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OBJECTIVES: Adverse childhood experiences (ACEs) have a negative impact on childhood health, but their impact on education outcomes is less well known. We investigated whether or not ACEs were associated with reduced educational attainment at age 7 and 11 years. STUDY DESIGN: The study design used in the study is a population-based electronic cohort study. METHODS: We analysed data from a total population electronic child cohort in Wales, UK. ACEs (exposures) were living with an adult household member with any of (i) serious mental illness, (ii) common mental disorder (CMD), (iii) an alcohol problem; (iv) child victimisation, (v) death of a household member and (vi) low family income. We used multilevel logistic regression to model exposure to these ACEs and not attaining the expected level at statutory education assessments, Key Stage (KS) 1 and KS2 separately, adjusted for known confounders including perinatal, socio-economic and school factors. RESULTS: There were 107,479 and 43,648 children included in the analysis, with follow-up to 6-7 years (KS1) and 10-11 years (KS2), respectively. An increased risk of not attaining the expected level at KS1 was associated with living with adult household members with CMD (adjusted odds ratio [aOR]: 1.13 [95% confidence interval [CI]: 1.09-1.17]) or an alcohol problem (adjusted odds ratio [aOR]: 1.16 [95% confidence interval [CI]: 1.10-1.22]), childhood victimisation (adjusted odds ratio [aOR]: 1.58 [95% confidence interval [CI]: 1.37-1.82]), death of a household member (adjusted odds ratio [aOR]: 1.14 [95% confidence interval [CI]: 1.04-1.25]) and low family income (adjusted odds ratio [aOR]: 1.92 [95% confidence interval [CI]: 1.84-2.01]). Similar results were observed for KS2. Children with multiple adversities had substantially increased odds of not attaining the expected level at each educational assessment. CONCLUSION: The educational potential of many children may not be achieved due to exposure to adversity in childhood. Affected children who come in to contact with services should have relevant information shared between health and care services, and schools to initiate and facilitate a coordinated approach towards providing additional support and help for them to fulfil their educational potential, and subsequent economic and social participation.
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Sucesso Acadêmico , Experiências Adversas da Infância/estatística & dados numéricos , Escolaridade , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Vítimas de Crime/estatística & dados numéricos , Feminino , Humanos , Renda/estatística & dados numéricos , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , Razão de Chances , Instituições Acadêmicas , Fatores Socioeconômicos , País de GalesRESUMO
OBJECTIVES: Educational and employment outcomes are critical elements in determining the life course of individuals, yet through health and other mechanisms, those who suffer adverse childhood experiences (ACEs) may experience barriers to achieve in these domains. This study examines the association between ACEs and poor educational outcomes, before considering the impact of ACEs and education on employment in adulthood. STUDY DESIGN: Retrospective cross-sectional surveys were conducted in England and Wales using a random stratified sampling methodology. METHODS: During face-to-face household interviews (n = 2881), data were collected on demographic factors, ACEs, self-rated childhood affluence, the highest qualification level attained and the current employment status. RESULTS: While respondents with ≥4 ACEs were significantly more likely to have no formal qualifications (adjusted odds ratio [AOR] = 2.18; P < 0.001), among those who did achieve secondary level qualifications, the presence of ACEs did not further impact subsequent likelihood of going on to attain college or higher qualifications. However, results suggest a persisting independent impact of high (≥4) ACEs, which were found to be significantly associated with both current unemployment (AOR = 2.52, P < 0.001) and long-term sickness and disability (AOR = 3.94, P < 0.001). Modelled levels of not being in employment ranged from as little as 3% among those with 0 or 1 ACE and higher qualifications to 62% among those with no qualifications and ≥4 ACEs (adjusted for age, gender and childhood affluence effects). CONCLUSIONS: Compulsory education may play a pivotal role in mitigating the effects of adversity, supporting the case for approaches within schools that build resilience and tackle educational inequalities. However, adults with ACEs should not be overlooked and efforts should be considered to support them in achieving meaningful employment.
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Experiências Adversas da Infância/estatística & dados numéricos , Escolaridade , Emprego/estatística & dados numéricos , Adulto , Estudos Transversais , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , País de GalesRESUMO
Laguna Negra virus (LNV) is a New World hantavirus associated with severe and often fatal cardiopulmonary disease in humans, known as hantavirus pulmonary syndrome (HPS). Five hamster species were evaluated for clinical and serologic responses following inoculation with 4 hantaviruses. Of the 5 hamster species, only Turkish hamsters infected with LNV demonstrated signs consistent with HPS and a fatality rate of 43%. Clinical manifestations in infected animals that succumbed to disease included severe and rapid onset of dyspnea, weight loss, leukopenia, and reduced thrombocyte numbers as compared to uninfected controls. Histopathologic examination revealed lung lesions that resemble the hallmarks of HPS in humans, including interstitial pneumonia and pulmonary edema, as well as generalized infection of endothelial cells and macrophages in major organ tissues. Histologic lesions corresponded to the presence of viral antigen in affected tissues. To date, there have been no small animal models available to study LNV infection and pathogenesis. The Turkish hamster model of LNV infection may be important in the study of LNV-induced HPS pathogenesis and development of disease treatment and prevention strategies.
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Antígenos Virais/imunologia , Modelos Animais de Doenças , Síndrome Pulmonar por Hantavirus/patologia , Doenças Pulmonares Intersticiais/patologia , Mesocricetus , Orthohantavírus/imunologia , Edema Pulmonar/patologia , Animais , Cricetinae , Feminino , Humanos , Pulmão/patologia , MasculinoRESUMO
BACKGROUND: ACE (adverse childhood experience) studies typically examine the links between childhood stressors and adult health harming behaviours. Using an enhanced ACE survey methodology, we examine impacts of ACEs on non-communicable diseases and incorporate a proxy measure of premature mortality in England. METHODS: A nationally representative survey was undertaken (n = 3885, aged 18-69, April-July 2013). Socio-demographically controlled proportional hazards analyses examined the associations between the number of ACE categories (<18 years; e.g. child abuse and family dysfunction such as domestic violence) and cancer, diabetes, stroke, respiratory, liver/digestive and cardiovascular disease. Sibling (n = 6983) mortality was similarly analysed as a measure of premature mortality. RESULTS: Of the total, 46.4% of respondents reported ≥1 and 8.3% ≥4 ACEs. Disease development was strongly associated with increased ACEs (e.g. hazard ratios, HR, 0 versus ≥4 ACEs; cancer, 2.38 (1.48-3.83); diabetes, 2.99 (1.90-4.72); stroke, 5.79 (2.43-13.80, all P < 0.001). Individuals with ≥4 ACEs (versus no ACEs) had a 2.76 times higher rate of developing any disease before age 70 years. Adjusted HR for mortality was strongly linked to ACEs (≥4 versus 0 ACEs; HR, 1.97 (1.39-2.79), P < 0.001). CONCLUSIONS: Radically different life-course trajectories are associated with exposure to increased ACEs. Interventions to prevent ACEs are available but rarely implemented at scale. Treating the resulting health costs across the life course is unsustainable.
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Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Efeitos Psicossociais da Doença , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Idoso , Inglaterra/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Modelos de Riscos Proporcionais , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
Lunar rock 66095 contains a hydrated iron oxide and has an unusual amount of water for a lunar rock (140 to 750 parts per million), 90 percent of which is released below 690 degrees C. The deltaof water released at these low temperatures varies from -75 to -140 per mil relative to standard mean ocean water (SMOW). The small amount of water released between 690 degrees and 1300 degrees C has a delta of about -175 +/-25 per mil SMOW. These delta values are not unusual for terrestrial water. The delta(18)O of water extracted from 110 degrees to 400 degrees C has a value of +5+/- I per mil SMOW, similar to the value for lunar silicates from rock 66095 and different from the value of -4 to -22 per mil found for samples of terrestrial rust including samples of rusted meteoritic iron. The amount of carbon varies from 11 to 59 parts per million with a delta(13)C from -20 to -30 per mil relative to Pee Dee belemnite. Only very small amounts of reduced species (such as hydrogen, carbon monoxide, and methane) were found, in contrast to the analyses of other lunar rocks. Although it is possible that most of the water in the iron oxide (goethite) may be terrestrial in origin or may have exchanged with terrestrial water during sample return and handling, evidence presented herein suggests that this did not happen and that some lunar water may have a deltaD that is indistinguishable from that of terrestrial water.
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The water content of the breccia is 150 to 455 ppm, with a deltaD from-580 to -870 per mil. Hydrogen gas content is 40 to 53 ppm with a deltaD of -830 to -970 per mil. The CO(2) is 290 to 418 ppm with delta (13)C = + 2.3 to + 5.1 per mil and delta(18)O = 14.2 to 19.1 per mil. Non-CO(2) carbon is 22 to 100 ppm, delta(13)C = -6.4 to -23.2 per mil. Lunar dust is 810 ppm H(2)O (D = 80 ppm) and 188 ppm total carbon(delta(13)C = -17.6 per mil). The (18)O analyses of whole rocks range from 5.8 to 6.2 per mil. The temperature of crystallization of type B rocks is 1100 degrees to 1300 degrees C, based on the oxygen isotope fractionation between coexisting plagioclase and ilmenite.
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The site preference for ligand substitution in the benzothiazolate-bridged cluster HOs3(CO)10(µ-1,2-N,C-η1,κ1-C7H4NS) (1) has been investigated using PPh3. 1 reacts with PPh3 in the presence of Me3NO to afford the mono- and bisphosphine substituted clusters HOs3(CO)9(PPh3)(µ-1,2-N,C-η1,κ1-C7H4NS) (2) and HOs3(CO)8(PPh3)2(µ-1,2-N,C-η1,κ1-C7H4NS) (3), respectively. 2 exists as a pair of non-interconverting isomers where the PPh3 ligand is situated at one of the equatorial sites syn to the edge-bridging hydride that shares a common Os-Os bond with the metalated heterocycle. The solid-state structure of the major isomer establishes the PPh3 regiochemistry at the N-substituted osmium center. DFT calculations confirm the thermodynamic preference for this particular isomer relative to the minor isomer whose phosphine ligand is located at the adjacent C-metalated osmium center. 2 also reacts with PPh3 to give 3. The locus of the second substitution occurs at one of the two equatorial sites at the Os(CO)4 moiety in 2 and gives rise to a pair of fluxional stereoisomers where the new phosphine ligand is scrambled between the two equatorial sites at the Os(CO)3P moiety. The molecular structure of the major isomer has been determined by X-ray diffraction analysis and found to represent the lowest energy structure of the different stereoisomers computed for HOs3(CO)8(PPh3)2(µ-1,2-N,C-η1,κ1-C7H4NS). The fluxional behavior displayed by 3 has been examined by VT NMR spectroscopy, and DFT calculations provide evidence for stereoselective tripodal rotation at the Os(CO)3P moiety that serves to equilibrate the second phosphine between the two available equatorial sites.
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[reaction: see text] This communication describes the first examples of tandem endo-regioselective and stereospecific oxacyclizations of 1, 5-diepoxides to oxepane products and a similar tandem oxacyclization of 1,5,9-triepoxides to fused bisoxepane cyclic carbonates. A mechanism for these biomimetic oxacyclizations is proposed in which the epoxides act as both electrophilic and nucleophilic reaction partners.
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Compostos de Epóxi/síntese química , Mimetismo Molecular , Oxepinas/síntese química , Toxinas Marinhas/síntese química , Compostos Policíclicos/síntese química , EstereoisomerismoRESUMO
Dental health can be a neglected area in the care of older people. This article considers some of the common dental problems experienced in older age and discusses strategies for treatment and prevention.
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Promoção da Saúde , Saúde Bucal , Idoso , Assistência Odontológica , Humanos , Doenças da Boca/prevenção & controleRESUMO
Reaction of the diferric sandwich-type polyoxometalate (NaOH(2))(2)Fe(III)(2)(P(2)W(15)O(56))(2)(16-)(1) with excess aqueous Cu(II) or Co(II) yields a new type of d-electron-metal substituted polyoxometalate, [TM(II)Fe(III)(2)(P(2)W(15)O(56)) (P(2)TM(II)(2)W(13)O(52))](16-), TM = Cu (2), Co (3), respectively. The structure of the sodium salt of 2 (Na2), determined by single-crystal X-ray diffraction analysis (a = 13.4413(9) A, b = 21.2590(15) A, c = 25.5207(18) A, alpha = 80.475(2) degrees, beta = 85.555(2) degrees, gamma = 89.563(2) degrees, triclinic, P(-)1, R1 = 5.42%, based on 43097 independent reflections), consists of a defect Fe(2)Cu central unit sandwiched between two different trivacant Wells-Dawson-type units, P(2)W(15) and P(2)Cu(2)W(13), where the latter unit has two octahedral Cu(II) ions substituted for two adjacent belt W(VI) atoms. The CuO(5)OH(2) octahedron in the central unit shows pronounced Jahn-Teller distortion. A low-resolution X-ray structure of Na3 is included in the Supporting Information. UV-visible, infrared, (31)P NMR, cyclic voltammetric, and elemental analysis data are all consistent with the structure determined from the X-ray analysis. Cyclic voltammograms of 2 and 3 exhibit multiple electron-transfer processes under ambient conditions, and copper or cobalt incorporation into the framework of 1 results in a substantial pertubation of the electrochemical properties of the polyoxotungstate framework. The tetra-n-butylammonium salts of 2 and 3 (readily prepared by metathesis) are stable and effective catalysts for the oxidation of some alkenes with high yields based on H(2)O(2).
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Trends in the stability of alpha- and beta-Keggin heteropolytungstates of the second-row main-group heteroatoms Al(III), Si(IV), and P(V) are elaborated by data that establish the roles of kinetic and thermodynamic control in the formation and isomerization of Keggin tungstoaluminates. Slow, room-temperature co-condensation of Al(III) and W(VI) (2:11 molar ratio) in water gives a pH 7 solution containing beta(1) and beta(2) isomers of [Al(AlOH(2))W(11)O(39)](6)(-) (beta(1)- and beta(2)-1). Partial equilibration of this kinetic product mixture by gentle heating (2 h at 100 degrees C) or, alternatively, co-condensation of Al(III) and W(VI) for 2.5 h at 100 degrees C both give mixtures of beta(2)-, beta(3)-, and alpha-1. Full equilibration, by prolonged heating (25 days at 100 degrees C), gives an isomerically pure solution of alpha-1, thus demonstrating that isomerization occurs in the direction beta(1) --> beta(2) --> beta(3) --> alpha. Furthermore, kinetically controlled conversions of 1 to H(5)[AlW(12)O(40)] (2)-achieved by heating pH 0-0.2 solutions of 1 for 5 days at 100 degrees C-occur with retention of isomeric integrity, such that alpha-1 is converted to alpha-2 (92%; 8% beta), while mixtures of beta(2)- and beta(3)-1 are converted to beta-2 (87%; 13% alpha). These data, when combined with previously reported observations (equilibria between alpha- and beta-2, kinetically controlled hydrolyses of alpha-2 to alpha-[AlW(11)O(39)](9)(-) (alpha-3) and of beta-2 to beta(2)-3, and equilibria between beta(3)- and alpha-3), provide a comprehensive picture regarding the roles of kinetic and thermodynamic control. Finally, a general method for preparation of the isomerically pure derivatives alpha-K(9)(-)(n)()[AlM(n)()(+)W(11)O(39)] (4), M(n)()(+) = Al(III), [V(IV)O](2+), [V(V)O](3+), Mn(II), Mn(III), Mn(IV), Co(II), and Co(III), is provided. The presence of Mn(IV) is confirmed by cyclic voltammetry, pK(a) values of the aquo ligands on 4 are determined by pH titration, and the isomeric structure of these derivatives is established by (27)Al, (51)V, and (183)W NMR and IR spectroscopies and X-ray crystallography.