A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study

ObjectivesChildhood socio‐economic status (SES) has long been associated with later‐life oral health, suggesting that childhood is a sensitive period for oral health. Far less attention has been given to the long‐term impact of childhood trauma, abuse, and smoking on later‐life oral health. This study fills the gap in the literature by examining how adverse childhood experiences—social, psychological, and behavioral—shape total tooth loss over the life course, with an assessment of the sensitive period, accumulation, and social mobility models from life course research.MethodsData are drawn from the 2012 Health and Retirement Study (HRS) merged with multiple HRS data sources to obtain childhood information (N = 6,427; age > 50). Adverse childhood experiences include childhood financial hardship, trauma, abuse, and smoking. Total tooth loss is measured to assess poor oral health in later life. Educational attainment and poverty status (since age 51) are measured as adult adversity. Current health conditions and health behaviors are assessed to reflect the correlates of oral health in later life.ResultsThe sensitive period model indicates that childhood trauma such as parental death or divorce (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.04, 1.80), physical abuse (OR = 1.17, 95% CI = 1.03, 1.34), and low educational attainment (≤ high school; OR = 1.52, 95% CI = 1.04, 2.22) are associated with higher odds of total tooth loss in later life. Poverty status was not associated with the outcome. There was a clear graded relationship between accumulation of adverse experiences and oral health, which supports the accumulation model. In the social mobility model, older adults who occupied a stable disadvantageous position were more likely to be toothless (OR = 1.77, 95% CI = 1.08, 2.90) compared to those who did not face adversity in any case. Neither upward nor downward mobility mattered.ConclusionsFailing oral health in older adults, especially total tooth loss, may have its roots in adverse experiences such as childhood trauma, abuse, and low educational attainment. Findings also suggest that oral health in later life may be more influenced by accumulation of adversity rather than changes in social and economic position over the life course.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150521/1/cdoe12463.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150521/2/cdoe12463_am.pd

Oral Health - A Neglected Aspect of Subjective Well-Being in Later Life

OBJECTIVES: This study examined whether oral health is a neglected aspect of subjective well-being (SWB) among older adults. The key research question was whether deterioration in oral health among dentate older adults living in England was associated with decreases in SWB, using measures of eudemonic, evaluative, and affective dimensions of well-being. METHODS: This secondary analysis used data from the third (2006-2007) and fifth (2010-2011) waves of respondents aged 50 and older from the English Longitudinal Study of Ageing (ELSA). We fitted multivariable regression models to examine the effects of changes in oral impacts on daily life and edentulism (complete tooth loss) on SWB (quality of life, life satisfaction, and depressive symptomatology). RESULTS: A worsening in both oral health measures was associated with an increase in depressive symptoms even after adjusting for time-varying confounders including declining health, activities of daily living, and reduced social support. Becoming edentate was also associated with decreases in quality of life and life satisfaction. DISCUSSION: A deterioration in oral health and oral health-related quality of life increases the risk of depressive symptoms among older adults and highlights the importance of oral health as a determinant of subjective well-being in later life

Is Social Capital a Determinant of Oral health among Older Adults? An Analysis of the English Longitudinal Study of Ageing (ELSA)

Background: A growing body of evidence shows that social capital may affect the health and well-being of older adults. A number of studies also suggest that social capital is a determinant of oral health. However, the evidence for these claims is weak in terms of causal inference criteria such as temporality because previous studies are mostly based on cross-sectional analysis. Aims: The aims of this thesis were to examine whether social capital is a determinant of oral health among older adults, and whether this association is explained by socio-demographic, socio-economic, health and behavioural factors. Methods: Secondary data from waves 3 (2006-07) and 5 (2010-11) of the English Longitudinal Study of Ageing (ELSA) were analysed with 6,977 adults aged 50 and over in the cross-sectional analysis, and 5,385 and 5,114 older adults in the longitudinal and modelling of change analyses respectively. Four measures of social capital were derived from the ELSA study, reflecting structural (membership in organisations and volunteering) and functional (number of close ties and social support) dimensions of the concept. Oral health outcomes were assessed using measures of self-rated oral health, oral health-related quality of life and edentulousness. Binary and multinomial logistic regression models were used to estimate the odds of poor oral health for different levels of social capital, sequentially adjusted for socio-demographic, socio-economic, health and behavioural factors. Results: There was some evidence that lower levels of social capital were associated with poorer oral health among older adults in the cross-sectional and longitudinal analyses. The size of the statistically significant associations ranged from odds ratios of 1.21 (95%CI:1.01-1.46) to 2.14 (95%CI:1.62-2.84) independent of other dimensions of social capital and several measures of oral health. Poor oral health at baseline (2006-07) also predicted lower levels of social capital 4 years later. There was weaker evidence that positive/negative changes in social capital were associated with improving/worsening oral health. The only consistent finding was the association between low social support and poor self-rated oral health, with odds ratios of 1.36 (95%CI:1.11-1.66) in the cross-sectional analysis, 1.27 (95%CI:1.01-1.60) in the longitudinal analysis, and 1.46 (95%CI:1.13-1.90) in the modelling of change analysis. Conclusions: Overall, the results of the thesis found weak evidence that low social capital is a determinant of poor oral health among older adults. There was some evidence of longitudinal associations between functional dimensions of social capital and subjective oral health, but little evidence for other measures of social capital and oral health. One key area of further research is the mechanisms and interventions by which older adults are able to generate and maintain social support and close ties in later life

Oral health-related quality of life and loneliness among older adults

Loneliness is a serious concern in aging populations. The key risk factors include poor health, depression, poor material circumstances, and low social participation and social support. Oral disease and tooth loss have a significant negative impact on the quality of life and well-being of older adults. However, there is a lack of studies relating oral health to loneliness. This study investigated the association between oral health-related quality of life (through the use of the oral impact on daily performances—OIDP—measure) and loneliness amongst older adults living in England. Data from respondents aged 50 and older from the third (2006–2007) and fifth (2010–2011) waves of the English Longitudinal Study of Ageing were analyzed. In the cross-sectional logistic regression model that adjusted for socio-demographic, socio-economic, health, and psychosocial factors, the odds of loneliness were 1.48 (1.16–1.88; p < 0.01) higher amongst those who reported at least one oral impact compared to those with no oral impact. Similarly, in the fully adjusted longitudinal model, respondents who reported an incident oral impact were 1.56 times (1.09–2.25; p < 0.05) more likely to become lonely. The association between oral health-related quality of life and loneliness was attenuated after adjusting for depressive symptoms, low social participation, and social support. Oral health-related quality of life was identified as an independent risk factor for loneliness amongst older adults. Maintaining good oral health in older age may be a protective factor against loneliness

Socioeconomic and ethnic inequalities in oral health among children and adolescents living in England, Wales and Northern Ireland

OBJECTIVES: Although adolescence is a sensitive developmental period in oral health, the social equalization hypothesis that suggests health inequalities attenuate in adolescence has not been examined. This study analyses whether the socioeconomic gap and ethnic disadvantage in oral health among children aged 5 reduces among adolescents aged 15. METHODS: Data from the cross-sectional Children's Dental Health Survey 2013 were analysed, comprising of 8541 children aged 5, 8, 12 and 15 attending schools in England, Wales and Northern Ireland. Oral health indicators included decayed and filled teeth, plaque, gingivitis and periodontal health. Ethnicity was measured using the 2011 UK census ethnic categories. Socioeconomic position was measured by family, school and residential deprivation. Negative binomial and probit regression models estimated the levels of oral health by ethnicity and socioeconomic position, adjusted for demographic and tooth characteristics. RESULTS: The predicted rate of decayed teeth for White British/Irish children aged 5 was 1.54 (95%CI 1.30-1.77). In contrast, the predicted rate for Indian and Pakistani children was about 2-2.5 times higher. At age 15, ethnic differences had reduced considerably. Family deprivation was associated with higher levels of tooth decay among younger children but not among adolescents aged 15. The influence of residential deprivation on the rate of tooth decay and filled teeth was similar among younger and older children. Moreover, inequalities in poor periodontal health by residential deprivation was significantly greater among 15-year-old children compared to younger children. CONCLUSIONS: This study found some evidence of smaller ethnic and family socioeconomic differences in oral health among British adolescents compared to younger children. However, substantial differences in oral health by residential deprivation remain among adolescents. Community levels of deprivation may be particularly important for the health of adolescents

Temperature dependence of the excitation spectrum in the charge-density-wave ErTe3_3 and HoTe3_3 systems

We provide optical reflectivity data collected over a broad spectral range and as a function of temperature on the ErTe$_3$ and HoTe$_3$ materials, which undergo two consecutive charge-density-wave (CDW) phase transitions at $T_{CDW1}$= 265 and 288 K and at $T_{CDW2}$= 157 and 110 K, respectively. We observe the temperature dependence of both the Drude component, due to the itinerant charge carriers, and the single-particle peak, ascribed to the charge-density-wave gap excitation. The CDW gap progressively opens while the metallic component gets narrow with decreasing temperature. An important fraction of the whole Fermi surface seems to be affected by the CDW phase transitions. It turns out that the temperature and the previously investigated pressure dependence of the most relevant CDW parameters share several common features and behaviors. Particularly, the order parameter of the CDW state is in general agreement with the predictions of the BCS theory

Evidence for coupling between collective state and phonons in two-dimensional charge-density-wave systems

We report on a Raman scattering investigation of the charge-density-wave (CDW), quasi two-dimensional rare-earth tri-tellurides $R$Te$_3$ ($R$= La, Ce, Pr, Nd, Sm, Gd and Dy) at ambient pressure, and of LaTe$_3$ and CeTe$_3$ under externally applied pressure. The observed phonon peaks can be ascribed to the Raman active modes for both the undistorted as well as the distorted lattice in the CDW state by means of a first principles calculation. The latter also predicts the Kohn anomaly in the phonon dispersion, driving the CDW transition. The integrated intensity of the two most prominent modes scales as a characteristic power of the CDW-gap amplitude upon compressing the lattice, which provides clear evidence for the tight coupling between the CDW condensate and the vibrational modes

Charge-Density-Wave like Behavior in the One-Dimensional Charge-Ordered Semiconductor (NbSe4)3I

We report on broadband dielectric spectroscopy on the one-dimensional semiconductor (NbSe4)3I. Below the structural phase transition close to 270 K we observe colossal dielectric constants with a frequency and temperature dependence very similar to what is observed in canonical charge-density wave systems. Guided by structural details we interpret this structural phase transition as driven by complex charge-order processes.Comment: 4 pages, 3 figure

Time-sensitive autonomous architectures

Autonomous and software-defined vehicles (ASDVs) feature highly complex systems, coupling safety-critical and non-critical components such as infotainment. These systems require the highest connectivity, both inside the vehicle and with the outside world. An effective solution for network communication lies in Time-Sensitive Networking (TSN) which enables high-bandwidth and low-latency communications in a mixed-criticality environment. In this work, we present Time-Sensitive Autonomous Architectures (TSAA) to enable TSN in ASDVs. The software architecture is based on a hypervisor providing strong isolation and virtual access to TSN for virtual machines (VMs). TSAA latest iteration includes an autonomous car controlled by two Xilinx accelerators and a multiport TSN switch. We discuss the engineering challenges and the performance evaluation of the project demonstrator. In addition, we propose a Proof-of-Concept design of virtualized TSN to enable multiple VMs executing on a single board taking advantage of the inherent guarantees offered by TSN