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Madura K. Legal Issues 101: Implications of Attendance, Absenteeism, and Truancy in the School Setting. NASN Sch Nurse 2024; 39:214-220. [PMID: 38853768 DOI: 10.1177/1942602x241257842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
This article is part of Legal Issues 101, a series of topics addressing some common questions and misconceptions about the law and school health. School nurse job responsibilities differ regarding monitoring student attendance and assisting school administrators with required truancy reporting. However, all school nurses support student attendance with a focus on students being safe, healthy, and ready to learn. In this article, the authors address frequently asked questions on topics surrounding student attendance including excused and unexcused absences, truancy, parent/guardian engagement, and related laws.
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Rankine J, Goldberg L, Miller E, Kelley L, Ray KN. School Nurse Perspectives on Addressing Chronic Absenteeism. J Sch Nurs 2023; 39:496-505. [PMID: 34647823 PMCID: PMC9062998 DOI: 10.1177/10598405211043872] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic absenteeism is associated with poor health and educational outcomes. School nurses have great potential to address the health and educational needs that contribute to absenteeism. Through qualitative analysis of interviews with school nurses, we characterize their current role in reducing absenteeism and identify barriers 3 that limit their capacity to meet this goal, organized by the Framework for 21st Century School Nursing Practice. Interviewees (n = 23) identified actions perceived to reduce absenteeism aligned with domains of care coordination, leadership, quality improvement, and community and public health. Barriers perceived to limit the capacity of school nurses to address absenteeism were identified within these domains and ranged from student- and family-level to federal-level barriers. Specific healthcare system-level barriers included insufficient communication with community-based healthcare teams and the need for coordinated approaches across health and education sectors to address absenteeism. Strategic opportunities exist to address barriers to comprehensive school nursing practice and reduce absenteeism.
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Affiliation(s)
- Jacquelin Rankine
- Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren Goldberg
- Pediatrics, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Lori Kelley
- Pennsylvania Association of School Nurses and Practitioners, Sewickley, Pennsylvania, USA
| | - Kristin N. Ray
- Pediatrics, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
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Rankine J, Fuhrman B, Copperman E, Miller E, Culyba A. School Absenteeism Among Middle School Students With High Exposure to Violence. Acad Pediatr 2022; 22:1300-1308. [PMID: 35342032 PMCID: PMC9509495 DOI: 10.1016/j.acap.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/16/2022] [Accepted: 03/19/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Chronic school absenteeism is linked to failure to graduate high school and poor health in adulthood. Contextual factors associated with absenteeism may be under-recognized in school and clinical settings. We examined the prevalence of self-reported absenteeism and violence exposure and their association among middle school students with identified risk of trauma. METHODS We analyzed baseline data from a dating violence prevention program. Participants completed surveys identifying lifetime exposure to 10 types of violence and past 30-day absence. Violence exposure and absenteeism were summarized and compared across demographic groups. Generalized linear models examined associations between 1) any history of violence exposure, 2) each type of violence exposure, and 3) summed exposures to different types of violence, and frequent absenteeism (≥2 absences in past 30 days). RESULTS Of all participants (overall n = 499), 45.5% reported frequent absenteeism and 71.5% reported violence exposure. Any self-reported violence exposure was associated with absenteeism (aRR = 1.43, 95%CI: 1.06-1.92). However, no specific type of violence exposure predicted absenteeism. Comparing summed exposures to different types of violence to no violence exposure, exposure to 1 type of violence was associated with absenteeism (aRR = 1.59, 95%CI: 1.15-2.20), with no evidence of stronger associations with greater exposure (2-3 types: aRR = 1.37, 95%CI: 1.00-1.88; ≥4 types: aRR = 1.31, 95%CI: 0.98-1.74). CONCLUSIONS Youth in this sample reported both high rates of violence exposure and absenteeism. Prior violence exposure was associated with absenteeism. Resources and contextual support for youth exposed to family or community violence may play a role in school attendance, emphasizing need for trauma-sensitive approaches to absenteeism.
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Affiliation(s)
- Jacquelin Rankine
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa.
| | - Barbara Fuhrman
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Ethan Copperman
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Elizabeth Miller
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Alison Culyba
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
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Kim CH, Gee KA, Byrd RS. Excessive Absenteeism Due to Asthma in California Elementary Schoolchildren. Acad Pediatr 2020; 20:950-957. [PMID: 31837461 DOI: 10.1016/j.acap.2019.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 12/02/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Previous studies of asthma-related school absenteeism have reported absenteeism dichotomously (ie, any school days missed vs none). However, schools use higher thresholds to identify and intervene for students at risk of chronic absenteeism (18 days or ≥10% schoolyear missed), which is associated with negative health and educational outcomes. We sought to identify factors associated with excessive absenteeism (EA) due to asthma (≥9 days missed), a threshold based on a convention defined by Attendance Works for absenteeism risk, and is linked to decreased academic performance and increased risk of chronic absenteeism. METHODS We examined responses for asthma-related absenteeism from the 2011 to 2014 California Health Interview Survey for children ages 5-11. Multivariate logistic regression modeled odds ratios of EA for demographic, healthcare utilization, and asthma-related factors. Sensitivity analysis was performed modeling a ≥1 threshold (any absenteeism). RESULTS 715 respondents represent an estimated 314,200 California schoolchildren with asthma. 50.3% of students missed ≥1 day, and 11.7% missed ≥9 days of school due to asthma. Odds of EA were significantly higher for younger children, lower-income families, and rural students, but not significant for any absenteeism. Indicators of greater asthma severity and poorer control were significantly associated with both EA and any absenteeism. CONCLUSIONS This study identified factors significantly associated with EA that were not significant for lower absence thresholds. This may help direct school-based asthma interventions for which limited resources must target students at higher risk of chronic absenteeism.
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Affiliation(s)
- Christopher H Kim
- Department of Pediatrics, University of California Davis Health (Christopher H. Kim, Robert S. Byrd), Sacramento, Calif.
| | - Kevin A Gee
- University of California Davis School of Education (Kevin A. Gee), Davis, Calif
| | - Robert S Byrd
- Department of Pediatrics, University of California Davis Health (Christopher H. Kim, Robert S. Byrd), Sacramento, Calif
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McKinley Yoder CL, Cantrell MA. Childhood Disability and Educational Outcomes: A Systematic Review. J Pediatr Nurs 2019; 45:37-50. [PMID: 30682721 DOI: 10.1016/j.pedn.2019.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/26/2022]
Abstract
PROBLEM Graduation from high school is an important milestone for all adolescents and affects future health in adulthood. Children with chronic illnesses have additional challenges that affect school attendance, grade retention and graduation. If children with chronic conditions are not able to participate fully in education, this may limit their opportunities for future health. The aim of this study was to integrate the evidence in the past 28 years about educational outcomes of children and adolescents with chronic conditions causing disability. ELIGIBILITY CRITERIA Quantitative studies reporting on a chronic condition and attendance, grade retention, or high school graduation, from a peer-reviewed journal in the English language, data collection since 1990, and research conducted with a population in the United States were eligible for review. SAMPLE Forty-three studies from a literature search of CINAHL, MEDLINE, ERIC, Teacher Reference Center, Psychology & Behavioral Science Collection, and Academic Search Elite databases, followed by ancestry searches, were included in this review. RESULTS In general, chronic conditions are significantly associated with increased absenteeism, grade repetition and not completing high school within four years, although hemophilia does not follow this pattern. Additionally, increased severity of the condition is associated with poorer educational outcomes. CONCLUSIONS Nurses and other healthcare providers should include an educational assessment as part of psychosocial assessment of children and adolescents to identify risk, intervene early and limit risk.
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Affiliation(s)
- Claire L McKinley Yoder
- OHSU School of Nursing, Portland, OR, United States of America; M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, United States of America.
| | - Mary Ann Cantrell
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, United States of America
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Alexander DS, Geryk L, Arrindell C, DeWalt DA, Weaver MA, Sleath B, Carpenter DM. Are children with asthma overconfident that they are using their inhalers correctly? J Asthma 2015; 53:107-12. [PMID: 26366974 PMCID: PMC4824618 DOI: 10.3109/02770903.2015.1057848] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objectives of this study were to quantify the extent to which children with asthma are overconfident that they are using their inhalers correctly and determine whether demographic and clinical characteristics are associated with children being overconfident. METHODS Children (n = 91) ages 7-17 with persistent asthma were recruited at two pediatric practices in North Carolina and demonstrated their inhaler technique for metered dose inhalers during an office visit. Children were dichotomized into two groups based on how confident they were that they were using their inhalers correctly: "completely confident" or "not completely confident". The mean number of inhaler steps (out of 8) children performed incorrectly was examined. We applied linear regression models for children in the "completely confident" group to determine whether demographic and clinical factors predicted their overconfidence, defined as the number of inhaler steps performed incorrectly. RESULTS Children were primarily male (56%) and non-Hispanic White (60%). Sixty-eight (75%) children were "completely confident" that they were using their inhalers correctly. The "completely confident" group missed an average of 1.5 steps. In the "completely confident" group, males (p < 0.04) missed significantly more steps than females. The two most common errors were forgetting to shake the inhaler and holding their breath for 10 s. CONCLUSION Regardless of their confidence level, children in our sample missed an average of 1-2 steps on an inhaler technique assessment. Findings from this study provide new evidence that it is insufficient to ask children if they are using their inhalers correctly. Therefore, it is vital that providers ask children to demonstrate their inhaler technique during health encounters.
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Affiliation(s)
- Dayna S Alexander
- a Eshelman School of Pharmacy, University of North Carolina , Asheville , NC , USA
| | - Lorie Geryk
- a Eshelman School of Pharmacy, University of North Carolina , Asheville , NC , USA
| | - Courtney Arrindell
- b Department of Health Behavior , University of North Carolina , Chapel Hill , NC , USA
| | - Darren A DeWalt
- c School of Medicine, University of North Carolina , Chapel Hill , NC , USA , and
| | - Mark A Weaver
- d Departments of Medicine and Biostatistics , University of North Carolina , Chapel Hill , NC , USA
| | - Betsy Sleath
- a Eshelman School of Pharmacy, University of North Carolina , Asheville , NC , USA
| | - Delesha M Carpenter
- a Eshelman School of Pharmacy, University of North Carolina , Asheville , NC , USA
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Xia Y, Kelton CML, Xue L, Guo JJ, Bian B, Wigle PR. Safety of long-acting beta agonists and inhaled corticosteroids in children and adolescents with asthma. Ther Adv Drug Saf 2013; 4:254-63. [PMID: 25114786 PMCID: PMC4125312 DOI: 10.1177/2042098613504124] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The introduction of long-acting beta agonists (LABAs) was considered a major advance in bronchodilator therapy for adult, as well as pediatric, patients with asthma. However, the use of LABAs has raised safety concerns, especially the potential for severe asthma exacerbations (SAEs) resulting in hospitalizations or even death. Meanwhile, the use of inhaled corticosteroids (ICSs), a cornerstone in the treatment of mild-to-severe persistent asthma, has been associated with growth suppression in children. The purpose of this review was to identify and discuss the major published safety studies surrounding LABA, ICS, and combined LABA/ICS usage in children. By way of a critical search for influential published clinical trials, meta-analyses, and observational studies, six studies relevant to the safety of LABA monotherapy, seven studies relevant to ICS monotherapy, and four studies on the subject of LABA/ICS combination usage were identified and reviewed. Based on the reviewed literature, the controversy surrounding these anti-asthma medications was clearly exposed. On the one hand, there is some evidence that LABA monotherapy may be associated with SAEs and asthma-related death, while ICS monotherapy may be associated with a higher risk of growth suppression. On the other hand, the concurrent use of a LABA with an ICS has been associated with positive outcomes including symptom reduction and reduced rate and severity of exacerbations. Further clinical research is warranted and has been called for by the US Food and Drug Administration.
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Affiliation(s)
- Ying Xia
- Division of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - Christina M L Kelton
- Division of Pharmacy Practice & Administrative Sciences, James L. Winkle College of Pharmacy, and Carl H. Lindner College of Business, University of Cincinnati, Cincinnati, OH, USA
| | - Liang Xue
- College of Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Jeff J Guo
- University of Cincinnati, James L. Winkle College of Pharmacy, 3225 Eden Avenue, Cincinnati, OH 45267-0004, USA
| | - Boyang Bian
- Division of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - Patricia R Wigle
- Division of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
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Rodriguez E, Rivera DA, Perlroth D, Becker E, Wang NE, Landau M. School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project. THE JOURNAL OF SCHOOL HEALTH 2013; 83:842-850. [PMID: 24261518 DOI: 10.1111/josh.12102] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 12/14/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. METHODS Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). RESULTS Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. CONCLUSION Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs.
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Affiliation(s)
- Eunice Rodriguez
- Associate Professor (of Teaching), , Department of Pediatrics, Stanford University, 1215 Welch Road, Modular G, Stanford, CA 94305
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Reuben CA, Pastor PN. The effect of special health care needs and health status on school functioning. Disabil Health J 2013; 6:325-32. [PMID: 24060255 DOI: 10.1016/j.dhjo.2013.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 02/07/2013] [Accepted: 03/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Past studies have shown that specific child conditions are associated with poor school outcomes. A national health survey with noncategorical measures of health and indicators of school functioning offers the opportunity to examine this association. OBJECTIVES To compare links between two health measures (children with special health care needs and general health status) and multiple school outcomes. METHODS The analysis was based on 59,440 children aged 6-17 years from the 2007 National Survey of Children's Health. Child health was assessed using the Children with Special Health Care Needs (CSHCN) screener and a question on general health status. CSHCN were classified by the complexity of their health care needs. Indicators of school functioning included special education use, many problem reports, repeated a grade, lack of school engagement, and many missed school days. RESULTS Overall 22% of children were identified as CSHCN: 13% with more complex needs (C-CSHCN) and 9% with medication use only (CSHCN-RX). Approximately 17% of children were in less than optimal health. After controlling for a child's sociodemographic characteristics C-CSHCN had an increased risk of all of the negative school outcomes compared to children without SHCN, while CSHCN-RX had an increased risk of only one school outcome (many missed school days). Children in less than optimal health were at an increased risk of all negative school outcomes compared to children in optimal health. CONCLUSIONS The CSHCN screener and health status question identify related, but distinct, groups of children with worse outcomes on the indicators of school functioning.
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Affiliation(s)
- Cynthia A Reuben
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA
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Akinbami LJ, Kit BK, Simon AE. Impact of environmental tobacco smoke on children with asthma, United States, 2003-2010. Acad Pediatr 2013; 13:508-16. [PMID: 24021528 PMCID: PMC4756763 DOI: 10.1016/j.acap.2013.07.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/03/2013] [Accepted: 07/09/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Given widespread interventions to reduce environmental tobacco smoke (ETS) exposure and improve asthma control, we sought to assess the current impact of ETS exposure on children with asthma. METHODS We analyzed 2003-2010 data for nonsmoking children aged 6 to 19 years with asthma from the National Health and Nutrition Examination Survey. Outcomes (sleep disturbance, missed school days, health care visits, activity limitation, and wheezing with exercise) were compared between ETS exposed children (serum cotinine levels 0.05 to 10 ng/mL) and unexposed children (<0.05 ng/mL) using ordinal regression adjusted for demographic characteristics. We also assessed whether associations were observable with low ETS exposure levels (0.05 to 1.0 ng/mL). RESULTS Overall, 53.3% of children aged 6 to 19 years with asthma were ETS exposed. Age-stratified models showed associations between ETS exposure and most adverse outcomes among 6- to 11-year-olds, but not 12- to 19-year-olds. Even ETS exposure associated with low serum cotinine levels was associated with adverse outcomes for 6- to 11-year-olds. Race-stratified models for children aged 6 to 19 years showed an association between ETS exposure and missing school, health care visits, and activity limitation due to wheezing among non-Hispanic white children, and disturbed sleep among non-Hispanic white and Mexican children. Among non-Hispanic black children, there was no elevated risk between ETS exposure and the assessed outcomes: non-Hispanic black children had high rates of adverse outcomes regardless of ETS exposure. CONCLUSIONS Among children with asthma 6 to 11 years of age, ETS exposure was associated with most adverse outcomes. Even ETS exposure resulting in low serum cotinine levels was associated with risks for young children with asthma.
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Affiliation(s)
- Lara J. Akinbami
- Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention Hyattsville, MD
,United States Public Health Service, Rockville, MD
| | - Brian K. Kit
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
,United States Public Health Service, Rockville, MD
| | - Alan E. Simon
- Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention Hyattsville, MD
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