PubMed · 13165365
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L E NEWMAN. 1954. Absenteeism.. https://pubmed.ncbi.nlm.nih.gov/13165365/
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OBJECTIVE: The objective of this study was to provide a national health and disability profile of Canadian school-aged children based on the World Health Organization's definitions of health condition and disability that would facilitate international comparisons of child health data. METHODS: Data were used from the National Longitudinal Survey of Children and Youth, a 1994 - 95 population-based sample of 22 831 children. FINDINGS: An estimated total of 30.3% of Canadian children aged 6 to 11 had one or more chronic physical health conditions/impairments, while 3.6% had activity-limiting conditions/impairments. Children living with one parent were significantly more likely to have activity-limiting conditions/impairments than those living with two parents. Children with conditions/impairments, particularly those with activity limitations, were significantly more likely than children without health problems to have experienced mental health conditions and learning disabilities, missed school days, received special education, visited health professionals, been hospitalized, and used prescription medication. CONCLUSION: Important differences were found among children in a number of areas as a function of overall physical health status. The findings emphasize the importance of measuring activity limitations distinctly from chronic conditions and impairments, and, perhaps, of measuring impairments distinctly from chronic conditions, and of comparing children with such health problems to children without health problems in order to obtain a more accurate picture of the impact of health on children's lives. The World Health Organization's distinct definitions of health condition and disability facilitate a dimensional approach for describing child health that can serve to clarify this field of study and improve comparability of data across countries.
OBJECTIVES: Hospitalization, surgery, work loss, and impaired quality of life contribute to the cost and burden of care for patients with Crohn's disease. We examined the impact of remission on patients' employment, quality of life, and hospitalization and surgery in a clinical trial to validate clinical remission, as defined by the Crohn's disease activity index (CDAI), as the key treatment goal in managing Crohn's disease. METHODS: ACCENT I evaluated the efficacy and safety of long-term dosing of infliximab compared to a single dose of infliximab in 573 patients with moderately-to-severely active Crohn's disease. At wk 54, employment status was compared between patients in CDAI remission and those not in CDAI remission, for those not employed at baseline. Physical component summary (PCS) and mental component summary (MCS) scores of the SF-36 questionnaire were also compared between these two groups. The numbers of Crohn's-related hospitalizations and surgeries were compared among four groups of patients who spent 0-25%, 25-50%, 50-75%, and 75-100% of time, respectively, in CDAI remission during the study. RESULTS: At baseline, patients had a severely impaired quality of life and a high unemployment rate (38.4%). Among the group of patients who were unemployed at baseline, 31% of those patients who achieved CDAI remission (CDAI < 150) at wk 54 were employed, compared to 16% who were not in CDAI remission at wk 54 (p < 0.05). PCS and MCS scores of patients in CDAI remission at wk 54 were significantly higher (p < 0.0001), indicating better mental and physical functioning, than those of patients not in CDAI remission at wk 54, and were similar to those of the general U.S. population. Hospitalization and surgery rates decreased as the percentage of time patients were in CDAI remission increased (p < 0.01 and p < 0.05, respectively). CONCLUSIONS: CDAI remission is associated with reduced hospitalizations and surgeries, increased employment, and normalized quality of life. Sustained CDAI remission should be the key therapeutic goal in managing Crohn's disease.
BACKGROUND: This population-based study investigated prospectively collected absence for respiratory illness data in two types of formal childcare (centre day care and family day care) in Perth, Western Australia, and factors associated with such absence. METHODS: All centres (n = 11) and 95% of family day care caregivers (n = 130) selected at random from licensing lists agreed to participate. Demographic details were obtained from a parental questionnaire and absences were recorded prospectively. Characteristics of the child and family were described using univariate odds ratios (OR) with 95% confidence intervals (CI). Multivariable analysis including generalized estimating equations was used to investigate having at least one absence for respiratory illness, having two or more absences, and having six or more absences. RESULTS: No statistically significant difference between care types for having had at least one absence episode for respiratory illness (OR 1.37, 95% CI 0.92-2.04) was found. Children who attended care for more days per week (OR 1.40, 95% CI 1.26-1.56) and those in the study for more weeks (OR 1.03, 95% CI 1.01-1.05) were more likely to be absent for respiratory illness. Those children in care for a greater number of hours per day were less likely to be absent (OR 0.88, 95% CI 0.80-0.97). Family history of bronchitis was also associated with absence for respiratory illness (OR 1.86, 95% CI 1.32-2.63). CONCLUSIONS: Statistically significant factors which had an impact on absence for respiratory illness were primarily those relating to the time spent in childcare and to family history of bronchitis.