Cardiovascular risk prediction with cardio-ankle vascular index in the malaysian cohort study

The cardio-ankle vascular index (CAVI) is an important parameter assessing arterial function. It reflects arterial stiffness from the origin of the aorta to the ankle, and the algorithm is blood pressure independent. Recent data have suggested that a high CAVI score can predict future cardiovascular disease (CVD) events; however, to date, no study has been done in Malaysia. We conducted a prospective study on 2,168 The Malaysian Cohort (TMC) CVD-free participants (971 men and 1,197 women; mean age 51.64 ± 8.38 years old) recruited from November 2011 to March 2012. This participants were followed-up until the emergence of CVD incidence and mortality (endpoint between May to September 2019; duration of 7.5 years). Eligible participants were assessed based on CAVI baseline measurement which categorised them into low (CAVI <9.0) and high (CAVI ≥ 9.0) scores. The CVD events in the group with high CAVI (6.5 %) were significantly higher than in the low CAVI (2.6 %) group (p < 0.05). CAVI with cut-off point ≥ 9.0 was a significant independent predictor for CVD event even after adjustment for male, ethnicity, age, and intermediate atherogenic index of plasma (AIP). Those who have higher CAVI have 78 % significantly higher risk of developing CVD compared to those with the low CAVI (adjusted OR [95 % CI] = 1.78 [1.04 - 3.05], p =0.035). In addition, the participants with higher CAVI have significantly lower survival probability than those who have lower CAVI values. Thus, this study indicated that the CAVI can predict CVD event independently among the TMC participants.

Public opinions and gender issue

OBJECTIVE

Gender is an aspect of the natural identity of a person that has been given ample attention in socio-cultural, psychological, and political studies worldwide. Transgender, which is a part of gender issues, is still lacking in information on definitions of transgender, its causes, society's perceptions toward it, and interpretations on transgender action. Transgender is an umbrella term that describes people whose gender identity or expression does not match the sex they have been assigned at birth. It is one of the most important signs of progress produced by scientific advancement in the field of medicine, which is a relatively new phenomenon. Due to the lack of research on transgender, researchers study this issue at the theoretical and public opinion levels and from different perspectives. The objectives are to provide insights into the landscape of gender issues, instill awareness among communities and make them understand the psychological pains and the emotional difficulties that the transgender go through. Transgender issues must be analyzed from the perspectives of humanity, ethics, and culture.

MATERIALS AND METHODS

Data were gathered through open-ended interviews among nine participants. And to complement the data, particularly about the public's opinions toward the transgender, a focus group discussion (FGD) was held among four participants.

RESULTS

The findings indicate that the transgender community often faces social discrimination due to the social stigma towards them. Thus, the treatment should be more on psychological therapies, family education, community awareness, and social activism that are needed to realign the transgender to the right track.

CONCLUSIONS

This study provides insights into the landscape of gender equality and ways to support those with gender identity issues. Hence, this research carries values to the Sustainable Development Goals (SDG) in enhancing the policy on gender equality.

An action research on promotion of healthy ageing and risk reduction of chronic disease: a need assessment study among rural elderly Malays, care givers and health professionals

OBJECTIVE

Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process.

DESIGN

A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects.

RESULTS

It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects.

CONCLUSION

Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays.