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Woodland L, Brooks SK, Webster RK, Amlôt R, Rubin GJ. Risk factors for school-based presenteeism in children: a systematic review. BMC Psychol 2023; 11:169. [PMID: 37221597 DOI: 10.1186/s40359-023-01207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Children attending school whilst unwell, known as school-based presenteeism, results in negative impacts on education and mental and physical health. We aimed to identify the risk factors for this behaviour. METHOD We conducted a systematic search of five databases (11 July 2022) using words associated with school (e.g., school and childcare) and presenteeism (e.g., presenteeism and sick leave). The studies are synthesised according to the risk factors associated with school-based presenteeism and are grouped into themes by related topics. RESULTS Our review included 18 studies, with quantitative, qualitative, and mixed-method study designs. Children, parents, and school staff reported past incidents and intentions for future presenteeism. We identified five themes from these reports: perceptions about the illness / signs and symptom(s); children's characteristics; children's and parents' motivations and attitudes towards school; organisational factors; and school sickness policy. Increased risk of school-based presenteeism was commonly linked to symptoms that were perceived low in severity and unidentifiable, children with a high school absence record, disbelief in children's illness, unsupportive employers, vague school policies and financial consequences. CONCLUSIONS School-based presenteeism is complex due to the competing interests of the multiple individuals involved, such as children, parents, and school staff. Sickness policies need to include clear and specific guidance about illness and the signs and symptoms of diseases and should be communicated to all relevant individuals to mitigate against discrepancies in how the policy is interpreted. Furthermore, parents and school staff need support, such as financial and childcare, to be able to manage children when they are unwell.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King's College London, London, UK.
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom.
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
| | | | - Richard Amlôt
- Behavioural Science and Insights Unit, Health Security Agency, Salisbury, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
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Carroll FE, Al-Janabi H, Rooshenas L, Owen-Smith A, Hollinghurst S, Hay AD. Parents' preferences for nursery care when children are unwell: a discrete choice experiment. J Public Health (Oxf) 2021; 42:161-168. [PMID: 30576558 DOI: 10.1093/pubmed/fdy215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/25/2018] [Accepted: 11/27/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pre-school children's daycare is associated with increased incidence of respiratory and diarrhoeal illnesses. While the incidence might be reduced if all unwell children were kept at home, parental employment pressures make this difficult when children are marginally unwell. METHODS A discrete choice experiment (DCE) was conducted to identify what aspects of daycare policy and provision would affect parents' decisions to keep marginally unwell children home. Prior qualitative research informed parameter choice. The DCE was accompanied by a best-worst scaling task examining preferences for four modifiable aspects of care: swapping unused daycare sessions, reimbursing unused sessions, daycare paracetamol policy and presence of a 'quiet room'. RESULTS Paracetamol guidelines and the presence of a quiet room had the strongest predicted influence on parents' decision-making. Conditional on assumptions about the set-up of the daycare, introducing a 'no paracetamol' policy would result in a fall from 62 to 25% in mean predicted probabilities of a parent sending a marginally unwell child to nursery, while introducing a quiet room would increase the mean probability from 34 to 53%. CONCLUSIONS Daycare policy, particularly the use of paracetamol prior to attendance, could impact parents' decisions to send unwell children to daycare, potentially influencing the transmission of children's infectious illness.
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Affiliation(s)
- Fran E Carroll
- Royal College of Obstetricians and Gynaecologists and Honorary Research Fellow, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Hareth Al-Janabi
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Leila Rooshenas
- Bristol Medical School, Population Health Sciences, Bristol, UK
| | | | - Sandra Hollinghurst
- Centre of Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School, Population Health Sciences, Bristol, UK
| | - Alastair D Hay
- Centre of Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School, Population Health Sciences, Bristol, UK
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Cherry MD, Tapley A, Quain D, Holliday EG, Ball J, Davey A, van Driel ML, Fielding A, Spike N, FitzGerald K, Magin P. Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis. J Prim Health Care 2021; 13:5-14. [PMID: 33785106 DOI: 10.1071/hc20040] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 01/14/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Over-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitioner (GP) antibiotic prescribing for this condition, which is inconsistent with evidence-based guidelines. AIM To investigate the prevalence and associations of GP registrars' (trainees') prescription of antibiotics for infective conjunctivitis. METHODS We performed a cross-sectional analysis of the Registrar Encounters in Clinical Training (ReCEnT) ongoing prospective cohort study, which documents GP registrars' clinical consultations (involving collection of information from 60 consecutive consultations, at three points during registrar training). The outcome of the analyses was antibiotic prescription for a new diagnosis of conjunctivitis. Patient, registrar, practice and consultation variables were included in uni- and multivariable logistic regression analyses to test associations of these prescriptions. RESULTS In total, 2333 registrars participated in 18 data collection rounds from 2010 to 2018. There were 1580 new cases of infective conjunctivitis (0.31% of all problems). Antibiotics (mainly topical) were prescribed in 1170 (74%) of these cases. Variables associated with antibiotic prescription included patients' Aboriginal or Torres Strait Islander status, registrar organisation of a follow up (both registrar and other GP follow up), and earlier registrar training term (more junior status). DISCUSSION GP registrars, like established GPs, prescribe antibiotics for conjunctivitis in excess of guideline recommendations, but prescribing rates are lower in later training. These prescribing patterns have educational, social and economic consequences. Further educational strategies may enhance attenuation of registrars' prescribing during training.
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Affiliation(s)
- Marcus D Cherry
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Amanda Tapley
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia
| | - Debbie Quain
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia
| | - Elizabeth G Holliday
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Jean Ball
- Hunter Medical Research Institute, Clinical Research Design IT and Statistical Support Unit, New Castle, NSW, Australia
| | - Andrew Davey
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia
| | - Mieke L van Driel
- The University of Queensland, Primary Care Clinical Unit, Faculty of Medicine, Brisbane, Queensland, Australia
| | - Alison Fielding
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia
| | - Neil Spike
- Eastern Victoria General Practice Training, Melbourne, Victoria, Australia; and Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Parker Magin
- University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia; and Corresponding author.
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Gordon-Shaag A, Zimmerman DR, Shneor E. The epidemiology and treatment of conjunctivitis at Urgent Care Centres in Israel. Clin Ophthalmol 2019; 13:771-779. [PMID: 31118555 PMCID: PMC6504553 DOI: 10.2147/opth.s202362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/04/2019] [Indexed: 12/02/2022] Open
Abstract
Purpose: Conjunctivitis is the most common ocular condition diagnosed at emergency departments (ED) in the USA, although it is generally not an emergent condition. Treatment of conjunctivitis at Urgent Care Centres (UCC) could offer lower cost than ED. This study describes the demographics and outcomes of a cohort presenting with conjunctivitis to a nationwide UCC system. Methods: This retrospective study included 17 branches of UCC. Electronic Medical Record data (November 2015–October 2016) of patients diagnosed with conjunctivitis or ocular disorder were retrieved. Data included gender, age, diagnosis, treatment, discharge status and temperature. Patients without conjunctivitis, presenting to UCC during this period served as the control. Results were compared to all ED patients in Israel (from a public report). Descriptive statistics, Chi-square and Z-proportion test were used. Results: Altogether, 602,074 patients presented to UCC, of which 5,045 (0.84%, 95% CI 0.74–0.94%) were diagnosed with conjunctivitis. Conjunctivitis was more prevalent among young males (0–14, p<0.001) and older females. The conjunctivitis cohort at UCC was significantly younger than the ED cohort (p<0.01). UCC treated and released home 96.7% (95% CI 96.2–97.2%) of cases. This is significantly higher than the treatment rate for the entire UCC cohort (93.2%, CI 93.2–93.3%, p<0.05). Treatment in most cases (82.0%, 95% CI 80.9–83.0%) involved the prescription of ocular antibiotic. Conclusion: Similar to previous studies at ED, conjunctivitis patients are primarily young males. Most patients were treated with antibiotics at UCC and released home. This suggests that UCC may be a good venue for treatment of conjunctivitis.
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Affiliation(s)
- Ariela Gordon-Shaag
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel
| | | | - Einat Shneor
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel
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Andersson J, Hofsli M, Gade UL, Heegaard S, Pottegård A. Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study. Acta Ophthalmol 2018; 96:789-794. [PMID: 29885649 DOI: 10.1111/aos.13813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/12/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Acute infectious conjunctivitis is a common disease. While usually self-limiting, children often receive treatment to be accepted back into nursery, day care or school. We aimed to describe trends in the utilization of topical ocular antibiotics in young children aged 0-4 years in Denmark, Norway and Sweden. METHODS Using individual-level data from the Danish National Prescription Registry (2000-2015), we provided detailed descriptions of treatment patterns at the individual level, stratified by age (0-1 years, 2-4 years) and antibiotic substance. Aggregate-level data for Danish, Norwegian and Swedish children (0-4 years) were obtained from publicly available data sources (2000-2016). RESULTS We identified 107 581 Danish children aged 0-4 years receiving 271 980 treatment episodes. The incidence rate was relatively stable between 2000 and 2010 (on average, 637 and 283/1000 person-years for 0- to 1- and 2- to 4-year-olds, respectively), after which it dropped by 37% until 2015. In the aggregated data, a markedly higher use was seen in Denmark (211/1000 children in 2016) compared with Sweden (42) and Norway (151). The decrease from 2010 onwards was observed in all three countries. Chloramphenicol and fusidic acid were the most commonly used topical ocular antibiotics across Scandinavia. Tobramycin was rarely used in Norway and Sweden (≤1/1000 children in 2016) compared with Denmark (24/1000 children). CONCLUSION Considerable variation is seen in the utilization of topical ocular antibiotics among children in Scandinavia, with Denmark having the highest use. Across the Scandinavian countries, however, a decline was noted from 2010 onwards.
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Affiliation(s)
- Jasmine Andersson
- Lysningen Research Center; Trekroner Denmark
- Department of Ophthalmology; Rigshospitalet-Glostrup Hospital; Copenhagen Denmark
| | - Mikael Hofsli
- Lysningen Research Center; Trekroner Denmark
- Department of Ophthalmology; Rigshospitalet-Glostrup Hospital; Copenhagen Denmark
| | - Uffe Lomholt Gade
- Lysningen Research Center; Trekroner Denmark
- Department of Medicine; Holbaek Hospital; Holbaek Denmark
| | - Steffen Heegaard
- Department of Ophthalmology; Rigshospitalet-Glostrup Hospital; Copenhagen Denmark
- Department of Ophthalmology and Pathology; Eye Pathology Section; Rigshospitalet-Glostrup Hospital; University of Copenhagen; Copenhagen Denmark
| | - Anton Pottegård
- Lysningen Research Center; Trekroner Denmark
- Clinical Pharmacology and Pharmacy; Department of Public Health; University of Southern Denmark; Odense Denmark
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Penza KS, Murray MA, Myers JF, Maxson J, Furst JW, Pecina JL. Treating pediatric conjunctivitis without an exam: An evaluation of outcomes and antibiotic usage. J Telemed Telecare 2018; 26:73-78. [PMID: 30153768 DOI: 10.1177/1357633x18793031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this research paper is to compare antibiotic treatment, follow-up rates, and types of follow-up encounters among eVisits, phone calls, and in-person encounters for pediatric conjunctivitis. STUDY DESIGN A retrospective chart review of pediatric patients evaluated for conjunctivitis between May 1, 2016 and May 1, 2017, was performed. A total of 101 eVisits, 202 in-person retail clinic visits, and 202 nurse phone calls for conjunctivitis were manually reviewed for outcomes. Exclusion criteria included previous encounter for conjunctivitis in the past 14 days, treatment with an oral antibiotic at the initial encounter, or patient outside Minnesota at the time of encounter. Comparison among the three encounter types with regard to follow-up rates, follow-up encounter type within 14 days of initial evaluation, and prescribing rates was performed. RESULTS Patients completing non-face-to-face encounters were significantly more likely to have follow-up care (34.6% and 45.5%) than those who had a face-to-face visit at the retail clinic (7.4%), p ≤ 0.0001. Patients initially evaluated by eVisit were more likely to have follow-up at the retail clinic while patients initially evaluated by phone call were more likely to have follow-up in their primary care office. Treatment rates with antibiotics were significantly higher in phone call encounters (41.6%) than in eVisits (25.7%) or face-to-face encounters (19.8%), p < 0.0001. CONCLUSIONS Non-face-to-face visits have significantly higher rates of follow-up when compared to face-to-face encounters. Antibiotic prescribing is greater with phone call triage encounters; however, there was no significant difference in antibiotic prescribing rates between eVisits and face-to-face visits. Follow-up type varied according to site of initial encounter.
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Affiliation(s)
- Kristine S Penza
- Mayo Clinic Express Care, USA.,Department of Family Medicine, Mayo Clinic Employee and Community Health, USA
| | - Martha A Murray
- Mayo Clinic Express Care, USA.,Department of Family Medicine, Mayo Clinic Employee and Community Health, USA
| | - Jane F Myers
- Department of Family Medicine, Mayo Clinic Employee and Community Health, USA
| | - Julie Maxson
- Department of Family Medicine, Mayo Clinic Employee and Community Health, USA
| | - Joseph W Furst
- Department of Family Medicine, Mayo Clinic Employee and Community Health, USA
| | - Jennifer L Pecina
- Department of Family Medicine, Mayo Clinic Employee and Community Health, USA
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Hayhoe B, Butler CC, Majeed A, Saxena S. Telling the truth about antibiotics: benefits, harms and moral duty in prescribing for children in primary care. J Antimicrob Chemother 2018; 73:2298-2304. [DOI: 10.1093/jac/dky223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Benedict Hayhoe
- Child Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Reynolds Building, St Dunstan’s Road, London, UK
| | - Christopher C Butler
- Nuffield Department of Primary Health Sciences, Medical Sciences Division, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, Reynolds Building, St Dunstan’s Road, London, UK
| | - Sonia Saxena
- Child Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Reynolds Building, St Dunstan’s Road, London, UK
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