RESUMO
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.
Assuntos
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
Presentamos un caso de melanoma angiomatoide localizado en la piel del muslo derecho en un hombre de 59 años de edad. La neoplasia mostró un patrón de crecimiento semejante a una proliferación vascular donde las células que revestían esos espacios ''pseudovasculares'' fueron positivas a la proteína S-100, al HMB45 y al MiTF1. El diagnóstico diferencial incluye el angiosarcoma y el carcinoma escamoso pseudovascular. El caso que aquí informamos es el quinto de la literatura mundial
We report a case of angiomatoid melanoma on the right thigh of a 59-year-old man. The histologic growth pattern of the tumor mimicked vascular proliferation, and the cells lining the pseudovascular spaces were positive for protein S-100, HMB-45, and MITF-1. The differential diagnosis is with angiosarcoma and pseudovascular adenoid squamous cell carcinoma. The case we present is the fifth reported to dat
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Melanoma/patologia , Neoplasias Cutâneas/patologia , Fator de Transcrição Associado à Microftalmia/análise , Proteínas S100/análise , Carcinoma de Células Escamosas/diagnóstico , Hemangiossarcoma/diagnóstico , Antígenos Específicos de Melanoma/análise , Diagnóstico Diferencial , Índice Mitótico , Proteínas de Neoplasias/análiseRESUMO
We report a case of angiomatoid melanoma on the right thigh of a 59-year-old man. The histologic growth pattern of the tumor mimicked vascular proliferation, and the cells lining the pseudovascular spaces were positive for protein S-100, HMB-45, and MITF-1. The differential diagnosis is with angiosarcoma and pseudovascular adenoid squamous cell carcinoma. The case we present is the fifth reported to date.