Abortion education: What are future physicians learning in medical school?

OBJECTIVES: The last nationwide evaluation of abortion education in undergraduate medical schools was conducted by Espey et al. more than 15 years ago. To better understand what medical schools are teaching medical students about abortion care, we conducted a brief assessment of abortion education and training at U.S. medical schools. STUDY DESIGN: In April 2019, the study team emailed a three-item survey to the obstetrics and gynecology clerkship directors at Association of American Medical Colleges-accredited U.S. allopathic medical schools (n = 143). The multiple-choice survey assessed the availability and type of reproductive health education students had during their preclinical and clinical experiences. RESULTS: Ninety-one (64%) medical schools responded. Fifty-four (59%) schools reported abortion education as part of their preclinical curriculum, with 26 (29%) dedicating at least one lecture to abortion education. Sixty-seven (74%) institutions provided a clinical abortion experience for students, with 24 (26%) indicating students had to arrange participation on their own. Nine programs (10%) reported offering no formal abortion education. CONCLUSIONS: While the availability of abortion education has increased since the last nationwide survey in 2005, discrepancies in the education offered persist, and many medical students remain without access to this training. IMPLICATIONS: Although abortion plays an essential role in women's health services, discrepancies in training opportunities limit abortion education in U.S. medical schools. Gaps in the education of medical students may have downstream effects on the availability of doctors who are trained in providing medically-safe abortions.

Subjective socioeconomic status and self-rated health in the English Longitudinal Study of Aging: A fixed-effects analysis.

Higher subjective socio-economic status (SES) goes along with better self-rated health: This finding is well-established in the literature, yet the majority of studies it is based on only rely on cross-sectional analyses and only account for few potential confounders of the association. Particularly wealth, which is increasingly thought of as an important dimension of accumulated advantage, is only rarely examined as a confounder. Using eight waves of panel data from the English Longitudinal Study of Aging (ELSA, 2002-19), we investigate the association between subjective SES and self-rated health. We use random effects models that account for theoretically important time-constant (such as education and social class) and time-varying confounders (such as income and wealth) as well as fixed-effects models, that in addition control for all time-constant confounders, whether observed or unobserved. The fully adjusted fixed-effects model reveals a statistically significant association between subjective SES and self-rated health. Yet, a one-point increase on the subjective SES ladder goes along with a two per cent of a standard deviation increase in self-rated health, only around a quarter of the size of the random-effects estimate. The role of wealth for the subjective SES-self-rated health association is negligible in the fixed-effects specifications. Smoking, drinking, and physical activity do not appear to mediate the association. A substantial part, though not all, of the observed association between subjective SES and self-rated health is due to unobserved confounding rather than a causal effect. Reducing health inequalities based on objective SES is likely more effective than based on subjective SES.

The Oral Health of a Group of 19th Century South Australian Settlers in Relation to Their General Health and Compared with That of Contemporaneous Samples.

The aims of this study are to determine the oral health status of a rare sample of 19th-century migrant settlers to South Australia, how oral conditions may have influenced their general health, and how the oral health of this group compares with contemporaneous samples in Australia, New Zealand, and Britain. Dentitions of 18 adults and 22 subadults were investigated using non-destructive methods (micro-CT, macroscopic, radiographic). Extensive carious lesions were identified in seventeen adults and four subadults, and from this group one subadult and sixteen adults had antemortem tooth loss. Sixteen adults showed evidence of periodontal disease. Enamel hypoplastic (EH) defects were identified in fourteen adults and nine subadults. Many individuals with dental defects also had skeletal signs of comorbidities. South Australian individuals had the same percentage of carious lesions as the British sample (53%), more than other historic Australian samples, but less than a contemporary New Zealand sample. Over 50% of individuals from all the historic cemeteries had EH defects, suggesting systemic health insults during dental development were common during the 19th century. The overall oral health of the South Australian settlers was poor but, in some categories, (tooth wear, periapical abscess, periodontal disease), better than the other historic samples.

Erosion-inhibiting potential of the stannous fluoride-enriched CPP-ACP complex in vitro.

Currently available anti-erosive agents only provide partial protection, emphasizing the need to enhance their performance. By characterizing erosive enamel wear at the nanoscale, the aim of this in vitro study was to assess the anti-erosive effects of SnF2 and CPP-ACP both individually and synergistically. Erosion depths were assessed longitudinally on 40 polished human enamel specimens after 1, 5, and 10 erosion cycles. Each cycle comprised one-min erosion in citric acid (pH 3.0) and one-min treatment in whole saliva (control group) or a slurry of one of the three anti-erosive pastes (10% CPP-ACP; 0.45% SnF2 (1100 ppm F); or SnF2/CPP-ACP (10% CPP-ACP + 0.45% SnF2)) (n = 10 per group). Scratch depths were assessed longitudinally in separate experiments using a similar protocol after 1, 5, and 10 cycles. Compared with the control groups, all slurries reduced erosion depths after 1 cycle (p ≤ 0.004) and scratch depths after 5 cycles (p ≤ 0.012). The order of anti-erosive potential was SnF2/CPP-ACP > SnF2 > CPP-ACP > control for erosion depth analysis, and SnF2/CPP-ACP > (SnF2 = CPP-ACP) > control for scratch depth analysis. These data provide 'proof of concept' evidence that SnF2/CPP-ACP has superior anti-erosive potential compared to SnF2 or CPP-ACP alone.

Subjective social status and allostatic load among older people in England: A longitudinal analysis.

BACKGROUND: Subjective social status has a known association with health, whereby better health outcomes are observed for those with higher perceived status. In this research, we offer new evidence on the status-health relationship using a rigorous methodological approach that considers both observed and unobserved confounders. METHODS: We use 5 waves of data spanning 15 years from the English Longitudinal Study of Ageing and derive a measure of allostatic load with biomarkers as an objective measure of health. We apply 'within-between' panel regression models. RESULTS: Models reveal the expected association between subjective status and health when comparing participants (the 'between' estimate), but no association when examining temporal variation within participants (the 'within' estimate). When controlling for personality traits including optimism, and parental education, the 'between' association between subjective status and allostatic load is reduced but does not disappear. CONCLUSIONS: Person-level confounders play some role in explaining the observed link between subjective status and health. The exact nature of the link, including the role of psychological pathways and early-life confounders, remains a question for future research.

A descriptive analysis of the Canadian prehospital and transport transfusion (CAN-PATT) network.

Objective: Out-of-hospital blood transfusion (OHBT) is becoming increasingly common across the prehospital environment, yet there is significant variability in OHBT practices. The Canadian Prehospital and Transport Transfusion (CAN-PATT) network was established to collaborate, standardize, and evaluate the effectiveness of out-of-hospital blood transfusion (OHBT) across Canada. The objectives of this study are to describe the setting and organizational characteristics of CAN-PATT member organizations and to provide a cross-sectional examination of the current OHBT practices of CAN-PATT organizations. Methods: This was a cross-sectional examination of all six critical care transport organizations that are involved in CAN-PATT network. Surveys were sent to identified leads from each organization. The survey focused on three main areas of interest: 1) critical care transport organizational service and coverage, 2) provider, and crew configurations, and 3) OHBT transfusion practices. Results: All six surveys were completed and returned. There are a total of 30 critical care transport bases (19 rotor-wing, 20 fixed-wing and 6 land) across Canada and 11 bases have a blood-on-board program. Crew configurations very between organizations as either dual paramedic or paramedic/nurse teams. Median transport times range from 30 to 46 minutes for rotor-wing assets and 64 to 90 minutes for fixed-wing assets. Half of the CAN-PATT organizations started their out-of-hospital blood transfusion programs within the last three years. Most organizations carry at least two units of O-negative, K-negative red blood cells and some organizations also carry group A thawed plasma, fibrinogen concentrate and/or prothrombin complex concentrate. All organizations advocate for early administration of tranexamic acid for injured patients suspected of bleeding. All organizations return un-transfused blood components to their local transfusion medicine laboratory within a predefined timeframe to reduce wastage. Conclusions: Variations in OHBT practices were identified and we have suggested considerations for standardization of transfusion practices and patient care as it relates to OHBT. This standardization will also enable a robust means of data collection to study and optimize outcomes of patients receiving OHBT. A fulsome description of the participating organizations within CAN-PATT should enhance interpretation of future OHBT studies that will be conducted by this network.

Biogeographical characteristics of Schistosoma mansoni endemic areas in Ethiopia: a systematic review and meta analysis.

BACKGROUND: In Ethiopia, schistosomiasis is caused by Schistosoma mansoni and S. haematobium with the former being widespread and more than 4 million people are estimated to be infected by S. mansoni annually with 35 million at risk of infection. Although many school- and community-based epidemiological surveys were conducted over the past decades, the national distribution of schistosomiasis endemic areas and associated socio-environmental determinants remain less well understood. In this paper, we review S. mansoni prevalence of infections and describe key biogeographical characteristics in the endemic areas in Ethiopia. METHODS: We developed a database of S. mansoni infection surveys in Ethiopia through a systematic review by searching articles published between 1975 and 2019 on electronic online databases including PubMed, ScienceDirect, and Web of Science. A total of 62 studies involving 95 survey locations were included in the analysis. We estimated adjusted prevalence of infection from each survey by considering sensitivity and specificity of diagnostic tests using Bayesian approach. All survey locations were georeferenced and associated environmental and geographical characteristics (e.g. elevation, normalized difference vegetation index, soil properties, wealth index, and climatic data) were described using descriptive statistics and meta-analysis. RESULTS: The results showed that the surveys exhibited a wide range of adjusted prevalence of infections from 0.5% to 99.5%, and 36.8% of the survey sites had adjusted prevalence of infection higher than 50%. S. mansoni endemic areas were distributed in six regional states with the majority of surveys being in Amhara and Oromia. Endemic sites were found at altitudes from 847.6 to 3141.8 m above sea level, annual mean temperatures between 17.9 and 29.8 â„ƒ, annual cumulative precipitation between 1400 and 1898 mm, normalized difference vegetation index between 0.03 and 0.8, wealth index score between -68 857 and 179 756; and sand, silt, and clay fraction in soil between 19.1-47.2, 23.0-36.7, and 20.0-52.8 g/100 g, respectively. CONCLUSIONS: The distribution of S. mansoni endemic areas and prevalence of infections exhibit remarked environmental and ecological heterogeneities. Future research is needed to understand how much these heterogeneities drive the parasite distribution and transmission in the region.

Genetic contribution to palatal morphology variation using three-dimensional analysis in Australian twins.

OBJECTIVE: This study aimed to provide insight into the relative contributions of genetic and environmental factors to palatal morphology variation in a cohort of Australian twins. METHODS: Healthy Australian twins, aged 12-15 years (45 monozygotic, 46 same sex dizygotic, and 32 opposite-sex dizygotic) were included in the study groups. A scanner was used to obtain three-dimensional data of the maxillary arch. Palatal depth was defined by a line to the deepest point measured from the reference plane at the mid-point of the inter-pre-molar or inter-molar line. This line was then divided into 10 equal sections in order to created 10 different depths for each palatal width. Each palatal width was divided into anterior and posterior areas. Univariate genetic analysis, using the OpenMx structural equation modelling package in R, was carried out on the quantitative data using the normal assumptions of a twin model. RESULTS: Heritability estimates for anterior palatal width ranged from 0.75 to 0.80, and from 0.78 to 0.86 for posterior palatal width. Estimates for anterior and posterior palatal depth were 0.72 and 0.86, respectively. CONCLUSIONS: Palatal morphology tends to have a moderate to relatively high genetic contribution overall. Palate height has a higher genetic contribution posteriorly than anteriorly. The width of the deep palate is under marginally less stringent genetic regulation than the width of the shallow palate.

The use of a psychological testing instrument as an indicator of dissatisfaction with aesthetic dental treatment - a preliminary study.

BACKGROUND: The use of psychological testing to indicate the potential for dissatisfaction with dental treatment has many potential patient and clinician benefits but has been rarely investigated. The study aimed to explore the use of the Symptom Checklist-90-Revised (SCL-90-R) psychological testing instrument in describing the relationship between pre-treatment psychological traits and aesthetic restorative treatment satisfaction. METHODS: Thirty patients requiring aesthetic restorative dental treatment completed three questionnaires, namely 1) a pre-treatment expectation assessment, 2) an SCL-90-R analysis pre-treatment and 3) an outcome assessment post-treatment to assess patient's expectations and satisfaction of the proposed dental treatment relating to function, aesthetics, comfort and tissue preservation. Logistic regression models were used to assess the impact of psychological variables on patient satisfaction after adjusting for baseline expectations (P < 0.05). RESULTS: The satisfaction for the aesthetic component of treatment was significantly associated with psychoticism and positive symptom distress index. The satisfaction for the comfort component of treatment was significantly associated with obsessive compulsive symptoms, depression and anxiety. Following adjustment for baseline expectation, tissue preservation satisfaction was associated with somatization, obsessive compulsive, interpersonal sensitivity, depression and global severity index. No baseline psychological measures were significantly associated with chewing satisfaction. CONCLUSIONS: The SCL-90-R shows initial promise in assisting clinicians to identify and understanding patients who have a high risk of dissatisfaction with aesthetic dental treatment. The ability to indicate aesthetic restorative treatment dissatisfaction is of great benefit to clinicians in maximising success and mitigating risk.

Remainers are nostalgic too: An exploration of attitudes towards the past and Brexit preferences.

Nostalgia had a prominent place in the Brexit Referendum campaign, epitomized by Nigel Farage carrying around with him an old-fashioned blue British passport on the campaign trail. In this paper, we seek to examine British attitudes towards the past through a new survey instrument administered online in July and August 2018 (N = 3,000). We empirically establish two dimensions of nostalgia that are differentially associated with political preferences. We conclude that it is the substance of the nostalgia that matters, not the looking towards the past per se.

Relation of dietary preference to masticatory movement and masticatory exercises in Japanese children.

OBJECTIVE: Modern Japanese children have decreased masticatory function, which can be explained by the dietary change to soft foods. In earlier studies involving children with mixed dentition, masticatory exercises were shown to improve masticatory function and modify dental arch growth. Grinding type of mastication with a wide path reportedly increases lateral growth of the dental arch. This study aimed to assess the relationship between masticatory movements and dietary preference, and how masticatory exercises affected masticatory movement during Hellman's dental stages IIA to IIC (period of first molar eruption). DESIGN: In 64 Japanese pre-school children, we measured masticatory movements with foods of five different levels of hardness and investigated the dietary preference for hard foods through a questionnaire. Participants were also required to perform masticatory exercises. Masticatory movements and dietary preference for hard foods were assessed at the start (T1), conclusion (T2), and after six months of exercises (T3). Participants were allocated to Wide and Narrow groups at T1 based on their masticatory path width. RESULTS: Baguettes and bananas resulted in the widest and narrowest masticatory paths, respectively, at T1. Results of questionnaire indicated that those eating hard foods had a broad grinding type of masticatory path. Masticatory exercises significantly widened the masticatory path in the Narrow group demonstrating that masticatory exercises help children learn to chew with grinding strokes. Moreover, the masticatory path remained stable on assessment at T3 (six-month follow-up). CONCLUSIONS: Masticatory exercises are effective in children who are unable to grind hard foods, affecting their dietary preferences.

Assessing the nonhuman primate reservoir of Schistosoma mansoni in Africa: a systematic review.

BACKGROUND: Reports of natural infections of Schistosoma mansoni in a number of species of nonhuman primates (NHPs) in Africa, coupled with the substantial overlap of NHP habitats and human schistosomiasis endemic areas, has led to concerns about the role of NHPs in the transmission of human schistosomiasis. We conducted a systematic review of the literature to describe the current scope of knowledge for Africa, for the NHP species implicated, their geographical distribution, infection rates with S. mansoni, and to discuss the implications for public health and conservation. MAIN TEXT: A systematic search of the literature was performed using PubMed, Web of Science, Google Scholar, the World Health Organization (WHO) library database, World Cat, and ScienceDirect without any language restriction. Studies examining S. mansoni infection of any African NHP species were included. Study types, primate species, their geographical distribution, and parasite diagnostic techniques reported in the studies were qualitatively summarized. Data for species with sample sizes ≥10 were included in the meta-analysis. We assessed the reported infection rate, and used a random-effects model to estimate the summary infection rates and 95% confidence intervals (CIs). We assessed heterogeneity among studies using the I2 statistics. Twenty-nine publications, from 1960 to 2018, were identified and included in the review. The studies examined a total of 2962 primates belonging to 22 species in 11 genera across ten countries (Cameroon, Eritrea, Ethiopia, Gabon, Kenya, Nigeria, Senegal, Tanzania, Uganda, and Zimbabwe), and S. mansoni infections were found in nine species of five genera in all countries. When we excluded studies with sample sizes < 10, data from 24 studies on 11 species of primates in three genera in ten countries remained in the meta-analysis. The overall pooled estimate of infection rate was 10% (95% CI: 6-16%) with high heterogeneity (I2 = 94.77%) across countries and species/genera. Among the three genera, Pan had the highest infection rate of 15% (95% CI: 0-55%), followed by Papio at 11% (95% CI: 6-18%), and Cercopithecus at 5% (95% CI: 0-14%). The association between NHP and human infections was positive, but not significant, due to low study sample matches and high variation. CONCLUSIONS: Our findings suggest that S. mansoni infection rate is high in African NHPs, with substantial heterogeneities across species/genera and countries in Africa. Given the evidence for potential spillover and spillback of S. mansoni between African NHPs and humans, further research is urgently needed to understand ecology and mechanisms of transmission of the parasite between NHP and human hosts, in order to inform control strategies of this important neglected tropical disease.

Preference for realistic art predicts support for Brexit.

Following the UK's EU referendum in June 2016, there has been considerable interest from scholars in understanding the characteristics that differentiate Leave supporters from Remain supporters. Since Leave supporters score higher on conscientiousness but lower on neuroticism and openness, and given their general proclivity toward conservatism, we hypothesized that preference for realistic art would predict support for Brexit. Data on a large nationally representative sample of the British population were obtained, and preference for realistic art was measured using a four-item binary choice test. Controlling for a range of personal characteristics, we found that respondents who preferred all four realistic paintings were 15-20 percentage points more likely to support Leave than those who preferred zero or one realistic paintings. This effect was comparable to the difference in support between those with a degree and those with no education, and was robust to controlling for the respondent's party identity.

Intergenerational social mobility and allostatic load in Great Britain.

BACKGROUND: Intergenerational social mobility is hypothesised to be a stressful process that has a negative effect on health. By examining the relationship between own socioeconomic position, parental socioeconomic position and allostatic load (AL) in a representative sample of the British population, we test this hypothesis. METHODS: Our study uses cross-sectional data from 9851 adult participants of waves 2 and 3 of Understanding Society. The relationship between parental occupational class at age 14 years, respondents' social class at the time of the interview and AL is explored by means of diagonal reference models, which allow us to disentangle the effects of parental social class, own social class and the mobility process. The AL score comprises the following biomarkers: (1) total cholesterol, (2) high-density lipoprotein cholesterol, (3) triglycerides, (4) glycated haemoglobin, (5) C-reactive protein, (6) fibrinogen, (7) systolic blood pressure, (8) diastolic blood pressure, (9) resting heart rate, (10) body mass index and (11) waist circumference. RESULTS: AL is particularly high among the stable working class and low among the stable upper class. On average, current class and origin class exert about equal weight on current AL. However, social mobility-regardless of whether upwards or downwards-is not detrimental for AL. Furthermore, we find evidence that class of origin may be less important among those outside the labour market for reasons other than retirement. CONCLUSION: Both own social class and parental social class influence AL to a similar extent. However, we find no evidence that mobility trajectories exert any effects, good or bad, on AL.

Effect of demineralization time on the mineral composition and mechanical properties of remineralized dentin.

The aim of this study was to determine whether recovery of mineral levels restored the mechanical properties of dentin subjected to different durations of demineralization. Dentin at the floor of class 1 cavities (n = 12) was demineralized for 1, 2, and 3 weeks. Half the demineralized cavity floor was coated (control side), and a Fuji IX restoration was placed. The remaining half was therefore in contact with the Fuji IX restoration (test side). Simulated dentin tubular fluid was then supplied to each pulp chamber for 6 weeks. After remineralization, the teeth were detached from the system and sectioned. Concentrations of calcium, phosphorus, fluorine, and strontium and mechanical properties (hardness and Young's modulus) of the test and control sides were determined by electron probe microanalysis and nano-indentation, respectively. For remineralized dentin demineralized for 1 week, the substantial uptake of mineral elements restored hardness and Young's modulus at depths of 50 to 200 µm from the lesion front. For longer periods of demineralization (2 and 3 weeks), structural damage to the demineralized dentin was severe and impeded recovery of mechanical properties, despite mineral uptake.

Histological assessment of regenerative endodontic treatment in animal studies with different scaffolds: A systematic review.

BACKGROUND/AIM: The concept of regenerative endodontic procedures remains controversial. The aim of this study was to evaluate the histology of the tissues formed in immature animal teeth with necrotic and infected pulps after attempted endodontic regeneration procedures using different scaffolds. DESIGN: A systematic electronic literature search was performed in PubMed, Web of Science, Scopus, EMBASE, DOSS, and Cochrane Library databases. The terms used were a combination of the following: "immature permanent necrotic tooth or teeth" or "open apex or apices" and "regeneration or revitalization or revascularization" and "histology." The inclusion criteria comprised animal studies with histological examination following regenerative endodontics in immature necrotic-infected permanent teeth. RESULTS: From 123 screened studies, 13 met the inclusion criteria. Formation of dentin-like tissue on the dentinal walls was reported in only 4% of teeth treated with blood clot scaffold and 2% treated with blood clot with additional materials. Cementum-like hard tissue was found in 64% of teeth with blood clot, 80% treated with blood clot with additional materials, 50% treated with alternative scaffolds, and 5% that were left empty. Bone-like tissue was reported in 10% of teeth treated with blood clot, 2% treated with blood clot with additional materials, and 4% treated with alternative scaffolds. The tissues in the canal space were found to be connective tissue with infiltration of fibroblast-like cells and blood vessels. Forty-six percent of the studies reported formation of periodontal ligament-like tissues. CONCLUSIONS: None of the regeneration protocols resulted in the predictable formation of a true pulp-dentin complex.

Social class, employment status and inequality in psychological well-being in the UK: Cross-sectional and fixed effects analyses over two decades.

A body of academic research has shown a social class gradient in psychological well-being. Some recent work has also suggested that the gradient is worsening over time, though the evidence is mixed. We focus on two straightforward research questions: Is there a class gradient in mental health? Has this gradient changed over time? We answer these questions with attention to two specific causal pathways: employment status and unobserved heterogeneity. We use two data sources: repeated cross-sections from the Health Survey of England (HSE) and longitudinal data from the British Household Panel Survey (BHPS). The combination of pooled OLS regression (with HSE) and fixed effects analysis (with BHPS) allows for a robust analysis of the relationship between class and psychological well-being. We argue that employment status is a confounder in the analysis of class inequalities and show that, along with unobserved heterogeneity, these two pathways go a long way to explain the class gradient. The effects of employment status are substantive and, unlike social class, cannot be explained away by unobserved heterogeneity. We conclude that employment status deserves greater prominence in the debate as both a pathway by which the class gradient transpires, and as another 'dimension' of inequality in its own right. Our overtime analysis suggests that skilled and unskilled manual workers had higher psychological well-being in the 1990s but by 2008 were closer to the average. Class inequalities do not appear to be widening.

Standardisation of sheep model for endodontic regeneration/revitalisation research.

OBJECTIVE: Different endodontic regeneration/revitalisation protocols have been suggested for the treatment of immature permanent teeth with pulp necrosis. Many aspects of these protocols require further investigating necessitating a suitable standardised animal model for research purposes. The focus of this study was to examine the anatomy and histology of sheep teeth at different stages of development to find an appropriate dental age for endodontic regeneration/revitalisation research. DESIGN: Sheep teeth at mature and immature dental ages were investigated. Standardized radiography, computed tomography, and histology were used to measure root length, apical-third dentine thickness and apex diameter, and to evaluate tissue development stages. RESULTS: A mature sheep tooth has an apical area which consists of a major foramen, intermediate dilatation and minor foramen. From the time of eruption to maturation no major changes occur in the incisor root lengths, but the apical foramen width decreases and the dentinal wall thickness increases. The two-tooth age exhibited the most similar features to that of an immature permanent human tooth. CONCLUSION: Sheep appears to be an appropriate animal model for endodontic regeneration/revitalization research with similar dimension and characteristics to human anterior teeth. Each dental age has its advantages and disadvantages. The two-tooth age showed the most favourable criteria making this age the most suitable for in vivo regeneration/revitalisation research.

For Whom Money Matters Less: Social Connectedness as a Resilience Resource in the UK.

The current literature shows that both absolute and relative income are important for happiness, but there is little work emphasising how the strength of the relationship is dependent on personal and social factors. I hypothesise that social connectedness influences the money-happiness relationship because the effect of money is in part felt through the acquisition of social status, whereas status (and associated psychological benefits such as self-worth) can alternatively be gained through social connectedness. In particular, it is theorised that 'weak ties' when co-existing with good quality informal ties have a separable and additional benefit to subjective well-being, and that it is the socially isolated who have the most to gain from doing well financially. Social connectedness is conceptualised as a 'resilience resource' which has a buffering effect on subjective well-being. Data from the British Household Panel Survey are used, first to establish a measurement schema of connectedness using latent class analysis, and secondly in a multilevel model of life satisfaction with observations from seven consecutive years nested within individuals. The results show that connectedness makes a larger difference to satisfaction in times of financial stress, and that the satisfaction of the socially isolated can 'catch up' to some degree with those with larger networks when things are going well financially. The findings also confirm that those for whom money makes the smallest contribution to happiness are those with both strong and weak ties. Weak ties have an additional benefit compared to having strong ties alone. In summary, connectedness has the power to narrow the well-being gap that exists between times of financial struggle and times of relative comfort. It suggests that the psychological benefits of social integration have the capacity to displace money as a source of status and self-worth, and similarly that the importance of money may be exaggerated where these psychological gains are not available through other domains of life.