Health Care Needs Research Articles

Prognostic significance of socioeconomic deprivation in patients with colorectal liver metastasis undergoing liver resection: a retrospective cohort study.

To evaluate the effect of socioeconomic deprivation on overall survival (OS) in patients undergoing liver resection for colorectal liver metastasis (CRLM). The STROCSS guideline for observational studies was followed to conduct a single-centre retrospective cohort study. All consecutive patients undergoing resection of CRLM between 2013 and 2021 were considered eligible for inclusion. The Welsh Index of Multiple Deprivation (WIMD) rank was used to determine socioeconomic deprivation status of each patient. Prognostic significance of socioeconomic deprivation was determined by Kaplan-Meier survival statistics and stepwise Cox proportional-hazards regression model. A total of 455 patients were eligible for inclusion; 237 patients were classed as least socioeconomically deprived and 218 patients as most socioeconomically deprived. Kaplan-Meier survival statistics showed that socioeconomic deprivation was associated with significantly lower probability of overall survival (HR: 1.55, 95% CI 1.23-1.95; logrank test: P = 0.0001). The stepwise Cox proportional-hazards regression analysis identified socioeconomic deprivation as predictor of OS (HR: 1.56, P = 0.0003) alongside the following variables: ASA status 1 (HR: 0.43, P = 0.0349), presence of extrahepatic disease (HR: 1.51, P = 0.0075), number of tumours (HR: 1.07, P = 0.0221), size of largest tumour (HR: 1.01, P = 0.0003), extended hemihepatectomy (HR: 3.24, P = 0.0018) and absence of recurrence (HR: 0.55, P < 0.0001). Socioeconomic deprivation reduces the probability of long-term overall survival following liver resection in patients with CRLM. This should be taken into account at different levels of health care planning for management of patients with CRLM including preoperative risk assessment, health care need assessment and allocation of resources.

IoT-Based Technologies for Addressing the Unique Healthcare Needs of the Elderly Population

IoT-Based Technologies for Addressing the Unique Healthcare Needs of the Elderly Population

Association of Maternal Sense of Coherence With Oral Health Behavior of Children With Special Health Care Needs: A Cross-Sectional Study.

Sense of coherence (SOC) has been adopted to analyze stress coping skills as well as to find its association with health and oral health behavior. The Arabic version of SOC has not been developed and adopted in the Saudi Arabian population; furthermore, few studies have attempted to analyze the association of a mother's sense of coherence with the oral health behavior of Special Care Health Needs (SCHN) children. Hence, this study aimed to observe the association of mothers' SOC scores with their children's oral health behavior, along with the validation of the scale. A cross-sectional study was conducted among 170 mothers of children with SCHN. Participants were recruited from two schools in Riyadh City and one school in Makkah, respectively. Descriptive statistics, validation, reliability, factor analysis, and multinomial logistic regression were carried out using the Statistical Package for the Social Sciences (SPSS, Version 20, 2011; IBM Corp., Armonk, USA). The mean SOC-13 score was 61.6 (±10.1), with a median value of 61. The SOC scale elicited a Cronbach's alpha value of 0.77. The Spearman-Brown-Brownuttman split-half reliability coefficients were found to be 0.70, respectively. The analysis confirmed a three-factor solution, which explains about 51.9% of the total variance. Mothers with higher SOC tend to utilize dental services for children [OR 5.69, P = 0.029, CI 1.19-27.02] and restrict sugary drinks to once a day [OR 9.31, P = 0.00, CI 1.95-44.44]. The reliability of the Arabic scale that was adopted after translation in the present study was found to be high; the scale confirms the three-factor solution. Mothers who scored low on the SOC scale tended to utilize less dental service for their children as well as overlook the sugary drink/day intake of the children.

Unmet need for healthcare in the Russian Federation: subnational retrospective modelling analysis (2014–2018)

IntroductionUnmet need for healthcare is a proxy indicator used to assess the performance of healthcare systems throughout the world. While the Russian Federation is committed to improving healthcare for its...

Enhancing Nursing Education to Address LGBTQ+ Healthcare Needs: Perspectives from the Philippines.

Enhancing healthcare professionals' education and training to effectively manage the healthcare needs of People Identifying as Lesbian, Gay, Bisexual, Transgender, Queer, and other Sexual and Gender Minorities (LGBTQ+) is imperative. Recognizing the importance of mitigating LGBTQ+ health disparities, healthcare associations have affirmed their commitment to providing inclusive and culturally competent healthcare. However, despite these efforts, there is still a gap in LGBTQ+-specific teaching within nursing and other healthcare professionals' schools, resulting in healthcare professionals being ill-equipped to meet the unique needs of LGBTQ+. To address this gap, we suggest integrating LGBTQ+ health content into healthcare training programs, focusing on the Philippine nursing curriculum. Drawing from various reports, including insights from discussions with the local LGBTQ+, the suggested topics include LGBTQ+ identities, sexual health, trans health, mental health, and social determinants of LGBTQ+ health. By fostering understanding and competence through education, equitable and inclusive healthcare practices for LGBTQ+ can be better cultivated, helping to ensure that the unique healthcare needs of LGBTQ+ are met effectively. Furthermore, it is necessary to share best practices for providing health services to LGBTQ+ people. Additionally, future studies can explore the median time allocated to LGBTQ+ teaching, the optimal number of teaching hours for LGBTQ+ content, and the specific contents of local nursing curricula that can better address their needs. By undertaking these steps, we can move toward effectively addressing the unique healthcare needs of LGBTQ+.

Development and feasibility of a virtual, synchronous mind-body resiliency intervention for fathers of children and youth with special healthcare needs

BackgroundFathers of children and youth with special healthcare needs (FCYSHCN) are an overlooked population at risk for chronic stress. Mind-body practices offer a patient-centered approach to foster coping and resiliency, yet low engagement from fathers in existing programs suggests adaptation is needed. This multiphase study examines the feasibility of a synchronous, virtual mind-body intervention adapted for FCYSHCN. Methods31 FCYSHCN were recruited online via community partners and recruitment portals in an academic medical center in Boston, MA. Phase 1 consisted of individual interviews (N = 17) to determine fathers’ stressors, coping strategies, program needs, and suggested adaptations to the intervention protocol. The Phase 2 single arm pilot feasibility trial (N = 14) consisted of eight weekly 60-minute group sessions delivered virtually. Primary feasibility metrics were attendance (benchmark: mean=6 sessions) and electronic survey completion at baseline and post-intervention. Acceptability was assessed using post-session ratings of program satisfaction (4-point Likert scale; scores ≥3 coded as helpful) and helpfulness (e.g., group structure). Exploratory outcomes included validated measures of stress coping, resiliency, parental stress, depression, anxiety, which were analyzed using paired-samples t-tests (alpha=.05) to generate effect sizes (η2). ResultsIn Phase 1, FCYSHCN discussed primary stressors (e.g., perceived inadequacy as a father) and multifaceted impacts of these stressors on physical, cognitive, emotional, and social wellbeing. Fathers also described coping strategies deemed helpful (e.g., humor) and unhelpful (e.g., “shutting down” from others). Qualitative findings informed intervention modifications. In Phase 2, most FCYSHCN (79%) attended ≥ 6 intervention sessions (mean=7). Follow-up survey completion was high (86%). Session satisfaction was high, with 7/8 sessions rated as helpful by most fathers. Program components deemed most helpful were the group structure, virtual delivery, exposure to a variety of relaxation and meditation skills, and the length of sessions. Although we were not powered to observe pre-post change, stress coping improved (p = .02, η2 = 0.42) and confidence increased in applying relaxation (p = .04, η2 = 0.34) and assertiveness techniques (p = .05, η2 = 0.31). ConclusionsThe first mind-body resiliency program for FCYSHCN is feasible and acceptable. Further testing is warranted in randomized trials with diverse samples of fathers, an appropriate comparison arm, and longitudinal assessments of psychosocial and biobehavioral outcomes.

Accessibility of Patients With Special Healthcare Needs to Dental Care in the Eastern Province of Saudi Arabia: A Multicentre Study From Perspective of Caregiver and Dental Care Providers.

Dental care accessibility is subject to a dentist's qualification, practice and intention to treat patients, regardless of whether those patients have special healthcare needs (SCN) and should receive treatment in a dental setting. This multicentre study aimed to evaluate the characteristics of patients with SCN, their access to dental care and behaviour towards dental care from their caregiver's perspective. In addition, the perspective of dental care providers who care for patients with SCN and the factors affecting the provision of treatment was also appraised. The Eastern Province of Saudi Arabia served as the site of this cross-sectional study from 1 February 2020 to 31 January 2022. Caregivers of 272 patients with SCN, regardless of age and gender, were recruited in the study. The caregiver's proforma sought information on the demographic characteristics, type of disability, cooperation, medical history, occupation of the parent and patient's behaviour towards oral hygiene and dental healthcare. The second proforma had the dental care provider's perspective about the common disabilities, factors that affect the decision to provide treatment, difficulties patients face in getting their dental treatment and, from the dentist's experience, recommendations to improve the access to dental care for patients with SCN. Statistical analysis was carried out by using SPSS version 22.0. The demographic features, caregiver's perception about oral healthcare accessibility and dental professional's point of view were presented as frequencies and percentages. Chi-square test was applied to compare the proportions. The majority of the caregivers were satisfied with the dental service providers (91.9%) for their patients with SCN. The dental care provider's survey results indicated a shortage of dentists (54.7%) in the region and other factors that pose challenges to special care, like the severity of the disability of patients with SCN (50%), family structure (46.7%), treatment cost (35.6%) and transportation (32.8%). Patients with SCN in Saudi Arabia had a high appraisal of access to dental care and were very satisfied with dental treatment results. However, the presence of a dental care provider in the same rehabilitation centre was a major concern. The severity of the disability and the patient's cooperation were the major factors that may have affected the decision of the dental care provider.

Mental Health Care Utilization and its Barriers among Iranian Breast Cancer Survivors: A Cross-sectional Study.

Depression and anxiety are common comorbidities complicating the care of breast cancer patients, but many patients do not receive the needed care. We aimed to assess utilization of mental health care and its barriers in breast cancer survivors. This cross-sectional study was conducted on 311 patients with breast cancer, in Iran, November 2021 to March 2022. Perceived need and utilization of mental health care and barriers to service utilization were measured based on self-report. Depression, Anxiety, and Stress Scale-21 and Multidimensional Scale of Perceived Social Support were used to assess depression, anxiety, and stress as well as social support, respectively. A linear and logistic regression model was used to analyze the data using SPSS version 22. A P-value less than 0.05 was considered statistically significant. 70.1% of the participants perceived need for mental health care, 28.0% of them had used mental health services, and 72% were classified as having unmet needs. The most common perceived barrier to service use was patients' self-adequacy. The prevalence of extremely severe levels of depression, anxiety, and stress was 14.8%, 23.5%, and 10.6%. Also, 48.6%, 78.5%, and 75.6% of patients received a high level of social support from friends, family, and significant others. Findings highlight a substantial unmet need for mental health care and low utilization of mental health services among breast cancer survivors. Given the significant prevalence of depression, anxiety, and stress in this population, it is imperative to address the underutilization of mental health services and to further examine the barriers preventing patients from seeking the care they require.

The assessment of national conduct in realizing the right to heath: using the framework of United Nations

Purpose Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the situation of the right and its determinants is necessary. This paper aims to analyze Iran’s conduct in realizing its population’s right to health. Design/methodology/approach A qualitative case study design involving a structured review of relevant laws, policy documents, reports and academic literature was undertaken. The data were collected from electronic databases and the official Web pages of the United Nations (UN) and Iran’s Government and analyzed by a framework suggested by the UN. Findings Iran’s law and policies intend to combat health inequalities and to provide an adequate standard of living for everyone, particularly disadvantaged groups and individuals. However, not all laws and policies protecting disadvantaged groups are adequately implemented. There are disparities in health status and access to health care among different socio-economic groups. International economic sanctions and government policies decreased people’s ability to access the necessities of life including health care. Moreover, social determinants of health, such as cultural beliefs regarding women’s rights have not been addressed sufficiently in the country’s laws. Research limitations/implications This study includes a broad range of subjects and provides an overview of the health-care system of Iran. However, more detail is needed to describe every aspect of the right to health. It was not feasible to address them all in this paper and needs more research. In addition, as with the majority of qualitative studies, the design of the current study is subject to limitations. Firstly, the research quality of narrative reviews is dependent on the researcher’ skills and more easily can be influenced by his/her personal biases. Second, the rigor is more difficult to maintain, assess and demonstrate. Nevertheless, narrative studies often complement quantitative studies and are informative. Originality/value To fulfill the right to health, Iran should improve affordability and quality of care and the situation of the determinants of health. The gaps in people’s access to health care need to be identified, and all necessary means and scarce resources be allocated to remove access barriers and to improve the situation of disadvantaged people. The adoption of relatively low-cost targeted programs, the proper management of resources and the prevention of unnecessary costs are suggested.

Realities of Children with Special Health Care Needs and Disabilities

Realities of Children with Special Health Care Needs and Disabilities

Telemedicine Abortion in Primary Care: An Exploration of Patient Experiences.

The purpose of the study was to explore patients' experiences and perspectives obtaining telemedicine medication abortion (TeleMAB) through their primary care health system. We conducted in-depth telephone interviews with 14 English-, Spanish-, and/or Portuguese-speaking patients who received a TeleMAB between July 2020 and December 2021, within a large primary care safety-net community health system in Massachusetts. We created and piloted a semistructured interview guide informed by patient-clinician communication frameworks and prior studies on patient experiences with TeleMAB. We analyzed data using reflexive thematic analysis and summarized main themes. Overall, participants found TeleMAB services in their primary care health system acceptable, positive, and easy. Participants discussed how TeleMAB supported their ability to exercise control, autonomy, and flexibility, and decreased barriers experienced with in-clinic care. Many participants perceived their primary care health system as the place to go for any pregnancy-related health care need, including abortion. They valued receiving abortion care from their established health care team within the context of ongoing social and medical concerns. Patients find TeleMAB from their primary care health system acceptable and beneficial. Primary care settings can integrate TeleMAB services to decrease care silos, normalize abortion as a part of comprehensive primary care, and improve access through remote care offerings. TeleMAB supports patients' access and autonomy, with the potential to benefit many people of reproductive age.

Bridging the Gap: Oral Health-care Delivery Plan in Tribal Belt of Western India

Abstract Background: India has launched many initiatives to achieve Universal Health Coverage, despite there exist gaps in oral health-care need and service delivery. Especially in tribal areas, due to the prevalence of risk factors as well as the lack of accessibility and affordability for health-care services, oral diseases remain unidentified and untreated. Therefore, the present study aims to assess the needs and design an implementation plan for sustainable and culturally acceptable oral health-care delivery in one of the tribal blocks of Mokhada in the state of Maharashtra, Western India. Methodology: The study included participants above 18 years of age and adopted a co-design approach. Data collection methods consisted of a short-form survey and focused group discussion. Convenient and purposive sampling methods were used to select participants for quantitative and qualitative data collection, respectively. Quantitative data analysis was performed using the STATA 16 tool, whereas thematic analysis was performed for the qualitative data. Need assessment led to the design of implementation by engaging multiple stakeholders. Results: A total of 2008 adults participated in the survey with a mean age being 37.7 years. 52.4% of participants were male. Out of 2008 screened, 83.2% were found to have at least one oral disease and a high prevalence of tobacco consumption (42%). Barriers of oral healthcare-seeking behaviour were addressed in the proposed model of care. Accordingly, a twice-a-week functional comprehensive oral care health-care model was integrated into the already existing health center of a community led development organization and portable mobile dental unit were planned with the support of multiple stakeholders. Conclusion: The study demonstrates the feasibility of delivering oral healthcare through integration into primary healthcare and multiple stakeholder engagement.

“Sometimes I Get So Extremely Tired”: Sámi Healthcare Staff Experiences of Cultural Load in Practice

The study aim was to explore how Sámi healthcare staff experience working as an ethnic minority in the Norwegian healthcare system. This was a qualitative focus group and individual interview study inspired by interpretive description, with 14 participants. The results indicate that Sámi healthcare staff experience various degrees of cultural load in their jobs. This was shown through the two themes: “Feeling responsible for Sámi patients and non-Sámi colleagues” and “Feeling exhausted as a Sámi healthcare worker.” To provide culturally safe care for all Sámi patients and their families, it is vital to ensure the well-being of the small number of Sámi healthcare personnel. Therefore, we emphasize the need for training programs for non-Sámi healthcare staff to provide them with the knowledge needed to support their encounters with Sámi patients in culturally safe ways. Sámi healthcare staff cannot take all responsibility for teaching their non-Sámi colleagues and acting as cultural mediators in all situations that non-Sámi staff find challenging. The risk of cultural load and burnout is very present. Nursing departments in universities and leaders in primary and secondary healthcare need to address these issues in order to ensure culturally safe care to all patients and support Sámi healthcare staff.

Male Survivors’ Disclosure of Conflict‐Related Sexual Violence in Mental Health Care Settings: Results from a Phenomenological Study with Clinical Experts in Germany

Conflict‐related sexual violence (CRSV) can severely impair survivors’ mental health and prompt their need for mental health care. Male survivors face gender‐related barriers to disclosing experiences of sexual violence, yet the understanding of factors impeding or promoting disclosure is limited. This knowledge gap is even more pronounced regarding male disclosure in refugee settings. The high prevalence of CRSV experiences in male refugees in European host countries points to the urgency of understanding male disclosure processes along with its barriers and facilitators, in order to provide for adequate mental health care. 10 clinical experts working with male survivors of CRSV in Germany were interviewed adopting an explorative phenomenological approach and using the Problem‐Centered Interview. Qualitative content analysis yielded five themes describing male disclosure of CRSV: 1. Experiences of CRSV commonly remain nonverbalized, 2. Disclosure of CRSV is a dialogical and iterative process, 3. The process of (non‐)disclosure is a negotiation of agency, 4. Disclosure of CRSV affects the survivor’s psychoemotional state, and 5. Disclosure and recovery are interdependent processes. Additionally, seven categories describing barriers to and facilitators of male disclosure were extracted: 1. trauma characteristics, 2. survivor variables, 3. clinician variables, 4. interpreter variables, 5. interpersonal variables, 6. contextual variables, and 7. sociocultural variables. Clinical experts emphasize the effectivity of a gender‐specific communicative taboo for male refugee survivors that intersect with socio‐cultural norms. Variables characterizing survivors who are at risk of not disclosing CRSV are identified. A discussion of clinical approaches to address the taboo surrounding CRSV and to support male refugee survivors in agentic disclosure and recovery is provided.

1171 The need for mental health screening and care at a high-risk fourth trimester clinic

1171 The need for mental health screening and care at a high-risk fourth trimester clinic

Unmet need for primary health care and subsequent inpatient hospitalisation in Aotearoa New Zealand. A cohort study.

Introduction The inability to afford a consultation with a general practitioner may lead to delays in accessing care pathways. Aim This study aimed to explore the characteristics of people by their unmet need for a general practitioner consultation because of cost, and the characteristics of subsequent inpatient hospitalisations. Methods From the New Zealand Health Surveys (2013/14-2018/19), two groups were formed based on their unmet need for a general practitioner consultation due to cost. These groups were compared by socio-demographic factors and subsequent inpatient hospitalisation characteristics during follow-up. Time to an inpatient hospitalisation was the outcome in a proportional hazards regression model with need status as the key variable. The model was expanded to include confounding variables: sex, age group, ethnicity, the New Zealand Deprivation Index and self-rated health. Results The need group, characterised by having a higher proportion of females, younger adults, Māori, increased socioeconomic deprivation and poorer self-rated health experienced a greater chance of hospitalisation, a similar number of visits during follow-up, shorter stays and a quicker time to hospitalisation compared to the no-need group. Proportional hazards survival models gave a 28% higher hazard rate for the time to an inpatient hospitalisation for the need group compared to the no-need group. The inclusion of all the confounders in the model gave a similar hazard ratio. Discussion Although consultation fees vary across general practices, it is evident that this may not eliminate the cost barriers to accessing care for some groups. Needing multiple consultations may contribute to persistent unmet needs.

Recent racial/ethnic disparities in cancer-specific mortality among patients diagnosed with rectal cancer.

African American patients frequently receive nonstandard treatment and demonstrate poorer overall survival (OS) outcomes compared to White patients. Our objective was to analysis whether racial/ethnic disparities in rectal cancer-specific mortality remain after accounting for clinical characteristics, treatment, and access-to-care-related factors. Individuals diagnosed with rectal cancer between 2011 and 2020 were identified using the Surveillance, Epidemiology, and End Results Database. The cumulative incidence of rectal cancer-specific mortality was computed. Sub-distribution hazard ratios (sdHRs) and 95% confidence intervals (CIs) for rectal cancer-specific mortality associated with race/ethnicity were estimated using Fine and Gray model with stepwise adjustments for clinical characteristics, treatment modalities, and factors related to access-to-care. Among 54,370 patients, non-Hispanic (NH) Black individuals exhibited the highest cumulative incidence of rectal cancer-specific mortality (39%), followed by American Indian/Alaska Native (AI/AN) (35%), Hispanics (32%), NH-White (31%), and Asian/Pacific Islander (API) (30%). After adjusting for clinical characteristics, NH-Black patients had a 28% increased risk of rectal cancer mortality (sdHR, 1.28; 95% CI: 1.20-1.35) compared to NH-White patients. In contrast, mortality disparities between Hispanic-White, AI/AN-White, and API-White groups were not significant. The Black-White mortality differences persisted even after adjustments for treatment and access-to-care-related factors. In stratified analyses, among patients with a median household income below $59,999, AI/AN patients showed higher mortality than NH-Whites when adjusted for clinical characteristics (sdHR, 1.32; 95% CI: 1.03-1.70). Overall, the racial/ethnic disparities in rectal cancer-specific mortality were largely attributable to differences in clinical characteristics, treatment modalities, and factors related to access-to-care. These findings emphasize the critical need for equitable healthcare to effectively address and reduce the significant racial/ethnic disparities in rectal cancer outcomes.

Primary care-based screening and recruitment for an adolescent depression prevention trial: Contextual considerations during a youth mental health crisis.

Rising rates of adolescent depression in the wake of COVID-19 and a youth mental health crisis highlight the urgent need for accessible mental healthcare and prevention within primary care. Digital mental health interventions (DMHIs) may increase access for underserved populations. However, these interventions are not well studied in adolescents, nor healthcare settings. The purpose of this study was to identify barriers and facilitators to screening and recruitment activities for PATH 2 Purpose (P2P): Primary Care and Community-Based Prevention of Mental Disorders in Adolescents, a multi-site adolescent depression prevention trial comparing two digital prevention programs within four diverse health systems in two U.S. states. This qualitative study is a component of a larger Hybrid Type I trial. We conducted semi-structured key informant interviews with clinical and non-clinical implementers involved with screening and recruitment for the P2P trial. Informed by the Consolidated Framework for Implementation Research (CFIR), interviews were conducted at the midpoint of the trial to identify barriers, facilitators, and needed adaptations, and to gather information on determinants that may affect future implementation. Respondents perceived the P2P trial as valuable, well aligned with the mission of their health systems. However, several barriers were identified, many of which stemmed from influences outside of the healthcare settings. Universal and site-specific outer setting influences (COVID-19 pandemic, youth mental health crisis, local community conditions) interacted with Inner Setting and Innovation domains to create numerous challenges to the implementation of screening and recruitment. Our findings emphasize the need for ongoing, comprehensive assessment of dynamic inner and outer setting contexts prior to and during implementation of clinical trials, as well as flexibility for adaptation to unique clinical contexts. The CFIR is useful for assessing determinants during times of rapid inner and outer setting change, such as those brought on by the COVID-19 pandemic, youth mental health crisis, and the corresponding exacerbation of resource strain within healthcare settings. PATH 2 Purpose: Primary Care and Community-Based Prevention of Mental Disorders in Adolescents https://www.clinicaltrials.gov/study/NCT04290754.

Association between gingivitis, tooth loss and cardiovascular risk: Insights from a 10-year nationwide cohort study of 3.7 million Koreans.

While studies have suggested an association between periodontal disease and an increased risk of cardiovascular disease, the strength of this association and its specific links to various types of cardiovascular disease have not been thoroughly investigated. This study aimed to examine how gingivitis and tooth loss affect cardiovascular diseases, probing their individual impacts. A retrospective cohort study was conducted, encompassing 3,779,490 individuals with no history of cardiovascular disease, utilizing data from the National Health Examination and the Korean National Health Insurance database from 2006 to 2019. Cox proportional hazards models were applied to estimate the association between tooth loss, gingivitis, and cardiovascular disease. Following a median follow-up of 10.38 years, 17,942 new cardiovascular disease cases were identified, comprising 10,224 cases of angina pectoris, 6,182 cases of acute myocardial infarction, and 9,536 cases of stroke. It was observed that the risk of stroke was significantly higher in the tooth loss group compared to the control group (adjusted hazard ratio [aHR]: 1.09, 95% confidence interval [CI]: 1.04-1.15). In the group with gingivitis and tooth loss, the risk of stroke and cardiovascular disease was significantly higher than in the control group (aHR: 1.12, 95% CI: 1.04-1.20; aHR: 1.08, 95% CI: 1.03-1.14). The gingivitis group exhibited a higher risk associated with stroke (aHR: 1.05, 95% CI: 1.01-1.10) among individuals aged 50 and above. However, statistically significant associations between periodontal disease and angina pectoris were not observed, nor between periodontal disease and acute myocardial infarction except among those aged above 50. Furthermore, the association between periodontal disease and cardiovascular disease was found to be stronger among individuals over the age of 50, males, those with obesity, and smokers compared to the control group. Our results emphasize the association of tooth loss and gingivitis with cardiovascular disease, specifically stroke, underlining the critical need for preventive oral healthcare. Tailored interventions are necessary to reduce the heightened risk of cardiovascular disease events, especially stroke, among older, obese individuals and smokers.

Prevalence and Factors Associated with Malnutrition and Hypertension among University Students in Southwest Nigeria

Background: Malnutrition and hypertension are widespread among university students, with dietary habits and sedentary lifestyles playing significant roles. This study aimed at determining the prevalence and factors linked to malnutrition and hypertension in Southwest Nigeria’s university population. Methods: Conducted from January 2018 to December 2022, a cross-sectional study was undertaken at Lead City University in South-West Nigeria. Medical records of 5110 enrolled students were analyzed to assess the prevalence and factors associated with malnutrition and hypertension within the university population. Data encompassing demographic information and health metrics were examined for this study. Results: A study of 5110 participants, mean age (23.57+14.89), female sex (54.1%), blood group O prevalence (53.6%), Rhesus negative (4.9%), and genotype AA prevalence (73.6%). The average weight was 67.17+ 15.18 kg and height of 1.67+ 0.93 meters. Hypertension prevalence was at 8.7%, while malnutrition is 42.7%. Among the participants, 3% were anemic while the mean systolic and diastolic blood pressure were 115.93+15.26 and 73.52+17.43 respectively. Male sex was significant factor in hypertension and malnutrition (p &lt; 0.001). PCV levels lack significant associations, while BMI categories strongly correlate with hypertension (p &lt; 0.001). Discussion: The demographic profile reveals a youthful population vulnerable to behaviors impacting long-term health. With malnutrition prevalence at 47.2%, significant health concerns arise, while the relatively low hypertension rate of 8.7% is promising but requires ongoing monitoring. Age is a notable risk factor for hypertension, stressing targeted interventions for older adults. Sex disparities highlight the need for sex-specific healthcare. Blood group, Rhesus factor, and genotype lack significant associations with hypertension, while hypertension prevalence varies across packed cell volume levels. BMI strongly links to hypertension, highlighting obesity management’s importance. Conclusion: Understanding demographic factors and health metrics is crucial for developing effective interventions to address malnutrition and hypertension risks within populations.