Validation of a Stochastic Discrete Event Model Predicting Virus Concentration on Nurse Hands

Understanding healthcare viral disease transmission and the effect of infection control interventions will inform current and future infection control protocols. In this study, a model was developed to predict virus concentration on nurses’ hands using data from a bacteriophage tracer study conducted in Tucson, Arizona, in an urgent care facility. Surfaces were swabbed 2 hours, 3.5 hours, and 6 hours postseeding to measure virus spread over time. To estimate the full viral load that would have been present on hands without sampling, virus concentrations were summed across time points for 3.5‐ and 6‐hour measurements. A stochastic discrete event model was developed to predict virus concentrations on nurses’ hands, given a distribution of virus concentrations on surfaces and expected frequencies of hand‐to‐surface and orifice contacts and handwashing. Box plots and statistical hypothesis testing were used to compare the model‐predicted and experimentally measured virus concentrations on nurses’ hands. The model was validated with the experimental bacteriophage tracer data because the distribution for model‐predicted virus concentrations on hands captured all observed value ranges, and interquartile ranges for model and experimental values overlapped for all comparison time points. Wilcoxon rank sum tests showed no significant differences in distributions of model‐predicted and experimentally measured virus concentrations on hands. However, limitations in the tracer study indicate that more data are needed to instill more confidence in this validation. Next model development steps include addressing viral concentrations that would be found naturally in healthcare environments and measuring the risk reductions predicted for various infection control interventions.     

From the Cradle to the Grave: Funeral Welfare from an International Perspective

This article reports on a pilot study examining funeral welfare for citizens from low income backgrounds. Through a review of funeral welfare provision in 12 capitalist democratic countries it seeks to inform the current system of state support in Britain, arguing that insufficient attention has been given to funeral costs as a policy issue. Mindful of the British welfare state's original ‘cradle to grave’ ethos, such attention is ever more pressing in light of rising funeral costs, an ageing population and projected increases in the death rate. Arguing that funeral costs are an issue of income support, the article draws on Esping‐Andersen's threefold welfare‐regime typology to situate the British system within a comparative study of funeral welfare that identifies similarities and differences both within and between the three welfare‐regime types. On the basis of an empirical example, the article further argues that systems of funeral welfare reflect the relationship between culture, politics and local practice. The findings indicate that the British system is hampered by a discourse of welfare dependency rather than entitlement, which stigmatises those who need support with funeral costs at a time when they are under pressure to ensure that the deceased person receives a ‘dignified’ send‐off.     

Apprenticeships in homelessness: a quantitative study

Training and education are acknowledged routes into employment, but they also entail risks of contemporaneous financial loss, and economic and social insecurity. This paper explores the specific risk of homelessness among apprentices and trainees, drawing on a survey conducted in South Australia in 2013. Housing has been largely overlooked by studies of the wellbeing of apprentices and trainees, and by explorations of the drivers of attrition rates that continue to plague Australia's training schemes. The data examined here reveal the high proportion of income that trainees spent on their housing; home moves motivated by the desire to reduce rental or mortgage payments; and a small proportion of learners who experienced periods of homelessness. Closer statistical analysis reveals that apprentices and trainees with past experiences of homelessness were disproportionately likely to be pursuing courses in retail and personal services, or in transport. They were also likely to be receiving Youth Allowance or AUSTUDY payments. We recommend better recording of apprentices' and trainees' housing situations and greater use of administrative data to improve our understanding and reduce the incidence of homelessness among this population.     

Optimal Choice for Appointment Scheduling Window under Patient No‐Show Behavior

Observing that patients with longer appointment delays tend to have higher no‐show rates, many providers place a limit on how far into the future that an appointment can be scheduled. This article studies how the choice of appointment scheduling window affects a provider's operational efficiency. We use a single server queue to model the registered appointments in a provider's work schedule, and the capacity of the queue serves as a proxy of the size of the appointment window. The provider chooses a common appointment window for all patients to maximize her long‐run average net reward, which depends on the rewards collected from patients served and the “penalty” paid for those who cannot be scheduled. Using a stylized M/M/1/K queueing model, we provide an analytical characterization for the optimal appointment queue capacity K, and study how it should be adjusted in response to changes in other model parameters. In particular, we find that simply increasing appointment window could be counterproductive when patients become more likely to show up. Patient sensitivity to incremental delays, rather than the magnitudes of no‐show probabilities, plays a more important role in determining the optimal appointment window. Via extensive numerical experiments, we confirm that our analytical results obtained under the M/M/1/K model continue to hold in more realistic settings. Our numerical study also reveals substantial efficiency gains resulted from adopting an optimal appointment scheduling window when the provider has no other operational levers available to deal with patient no‐shows. However, when the provider can adjust panel size and overbooking level, limiting the appointment window serves more as a substitute strategy, rather than a complement.     

“The loss was traumatic… some healthcare providers added to that”: Women’s experiences of miscarriage

Background

Miscarriage is a common event in Australia and is estimated to occur in up to one in four confirmed pregnancies. Prior research has demonstrated that miscarriage is associated with significant distress, grief and loss, and in some cases clinically significant levels of depression, anxiety, and Post Traumatic Stress Disorder. Despite these consequences for women’s emotional and mental health, studies have commonly found that women feel that healthcare providers often lack empathy, support, and acknowledgement of their loss.

Determining person–organization fit for healthcare CEOs: How executive equity sensitivity relates to nonprofit and for‐profit sector selection

This article empirically examines the relationship between the trait of equity sensitivity and employment sector (for‐profit, public, and nonprofit) for senior executives. By controlling for industry (healthcare), we show a relationship between this trait and employment sector in both a single‐state survey and a multistate survey. Findings indicate that benevolents have a propensity to pursue nonprofit positions whereas entitleds are likely to gravitate toward for‐profit positions. Implications for job seekers, employers, and academics are provided.     

食品安全追溯研究

食品安全追溯是目前研究的热点,其存在的主要问题是追溯成本过高而且还要受供应链脆弱性的制约。在分析主要问题产生的原因和阐述中外食品安全追溯进展情况的基础上,提出了食品安全追溯的对策建议：改变食品流通方式,利用现代化交易手段;进一步完善食品安全追溯法律;进行食品安全追溯的绿色供应链设计,主要包括绿色设计、绿色材料的选取、绿色生产、绿色包装和运输、绿色营销以及绿色回收7个环节。     

汇率调整之谜:基于产业内贸易的新解释

在符合马歇尔—勒纳条件下,汇率调整可以平衡贸易差额的经典理论在实证上并没有得到很好的支持,学术界称之为“汇率调整”之谜.产业内贸易可以为“汇率调整之谜”提供新的解释,忽视产业内贸易对出口汇率弹性的影响是该谜题出现的重要原因.在理论分析基础上建立的实证模型,通过面板协整方法,可我国与包括美国、欧盟等36个国家和地区的出口贸易数据和分行业出口贸易进行检验.研究结果表明,不管是总体数据还是分行业数据,产业内贸易的存在均减弱了我国出口的汇率弹性效应,对于出口总体数据而言,其数值下降的幅度大约为九个百分点.由此可见,忽略产业内贸易的传统理论高估了汇率对出口贸易、国际收支的调节作用.     

西方现代产权学派企业边界的悖论

企业诞生伊始,其边界和规模的扩张便一天也没有停止过。西方现代产权学派界定企业边界的努力却引致相反的结果,企业的边界陷于模糊和不可知的泥沼。企业边界悖论形成的原因主要有三点:企业、市场互为参照这种单一维度的选择;夸大交易成本的作用;对企业产权以及效率概念的狭隘理解。对此悖论的克服,马克思唯物史观的分析范式具有重要理论参考价值。马克思的企业边界理论实则囊括了人的因素和物的因素在内,并合理建立了一个矛盾体系并以此确定企业边界。企业在发展中,不仅进行着规模上的量变,更有质的不断飞跃的双重性。在马克思的理论框架中,企业边界决定的悖论并不存在。     

新制度经济学视角下的中小企业融资制度研究

按照新制度经济学的理论,现实社会中的经济人具有有限的理性认识,容易产生机会主义的倾向,以及社会经济环境的不确定性和交易的垄断性,不可避免地产生交易费用,降低交易效率。而通过制度设定和变迁,可以降低环境的不确定性,提高人们认识环境的能力,从而降低交易费用、提高经济效率。中小企业融资难是金融资源在中小企业之间配置的交易费用过高,资源配置效率低下的表现,合理的制度安排是解决中小企业融资难的有效途径。