Almost identical but still treated differently: hiring discrimination against foreign-born and domestic-born minorities

Focusing on birthplace (foreign vs. domestic) and origin group (European vs. Middle Eastern or African), this article examines the effects of cultural distance signals on discrimination against ethnic minority job applicants. Drawing on a cross-nationally harmonised correspondence test (N = 5780), we investigate how employers in five Western European destination countries (Germany, the Netherlands, Norway, Spain, and the U.K.) respond to job applications from majority and minority group members, with minority job applicants being either very similar (domestic-born and/or European origin) to the majority population or rather different (foreign-born and/or Middle Eastern/African). Our results are generally consistent with taste-based discrimination theory. Employers pay attention to signals of cultural distance, which results in particularly high levels of discrimination against foreign-born minorities and against minorities originating from Middle Eastern and African countries. Although origin group has a stronger effect on employer responses than birthplace, they jointly exert an additive effect. This results in particularly low labour market chances for foreign-born minorities of Middle Eastern and African origin. Separate country analyses, however, reveal important country differences, both with respect to the size of the minority penalty and the joint effect of birthplace and origin group

Effects of Decontamination of the Oropharynx and Intestinal Tract on Antibiotic Resistance in ICUs A Randomized Clinical Trial

IMPORTANCE Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) are prophylactic antibiotic regimens used in intensive care units (ICUs) and associated with improved patient outcome. Controversy exists regarding the relative effects of both measures on patient outcome and antibiotic resistance. OBJECTIVE To compare the effects of SDD and SOD, applied as unit-wide interventions, on antibiotic resistance and patient outcome. DESIGN, SETTING, AND PARTICIPANTS Pragmatic, cluster randomized crossover trial comparing 12 months of SOD with 12 months of SDD in 16 Dutch ICUs between August 1, 2009, and February 1, 2013. Patients with an expected length of ICU stay longer than 48 hours were eligible to receive the regimens, and 5881 and 6116 patients were included in the clinical outcome analysis for SOD and SDD, respectively. INTERVENTIONS Intensive care units were randomized to administer either SDD or SOD. MAIN OUTCOMES AND MEASURES Unit-wide prevalence of antibiotic-resistant gram-negative bacteria. Secondary outcomes were day-28 mortality, ICU-acquired bacteremia, and length of ICU stay. RESULTS In point-prevalence surveys, prevalences of antibiotic-resistant gram-negative bacteria in perianal swabs were significantly lower during SDD compared with SOD; for aminoglycoside resistance, average prevalence was 5.6%(95% CI, 4.6%-6.7%) during SDD and 11.8%(95% CI, 10.3%-13.2%) during SOD (P <.001). During both interventions the prevalence of rectal carriage of aminoglycoside-resistant gram-negative bacteria increased 7% per month (95% CI, 1%-13%) during SDD (P = .02) and 4% per month (95% CI, 0%-8%) during SOD (P = .046; P = .40 for difference). Day 28-mortality was 25.4% and 24.1% during SOD and SDD, respectively (adjusted odds ratio, 0.96 [95% CI, 0.88-1.06]; P = .42), and there were no statistically significant differences in other outcome parameters or between surgical and nonsurgical patients. Intensive care unit-acquired bacteremia occurred in 5.9% and 4.6% of the patients during SOD and SDD, respectively (odds ratio, 0.77 [95% CI, 0.65-0.91]; P = .002; number needed to treat, 77). CONCLUSIONS AND RELEVANCE Unit-wide application of SDD and SOD was associated with low levels of antibiotic resistance and no differences in day-28 mortality. Compared with SOD, SDD was associated with lower rectal carriage of antibiotic-resistant gram-negative bacteria and ICU-acquired bacteremia but a more pronounced gradual increase in aminoglycoside-resistant gram-negative bacteria