Adverse childhood experiences, support, and the perception of ability to work in adults with disability

Objective To examine the impact of adverse childhood experiences (ACEs) and support on self-reported work inability of adults reporting disability. Participants Adults (ages 18–64) who participated in the Behavioral Risk Factor Surveillance System in 2009 or 2010 and who reported having a disability (n = 13,009). Design and Main Outcome Measures The study used a retrospective cohort design with work inability as the main outcome. ACE categories included abuse (sexual, physical, emotional) and family dysfunction (domestic violence, incarceration, mental illness, substance abuse, divorce). Support included functional (perceived emotional/social support) and structural (living with another adult) support. Logistic regression was used to adjust for potential confounders (age, sex and race) and to evaluate whether there was an independent effect of ACEs on work inability after adding other important predictors (support, education, health) to the model. Results ACEs were highly prevalent with almost 75% of the sample reporting at least one ACE category and over 25% having a high ACE burden (4 or more categories). ACEs were strongly associated with functional support. Participants experiencing a high ACE burden had a higher adjusted odds ratio (OR) [95% confidence interval] of 1.9 [1.5–2.4] of work inability (reference: zero ACEs). Good functional support (adjusted OR 0.52 [0.42–0.63]) and structural support (adjusted OR 0.48 [0.41–0.56]) were protective against work inability. After adding education and health to the model, ACEs no longer appeared to have an independent effect. Structural support remained highly protective, but functional support only appeared to be protective in those with good physical health. Conclusions ACEs are highly prevalent in working-age US adults with a disability, particularly young adults. ACEs are associated with decreased support, lower educational attainment and worse adult health. Health care providers are encouraged to screen for ACEs. Addressing the effects of ACEs on health and support, in addition to education and retraining, may increase ability to work in those with a disability

The First Vega Ride-Share Mission Flight

The first European ride-share mission will be carried out by the Vega launch system in September 2019. The VEGA PoC (Proof of Concept) flight using the SSMS (Small Satellite Mission Service) hardware was conceived in the context of ESA LLL Initiative. This paper reports on the highlights of the preparation of the first European rideshare mission with Vega launcher and on the development of the related launch system. Based on Vega flights accumulated experience, the development of multi-Payload mission concept started from analysis of the activities currently foreseen to fly a single payload mission adapted to the needs of multi payload rideshare missions. After evaluation of impacts in terms of technical feasibility, missioning schedule and related programmatic and cost elements for the missioning of the Light Sats launch service, the implementation phase was initiated and description of its major tasks is the focus of this paper. The described hardware development and processes to reach SSMS PoC flight using the Vega launch system, are the first step towards the ultimate goal of a finally optimized process for Light Sats ride-share missions applicable to all European launchers

Chronic treatment with statins increases the availability of selenium in the antioxidant defence systems of hemodialysis patients.

Project. Oxidative stress (OS) is enhanced in hemodialysis (HD) patients. Lipid peroxidation and oxidative damage to glycids, proteins and nucleic acids are main consequences of OS and are associated to increased cardiovascular risk. Vitamin E and Glutathione Peroxidase (GSH-Px) represent main antioxidant systems in human cells. Selenium (Se), bound to the active sites of GSH-Px, plays a critical role in this antioxidant defense system. Statins are widely used and extensively investigated in the prevention of cardiovascular disease, notably in high-risk subjects. Several studies suggest that statins show antioxidant effects, protecting low-density lipoproteins from oxidation. Aim of our study was to compare serum Se concentration in ESRD patients on maintenance HD and in homogeneous healthy subjects and to investigate whether chronic assumption of statins may interfere with serum Se concentration in HD patients. Procedure. A total of 103 HD patients and 69 healthy subjects were enrolled; HD patients were then divided into patients who were not treated with statins (group A) and patients who assumed statins since six months at least (group B). Serum Se was determined by atomic absorption spectrometry. Results. Serum Se was significantly lower in HD patients of group A compared to healthy subjects (81.65±19.66mcg/L Vs. 96.47±15.62mcg/L, p<0.0040). However, in HD patients who assumed statins serum Se was significantly higher than in HD patients who did not. (111.83±18.82mcg/L Vs. 81.65±19.66mcg/L, p<0.0001). Conclusions. our results suggest that in HD patients chronic assumption of statins is related to a higher availability of active antioxidant agents and to reduced oxidative stress

The severity of pandemic H1N1 influenza in the United States, from April to July 2009: A Bayesian analysis

Background: Accurate measures of the severity of pandemic (H1N1) 2009 influenza (pH1N1) are needed to assess the likely impact of an anticipated resurgence in the autumn in the Northern Hemisphere. Severity has been difficult to measure because jurisdictions with large numbers of deaths and other severe outcomes have had too many cases to assess the total number with confidence. Also, detection of severe cases may be more likely, resulting in overestimation of the severity of an average case. We sought to estimate the probabilities that symptomatic infection would lead to hospitalization, ICU admission, and death by combining data from multiple sources. Methods and Findings: We used complementary data from two US cities: Milwaukee attempted to identify cases of medically attended infection whether or not they required hospitalization, while New York City focused on the identification of hospitalizations, intensive care admission or mechanical ventilation (hereafter, ICU), and deaths. New York data were used to estimate numerators for ICU and death, and two sources of data - medically attended cases in Milwaukee or self-reported influenza-like illness (ILI) in New York - were used to estimate ratios of symptomatic cases to hospitalizations. Combining these data with estimates of the fraction detected for each level of severity, we estimated the proportion of symptomatic patients who died (symptomatic case-fatality ratio, sCFR), required ICU (sCIR), and required hospitalization (sCHR), overall and by age category. Evidence, prior information, and associated uncertainty were analyzed in a Bayesian evidence synthesis framework. Using medically attended cases and estimates of the proportion of symptomatic cases medically attended, we estimated an sCFR of 0.048% (95% credible interval [CI] 0.026%-0.096%), sCIR of 0.239% (0.134%-0.458%), and sCHR of 1.44% (0.83%-2.64%). Using self-reported ILI, we obtained estimates approximately 7-96lower. sCFR and sCIR appear to be highest in persons aged 18 y and older, and lowest in children aged 5-17 y. sCHR appears to be lowest in persons aged 5-17; our data were too sparse to allow us to determine the group in which it was the highest. Conclusions: These estimates suggest that an autumn-winter pandemic wave of pH1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher, but with the greatest impact in children aged 0-4 and adults 18-64. These estimates of impact depend on assumptions about total incidence of infection and would be larger if incidence of symptomatic infection were higher or shifted toward adults, if viral virulence increased, or if suboptimal treatment resulted from stress on the health care system; numbers would decrease if the total proportion of the population symptomatically infected were lower than assumed.published_or_final_versio

The economics of debt clearing mechanisms

We examine the evolution of decentralized clearinghouse mechanisms from the 13th to the 18th century; in particular, we explore the clearing of non- or limitedtradable debts like bills of exchange. We construct a theoretical model of these clearinghouse mechanisms, similar to the models in the theoretical matching literature, and show that specific decentralized multilateral clearing algorithms known as rescontre, skontrieren or virement des parties used by merchants were efficient in specific historical contexts. We can explain both the evolutionary self-organizing emergence of late medieval and early modern fairs, and its robustness during the 17th and 18th century

Segismundi scacciae ... Tractatus de appellationibus : in duas partes divisus ... nunc primum in Germania cum indice copiosissimo, excusus, & a mendis vindicatus

Copia digital. Madrid : Ministerio de Cultura. Subdirección General de Coordinación Bibliotecaria, 2008Sign.: (?)\p4\s, A-Z\p6\s, 2A-2Z\p6\s, 3A-3D\p6\s, 2A-2F\p6\s, 2G\p8\sError tip. de sign., en la segunda secuencia, en 2B\b3\s consta 2B\b2\sTexto a dos colPort. con grab. xil

Characterization of Sol-Gel-Synthesized LiFePO4 by Multiple Scattering XAFS

X-ray Absorption Spectroscopy (XAS) was used to investigate the local structure arrangements of sub-microcrystalline lithium iron phosphate and its precursors. The former material, proven to be very promising as active cathode material in lithium metal and lithium-ion batteries, was synthesized through a new procedure that combines a simple sol-gel precipitation with a moderate temperature (e.g., low cost) heat treatment. X-Ray Absorption Near Edge Structure (XANES) and Extended X-Ray Absorption Fine Structure (EXAFS) spectra taken at the Fe K-edge pointed out the modification of the Fe site during the synthesis steps that allow to produce the sub-micron size crystalline LiFePO4 (active material) useful for batteries applications. The XAS investigation has shown that such a material is different from the conventional crystalline LiFePO4 on the short range order. The difference is attributed to the synthesis procedure