Resource Allocation for Epidemic Control in Metapopulations

Deployment of limited resources is an issue of major importance for decision-making in crisis events. This is especially true for large-scale outbreaks of infectious diseases. Little is known when it comes to identifying the most efficient way of deploying scarce resources for control when disease outbreaks occur in different but interconnected regions. The policy maker is frequently faced with the challenge of optimizing efficiency (e.g. minimizing the burden of infection) while accounting for social equity (e.g. equal opportunity for infected individuals to access treatment). For a large range of diseases described by a simple SIRS model, we consider strategies that should be used to minimize the discounted number of infected individuals during the course of an epidemic. We show that when faced with the dilemma of choosing between socially equitable and purely efficient strategies, the choice of the control strategy should be informed by key measurable epidemiological factors such as the basic reproductive number and the efficiency of the treatment measure. Our model provides new insights for policy makers in the optimal deployment of limited resources for control in the event of epidemic outbreaks at the landscape scale

Epidemics in Networks of Spatially Correlated Three-dimensional Root Branching Structures

Using digitized images of the three-dimensional, branching structures for root systems of bean seedlings, together with analytical and numerical methods that map a common 'SIR' epidemiological model onto the bond percolation problem, we show how the spatially-correlated branching structures of plant roots affect transmission efficiencies, and hence the invasion criterion, for a soil-borne pathogen as it spreads through ensembles of morphologically complex hosts. We conclude that the inherent heterogeneities in transmissibilities arising from correlations in the degrees of overlap between neighbouring plants, render a population of root systems less susceptible to epidemic invasion than a corresponding homogeneous system. Several components of morphological complexity are analysed that contribute to disorder and heterogeneities in transmissibility of infection. Anisotropy in root shape is shown to increase resilience to epidemic invasion, while increasing the degree of branching enhances the spread of epidemics in the population of roots. Some extension of the methods for other epidemiological systems are discussed.Comment: 21 pages, 8 figure

Development of a Patient-Centered Health Literacy Toolkit for Audiology and Hearing Loss (The \u27HH Lit Kit\u27)

The Patient-Centered Health Literacy Toolkit for Audiology & Hearing Loss (‘HH Lit Kit’) represents four years of inquiry into health literacy and Patient-Centered Care (PCC) in audiology. While awareness of health literacy continues to gain momentum in medicine and public health, there is a paucity of information on PCC and health literacy in audiology. Low health literacy is linked to poorer health and poorer quality of life. Patients with hearing loss are at high risk for low health literacy. This presents a major concern because hearing loss affects the way information is processed, retained, and applied. Gaps have been identified in the literature that highlight the necessity to better provide patients with evidence-based, unbiased counseling, and appropriate treatment options that can be readily understood and acted upon. The ‘HH Lit Kit’ and accompanying ‘Clinician Guide’ were developed to address these issues using evidence-based and validated resources specific or relevant to the discipline. The main aim of the ‘HH Lit Kit’ is to promote a clinical environment conducive to positive patient outcomes for adults with acquired sensorineural hearing loss and hearing handicap, making it an ideal intervention tool for the private practice, hospital or VA setting

Negotiating professional and social voices in research principles and practice

This paper draws on work conducted for a qualitative interview based study which explores the gendered racialised and professional identifications of health and social care professionals. Participants for the project were drawn from the professional executive committees of recently formed Primary Care Trusts. The paper discusses how the feminist psychosocial methodological approach developed for the project is theoretically, practically and ethically useful in exploring the voices of those in positions of relative power in relation to both health and social care services and the social relations of gender and ethnicity. The approach draws on psychodynamic accounts of (defended) subjectivity and the feminist work of Carol Gilligan on a voice-centred relational methodology. Coupling the feminist with the psychosocial facilitates an emphasis on voice and dialogic communication between participant and researcher not always captured in psychosocial approaches which tend towards favouring the interviewer as ‘good listener’. This emphasis on dialogue is important in research contexts where prior and ongoing relationships with professional participants make it difficult and indeed undesirable for researchers to maintain silence

Educating Pharmacy Students to Improve Quality (EPIQ) in Colleges and Schools of Pharmacy

Objective. To assess course instructors’ and students’ perceptions of the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) curriculum. Methods. Seven colleges and schools of pharmacy that were using the EPIQ program in their curricula agreed to participate in the study. Five of the 7 collected student retrospective pre- and post-intervention questionnaires. Changes in students’ perceptions were evaluated to assess their relationships with demographics and course variables. Instructors who implemented the EPIQ program at each of the 7 colleges and schools were also asked to complete a questionnaire. Results. Scores on all questionnaire items indicated improvement in students’ perceived knowledge of quality improvement. The university the students attended, completion of a class project, and length of coverage of material were significantly related to improvement in the students’ scores. Instructors at all colleges and schools felt the EPIQ curriculum was a strong program that fulfilled the criteria for quality improvement and medication error reduction education. Conclusion. The EPIQ program is a viable, turnkey option for colleges and schools of pharmacy to use in teaching students about quality improvement

Sharing a different voice: Attending to stories in collaborative writing

Through three stories, we hope to reveal how sometimes contradictory or unrecognizable aspects of our lives, selves, and stories can create tensions in the collaborative writing endeavor. We begin with a story that illuminates some of the narrative tensions that surface during a decade of writing collaboratively. In an effort to navigate these tensions, we explore two further stories in dialogue as a way to reveal how dominant narratives shape our lives and the stories we might tell. One aim of sharing these stories is to reveal how problematic ways of being are often inseparable from one’s cultural legacy. Making previously obscured narratives visible paves the way for imaginary leaps that are necessary for change. We hope these insights are useful for other writers and collaborators and those who seek caring, responsive, and nurturing writing relationships yet realize this journey can be problematic

Economically optimal timing for crop disease control under uncertainty: an options approach

Severe large-scale disease and pest infestations in agricultural regions can cause significant economic damage. Understanding if and when disease control measures should be taken in the presence of risk and uncertainty is a key issue. We develop a framework to examine the economically optimal timing of treatment. The decision to treat should only be undertaken when the benefits exceed the costs by a certain amount and not if they are merely equal to or greater than the costs as standard net-present-value (NPV) analysis suggests. This criterion leads to a reduction in fungicide use. We investigate the effect of the model for disease progress on the value required for immediate treatment by comparing two standard models for disease increase (exponential and logistic growth). Analyses show that the threshold value of benefits required for immediate release of treatment varies significantly with the relative duration of the agricultural season, the intrinsic rate of increase of the disease and the level of uncertainty in disease progression. In comparing the performance of the delay strategy introduced here with the conventional NPV approach, we show how the degree of uncertainty affects the benefits of delaying control

A Cellular Automata Model for Citrus Variagated Chlorosis

A cellular automata model is proposed to analyze the progress of Citrus Variegated Chlorosis epidemics in S\~ao Paulo oranges plantation. In this model epidemiological and environmental features, such as motility of sharpshooter vectors which perform L\'evy flights, hydric and nutritional level of plant stress and seasonal climatic effects, are included. The observed epidemics data were quantitatively reproduced by the proposed model varying the parameters controlling vectors motility, plant stress and initial population of diseased plants.Comment: 10 pages, 10 figures, Scheduled tentatively for the issue of: 01Nov0