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PubMed · 15438433

[Absenteeism].

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F PATARO. 1950. [Absenteeism].. https://pubmed.ncbi.nlm.nih.gov/15438433/

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Bivariate poisson-poisson model of zero-inflated absenteeism data.

Bimodal distributions of counts with one mode at zero are often seen in medical research. In a health survey parents were asked the number of days their children missed their activities (Y(1)) and the number of days their children spent in bed (Y(2)) due to illness in the past four weeks. Both variables exhibited zero inflation. We consider a bivariate Poisson-Poisson regression model, in which the two variables are regarded as indicators of an unobserved health status variable. Based on this, we further develop a bivariate Poisson-Poisson model that constrains Y(1)>or=Y(2). It is often claimed that there is a critical window of growth and nutrition in foetal life and infancy during which subsequent health status is affected. It is not clear whether the claim is true and whether childhood growth matters more. We analyse the bivariate data in relation to weight-for-age in infancy and weight gain from infancy to age 7 years. The findings do not support the existence of a critical window in infancy. There is some indication that childhood weight gain might affect health status.

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Clinical differences among depressed patients with and without a history of suicide attempts: findings from the STAR*D trial.

BACKGROUND: This study sought to determine whether a history of suicide attempts among outpatients diagnosed with nonpsychotic major depressive disorder (MDD) is correlated with any difference in clinical presentation that should influence patient care. METHODS: Baseline data from the Sequenced Treatment Alternatives to Relieve Depression (STAR()D) trial on outpatients with MDD treated in primary and specialty care settings were used to model significant demographic and clinical correlates of suicide attempter status. RESULTS: Altogether, 16.5% of participants (n=667) reported prior suicide attempts. Controlling for age, gender, and depressive symptom severity, previous attempters had more current general medical conditions (micro=3.2 vs. 2.9, p<.0001), more current alcohol/substance abuse (p<.0001), and more work hours missed in the past week (26.2% vs. 18.2%, p<.0001) than non-attempters. On average, for the previously suicidal, the onset of MDD occurred 8.9 years earlier in life (p<.0001) and had included 1.2 additional depressive episodes (p=0.001) compared to those without prior suicidal behavior. Previous attempters also reported more current suicidal ideation (61.3% of previous attempters, adjusted OR 1.6, vs. 45.5% of nonattempters, p<.0001). LIMITATIONS: Presence or absence of a history of suicide attempts was determined only through self report. CONCLUSIONS: Those with a history of suicidal behavior suffer a greater burden of depressive illness. Earlier intervention and ongoing, aggressive care, including maintenance-phase pharmacotherapy, may be critical to mitigating the long-term consequences associated with this increased disease burden.

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Prospective study of physical and psychosocial risk factors for sickness absence.

AIM: To investigate the associations between psychosocial and physical work environment exposures and sickness absence from work taking into account health, health behaviour and employer characteristics known to affect sickness absence. METHODS: In 1995, a random sample of 5574 employees aged 18-64 years were interviewed. In 2000, 3792 of those still employed supplied data on days absent from work the year preceding the date of follow-up. Associations between risk factors at baseline and sickness absence at follow-up were studied. Logistic regression analyses were performed. RESULTS: Sickness absence was associated with working with arms lifted/hands twisted, extreme bending/stooping of the back/neck, repetitive monotonous work, low skill discretion, low decision authority, obesity, current and former smoking, poor self-rated health, female gender, increasing age and public employer. The aetiological fraction attributable to differences in work environment exposures was calculated to be 40%. CONCLUSION: The study suggests a potential for reducing sickness absence through multifactorial interventions towards smoking, obesity, physical and psychosocial work environment exposures. The study showed that differences in work environment exposures account for 40% of the cases of high sickness absence.

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