Talents, Tears, Stories of Our Identities, and Community Building: Toward Community-Based Ecosystems of Latiné Health Driven by Promotores.

This essay describes a process for integrating US Latiné communities as drivers of a grassroots vision for healthy Latiné communities and health equity planning that addresses racial injustices. Transforming structural conditions to promote Latiné community health happens alongside creating conditions for community-level self-determination to foster community-based ecosystems of health. Integrating a life course perspective, we describe a vision for community-based ecosystems of Latiné health that is rooted in forging connections and cultivating community; building community power to address structural drivers of health; leveraging the expertise and assets of promotores to reach, engage, and mobilize communities; scaling solutions through policy, system, and environment changes; and grounding research processes in community-driven priorities. Such processes must affirm the expertise of promotores and Latiné communities and recognize the interconnectedness of communities and systems (e.g., food, housing, living wages) to nurture health at local levels. Research can advance the science and evidence-based models that support community-based ecosystems of Latiné health. (Am J Public Health. 2024;114(S6):S525-S533. https://doi.org/10.2105/AJPH.2024.307763) [Formula: see text].

Evaluation of microbial air quality and aerosol distribution in a large dental clinic.

PURPOSE: To evaluate the microbial air quality during dental clinical procedures in a large clinical setting with increasing patient capacity. METHODS: This was a single-center, observational study design evaluating the microbial air quality and aerosol distribution during normal clinical sessions at 5% (sessions 1 and 2) and at > 50% (session 3) treatment capacity of dental aerosol generating procedures. Sessions 1 and 2 were evaluated on the same day with a 30-minute fallow time between the sessions. Session 3 was evaluated on a separate day. For each session, passive air-sampling technique was performed for three collection periods: baseline, treatment, and post-treatment. Blood agar plates were collected and incubated at 37°C for 48 hours. Colonies were counted using an automatic colony counter. Mean colony forming units (CFU) per plate were converted to CFU/m²/h. RESULTS: Kruskal Wallis test was performed to compare the mean CFU/m²/h between the clinic sessions. Statistically significant differences were observed between sessions 1 and 2 (P< 0.05), but not between sessions 2 and 3 (P> 0.05). Combining all clinical sessions, the mean CFU/m²/h were 977 (baseline), 873 (treatment), and 1,631 (post-treatment) for the collection periods. A decrease-to-increase CFU/m²/h trend was observed from baseline to treatment, and from treatment to post-treatment that was observed for all clinic sessions and was irrespective to treatment capacity. Higher amounts of CFU/m²/h were found near the air exhaust outlets for all three clinic sessions. Microbial aerosol distribution is most likely due to the positions and power levels of the air inlets and outlets, and to a lesser extent with patient treatment capacity. CLINICAL SIGNIFICANCE: Dental clinics should be designed and optimized to minimize the risk of airborne transmissions. The results of this study emphasize the need to evaluate dental clinic ventilation systems.

Examining Interpersonal Traumas Across Low Income Latinx Mother-Youth Dyads: Associations Between Maternal Child Abuse Exposure and Racial Discrimination with Mother and Youth Psychopathology.

Child abuse has intergenerational consequences for psychopathology, however, there remains a paucity of research regarding how these experiences affect Latinx families, particularly those at risk for additional negative life events, such as racial discrimination. This study aims to contribute to this gap in the literature by examining the impact maternal child abuse exposure has on youth and maternal psychopathology, as well as whether these associations are moderated by racial discrimination, in a sample of 224 Latinx mother-youth dyads. Hierarchical regressions revealed small but significant maternal child abuse exposure x racial discrimination interactions for youth depression and anxiety, but not maternal depression or anxiety, which were solely positively associated with maternal child abuse exposure. Findings highlight the multifarious, and at times convergent, nature of trauma and oppression among Latinx families, as well as the impact across generations. Future work is needed to further elucidate developmental pathways of intergenerational trauma in understudied populations.

Barreras y Soluciones: Lessons learned from integrating research-based clinical techniques into a community agency serving low-income Latinx immigrant families.

Barriers facing effective science-to-practice translation have led scholars to conduct early-stage intervention research within community organizations. We describe our experiences developing a manualized parent-youth attachment-based group therapy intervention within a community health organization dedicated to serving low-income Latinx immigrant families, Latino Health Access (LHA), in which services are rendered by trained community workers (promotores). By conducting a qualitative analysis of interviews with all members of this academic-community partnership (research [Principal Investigator, student researchers] and community agency team members [Administrators, promotores]), we discuss the challenges and opportunities that this collaboration has generated. The results led both the research and community teams to question assumptions about the basic skills, values, and attitudes that underlie the integration of science and practice. We will share the insights that have helped to promote connection and understanding among the stakeholders and the efforts made to support the progress and successes of developing community interventions.

Los obstáculos que enfrenta el traslado eficaz de la ciencia a la práctica han conducido a los investigadores a realizar investigaciones en etapas iniciales de las intervenciones dentro de las organizaciones comunitarias. Describimos nuestras experiencias con el desarrollo de una intervención estandarizada de terapia grupal basada en el apego entre padres y jóvenes dentro de una organización de salud comunitaria dedicada a asistir a familias inmigrantes latinas de bajos recursos, Latino Health Access (LHA), en la cual prestan servicios trabajadores comunitarios capacitados (promotores). Al realizar un análisis cualitativo de las entrevistas con todos los miembros de esta asociación académico-comunitaria (investigación [investigador principal, investigadores estudiantes] y los miembros del equipo de la organización comunitaria [administradores, promotores], comentamos las dificultades y las oportunidades que ha generado esta colaboración. Los resultados llevaron a los equipos comunitarios y de investigación a cuestionar las suposiciones acerca de las habilidades básicas, los valores y las actitudes que forman la base de la integración de la ciencia y la práctica. Compartiremos los conocimientos que han contribuido a promover la conexión y la comprensión entre las partes interesadas y los esfuerzos realizados para fomentar el avance y los logros de desarrollar intervenciones comunitarias.

Imaging of the upper airway: which method is best for orthodontic assessment?

The objectives of the present study were to compare measurements of pharyngeal airway subregions on lateral cephalometric (LC) and cone beam computed tomographic (CBCT) images in relation to skeletal classes and discuss the advantages and disadvantages of these imaging formats for this type of assessment. The CBCT images were assessed via both multiplanar reconstruction (MPR) and 3-dimensional (3D) reconstruction. The LC and CBCT images from 107 patients were classified according to skeletal class: I, n = 35; II, n = 35; and III, n = 37. Linear measurements of the subdivisions of the upper airway were performed on the LC, MPR, and 3D images. In addition, area and volumetric measurements were performed on the MPR images. The relationships among imaging methods, skeletal class, and pharyngeal thirds were assessed by means of a 1-way analysis of variance (α = 0.05). No statistically significant differences in the linear, area, or volumetric measurements of the upper airway subregions were found among the skeletal classes (P > 0.05). For the linear measurements in the oropharynx and hypopharynx, greater values were observed for the LC images than for the MPR and 3D images (P ≤ 0.05). Based on the study findings, MPR images should be preferred for visualization of the pharyngeal airway subregions. However, LC imaging is preferable to 3D reconstruction.

Confía en mí, Confío en ti: Applying developmental theory to mitigate sociocultural risk in Latinx families.

Ed Zigler was a champion for underprivileged youth, one who worked alongside communities to fight for long-lasting systemic changes that were informed by his lifespan and ecological perspective on the development of the whole child. This paper reports on the development, implementation, and preliminary outcomes of an intervention that embodied the Zigler approach by adopting a community participatory research lens to integrate complementary insights across community-based providers (promotoras), Latinx immigrant families, and developmental psychologists in the service of promoting parent-child relationship quality and preventing youth aggression and violence. Analyses from the first 112 Latinx mother-youth dyad participants (46% female children, ages 8-17) in the resultant, Confía en mí, Confío en ti, eight-week intervention revealed significant pre-post increases in purported mechanisms of change (i.e., attachment security, reflective functioning) and early intervention outcomes (i.e., depressive, anxiety, and externalizing problems). Treatment responses varied by youth age. A case analysis illustrated the lived experiences of the women and children served by this intervention. We discuss future directions for the program, as well as challenges to its sustainability. Finally, we consider Ed's legacy as we discuss the contributions of this work to developmental science and our understanding of attachment relationships among low-income immigrant Latinx families.

Does the administration of meloxicam before head and neck radiotherapy reduce the risk of mandibular osteoradionecrosis? An animal model study.

OBJECTIVE: To assess whether the administration of meloxicam before head and neck radiotherapy reduces the risk of mandibular osteoradionecrosis in rats. MATERIAL AND METHODS: Sixty male Wistar rats were randomly divided into 6 groups (n = 10) according to the meloxicam administration and radiation therapy: control (C), irradiated (I), single dose of meloxicam (M1), single dose of meloxicam and irradiated (M1I), triple dose of meloxicam (M3), triple dose of meloxicam and irradiated (M3I). Meloxicam was administrated (20 mg/kg per dose) 1 h before the radiation therapy (single dose of 20 Gy) and 24 h and 48 h after the radiation therapy for groups with two additional doses. Ten days after the radiation therapy, the three right mandibular molars were extracted from all rats, who were euthanatized after 21 or 35 days (n = 5 per group). The mandibles were assessed by macroscopic evaluation and micro-CT analysis. RESULTS: The right hemimandibles of the irradiated groups revealed macroscopic signs of osteoradionecrosis, and those of the non-irradiated groups revealed complete gingival healing. A significant delay in alveolar socket healing in all irradiated groups was observed in the micro-CT assessment regardless meloxicam treatment. CONCLUSION: The administration of meloxicam before head and neck radiotherapy does not reduce the risk of mandibular osteoradionecrosis when associated to dental extractions. CLINICAL RELEVANCE: Since meloxicam has been shown to be a potential radiation-protective agent, and osteoradionecrosis physiopathology is believed to be related to an inflammatory process, possible interactions are relevant to be investigated.

Micro computed tomography analysis of abrasivity of toothpaste tablets compared to conventional toothpaste.

PURPOSE: To evaluate with microCT dentin and enamel abrasion depth caused by toothpaste tablets when compared to conventional toothpastes. METHODS: Dentin (N= 64) and enamel blocks (N=64) were randomized into four experimental groups of 16 specimens each for dentin and enamel. CP: Colgate Cavity Protection, served as the low abrasive toothpaste; AW: Colgate Total Advanced Whitening was used to represent a highly abrasive toothpaste. Two different types of toothpaste tablets were used. DT: Denttabs and BT: Bite tabs. To prepare the slurries, 40 mL of water was added to 25 g of each toothpaste and 4.4 g of each toothpaste tab. Blocks were brushed for a total of 10,000 and 40,000 strokes for dentin and enamel, respectively following ISO standard 11609. On completion of brushing, specimens were scanned with a microCT system. Tomographic 3D reconstruction followed by abrasion depths measurements were performed. Kruskal-Wallis procedure tested abrasion depths among the different groups. Tests of hypotheses were two-sided with an alpha level at 0.05. RESULTS: There was a statistically significant difference in dentin abrasion depth among the groups (P< 0.001). The mean dentin/enamel abrasion depths in microns were 25.3/4.4, 36.8/4.4, 66.8/3.0, and 230.3/15.5 for DT, BT, CP, and AW respectively. Dentin and enamel abrasion depth of AW was the highest and was different from all other groups after multiple comparisons (P< 0.05). CLINICAL SIGNIFICANCE: Dentin abrasivity of toothpaste tabs is negligible as determined with microCT.

A modified protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy.

OBJECTIVE: To propose a modified protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. MATERIAL AND METHODS: A total of 45 male Wistar rats were used in this study. Firstly, 25 rats were divided into 5 groups (n = 5) according to the radiation dose protocol: without irradiation and irradiated with 15 Gy, 20 Gy, 25 Gy, or 30 Gy using a linear accelerator. Secondly, 15 other rats were divided into 3 groups (n = 5) according to the time of extraction of the three right mandibular molars: 7, 10, or 14 days after irradiation of 20 Gy. Lastly, dental extractions were performed in 5 other rats without irradiation (C-E10) for comparison with those of the group of dental extractions 10 days after irradiation (I-E10). RESULTS: The irradiated animals survived throughout the study period only at single doses of 15 Gy and 20 Gy. The suitable time for dental extractions after irradiation to induce mandibular osteoradionecrosis was defined as 10 days. Macroscopic evaluation of the right hemimandibles showed presence of osteoradionecrosis in I-E10 group and complete gingival healing in C-E10 group. CONCLUSION: A single radiation dose of 20 Gy focused on head and neck region combined with the extraction of the three mandibular molars 10 days after irradiation constitutes a feasible protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. CLINICAL RELEVANCE: Establishing a solid and widely available protocol of mandibular osteoradionecrosis induction is essential in the search for methods to prevent this complex disease.

Evaluation of the articular eminence and the occlusal surface of the molars by cone beam computed tomography.

The objective of this study was to utilize cone beam computed tomography (CBCT) to evaluate the posterior slope of the articular eminence and the lateral slope of the mandibular fossa in relation to the cusp-fossa angle of the first molars. The evaluation included 93 CBCT images from 93 patients aged 16-30 years. The angle of the posterior slope of the articular eminence was determined from the intersection of a line tangent to the uppermost point of the mandibular fossa and another line tangent to the slope of the anterior wall of the mandibular fossa. The angle of the mandibular fossa slope was determined from the intersection of a line tangent to the most superior point of the mandibular fossa and another line tangent to the slope of the lateral wall of the mandibular fossa. The cusp-fossa relationship of the maxillary and mandibular first molars was also verified on the CBCTs. There was a correlation between the angles of the mandibular left first molar fossa and the lateral slope of the left mandibular fossa. There was also a correlation between the cusp height of the mandibular left first molar and the angle of the lateral slope of the right mandibular fossa. Dentists should consider anatomical factors during restorative, prosthodontic, and orthodontic treatment planning, especially for treatment that will affect the molars, to prevent the development of occlusal interferences that can trigger temporomandibular disorders.

Correlation between midline deviation and condylar position in patients with Class II malocclusion: A cone-beam computed tomography evaluation.

INTRODUCTION: Midline deviation of the mandible and maxilla can affect craniofacial growth and occlusion and cause consequences to the temporomandibular joint. The aim of this study was to evaluate the lateral displacement of the skeletal and dental midlines in relation to the condyle head position in Class II patients with cone-beam computed tomography. METHODS: We used 82 cone-beam computed tomography images. The lateral displacement of the skeletal and dental midlines considering the 3-dimensional reference plane was analyzed with points in the maxillary and mandibular central incisors, anterior nasal spine, and menton. The condyle-fossa relationship, concentric position of the condyles, and dimensional and positional symmetries between the right and left condyles were evaluated. RESULTS: There was a statistically significant difference regarding anterior nasal spine with maxillary central incisor, menton, and mandibular central incisor points for both sides, and also for maxillary central incisor-menton for the displacement of the left side. We found differences in the temporomandibular joint for inclination and diameter measurements of the condylar process. Strong correlations were observed between the maxilla and the condylar process diameter (right side) and the distance between the geometric centers (left side), in addition to a strong correlation between the sagittal midline displacement and the geometric center differences on the right and left sides. CONCLUSIONS: In patients with Class II malocclusion, lateral displacement of skeletal and dental midlines in relation to the condyle head position has a significant correlation with the anteroposterior difference between the geometric center of the right and left condylar processes.

Simple bone cyst: rare incidental finding in the mandibular condyle by cone beam computed tomography.

The simple bone cyst (SBC) is a benign intraosseous lesion that is considered to be a pseudocyst because the cystic cavity does not present an epithelial lining. The most accepted theory regarding its etiology is that the SBC develops when the blood clot fails to organize subsequent to bleeding caused by trauma. The SBC is asymptomatic, and therefore the diagnosis is made through routine imaging examinations. In imaging examinations, the lesion is characterized by a radiolucent, unilocular, well-delimited appearance and an irregular or scalloped contour with or without a sclerotic halo. This case report describes an SBC in the mandibular condyle region, discovered incidentally on imaging examinations.

The Effect of Calcium Hydroxide Pastes on Isolated Vital Nerve Fibers.

INTRODUCTION: Calcium hydroxide pastes (CHPs), commonly used for disinfecting root canals during endodontic treatment, are generally considered safe. However, accidental extrusions result in minimal injuries and little to no discomfort, except when extruded pastes come into contact with nerve bundles, such as the inferior alveolar nerve. Currently, there is a lack of information about the possible role of specific paste vehicles on the extent of nerve injury. The purpose of this study was to compare the role that paste vehicles, such as water or methylcellulose, may play when nerve fibers are exposed to CHP. METHODS: Isolated sciatic nerves of Sprague-Dawley rats were exposed to either water-based or methylcellulose-based CHP for varying durations of time (30, 60, or 90 minutes). Histopathological changes, including axonal edema, myelin alterations, and loss of cellular outlines, were assessed, and the degrees of changes were compared using chi-square intraclass correlation coefficient tests. RESULTS: Both groups exposed to the pastes demonstrated varying degrees of histopathologic changes, including axonal edema, myelin changes, and loss of cellular outlines, at different exposure times. The water-based calcium hydroxide paste induced these changes more rapidly than the methylcellulose-based paste. Similar patterns were observed in the scanning electron microscopic findings. Exposure time emerged as an important difference in the effects of the 2 pastes. In each of these tests, all observations of water-based paste exposure were rated as moderate to severe, whereas the observed cellular changes (axonal, myelin, and intact cellular outline) were rated as mild to moderate after exposure to methylcellulose-based paste for the same exposure durations. The chi-square tests indicated a statistically significant association between the material and each of the outcomes (axonal changes: χ²15 = 81.0, P < .001; myelin changes: χ²15 = 81.0, P < .001; intact cellular outline, χ²15 = 81.0, P < .001). The intraclass correlation coefficient value was 0.93. CONCLUSIONS: The study demonstrates that axonal and myelin damage increase with longer exposure times, with water-based CHP causing more damage than methylcellulose-based CHP at each time point.

Effects of Apical Barriers and Root Filling Materials on Stress Distribution in Immature Teeth: Finite Element Analysis Study.

PURPOSE: A finite element analysis (FEA) study was performed to determine whether the material of apical barrier used for root apexification and/or the use of canal reinforcement affect the stress distribution in an endodontically treated immature permanent tooth in order to infer in which clinical scenarios a fracture is more likely to occur based on the ultimate tensile strength threshold of dentin. METHODS AND MATERIALS: An extracted human immature mandibular premolar was selected as the reference model and scanned by micro-computed tomography (micro-CT). The digital model was segmented and converted to STL (Standard Tessellation Language) using Simpleware Scan-IP and exported in IGES (Initial Graphics Exchange Specification) to Ansys 19. Six experimental models were designed with different combinations of composite, mineral trioxide aggregate (MTA), and Biodentine (BIO). Using FEA, a static 300 N load at a 135 angle with respect to the axis of the tooth was applied to each model and von Mises stress values (MPa) were measured at the sagittal, apical 8-mm, 5-mm, 2-mm, and 1-mm levels. RESULTS: In all regions examined, the control (NT model) had lower stress in the root compared WITH experimental models. At the mid-root level, models with composite, MTA, and BIO reinforcement exhibited lower stresses in the root dentin than those with pulp or gutta-percha. BIO models had equal or greater average von Mises stress values than those of MTA models in all regions. Both, MTA and BIO, caused increases in stress of surrounding root dentin, with BIO causing a greater increase than MTA. CONCLUSIONS: Stress distribution in immature permanent teeth treated by apexification is affected by the types of materials used. Root dentin's stress was lower when the mid-root canal was reinforced by composite, MTA, or BIO, which provided similar stress reduction to the root dentin. MTA is a more favorable apical barrier material from a mechanical standpoint because it induces less stress on apical root dentin than BIO.

COVID-19 and the Latinx Community: "Promotoras Represent a Community in Pain".

COVID-19 has disproportionately affected the Latinx community, leading to heightened economic instability and increased mortality/morbidity. Frontline community health workers (promotoras) have played an integral role in serving low-income Latinx immigrant communities, disseminating health information to this vulnerable community while also facing heightened risks to their own health and wellbeing. This study explores the impact of the pandemic on Latinx communities and the promotoras that serve them, examining how the stresses and inequities the pandemic wrought might be mitigated. Promotoras (N = 15, all female) were recruited from a local health agency in Santa Ana, CA and completed a semi-structured interview about their experiences during COVID-19. Qualitative analyses demonstrated that the pandemic substantially affected the daily lives both of community members, via economic challenges, limited access to reliable pandemic-related information, and psychological and social stress, and of promotoras, via changes to the nature of their work and psychological and social stress. Promotoras perceived that these harms might be mitigated by providing for economic and material needs in the community, and that promotoras can be fortified to continue serving the community through self-care and psychosocial healing practices. According to promotoras, the Latinx community needs economic and material resources to overcome COVID-19 related stressors. Additionally, promotoras may benefit from programming to preserve mental and physical health in the wake of new stressors. Lending greater support to promotoras within the agencies in which they are nested may enable them to be more successful in fulfilling their mission and sustaining their own health.

Saving a seat at the table for community members: co-creating an attachment-based intervention for low-income Latinx parent-youth dyads using a promotor/a model.

Evidence for the effectiveness of attachment-based interventions in improving youth's socioemotional health increases each year, yet potential for scalability of existing programs is limited. Available programs may have lower acceptability within low-income immigrant communities. Co-designing and implementing interventions with trained community workers (Promotors) offers an appealing solution to multiple challenges, but community workers must have high investment in the program for this to be a workable solution. This study examines the experiences of promotors involved in the co-creation and delivery of an attachmentbased intervention program for low-income Latinx youth (ages 8 to 17) and their mothers. Promotors (N=8) completed surveys, reporting on the experiences of each therapy group in terms of group dynamic (e.g., promotors' connectedness to each group, perceived program relevance). Following the completion of the intervention study, promotors participated in interviews in which they described their experiences in co-creating the intervention, delivering the intervention to the community, and their recommendations for improving the intervention. Overall, promotors perceived group dynamics as positive, though the mother groups were evaluated as significantly higher in quality (e.g., lower conflict) than the youth groups. Interviews revealed that promotors enjoyed the cocreation process and identified important areas for improvements for the intervention (incorporation of more visuals, creation of agelimited groups, reducing number of youth sessions) and evaluation (reduction in length, modification of language). Integrating input from promotors in the process of co-creating and implementing an intervention can benefit every member of the community from the program participants to the providers themselves.

A clinical investigation of dental evacuation systems in reducing aerosols.

BACKGROUND: The route of transmission of severe acute respiratory syndrome coronavirus 2 has challenged dentistry to improve the safety for patients and the dental team during various treatment procedures. The purpose of this study was to evaluate and compare the effectiveness of dental evacuation systems in reducing aerosols during oral prophylactic procedures in a large clinical setting. METHODS: This was a single-center, controlled clinical trial using a split-mouth design. A total of 93 student participants were recruited according to the inclusion and exclusion criteria. Aerosol samples were collected on blood agar plates that were placed around the clinic at 4 treatment periods: baseline, high-volume evacuation (HVE), combination (HVE and intraoral suction device), and posttreatment. Student operators were randomized to perform oral prophylaxis using ultrasonic scalers on 1 side of the mouth, using only HVE suction for the HVE treatment period and then with the addition of an intraoral suction device for the combination treatment period. Agar plates were collected after each period and incubated at 37 °C for 48 hours. Colony-forming unit (CFU) counts were determined using an automatic colony counter. RESULTS: The use of a combination of devices resulted in significant reductions in CFUs compared with the use of the intraoral suction device alone (P < .001). The highest amounts of CFUs were found in the operating zone and on patients during both HVE and combination treatment periods. CONCLUSIONS: Within limitations of this study, the authors found significant reductions in the amount of microbial aerosols when both HVE and an intraoral suction device were used. PRACTICAL IMPLICATIONS: The combination of HVE and intraoral suction devices significantly decreases microbial aerosols during oral prophylaxis procedures.