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Aim To quantify the impact of the pandemic on fatal burden of disease among those living in residential aged care homes (RACH) in Australia. Methods Using Residential Aged Care data linked to Death Registrations (Jan 2016 to 11 Aug 2022), we estimated years of life lost per person-year (YLL/py) among people living in RACH. Additional linkage of notifications data from the state of Victoria enabled comparisons of average survival times between notified COVID-19 cases and matched non-cases living in RACH using COVID-19. Results COVID-19 deaths were low in 2020 and 2021 (610 and 260 deaths, respectively) but increased in 2022 (3230 deaths). Years of life lost due to COVID-19 was low in 2020 and 2021 (1.2% and 0.5% of the total YLL/py, respectively) but increased substantially in 2022 (8.3% of the total YLL/py). However, there was little evidence that YLLs/py overall increased in the pandemic (range: 0.87 to 0.93 in 2016-2019 and 0.85 to 0.88 in 2020-2022). Results describing differences in survival between notified COVID-19 cases and non-cases are forthcoming. Conclusion We observed no substantial increase in overall fatal burden of disease among the RACH population during the pandemic period. While COVID-19 case numbers increased in 2022 relative to 2020-2021, this was offset with better survival among cases over time, reflecting, at least in part, decreasing disease severity, high uptake of COVID-19 vaccines and antiviral medications.

Abstract Background Globally, detections of carbapenemase-producing Enterobacterales (CPE) colonisations and infections are increasing. The spread of these highly resistant bacteria poses a serious threat to public health. However, understanding of CPE transmission and evidence on effectiveness of control measures is severely lacking. This paper provides evidence to inform effective admission screening protocols, which could be important in controlling nosocomial CPE transmission. Methods CPE transmission within an English hospital setting was simulated with a data-driven individual-based mathematical model. This model was used to evaluate the ability of the 2016 England CPE screening recommendations, and of potential alternative protocols, to identify patients with CPE-colonisation on admission (including those colonised during previous stays or from elsewhere). The model included nosocomial transmission from colonised and infected patients, as well as environmental contamination. Model parameters were estimated using primary data where possible, including estimation of transmission using detailed epidemiological data within a Bayesian framework. Separate models were parameterised to represent hospitals in English areas with low and high CPE risk (based on prevalence). Results The proportion of truly colonised admissions which met the 2016 screening criteria was 43% in low-prevalence and 54% in high-prevalence areas respectively. Selection of CPE carriers for screening was improved in low-prevalence areas by adding readmission as a screening criterion, which doubled how many colonised admissions were selected. A minority of CPE carriers were confirmed as CPE positive during their hospital stay (10 and 14% in low- and high-prevalence areas); switching to a faster screening test pathway with a single-swab test (rather than three swab regimen) increased the overall positive predictive value with negligible reduction in negative predictive value. Conclusions Using a novel within-hospital CPE transmission model, this study assesses CPE admission screening protocols, across the range of CPE prevalence observed in England. It identifies protocol changes—adding readmissions to screening criteria and a single-swab test pathway—which could detect similar numbers of CPE carriers (or twice as many in low CPE prevalence areas), but faster, and hence with lower demand on pre-emptive infection-control resources. Study findings can inform interventions to control this emerging threat, although further work is required to understand within-hospital transmission sources.

In the last five decades, the number of women behind bars in the United States has risen exponentially. It is now estimated that there are nearly 58,000 admissions of pregnant people—disproportionately women of color—to jails and prisons each year. Recognizing the urgency and consequences of mass incarceration on pregnant people, their families, and communities, House Resolution 948: Justice for Incarcerated Moms Act of 2021 was introduced to Congress as a part of the Black Maternal Health Momnibus. The Justice for Incarcerated Moms Act aims to improve health care and promote dignity for incarcerated pregnant and parenting people through an array of policies and oversight. In this article, we review and reflect on the components of this bill within their broader public health and reproductive justice contexts. We close with recommendations for policymakers and professionals committed to promoting equity and justice for pregnant and postpartum incarcerated people.

Scientific modelling is a prime means to generate understanding and provide much-needed information to support public decision-making in the fluid area of sustainability. A growing, diverse sustainability modelling literature, however, does not readily lend itself to standard validation procedures, which are typically rooted in the positivist principles of empirical verification and predictive success. Yet, to be useful to decision-makers, models, including their outputs and the processes through which they are established must be, and must be seen to be “valid.” This study explores what model validity means in a problem space with increasingly interlinked and fast-moving challenges. We examine validation perspectives through ontological, epistemic, and methodological lenses, for a range of modelling approaches that can be considered as “complexity-compatible.” The worldview taken in complexity-compatible modelling departs from the more standard modelling assumptions of complete objectivity and full predictability. Drawing on different insights from complexity science, systems thinking, economics, and mathematics, we suggest a ten-dimensional framework for progressing on model validity when investigating sustainability concerns. As such, we develop a widened view of the meaning of model validity for sustainability. It includes (i) acknowledging that several facets of validation are critical for the successful modelling of the sustainability of complex systems; (ii) tackling the thorny issues of uncertainty, subjectivity, and unpredictability; (iii) exploring the realism of model assumptions and mechanisms; (iv) embracing the role of stakeholder engagement and scrutiny throughout the modelling process; and (v) considering model purpose when assessing model validity. We wish to widen the debate on the meaning of model validity in a constructive way. We conclude that consideration of all these elements is necessary to enable sustainability models to support, more effectively, decision-making for complex interdependent systems.

Orientation: Day labouring is becoming more frequent in developing countries. Long spells of unemployment and the uncertainty of informal wage employment impact negatively on the subjective well-being (SWB) of day labourers. Research purpose: The aim of the article was to investigate the level and possible determinants of the SWB of day labourers in Pretoria and Windhoek. Motivation for the study: Up to now, only one study has been carried out in South Africa on the SWB of day labourers and none in Namibia. This study aimed to start filling this gap in the literature. The choice of the two cities was based on their status as the capital cities of two countries that are both experiencing increasing numbers of day labourers. Research design, approach and method: A mixed-method research design and purposeful sampling were used to obtain representative samples. Data were sourced from comparable surveys amongst day labourers in the two cities between 2015 and 2017. Questionnaires with quantitative and qualitative sections were completed during structured interviews with 290 and 80 day labourers in Pretoria and Windhoek respectively. The ordinary least squares model and ordered-probit analysis were employed to analyse the data. Main findings: In Pretoria, the number of dependents, the living conditions and whether they had a full-time job before were all significant in explaining the SWB of the day labourers. In Windhoek, education levels, total days without food, staying with their families and being a foreigner were also significant. Practical/managerial implications: The needs of the informally employed must be addressed in the integrated development plans of municipalities and integrated with day labour worker centres. Contribution/value-add: This is the first study to analyse SWB amongst day labourers in Namibia and lays the foundation for future expanded studies.

The potential for using findings from socio-technical energy transition (STET) models in integrated assessment models (IAMs) has been proposed by several authors. A STET simulation model called TEMPEST, which includes the influence of societal and political factors in the UK’s energy transition, is used to model three of the global shared socioeconomic pathways (SSPs) at the national level. The SSP narratives are interpreted as inputs to TEMPEST, which drive scenario simulations to reflect varying societal preferences for mitigation measures, the level of political support for energy transition, and future economic and population trends. SSP1 and SSP2 come close to meeting UK net zero targets in 2050 but SSP5 does not reach net zero before 2080. An estimate of the total societal, political, and economic cost of scenarios indicates that while SSP1 achieves the best emissions reductions it also has the highest total cost, and SSP2 achieves the best ratio between rate of emissions reductions and total cost. Feasibility appears to be highest for SSP2 since it is the least different to historical precedent. Current UK government energy strategy is closer to the narrative in SSP5, however, which has the highest total cost and exceeds an estimated carbon budget by 32%. Three key TEMPEST findings are recommended for use in IAMs: (i) the uncertainty in emissions savings due to variability in political and societal support for energy transition, (ii) the influence of negative societal pushback to policies in achievement of expected policy outcomes, and (iii) the combined influence on energy service demand of disposable income, public willingness to participate, and user impacts from measures.

Positive behavior support (PBS) is an evidence-based framework for improving quality of life and preventing challenging behavior that is often implemented in combination with person-centered practices in the intellectual and developmental disability (IDD) field. Recently, state agencies and organizations supporting people with IDD have adopted a system-wide approach to PBS, much like multi-tiered school-wide PBS for youth in educational settings (e.g., SW-PBIS). Fidelity tools for guiding team implementation and action planning are essential throughout every phase of implementation in any innovation. Although such tools exist for SW-PBIS, no widely used measure currently exists for assessing the implementation of organization-wide PBS in the adult IDD field. This article describes the initial development of a fidelity of implementation tool used to evaluate organization-wide implementation of PBS and person-centered practices in community settings. A Midwestern state Department of Human Services and a university Center on Developmental Disabilities (UCEDD) in the United States partnered to complete this project. The authors discuss the exploratory and descriptive evaluation process involved in the initial development of the tool and share data for 10 provider organizations over a 6-year period of implementation. A descriptive case study using mixed measures is used to provide more details about the implementation of PBS in one agency to show the types of changes captured by the fidelity tool.

Re-distributed manufacturing (RDM), broadly described as manufacturing done at a smaller-scale and locally, could be beneficial to business and urban society through creating jobs, reducing the environmental impacts of production, and improving resilience to future disturbances. Consideration of RDM within a city-region requires the consideration of a wide range of issues – societal, technical, economic and environmental. This paper presents the results of a study into the potential for RDM to contribute to a sustainable, resilient city in the face of a range of expected future disturbances on the city and on manufacturing sectors. The study took an integrated assessment approach which incorporated the development of a conceptual framework; a ‘strawman’ causal loop diagram which was reviewed by participants in a workshop; and a stock and flow system dynamics model that represents our understanding about the structure and behaviour of urban manufacturing. Several key themes emerged: similarities between RDM and traditional manufacturing, availability of physical space for RDM to be done, achieving urban resilience through RDM by enabling responsiveness to disturbances, changes in environmental impacts from production, additions or losses in jobs, the competitiveness of local manufacturing, and skills and innovation for RDM technologies. Further work is recommended.

The current study investigated the support that a facility dog can provide to survivors of sexual crimes when undergoing video-recorded police interviews. In total, 13 survivors of sexual offences, who were undergoing a video-recorded interview, were provided with a facility dog for the interview process. For each case, data were collected via interviews, observations and surveys. Using a multiple case study approach, qualitative data were analysed to identify patterns, with observational and survey data used to provide further support to these outcomes. A total of four main themes emerged from the data: (1) a change in focus for the survivor, (2) a difference in the survivors’ engagement, (3) the dog as a comforter to keep the survivor calm and (4) a positive environment. Overall, the findings suggest that the facility dog provided a much needed and beneficial service to survivors, helping them feel calmer and more comfortable. The dog also provided survivors with a more positive environment, allowing them to focus on the interview and communicate more openly about their experiences. The current study, therefore, presents very positive findings relating to improving survivors’ perspectives of justice within the framework of kaleidoscopic justice, bridging their perceived justice gap.

The paradox underlying the rebound effect is that, due to secondary effects, improvements in resource efficiency provide smaller reductions in the consumption of energy and/or material resources than are expected—or even an overall net increase in resource use. The rebound effect has played a role in economic growth and industrialization, yet it remains a problem for the task of reducing negative environmental impacts. This paper proposes that the size of the rebound effect, and the type of impacts it causes, may be affected by future changes in the system within which it arises. Four types of rebound effect are considered: economy-wide effects, transformational effects, frontier effects, and international rebound effects. A conceptual model of the historical role of the rebound effect in socio-technical systems, and the relationship of socio-technical systems with natural capital and human-created capital, provides a “sandbox” for testing ideas about the future. The model theory draws upon the concepts of natural capital, the Global Ecological Footprint, and the Great Acceleration. How the size of four types of the rebound effect might change in future, as supplies of resources from natural capital become more constrained, is discussed within three storylines. In the first storyline, natural capital declines but remains fairly stable; rebound is much decreased as resources are less available and efficiency is used up more in stabilizing supplies of goods and services. In the second storyline, growth continues without constraint amid regional rivalry; eventually there is a strong downturn in availability of resources and negative impacts on both society and natural capital. In the third storyline, impact caps are implemented for different types of resources; for some time, industry and society adapt by investing in low resource-use innovation and global cooperation on management of natural capital; once natural capital recovers and stabilizes, growth and consumption may increase along with the rebound effect, but staying within a Global Ecological Footprint of 1 Earth. The theory and model in this paper are intended to contribute to new thinking on the subject of the rebound effect.