Health Care Needs Research Articles

Prevalence and sociodemographic associations with weight discrimination in early adolescents

ObjectivesTo evaluate the prevalence of weight discrimination (the perception of being treated unfairly based on weight) and its sociodemographic associations among early adolescents aged 10 to 13 in the United States. MethodsWe analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study in Year Two (2018–2020). Multivariable logistic regression analyses were conducted, with perceived weight discrimination as the dependent variable and age, sex, sexual orientation, race and ethnicity, body mass index (BMI) category, household income, and highest parental education level as adjusted independent variables. Interaction with BMI category and weight discrimination by sex, sexual orientation, race and ethnicity, and household income was tested for. ResultsIn our analytical sample (N = 7129), we found that 5.46 % of early adolescents reported experiencing weight discrimination. Adolescents with BMI percentile ≥95th (adjusted odds ratio [AOR], 6.41; 95 % confidence interval [CI], 4.71–8.70), <5th (AOR, 3.85; 95 % CI, 2.10–7.07), and ≥85th to <95th (AOR, 2.22; 95 % CI, 1.51–3.25) had higher odds of experiencing weight discrimination compared to adolescents with BMI percentile 5th to <85th. Sex and race and ethnicity modified the relationship between BMI category and weight discrimination. Adolescents who identified as gay/bisexual (AOR, 3.46; 95 % CI, 2.19–5.45) had higher odds of experiencing weight discrimination compared with heterosexual adolescents. ConclusionsOur results underscore the need for anti-bullying campaigns and positive media representation of all body types. Clinicians should recognize that sexual minority youth disproportionately experience weight discrimination, emphasizing the need for affirmative healthcare and early intervention to prevent the mental health impacts of such discrimination.

National Trends in the Prevalence of Unmet Health Care and Dental Care Needs During the COVID-19 Pandemic: Longitudinal Study in South Korea, 2009-2022.

Although previous studies have investigated trends in unmet health care and dental care needs, most have focused on specific groups, such as patients with chronic conditions and older adults, and have been limited by smaller data sets. This study aims to investigate the trends and relative risk factors for unmet health care and dental care needs, as well as the impact of the COVID-19 pandemic on these needs. We assessed unmet health care and dental care needs from 2009 to 2022 using data from the Korea Community Health Survey (KCHS). Our analysis included responses from 2,750,212 individuals. Unmet health care or dental care needs were defined as instances of not receiving medical or dental services deemed necessary by experts or desired by patients. From 2009 to 2022, the study included 2,700,705 individuals (1,229,671 men, 45.53%; 673,780, 24.95%, aged 19-39 years). Unmet health care needs decreased before the COVID-19 pandemic; however, during the pandemic, there was a noticeable increase (βdiff 0.10, 95% CI 0.09-0.11). Unmet dental care needs declined before the pandemic and continued to decrease during the pandemic (βdiff 0.23, 95% CI 0.22-0.24). Overall, the prevalence of unmet dental care needs was significantly higher than that for unmet health care needs. While the prevalence of unmet health care needs generally decreased over time, the β difference during the pandemic increased compared with prepandemic values. Our study is the first to analyze national unmet health care and dental care needs in South Korea using nationally representative, long-term, and large-scale data from the KCHS. We found that while unmet health care needs decreased during COVID-19, the decline was slower compared with previous periods. This suggests a need for more targeted interventions to prevent unmet health care and dental care needs.

Do Preventive Programs Reduce the Need for New Sedations for the Treatment of Oral Pathologies in Healthy and Special Health Care Needs Children?

Background: The goal is to analyze the need for reinterventions under deep sedation to treat oral pathologies in a population of children with special health care needs (SHCNs) and healthy children who followed a prevention program and to study the influence of parental motivation and child collaboration on the need for reinterventions under deep sedation. Methods: A retrospective study was carried out in a private clinic in Cartagena (Murcia, Spain), with patients treated under deep sedation from 2006 to 2018, both years included, following the Strobe statement. Results: In this study with 230 children who were treated under deep sedation, 23.92% underwent two or more sedations. The mean time elapsed between the first and the second sedations was 21.64 ± 15.87 months, and the main cause for reinterventions was the occurrence of new pathologies. Significantly more pulp treatments were performed in the first sedation than in the second (p = 0.013) and in the third (p = 0.007). Healthy children required fewer reinterventions under deep sedation than children with special needs (6.42% vs. 39.67%). Similarly, patients who followed the preventive program and required some type of dental treatment were reoperated fewer times than those who did not follow the preventive program (35.8 vs. 50%); than "cooperative" children as opposed to "non-cooperative" (12.12% vs. 60.93%) and than patients with "motivated" parents as opposed to those with "non-motivated" parents (20.83% vs. 46.34%). A total of 50% of the children who participated in the preventive program became "cooperative", and 100% were able to receive some treatment in the dental chair. Conclusions: Prevention programs, including motivational interviewing, are essential to improve children's behavior in the dental chair and reduce the need for reinterventions under general anesthesia or deep sedation. Although patients with special needs do require more sedation during their lifetime due to their inability to cooperate, these programs are necessary for the maintenance of oral health status and for the early diagnosis of caries lesions. Pediatric dentists should implement a quarterly preventive program because it improves patient collaboration. It is essential to achieve the motivation of parents in the oral care of their children.

Application of Industry 4.0 and digital twin in the field of smart healthcare

There is an increasing need for preventive health care as well as precise diagnosis and tailored treatment of different diseases in recent years. Providing customized treatment for each patient and maximizing accuracy and efficiency are main goals of a good healthcare system. This thesis explores the integration of digital twin technology with Industry 4.0 in healthcare. Digital twins create virtual representations of physical systems, enabling real-time monitoring and tailored treatments. Key elements include the living human body, IoT, digital twin, cloud computing, and simulation. The architecture comprises data acquisition, data munging, data storage, data simulation with analytics, and user access layers. Creating a digital twin involves precise 3D modeling, representing the entire body or specific organs. A case study demonstrates real-time monitoring using wearable sensors for blood pressure, blood sugar, and heart rate. Data is transmitted, integrated with the digital twin, and accessible via a website with alarms for abnormal readings. While Industry 4.0 and digital twin adoption in healthcare is evolving, the architecture serves as a reference. It offers real-time data for diagnosis and treatment, with potential for advanced simulations. Challenges include automated data systems and privacy concerns. Despite limitations, this integration holds promise for precision medicine and personalized healthcare.

Homeless patients requiring haemodialysis: incidence, caseload characteristics, and implications for care

Background Homelessness is a recognized risk factor for the development of kidney failure. However, the risk of requiring renal replacement therapy (RRT) in homeless populations remains unknown. Furthermore, access to and provision of RRT for homeless populations have not been described. Methods We performed a retrospective study of all patients who newly commenced in-centre haemodialysis at St. James’s Hospital, Dublin, from January 2021 to December 2023. Housing status was captured using registered addresses and a review of social workers’ assessments. Homelessness was defined according to the European Typology on Homelessness and Housing Exclusion Criteria. Using publicly available census and homelessness data, we estimated the risk of commencing haemodialysis among homeless and non-homeless populations in the catchment area. Results The overall prevalence of homelessness among adults in the catchment area was approximately 2000/270,000 (0.74%). Of the 74 patients who commenced haemodialysis over the 3-year period, 13 (17.6%) were homeless. There was a significant difference in the incidence of commencing haemodialysis between non-homeless and homeless individuals in the catchment area (p&lt;0.001, chi-square test). Among patients who commenced haemodialysis, the mean age was 53 years in homeless patients and 62 years in non-homeless patients (p&lt;0.05, one-way ANOVA). 3/13 homeless patients (23%) had received nephrology healthcare at least 3 months prior to haemodialysis, compared with 39/61 non-homeless patients (64%) (p &lt;0.05, chi-square). Of the three homeless patients who had received three months of nephrology healthcare prior to haemodialysis, all three patients commenced haemodialysis via an arteriovenous fistula. Mental health comorbidities were more frequent among homeless patients than among non-homeless patients (23% versus 8%) (not statistically significant), as were substance use disorders (38% versus 7%) (p&lt;0.05, chi-squared test). Conclusion The incidence of kidney failure requiring haemodialysis was higher in homeless adults than in their non-homeless peers. Homeless patients were younger and started haemodialysis more urgently. There is an unmet need for nephrology healthcare for the homeless population.

The Use of Audiovisual Distraction Tools in the Dental Setting for Pediatric Subjects with Special Healthcare Needs: A Review and Proposal of a Multi-Session Model for Behavioral Management.

A Special Health Care Need (SHCN) is characterized by any type of physical, mental, sensorial, cognitive, emotional, or developmental condition that requires medical treatment, specialized services, or healthcare interventions. These conditions can negatively impact oral health as SHCN children can hardly cooperate or communicate and experience higher levels of dental fear/anxiety, which interfere with regular appointments. The present narrative review aims to analyze the use of audiovisual (AV) tools in dental setting for the management of SHCN children during dental treatment and to evaluate their effectiveness in anxiety/behavior control from the child, dentist, and care-giver perspectives. This analysis leads to the proposal of a new multi-session model for the behavioral management of SHCN pediatric subjects. An electronic search on the MEDLINE/Pubmed, Scopus, and Web of Science databases was carried out and through this analysis, a new model was proposed, the "UNISA-Virtual Stepwise Distraction model", a multi-session workflow combining traditional behavior management and the progressive introduction of AV media to familiarize the SHCN child with dental setting and manage behavior. AV tools helped in most cases to manage SHCN behavior and decreased stress in both the dentist and child during dental treatments. Care-givers also welcomed AV distractors, reporting positive feedback in using them during future treatments. The present narrative review found increasing evidence of the use of AV media for SHCN pediatric subjects as distraction tools during dental treatment. In the majority of the studies, AV tools proved to be effective for the management of anxiety, dental fear, and behavior in dental setting.

BURN-OP: a Screening Tool for Identifying a Symptomatically Distinct Cluster of Burn Patients with the Greatest Healthcare Needs at Discharge

ObjectiveTo identify burn patients needing intensive rehabilitation based on discharge symptoms. MethodsWe conducted a retrospective analysis of 1,049 adult burn patients recruited to the Burn Injury Model System National Database. Using unsupervised hierarchical clustering, we identified three distinct patient clusters based on discharge symptoms and compared their clinical and demographic profiles, long-term rehabilitative needs, and self-reported quality of life. We also developed a weighted BUrn Rehabilitative Needs - OutPatient (BURN-OP) to prospectively identify patients with highest rehabilitative needs. ResultsThree burn patient clusters were identified: Cluster 1 with low, Cluster 2 with moderate, and Cluster 3 with high symptom burdens. Cluster 3, comprising 6% of discharged patients, had notably longer hospital stays, older age at burn, larger total body surface area (TBSA), increased days on ventilator, a higher number of surgical procedures, concomitant inhalation injury, and higher weight loss from admission to discharge. Cluster 3 patients preferentially utilized a wide spectrum of rehabilitative services (including physiotherapy, occupational therapy, speech-language pathology, social work, psychologic services, vocational services) extending up to 2 years post-discharge. Their self-reported health outcomes were worse, with greater limitations in work/activity and elevated pain interference persisting 5-years post-discharge. BURN-OP demonstrated high specificity (98.99%) and accuracy (96.19%, ROC AUC: 0.93) in identifying Cluster 3 patients at discharge. ConclusionsWe identify distinct burn patient clusters based on discharge symptoms, with Cluster 3 exhibiting the highest post-discharge healthcare needs. BURN-OP (https://burn-op.streamlit.app/) identifies high-risk patients, offering a tool for prioritizing interventions and designing trials that mitigate risk of Cluster 3 membership.

Quality indicators to monitor the quality and safety of care for older people: a scoping review protocol.

The objective of this review is to identify quality indicators used to monitor the quality and safety of care provided to older people (≥ 65 years old) in 8 care settings: primary care; hospital/acute care; aged care (including residential aged care and home or community care); palliative care; rehabilitation care; care transitions; dementia care; and care in rural areas. There is a need for high-quality, holistic, person-centered care for older people. Older people receive care across multiple care settings, and population-level monitoring of quality and safety of care across settings represents a significant challenge. National and international quality indicators used to monitor and evaluate the quality and safety of care at the population level for older individuals in the 8 key care settings will be considered for inclusion. English-language quantitative and mixed method studies published from 2012 will be considered. Academic (MEDLINE, Embase) and gray (government websites, clinical guidelines, Google) literature searches will be conducted. A standardized data extraction tool will be used to describe the identified quality indicators and associated tools. Quality indicators will be categorized by key domains (ie, pain, function, consumer experience, service delivery); quality indicator type (structure, process, outcome); and the Institute of Medicine's 6 dimensions of care quality (eg, efficiency, effectiveness, appropriateness, accessibility, acceptability/person-centered, safety). The scoping review will be conducted in accordance with the JBI methodology for scoping reviews and will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Open Science Framework https://osf.io/8czun.

Alberta Complementary Health Integration Project (ABCHIP): Meeting the Pain and Mental Health Care Needs under COVID-19 for Vulnerable Populations

Alberta Complementary Health Integration Project (ABCHIP): Meeting the Pain and Mental Health Care Needs under COVID-19 for Vulnerable Populations

The Analysis Study of Prevalence of Chronic Kidney Disease in Patients with Chronic Obstructive Pulmonary Disease : A Comprehensive Systematic Review

Background: The relationship between COPD and chronic kidney disease (CKD) is complex, with CKD often overlooked in older populations. The study aims to investigate the prevalence, risk factors, and impact of CKD on mortality and renal failure, highlighting the need for comprehensive health care. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2011 and 2024. Result: The study conducted a comprehensive review of over 8,000 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, eight publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: CKD is a significant risk factor for COPD patients, with 15.6% diagnosed aged 40 and older. Common risk factors include advancing age, diabetes, hypertension, elevated BMI, and cigarette smoking. COPD is associated with systemic inflammation, contributing to conditions like diabetes, muscle wasting, and kidney disease. Proactive management approaches are needed to address renal implications.

Assessing the Veterinary Health Care Needs of Knoxville’s Latino Community Through a Community-Based Participatory Approach: A Short Report

The primary objective of the study was to better understand the interests, needs, and perceived barriers to veterinary care of Knoxville’s Latino community. Investigators adapted a national survey designed to understand access to veterinary care for distribution to the Latino population through a community-based participatory approach with an established community center. Seventy-six percent of survey respondents (n = 46) reported that they consider the pet as part of the family. Forty-eight percent said their pets were not spayed or neutered (s/n), and of these, 39% said s/n was cost-prohibitive, whereas 22% did not know where to receive services. Twenty-six percent identified an inability to obtain treatment for a sick pet, primarily due to a lack of access to affordable care. Participants expressed interest in vaccines and parasite prevention (64%), training and behavior (36%), and information on veterinary and pet care resources (29%). The survey tool (provided in English and Spanish) and community engagement approach can assist animal welfare organizations in identifying and addressing community veterinary needs and barriers to care.

How We Feel: COVID-19 Pandemic Experiences Among Intergenerational Cambodian, Laotian, and Vietnamese Americans in San Francisco

The COVID-19 pandemic has exacerbated many social determinants of health and barriers to health care for Southeast Asian Americans. The objective of this study is to understand the impact of the COVID-19 pandemic on Southeast Asian American communities’ health care utilization and need for support. This cross-sectional study administered surveys and conducted focus groups with 78 participants (&gt;= 14 years) across generations and Cambodian, Laotian, and Vietnamese ethnicity in partnership with the Southeast Asian Development Center in San Francisco, California between July and September 2021. We identified two themes in health care utilization: barriers to health care and fear of anti-Asian violence; two themes in COVID-19 prevention: utilization of COVID-19 services and COVID-19 safety precautions; and two themes in the role of community and community centers: intergenerational community and crucial services provided by community centers. Despite the challenges posed by the duality of the COVID-19 pandemic and fear of anti-Asian violence, Southeast Asian Americans persisted with resilience to seek health services with intergenerational support and the guidance of community centers. This highlights the significance of community-oriented health among Southeast Asian Americans and the value of community-led health interventions in advancing health for a historically underserved population.

Mental health service use and shortages among a cohort of women living with HIV in Canada

BackgroundThe prevalence of mental health conditions among women with HIV in Canada ranges between 29.5% and 57.4%, highlighting the need for accessible mental health care. We aimed to (1) describe the availability and use of mental health services among women with HIV and (2) identify characteristics associated with reporting that shortages of these services presented a problem in their care.MethodsBaseline data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study were analysed. Self-reported availability and use of mental health services were examined using descriptive statistics. Participants indicated whether a lack of mental health support was a problem in their care. Logistic regression models were constructed to determine associations between sociodemographic, clinical, and psychosocial characteristics and reported problematic shortages.ResultsOf 1422 women, 26.7% (n = 380) used mental health services in the last year, which most accessed through their HIV clinic. Thirty-eight percent (n = 541) reported that a shortage of mental health support was a problem in their care. Among this subset, 22.1% (n = 119) used services at their HIV clinic, 26.5% (n = 143) reported available services but did not use them, and 51.4% (n = 277) either indicated that these services were unavailable, did not know if such services were available, or were unengaged in HIV care. Factors associated with reporting problematic shortages included rural residence [adjusted odds ratio (aOR): 1.69, 95% confidence interval (CI): 1.03–2.77], higher education level (aOR: 1.43, 95% CI: 1.02–2.02), and higher HIV stigma score (aOR: 1.03, 95% CI: 1.02–1.03). Conversely, African/Caribbean/Black identity (aOR: 0.37, 95% CI: 0.26–0.54), history of recreational drug use (aOR: 0.56, 95% CI: 0.39–0.81), and Quebec residence (aOR: 0.69, 95% CI: 0.50–0.96) were associated with lower odds of reporting service shortages.ConclusionOur findings highlight the HIV clinic as the primary location of mental health service use. However, existing services may not be sufficient to reach all patients or meet specific needs. Furthermore, the low uptake among those reporting a shortage suggests a lack of connection to services or patient knowledge about their availability. Characteristics associated with reporting shortages reflect geographic and socioeconomic disparities that must be accounted for in future service design.

Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts.

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women's experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women's Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.

Understanding Depression in the Elderly: A Research Review

Introduction: This study, Dr. Robert L. Spitzer's PHQ-9 scale is a reliable tool to measure the severity of depression. Recognizing the importance of mental health among the elderly in Ahmedabad, Gujarat. Aim: To determine the prevalence and risk factors of depression in the elderly. Materials and Methods: To identify the prevalence and factors associated with depression in elderly population by using PHQ-9 Scale of 400 Cases. Conclusion: Data show the burden of depressive symptoms among seniors and underscore the urgent need for mental health care. fatigue, self-criticism and mental illness.

Association between air temperature and self-perceived health status in Southern Germany: Results from KORA FIT study

BackgroundShort-term exposure to low and high air temperatures can cause serious harmful effects on human health. Existing literature has mostly focused on associations of ambient air temperature with mortality and the need for health care in population-level studies. Studies that have considered self-perceived health status as an outcome when examining the effects of air temperature on health are scarce. In this study, we explored the short-term association of daily mean air temperature with various measures of self-perceived health status. MethodsThis cross-sectional analysis is based on the Cooperative Health Research in the Region of Augsburg (KORA) FIT study conducted in 2018/2019 and included participants from the Augsburg region of Southern Germany. Health-related quality of life (HRQOL) was evaluated by using the 5-level EuroQol Five Dimension (EQ-5D-5L) questionnaire, including the EuroQol visual analog scale (EQ-VAS). Self-rated health (SRH) and comparative self-rated health (CSRH) were each assessed using a single question. Daily mean air temperature data was estimated using a spatiotemporal model and assigned to participants' home addresses at a resolution of 1 × 1 km. Regression models with a Distributed Lag Non-linear Modeling (DLNM) approach were used to investigate the associations between daily mean air temperature and self-perceived health measures. ResultsWe found no association of heat or cold with the HRQOL, SRH or CSRH. Nevertheless, there was a significant protective association of low air temperature with the EQ-5D-5L dimension “usual activities.” ConclusionThere was no evidence of daily mean air temperature adversely affecting participants' self-perceived health status.

Utilization of Special Services among Children and Youth with Special Healthcare Needs: A Time-to-Event Analysis of the National Survey of Children’s Health Data, 2016-2022

BackgroundSpecial services including physical, occupational, speech, or behavioral therapies are associated with enhanced long-term functioning and well-being of children and youth with special healthcare needs (CYSHCN). Yet, there is a lack of recent evidence on the utilization of these services, and the age at which CYSHCN first receive them. ObjectiveThis study assessed the distribution, timing, and determinants of special services utilization across different types of special healthcare needs. MethodsData from 63,734 caregivers of CYSHCN aged 0-17 years from the 2016-2022 National Survey of Children’s Health were analyzed using Rao-Scott Chi-Square, Log-rank, and Cox proportional hazard tests. ResultsOverall, 41.9% of CYSHCN ever received special services, including 91.4%, 90.3%, 88.0, and 34.1% of children and youth with Down syndrome, cerebral palsy, autism, and other special healthcare needs (OSHCN), respectively. Children with Down syndrome and cerebral palsy received special services earlier than those with autism or OSHCN. Utilization of special services was higher among male children and youth (aHR 1.41; 95% CI: 1.33-1.49), aged 0-5 years (aHR: 4.70; 95% CI: 4.32-5.11), second or later born children (aHR: 1.18; 95% CI: 1.10-1.26), from families with low-income (aHR: 1.14; 95% CI: 1.04-1.24), living with married parents (aHR: 1.11; 95% CI: 1.04-1.19), consistently insured (aHR: 1.24; 95% CI: 1.08-1.42), and with a more complex health condition (aHR: 3.40; 95% CI: 3.13-3.70) compared to their counterparts. ConclusionsThese findings highlight the necessity of adopting tailored approaches for children with different special healthcare needs to optimize and sustain the utilization of special services.

Health Care Needs of the Sex Trafficking Patient

Caring for and identifying a victim of sex trafficking can be very challenging at times. Sex trafficking victims often don't see themselves as victims and often times are victimized by a boyfriend or relative. These patients can be non-compliant with treatments and difficult to provide follow up care. Often times the only time they are receiving medical care is when they are in the emergency department as many of these patients do not seek routine medical care through a family practioner. Forensic nurses are are able to identify potential sex trafficking victims and advocate them for their medical needs.

Countering the Identified Barriers to Delivered Oral Care for Children With Special Healthcare Needs: A Narrative Review.

Children with Special Health Care Needs (SHCNs) have poor oral health as a result of structural and systemic barriers. These children frequently have limited access to dental treatment, a higher prevalence and incidence of dental problems, and worse oral hygiene than the rest of the population.This review aims to offer an understanding of the existing oral care barriers of children with SHCNs. We reviewed the literature on children with SHCNs and their caregivers to identify the implications of the barriers faced by these individuals. Some of the perceived barriers to appropriate oral healthcare faced by these children include obstacles to adequate oral care and hygiene in the home, challenging behaviours, and limited preventive care and accessibility. We focussed on interventions and different management approaches to support the stakeholders responsible for these children. There is a need for strong communication as well as care coordination between caregivers, dentists, and other providers to achieve positive outcomes. The current dental healthcare system appears to desert the needed demands of this demographic.

Sex differences in early-onset atrial fibrillation in Norwegian primary care: a retrospective national database analysis

BackgroundIndividual variation in the need for healthcare constitutes knowledge gaps for young atrial fibrillation (AF) patients. We aimed to estimate the prevalence and primary care burden of early-onset AF in...