaint which is often considered to be a consequence of altered mechanics. Foot orthoses are often prescribed to reduce 1 stMTP joint pain with the aim of altering dorsiflexion at propulsion. This study explores changes in 1 stMTP joint pain and kinematics following the use of foot orthoses.Methods: The effect of modified, pre-fabricated foot orthoses (X-line ®) were evaluated in thirty-two patients with 1 stMTP joint pain of mechanical origin. The primary outcome was pain measured at baseline and 24 weeks using the pain subscale of the foot function index (FFI). In a small sub-group of patients (n = 9), the relationship between pain and kinematic variables was explored with and without their orthoses, using an electromagnetic motion tracking (EMT) system.Results: A significant reduction in pain was observed between baseline (median = 48 mm) and the 24 week endpoint (median = 14.50 mm, z = -4.88, p < 0.001). In the sub-group analysis, we found no relationship between pain reduction and 1 stMTP joint motion, and no significant differences were found between the 1 stMTP joint maximum dorsiflexion or ankle/subtalar complex maximum eversion, with and without the orthoses.Conclusions: This observational study demonstrated a significant decrease in 1 stMTP joint pain associated with the use of foot orthoses. Change in pain was not shown to be associated with 1 stMTP joint dorsiflexion nor with altered ankle/subtalar complex eversion. Further research into the effect of foot orthoses on foot function is indicated. © 2010 Welsh et al; licensee BioMed Central Ltd

Clinical evaluation of marketed orthodontic products: are researchers behind the times? A meta-epidemiological study.

BACKGROUND: The role of marketing and industry in the treatment decisions of orthodontists has received increasing attention in recent years with clinical research typically undertaken subsequent to established use of these devices and often failing to confirm the promise of manufacturers' claims. This meta-epidemiological study was undertaken to assess the proportion of clinical trials in orthodontics evaluating commercially marketed products and to evaluate the direction of the results of these studies. METHODS: Electronic searching was undertaken to identify randomized controlled trials (RCTs) published over a 5-year period (1 January 2012 to 31 December 2016). Data obtained included the type of marketed intervention, direction of effect and declaration of both industry sponsorship and conflict of interest. RESULTS: Eighty-four RCTs published in 23 scientific journals were included with the highest percentage in the American Journal of Dentofacial Orthopedics (AJO-DO) (23.8%), followed by the European Journal of Orthodontics (EJO) (14.3%), Journal of Orthodontics (JO) (10.7%) and Angle Orthodontist (AO) (10.7%). Overall, 45% (38/84) of clinical trials assessed involved analysis of marketed products after their introduction. Interventions to improve oral health or circumvent the risk of iatrogenic damage, such as white spot lesions, were most commonly assessed (15.8%), with the relative merits of non-surgical adjuncts (14.1%) and other orthodontic auxiliaries (13.1%) also frequently evaluated. In 44% of RCTs, a positive effect of the marketed intervention was not reported. Industry sponsorship of the research was declared in 9.5% RCTs. No significant associations between the direction of the effect and both declaration of industry sponsorship (p = 0.56) and conflict of interest (p = 0.96) were detected. Moreover, for marketed and non-marketed products, no significant associations for both declaration of industry sponsorship (p = 0.44) and conflict of interest (p = 0.28) were found. CONCLUSIONS: Almost half of orthodontic clinical trials over the past 5 years involve analysis of marketed products after their introduction. The results highlight a potential source of waste in orthodontic research emanating from existing approaches to licensing and marketing of orthodontic products