David Keen

Abstract:

Objectives

Vaccinate-or-mask (VOM) policies aim to improve influenza vaccine coverage among healthcare workers (HCW) and reduce influenza-related illness among patients and staff. In 2012, British Columbia (BC) implemented a province-wide VOM influenza prevention policy. This study describes an evaluation of policy impacts on HCW absenteeism rates from before to after policy implementation.

Methods

Using payroll data from regional and provincial Health Authorities (HA), we assessed all-cause sick rates (sick time as a proportion of sick time and productive time) before (2007-2011, excluding 2009-2010) and after (2012-2017) policy implementation, and during influenza season (December 1-March 31) and non-influenza season (April 1-November 30). We used a two-part negative binomial hurdle model to calculate odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates, adjusting for age group, sex, job type, job classification, HA, year and vaccine effectiveness.

Results

During influenza season, HCWs in the post-policy period were less likely to take any sick time (OR 0.989, 95%CI: 0.979-0.999) but had higher rates of sick time (RR 1.038, 95%CI: 1.030-1.045). However, during non-influenza season, HCWs in the post-policy period were more likely to take any sick time (OR 1.015, 95%CI: 1.008-1.022) but had lower rates of sick time (RR 0.971, 95%CI: 0.966-0.976). There was an overall increase in predicted mean sick rate from pre to post-policy in influenza season (4.392% to 4.508%) and non-influenza season (3.815% to 3.901%).

Conclusions

The observed year-round increase in sick rates from pre-to-post policy was likely influenced by other factors; however, opposite trends in how HCWs took sick time in the influenza and non-influenza seasons may reflect policy influences and need further research to explore reasons for these differences.

Abstract:

Objectives

In 2012, British Columbia (BC) implemented a province-wide vaccinate-or-mask influenza prevention policy for healthcare workers (HCWs) with the aim of improving HCW coverage, and reducing illness in patients and staff. We assess post-policy impacts of HCW vaccination status on their absenteeism.

Methods

We matched individual HCW payroll data from December 1, 2012 to March 31, 2017 with annually self-reported vaccination status for BC health authority employees to assess sick rates (sick time as a proportion of sick time and productive time). We modelled adjusted odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates by vaccination status in influenza (December 1-March 31) and non-influenza seasons (April 1 to November 30). We used two methods to assess changes in influenza season sick rates for HCWs who had a change in their vaccination status over the five years.

Results

HCWs who reported 'early' vaccination (before December 1 when the policy is in effect) were less likely to take sick time (OR 0.874, 95%CI: 0.866-0.881) and took less sick time (RR 0.907, 95%CI: 0.901-0.912) in influenza season compared to HCWs who did not report vaccination; whereas HCWs who reported 'late' (between December 1 and March 31, and subject to masking until vaccinated) had similar sick rates to HCWs who did not report vaccination. These trends were also observed in non-influenza season. Influenza season sick rates were similar for HCWs that had at least one year of 'early' vaccination and one year where vaccination was not reported over the five year period.

Conclusions

Overall absenteeism is lower among HCWs who report vaccination versus those who do not report. However, absenteeism behaviours appear to be influenced by individual level factors other than vaccination status.

Abstract:

The majority of research into metal-organic frameworks (MOFs) focuses on their crystalline nature. Recent research has revealed solid-liquid transitions within the family, which we use here to create a class of functional, stable and porous composite materials. Described herein is the design, synthesis, and characterisation of MOF crystal-glass composites, formed by dispersing crystalline MOFs within a MOF-glass matrix. The coordinative bonding and chemical structure of a MIL-53 crystalline phase are preserved within the ZIF-62 glass matrix. Whilst separated phases, the interfacial interactions between the closely contacted microdomains improve the mechanical properties of the composite glass. More significantly, the high temperature open pore phase of MIL-53, which spontaneously transforms to a narrow pore upon cooling in the presence of water, is stabilised at room temperature in the crystal-glass composite. This leads to a significant improvement of CO₂ adsorption capacity.

Abstract:

Recent demonstrations of melting in the metal-organic framework (MOF) family have created interest in the interfacial domain between inorganic glasses and amorphous organic polymers. The chemical and physical behaviour of porous hybrid liquids and glasses is of particular interest, though opportunities are limited by the inaccessible melting temperatures of many MOFs. Here, we show that the processing technique of flux melting, 'borrowed' from the inorganic domain, may be applied in order to melt ZIF-8, a material which does not possess an accessible liquid state in the pure form. Effectively, we employ the high-temperature liquid state of one MOF as a solvent for a secondary, non-melting MOF component. Differential scanning calorimetry, small- and wide-angle X-ray scattering, electron microscopy and X-ray total scattering techniques are used to show the flux melting of the crystalline component within the liquid. Gas adsorption and positron annihilation lifetime spectroscopy measurements show that this results in enhanced, accessible porosity to a range of guest molecules in the resultant flux melted MOF glass.