In response to the shortage of nursing staff and the so-called refugee crisis in 2015, two residential homes invited first-generation immigrants with a refugee background to participate in a... Show moreIn response to the shortage of nursing staff and the so-called refugee crisis in 2015, two residential homes invited first-generation immigrants with a refugee background to participate in a project for nursing education, orientation and internships. Between 2015 and 2018, a group of ten immigrants started working in a Dutch residential home and a group of seventeen immigrants in the German home. This dissertation investigates the social processes when these newcomers start working with the established staff, as well as the extent to which their mutual interactions and values of good care influence the enactment of geriatric care. Using ethnographic observations (305 hours), in-depth interviews (44) and six focus groups (24), the established care workers and immigrants were followed in both homes. The empirical data shows that institutional constraints, such as staff shortage, the imposition of professional norms, gossip used as a ‘weapon of the weak’, mutual suspicions of indifference, and collective images of ‘us’ versus ‘them’ affected the enactment of geriatric care. Their habitus stimulated them to tinker among each other as well as with different, sometimes conflicting, values of good care. However, both groups shared the feeling of ignorance by management, a pain of not mattering. Show less
Doesschate, T. ten; Vaart, T.W. van der; Debisarun, P.A.; Taks, E.; Moorlag, S.J.C.F.M.; Paternotte, N.; ... ; Werkhoven, C.H. van 2022
Objectives: The COVID-19 pandemic increases healthcare worker (HCW) absenteeism. The bacillus Calmette-Gue?rin (BCG) vaccine may provide non-specific protection against respiratory infections... Show moreObjectives: The COVID-19 pandemic increases healthcare worker (HCW) absenteeism. The bacillus Calmette-Gue?rin (BCG) vaccine may provide non-specific protection against respiratory infections through enhancement of trained immunity. We investigated the impact of BCG vaccination on HCW absenteeism during the COVID-19 pandemic. Methods: HCWs exposed to COVID-19 patients in nine Dutch hospitals were randomized to BCG vaccine or placebo in a 1:1 ratio, and followed for one year using a mobile phone application. The primary endpoint was the self-reported number of days of unplanned absenteeism for any reason. Secondary endpoints included documented COVID-19, acute respiratory symptoms or fever. This was an investigator-funded study, registered at ClinicalTrials.gov (NCT03987919). Results: In March/April 2020, 1511 HCWs were enrolled. The median duration of follow-up was 357 person-days (interquartile range [IQR], 351 to 361). Unplanned absenteeism for any reason was observed in 2.8% of planned working days in the BCG group and 2.7% in the placebo group (adjusted relative risk 0.94; 95% credible interval, 0.78-1.15). Cumulative incidences of documented COVID-19 were 14.2% in the BCG and 15.2% in the placebo group (adjusted hazard ratio (aHR) 0.94; 95% confidence interval (CI), 0.72-1.24). First episodes of self-reported acute respiratory symptoms or fever occurred in 490 (66.2%) and 443 (60.2%) participants, respectively (aHR: 1.13; 95% CI, 0.99-1.28). Thirty-one serious adverse events were reported (13 after BCG, 18 after placebo), none considered related to study medication.Conclusions: During the COVID-19 pandemic, BCG-vaccination of HCW exposed to COVID-19 patients did not reduce unplanned absenteeism nor documented COVID-19. (C) 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. Show less
