Head injuries in early childhood in the UK; is there a social gradient?

Objectives To examine if there is a social gradient in early childhood head injuries among UK children. Methods Cross-sectional study, using data from the UK Millennium Cohort Study (MCS). The second, third and fourth sweeps of the MCS were analysed separately, when children were 3, 5 and 7 years old. Logistic regression models were used to explore the associations between head injuries and family socioeconomic position (social class, household income, maternal education and area deprivation). Results The unadjusted analyses showed different associations with socioeconomic indicators at different ages. At age 3 and 5 years, head injuries were associated with higher area deprivation, lower household income and parents not being in work or in the routine social class. At age 5 years head injuries were also associated with lower maternal education. At age 7 years only associations with area deprivation and maternal education were found. In adjusted analyses (mutually adjusted for all four socioeconomic indicators, maternal age, child age and child sex), the following associations were observed: at ages 3 and 5 years, higher levels of area deprivation were related to higher odds of head injuries. At age 3 years only, lower levels of maternal education were related to lower odds of head injuries. No social gradients were observed. At age 7 years, there were no significant associations between head injuries and any of the SEP measures. Conclusion We observed no social gradients in early childhood head injuries. However, at ages 3 and 5 years, head injuries were more frequently reported for children living in more deprived areas

Do social relationships mediate or moderate social inequalities in health? A systematic review protocol

INTRODUCTION: Explanations for health inequalities include material, behavioural and psychosocial pathways. Social relationships are an important determinant of health, and research has consistently found that a lack of support networks may diminish favourable health outcomes. There is some evidence that social network structures, partly shaped by socioeconomic factors, contribute to health inequalities. This protocol will summarise the systematic review process. METHODS AND ANALYSES: The Systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic database search of MEDLINE, Embase Classic + Embase and PsychINFO using the OvidSP platform will be undertaken. Databases will be searched from the earliest date of entry until 10 June 2022. Articles that have quantitatively assessed the role of social relationships in mediating or moderating health inequalities will be included and any health outcome (mental/physical) will be considered. The database search will be supplemented by reference list screening of all relevant full-text articles identified through the search. Two independent reviewers will be responsible for screening of articles, data extraction and assessment of bias. Observational studies will be risk assessed for bias using a modified version of the Newcastle-Ottawa Quality Assessment Scale, and intervention studies will be assessed using the revised Cochrane risk-of-bias tool. It is anticipated that the eligible studies will be highly variable; therefore, a meta-analysis will only be considered if the available data of the selected studies are similar. If the studies are too heterogeneous, a narrative synthesis of the extracted data will be presented. CONCLUSION: The results of the systematic review will examine the link between social relationships and health inequalities. The findings of the review will identify gaps in knowledge where further research is needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020181706

Life course socioeconomic position and general and oral health in later life: Assessing the role of social causation and health selection pathways

Objective: To examine the pathways between life course socioeconomic position (SEP) and general and oral health, assessing the role of two competing theories, social causation and health selection, on a representative sample of individuals aged 50 years and over in England. // Methods: Secondary analysis from the English Longitudinal Study of Ageing Wave 3 data (n = 8659). Structural equation models estimated the social causation pathways from childhood SEP to adult self-rated general health and total tooth loss, and the health selection pathways from childhood health to adult SEP. // Results: There were direct and indirect (primarily via education, but also adult SEP, and behavior) pathways from childhood SEP to both health outcomes in older adulthood. There was a direct pathway from childhood health to adult SEP, but no indirect pathway via education. The social causation path total effect estimate was three times larger for self-rated general health and four times larger for total tooth loss than the health selection path respective estimates. // Conclusions: The relationship between SEP and health is bidirectional, but with a clearly stronger role for the social causation pathway

Cross cultural adaptation and psychometric properties of the Bengali version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5)

BACKGROUND: The oral health related quality of life (OHRQoL) of children in Bangladesh has not yet been measured, as there is no validated OHRQoL measure for that population. The aim of this study was to cross-culturally adapt the child self-report and parental proxy report versions of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) into Bengali and test their psychometric properties: face validity, construct validity (convergent and discriminant validity) and reliability (internal consistency and test-retest reliability), among 5-9-year-old children and their parents in Bangladesh and assess associations between dental caries/sepsis and OHRQoL in this population. METHODS: The forward-backward translated Bengali SOHO-5 was piloted among 272 children and their parents to test its face validity. The questionnaire was administered to 788 children and their parents to evaluate its psychometric properties. Internal consistency of Bengali SOHO-5 was assessed using Cronbach's alpha, and test-retest reliability was assessed using Kappa. Convergent and discriminant validity were assessed through nonparametric tests. The calculation of effect sizes and standard error of measurement facilitated the assessment of minimally important difference (MID) for SOHO-5. The associations of reporting an oral impact with caries and sepsis were assessed via logistic regression models. RESULTS: Both child self-report and parental proxy report questionnaires showed good face validity. Cronbach's alpha scores were 0.79 and 0.87 for child and parental questionnaire, respectively. A weighted Kappa score of 0.85 demonstrated test-retest reliability of child questionnaire. SOHO-5 scores were significantly associated with subjective oral health outcomes and discriminated clearly between different caries severity and sepsis groups. These differences were considerably higher than the MID. After adjusting for child's age, sex, setting, maternal education and family income, the odds of reporting an oral impact were 2.25 (95% CI 1.98-2.56) and 4.44 (95% CI 3.14-6.28) times higher for each additional tooth with caries and sepsis, respectively. CONCLUSION: This study provided strong evidence supporting the validity and reliability of both versions of Bengali SOHO-5 as OHRQoL measures. Dental caries and sepsis were associated with poor OHRQoL in this population. The Bengali SOHO-5 is expected to be a useful outcome measure for research and clinical purposes in Bengali speaking child populations

Micro-computed tomography, scanning electron microscopy and energy X-ray spectroscopy studies of facet joint degeneration : A comparison to clinical imaging

Segmental degeneration in the human lumbar spine affects both the intervertebral discs and facet joints. Facet joint degeneration not only affects the cartilage surface, but also alters the cellular properties of the cartilage tissue and the structure of the subchondral bone. The primary focus of this study is the investigation of these microstructural changes that are caused by facet joint degeneration. Microstructural analyses of degenerated facet joint samples, obtained from patients following operative lumbar interbody fusion, have not previously been extensively investigated. This study analyzes human facet joint samples from the inferior articular process using scanning electron microscopy, micro-computed tomography, and energy dispersive X-ray spectroscopy to evaluate parameters of interest in facet joint degeneration such as elemental composition, cartilage layer thickness and cell density, calcification zone thickness, subchondral bone portion, and trabecular bone porosity. These microstructural analyses demonstrate fragmentation, cracking, and destruction of the cartilage layer, a thickened calcification zone, localized calcification areas, and cell cluster formation as pathological manifestations of facet joint degeneration. The detailed description of these microstructural changes is critical for a comprehensive understanding of the pathology of facet joint degeneration, as well as the subsequent development and efficacy analysis of regenerative treatment strategies.Peer reviewe

Adverse childhood experiences and trajectories of internalizing, externalizing, and prosocial behaviors from childhood to adolescence

Adverse childhood experiences (ACEs) predict poorer mental health across the life course but most of the extant research has employed ACE scores or individual adversities using retrospective data. Objectives: To study the impact of ACEs on later mental health using not only ACEs scores and individual ACEs, but also latent class analysis (LCA), which respects the clustering of adversities. Participants and setting: 8823 members from the UK Millennium Cohort Study. Methods: We investigated the impact of prospectively reported ACEs on mental health trajectories derived using the Strengths and Difficulties Questionnaire at age 3, 5, 7, 11 and 14. Associations between LCA-derived ACE clusters, ACE scores, individual ACEs and mental health trajectories were tested using linear mixed effects models. Results: With statistical significance set at 5% level, ACE scores showed a graded association with internalizing (ACE score of 1: β = 0.057; ACE score of 2: β = 0.108; ACE score of 3: β = 0.202), externalizing (ACE score of 1: β = 0.142; ACE score of 2: β = 0.299; ACE score of 3: β = 0.415) and prosocial behaviors (ACE score of 1: β=-0.019; ACE score of 2: β=-0.042; ACE score of 3: β=-0.059). Harsh parenting and physical punishment were particularly strongly associated with externalizing (β = 0.270 and β = 0.256) and negatively associated with prosocial behaviors (β=-0.046 and β=-0.058). Parental discord and parental depression showed the strongest associations with internalizing problems (β = 0.125 and β = 0.113). LCA did not discriminate ACE clusters in this dataset. Conclusions: ACEs have an important impact on mental health from childhood to adolescence. ACEs score approach yielded useful results, which were further enhanced by exploring individual ACEs.LB and RL are supported by the Economic and Social Research Council [grant number: ES/P010229/

Importance of socioeconomic factors in predicting tooth loss among older adults in Japan: Evidence from a machine learning analysis

Prevalence of tooth loss has increased due to population aging. Tooth loss negatively affects the overall physical and social well-being of older adults. Understanding the role of socio-demographic and other predictors associated with tooth loss that are measured in non-clinical settings can be useful in community-level prevention. We used high-dimensional epidemiological data to investigate important factors in predicting tooth loss among older adults over a 6-year period of follow-up. Data was from participants of 2010 and 2016 waves of the Japan Gerontological Evaluation Study (JAGES). A total of 19,407 community-dwelling functionally independent older adults aged 65 and older were included in the analysis. Tooth loss was measured as moving from a higher number of teeth category at the baseline to a lower number of teeth category at the follow-up. Out of 119 potential predictors, age, sex, number of teeth, denture use, chewing difficulty, household income, employment, education, smoking, fruit and vegetable consumption, community participation, time since last health check-up, having a hobby, and feeling worthless were selected using Boruta algorithm. Within the 6-year follow-up, 3013 individuals (15.5%) reported incidence of tooth loss. People who experienced tooth loss were older (72.9 ± 5.2 vs 71.8 ± 4.7), and predominantly men (18.3% vs 13.1%). Extreme gradient boosting (XGBoost) machine learning prediction model had a mean accuracy of 90.5% (±0.9%). A visual analysis of machine learning predictions revealed that the prediction of tooth loss was mainly driven by demographic (older age), baseline oral health (having 10–19 teeth, wearing dentures), and socioeconomic (lower household income, manual occupations) variables. Predictors related to wide a range of determinants contribute towards tooth loss among older adults. In addition to oral health related and demographic factors, socioeconomic factors were important in predicting future tooth loss. Understanding the behaviour of these predictors can thus be useful in developing prevention strategies for tooth loss among older adults

Molecular Characterization of a Novel Staphylococcus Aureus Surface Protein (SasC) Involved in Cell Aggregation and Biofilm Accumulation

BACKGROUND:Staphylococci belong to the most important pathogens causing implant-associated infections. Colonization of the implanted medical devices by the formation of a three-dimensional structure made of bacteria and host material called biofilm is considered the most critical factor in these infections. To form a biofilm, bacteria first attach to the surface of the medical device, and then proliferate and accumulate into multilayered cell clusters. Biofilm accumulation may be mediated by polysaccharide and protein factors. METHODOLOGY/PRINCIPAL FINDINGS:The information on Staphylococcus aureus protein factors involved in biofilm accumulation is limited, therefore, we searched the S. aureus Col genome for LPXTG-motif containing potential surface proteins and chose the so far uncharacterized S. aureus surface protein C (SasC) for further investigation. The deduced SasC sequence consists of 2186 amino acids with a molecular mass of 238 kDa and has features typical of gram-positive surface proteins, such as an N-terminal signal peptide, a C-terminal LPXTG cell wall anchorage motif, and a repeat region consisting of 17 repeats similar to the domain of unknown function 1542 (DUF1542). We heterologously expressed sasC in Staphylococcus carnosus, which led to the formation of huge cell aggregates indicative of intercellular adhesion and biofilm accumulation. To localize the domain conferring cell aggregation, we expressed two subclones of sasC encoding either the N-terminal domain including a motif that is found in various architectures (FIVAR) or 8 of the DUF1542 repeats. SasC or its N-terminal domain, but not the DUF1542 repeat region conferred production of huge cell aggregates, higher attachment to polystyrene, and enhanced biofilm formation to S. carnosus and S. aureus. SasC does not mediate binding to fibrinogen, thrombospondin-1, von Willebrand factor, or platelets as determined by flow cytometry. CONCLUSIONS/SIGNIFICANCE:Thus, SasC represents a novel S. aureus protein factor involved in cell aggregation and biofilm formation, which may play an important role in colonization during infection with this important pathogen

Flächenpolitische Ziele unter Schrumpfungsbedingungen in der Kernregion Mitteldeutschland: normative überörtliche Aussagen im Spiegel der Fachdiskussion

Die derzeit in der Planungspraxis vorzufindende Ausweisung von Siedlungsflächen führt zu einer erheblichen Änderung der bisherigen Siedlungsstrukturen. Weiterhin tritt verstärkt das Problem des Bevölkerungsrückgangs und der Alterung auf. Sowohl im bundesdeutschen Durchschnitt, insbesondere aber in Ostdeutschland, sinkt damit die Nutzungsdichte. Die höhere Inanspruchnahme von Flächen für Siedlungs- und Verkehrszwecke führt außerdem zu einem Verlust einer nicht erneuerbaren Gutes und verändert das Landschaftsbild. Sowohl im Wohn- als auch im gewerblichen Bereich werden die vorhandenen Potenziale zu wenig genutzt. Während innerstädtische Flächen brachfallen, erfolgt die Ausweisung neuer Baugebiete im Außenbereich. Mit einem nachhaltigen regionalen Flächenmanagement sollen der Flächenverbrauch reduziert und eine zukunftsfähige Raumstruktur entwickelt werden. Vor der Diskussion geeigneter Instrumente ist eine kritische Auseinandersetzung mit den gegenwärtigen flächenpolitischen Zielen und deren Optimierung erforderlich. In diesem fünften Band der KoReMi-Schriftenreihe werden daher die flächenpolitischen Ziele unter Schrumpfungsbedingungen diskutiert. Dabei wird zunächst ein theoretischer flächenpolitischer Zielkatalog erarbeitet, der Handlungsziele und Maßnahmen enthält und eine Ableitung flächenpolitischer Strategien ermöglicht. Diesem Katalog werden die gegenwärtigen normativen Aussagen der Landes- und Regionalplanung in der Kernregion Mitteldeutschland gegenübergestellt. Die gewonnenen Erkenntnisse liefern eine wertvolle Grundlage für die Auseinandersetzung mit den gemeindlichen Entwicklungsperspektiven, die als Band 06 dieser Schriftenreihe veröffentlicht werden