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Kim J, Nwaogu C, Mitchell RB, Johnson RF. Influence of Economic Connectedness on Pediatric Obstructive Sleep Apnea Severity and Adenotonsillectomy Outcomes. Otolaryngol Head Neck Surg 2024. [PMID: 38881394 DOI: 10.1002/ohn.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To examine the influence of economic connectedness (EC), a measure of social capital, on obstructive sleep apnea (OSA) severity and adenotonsillectomy outcomes in children. STUDY DESIGN Retrospective study. SETTING Single tertiary medical center. METHODS The study population included 286 children who were referred for full-night polysomnography for OSA and underwent adenotonsillectomy. The primary outcome was the relationship between EC and the presence of severe OSA, and secondary outcomes included postoperative emergency room visits and residual OSA after adenotonsillectomy. Linear regression, Kruskal-Wallis test, Pearson's χ2 test, and multiple logistic regression were used for categorical and continuous data as appropriate. RESULTS In this population, the median age was 9.0 (interquartile range [IQR] = 6.9-11.7) and 144 (50.3%) were male. The majority were white (176, 62.0%), black (60, 21.1%), and/or of Hispanic ethnicity (173, 60.9%). The median EC of this population was 0.64 (IQR = 0.53-0.86). Higher EC was associated with decreased odds of having severe OSA (odds ratio: 0.17, 95% confidence interval = 0.05-0.61). However, EC was not associated with either postoperative emergency room visits or residual OSA. CONCLUSION EC was significantly associated with severe OSA (ie, apnea-hypopnea index ≥ 10) but not with postoperative emergency room visits or residual OSA after adenotonsillectomy. Further research is needed to understand the effects of various social capital measures on pediatric OSA and adenotonsillectomy outcomes.
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Affiliation(s)
- Jenny Kim
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Cullins Nwaogu
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ron B Mitchell
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, USA
| | - Romaine F Johnson
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, USA
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Silva APMA, Knorst JK, Andrade JR, Pinto RS, Martins RC, Moreno A, Vargas-Ferreira F. Contextual and individual determinants of oral health-related quality of life among adolescents. Braz Oral Res 2024; 38:e019. [PMID: 38477805 DOI: 10.1590/1807-3107bor-2024.vol38.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 08/08/2023] [Indexed: 03/14/2024] Open
Affiliation(s)
- Ana Paula Milagres Alfenas Silva
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Jessica Klockner Knorst
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Julia Rodrigues Andrade
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Rafaela Silveira Pinto
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Renata Castro Martins
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Amália Moreno
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Fabiana Vargas-Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
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Knorst JK, Vettore MV, Brondani B, Emmanuelli B, Ardenghi TM. The Different Roles of Structural and Cognitive Social Capital on Oral Health-Related Quality of Life among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085603. [PMID: 37107885 PMCID: PMC10138599 DOI: 10.3390/ijerph20085603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 05/10/2023]
Abstract
This study evaluated the relationship of structural and cognitive dimensions of social capital with oral health-related quality of life (OHRQoL) among adolescents. This was a cross-sectional study nested in a cohort of adolescents from southern Brazil. OHRQoL was evaluated using the short version of the Child Perceptions Questionnaire 11-14 (CPQ11-14). Structural social capital was measured by attendance of religious meetings and social networks from friends and neighbours. Cognitive social capital was evaluated through trust in friends and neighbours, perception of relationships in the neighbourhood, and social support during hard times. Multilevel Poisson regression analysis was performed to estimate the association between social capital dimensions and overall CPQ11-14 scores; higher scores corresponded to worse OHRQoL. The sample comprised 429 adolescents with a mean age of 12 years. Adolescents who attended religious meetings less than once a month or never presented higher overall CPQ11-14 scores. Adolescents who did not trust their friends and neighbours, those who believe that their neighbours did not have good relationships, and those reporting no support during hard times also presented higher overall CPQ11-14 scores. OHRQoL was poorer in individuals who presented lower structural and cognitive social capital, with the greatest impact related to the cognitive dimension.
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Affiliation(s)
- Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria 97105-900, Brazil
| | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Postbox 422, N-4604 Kristiansand, Norway
| | - Bruna Brondani
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade de São Paulo, São Paulo 05508-000, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria 97105-900, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria 97105-900, Brazil
- Correspondence: ; Tel./Fax: +55-55-3220-9272
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Knorst JK, Tomazoni F, Sfreddo CS, Vettore MV, Hesse D, Ardenghi TM. Social capital and oral health in children and adolescents: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2022; 50:461-468. [PMID: 34951711 DOI: 10.1111/cdoe.12714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/05/2021] [Accepted: 11/23/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To systematically evaluate the association of individual and contextual social capital with oral health outcomes in children and adolescents. METHODS Electronic searches were performed in PubMed/Medline, Embase, Web of Science and Scopus databases for articles published from 1966 up to June 2021. Two calibrated reviewers screened and critically appraised the identified papers. Observational studies that evaluated the relationship of individual or/and contextual social capital or their proxies with oral health outcomes in children and adolescents using validated methods were included. Quality assessment was conducted using the Newcastle-Ottawa Scale. Data were extracted for narrative synthesis and meta-analysis followed by a meta-regression model. Meta-analysis using random effects method was used to estimate pooled prevalence ratio (PR) and 95% confidence intervals (CI). RESULTS Of the 3060 studies initially retrieved, 31 were included in the systematic review and 21 in the meta-analysis, totalling 81 241 individuals. The clinical outcomes included dental caries and gingival bleeding and subjective outcomes were oral health-related quality of life (OHRQoL) and self-rated oral health (SROH). Individuals with lower levels of individual social capital had a higher prevalence of poor clinical (PR 1.11; 95%CI 1.02-1.22) and subjective (PR 1.25; 95%CI 1.09-1.45) oral health conditions. The prevalence of worse clinical (PR 1.34; 95%CI 1.11-1.61) and subjective (PR 1.56; 95%CI 1.13-2.16) oral health outcomes were also associated with lower levels of contextual social capital. In general, the contextual level of social capital exerted more impact, and the subjective oral health outcomes were the more affected. CONCLUSIONS Contextual and individual social capital were positively related to oral health outcomes, such as dental caries, gingival bleeding, SROH and OHRQoL in children and adolescents.
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Affiliation(s)
- Jessica K Knorst
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Fernanda Tomazoni
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Camila S Sfreddo
- School of Dentistry, Universidade Franciscana, Santa Maria, Brazil
| | - Mario V Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Daniela Hesse
- Department of Pediatric Dentistry, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Thiago M Ardenghi
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Knorst JK, Vettore MV, Ardenghi TM. Social capital and oral health promotion: Past, present, and future challenges. FRONTIERS IN ORAL HEALTH 2022; 3:1075576. [PMID: 36507311 PMCID: PMC9732376 DOI: 10.3389/froh.2022.1075576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
Social capital has been widely inserted in health discussions in recent decades. In this sense, social capital has become a popular term and has been highlighted as one of the main determinants of health in the conceptual framework of the social determinants of the World Health Organization. The concept of social capital focuses on the positive consequences of sociability and places these consequences in the broader discussion of capital. In this sense, social capital reflects the benefits that individuals and communities derive from having broad social networks or high levels of social trust. Despite controversies regarding its definition and numerous criticisms, a growing body of evidence suggests that high levels of social capital benefit oral health. This factor has also been recognized as a potential softener of the impact of oral conditions on oral health, through behavioural and psychosocial processes. Thus, efforts to reduce inequities in oral health preferably should be based on their origins and on their complex causal process, such as the social determinants. The future challenges in the area are specially related to the development of interventions and health promotion actions that aim to stimulate social capital, aiming to reduce the impact of social inequalities on oral health throughout the life course.
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Affiliation(s)
- Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway,Correspondence: Mario Vianna Vettore
| | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Impact of community and individual social capital during early childhood on oral health-related quality of life: A 10-year prospective cohort study. J Dent 2022; 126:104281. [PMID: 36084761 DOI: 10.1016/j.jdent.2022.104281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 11/22/2022] Open
Abstract
AIM To evaluate the impact of community and individual social capital during early childhood on oral health-related quality of life (OHRQoL) over a 10-year follow-up period. METHODS A prospective cohort study was conducted in the southern Brazil. Baseline (T1) data collection occurred in 2010 with preschool children aged 1-5 years. Participants were assessed in 2012 (T2), 2017 (T3), and 2020 (T4). OHRQoL was assessed using the B-ECOHIS at T1 and T2 and through CPQ8-10 at T3 and CPQ11-14 at T4. Community social capital was evaluated through the presence of formal institutions in the neighbourhood and individual social capital by social networks, both at T1. Demographic and socioeconomic characteristics were also evaluated. Multilevel Poisson regression analysis was performed to estimate the impact of social capital measures on OHRQoL. RESULTS Of the 639 children assessed at T1, 469 were followed at T2 (73.3% response rate), 449 at T3 (70.3% response rate), and 429 at T4 (67.1% response rate). Individuals living in neighbourhoods with the presence of social class associations at T1 had higher OHRQoL at T3 and T4. Individuals whose families visit friends and neighbours less than once a month or never at T1 had lower OHRQoL at T1, T3 and T4. Attending religious meetings less than once a month or never at T1 was associated with lower OHRQoL at T2 and T4. CONCLUSION Social capital at the community level had a long-term effect on OHRQoL, especially during adolescence, while individual social capital levels impacted OHRQoL across the assessments. CLINICAL SIGNIFICANCE The findings indicate that psychosocial variables can impact OHRQoL, a fundamental aspect of clinical practice.
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Knorst JK, Brondani B, Vettore MV, Hesse D, Mendes FM, Ardenghi TM. Pathways between Social Capital and Oral Health from Childhood to Adolescence. J Dent Res 2022; 101:1155-1164. [PMID: 35593509 DOI: 10.1177/00220345221094510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the theoretical pathways by which social capital can influence dental caries and oral health-related quality of life (OHRQoL) of children over time. This 10-y prospective cohort started in 2010 with a sample of 639 preschoolers aged 1 to 5 y from the southern Brazil. Community and individual social capital were assessed at baseline through the presence of formal institutions in the neighborhood and social networks, respectively. In the 10-y follow-up, the individual social capital was evaluated by social trust and social networks. Dental caries was measured by the International Caries Detection and Assessment System (ICDAS), and the short version of the Child Perception Questionnaire (CPQ11-14) was used to assess OHRQoL. Demographic, socioeconomic, behavioral (frequency of toothbrushing and use of dental services), and psychosocial (sense of coherence) characteristics were also assessed. Structural equation modeling was used to evaluate the associations between variables over time. About 429 children were reassessed at 10-y follow-up (67.1% cohort retention rate). High community social capital at baseline directly predicted lower occurrence of dental caries and better OHRQoL after 10 y. Social capital at community level also indirectly predicted lower occurrence of dental caries through sense of coherence, frequency of toothbrushing, and use of dental services. Individual social capital at follow-up was indirectly linked to OHRQoL via the psychosocial pathway (sense of coherence). Community-level social capital was associated with dental caries and OHRQoL over time. The relationship between individual social capital and oral health was mediated through the psychosocial pathway.
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Affiliation(s)
- J K Knorst
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - B Brondani
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - M V Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - D Hesse
- Department of Pediatric Dentistry, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - F M Mendes
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - T M Ardenghi
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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