Number Of Absence Days Research Articles

An analysis of direct and indirect costs in Hidradenitis Suppurativa.

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition with recurrent nodules and abscesses that culminate in purulent discharge and scarring. It has significant physical, psychological and financial impact. This study plans to analyse patient costs associated with HS. Direct costs include prescription items. Indirect or out-of-pocket costs include dressings, analgesia, and healthcare-related travel costs. This study will also assess disease impact on quality-of-life (QOL). Patients with HS diagnosis attending dermatology OPD at our public tertiary centre were invited to participate. Ethical approval was secured, and informed consent was obtained. Participants completed an anonymous survey which was analysed to identify costs associated with HS as well as demographics and QOL impact. A total of 25 patients completed the survey; median age was 29% and 80% were female. Median time from HS onset to diagnosis was 2years, with 24% waiting >10years to be diagnosed. In the past 3months, 20% spent >€200 in both categories; prescription and non-prescription items. In the non-prescription category, 36% of patients reported expenditure >€100 in the past 3months. Dressings were the most common out-of-pocket expense (in 15/25 patients), followed by analgesia and protective clothing. Attendance at medical appointments cost 24% of patients €50-€200. Four participants reported difficulty accessing HS treatments due to associated costs. Mean number of absence days from work/education as result of HS was 8.7 in the past 3months. Two patients reported being on disability allowance, and two on unemployment benefit as result of their skin disorder. In the QOL question; 96% reported disease impact on QOL, and 11 participants reported that it affected their life 'very much'. HS is a chronic inflammatory skin condition with significant financial burden alongside the well-analysed biopsychosocial disease impact. Financial burden can be divided into direct prescription costs and indirect costs such as non-prescription items, protective clothing and travel costs which we have explored in this study. Further research is needed in this area to identify and optimise both the financial and QOL implications of HS in acute flares and chronic disease management.

Incidence and cost of COVID-19-related work absence based on social insurance data from Poland

Abstract Background COVID-19 pandemic and public health measures aimed at limiting the spread of the disease caused widespread work absence. This research aimed to identify the incidence of COVID-19-related short-term work absence and to estimate the cost associated with this absence. Methods The study used quarterly (Q) social insurance data from Poland (2020-2022). COVID-19-related absence was identified with four ICD-10 classification diagnoses: COVID-19; personal history of COVID-19; post-COVID-19 condition; and multisystem inflammatory syndrome associated with COVID-19. To identify work absence, the study relied on real-life, disease-specific data on the number of absence days from the Social Insurance Institution. Additionally, excess caregiving resulting from the pandemic was estimated based on all-cause caregiving days. To estimate the cost of work absence, the study relied on the human capital method. Results There were 15.2 million absence days resulting from four COVID-19-related diagnoses (2.1% of total all-cause absence days). Of these, COVID-19 caused 12.2 million absence days, followed by post-COVID-19 condition (2.9 million). Excess caregiving was a dominant pandemic-related work absence category, with 37.7 million work days lost. COVID-19 absence was concentrated in Q4-2020 and high in Q1-2021 and Q3-2022. On the other hand, the incidence of the remaining three diagnoses was the highest in Q1-2022. The total indirect cost of work absence was €4.3 billion, and 69.2% of this loss resulted from excess caregiving. For this cost category, 79.1% of costs were borne in Q2- and Q3-2020 when severe lockdowns were imposed. Conclusions The estimates show that COVID-19-related short-term absenteeism was a significant public health burden and translated to severe economic losses. The economic loss from caregiving resulted in more burden than the COVID-19 health-related absence. Key messages • There were 52.9 million work absence days from the COVID-19 pandemic in Poland until the end of 2022, resulting in an indirect cost of €4.3 billion. • Most (∼70%) of the pandemic work absence and its cost resulted from caregiving responsibilities, which applied to care for the sick and children unable to attend educational facilities.

Productivity Loss Across Socioeconomic Groups Among Patients With Low Back Pain or Osteoarthritis: Estimates Using the Friction-Cost Approach in Norway.

Our aim was to estimate the productivity loss (PL) among patients with low back pain (LBP) or osteoarthritis (OA) across socioeconomic groups, using the friction-cost approach (FCA). A total of 175,550 patients aged 18-65 years were included at their first diagnosis in specialty care between 2011 and 2016. PL was calculated for the year following diagnosis using individual wages, while adjusting for the friction length at 78 days per episode, a team production multiplier at 1.6, compensation mechanisms of 26.8%, and a chain-of-vacancies multiplier at 3.95. We included a simpler FCA model, omitting the latter three parameters, and a human capital approach (HCA) model. Socioeconomic stratifications were created based on education and income. One-way sensitivity analysis was used to assess the influence of the parameters in the full FCA model. The overall mean number of absent days was 23, while it was 25.3 and 20.1 for those with low and high education levels. The per-patient friction costs were €4395 among all patients and when extending the friction length to 98 days costs were €4342. For those with low and high education levels, the costs were €3671 and €4464, respectively. The costs in the simple FCA and HCA models were €1539 and €2088. Socioeconomic status and model design are sources of variation in PL. In health economic applications with PL and in patient populations with large socioeconomic differences, adjusting for these factors may be as important as sensitivities in parameters such as the friction length.

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 < 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 < 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

Influence of the COVID-19 Lockdown and Restart on the Injury Incidence and Injury Burden in Men’s Professional Football Leagues in 2020: The UEFA Elite Club Injury Study

BackgroundStudies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce.ObjectiveTo describe the injury incidence and injury burden in men’s professional football teams during the pandemic year of 2020.MethodsNineteen teams in 12 countries prospectively registered data on player-exposure and time-loss injuries throughout 2020. All major football leagues were paused as a direct response to the pandemic in March 2020 and were thereafter completely cancelled or restarted after a lockdown interval of at least two months. Historical data from 43 teams in the same cohort during the five preceding years (2015–2019) were used as reference. Between-season and within-season comparisons were made for injury incidence (number of injuries per 1000 h) and injury burden (number of absence days per 1000 h) with 95% confidence intervals and interquartile ranges.ResultsThere was no increased match injury incidence or injury burden following the restart in 2020 compared with other time periods of 2020 and the corresponding periods 2015–2019. There was an increased training injury incidence and injury burden immediately during the lockdown in 2020, and they remained elevated also following the restart, being higher in 2020 compared with 2015–2019, respectively. The injury characteristics during the first months of the new 2020/21 season (August/September–December) were similar between the five teams that cancelled their 2019/20 season in March 2020 and the 14 teams that restarted their season in May/June 2020.ConclusionsThere was no increased match injury incidence or injury burden following the COVID-19 lockdown and restart of the football season in 2020, but training injury incidence and injury burden were elevated and higher than in 2015–2019.

Doenças osteomusculares são a principal causa de absenteísmo-doença entre trabalhadores da indústria de petróleo no Brasil: resultados de um estudo de coorte

Abstract Objective: to describe the incidence of sickness absence among workers of an oil industry in Brazil. Methods: retrospective cohort study conducted with 2,028 workers. Study data were obtained from workers’ medical records from 2012 to 2016. Indicators of absenteeism were calculated by sociodemographic characteristics, occupational characteristics, and morbidity. Results: of the participants, 87.6% were men, 49.2% with high school educational level, 46.9% aged 50 years or older, 65.1% worked in non-operational activities. The cumulative incidence of sick leave was 71.5% and its incidence rate, 25.8 per 100 person-years. We found the highest incidence rates amongst women (31.6), workers aged 50 years or older (29.9), lower educational attainment (29.2), work experience spanned 30 years or more (31.9), working in operational activities (27.9), and regular work schedule (26.1). Musculoskeletal (n=2,001), respiratory (n=1,016), and digestive diseases (n=967) were responsible for the largest number of sick leaves. The highest number of absence days was due to musculoskeletal diseases (n=11,640), followed by injuries (n=6,267) and mental disorders (n=5,042). Low back pain diagnostic was responsible for the greatest number of absence days (n=3,632). Conclusions: health programs aimed at controlling the identified morbidities should target women, those with longer work experiences, and those with lower educational attainment.

Nutritional Status, Health Status, and Work Productivity of Cocoa Farmers in Polewali Mandar, Indonesia

The objective of this study was to analyze the associations between nutritional status, health status, other determining factors with work productivity of cocoa farmers. This cross-sectional study involved 58 male cocoa farmers aged 18–65 years old in two districts of Polewali Mandar. Data on food consumption and habit as well as health status were collected via structured interviews. While, blood pressure and anthropometric parameters were measured using standard equipment of blood pressure meter, weight scale, and height scale. Spearman’s test and Principal Components Regression (PCR) analysis were implemented to explore factors associated with farmers’ work productivity. There was no relationship between Body Mass Index (BMI) and work productivity. However, there was a significant positive association between central obesity with days of absent (r=0.275; p=0.037). We also found negativeassociation between blood pressure and the amount of cocoa picked daily (r=-0.366; p=0.005). PCR statistical analysis results showed that the amount of cocoa picked per day were significantly associated with smaller waist circumference, coffee consumption, and good exercise habit. While, decrease in consumption of fruits and vegetables was significantly associated with the number of absence days due to health problems. Thus, it can be concluded that work productivity of male cocoa farmers was associated with food consumption, physical activity, and lifestyle factors.

STUDENT ASTHMA STATUS AND SCHOOL ABSENCE

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To examine the association of student asthma status and student absences for students enrolled in first through twelfth grade in an urban school district. METHODS: A retrospective study was conducted using 112,694 students demographic and absence records for the 2010–17 academic school years for students enrolled. The school district created the data for district and state mandatory reporting. The student asthma status was based upon the student record containing an asthma action plan (AAP) that was signed by a licensed healthcare provider. The student absence was based on the attendance record for each student each day of each year. The number of absence records for each student is the number of days a student was coded as absent. Characteristics of the student included gender, race, ethnicity, socioeconomic status and grade. The main outcome of this study was school absence and all descriptive data are stratified by asthma status. To determine any major differences by year, all data was analyzed separately. The absence data is reported by number of cumulative days of school absence in categories; the proportion of students having missed at least one day of school, and only among students who missed at least one day of school. RESULTS: Because the data is consistent across the study period only 2016–17 results are reported.The population was mostly boys (51.2%) of white race (71.6%), of Hispanic/Latino ethnicity (58,7%) and from low income homes (50.1%). Asthma prevalence was 6.7% with higher proportions of asthma in boys (7.3%), among Blacks (10.1%), among students of non-Hispanic/Latino ethnicity (6.9%), and among students from low income homes (13.3%), among those who missed at least one day of school (7.1%) and especially among students who had missed 18 or more days (10.1%). Overall majority of students (90.0%) missed one day of school, with a median number of absent days of 6 days (p25=3, p75=10). Of students who missed at least one day, the proportion was higher in girls (90.2%), among American Indians or Alaskan Natives (91.2%), Of students who missed at least one day, the proportion of students with asthma (94.1%) was higher than those without asthma (89.7%). Students with asthma missed a median of seven days (p25=4; p75=13). Students with asthma missed a higher proportion of 18 or more days (13.6% vs.9.1%) compared to students without asthma. CONCLUSIONS: Although 90% of all students missed at least one day of school, a higher proportion of students were identified as having asthma and from a low income income homes, and missed more days of school. CLINICAL IMPLICATIONS: Asthma disease management strategies are needed for students that are boys, Black, non-Hispanic/Latino and from low income homes to improve school absences. DISCLOSURES: No relevant relationships by Jose Betancourt, source=Web Response No relevant relationships by De De Gardner, source=Web Response

A Double-Blind, Randomized, Placebo-Controlled Trial of Heat-Killed Pediococcus acidilactici K15 for Prevention of Respiratory Tract Infections among Preschool Children.

Although some probiotic bacteria have been reported to prevent infections in children, there are few well-designed double-blind studies. Here we evaluated the effects of a probiotic strain of lactic acid bacteria (LAB), Pediococcus acidilactici K15, on viral respiratory tract infections in preschool children. A four-month, randomized, double-blind, placebo-controlled study was performed in 172 healthy children aged 3 to 6 years. Subjects were administered dextrin alone or dextrin including heat-killed K15 (5 × 1010 bacteria). The number of febrile days was the primary outcome. The number of absent days from preschools and the influenza incidence were secondary outcomes. Secretory IgA (sIgA) concentrations in saliva were measured as an exploratory outcome. The primary and secondary outcomes were not significantly different between both groups. Analyses in children with little intake of fermented foods including LAB showed that the duration of a fever significantly decreased by K15 intake. The salivary sIgA level in the K15 group was maintained significantly higher than it was in the placebo group. The effects of K15 on preventing viral respiratory tract infections were not observed without the restriction of fermented foods intake. However, K15 supported anti-infectious immune systems in children who took less fermented foods and the maintenance of salivary sIgA levels in all subjects.

Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy.

There is controversy regarding the widespread uptake of robotic surgery across several surgical disciplines. While it has been shown to confer clinical benefits such as decreased blood loss and shorter hospital stays, some argue that the benefits of this technology do not outweigh its high cost. We performed a retrospective insurance-based analysis to investigate how undergoing robotic surgery, compared to open surgery, may impact the time in which an employed individual returns to work after undergoing major surgery. We identified a cohort of US adults with employer-sponsored insurance using claims data from the MarketScan database who underwent either open or robotic radical prostatectomy, hysterectomy/myomectomy, and partial colectomy from 2012 to 2016. We performed multiple regression models incorporating propensity scores to assess the effect of robotic vs. open surgery on the number of absent days from work, adjusting for demographic characteristics and baseline absenteeism. In a cohort of 1157 individuals with employer-sponsored insurance, those undergoing open surgery, compared to robotic surgery, had 9.9 more absent workdays for radical prostatectomy (95%CI 5.0 to 14.7, p < 0.001), 25.3 for hysterectomy/myomectomy (95%CI 11.0-39.6, p < 0.001), and 29.8 for partial colectomy (95%CI 14.8-44.8, p < 0.001) CONCLUSION: For the three major procedures studied, robotic surgery was associated with fewer missed days from work compared to open surgery. This information helps payers, patients, and providers better understand some of the indirect benefits of robotic surgery relative to its cost.

A Longitudinal Investigation of Muscle Injuries in an Elite Spanish Male Academy Soccer Club: A Hamstring Injuries Approach

The aims of this study were to analyze the muscle injury incidence in an elite Spanish soccer academy during three consecutive seasons attending to different chronological age groups (i.e., U14, U16, U19 and senior) and to examine the hamstring injury incidence in this elite soccer academy. Elite male youth soccer players (227) participated in this study. A total of 207 time-loss injuries (i.e., injuries that involve at least one absence day) were observed during this study period. The overall incidence rate of muscle injury was 1.74 muscle injuries/1000 h. In addition, higher muscle injury incidence was observed during match play in comparison to training sessions (6.78 vs. 3.20 muscle injuries/1000 h, p &lt; 0.05). The oldest age group presented the highest injury rate (2.73 muscle injuries/1000 h, p &lt; 0.05), with the burden (i.e., number of absence days per 1000 h of exposure) peak values recorded in the U16 age group (26.45 absence days/1000 h). In addition, muscle tears accounted for the greatest percentage of muscle injuries (43.5%), and the most frequent anatomical site of injury was the hamstring (30.4%). Muscle tear was the most common type of hamstring injury (49.2%), with the biceps femoris the most commonly injured muscle of the hamstring complex (39.7%). Fullbacks (FB), wide midfielders (WM) and forwards (F) suffered a greater number of hamstring injuries. Hamstring injury incidence showed a seasonal variation, as indicated by peaks in August and October. Specifically, the highest injury incidence was observed in the final part of each period during match play. These results reinforce the necessity to implement individual preventive strategies according to each specific injury profile across the youth soccer development phase.

173 Impact of Clinical Severity on Absenteeism and Presenteeism in Patients with Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) negatively impacts patients’ quality of work and productivity. To determine how HS Hurley staging, Physician Global Assessment(PGA) and Severity Assessment of Hidradenitis Suppurativa (SAHS) relate to absenteeism and presenteeism in patients with HS. A cross-sectional study, run from Dec 2018-Apr 2019. Eligibility: age 12+ and a clinical visit for HS. Exclusions: declined involvement; English or French illiteracy and unemployed. Severity of HS was assessed using Hurley staging, PGA, SAHS. Absenteeism and presenteeism in the 4 weeks preceding the clinical encounter were evaluated by absenteeism and presenteeism modules of iMTA Productivity Cost Questionnaire(iPCQ). Poisson regressions were used to investigate the impact of each clinical HS severity measure (VAS,PGA,SAHS or Hurley Stage) on the number of missed work days, worked days with bothersome physically/psychologically, and the quantity of work measured on a scale of 0 ‘not able to work’ -10 ‘doing work normally’.Adjustment was done for surgical intervention in the past 4 weeks. For absenteeism, a statistically significant effect on the number of missed work days for Hurley (p = 0.002), SAHS (p < 0.001), PGA (p = 0.004) and VAS (p = 0.025). Comparing to ‘Mild disease’ on SAHS, the expected number of absent days for ‘Moderate disease’ increases by about 3.6 days (1.1, 11.0) and for ‘Severe disease’ increases by about 4.8 days (1.4, 16.8).[Note: (-1.3, 4.3) is the 95% confidence interval]. For presenteeism, a statistically significant effect on the number of symptomatic worked days for Hurley (p < 0.001), PGA (p < 0.001), SAHS, (p < 0.001) and VAS (p < 0.001). Comparing to ‘Mild disease’ on SAHS, the expected number of worked days bothered by ‘Moderate disease’ increases by about 1.6 days (-1.4, 3.5) and for ‘Severe disease’ increases by about 2.0 (-1.1, 4.5). The clinical severity of HS assessed by Hurley staging, VAS, PGA and SAHS impacts the quantity and quality of patients’ work. Presenteeism is more frequent than absenteeism; SAHS is a good clinical predictor for both outcomes.

Effect of Pre-training and Post-training Nordic Exercise on Hamstring Injury Prevention, Recurrence, and Severity in Soccer Players

ObjectiveTo investigate the effect of adding Nordic exercise as post-training in decreasing hamstring initial, recurrent injuries rates, and their severity.MethodsIn this randomly controlled trial study, 34 professional football players aged 21 to 35 years were randomly assigned into two groups (17 players each) from Sporting clubs at Alexandria, Egypt. For group one, Nordic hamstring exercise (NHE) was performed pre-training and post-training. For group two, NHE was only performed pre-training. The control group was the same team during the previous season. Length of the trial was 12 weeks. The Australian football association injury form was used to collect incidence of injuries for each subject in both groups.ResultsPooled results based on total injuries showed that group one had significantly less hamstring initial injuries (92% less) than the previous season, while group two had 80% less initial injuries and 85% less recurrent injuries than previous season. Regarding the severity of injuries in term of mean number of absent days, it was 1 day for group one and 2.7 days for group two while it was 7.95 days for the previous season during total risk time of 116.3±13.2 and 117.6±5.7 exposure hours for group one and group two, respectively.ConclusionThe use of NHE as a prevention protocol was effective in reducing all hamstring injuries with the use of NHE during pre-training and post-training having the greatest effect.

Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a oral spray for children with recurrent streptococcal pharyngotonsillitis: a randomized placebo-controlled clinical study.

Group A beta-hemolytic Streptococcus (GABHS) causes a recurrent acute pharyngotonsillitis (RAPT) in children. Moreover, the repeated use of antibiotics contributes to its resistance. However, S. Salivarius 24SMB and S. oralis 89a were effective probiotics in other infections. Thus, we decided to evaluate this combination efficacy compared to placebo in RAPT. Patients with microbiologically confirmed GABHS were enrolled in this randomized, placebo-controlled trial. They received the aforementioned combination or placebo as an oral spray. We investigated episodes of frequency and duration, need for antibiotics, school days lost, the treatment impact on life quality, treatment compliance and side effects during a 90-day treatment and a 6-month follow-up. We included 41 patients in each group. The mean number of GABHS infection was significantly lower during both study periods for the two groups. However, our treatment group showed a lower rate. Moreover, the probiotic group had a lower mean number and a shorter median duration of GABHS episodes during both study periods than controls. Furthermore, the mean duration of antibiotic treatment was lower in the probiotic group during the 90-day and 6-month follow-up periods. Similarly, patients in the probiotic group showed a significantly lower mean number of absence days from school but higher EQ-VAS score. Indeed, all patients included were compliant to treatment. We identified potential probiotics, possessing desirable features against GABHS pharyngotonsillitis. Our findings represent the first evidence which throws the light on using these probiotics that can reduce antibiotics use which did not have efficient results regarding recurrence.

Life Satisfaction, Interpersonal Relationships, and Learning Influence Withdrawal from School: A Study among Junior High School Students in Japan.

School absenteeism, particularly among junior high school students, has increased annually in Japan. This study demonstrates the relationship between subjective adjustment to school life and students’ absenteeism. Data were collected from 17,378 junior high school students in Japan. A longitudinal design was used for the study. Teachers were asked to distribute the Adaptation Scale for School Environments on Six Spheres (ASSESS) questionnaire to junior high school students and ask the students to fill out the questionnaire at the beginning of the 2014 academic year in April 2014, and the relationship between their subjective adjustment and absenteeism as measured by the total number of absent days during the 2014 academic year was evaluated by logistic regression and a survival analysis model. Low life satisfaction was associated with absences. The corresponding odds ratio (OR) was higher for seventh graders (OR 3.29, confidence interval (CI): 2.41–4.48, hazard ratio (HR) 5.57, CI: 3.51–8.84) than for students in other grades. Interpersonal relationships were significantly related to absenteeism for seventh and eighth graders in the group with scores less than 39 points. Lower adjustment to learning seemed to be related to absenteeism for seventh and eighth graders. For effective interventions, a well-designed study that uses detailed information regarding life-related covariates is necessary.

Evaluation of Cyavanaprāśa on Health and Immunity related Parameters in Healthy Children: A Two Arm, Randomized, Open Labeled, Prospective, Multicenter, Clinical Study.

Context:Cyavanaprāśa (CP) is an Ayurvedic immune booster formulation that confers vigor and vitality while delaying the ageing process. Benefits of CP have been studied widely in adult population.Objectives:Current study assessed beneficial effects of CP on health and immunity related parameters in healthy children.Methods:This study was a 6 month long two armed, randomized, open labeled, prospective clinical study. School going healthy children between ages of 5-12 years were randomized to receive orally daily either CP (approx. 6 g) followed by a cup of milk (100 – 200 ml) or cup of milk only twice a day while continuing with their normal/routine diet. Results were analyzed based on number of episodes, severity, duration of illness (infections and allergies) and number of absent days due to illness during the study duration and changes in levels of energy, physical fitness, strength, stamina and quality of life in children which were recorded in subject diary by their parents/Legally Acceptable Representative (LAR).Results:702 participants were randomized, out of which 627 completed the study (CP n = 313; Control n = 314). Results of immunity (episodes of infections or allergy related conditions) showed more than 2 times protection from immunity related illness in CP Group as compared to the control. CP also showed better percentage improvement in energy levels, physical fitness, strength, stamina and quality of life assessed through KIDSCREEN QOL-27 questionnaires in children.Conclusion:Regular consumption of CP for a period of six months could significantly improve immunity, energy levels, physical fitness, strength, stamina and quality of life in school going healthy children.Study Registration:Clinical Trail Registry of India vide CTRI/2015/02/005574, Dated 24 February 2015.

Addressing medical absenteeism in pre-vocational secondary students: effectiveness of a public health intervention, using a quasi-experimental design.

BackgroundStudents’ health and school absenteeism affect educational level, with adverse effects on their future health. This interdependence is reflected in medical absenteeism. In the Netherlands, a public health intervention has been developed to address medical absenteeism in pre-vocational secondary education. This study aims to investigate the effectiveness of this intervention on students’ medical absenteeism, compared to “medical absenteeism policy as usual”.MethodsA quasi-experimental design with an intervention group (493 students) and a control group (445 students) was applied. Multilevel analysis was used to study differences in the development of the level of a student’s medical absence over time (after 3 and 12 months).ResultsIn the intervention group, the level of absenteeism decreased from 8.5 days reported sick in 12 school weeks to 5.7 days after 3 months, and to 4.9 days after 12 months. The number of absence periods fell from 3.9 in 12 school weeks to 2.5 after 3 months, and to 2.2 after 12 months. In the control group, the absence days initially decreased from 9.9 days reported sick in 12 school weeks to 8.4 days after 3 months, after which an increase to 8.9 days was measured. The number of absence periods initially decreased from 4.5 in 12 school weeks to 3.5, after which an increase to 3.7 was measured. The number of absence days per period remained about the same in both groups.ConclusionsThe study provides first indications for the intervention to be effective for Dutch pre-vocational secondary students with increased medical absence rates. The intervention, which consists of personalised management of medical absenteeism by systematic identification of students with extensive medical absenteeism and consistent referral to youth health care physicians, appears to reduce the absence rates more effectively than “medical absenteeism policy as usual”. The effectiveness of the intervention is shown primarily by a decrease in the number of periods reported sick.

Organizational Initiatives for Promoting Employee Work-Life Reconciliation Over the Life Course. A Systematic Review of Intervention Studies

This review aimed to explore the initiatives, interventions, and experiments implemented by employing organizations and designed to support the work-life reconciliation at workplaces, and the effects of these actions on employees’ well-being at work. A systematic literature review was conducted on the basis of a search in PsycInfo, ERIC, and the ISI Web of Science database of Social Sciences between January 2000 and May 2015. Those studies were included in which either organizational or individual-level initiatives, interventions, or experiments were implemented by employers at workplaces in order to promote the work-life reconciliation of their employees. Work-life reconciliation was considered to encompass all life domains and all career stages from early to the end of working career. The content analysis of 11 studies showed that effective employer actions focused on working time, care arrangements, and training for supervisors and employees. Flexibility, in terms of both working time and other arrangements provided for employees, and support from supervisors decreased work-family conflict, improved physical health and job satisfaction, and also reduced the number of absence days and turnover intentions. Overall, very few intervention studies exist investigating the effects of employer-induced work-life initiatives. One should particularly note the conditions under which interventions are most successful, since many contextual and individual-level factors influence the effects of organizational initiatives on employee and organizational outcomes.

Impact of Juvenile Idiopathic Arthritis on School Attendance and Performance

Juvenile idiopathic arthritis (JIA) includes a group of disorders characterized by chronic arthritis. It is the most common chronic rheumatic illness in children and is a significant cause of morbidity, disability and dysfunction. Therefore, the potential for school attendance and academic performance become compromised and these children are often confronted with educational difficulties. Objectives: To assess the impact JIA on academic difficulty, academic performance, potential causes of absenteeism, school failure and relationship between schooling and different types of JIA. Materials and Methods: All school going JIA patients between 6-16 years of age who had at least 2 years of schooling (1 year before disease onset and 1 year during the course of disease) were included for the analysis. Two hundred JIA patients were selected by purposive sampling method. A detailed questionnaire was completed for each participant which included socio-demographic, clinical and laboratory characteristics, data related to schooling, academic difficulties and their causes, absenteeism and causes, sports and cultural activities, school failure and school re-entry if any. Fifty four controls were taken who were the healthy sibs of those JIA patients having at least 2 previous years of schooling. Results: Mean age of JIA patients were 10.8 years, 67% were male and male female ratio was 2:1. Academic difficulties were observed for reading, writing and both due to disease process and deformity. Number of absent days and poor attendance in examination was significantly higher in JIA patients (p value < 0.001). Moreover, in case group, only 18% had improved result than the academic year prior to disease onset, 3% had no change, 57% deteriorated and 22% stopped schooling. There were 44 cases of school failure among JIA patients, 30 had school re-entry. No children had school failure or re-entry among the control group. Multiple causes of absenteeism like flare, hospitalization, side effects of drugs, movement difficulties, parental non-interest and some other factors like rainfall, delayed rising from sleep etc co-existed for most of the cases. In control group, mean percentage of absenteeism was 1.6%, mostly due to some febrile illness, cold weather, rainfall, lack of transport, sickness of caregiver etc. Children who did not participate in sports activities were 9.3% in control group and 48.5% in case group (p value < 0.001). Conclusion: It is evident from this study that JIA has negative impact on schooling characterized by poor attendance and academic performance.

Occupational Accidents Due to Stepladders in Japan: Analysis of Industry and Injured Characteristics

In this study, occupational accident cases in Japan were analyzed to better characterize accidents due to the use of stepladders. The analysis investigated 34,195 occupational accidents that resulted in at least a four-day absence from work in 2006 (25.5% of total occupational accidents), based on casualty reports from the Japanese Ministry of Health, Labour and Welfare. The instances were classified by industry type, accident type, number of absent days, victim's age, gender, employment period, injury/disease type, and injured body part. The results of the analysis revealed that there were 992 accidents (six were fatal) due to stepladders in 2006, representing 2.9% of all accidents that year. The total number of estimated accidents that year was 3,896 (24 were fatal). The results also indicated that individuals who fell from stepladders most frequently suffered from fractures (68.6%) or contusions (16.2%) and that 64.9% of all victims took more than a month's leave of absence. The most common injured parts were the lower limbs (34.7%) and the upper limbs (21.4%). For 18.4% victims, the length of employment with the company they were working for at the time of the accident was one year or less. Most of the accidents occurred while standing on the stepladder (70.4%), whereas 19.4% and 7.9% of the accidents occurred during descending and ascending, respectively. Moreover, out of all the stepladder accidents in 2006, 45.4% occurred in the construction industry, 15.5% in the manufacturing industry, and 12.3% in the commercial industry. The occurrence rate of stepladder accidents in different industries were 7.9% in construction, 4.4% in cleaning, and 3.8% in agriculture and forestry, which were higher than the mean rate (2.9%). This result demonstrates that further research is needed to investigate the working methods with stepladders and their risk evaluation.