Tuberculosis with relapse: A model

ABSTRACT

In a model of tuberculosis with relapse, the basic reproduction number R₀ includes new and relapse infections. Lyapunov functions help to prove that the global dynamic is completely determined by R₀. Replicated Latin hypercube sampling shows that early diagnosis and treatment are more efficient when relapse cases are considered.     

Evolution of an urban epidemic: The first 100,000 AIDS cases in New York City

Between 1981 and August 1997, 100,000 AIDS cases were reported in New York City (NYC): 77,067 men, 20,818 women, 307 teenagers, and 1,808 children. This report examines AIDS trends in NYC as the epidemic evolved from a predominantly white male epidemic among men with same sex contact (MSM) mostly from a single borough to a geographically diffuse epidemic that includes injecting drug users (IDU), persons of color, and women infected heterosexually. Case data were collected by active surveillance methods augmented by electronic laboratory based reporting. Mortality data were obtained from NYC Vital Statistics. 1990 Census data were used to derive incidence rates and prevalence by neighborhood income. Rates per 100,000 adults by neighborhood ranged from 260 to 5,500. Total AIDS incidence peaked in 1993 and has subsequently declined. Among men there was a shift from MSM to IDU as the predominant risk group, and increasing incidence among men reporting heterosexual contact. IDU was the leading risk factor among women, and women increased from 8 to 30 percent of all cases between 1982 and 1997. Unlike incidence, AIDS prevalence is rising among socially and economically marginalized populations, and will remain a major public health challenge well into the next century.     

Human migrations and mosquito-borne diseases in Africa

ABSTRACT

The efficacy of border screening as a prophylactic measure against mosquito-borne diseases in Africa depends on the value of the lower bound of the basic reproduction number. If this lower bound is greater than one, then border screening may be ineffective. In this case, the best prophylaxis is to isolate and treat patients in their region of residence.     

Ergodicity and extinction in a stochastic susceptible-infected-recovered-susceptible epidemic model with influence of information

An epidemic model with stochastic contact transmission coefficient takes into account white noise and the influence of information. Sufficient conditions for the extinction and persistence of the disease are expressed. The existence of a stationary distribution and the ergodic property are proved. The peak of infected population can be decreased by information. The analytical results are showed by simulations and the influence of white noise and information on the dynamics of epidemics are evaluated.     

Time preference and capital mobility in an OLG model with land

This paper examines the pattern of capital mobility in a two-country overlapping generations world in which production uses three inputs: capital, labor and land. The steady-state welfare consequences of opening countries to financial capital or labor mobility are then compared. In particular, it is shown that capital mobility does not equalize standards of living across countries. To achieve this goal, one has to rely on labor mobility. Received: 8 January 1996 / Accepted: 6 June 1996     

Time preference and labour migration in an OLG model with land and capital

This paper constructs a two-country migration model in the lines of Galor (1986), in which the world population consists of individuals of two types who have different time preferences. Production uses three inputs: mobile labour, immobile capital and land. It is shown that both countries are necessarily inhabited by agents of both types and exhibit equal density of population and equal interest rate at the steady state equilibrium of the integrated economy. The steady state welfare implications of international labour migration are studied.This paper has been written during Philippe Michel's visit at CORE, September 1994. Earlier drafts of this paper have been presented at the meeting Journées d'étude générations imbriquées (Marseille, November 24–26, 1994), at the ESPE conference (Lisbon, June 1–3, 1995) and at the EEA annual meeting (Prag, September 1–3, 1995). Comments by participants are gratefully acknowledged. We are also grateful to Stéphane Déo, Kamhon Kan, Pierre Pestieau, Christoph Schmidt and two anonymous referees for helpful comments. The usual disclaimer applies.Responsible editor: Alessandro Cigno     

An analysis of reproductive behaviour in Canada: results from an intertemporal optimizing model

Results based on a sample of Canadian households challenge the findings of most studies which show significant negative effects of schooling on the fertility of women under the age of 45. This is due to the application of methods to an optimization model which distinguish between those households which have completed their reproductive behaviour from those which have not. Completion status and the desired number of children are used to infer characteristics of the optimal programme which are then employed to derive a likelihood function. Traditional demographic methods have so far not fully utilized the distinction between incomplete and completed households in sample surveys. These methods also lead to the conclusion that completed fertility had increased from its all time low in the nineteen seventies. Received: 9 July 1997/Accepted: 6 June 1998     

Physical capital taxation and labor income taxation in an endogenous growth model with new generations

This paper examines the growth and welfare effects of physical capital taxation and labor income taxation. It is found that the impact of a rise in the physical capital tax rate on the balanced growth rate is crucially related to the birth rate, but a rise in the labor income tax rate definitely reduces the balanced growth rate regardless of the birth rate. It is also found that an increase in the physical capital income tax rate will harm the older but will benefit the younger, while an increase in the labor income tax rate will benefit the older but will harm the younger.

Addressing the midwifery workforce crisis: evaluating an employment model for undergraduate midwifery students at a tertiary maternity hospital in Melbourne, Australia

Background and aims

In Victoria, maternity services are under significant strain due to increased numbers of women giving birth and critical workforce shortages. Hospitals have experienced challenges in adequately staffing maternity units, particularly on postnatal wards. In 2008, a tertiary maternity hospital in Melbourne introduced a model where undergraduate midwifery students were employed as Division 2 nurses (SMW_Div2) (enrolled nurses), to work in the postnatal area only. This study explored the pilot employment model from the perspective of the SMW_Div2 and hospital midwives.

Methods

A web-based survey was administered to hospital midwives and the SMW_Div2s in the employment model in January 2010. The survey explored the views of midwives and SMW_Div2s regarding the perceived impact of the model on workforce readiness, recruitment and retention, and clinical competence and confidence.

Findings

Forty-seven of 158 midwives (30%) and five of nine SMW_Div2s employed in the model responded to the survey. Both groups considered the model to have benefits for the organisation, including increased: student workforce readiness; clinical confidence and competence; and organisational loyalty. Both groups also considered that the model would facilitate: workforce recruitment; a teaching and learning culture within the organisation; and enhanced partnerships between students, hospitals and universities. Caution was expressed regarding workload and the need for ongoing support for SMW_Div2s working in the model.

Discussion and conclusion

SMW_Div2s and midwives were positive about the introduction of the paid employment model at the Women's. The findings are consistent with evaluations of similar programs in the nursing setting. The employment model has potential short and long term individual and organisational advantages, which is important in the context of increasing births and workforce shortages. Progression of such models will be contingent on the collaboration and cooperation of the various stakeholders involved in maternity workforce and education.     

Supporting the midwifery workforce: An evaluation of an undergraduate midwifery student employment model at a large tertiary maternity service in Victoria,Australia

BackgroundIn 2020, in response to major maternity workforce challenges exacerbated by the COVID-19 pandemic, the Victorian Department of Health implemented a number of workforce maximisation strategies, one of which was employment of undergraduate midwifery students called ‘Registered Undergraduate Student Of Midwifery’ (RUSOM).AimTo evaluate the RUSOM model implemented in a tertiary maternity service in Melbourne, Australia.MethodsA cross-sectional online survey was distributed to all RUSOMs and midwives at the study site in August 2021.FindingsTwenty of 26 RUSOMs (77%) and 110 of 338 permanent midwives (33%) responded. Both groups considered the model to be a positive workforce strategy that contributed to work readiness of students, and increased confidence and competence to practise. RUSOMS and midwives reported positives for the organisation including improving workload for midwives on the postnatal ward, enhancing quality of care and outcomes for women and babies, and the value of RUSOMs as team members. RUSOMs felt well supported, supervised and clinically and theoretically prepared. Both groups considered RUSOMs were underutilised, and that they could undertake additional duties, and both thought that the RUSOM model should continue.ConclusionThe model was highly valued by both RUSOMs and midwives. There was strong agreement that the model should continue and that the list of duties could be expanded. Given these findings, further research should explore the expansion and sustainability of RUSOMs in the maternity workforce.