Time Employment Research Articles

P-58. Quantifying the impact of introducing a new adult-focused PCV in the United States

Abstract Background In the United States, pneumococcal conjugate vaccines (PCVs) were first recommended for use in children in 2000, and approximately 82% currently receive the full 3+1 schedule. As of May 2024, adults aged 65 years and older are currently recommended to receive PCV15+PPSV23 or PCV20. Approximately 60% of adults have received at least one pneumococcal vaccination. A new investigational PCV, V116, is designed specifically for adults, as it contains 21 serotypes which account for the majority of pneumococcal disease in adults, including 8 unique serotypes not included in any other currently licensed vaccine. We sought to quantify the health impact of the new adult focus vaccine, V116 in comparison to PCV20 in adults.Table 1:Total IPD incidence per 100,000 (all ages) for each scenario at different time points. Also shown is the percent change from present values. Methods We developed a compartmental model to capture pneumococcal carriage transmission in the United States in the presence of age- and serotype-specific pneumococcal vaccines. A dynamic transmission model is preferable as it accounts for serotype replacement and herd protection. We calibrated the model to historical age- and serotype-specific invasive pneumococcal disease (IPD) data in the United States. The model was then used to quantify the epidemiological differences between PCV20 or V116 in 65+ year-olds in the presence of pediatric vaccination. We assumed pediatric vaccination continued at 82% coverage with an 80/20 mix of PCV20/PCV15 and that 57% of adults aged 65+ would have received a PCV in the last 10 years.Table 2:Cumulative IPD cases in a 10-year projection period for V116 and PCV20. Results While the introduction and continued use of either PCV20 or V116 led to reductions in IPD incidence, the use of V116 led to fewer overall cases. When compared to current IPD incidence, V116 led to an overall 39.3% reduction across all ages while PCV20 led to a 33.7% reduction after 10 years (Table 1). Conclusion The use of V116 in adults combined with continued pediatric PCV vaccination reduced population level IPD incidence by nearly 40% in the United States after only 10 years, which equated to approximately 15,000 fewer cases with V116 than PCV20 (Table 2). While there was a greater number of cases in the serotypes not included in V116 when compared to adult PCV20 use, indirect protection from pediatric vaccination still led to declines in these serotypes from present values. Disclosures Kevin Bakker, PhD, Merck & Co., Inc.: Grant/Research Support|Merck & Co., Inc.: Stocks/Bonds (Public Company) Giulio Meleleo, PhD, Merck & Co., Inc.: Vendor Oluwaseun Sharomi, MSc, PhD, Merck & Co., Inc.: Full time employee|Merck & Co., Inc.: Stocks/Bonds (Public Company) Robert Nachbar, PhD, Merck & Co., Inc.: US 7,219,020, US 5,292,741|Merck & Co., Inc.: Vendor|Merck & Co., Inc.: Stocks/Bonds (Public Company) Rachel Oidtman, PhD, Merck & Co., Inc.: Full time employee|Merck & Co., Inc.: Stocks/Bonds (Public Company)

P-1848. Reduction of microbial burden on environmental floor samples through advanced photohydrolysis technology and its impact on Candida auris, fungi, and aerobic bacteria

Abstract Background The continued rise of antimicrobial resistance (AMR) and reduction of pharmacological options has created an urgent need for new treatments or countermeasures to combat the spread of multi-drug resistant organisms (MDROs). Focus on MDROs has become paramount with the rise of Candida auris (C. auris) infections that are associated with high mortality and AMR. Attention must be given to pathogen reservoirs such as the surfaces of floors, which have an underappreciated potential to transfer pathogens to hands from objects in contact with the floor. Mean CFUs of Aerobic Bacteria from Baseline to Post-Activation #4. Methods An experimental study to explore the impact of advanced photohydrolysis (AP) technology inside a high acuity hospital unit with active C. auris infections was performed from September 2023 to January 2024 and investigated the effect of the AP system on floor colony forming units (CFUs) of aerobic bacteria, fungi, and C. auris. Baseline pre-activation samples were compared to post-activation samples, which occurred every four weeks on Tuesday mornings prior to shift change and daily environmental services (EVS) cleaning. Mean CFUs of Fungi from Baseline to Post-Activation #4. Results Pairwise comparisons with a Bonferroni correction found median floor fungal CFUs achieved a statistically significant reduction of 99% (p=.011) from Baseline to Post-Activation #4. Aerobic bacteria decreased 98%; C. auris by 66% but did not achieve statistical significance. The mean CFUs on high-touch surfaces were reduced for aerobic bacteria by 82% and fungi by 99%. C. auris was reduced by 100% from Baseline to Post-Activation #3 (41 CFUs to 0 CFUs) but increased in Post-Activation #4 due to two positive sample locations in a patient room with an active C. auris infection. Although the locations were positive for C. auris, they both tested under 500 CFU/cm2, which is associated with a reduced level of infection risk from environmental bioburden. Mean CFUs of Candida Auris from Baseline to Post-Activation #4. Conclusion This study clearly demonstrates that despite intensive efforts by EVS, serious microbes remain on floors; however, application of the AP technology provided a continual and persistent decline in floor microbial burden all without the need for additional skilled labor or increases in cleaning and disinfection practices. A forthcoming study will analyze how these demonstrated environmental changes affected patient outcomes. Disclosures Kimberly Trosch, RN, BSN, ActivePure Technologies: Full time employee Amy Carenza, BBA, ActivePure Technologies: Full time employee Deborah Birx, MD, ActivePure Technologies: Advisor/Consultant

P-528. Opportunities for PrEP Awareness and Engagement: A Survey among Healthcare-Seeking Cisgender Women in the US

Abstract Background Cisgender women comprise 19% of new HIV diagnoses and account for 8% of HIV pre-exposure prophylaxis (PrEP) users in the US. These data highlight the need to close this gap, especially as new PrEP options, such as long-acting (LA) PrEP, are available. This study assessed PrEP awareness and interest among healthcare-seeking women. Methods Cisgender women participated in an in-person survey at four health clinics in Kentucky, Seattle, St. Louis, and Philadelphia between Oct–Dec 2022. Inclusion criteria included: age ≥18 years; penetrative sex in the past six months; unknown or negative HIV status. The survey covered demographics, sexual and reproductive health, healthcare engagement, and HIV prevention, including PrEP awareness and interest. Descriptive statistics were calculated using SAS v9.4. Results Among the 185 women completing the survey (median age: 28, women of color: 48%, single/dating: 69%), half (51%, n=95) had heard of daily oral (DO) PrEP, and 18% (n=33) had heard of LA PrEP prior to taking the survey; none were currently taking any form of PrEP. Regarding sexual practices, participants reported: no condom use during last sex (68%, n=126); ≥2 sexual partners in the last year (58%, n=108); ever received an HIV test (64%, n=119); STI diagnosis in the past two years (17%, n=32). Participants who saw a healthcare provider (HCP) in the past two years (n=174) reported discussing the following with their HCP: birth control (85%), sexual health (62%), STI testing (67%), and HIV testing (32%); only 5% of participants (n=9/185) reported ever discussing PrEP with an HCP. When asked about starting PrEP, 25% expressed interest in DO PrEP and 18% in LA PrEP. Among participants not interested in LA PrEP (n=104, 56%), the main reasons cited were: “I don’t need it” (60%) and “I don’t think that I am at risk for HIV” (55%). However, among women expressing interest in multiple PrEP options (n=42, 23%), 45% would choose to start LA PrEP over the other PrEP options provided. Conclusion PrEP awareness and usage remain considerably low in the US among cisgender women who may benefit from PrEP. Efforts to increase awareness of PrEP among women in the US are needed, and newer PrEP options may provide HCPs opportunities to discuss PrEP in conjunction with other sexual and reproductive health topics. Disclosures Tonia Poteat, PhD, MPH, PA-C, ViiV Healthcare: Grant/Research Support Supriya Sarkar, PhD, MPH, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Full time employee Leigh Ragone, MS, GlaxoSmithKline: Stocks/Bonds (Public Company)|ViiV Healthcare: Full time employee Kyli Gallington, MPH, ViiV Healthcare: Advisor/Consultant Patrick Daniele, MS, GSK: Advisor/Consultant|ViiV Healthcare: Advisor/Consultant Karin S. Coyne, PhD, MPH, ViiV: Advisor/Consultant|ViiV: Grant/Research Support Vani Vannappagari, MBBS, MPH, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Full time Employee|ViiV Healthcare: Stocks/Bonds (Public Company)

P-732. Clinical Outcomes in Adults Hospitalized with Viral Lower Respiratory Tract Disease with a Bacterial and/or Fungal Coinfection: A US Claims Data Base Study

Abstract Background Bacterial and fungal coinfections in people hospitalized for viral lower respiratory tract disease (LRTD) may worsen clinical outcomes. We describe US adults hospitalized with viral LRTD and diagnosed with bacterial/fungal coinfection in a large US claims database.Table 1:Clinical outcomes in patients with severe viral LRTD diagnosed with a bacterial or fungal coinfection Methods We included adults with a first hospitalization for viral LRTD (2015–2023) based on ICD codes using Optum’s de-identified Clinformatics® Data Mart Database. From this cohort, we identified patients with a bacterial or fungal coinfection using ICD codes. We descriptively analysed patient characteristics in the 12 months pre-hospitalization and clinical outcomes for the first 30 days from hospital admission. Results We identified 387,449 patients with severe viral LRTD (75% with coronavirus etiology), of which 67,517 (17%) also had a bacterial/fungal coinfection diagnosis. Mean (SD) age was 73 (14) years in these patients and 54% were women (similar to the overall viral LRTD cohort). Mean (SD) Charlson Comorbidity Index (CCI) was 4 (3), which was slightly higher than in the overall cohort (mean CCI [SD]: 3 [3]). Just over half (51%) had an intensive care unit (ICU) admission (overall cohort: 39%), and among these patients 91% received their coinfection diagnosis while in the ICU (Table). Outcomes including invasive mechanical ventilation (IMV)/extracorporeal membrane oxygenation (ECMO) and death were more frequent in patients with coinfections versus the overall cohort. Among patients receiving IMV/ECMO, 73% received their coinfection diagnosis on the day of the procedure (12% were diagnosed before; 15% were diagnosed after receiving IMV/ECMO). Length of stay was shorter among those diagnosed with a coinfection at ICU admission (vs those diagnosed before ICU admission or during/after an ICU stay). IMV/ECMO frequency was highest in those who were diagnosed with coinfection before their ICU admission; mortality was higher among those diagnosed during their ICU stay. Conclusion Patients with viral LRTD and bacterial/fungal coinfection had a higher frequency of severe clinical outcomes compared with the overall viral LRTD cohort, that could not be fully explained by a high ICU admission in this cohort. Coinfection may be an important consideration for high-risk patients even prior to ICU admission. Disclosures Susan J. Johnson, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds (Public Company) Ekaterina Maslova, ScD, AstraZeneca: Employee of AstraZeneca|AstraZeneca: Stocks/Bonds (Private Company) Malin Fageras, PhD, AstraZeneca: Full time employee|AstraZeneca: Stocks/Bonds (Private Company) Gopal Dalal, PhD, AstraZeneca: Advisor/Consultant|AstraZeneca: Employee of ZS Associates India Pvt. Ltd. and contracted to AstraZeneca at time of study Hashmath Ulla T. A. Syed, PhD, AstraZeneca: Advisor/Consultant|AstraZeneca: Employee of ZS Associates India Pvt. Ltd. and contracted to AstraZeneca at time of study Nadir Yehya, MD, AstraZeneca: Advisor/Consultant

P-12. Evaluating the Epidemiological Impact of Lowering the Recommended Age for Adult Pneumococcal Vaccination in the United States

Abstract Background In the United States, there are two age-based pneumococcal vaccine recommendations – children aged 0-2 years and adults aged 65+ years. Adults aged 50-64 are recommended to receive a pneumococcal vaccine if at increased risk of pneumococcal disease; disease burden in this age groups represents the third highest level of pneumococcal disease. PCV20, a 20-valent PCV, and PCV15 are higher valent vaccines currently approved for adults. V116, an investigational adult specific PCV is being developed to specifically broaden protection in the adult population, by including key serotypes in currently licensed vaccines and 8 unique serotypes responsible for ∼30% of pneumococcal disease in adults in the US. Cumulative IPD cases in a 10-year projection period for V116 and PCV20. Methods We evaluated the impact of lowering the pneumococcal adult age-based vaccine recommendations in the United States to individuals aged 50+ years using a model that tracked age- and serotype-specific Streptococcus pneumoniae (SP) transmission. The model was calibrated to historical age- and serotype-specific invasive pneumococcal disease (IPD) data in the United States spanning 2000-2019. We evaluated the impact of lowering the recommended vaccination age in adults to 50+ years-old with V116. For projections we maintained an 80/20 coverage of PCV20/PCV15 in 82% of children and assumed a VCR of 57% for adults aged 65+. In the 50+ years old scenario, we reduced VCR to 46%, which was the age-specific tetanus rates for individuals aged 50-64 years-old multiplied by the reduction in uptake from the Shingrix vaccine when the recommended age was lowered. These adult VCR values assume a PCV was received in the last 10 years. Results Reducing the adult recommended vaccination age to 50+ years with the reduced VCR, led to similar overall reductions in IPD incidence when compared to maintaining the vaccination age at 65+ years (Table 1). The additional reductions in IPD in 50-64 year-olds was negated by the increase in cases in individuals aged 65+ years, due to vaccine waning. Conclusion If the recommended pneumococcal vaccination age for adults is reduced, additional efforts must be made to minimize the reduction of VCR, otherwise total IPD incidence will be similar to the current 65+ year-old age recommendation due to vaccine waning. Disclosures Kevin Bakker, PhD, Merck & Co., Inc.: Grant/Research Support|Merck & Co., Inc.: Stocks/Bonds (Public Company) Giulio Meleleo, PhD, Merck & Co., Inc.: Vendor Oluwaseun Sharomi, MSc, PhD, Merck & Co., Inc.: Full time employee|Merck & Co., Inc.: Stocks/Bonds (Public Company) Robert Nachbar, PhD, Merck & Co., Inc.: US 7,219,020, US 5,292,741|Merck & Co., Inc.: Vendor|Merck & Co., Inc.: Stocks/Bonds (Public Company) Rachel Oidtman, PhD, Merck & Co., Inc.: Full time employee|Merck & Co., Inc.: Stocks/Bonds (Public Company)

P-1783. Differences in stewardship strategies across hospitals performing well and poorly on a risk-adjusted metric for post-discharge antibiotic use

Abstract Background Antibiotic overuse at hospital discharge is common, and it is unclear which antibiotic stewardship (AS) strategies are effective at improving post-discharge antibiotic-prescribing. In this study, we compared how hospitals’ AS processes differed based on their performance on a risk-adjusted metric for post-discharge antibiotic use.Figure 1.Risk-adjusted comparison of post-discharge antibiotic-prescribing frequency and duration across 124 VA hospitalsGroup 1 hospitals (n=40) had less frequent post-discharge antibiotic-prescribing and used shorter post-discharge antibiotic duration. Group 2 hospitals (n=26) had more frequent post-discharge antibiotic-prescribing and used shorter post-discharge antibiotic durations. Group 3 hospitals (n=34) had less frequent post-discharge antibiotic-prescribing and used longer post-discharge antibiotic durations. Group 4 hospitals (n=24) had more frequent post-discharge antibiotic-prescribing and used longer post-discharge antibiotic durations. Methods We performed a retrospective study of discharges to home from 124 acute-care VA hospitals. Discharges occurred 6 months before/after a mandatory hospital-level AS survey (11/10/20); patients who received ≥ 30 days of post-discharge antibiotics were excluded. We built a zero-inflated negative binomial mixed-model with two random intercepts for each hospital to predict post-discharge oral antibiotic exposure and duration. Key model covariates included patient comorbidities, discharge diagnoses of infection, and inpatient antibiotic duration. Using the predicted random intercepts, hospitals were categorized into 4 groups. Next, we used a multinomial logistic regression model to compare how often AS processes, as reported in the survey, were used at hospitals across these groups.Table 1.Characteristics of 124 VA hospitals, stratified by a hospital’s performance on a risk-adjusted metric for post-discharge antibiotic useAbbreviations: AS = antibiotic stewardship; FTEE = full time employee equivalents; IQR = interquartile range; LOT = length of therapy; PA = prior authorization; PAF = prospective audit-and-feedback; SD = standard deviation. (1) Facility complexity scores are created by the VA Healthcare Analysis and Information Group. Hospitals are scored according to their patient population, clinical services (e.g., intensive care unit and surgery services), education and research. A score of 1a and 1b is categorized as the highest complexity. Lower complexity facilitates are scored as 1c, 2, or 3. (2) This survey question was dichotomized to compare stewardship physicians and stewardship pharmacists who interact daily or several times a week versus teams that interact weekly, monthly or less frequently than monthly. (3) This variable ranges from 1-10 and captures whether certain antibiotics were managed by prior authorization (PA) or prospective audit-and-feedback (PAF). Each additional antibiotic managed with one of these strategies increased the PA or PAF score by 1, except as noted: vancomycin (intravenous), daptomycin, oral/IV linezolid (each formulation = 0.5 points), piperacillin-tazobactam, cefepime, ceftazidime, anti-pseudomonal carbapenems, ertapenem, ciprofloxacin + levofloxacin oral/IV (each 0.5), and moxifloxacin oral/IV (each 0.5). Results There were 399,234 discharges; 17.2% received post-discharge antibiotics (median duration 6). Hospital performance on the metric is shown in Figure 1, and Table 1 shows hospital characteristics, based on the group. Forty (32.3%) hospitals were in group 1, i.e., they prescribed antibiotics less frequently than expected at discharge and used shorter post-discharge duration. Twenty-four (19.4%) hospitals were in group 4, i.e., they prescribed antibiotics more often than expected at discharge and used longer post-discharge duration. Compared to group 1 hospitals, hospitals in group 4 were less likely to report interactions between their AS physician and AS pharmacist(s) every day or several times per week (0.17, 95% CI 0.05-0.64). No other AS processes significantly differed between the groups (Table 2).Table 2.Odds ratios for a hospital within each group reporting the use of specific antibiotic stewardship processes, based on a multinomial logistic regression modelAbbreviations: AS = antibiotic stewardship; FTEE = full time employee equivalents; LOT = length of therapy; OR = odds ratio; PA = prior authorization; PAF = prospective audit-and-feedback; Ref = reference group. (1) This survey question was dichotomized to compare stewardship physicians and stewardship pharmacists who interact daily or several times a week versus teams that interact weekly, monthly or less frequently than monthly. (2) The odds ratio reflects the effect on the odds of increasing the number of antibiotics managed with this strategy by a single unit (i.e., managing 10 antibiotics by PA versus managing only 9 by PA). Conclusion The findings of this mixed-methods study suggest that routine AS physician-pharmacist collaboration may be important to reducing antibiotic overuse at discharge. Future studies should more precisely measure AS processes to better understand how these are associated with differences in hospital performance at this transition of care. Disclosures Daniel J. Livorsi, MD, Merck: Grant/Research Support Michihiko Goto, MD MSCI, Merck: Grant/Research Support

304. Global Incidence of Viral Lower Respiratory Tract Disease (LRTD) Episodes and Hospitalizations (2010–2021)

Abstract Background The COVID-19 pandemic highlighted the impact of viruses on lower respiratory tract diseases (LRTD); however, the global burden of viral LRTD is undefined. To bridge this gap, we estimated the global incidence of viral LRTD and hospitalizations in 2010–21. Figure 1. Global incident count of viral LRTD episodes by viral etiology (2010–2021). Non-viral causes are shown for comparison. Methods We used the Global Burden of Diseases, Injuries, and Risk Factors 2021 (GBD) framework and a Bayesian meta-regression tool (DisMod-MR 2.1) to estimate the global incidence of viral LRTD. We defined viral LRTD as clinician-diagnosed pneumonia/bronchiolitis, capturing symptoms such as cough, difficulty breathing, fever, and chest discomfort. Viral LRTD were categorized by pathogen (SARS-Cov2; influenza; respiratory syncytial virus [RSV]; ‘other’). We estimated hospitalizations by applying a country-specific scalar, informed by inpatient admission data and a country-specific healthcare access and quality index from the GBD, on pathogen-specific estimates of LRTD for each country. In data sparse regions, estimates were generated by extrapolation.Figure 2.Global incident count of viral LRTD hospitalizations, by viral etiology (2010–2021). Non-viral causes are shown for comparison. Results Average global incidence (per 100,000 person-years [PY]) of viral-associated LRTD episodes was 1,198 in 2010–19 and 25,716 in 2020–21. The number of viral LRTD cases was 880 million in 2010–19 and 4 billion in 2020–21. Average overall global incidence (per 100,000 PY) of viral LRTD hospitalizations was 170 (123 in 2010–19; 388 in 2020–21). The total number of hospitalizations was 90 million in 2010–19 and 61 million in 2020–21. Influenza and ‘other’ viruses accounted for most viral LRTD episodes (Figure 1) and hospitalizations in 2010–19 (Figure 2). Viral LRTD episode rates remained stable until 2019, while hospitalization rates increased. A decrease in influenza- and RSV-related episodes and hospitalizations was noted in 2020–21. Conclusion Viral LRTD are common and incur substantial global healthcare burden. Year-on-year increases in severe cases requiring hospitalization, most recently compounded by the COVID-19 pandemic, are alarming. Given the previously underappreciated scale of the problem, increased surveillance and novel therapeutic options may help reduce the burden of viral LRTD. Disclosures Ekaterina Maslova, ScD, AstraZeneca: Employee of AstraZeneca|AstraZeneca: Stocks/Bonds (Private Company) Malin Fageras, PhD, AstraZeneca: Full time employee|AstraZeneca: Stocks/Bonds (Private Company) Lisa White, PhD, AstraZeneca: Advisor/Consultant Pratik Sinha, MBChB/PhD, AstraZeneca: Advisor/Consultant|Prenosis Inc: Board Member

P-356. Reduction of high-touch surface aerobic bacteria and fungi colony counts with the implementation of ActivePure continuous disinfection technology

Abstract Background As hospitals nationwide rebound from the effects of the COVID pandemic, reduced staffing and increased hospital-acquired infections (HAIs) are still challenges. Surface disinfection plays a pivotal role in the prevention of HAIs. To improve high-touch surface disinfection and remove the dependence on the human factor, ActivePure continuous disinfection technology devices were installed in the Medical Intensive Care Unit (MICU) HVAC system at Ochsner LSU Health Shreveport in October 2023. ActivePure is a novel technique that kills microbes in the environment by using an advanced photocatalytic oxidation particle. Methods A prospective study was conducted in the 19-bed MICU. Two weeks before device activation, 50 high-touch surface samples and 10 reservoir samples were collected by sterile sponge in situ and plated onto Nutritive (tryptic soy) agar for total aerobic microbial counts, Selective (Sabouraud dextrose) agar for total fungal counts, selective (MeReSa) agar for total MRSA counts, and CHROMagar selective for Carbapenem-Resistant Acinetobacter baumannii (CRAB). All agar plates were incubated at 30°C or 37°C (as applicable) for 48-96 hours. For evaluation, serial dilution plate counts were used to calculate the CFU per sponge for each media type. The detection limit was 10 CFU/sponge for each evaluation. After 4 weeks post-activation, 50 high-touch surface samples and 10 reservoir samples from the same pre-activation sample locations were collected and evaluated via the same methods, and the same was repeated at 9 weeks post-activation. Routine cleaning and disinfection protocols were unchanged during the entire study period. Figure 2 Results The mean aerobic bacterial and fungi surface CFUs were reduced over 99.78% (Fig 1). The mean MRSA surface CFUs were reduced by 99.99% and the mean CRAB surface CFUs were reduced by 99.75% (Fig 2). There was a 94% reduction in surfaces with greater than 500 CFUs/100cm2 of MRSA. There was a 100% reduction in reservoirs with greater than 500 CFUs/100cm2 of CRAB and 80% reduction in reservoirs with greater than 10 CFUs/100cm2 of CRAB. Conclusion The ActivePure continuous disinfection technology devices significantly reduced total aerobic bacteria, including MRSA, difficult-to-treat CRAB, and fungi surface colony counts on high-touch surfaces. Disclosures Kimberly Trosch, RN, BSN, ActivePure Technologies: Full time employee Daniel Marsh, n/a, ActivePure Medical: Advisor/Consultant

Emphasis on Financial vs Nonfinancial Criteria in Employer Benefits’ Measurements

Few studies have examined the extent to which employers emphasize financial over nonfinancial criteria in measurement, reporting, and decision-making about health care benefits. To measure and identify factors associated with financial over nonfinancial emphasis in employer decision-making about health benefits. A survey was administered to a nationally representative sample of US employers to assess the extent of employers' emphasis on benefits plans' costs over member experience, access to care, and equity, and on financial vs other considerations when choosing third-party benefits administrators. The sample included in-company human resources administrators from randomly selected nongovernmental organizations with at least 50 employees. The survey was administered in 2 waves: May 2022 to July 2022 and November 2022 to April 2023. The survey included 41 multipart questions capturing information about the respondent, company, company interactions with benefits consulting firms and benefits administrators, and company approach to managing employee health benefits. Main outcomes were proportion of financially oriented measures that internal benefits administrators and external benefits consultants use and importance of financial vs other factors in companies' choice of third-party administrators. Of 1159 companies sampled, 251 (22%) responded; 30 with less than 50 employees were excluded. Of the 221 remaining companies, 147 (67%) used a benefits consulting firm. The companies and their benefits consultants focused on financial over nonfinancial performance dimensions in decision-making. While 125 companies (74%) tracked trends in health benefits costs and 109 (64%) tracked spending on the highest cost cases, only 14 (8%) tracked time employees spent having questions answered, and 12 (7%) tracked how often employees delayed receiving care because of an insurance company's actions. This financial focus was largely independent of organizational characteristics and other potential explanatory factors. Of 37 paired differences comparisons in the proportion of financial vs nonfinancial items, only 6 proportions (16%) differed significantly, with differences in proportions of 0.22 or less. In this survey study, US employers emphasized financial over nonfinancial criteria in their measurement and decision-making about health benefits. To improve health plan performance, employer measurement and decision-making must emphasize both nonfinancial and financial criteria.

The Fate of Employees of the Lithuanian Forest Industry 1939–1953

The article explores the fate of employees of the Lithuanian State Forest Industry, a separate branch of the economy, between 1939 and 1953, the staffing policy in this industry and specific features and results of its implementation. The forest was the location closely associated with the post-war resistance struggle, because a large number of partisan headquarters and hideouts were located in the forests. As a result, the work of forestry professionals and foresters and their attitude to events of that time were very important both to resistance fighters and the occupational government structures. The majority of them were under pressure to ‘double deal’, with the result that many left their jobs voluntarily as such conditions were not acceptable to them. The article explores all the events related to the turnover and fate of staff in chronological order: their deaths due to all possible reasons, including at the hands of their own partisans or the collaboration of foresters with the Nazis and the Soviet forces; various reprisals – from deportations and labour camps to violence; emigration to the west and the east due to political reasons; repatriation; peculiarities of employment of people who returned after deportation and imprisonment; the extent of employment of staff of Russian and other nationalities in the post-war years in the Lithuanian forestry system, etc. If the number of full time employees of the industry at the beginning of the Second World War (3,900 people) is held as a point of reference, major losses of the industry can also be expressed in the following figures: one in every eleven employees of this industry was killed; one in four employees suffered reprisals and were sentenced for various periods of time; and one in three suffered physical or moral violence. In the post-war years, only 75 Russian-speaking employees were recruited to the Lithuanian State Forest Industry and after Stalin’s death, over 1,000 of people who returned after deportation and imprisonment were employed.

A Study on Employee Welfare Measures with Reference to the Garments Industry

The goal of the current study is to identify the employee welfare strategies used by the IT sector. Anything done for the comfort and betterment of employees beyond the payment of wages—which is not a requirement of the industry—is referred to as employee welfare. The main goal of employee welfare is to maintain and improve the quality of life for employees. Half of an employee's time is spent either arriving at work or departing from it. When they are comparatively worry-free, they feel that they are contributing to the organization, and when they are having issues, they believe that the organization should be helping them. Individuals have the right to be regarded as complete human beings with unique needs.

ОСОБЛИВОСТІ ВПРОВАДЖЕННЯ МОНІТОРИНГУ ПЕРСОНАЛУ НА СУЧАСНИХ ПІДПРИЄМСТВАХ

Businesses related to various niches and industries use employee monitoring to protect themselves from potential risks of data leakage and other external threats. Employee monitoring is a new strategy in today's business that is central to improving productivity and operational efficiency. The application of scientific methods of monitoring and analyzing the activities of employees in real time allows organizations to achieve a high level of accountability, optimal allocation of resources and making informed management decisions. Such a monitoring system contributes to the rise and development of the enterprise, creating a more productive and motivated work environment. The article examines the peculiarities of the implementation of employee monitoring as an important tool for ensuring the efficient operation of the enterprise, maintaining labor discipline and rational use of resources. Separate forms of monitoring that are used in practice are considered. Attention is focused on the legal aspects of the monitoring process, compliance with the needs of both employers and employees, in particular, taking into account the rights and privacy of the latter. In the modern conditions of business operation and development, employers have an interest in the most efficient use of their staff's working time. Time control is one way to achieve this. Controlling working hours can be efficient and beneficial for a company, but it can also raise certain ethical and legal issues. It is important that this control is carried out in compliance with all relevant legal requirements and taking into account the rights and interests of employees. Therefore, the employer must develop and implement internal regulatory documents that regulate monitoring procedures, as well as ensure that employees are informed about their rights and obligations in this process. This will avoid conflicts and ensure the legal purity of monitoring, maintaining a balance between the needs of the enterprise and the rights of employees. The choice of personnel monitoring and tracking tools is not limited to technical aspects, but includes the creation of a culture of trust and openness in the relationship between the employer and employees.

Nutritional Education in Polish Companies: Employee Needs and the Role of Employers in Health Promotion.

Nutritional education has become a key component of health promotion strategies in many companies that recognize the benefits of healthy eating habits for enhancing efficiency and job satisfaction. The aim of this study was to understand employees' nutritional needs at work, and to assess the support provided by employers. The analysis focused on employees' eating habits and their attitudes towards eating at work, motives and barriers to healthy eating. The study was conducted using an anonymous survey completed by 1.056 individuals from across Poland. A discriminant function was selected for data analysis, which examined the differences between groups. The larger enterprises are more inclined to establish meal consumption spaces, which contributes to a more organised work culture. The larger the business, the more time employees spend eating meals, it being influenced by better-developed eating facilities, which undoubtedly encourages the workers to take longer breaks. The people with obesity were found to place the highest value on healthy food options and the people with a normal BMI are more responsive to healthy food subsidies, nutritional advice provided by a dietitian, and access to fitness facilities.

The Impact Of Job Characteristics On Employee Turnover Intention Through Psychological Contract In The Pharmaceutical Industry Of Pakistan

Introduction: The purpose of this research work is to examine the effect of job characteristics on intended turnover in the pharmaceutical industry of Pakistan with the ‘Psychological contract’ as a mediator amidst specialized knowledge that is pertinent to the sector’s growth. The characteristics included in this paper are autonomy, task identity, and skill variety, whereby studies were done to determine the effects of these characteristics on employee turnover intentions. Thus, the psychological contract acts as a pivotal link to breach, thereby increasing dissatisfaction and emergence of turnover. Objective: The study aims at establishing correlation between job content and turnover intention, Leader Member Exchange (LMX) as the moderator and psychological contract as mediator. Therefore, this research aims at filling this knowledge gap in relation to strategies of employee retention within the pharmaceutical industry of Pakistan and the way through which workforce stability could be boosted. Methods: The quantitative method was adopted, and based on the PLS-SEM technique to assess the hypothesis regarding the interaction[1] of job characteristics, psychological contract, LMX and turnover intention. The data were collected form 328 full time employees of pharmaceutical industries established in Pakistan. Recording of overall fit indices also supported these results. Results: The results show that among the job characteristics, autonomy was statistically significant and positive with β = 0. 058 and p < 0. 05 with corresponding tests showing significance for the-job skill variety (β = 0. 184, p < 0. 01) and feedback (β = 0. 166 p < 0. 01) to positively influence the psychological contract, thus translating to reduced turnover intention. LMX mitigates this relationship with high-quality LMX being particularly beneficial in enhancing the effect of the psychological contract on retention; (β = 0. 329, t < 0. 001). Conclusion: Consequently, the study shown that job characteristics should be encouraged and leader member relations should be promoted in order to minimize turnover intention in the context of Pakistan’s pharmaceutical industry. These findings are relevant to the organizational leaders who wish to enhance the retention rates of their employees and increase productivity through the effective job design and leadership practices. This is an important step in the validation of the model and has implications for the discussion on workforce stability within growing high demand sectors for application across the industries.

Polychronic Time Management and Employee Burnout: Supportive Roles of Organization and Supervisor

Polychronic Time Management and Employee Burnout: Supportive Roles of Organization and Supervisor

Perancangan Aplikasi Penggajian Karyawan Berbasis WEB Mengunakan Framework Codeigniter (Studi Kasus: Outlet Papoy Chicken)

Papoy chicken, a chicken restaurant in Tasikmalaya, is still facing management challenges, especially in the employee payroll process which is still done manually. This research aims to investigate the move from manual payroll to web application as a solution to increase the efficiency and accuracy of the payroll process at Papoy chicken. The research methods used include internal surveys, analysis of existing processes and development of web application prototypes for employee payroll. The research results show that the manual payroll process is prone to errors and takes up valuable time, by introducing a web application for employee payroll, Papoy chicken can reduce errors, save time and increase employee satisfaction. This web application will provide an intuitive interface and it is integrated with the internal management system, enabling managers to easily manage payroll information

Performance appraisal interval and employee exploratory innovation behavior: the curvilinear relationship and the boundary conditions

PurposeCompressing project timelines represents a prevalent temporal tactic aimed at accelerating the innovation process. However, empirical evidence on the impact of such time constraints on innovation remains inconclusive. This study aims to investigate the relationship between a prevalent organizational time mechanism—Performance Appraisal Interval (PAI)—and employee exploratory innovation behavior. Additionally, we explore the boundary conditions that may influence this relationship: the moderating effects of future work self salience and supervisory developmental feedback.Design/methodology/approachUsing online survey data collected in two waves from 426 employees working in hi-tech companies in China, we tested all the hypotheses.Findings(1) PAI demonstrates an inverted U-shaped influence on employees exploratory innovation behavior; (2) Employees’ future work self salience serves as a moderator that enhances the positive nature of this inverted U-shaped relationship; (3) Supervisory developmental feedback amplifies the moderating role of future work self salience, and the synergistic effect of PAI, future work self salience, and supervisory developmental feedback significantly enhances exploratory innovation behavior.Practical implicationsBy providing insights that are attuned to the temporal aspects of performance appraisal, this study aids organizations in making more informed, strategic decisions that enhance both the effectiveness of performance assessments and the cultivation of an environment that encourages exploratory innovation. Additionally, it is recommended that organizational leaders incorporate future-oriented interventions and developmental feedback into their management practices to further promote employees' engagement in exploratory innovation.Originality/valueDrawing on the interactive theory of performance, this study introduces a novel perspective on how an organizational temporal mechanism influences exploratory innovation and advances our understanding of the non-linear link between time constraints and employees' innovative behaviors.

(086) MEDICAL GASLIGHTING AND VULVOVAGINAL PAIN DISORDERS

Abstract Introduction Gaslighting is a form of epistemic injustice that involves testimonial injustice, in which patient’s experiences are discounted by others. The incidence of epistemic injustice has been described in a number of pain conditions including chronic fatigue syndrome and fibromyalgia, as well as in marginalized obstetric populations. Little research has been directed towards epistemic injustice in populations seeking treatment for benign gynecologic conditions or the unique context of vulvovaginal pain conditions. Additionally, little is known about the consequence of this type of injustice on patient’s perception of their care or willingness to seek care. Objective The purpose of this study was to develop a patient-validated instrument to measure patient experience of epistemic injustice in their past gynecologic care and to use the instrument to explore patient experiences in a vulvovaginal pain referral center. Methods An instrument was designed by the study team to quantify the incidence and distressed caused by gaslighting in patients seek care for vulvovaginal pain conditions. This was created based on common themes from written testimonials of patients available from National Vulvodynia Association. After construction, the instrument was submitted for feedback to officers from two vulvovaginal pain disorder patient societies. The survey was modified to include the feedback from these sources. The survey was then completed by patients establishing care with the clinic prior to their first appointment. Results 187 patients completed the survey in part or in full. Patients reported having seen an average of 5.7 providers prior to presentation. Patients felt supported by only 42% of past providers. Patients felt belittled by 27% of past providers. Patients felt 21% of past providers did not believe their symptoms. 45% of patients were told they “just needed to relax more”; 18% percent were recommended to drink alcohol to improve their condition; 55% considered giving up seeking care because they felt their concerns were not being addressed; 31% were told their symptoms were caused by high levels of anxiety; 22% were referred to psychiatry without other medical treatment for their symptoms; 19% felt unsafe during a medical encounter. 39% percent of patients were made to feel they were “crazy” and this was the most distressing of the questions asked (average 7.3/10 on a likert scale for distress for patients who had experienced this). Conclusions A survey based on patient concerns and validated by patients affected by vulvovaginal pain conditions has not been previously reported. This instrument was applied to a patient population at a large referral center for vulvovaginal pain conditions and the results showed that patients commonly experienced many forms of epistemic injustice, and greater than half of patients consider cessation of care for their condition because of these experiences. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Dr. Jill Krapf is a medical advisor for Evvy. Dr. Andrew Goldstein is a part time Employee of Daré Bioscience. He is a member of the board of directors of The Gynecologic Cancers Research Foundation. He is an advisor for: AbbVie, Incyte, and the National Vulvodynia Association. He has received research funding from Incyte.

Diversity in Frontline Employee Perceptions: Policies and Procedures, Training, and Leadership as Drivers of Service Equality

Excellent service is often discussed with an assumption of equivalency in its application, yet the reality is far more complex. Customers have distinct needs that pose distinct challenges for frontline service employees. In hotel settings, providing excellent service to a diverse set of guests is more nuanced when frontline employees themselves are from a wide variety of backgrounds. Whereas the literature considers operational tactics to promote excellence in guest service, it is unclear whether training, policies and procedures, and leadership designed to advance excellence have the same impact on employees who, by virtue of their background, are more attuned to guests’ needs. We extend the literature by empirically demonstrating that operational tactics impact frontline employees’ perceptions of service equality, with racial/ethnic minority employees seeing statistically distinct impacts. Employing a sample of 25,698 employee-year observations across 32 luxury hotels in the United States over 3 years, we find that codified policies and procedures, as well as training, improve assessments of guest service equality. In contrast, racial/ethnic minority employees are less impacted than their White counterparts by leadership stances that seem to promote equality more broadly. After controlling for time and other relevant employee- and hotel-level variables, operational tactics (a) improve perceptions of service equality, and (b) reduce the disparity between White and racial/ethnic-minority service-quality assessments. Our findings provide further direction for managers to elevate such perceptions of customer service equality across the board by leveraging training and by reinforcing clear operating policies and procedures.

Preface

The Iraqi Bulletin of Geology and Mining (IBGM) was first issued in April 2005 and published local research, mostly of the Iraq Geological Survey (State company of geological survey and mining at that time) employees’ research. It was aimed at encouraging geologists of the survey to publish the results of the regional geological survey of Iraq, largely archived within their library. Fortunately, after 20 years, the current issue of volume 20 publishes 9 international articles from various institutes and universities, such as Baghdad, Sulaimani, Babylon, and Salahaddin universities from Iraq in addition to Federation University Australia. These articles cover several geological fields, which microfacies analysis, structure geology, seismology, groundwater, industrial geology, petrology, geochemistry, and engineering geology. The Editorial Board of the bulletin hopes that the articles published in the present issue will provide valuable and accurate information for the scientific community in general. I take the opportunity to tell you that the Editorial Board has taken action to improve the template, reference style, way of citation, website, etc. of the bulletin to be ready for the next achievement by indexing the bulletin within the SCOPUS database. It was important to include a Digital Object Identifier (DOI) for each article. Being within the SCOPUS index is a significant step, where almost all the authors prefer such indexed journals.