Days Of Absence Research Articles

Informational and instrumental support related to menstruation: adolescents’ perspective

<div align="center">Adolescent girls can experience puberty and menstruation in their school environment, especially when they decide to study in a boarding school for girls. The study aimed to describe the adolescent perception of informational and instrumental support related to menstruation. The descriptive study was conducted at a single institution-boarding school for girls in East Java, Indonesia. There were 236 students in junior high school were asked to fill out a questionnaire. Absenteeism due to menstruation was experienced by 35 students with 1-2 days of absence. In terms of informational support, more than 50% of students received information related to menstruation from their teachers. The school did not provide materials on menstrual hygiene on the toilet walls. In terms of instrumental support, most adolescents reported that clean water was available but soap for washing hands was not always available. Closed trash cans and access to a sanitary pad are available. According to most of the adolescents, the latrines in their school were easy to clean, but there were still around 10% who stated that the latrines were difficult to clean. Schools need to evaluate and improve support for students who are menstruating at school. Teachers' knowledge of reproductive health is a major concern.</div>

Stress and work-related mental illness among working adults with ADHD: a qualitative study

BackgroundThough many adults with ADHD underperform professionally, are more stressed, and have more days of sickness absence compared to adults without ADHD, few studies have explored the experience of working as an adult with ADHD. This study explores the general experience of working with ADHD, including stress and work-related mental illness.MethodsSemi-structured telephone interviews were conducted with 20 working adults with ADHD. Interview topics included how the ADHD diagnosis and/or symptoms of ADHD may have affected participants on the job, how work may have affected participants’ well-being, and the need for support and accommodation. Qualitative content analysis was used to explore verbatim transcripts from the interviews.ResultsThe analysis yielded three themes that describe some of the challenges of working with ADHD: Working and living with ADHD, Needs, and Special abilities, with a total of eight subcategories. Subcategories were Specific challenges; Relationships and cooperation; Negative consequences; Planning, prioritization, organization, and structure; Support, interventions, accommodations, and aids; Openness, understanding, and acceptance; Strategies; Strengths and qualities.ConclusionFurther knowledge about the challenges of working with ADHD is needed in workplaces; where organizational support is lacking, much in terms of accommodations and aids is up to the employee, and the disclosure of diagnoses may be associated with great dilemma.

Excess costs of multiple sclerosis: a register-based study in Sweden

Background and objectivePopulation-based estimates of the socioeconomic burden of multiple sclerosis (MS) are limited, especially regarding primary healthcare. This study aimed to estimate the excess costs of people with MS that could be attributed to their MS, including primary healthcare.MethodsAn observational study was conducted of the 2806 working-aged people with MS in Stockholm, Sweden and 28,060 propensity score matched references without MS. Register-based resource use was quantified for 2018. Annual healthcare costs (primary, specialised outpatient, and inpatient healthcare visits along with prescribed drugs) and productivity losses (operationalised by sickness absence and disability pension days) were quantified using bottom-up costing. The costs of people with MS were compared with those of the references using independent t-tests with bootstrapped 95% confidence intervals (CIs) to isolate the excess costs of MS from the mean difference.ResultsThe mean annual excess costs of MS for healthcare were €7381 (95% CI 6991–7816) per person with MS with disease-modifying therapies as the largest component (€4262, 95% CI 4026–4497). There was a mean annual excess cost for primary healthcare of €695 (95% CI 585–832) per person with MS, comprising 9.4% of the excess healthcare costs of MS. The mean annual excess costs of MS for productivity losses were €13,173 (95% CI 12,325–14,019) per person with MS, predominately from disability pension (79.3%).ConclusionsThe socioeconomic burden of MS in Sweden from healthcare consumption and productivity losses was quantified, updating knowledge on the cost structure of the substantial excess costs of MS.

Injury Burden in Professional European Football (Soccer): Systematic Review, Meta-Analysis, and Economic Considerations.

We performed a systematic review and meta-analysis to evaluate the injury burden and the related economic cost in European professional male football players. Multiple database research was performed up to August 5, 2022 (PubMed, EMbase, Scopus, Cochrane Library), including only studies that reported severity in the number of days of absence for each injury, incidence reported in the number of injuries/1000 hours, or reported number of injuries and exposure time and adult male football players, professionals from European clubs. Two reviewers extracted data and assessed paper quality with the Strengthening the Reporting of Observational Studies in Epidemiology statement and the Newcastle-Ottawa Scale. Twenty-two studies have reported incidence, severity, and burden of injuries in professional football. The highest injury burden was found for ligament-joint injuries (37.9 days/1000 hours; 222 397 €/1000 hours) and for muscle injuries (34.7 days/1000 hours; 203 620 €/1000 hours). Injury locations with high burden were knee injuries (34.8 days/1000 hours; 20 4206 €/1000 hours)-mainly anterior cruciate ligament injuries (14.4 days/1000 hours; 84 499 €/1000 h)-followed by thigh injuries (25.0 days/1000 hours; 146 700 €/1000 hours), hamstrings injuries (15.4 days/1000 hours; 90 367 €/1000 hours), hip-and-groin injuries (16.1 days/1000 hours; 94 475 €/1000 hours), primarily adductor muscles injuries (9.4 days/1000 hours; 55 159€/1000 hours), and ankle injuries (13.1 days/1000 h; 76 871 €/1000 hours) with ankle sprains (7.4 days/1000 hours; 43 423 €/1000 hours). Being exposed to injury risk has serious consequences for individual and club performance and economy. This review identified the most relevant targets in injury management, compared their injury data with reference values, and provided economic evidence when trying to gain buy-in from the key decision makers.

Interventions for preventing back pain among office workers - a systematic review and network meta-analysis.

Back pain is common in the working population. This systematic review with network meta-analysis (NMA) aimed to compare the effects of interventions for preventing back pain among office workers. We searched eight databases and additional sources up to March 2021. We included randomized controlled trials (RCT) and cluster RCT focusing on office workers, comparing work-related interventions aimed at preventing back pain (defined as pain in any part of the spine) to a control condition and assessing back pain and/or work absence. Further outcomes considered were adverse events and participants' satisfaction. We performed both frequentist and component NMA. Risk of bias (RoB) was evaluated using RoB 2 and certainty of the evidence (CoE) was assessed using GRADE. We screened 9809 records and included 24 studies with a total of 7080 participants. RoB was assessed as "some concerns" or "high" for all studies and outcomes. Included studies investigated multicomponent interventions, ergonomics, physical activity, education, behavioral interventions and no/minimal interventions. Effects were mostly not statistically significant and based on low/very low CoE. Physical activity probably reduces days of work absence slightly [mean difference (MD) -1.10, 95% confidence interval (CI) -2.07- -0.13], and combining physical activity and ergonomics may reduce back pain intensity (standardized MD -0.41, 95% CI -0.80- -0.02) when compared to no/minimal intervention. A large proportion of participants were satisfied with the interventions, adverse events were rarely assessed. We observed mostly minor effects of interventions on back pain and work absence among office workers. The practical relevance of these effects is questionable.

Does a 40-week football and Zumba exercise intervention influence self-reported job satisfaction, work role functioning and sick leave among female hospital employees? A cluster-randomised controlled trial

ABSTRACT This 40-week cluster-randomised controlled trial (RCT) examines the effects of football and Zumba on self-perceived job satisfaction, work role functioning and sick leave among Norwegian female hospital employees. Hundred-and-seven employees, mainly consisting of nurses (80%), were allocated into three groups; Football (FG), Zumba (ZG) and Control (CG). The exercise groups were offered two to three and one to two 1-h weekly sessions during the first 12 and last 28 weeks, respectively, with an actual weekly exercise frequency of 2.4 ± 0.5 and 0.9 ± 0.2 in FG and 2.3 ± 0.3 and 0.8 ± 0.2 in ZG. Outcome variables were measured at baseline, 12 and 40 weeks. In comparison to CG (4.8 days 95% CI 3.2–6.4), ZG (1.9 days, 95% CI 0.4–3.5) had a significant lower overall mean days of sickness absence during last sick leave period (−2.9 days, 95% CI −5.1 to −0.7, p = .011) which corresponded to a moderate effect size (d = 0.60). Between baseline (88.5%, 95% CI 84.3–92.6) and 12 weeks (93.8%, 95% CI 89.4–98.2), ZG showed significant within-group improvement in total score of the Work Role Functioning Questionnaire (WRFQ) (5.3%, 95% CI 0.6–10.1, p = .029), corresponding to a moderate effect size (d = 0.40). This study indicates that two to three 1-h weekly Zumba sessions can have a preventive effect on sick leave in female hospital employees. Highlights Participants in Zumba exercise organised by the workplace showed a significant lower number of sick leave days compared with the controls. Despite a correspondingly significant reduction in exercise adherence in both groups in the last 28 weeks, only FG showed tendencies for group improvement in job satisfaction and total WRFQ in this period. Workplace promotion of exercise and physical activity can thus be beneficial for both the workers and the organisation.

Association between COVID-19 vaccination status, time elapsed since the last vaccine dose, morbidity, and absenteeism among healthcare personnel: A prospective, multicenter study

AimWe assessed the impact of COVID-19 vaccination status and time elapsed since the last vaccine dose on morbidity and absenteeism among healthcare personnel (HCP) in the context of a mandatory vaccination policy. MethodsWe followed 7592 HCP from November 15, 2021 through April 17, 2022. Full COVID-19 vaccination was defined as a primary vaccination series plus a booster dose at least six months later. ResultsThere were 6496 (85.6 %) fully vaccinated, 953 (12.5 %) not fully vaccinated, and 143 (1.9 %) unvaccinated HCP. A total of 2182 absenteeism episodes occurred. Of 2088 absenteeism episodes among vaccinated HCP with known vaccination status, 1971 (94.4 %) concerned fully vaccinated and 117 (5.6 %) not fully vaccinated. Fully vaccinated HCP had 1.6 fewer days of absence compared to those not fully vaccinated (8.1 versus 9.7; p-value < 0.001). Multivariable regression analyses showed that full vaccination was associated with shorter absenteeism compared to not full vaccination (OR: 0.56; 95 % CI: 0.36–0.87; p-value = 0.01). Compared to a history of ≤ 17.1 weeks since the last dose, a history of > 17.1 weeks since the last dose was associated with longer absenteeism (OR: 1.22, 95 % CI:1.02–1.46; p-value = 0.026) and increased risk for febrile episode (OR: 1.33; 95 % CI: 1.09–1.63; p-value = 0.004), influenza-like illness (OR: 1.53, 95 % CI: 1.02–2.30; p-value = 0.038), and COVID-19 (OR: 1.72; 95 % CI: 1.24–2.39; p-value = 0.001). ConclusionsThe COVID-19 pandemic continues to impose a considerable impact on HCP. The administration of a vaccine dose in less than four months before significantly protected against COVID-19 and absenteeism duration, irrespective of COVID-19 vaccination status. Defining the optimal timing of boosters is imperative.

Absence among National Health Service workers during the COVID-19 pandemic in Portugal

Abstract Background By March 2020, the first Covid-19 cases were detected in Portugal. While the National Health Service (NHS) faced an increased demand for health care, anecdotal evidence showed that the NHS absenteeism rose. This might be explained by outbreaks in healthcare units, COVID-19 infection due to close contact with patients, self-isolation and quarantines, and family challenges originated by lockdowns. The present work aimed to quantify the absenteeism among NHS workers during the COVID-19 pandemic in Portugal. Methods This study used data for the number of NHS workers and absence days (2015-2021), from the Portuguese NHS Transparency Portal and the Strategy and Planning Office. Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absence rates (number of absent days as a percentage of potential workforce days). Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms (pairs of sine and cosine functions). Results From 2015 until March 2020, the average monthly absence rate was of 12.2, rising to 14.4 in the remaining period. This represented an increase of 18% in the absence rate. The interrupted time series showed an increase of 10.8% in the NHS absenteeism after the pandemic onset [Relative risk =1.10; 95% confidence interval (CI) 1.10-1.11; p &amp;lt; 0.01]. When accounting for seasonality in the data, the model showed an increase of 11.0% in the NHS absenteeism [Relative risk =1.11; 95% CI 1.01-1.22; p &amp;lt; 0.05]. Conclusions These results highlight the excess of absence days among the NHS workers during the COVID-19 pandemic. In future healthcare crises, health professionals should be protected, by assuring a safe workplace and making protective equipment available. Only then will be possible to reduce constraints in healthcare assistance, guarantee the adequate response, and contain the absence costs. Key messages

Excess costs of multiple sclerosis: A register-based study in Sweden

Abstract Background and Objective Population-based estimates of the socioeconomic burden of multiple sclerosis (MS) are limited, especially regarding primary healthcare. This study aimed to estimate the excess costs of people with MS that could be attributed to MS, including primary healthcare. Methods An observational study was conducted of the 2806 working-aged people with MS in Stockholm, Sweden and 28,060 propensity score matched references without MS. Register-based resource use was quantified for 2018. Annual healthcare costs (primary, specialised outpatient, and inpatient healthcare visits along with prescribed drugs) and productivity losses (operationalised by sickness absence and disability pension days) were quantified using bottom-up costing. Costs were compared between the people with MS and references with independent t-tests with bootstrapped 95% confidence intervals (CIs) to isolate the excess costs of MS. Results The mean annual excess costs of MS for healthcare were €7381 (95% CI: 6991-7816) per person with MS with disease modifying therapies as the largest component (€4262, 95% CI: 4026-4497). There was a mean annual excess cost for primary healthcare of €695 (95% CI: 585-832) per person with MS, comprising 9.4% of the excess healthcare costs of MS. The mean annual excess costs of MS for productivity losses were €13,173 (95% CI: 12,325-14,019) per person with MS, predominately from disability pension (79.3%). Conclusions The socioeconomic burden of MS in Sweden from healthcare consumption and productivity losses was quantified, updating knowledge on the cost structure of the substantial excess costs of MS. Key messages • Primary healthcare contributes around a tenth of the excess healthcare costs of MS in Sweden, primarily owing to contacts with healthcare professionals other than physicians. • Overall, the excess costs of MS in Sweden from lost production are larger in magnitude than the excess costs for healthcare consumption.

Psychotherapy and change in mental health-related work disability - A prospective population level register-based study in Finland

Abstract Introduction Mental disorders are a major cause of work disability among working age population. Psychotherapy has been shown to be an effective treatment for mental disorders, but the evidence mainly comes from small scale randomised trials with a relatively short follow-up. Objectives We used population-based register data to examine the association between statutory rehabilitative psychotherapy and change in depression or anxiety related work disability using a quasi-experimental interrupted time series analysis. Methods All those who started rehabilitative psychotherapy in 2011-2014 comprised the study group. The study group included 10436 participants who were followed from three years prior to four years after the onset of rehabilitative psychotherapy, resulting in 83488 observations. Annual total number of mental health related work disability months was calculated based on total number of annual compensated sickness absence and disability pension days. Results The onset of rehabilitative psychotherapy marked a decline in depression or anxiety related work disability as compared to the counterfactual trend. Specifically, a 20% decrease in the level (incidence rate ratio, IRR 0.80; 95% CI 0.76-0.85) as well as a 48% decrease in the slope (IRR 0.52; 95% CI 0.50-0.54) of work disability was detected. The decline was steepest in the oldest age-group Conclusions Providing statutory psychotherapy may decrease work disability at the population level. Further evidence for causal inference and the potential heterogeneity of the association is required.

Statistical Analysis of Absenteeism in a University Hospital Center between 2007 and 2019.

Objectives: To estimate the evolution of compressible absenteeism in a hospital center and identify the professional and sociodemographic factors that influence absenteeism. Method: All hospital center employees have been included over a period of twelve consecutive years (2007 to 2019). Compressible absences and occupational and sociodemographic factors were analyzed using Occupational Health data. Since the distribution of the data did not follow a normal distribution, the number of days of absence was presented as a median (interquartile range (IQR): 1st quartile–3rd quartile), and comparisons were made using non-parametric tests followed by a negative binomial model with zero inflation (ZINB). Results: A total of 16,413 employees were included, for a total of 2,828,599 days of absence, of which 2,081,553 were compressible absences (73.6% of total absences). Overall, 42% of employees have at least one absence per year. Absent employees had a median of 15 (IQR 5–53) days of absence per year, with an increase of a factor of 1.9 (CI95 1.8–2.1) between 2007 and 2019 (p < 0.001). Paramedical staff were most at risk of absence (p < 0.001 vs. all other occupational categories). Between 2007 and 2019, the number of days of absence was multiplied by 2.4 (CI95 1.8–3.1) for administrative staff, 2.1 (CI95 1.9–2.3) for tenured, 1.7 (CI95 1.5–2.0) for those living more than 12 km from the workplace, 1.8 (CI95 1.6–2.0) among women, 2.1 (CI95 1.8–2.6) among those over 50 years of age, 2.4 (CI95 1.8–3.0) among “separated” workers, and 2.0 (CI95 1.8–2.2) among those with at least one child. Conclusions: Paramedical personnel are most at risk of absenteeism. Meanwhile, absenteeism is increasing steadily, and overall, the increase is major for administrative staff. The profile of an employee at risk of absenteeism is a titular employee, living at distance from work, probably female, over 50 years old, separated, and with children. Identifying professionals at risk of absenteeism is essential to propose adapted and personalized preventive measures.

Association between asthma and work absence in working adults in the United States

Objectives: The present study aimed to investigate the association between asthma and work absence in a large sample of US working adults, while controlling for several sociodemographic and health characteristics. Methods: This study used data from the 2019 Health and Functional Capacity Survey of the RAND American Life Panel (ALP). Work absence corresponded to the number of days of absence from work for health-related reasons in the past 12 months. Current asthma was self-reported and was included in the analyses as a dichotomous variable. Control variables included sex, age, ethnicity, marital status, education, occupation, annual family income, health insurance, and number of chronic physical or psychiatric conditions. Finally, the association between asthma and work absence was analyzed using logistic regression models. Results: This study included 1,323 adults aged 22–65 years (53.1% males; mean [SD] age 43.1 [11.7] years). Individuals with asthma were more likely to report at least one (81.5% versus 56.8%, p-value<0.001) or three days of absence (56.9% versus 31.3%, p-value=0.003) from work in the past 12 months than those without asthma. These findings were corroborated in the regression analyses, as asthma was positively and significantly associated with work absence after adjusting for all control variables (at least one day of absence: OR=3.24, 95% CI=1.44–7.29; at least three days of absence: OR=2.61, 95% CI=1.26–5.40). Conclusions: This US study of working adults showed that asthma was a risk factor for work absence. Further research is warranted to better understand the factors predisposing to work absence in the asthma population.

Effect of online physical therapy on workplace accident-related outcomes in nursing care worker: study protocol of a multicentre randomised controlled trial

IntroductionAccording to the 2017 data, occupational accidents are more common in social welfare facilities compared with other industries; in particular, the number of occupational accidents resulting in four or more...

Psychotherapy and change in mental health-related work disability: a prospective Finnish population-level register-based study with a quasi-experimental design

BackgroundMental disorders are a major cause of work disability among the working-age population. Psychotherapy has shown to be an effective treatment for mental disorders, but the evidence is mainly based...

Identification and Characterisation of Trajectories of Sickness Absence Due to Musculoskeletal Pain: A 1-Year Population-based Study

Purpose This study aimed to identify trajectories of sickness absence in workers on sick leave due to musculoskeletal disorders and explore the association between these trajectories and established prognostic factors for sickness absence. Methods We conducted a prospective cohort study of 549 workers (56% women, aged 18–67 years) on sick leave due to musculoskeletal disorders in Norway in 2018–2019. Sickness absence data were collected from the Norwegian sick leave registry and prognostic factors via self-reported baseline questionnaires. We used group-based trajectory modelling to define the different trajectories of sickness absence spanning a 1-year period. Multivariable multinomial logistic regression was used to estimate odds ratios and 95% confidence intervals for prognostic factors associated with the identified trajectory groups. Results We identified six distinct trajectories of sickness absence over 1 year: ‘fast decrease’ (27% of the cohort): ‘moderate decrease’ (22%); ‘slow decrease’ (12%); ‘u-shape’ (7%); ‘persistent moderate’ (13%); and ‘persistent high’ (18%). Prognostic factors, such as previous sickness absence days, return-to-work expectancy, workability, multisite pain, and health scores, differentiated between the sickness absence trajectories (all P < 0.05). Negative return-to-work expectancy was associated with the three trajectory groups with the highest number of sickness absence days (‘slow decrease’, ‘persistent moderate’, and ‘persistent high’). Conclusions This is the first study to explore the association of return-to-work expectancy with trajectories of sickness absence. Our findings highlight different patterns of sickness absence and the complex range of prognostic factors. These findings have implications for secondary and tertiary prevention strategies for work absence in workers with musculoskeletal disorders.

Poor psychosocial job conditions increase sickness absence: evidence from the PATH Through Life Mid-Aged Cohort

ObjectivesEvidence is mounting that poor psychosocial job conditions increase sickness absence, but there is a need for further rigorous prospective research to isolate the influence of psychosocial job quality from...

Chikungunya in Brazil: An epidemic of high cost for private healthcare, 2017.

We evaluated the impact of direct and indirect medical costs incurred through chikungunya infections in patients treated in Fortaleza, Brazil. Cross-sectional study about the cost of illness. The valuation method of medical costs was based on the micro-costing approach (bottom-up). The study was carried out in a large general hospital of the private health network. The study population consisted of patients treated as suspected cases of chikungunya and hospital professionals who applied for sick leave due to chikungunya. In 2017, there were 2683 patients treated at this hospital who incurred an estimated cost of $383,514.40. From this amount, $174,322.91 (45.5%) were expended on emergency care, $194,700.59 (50.8%) on hospitalisations. 123 hospital professionals were infected with chikungunya and sick leave duration ranged between 1 and 19 days. Health professionals generated 746 days of absence and an amount of $14,490.90 due to absenteeism from work related to chikungunya. 31 symptoms were reported, especially arthralgia (91.1%) and fever (79.4%). There was a predominance of females (58.8%) and the age group of 20-39 years (42.1%). The average cost of admissions was over $2400. Considering the epidemic potential of chikungunya, our data indicate the huge economic burden of this disease to healthcare units in the presence of epidemics. Economic factors, added to the loss of life and the consequences of chronic chikungunya, make this disease a real scourge for countries with fewer material resources.

Trajectories of sickness absence and disability pension days among 189,321 white-collar workers in the trade and retail industry; a 7-year longitudinal Swedish cohort study

Objective1) identify different trajectories of annual mean number of sickness absence (SA) and disability pension (DP) days among privately employed white-collar workers in the trade and retail industries and 2) investigate if sociodemographic and work-related characteristics were associated with trajectory membership.MethodsA longitudinal population-based cohort register study of all white-collar workers in the trade and retail industry in 2012 in Sweden (N = 189,321), with SA and DP data for 2010–2016. Group-based trajectory analysis was used to identify groups of individuals who followed similar trajectories of SA/DP days. Multinomial logistic regression was used to determine associations between sociodemographic and work-related factors and trajectory membership.ResultsWe identified four trajectories of SA/DP days. Most individuals (73%) belonged to the trajectory with 0 days during all seven years, followed by a trajectory of few days each year (24%). Very small minorities belonged to a trajectory with increasing SA/DP days (1%) or to constantly high SA/DP (2%). Men had a lower risk of belonging to any of the three trajectories with SA/DP than women (OR Low SA/DP 0.42, 95% CI 0.41–0.44; Increasing SA/DP 0.34, 0.30–0.38; High SA/DP 0.33, 0.29–0.37). Individuals in occupations with low job control had a higher risk of belonging to the trajectory High SA/DP (OR low demands/low control 1.51; 95% CI 1.25–1.83; medium demands/low control 1.47, 1.21–1.78; high demands/low control 1.35, 1.13–1.61).ConclusionMost white-collar belonged to trajectories with no or low SA/DP. Level of job control was more strongly associated with trajectory memberships than level of job demands.

The comparison of Lobe-Specific or Systematic Mediastinal Lymph Node Dissection for Early-Stage Lung Adenocarcinoma With Consolidation Tumor Ratio Over 0.5

IntroductionSurgery is the most effective treatment for early-stage lung cancer. This study will propose a personalized plan for mediastinal lymph node dissection in early-stage lung adenocarcinoma to reduce the risk of surgery and improve the quality of life. MethodsThis study retrospectively analyzed the patients underwent lobectomy and lymph node dissection in the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University. Clinical stage I lung adenocarcinoma patients with solid component ratio (CTR) between 0.5 and 1 were included. Patients were divided into systematic (S-MLND) and lobe-specific (L-MLND) mediastinal lymph node dissection groups. The days of hospitalization, the presence or absence of complications, the recurrence-free survival rate, and the overall survival rate were calculated to evaluate the postoperative quality and operation risk of the patients. Results210 patients (138 L-MLND and 72 S-MLND) were included. 2 lymph node metastases appeared in the S-MLND group while none in the L-MLND group (P = .049). No differences were shown in age, tumor site, size, solid component, degree of tumor invasion, and stage. The proportion of patients with severe postoperative cough and the length of hospital stay in the L-MLND group decreased. The 5-year OS of the entire cohort was 98.1%, 98.6% in L-MLND, compared with 97.2% in S-MLND; RFS was 94.8%, 95.7% in L-MLND, compared with 93.0% in S-MLND. ConclusionFor cIA lung adenocarcinoma, according to the Thin-slice CT within 1 month before the operation, if the main lesion was less than 3 cm and CTR over 0.5, L-MLND is as effective as S-MLND.

Influenza vaccination of school teachers: A scoping review and an impact estimation.

Influenza vaccination, besides protecting traditional risk groups, can protect employees and reduce illness-related absence, which is especially relevant in sectors with staff shortages. This study describes current knowledge of influenza vaccination in teachers and estimates its potential impact. We conducted a scoping review of the considerations for and impact of influenza vaccination of schoolteachers (grey and scientific literature up to 2020 March, complemented with interviews). We then estimated the potential impact of teacher vaccination in the Netherlands, with different scenarios of vaccine uptake for 3 influenza seasons (2016-2019). Using published data on multiple input parameters, we calculated potentially averted absenteeism notifications, averted absenteeism duration and averted doctor visits for influenza. Only one scientific paper reported on impact; it showed lower absenteeism in vaccinated teachers, whereas more knowledge of vaccination impact was deemed crucial by 50% of interviewed experts. The impact for the Netherlands of a hypothetical 50% vaccine uptake was subsequently estimated: 74-293 potentially averted physician visits and 11,178-28,896 potentially averted days of influenza absenteeism (on ≈200,000 total teacher population). An estimated 12-32 vaccinations were required to prevent one teacher sick-leave notification, or 3.5-9.1 vaccinations to prevent one day of teacher absenteeism (2016-2019). Scientific publications on influenza vaccination in teachers are few, while public interest has increased to reduce teacher shortages. However, school boards and public health experts indicate requiring knowledge of impact when considering this vaccination. Estimations of 3.5-9.1 vaccinated teachers preventing one day of influenza-related sick leave suggest a possible substantial vaccination impact on absenteeism. Financial incentives, more accessible on-site vaccinations at workplaces, or both, are expected to increase uptake, but more research is needed on teachers' views and vaccine uptake potential and its cost-effectiveness. Piloting free on-site influenza vaccination in several schools could provide further information on teacher participation.