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2025

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Articles 31 - 60 of 135

Full-Text Articles in Dental Public Health and Education

Salivary Matrix Metalloproteinase-7, Human Beta-Defensin 1, And Mucin-4 As Potential Diagnostic Biomarkers In Periodontal Disease: A Review, Haider Mohammed Shaloom, Omar Husham Ali Sep 2025

Salivary Matrix Metalloproteinase-7, Human Beta-Defensin 1, And Mucin-4 As Potential Diagnostic Biomarkers In Periodontal Disease: A Review, Haider Mohammed Shaloom, Omar Husham Ali

Maaen Journal for Medical Sciences

Periodontal diseases are a group of chronic, immune-mediated inflammatory conditions affecting the periodontium, the supportive structures of the teeth. With severe forms affecting nearly 20% of the worldwide adult population, these diseases represent a significant global health challenge. Their impact extends beyond the oral cavity, as periodontitis is a recognized risk factor for systemic conditions like cardiovascular disease and diabetes mellitus. Characterized by the progressive destruction of tooth-supporting tissues, early diagnosis is crucial to prevent tooth loss. However, conventional diagnostic methods primarily quantify historical tissue damage rather than indicating current disease activity or predicting future progression. To overcome these limitations, …


Macomb Community College Dental Clinic Hosts First “Give Kids A Smile” Event Sep 2025

Macomb Community College Dental Clinic Hosts First “Give Kids A Smile” Event

Journal of the Macomb Dental Society

This feature article covers Macomb Community College Dental Clinic's first Give Kids a Smile event -- a collaboration between students, faculty, and community members.


Community Health Centers And The Changing Landscape In Colorado, Ethan Kerns Sep 2025

Community Health Centers And The Changing Landscape In Colorado, Ethan Kerns

Metro Denver Dental Society Articulator Magazine

This article examines the vital role Community Health Centers (CHCs) play in Colorado's oral health landscape, highlighting their delivery of comprehensive, integrated dental services to underserved and low-income populations. The author details how shifting state and federal policy and mounting financial challenges, threaten CHC’s sustainability, which could diminish access to essential dental care for hundreds of thousands and create ripple effects throughout the broader dental system.


The Effects Of Mouthguard And Physiotherapy On Bruxism: An Emg And Posture Angle Analysis—A Pilot Clinical Study, Nathalie Yared, Pascal El Braidy, Romy Slaiby, Amine El Zoghby Sep 2025

The Effects Of Mouthguard And Physiotherapy On Bruxism: An Emg And Posture Angle Analysis—A Pilot Clinical Study, Nathalie Yared, Pascal El Braidy, Romy Slaiby, Amine El Zoghby

International Arab Journal of Dentistry

Objectives: The purpose of this research was to determine whether a clinical trial to assess the impact of physiotherapy and mouthguards on bruxism was feasible. This included assessing participant recruitment, carrying out the interventions, and gathering data with appropriate techniques. The study focused on using posture angle analysis to evaluate changes in posture linked to bruxism and electromyography (EMG) to detect muscular activity. By exploring these elements, the study aimed to provide the groundwork for a more extensive, larger clinical trial.

Methods: Participants were recruited from the USJ dental clinics after their consultations. They were screened for bruxism using a …


J Mich Dent Assoc September 2025 Sep 2025

J Mich Dent Assoc September 2025

The Journal of the Michigan Dental Association

Each month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It stands as the primary publication reaching Michigan dentists.

The September issue marks the return to a hybrid publishing schedule, with print issues published bimonthly in January, March, May, July, September, and November, and online-only digital issues in February, April, June, August, October, and December. This return to print follows a suspension in May due to association-wide financial issues, with the MDA Board of Trustees approving changes in the 2025 budget to …


Dean’S Report: Detroit Mercy Dental - Dental Schools — Safeguarding The Future Of Oral Health, Mert N. Aksu Dds, Jd, Mhsa, Cert. Dph Sep 2025

Dean’S Report: Detroit Mercy Dental - Dental Schools — Safeguarding The Future Of Oral Health, Mert N. Aksu Dds, Jd, Mhsa, Cert. Dph

The Journal of the Michigan Dental Association

This report from the University of Detroit Mercy School of Dentistry highlights its mission to prepare students as clinicians, leaders, and advocates for public health and equitable access to care, emphasizing evidence-based practices and community service. It addresses critical public health measures like community water fluoridation and HPV vaccination, advocating for policies that protect oral health. The report notes concerns over proposed Michigan Medicaid dental program changes that could burden dental schools with increased uncompensated and emergency care. Initiatives to meet workforce needs include the new Detroit Mercy Dental Vermont Track and community-based education programs, which provided care to over …


Oral Hygiene Practices, Treatment Needs And Barriers To Dental Care Among Adolescents Attending Special Education Schools In Shah Alam, Selangor, Malaysia, Nur Hafizah Nor Wira, Noraida Mamat, Maryani Mohamed Rohani, Aimi Kamarudin, Sofia Anis Aug 2025

Oral Hygiene Practices, Treatment Needs And Barriers To Dental Care Among Adolescents Attending Special Education Schools In Shah Alam, Selangor, Malaysia, Nur Hafizah Nor Wira, Noraida Mamat, Maryani Mohamed Rohani, Aimi Kamarudin, Sofia Anis

Journal of Dentistry Indonesia

Objective: This study aimed to evaluate the oral health practices, status, and treatment requirements of adolescents with special healthcare needs attending special education schools in Selangor, Malaysia. The adolescents’ parents perceived challenges to oral healthcare were also established. Methods: The current study employed a cross-sectional approach involving 131 adolescents with varying special needs. The participants were between 13 and 18 years old and fulfilled the pre-determined inclusion criteria. The participants’ parents supplied information on sociodemographic, oral health practices, and possible obstacles to dental care through an online survey form. The oral examination on decay, missing, and filled teeth (DMFT), simplified …


Positive And Negative Personality Traits In Relation To Oral Health-Related Quality Of Life And Satisfaction After Implant-Supported Prosthetic Treatment, Naimeh Hasheminejad, Maryam Farzadmoghadam, Mohammad Mohammadi, Amir Nekouei, Mohammadreza Rostamizadeh Aug 2025

Positive And Negative Personality Traits In Relation To Oral Health-Related Quality Of Life And Satisfaction After Implant-Supported Prosthetic Treatment, Naimeh Hasheminejad, Maryam Farzadmoghadam, Mohammad Mohammadi, Amir Nekouei, Mohammadreza Rostamizadeh

Journal of Dentistry Indonesia

Objective: This study aimed to determine patients’ positive and negative personality traits in relation to treatment satisfaction and oral health-related quality of life (OHRQOL) in patients who have received dental implant-supported prosthesis. Methods: This study was carried out on 135 adults above the age of 30 who had received reasonable implant treatment and prosthesis in the last 1–24 months in a private and a public dental office. Data collection was carried out using a questionnaire, which was sent to patients via WhatsApp and email. Also, the Persian version of the Oral Health Impact Profile 14 and the Positive Affect Negative …


Perception Of Conventional Cigarettes And Vaping Among Smokers And Nonsmokers: A Cross-Sectional Study, Indrayadi Gunardi, Rahmi Amtha, Firstine Kelsi Hartanto, Niko Falatehan, Alyah Heriandi, Angelita Victoria Kurniawan, Najla Nadiah, Wiwiek Poedjiastoeti, Andrijanto Andrijanto, Elizabeth Fitriana Sari Aug 2025

Perception Of Conventional Cigarettes And Vaping Among Smokers And Nonsmokers: A Cross-Sectional Study, Indrayadi Gunardi, Rahmi Amtha, Firstine Kelsi Hartanto, Niko Falatehan, Alyah Heriandi, Angelita Victoria Kurniawan, Najla Nadiah, Wiwiek Poedjiastoeti, Andrijanto Andrijanto, Elizabeth Fitriana Sari

Journal of Dentistry Indonesia

Objectives: The growing popularity of vaping has introduced additional challenges, as potential health risks are still under investigation. Exploring differences in smoking perceptions between smokers and non-smokers could provide valuable insights into smoking behavior and inform effective intervention strategies. This study aimed to evaluate and compare the perceptions of smoking, specifically vaping and conventional cigarette use, among young adult smokers and non-smokers. Methods: An analytical cross-sectional design was employed, with 542 university students included through random sampling, using a questionnaire consisting of 8 items. Data were analyzed using the Kruskal-Wallis test and Rasch model analysis. Results: Of the subjects, 259 …


Comparison Of Pharyngeal Airway And Dentoskeletal Effects Of 2 And 4 Premolar Extraction Treatment In Adult Orthodontic Patients, Esra Genc, Ahmet Karaman Aug 2025

Comparison Of Pharyngeal Airway And Dentoskeletal Effects Of 2 And 4 Premolar Extraction Treatment In Adult Orthodontic Patients, Esra Genc, Ahmet Karaman

Journal of Dentistry Indonesia

Objective: This study aimed to compare pharyngeal airway and dentoskeletal effects of 2 and 4 premolar extraction treatments in adult patients separately for each gender. Methods: The study was conducted with 60 adults (26 males; 34 females) aged 18-35 years. Individuals were divided into 3 groups as non-extraction, 2-premolar extraction, and 4-premolar extraction. Pre-treatment (T0) and post-treatment (T1) dentoskeletal and pharyngeal airway measurements were performed on cephalometric radiographs. Results: A significant increase in nasopharyngeal airway (PNS-ad2) and anterior hyoid bone movement (CV3ai-H) was observed in the 4-extraction group; whereas in the 2-extraction group, inferior oropharyngeal airway (IAS) narrowing and hyoid …


Understanding And Predicting Flossing Behavior In A Rural Appalachian Community Using The Multi-Theory Model, Rahib K. Islam, Manoj Sharma, Amanda H. Wilkerson, Bradford Layman, Clyde Dunn, Shamima A. Somi, Ratnesh Sharma, Karen Gruszynski, Syed S. Quadri, Vinayak K. Nahar, Robert E. Davis Aug 2025

Understanding And Predicting Flossing Behavior In A Rural Appalachian Community Using The Multi-Theory Model, Rahib K. Islam, Manoj Sharma, Amanda H. Wilkerson, Bradford Layman, Clyde Dunn, Shamima A. Somi, Ratnesh Sharma, Karen Gruszynski, Syed S. Quadri, Vinayak K. Nahar, Robert E. Davis

School of Medicine Faculty Publications

Effective flossing is essential for preventing periodontal disease. However, in a rural Appalachian community, adherence to flossing routines remains low, contributing to significant oral health disparities. The purpose of this study was to conceptualize intention of initiation and sustenance of flossing behaviors using the multi-theory model (MTM) of health behavior change. A cross-sectional survey was administered to individuals recruited from a shopping mall in rural Appalachia. The MTM constructs were measured and data were analyzed using multiple linear regression models. Of the 228 participants, 55% did not floss daily. Behavioral confidence (β = 0.571, p < 0.001) was a significant predictor for the intention of initiation of flossing among non-daily flossers, while emotional transformation (β = 0.377, p = 0.836) significantly explained sustenance among non-daily flossers. For daily flossers, changes in the physical environment (β = 0.432, p = 0.003) significantly predicted the intention of initiation of flossing, whereas emotional transformation (β = 0.344, p = 0.008) and practice for change (β = 0.594, p < 0.001) significantly predicted sustenance of flossing behavior. The MTM appears to be a robust framework for understanding and predicting flossing behaviors in rural Appalachian populations. Interventions designed to enhance behavioral confidence, physical environment changes, emotional transformation, and practice for change could improve flossing adherence. Further research should explore these constructs to develop targeted public health strategies.


August 19, 2025 — Coalition Letter - Reauthorization Of The Health Resources And Services Administration (Hrsa) Title Vii Health Professions And Title Viii Nursing Workforce Development Programs, American Dental Association Aug 2025

August 19, 2025 — Coalition Letter - Reauthorization Of The Health Resources And Services Administration (Hrsa) Title Vii Health Professions And Title Viii Nursing Workforce Development Programs, American Dental Association

Advocacy in Action letters

No abstract provided.


Charting New Territory: Ai Applications In Dental Caries Detection From Panoramic Imaging., Man Hung, Daniel Yevseyevich, Milan Khazana, Connor Schwartz, Martin S. Lipsky Aug 2025

Charting New Territory: Ai Applications In Dental Caries Detection From Panoramic Imaging., Man Hung, Daniel Yevseyevich, Milan Khazana, Connor Schwartz, Martin S. Lipsky

Institute on Aging Publications

Dental caries remains a public health concern, and early detection prevents its progression and complications. Panoramic radiographs are essential diagnostic tools, yet the interpretation of panoramic X-rays varies among practitioners. Artificial intelligence (AI) presents a promising approach to enhance diagnostic accuracy in detecting dental caries. This scoping review examines the current literature on the use of AI programs to analyze panoramic radiographs for the diagnosis of dental caries. This scoping review searched PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source, adhering to PRISMA guidelines. The review included peer-reviewed, original research published in English that investigated the use …


Classification Of Dental Adverse Events Using Iterative Qualitative Analysis, Kiti Siriwatana, Sathirakorn Pongpanich Aug 2025

Classification Of Dental Adverse Events Using Iterative Qualitative Analysis, Kiti Siriwatana, Sathirakorn Pongpanich

Journal of Health Research

Background: Effective incident reporting systems (IRS) are essential in dentistry for identifying and preventing adverse events (AEs), with standardized classifications ensuring consistent incident categorization. This study aimed to develop and validate a classification system for dental patient safety incidents based on a 5-year case study at the Dental Hospital at Chulalongkorn University, Thailand.

Methods: An iterative qualitative approach was used. A literature review explored existing accreditation standards and AE classification systems. Incident reports from 2018–2022 informed a draft classification system aligned with Thailand’s National Reporting and Learning System and accreditation standards. Reports from 2023 were used for validation. An expert …


Mda Services: Endorsed Programs News Aug 2025

Mda Services: Endorsed Programs News

The Journal of the Michigan Dental Association

Throughh MDA Services, the Michigan Dental Association (MDA) has announced several endorsed programs aimed at supporting dental practices across Michigan: Compass Dental Gas Service is now endorsed by the MDA for its expertise in installing, maintaining, and repairing dental gas systems. Members benefit from exclusive discounts and safety compliance support. MEDVA Virtual Staffing offers HIPAA-compliant, human virtual assistants to handle administrative tasks remotely. This service helps reduce labor costs and allows in-office staff to focus on patient care. MDA Health Plan sponsors are reminded to submit overdue eligibility verification documents, which are essential for compliance and 2026 renewal preparations. DBS …


J Mich Dent Assoc August 2025 Aug 2025

J Mich Dent Assoc August 2025

The Journal of the Michigan Dental Association

Each month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It stands as the primary publication reaching Michigan dentists. The August issue marks the end of digital only publishing, as the MDA announced it will provide members a bimonthly print issue along with monthly digital distribution. This issue includes:

  • A cover feature on the impact on the dental community of the recently adopted Big Beautiful Bill federal budget
  • Mandibular Lingual Concavity Evaluation Using CBCT
  • A reprinted clinical feature from New York on …


Water Fluoridation: A Personal Perspective On The Effectiveness Of Community Water Fluoridation, William Chase Dds, Maom Aug 2025

Water Fluoridation: A Personal Perspective On The Effectiveness Of Community Water Fluoridation, William Chase Dds, Maom

The Journal of the Michigan Dental Association

This article offers Dr. William R. Chase's personal insights into community water fluoridation, emphasizing its effectiveness in preventing dental caries. It traces the discovery of fluoride's benefits back to Frederick McKay's 1901 observations and highlights the pivotal 1945 Grand Rapids Study, which demonstrated significant caries reduction, especially in younger age groups. Despite long-standing support from the American Dental Association, controversies regarding fluoride's safety persist, leading to recent state-level bans. Dr. Chase's experiences in countries without fluoridated water, where he observed severe decay and life-threatening cellulitis, underscore his belief in fluoride as a "miracle supplement" when properly utilized. The Michigan Dental …


The Back Page: Hospital General Dentistry: Needed Now More Than Ever, Tanaya K. Porter Dds, Craig C. Spangler Dds Aug 2025

The Back Page: Hospital General Dentistry: Needed Now More Than Ever, Tanaya K. Porter Dds, Craig C. Spangler Dds

The Journal of the Michigan Dental Association

This commentary emphasizes the increasing necessity of hospital-based general dentists. Historically, dentists faced challenges for privileges in hospitals, but today they are crucial, especially for neurodivergent adult patients and those with complex chronic illnesses requiring general anesthesia for dental care. Untreated oral issues can lead to severe infections, complicating acute medical conditions and threatening the success of life-saving surgeries like organ transplants. Hospital dentists provide vital pre-surgical evaluation, diagnosis, and follow-up care to prevent dental complications and improve patient quality of life post-surgery. Despite their critical role, the article highlights a concerning trend of fewer hospitals having general dentists on …


An Analysis Of Employment Patterns And Career Decisions Among Dental Hygienists: In A Transforming Healthcare Landscape, Shirley Calderon Jamarck Jul 2025

An Analysis Of Employment Patterns And Career Decisions Among Dental Hygienists: In A Transforming Healthcare Landscape, Shirley Calderon Jamarck

Dental Hygiene ETDs

The purpose of this study was to identify the factors contributing to dental hygienists’ consideration of changing careers, retiring early, or feeling burned out. A 26-question survey was emailed to members of the American Dental Hygienists’ Association, with 742 responses meeting inclusion criteria. Participants evaluated aspects of their careers, including job satisfaction, wages and benefits, personal growth, work-related stress, burnout, work-life balance, and retirement plans. Results revealed that one-third of respondents planned to leave the profession, citing burnout, physical strain, and limited career growth as reasons. High correlations were found between job satisfaction and feeling valued, professional accomplishment, and growth …


July 15, 2025 — Ada Letter To House Subcommittee On Health, Energy And Commerce Committee On "Legislative Proposals To Maintain And Improve Public Health Workforce, Rural Health, And Over-The-Counter Medicines.", American Dental Association Jul 2025

July 15, 2025 — Ada Letter To House Subcommittee On Health, Energy And Commerce Committee On "Legislative Proposals To Maintain And Improve Public Health Workforce, Rural Health, And Over-The-Counter Medicines.", American Dental Association

Advocacy in Action letters

No abstract provided.


A Call To Arms: Community Water Fluoridation Is Under Attack In Florida And Elsewhere In The Us, Richard A. Mufson Jul 2025

A Call To Arms: Community Water Fluoridation Is Under Attack In Florida And Elsewhere In The Us, Richard A. Mufson

SFDDA Newsletter

Editorial feature from lead editor, Dr. Richard Mufson


Lsu Dental Students Provide Free Care To Homeless Through Ozanam Inn Partnership Jul 2025

Lsu Dental Students Provide Free Care To Homeless Through Ozanam Inn Partnership

New Orleans Dental Association News

LSU dental students provide free care to homeless individuals through a well-established student-run clinic at Ozanam Inn. Guided by faculty, the program offers hands-on experience, holistic service delivery, and compassionate outreach to New Orleans' underserved populations.


The Implications Of Alpha-Gal Syndrome For Dental And Medical Treatment, Adam Degenova Mba, Kristi Soileau Jul 2025

The Implications Of Alpha-Gal Syndrome For Dental And Medical Treatment, Adam Degenova Mba, Kristi Soileau

New Orleans Dental Association News

Alpha-gal syndrome (AGS) is a potentially life-threatening allergic reaction to a mammalian sugar molecule introduced through tick bites. With rising U.S. diagnoses, dentists must recognize AGS symptoms and understand its implications. Many dental medications and materials contain mammalian-derived ingredients, requiring providers to adapt treatment plans and remain vigilant for delayed allergic responses in undiagnosed patients.


The Back Page: Commentary: Going Non-Par: My Perspective, And 10 Lessons I’Ve Learned, Robert Antolak Dds Jul 2025

The Back Page: Commentary: Going Non-Par: My Perspective, And 10 Lessons I’Ve Learned, Robert Antolak Dds

The Journal of the Michigan Dental Association

Dr. Robert Antolak shares his experience and ten lessons from transitioning his dental practice to a non-participating (non-par) status with insurance in January 2025, driven by declining reimbursements and the need to prioritize patient care. He highlights the unfairness of lower PPO reimbursements for newer dentists. Key lessons include securing a trusted coach, early patient communication, building a financial safety net, ensuring full team buy-in, committing with faith, tightening billing systems, frequent patient reminders, advocating for patients, creating an in-office payment plan (not percentage discounts), and clearly articulating the "why". Though revenue initially dropped, he anticipates full recovery, aiming to …


Mda Foundation: $10k Grant To Utica Clinic Makes Quality Dental Care Possible, Anne Berquist Jul 2025

Mda Foundation: $10k Grant To Utica Clinic Makes Quality Dental Care Possible, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation awarded a $10,000 grant to the Trinity Community Care Clinic in Utica, enabling them to replace an aging panoramic X-ray machine. Founded in 2011 by Dr. Robert Antolak and volunteers, this faith-based 501(c)(3) non-profit provides free or reduced-cost medical and dental care to uninsured or underinsured patients whose incomes are at or below 250% of the federal poverty level. The clinic relies on grants and donations, with dentists, hygienists, and University of Detroit Mercy dental students volunteering. Trinity Community Care offers various services, including extractions, dentures, restorations, and oral hygiene, consistently seeking more volunteers to expand its …


News You Need July 2025 Jul 2025

News You Need July 2025

The Journal of the Michigan Dental Association

News You Need for July 2025 includes a listing of MDA members who have completed service on committees; a link to recent MDA Board actions; news about two dental journalism awards won by the MDA Journal; how younger patients are negatively influenced by social media; a letter to the editor regarding dental insurance; information about MDA Foundation scholarships; members receiving awards; a calendar of events; a patient fact sheet; and more.


Mda At Your Service: Does The Mda Have A Source For Free Labor Law Posters?, Rachel Sinacola Dds Jul 2025

Mda At Your Service: Does The Mda Have A Source For Free Labor Law Posters?, Rachel Sinacola Dds

The Journal of the Michigan Dental Association

This "Q&A" section addresses common MDA member inquiries. It confirms that MDA members receive free labor law posters and automatic updates directly from the association. The MDA also offers affiliate memberships for dentists moving out-of-state but retaining Michigan ties, preserving benefits like discounted CE. Information is provided on the Certified Dental Business Professional (CDBP) program, which offers affordable staff certification over three years. The next Mission of Mercy is scheduled for June 11-14, 2026, in Kalamazoo. Finally, the article notes the discontinuation of the MDA Fee Survey due to antitrust changes, and directs members to the ADA/MDA Code of Ethics …


J Mich Dent Assoc July 2025 Jul 2025

J Mich Dent Assoc July 2025

The Journal of the Michigan Dental Association

Each month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 5,800 members. It stands as the primary publication reaching Michigan dentists. The all-digital July issue features Dr. Michele Tulak-Gorecki’s "It’s Time to Dare Greatly at the ADA," where she outlines her vision for ADA president-elect, focusing on financial integrity, strengthened advocacy, and fostering unity amidst challenges like declining membership and issues with the association management system.

Supporting articles highlight the MDA’s endorsement of MEDVA, offering cost-effective, HIPAA-compliant virtual assistant solutions for dental practices to …


The Status Of Fluoridation Jun 2025

The Status Of Fluoridation

West Michigan District Dental Society Bulletin

The future of community water fluoridation is uncertain amid legal action and federal leadership changes. Fluoridation is still recommended by the federal government, with new research following those recommendations affirming previous findings of safety and efficacy, however dentists remain central to public education and advocacy. A link to updated resources from the MDA is included.


Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz Jun 2025

Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …