A Multicompartment SIS Stochastic Model with Zonal Ventilation for the Spread of Nosocomial Infections: Detection,Outbreak Management,and Infection Control

In this work, we study the environmental and operational factors that influence airborne transmission of nosocomial infections. We link a deterministic zonal ventilation model for the airborne distribution of infectious material in a hospital ward, with a Markovian multicompartment SIS model for the infection of individuals within this ward, in order to conduct a parametric study on ventilation rates and their effect on the epidemic dynamics. Our stochastic model includes arrival and discharge of patients, as well as the detection of the outbreak by screening events or due to symptoms being shown by infective patients. For each ventilation setting, we measure the infectious potential of a nosocomial outbreak in the hospital ward by means of a summary statistic: the number of infections occurred within the hospital ward until end or declaration of the outbreak. We analytically compute the distribution of this summary statistic, and carry out local and global sensitivity analysis in order to identify the particular characteristics of each ventilation regime with the largest impact on the epidemic spread. Our results show that ward ventilation can have a significant impact on the infection spread, especially under slow detection scenarios or in overoccupied wards, and that decreasing the infection risk for the whole hospital ward might increase the risk in specific areas of the health‐care facility. Moreover, the location of the initial infective individual and the protocol in place for outbreak declaration both form an interplay with ventilation of the ward.     

Evaluating Potential Distribution of High‐Risk Aquatic Invasive Species in the Water Garden and Aquarium Trade at a Global Scale Based on Current Established Populations

Aquatic non‐native invasive species are commonly traded in the worldwide water garden and aquarium markets, and some of these species pose major threats to the economy, the environment, and human health. Understanding the potential suitable habitat for these species at a global scale and at regional scales can inform risk assessments and predict future potential establishment. Typically, global habitat suitability models are fit for freshwater species with only climate variables, which provides little information about suitable terrestrial conditions for aquatic species. Remotely sensed data including topography and land cover data have the potential to improve our understanding of suitable habitat for aquatic species. In this study, we fit species distribution models using five different model algorithms for three non‐native aquatic invasive species with bioclimatic, topographic, and remotely sensed covariates to evaluate potential suitable habitat beyond simple climate matches. The species examined included a frog (Xenopus laevis), toad (Bombina orientalis), and snail (Pomacea spp.). Using a unique modeling approach for each species including background point selection based on known established populations resulted in robust ensemble habitat suitability models. All models for all species had test area under the receiver operating characteristic curve values greater than 0.70 and percent correctly classified values greater than 0.65. Importantly, we employed multivariate environmental similarity surface maps to evaluate potential extrapolation beyond observed conditions when applying models globally. These global models provide necessary forecasts of where these aquatic invasive species have the potential for establishment outside their native range, a key component in risk analyses.     

Paradoxes, locations and the need for social coherence: a qualitative study of living with a learning difficulty

Policy rhetoric over recent decades has promoted social inclusion of the more vulnerable sectors of society, such as people with learning difficulties. This study aimed to describe the experiences of people who live with learning difficulties in order to inform local service development. Thirty-five people with a learning difficulty and/or a family member were interviewed. A model of social coherence was developed that moves beyond the self-limiting debates about social inclusion and exclusion. It is underpinned by a sense of location for the person with a disability in relation to services and carers, family and community, dependency and risk, temporality and space, events, control and society. Key recommendations are for services to know the individual and his/her family; to be responsive to individual needs; to enhance the capacity of families and communities to support people with difficulty in learning; and to help these people to feel more valued.     

How Equal is Equal?

Some areas of educational inequality in the Australian school setting are explored. Crucial to the examination are two alternative definitions of ‘equality’. The educational implications of acceptance of one of these definitions rather than the other are explicated in relation to educational policy-making and educational practice.     

Differentiating conflicts in beliefs versus value tradeoffs in the domestic intelligence policy debate

Since the 9/11 terrorist attacks, there has been an increase in public discussion regarding U.S. domestic intelligence activities. Domestic intelligence activities focus on gathering information about potential threats from individuals within the United States, and completely rational members of the public can have different opinions about the acceptability of various alternatives depending on one's values toward privacy, civil liberty, and security. Past studies have demonstrated that construction of a multiobjective value model can help clarify public values in controversial risk debates. This research explores a range of domestic intelligence alternatives that vary on multiple objectives, and applies value-focused thinking to develop a multiattribute utility model to evaluate and compare the alternatives. The process demonstrates the feasibility of eliciting model parameters from individuals and provides a method for identifying the locus of possible disagreements among individuals. The development of the model is described first, followed by insights found from participants who provided both value tradeoffs and performance scores for six different domestic intelligence alternatives. The participants were two student groups and a group of police officers. The analysis showed differences among weights for an additive model for different stakeholder groups and differences among the performance scores. In particular, there is a "halo" effect for alternatives, such that its supporters ranked the alternative higher on all attributes compared to respondents who find the alternative unacceptable. This modeling approach and results offer organizations such as the Department of Homeland Security insights into the debate surrounding new policy initiatives, particularly those requiring sensitive value tradeoffs.     

Life after work: older Australians' experiences of early exit from the workforce

Little is known about the experience of those in the baby boom cohort who are outside the labour market. Understanding their experience has the potential to inform policy strategies to support older people to remain longer in the workforce. Using in‐depth interview data from 26 participants, this paper examines the reasons people aged between 50 and 64 years give for being not‐employed, how they perceive it affects their health, how socioeconomic characteristics shape their experience and what would entice them back into paid work. Participants' main reasons for being not‐employed included: feeling financially able and ready to exit, feeling unhappy about workplace reorganisations, disability, or their partner's retirement or ill‐health. The reasons given and the degree to which they had planned to exit the workforce affected their willingness and capacity to consider returning. Key determinants of participants' health and wellbeing after stopping paid work were the extent to which they had planned their exit and the status of their health and wealth at the time of their exit. The paper concludes there is some scope for increasing the number of employed older people if policy makers attend to workforce health and wellbeing as crucial to workforce retention policy development.     

Personalization: From Story‐line to Practice

Personalization has become a unifying theme and a dominant narrative across public services in England. Key to understanding the dominance of personalization is the recognition that it is a story that is told about public services, their history and the roles and experiences of the people who use them and work in them. Like other stories it is compelling, emotionally resonant, but also multi‐interpretable. This article identifies five key themes which are central to the personalization story‐line, noting their reliance on a combination of formal evidence, personal narratives and common sense. These are: (1) personalization works, transforming people's lives for the better; (2) person‐centred approaches reflect the way people live their lives, rather than artificial departmental boundaries; (3) personalization is applicable to everyone, not just to people with social care needs; (4) people are experts on their own lives; (5) personalization will save money. The article goes on to examine some of the complexities that audiences face in translating a story‐line into policy programmes and frontline practice. Three aspects in particular are considered: the ambiguity of personalization as a guide to action; the tensions between user empowerment and user responsibility; and the extent to which personalization is used to legitimize other reforms, in particular budget cuts.     

Ageing Populations and Housing Needs: Comparing Strategic Policy Discourses in France and England

Set against a broad European policy agenda which promotes ‘ageing in place’ and representations of older people as active, independent citizens, this article compares recent English and French policy discourses on population ageing and its implications for the housing needs of increasingly large numbers of older citizens. Through analysis of six recent strategic policy statements representing each government's official responses to population ageing and its social policy implications for the 21st century, we demonstrate how differences in the social representation of the ageing process and of older peoples themselves permeate policy discourse, influencing the perceptions of the housing needs of older citizens and the role that housing itself may play in promoting independent living. In England, demographic ageing, housing and its role in facilitating independent living and active ageing are explicitly articulated, whilst in France, the housing environment has until recently, been portrayed as one which must accommodate the illness, incapacity and dependency of later life. Our article offers explanations for these differences in terms of cultural variations in the social representations or ‘constructions’ of later life, divergences in political philosophies and welfare principles.     

Deconstructing language practices: discursive constructions of children in Individual Education Plan resource documents

Although Individual Education Plan (IEP) resource documents in Ontario, Canada aim to assist children in achieving their special educational goals, a point of disjuncture exists between the documents’ intentions and children’s actual experiences. Addressing this issue is crucial in preventing inequity and fostering educational development and social well-being for children. We employ critical discourse analysis informed by disability theory to deconstruct the language practices used to conceptualize children in IEP resource documents. Our purpose is to question the underlying assumptions regarding representations of children and illuminate the potentially harmful consequences of such conceptions. We expose the presence of both neutral and harmful language practices and consider how such language may shape the way the documents translate from policy to practice. This study offers a model through which the language of other special education documents can be critically evaluated and proposes potential avenues for creating documents that avoid disabling children further.