Addressing sickness absence among adolescents and young adults: an evaluation of the Medical Advice for Sick-reported Students intervention

Background Sickness absence is associated with lower school achievements and early school leaving. The Medical Advice for Sick-reported Students (MASS) intervention is a proactive school-based intervention focused primarily on early identification and reduction of sickness absence. This study used a program evaluation framework to evaluate the MASS intervention among intermediate vocational education students and Youth Health Care professionals. Outcome indicators were primarily number of sick days, education fit, and school performance, and secondarily, seven health indicators. Process indicators were dose delivered and received, satisfaction, and experience. Methods The MASS intervention evaluation was conducted in ten intermediate vocational education schools. Students with extensive sickness absence from school in the past three months were included in either the intervention or control condition. Students completed a baseline and a six-month follow-up self-report questionnaire. Linear and logistic regression analyses were applied. Students and Youth Health Care professionals completed an evaluation form regarding their satisfaction and experience with the intervention. Results Participants (n = 200) had a mean age of 18.6 years (SD = 2.02) and 78.5% were female. The MASS intervention showed positive results on decreasing sickness absence in days (β = -1.13, 95% CI = -2.22;-0.05, p < 0.05) and on decreasing depressive symptoms (β = -4.11, 95% CI = -7.06;-1.17, p < 0.05). No effects were found for other health indicators (p > 0.05). A significant interaction revealed a decline in sickness absence in males (p < 0.05) but not in females (p > 0.05). Youth Health Care professionals found the application of the MASS intervention useful (n = 35 forms). The mean rating of students for the consultation within the MASS intervention was an 8.3 (SD = 1.3) out of 10 (n = 14 forms). Conclusions Our study provides some indication that the MASS intervention has positive effects on decreasing both sickness absence and depressive symptoms among intermediate vocational education students. The Youth Health Care professionals who provided the consultation as part of the MASS intervention considered the intervention to be useful and stated that the consultation was delivered as intended in almost all cases. Students were generally satisfied with the intervention. We recommend that future research evaluates the MASS intervention in a large randomized controlled trial with a longer follow-up. Trial registration This study was prospectively registered in the Netherlands Trial Register under number NTR5556, in October 2015.

Hematological parameters in children with severe acute respiratory syndrome coronavirus 2 infection

Introduction. Recently, there has been a need to use more readily available parameters to assess the severe acute respiratory syndrome coronavirus 2 infection in children. Material and Methods. A single-center retrospective study included 30 children with severe acute respiratory syndrome coronavirus 2 infection who were admitted to the Isolation Department of the Institute for Child and Youth Health Care of Vojvodina from April to September 2020. A complete blood count with differential was performed. Additionally, systemic inflammatory index, neutrophil-lymphocyte ratio and plateletlymphocyte ratio were calculated. For comparison, age- and sex-matched 30 children negative for severe acute respiratory syndrome coronavirus 2 were included in the study. Results. In the period from April to September 2020, 30 laboratory-confirmed cases of coronavirus-19, aged 0 - 17 years, were admitted to the Institute for Child and Youth Health Care of Vojvodina. The age was not a risk factor for the development of coronavirus-19 (p = 0.707; OR: 1.018; 95% CI: 0.927 - 1.119). The comparison of hematological parameters of severe acute respiratory syndrome coronavirus 2 status showed that hemoglobin concentration (p < 0.01) and hematocrit (p < 0.01) were lower, and the percentage of neutrophil granulocytes (p < 0.05) was higher among severe acute respiratory syndrome coronavirus 2 positive children. Furthermore, it was found that some severe acute respiratory syndrome coronavirus 2 positive children had a higher (p < 0.01), while others had a lower (p < 0.01) percentage of lymphocytes. The systemic inflammatory index, the ratio of neutrophils to lymphocytes, and the ratio of platelets to lymphocytes, were not found to be statistically significantly different (p > 0.05). Conclusion. Low hemoglobin and hematocrit levels, a high percentage of neutrophil granulocytes, and a non-physiological percentage of lymphocytes (both, low and high) may have a diagnostic significance in children with severe acute respiratory syndrome coronavirus 2 infection.

Evaluation of effectiveness of (elements of) parenting support in daily practice of preventive youth health care; design of a naturalistic effect evaluation in ‘CIKEO’ (consortium integration knowledge promotion effectiveness of parenting interventions)

Background The number of interventions to support parents is growing. The level of evidence regarding these intervention varies. In this paper we describe a study that aims to assess the effectiveness of specific ‘elements’ within such parenting interventions for families with children up to 7 years. A naturalistic effect evaluation will be applied. Study questions are: What is the exposure of parents to (elements of) parenting interventions in the daily practice of preventive youth health care? What are the associations between the exposure to (elements of) parenting interventions and outcomes in parents/children related to parenting and child development? Methods/design Thousand parents/caregivers are recruited by preventive youth health care providers in the Netherlands. Measurements will be performed after inclusion and after 12-months follow up. Data regarding child/parent/caregiver characteristics, use of (parenting) interventions and care, and outcomes with regard to parenting skills, family functioning and child development will be collected. Outcomes will be compared between parents/children exposed and non-exposed to the (elements of) parenting interventions (adjusting for confounders). Discussion We hypothesize that parents/caregivers with exposure to (elements of) parenting interventions show (relatively more) improvements in parenting outcomes. Results will support intervention selection/development, and support communities/professionals to select appropriate intervention-elements. Trial registration Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

Acute poisoning in children and adolescents hospitalized at the Institute of Child and Youth Health Care of Vojvodina between 2015-2017

Introduction. Acute pediatric poisoning has become an increasingly important medical emergency. This study was aimed at determining characteristics of acute poisoning in children and adolescents hospitalized at the Institute of Child and Youth Health Care of Vojvodina from 2015 to 2017. Material and Methods. Data were collected from medical records of all patients hospitalized for suspected acute intoxication at the Institute of Child and Youth Health Care of Vojvodina during the observed time. Results. This study included 519 patients hospitalized for suspected exposure to toxic substances. There were 49% male and 51% female patients. The intoxications had no seasonal features. The toxic substances were commonly taken orally. Medications were the most frequent cause of all poisonings, among which the most commonly reported were drugs for central nervous system disorders. Medications were the most frequent cause of poisoning in children and adolescents, as well as in children up to 10 years of age. In adolescents, the most prevalent cause of intoxication was alcohol abuse. Poisoning with suicidal intent and intentional self-poisoning without suicidal attempt were considerably more frequent in girls than in boys. There were no fatalities. Conclusion. It is of great importance to be familiar with the characteristics and circumstances of acute poisoning to plan and implement adequate preventive measures.