Physical Disability at Work: How Functional Limitation Affects Perceived Discrimination and Interpersonal Relationships in the Workplace

Adults with disability have significantly lower rates of labor force participation relative to persons without disability, although it is unclear whether this disparity extends to subjective workplace experiences. Using data from the 2004 to 2006 wave of the National Survey of Midlife Development in the United States (n =2,030), we evaluate: (1) whether U.S. workers with physical disability report higher levels of perceived job discrimination and unequal workplace opportunities and lower levels of supervisor and coworker support and (2) whether these patterns differ by sex, age, and occupation group. We find that workers with physical disability fare significantly worse on all four outcomes net of covariates. Disability takes a particularly large toll on men’s perceived workplace opportunities and white-collar employees’ relationships with coworkers. Young adult workers (ages 30–39) with disability report significantly more support from their supervisor relative to their counterparts without disability. We discuss implications for research and policy.

Dynamics of the human nasal microbiota and Staphylococcus aureus CC398 carriage in pig truck drivers across one workweek

Drivers of pig trucks constitute a potential route of human transmission of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) CC398. In this study we determined MRSA prevalence in pig truck drivers (n=47) and monitored the nasal microbiota of nine drivers three times daily throughout one workweek (n=113 samples) and compared it to their spouses (n=25 samples from six spouses) and 89 non-exposed subjects. S. aureus isolates (n=232) derived from a subset of nasal and truck samples were whole-genome sequenced. Nasal alpha diversity of drivers in the beginning of the workday was lower compared to non-exposed subjects. During the workday, it increased significantly. Similarly, the drivers’ nasal composition shifted during the workday, becoming increasingly different from spouses and non-exposed individuals. Clustering into community state types (CSTs) revealed frequent switches from either S. aureus - or Corynebacterium -dominated CSTs in the mornings to a Psychrobacter- dominated CST during the workday. Six intermittent MRSA carriers were mostly MRSA-negative in the mornings and their nasal microbiota resembled that of non-exposed subjects. When acquiring MRSA during the workday, they switched to the Psychrobacter- dominated CST. In contrast, the nasal microbiota of two persistent MRSA carriers was dominated by staphylococci. In conclusion, we show that the nasal microbiota of pig truck drivers is very dynamic, undergoes drastic changes during workdays, and differs from non-exposed subjects even before pig-contact. MRSA-carrying drivers may eventually introduce MRSA into the community and health care facilities. Carriage dynamics, however, showed that for most drivers CC398 MRSA is rapidly lost and only rarely causes transmission to spouses. Importance In Denmark, the number of human MRSA cases has increased dramatically since the early 2000s, starting from imported cases and spread in the community. However, today approximately one third of all new cases are attributed to livestock-associated MRSA (LA-MRSA) CC398. This mirrors the increase in pig farms of which 95% are now positive for LA-MRSA, mainly caused by three dominant lineages enriched for a number of key antimicrobial resistance genes. Whereas most human LA-MRSA CC398 infections in Denmark are linked to livestock contact, still up to one third is not. Pig truck drivers constitute a hitherto understudied occupation group which may transmit LA-MRSA CC398 to household members, the community, and hospitals. In this study, we demonstrate dramatic work-related changes in the nasal microbiota of pig truck drivers, as well as in their carriage of LA-MRSA CC398. However, they likely do not constitute an important reservoir for LA-MRSA CC398 dissemination.

Cognitive orientation to daily occupation group in the adult day rehabilitation setting: A feasibility study Cognitive Orientation to daily Occupational Performance in day rehabilitation

Introduction The Cognitive Orientation to daily Occupational Performance (CO-OP) ApproachTM is a leading approach in occupational therapy. Implementing the CO-OP ApproachTM in a group format in day rehabilitation has not yet been explored. Method In day rehabilitation, a barrier to implementing the CO-OP ApproachTM is the group model. To address these challenges, this feasibility study involved the development, implementation, and evaluation of a CO-OP group for adults. Four patients participated in six group sessions. Pre- and post-measures included the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Subjective data were collected to reflect the participant’s experiences during the group. Results 80% of participants recruited completed the group. All participants demonstrated improvement in goals addressed within the group and goals not addressed within the group on the COPM. AMPS findings were inconclusive. Subjective findings indicated participants appreciated the group learning environment, valued the CO-OP process, were motivated to participate, and would have liked more groups. Conclusion To our knowledge, this is the first adult CO-OP group in a clinical setting. Results support the feasibility of a CO-OP group in day rehabilitation and the need for further examination of the effectiveness of this intervention.

The Effect of Public Reporting of Acute Myocardial Infarction on the Choice of Hospital

BackgroundPublic reporting of the quality of care delivered in hospitals is thought to improve patients’ choice and quality of care. When information about hospital rating is available, consumers may choose good-rated hospitals. To investigate the effect of public reporting of acute myocardial infarction (AMI) care on the people’s choice of hospitals. MethodsWe conducted a cross-sectional study using an online questionnaire. The survey questions include the awareness and usage of public reporting, and the impact of the public reporting on the choice of hospitals. The difference in responses before and after acquiring information about public reporting was compared using Wilcoxon Signed Rank test.ResultsThe final survey data set includes 740 respondents after a rigorous validity check (response rate: 66.7%). Before providing information about public reporting of AMI care, 62.8% of respondents selected ‘nearby hospitals’ as the best option for AMI patients, followed by ‘famous hospitals’ (14.4%), ‘usual hospitals’ (10.5%) and ‘hospitals with good rates’ (9.9%). However, after acquiring information about the public reporting of AMI care, 10.3% of respondents changed their original responses to ‘hospitals with good rates’. Among the factors of hospital choice that differ before and after obtaining public reporting information, 'nearby hospitals' and 'hospitals with good rates' increased, while 'usual hospitals’ and 'famous hospitals' decreased. Compared to the health-related occupation group, the non-health related occupation group showed a significant difference between 'famous hospitals', and 'hospitals with good rates' before and after obtaining information (Famous hospitals p=0.003, Hospitals with good rates p=0.002).ConclusionsThe publicly available hospital quality ratings influence people’s choice of hospital, increasing the risk of selecting a hospital with a good rating than the nearest hospital, which is recommended for AMI patients. Policy-makers need to stress the importance of choosing the nearest hospital when AMI symptoms occur, in addition to hospital ratings, in the public reporting.

A spatiotemporal simulation study on the transmission of harmful microorganisms through connected healthcare workers in a hospital ward setting

Background Hand transmission of harmful microorganisms may lead to infections and poses a major threat to patients and healthcare workers in healthcare settings. The most effective countermeasure against these transmissions is the adherence to spatiotemporal hand hygiene policies, but adherence rates are relatively low and vary over space and time. The spatiotemporal effects on hand transmission and spread of these microorganisms for varying hand hygiene compliance levels are unknown. This study aims to (1) identify a healthcare worker occupancy group of potential super-spreaders and (2) quantify spatiotemporal effects on the hand transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance caused by this group. Methods Spatiotemporal data were collected in a hospital ward of an academic hospital using radio frequency identification technology for 7 days. A potential super-spreader healthcare worker occupation group was identified using the frequency identification sensors’ contact data. The effects of five probability distributions of hand hygiene compliance and three harmful microorganism transmission rates were simulated using a dynamic agent-based simulation model. The effects of initial simulation assumptions on the simulation results were quantified using five risk outcomes. Results Nurses, doctors and patients are together responsible for 81.13% of all contacts. Nurses made up 70.68% of all contacts, which is more than five times that of doctors (10.44%). This identifies nurses as the potential super-spreader healthcare worker occupation group. For initial simulation conditions of extreme lack of hand hygiene compliance (5%) and high transmission rates (5% per contact moment), a colonised nurse can transfer microbes to three of the 17 healthcare worker or patients encountered during the 98.4 min of visiting 23 rooms while colonised. The harmful microorganism transmission potential for nurses is higher during weeknights (5 pm – 7 am) and weekends as compared to weekdays (7 am – 5 pm). Conclusion Spatiotemporal behaviour and social mixing patterns of healthcare can change the expected number of hand transmissions and spread of harmful microorganisms by super-spreaders in a closed healthcare setting. These insights can be used to evaluate spatiotemporal safety behaviours and develop infection prevention and control strategies.

PREVENTIVE MEASURES IMPLEMENTATION AMONG LIBYAN GENERAL DENTISTS AND PROSTHODONTISTS DURING COVID-19 OUTBREAK IN TRIPOLI: A CROSS-SECTIONAL STUDY.

Introduction: The available knowledge about Covid-19 mandate applying set of strict preventive measures for medical and dental professions. Dental health personnel are considered among high risk occupation group during the pandemic. Objective: This study aimed to assess the level of adherence to the preventive measures against the coronavirus disease and infection control among prosthodontists and general dentists in Tripoli, Libya. Methods: A questionnaire consisting of 8 questions was distributed among dentists who are working in private clinics or public health centers during Covid-19 pandemic, in Tripoli. Dentists were selected randomly to participate in this survey. Results: This study included a total of 70 dentists forming a response rate of about 87,5% (70 dentists participated out of 80 dentists), a total of 19 were prosthodontists and 51 were general dentists. The results showed that only 32% had attended lectures regarding COVID-19. The percentage of dentists who wear PPE during fixing post insertion complete denture complains and during fixing high spots before final cown/ bridge cementation were (60%, and 61.4%) respectively. During dental treatment, all dentists reported they do keep frequent hand hygiene by using ABHR or water and soap, (72.8%) ask their patients for pre procedural mouth rinse before starting the treatment, (62.8%) stated that they use rubber dam during aerosol generating procedures.. Conclusions: Libyan dentists in this study showed practicing of moderate infection control procedures to minimize transmission of Covid-19, limited comprehension of what constitutes as emergency dental procedures was recognized. Dentists are required for attending awareness days and workshops in this respect. Keywords: COVID-19, Dentists, Preventive measures, Infection control.

Addiction Problems, Aggression, and Quality of Life in People with Different Occupations in South Korea

Addiction is related to aggression and quality of life. This study examined the relationship between these three factors according to occupation group in a mixed urban/rural area to better understand adult addiction problems. This study was a secondary data analysis of cross-sectional data collected by a 2017 regional survey of adults living in Gunsan City, South Korea. The survey included 500 people split into the unemployed (Group1), full-time homemakers (Group2), and primary (Group3), secondary (Group4), and tertiary (Group5) industry workers. Addiction problems and aggression were positively correlated (p < 0.01). Aggression and alcohol use disorder were correlated in Group3 (r = 0.31), Group4 (r = 0.34), and Group5 (r = 0.32), and aggression and smartphone addiction were correlated in Group2 (r = 0.39) and Group4 (r = 0.31). Problem gambling was correlated with aggression in Group5 (r = 0.39). A negative relationship between quality of life and alcohol use disorder occurred in Group1 (r = −0.36). According to the occupation group, the relationships between addiction problems, aggression, and quality of life were different. These findings suggest that addiction management for adults should be implemented in consideration of occupation groups.

Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Healthcare Workers in Chicago

Background Identifying factors associated with SARS-CoV-2 infection among healthcare workers (HCW)s may help health systems optimize SARS-CoV-2 infection control strategies. Methods We conducted a cross-sectional analysis of baseline data from the Northwestern HCW SARS-CoV-2 Serology Cohort Study. We used the Abbott Architect Nucleocapsid IgG assay to determine seropositivity. Logistic regression models (adjusted for demographics and self-reported community exposure to COVID-19) were fit to quantify the associations between occupation group, healthcare delivery tasks, and community exposure and seropositive status. Results 6,510 HCWs, including 1,794 nurses, and 904 non-patient facing administrators participated. The majority were women (79.6%), 74.9% were white, 9.7% were Asian, 7.3% were Hispanic and 3.1% were non-Hispanic Black. The crude prevalence of seropositivity was 4.8%(95% confidence interval (CI):4.6%-5.2%). Seropositivity varied by race/ethnicity as well as age, ranging from 4.2% to 9.6%. Out-of-hospital exposure to COVID-19 occurred in 9.3% of HCWs, 15.0%(95%CI:12.2-18.1%) of whom were seropositive; those with family members diagnosed with COVID-19 had a seropositivity rate of 54%(95%CI: 44.2%-65.2%). Support service workers 10.4%(95% CI:4.6-19.4%), medical assistants 10.1%(95% CI:5.5-16.6%), and nurses 7.6%(95% CI:6.4%-9.0%) had significantly higher seropositivity rates than administrators (referent) 3.3%(95%CI:2.3–4.4%). However, after adjustment, nursing was the only occupation group with a significantly higher odds (OR:1.9, 95%CI:1.3-2.9) of seropositivity. Exposure to patients receiving high-flow oxygen therapy, and hemodialysis was significantly associated with 45% and 57% higher odds for seropositive status, respectively. Conclusions HCWs are at risk for SARS-CoV-2 infection from longer duration exposures to people infected with SARS-CoV-2 within healthcare settings and their communities of residence.