Human Health Risk Assessment of Penicillin/Aminopenicillin Resistance in Enterococci Due to Penicillin Use in Food Animals

Penicillin and ampicillin drugs are approved for use in food animals in the United States to treat, control, and prevent diseases, and penicillin is approved for use to improve growth rates in pigs and poultry. This article considers the possibility that such uses might increase the incidence of ampicillin-resistant Enterococcus faecium (AREF) of animal origin in human infections, leading to increased hospitalization and mortality due to reduced response to ampicillin or penicillin. We assess the risks from continued use of penicillin-based drugs in food animals in the United States, using several assumptions to overcome current scientific uncertainties and data gaps. Multiplying the total at-risk population of intensive care unit (ICU) patients by a series of estimated factors suggests that not more than 0.04 excess mortalities per year (under conservative assumptions) to 0.14 excess mortalities per year (under very conservative assumptions) might be prevented in the whole U.S. population if current use of penicillin drugs in food animals were discontinued and if this successfully reduced the prevalence of AREF infections among ICU patients. These calculations suggest that current penicillin usage in food animals in the United States presents very low (possibly zero) human health risks.     

Pandemic Recovery Analysis Using the Dynamic Inoperability Input-Output Model

Economists have long conceptualized and modeled the inherent interdependent relationships among different sectors of the economy. This concept paved the way for input-output modeling, a methodology that accounts for sector interdependencies governing the magnitude and extent of ripple effects due to changes in the economic structure of a region or nation. Recent extensions to input-output modeling have enhanced the model's capabilities to account for the impact of an economic perturbation; two such examples are the inoperability input-output model^{( 1 , 2 )} and the dynamic inoperability input-output model (DIIM).^{( 3 )} These models introduced sector inoperability, or the inability to satisfy as-planned production levels, into input-output modeling. While these models provide insights for understanding the impacts of inoperability, there are several aspects of the current formulation that do not account for complexities associated with certain disasters, such as a pandemic. This article proposes further enhancements to the DIIM to account for economic productivity losses resulting primarily from workforce disruptions. A pandemic is a unique disaster because the majority of its direct impacts are workforce related. The article develops a modeling framework to account for workforce inoperability and recovery factors. The proposed workforce-explicit enhancements to the DIIM are demonstrated in a case study to simulate a pandemic scenario in the Commonwealth of Virginia.     

Predicting infectious disease outbreak risk via migratory waterfowl vectors

The spread of an emerging infectious disease is a major public health threat. Given the uncertainties associated with vector-borne diseases, in terms of vector dynamics and disease transmission, it is critical to develop statistical models that address how and when such an infectious disease could spread throughout a region such as the USA. This paper considers a spatio-temporal statistical model for how an infectious disease could be carried into the USA by migratory waterfowl vectors during their seasonal migration and, ultimately, the risk of transmission of such a disease to domestic fowl. Modeling spatio-temporal data of this type is inherently difficult given the uncertainty associated with observations, complexity of the dynamics, high dimensionality of the underlying process, and the presence of excessive zeros. In particular, the spatio-temporal dynamics of the waterfowl migration are developed by way of a two-tiered functional temporal and spatial dimension reduction procedure that captures spatial and seasonal trends, as well as regional dynamics. Furthermore, the model relates the migration to a population of poultry farms that are known to be susceptible to such diseases, and is one of the possible avenues toward transmission to domestic poultry and humans. The result is a predictive distribution of those counties containing poultry farms that are at the greatest risk of having the infectious disease infiltrate their flocks assuming that the migratory population was infected. The model naturally fits into the hierarchical Bayesian framework.     

A model with long-term survivors: negative binomial Birnbaum-Saunders

Abstract

We propose a cure rate survival model by assuming that the number of competing causes of the event of interest follows the negative binomial distribution and the time to the event of interest has the Birnbaum-Saunders distribution. Further, the new model includes as special cases some well-known cure rate models published recently. We consider a frequentist analysis for parameter estimation of the negative binomial Birnbaum-Saunders model with cure rate. Then, we derive the appropriate matrices for assessing local influence on the parameter estimates under different perturbation schemes. We illustrate the usefulness of the proposed model in the analysis of a real data set from the medical area.     

Vocational education,self‐employment and burnout among Australian workers

We examine the relationship between vocational education and occupational burnout among workers in different forms of employment. Although the self‐employed enjoy higher levels of job autonomy and work‐related satisfaction, we do not know whether they experience lower rates of occupational burnout, and whether vocational education plays a role in this relationship. This latter consideration is important, given that vocational qualifications often lead to self‐employment and prior research demonstrated that formal training may reduce burnout. However, formal education was previously measured in years of schooling, without considering the distinction between academically‐oriented and vocational courses. Therefore, using data from a 2001 national survey of working Australians, we first establish that the self‐employed are significantly less likely to experience burnout. We then demonstrate that some resilience to burnout can be attributed to the attainment of skilled vocational training, net of employment characteristics which are also very important.     

The numerical evaluation of the distribution function of a bilinear from to a quadratic from with econometric examples

This paper considers a general and computationally convenient method of evaluating the distribution function of statistics that are the ratio of a bilinear form to a quadratic form. Numerous Economemc applications of the method are given.     

The recruitment and selection of hospital medical consultants

Abstract

The literature on selection has been dominated in recent decades by the ‘prediction’ paradigm. Such an approach requires a substantial number of positions to be filled in order to compute validity coefficients. There are other approaches, using a different paradigm, when concentrated on adjusting the organization and the employee. Here careful analysis of job demands is essential. This article describes such an analysis, taking the medical consultant as an example. The method can be used in an iterative way. It is useful when one has to work with small numbers of positions.     

A Diagnostic Test for Normality Within the Power Exponential Family

This article develops the locally uniformly most powerful unbiased Lagrange multiplier test of normality of regression disturbances within the family of power exponential distributions. The small sample power properties of the test are compared in a Monte Carlo study with 6 well-known tests across 12 alternative nonnormal distributions. In addition, the finite sample power properties for nonnormal alternatives within the power exponential family are summarized by estimating response surfaces. The results suggest that the proposed text is computationally convenient and possesses relatively attractive power properties even against alternatives outside the power exponential family.     

From the Editor

No abstract available for this article.