Determinants for Healthy Lifestyle of Patients with Familial Hypercholesterolaemia

Lifestyle modification is a pivotal intervention for Familial Hypercholesterolaemia (FH). This study aims to describe the lifestyles (physical activity and healthy diet) and their associations with sociodemography, illness characteristics, psychological elements, family support and level of barrier. 100 participants were given Pro forma questionnaires to assess sociodemography and illness characteristics. The lifestyles, psychological elements, family support and level of barrier were assessed using the Theory of Planned Behaviour questionnaire. The determinants of healthy lifestyles include the status of receiving treatment, level of barrier and intention for behavioural change. The findings may inform the strategy for lifestyle modification of FH patients.Keywords: Familial Hypercholesterolaemia; lifestyle; physical activity; healthy diet.eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/ebpj.v5i14.233

Determining Predictors of Depression and Anxiety for Prevention of Common Mental Illness among Staff of an Academic Institution in Malaysia

The Adopt-A-Park Programme has Information on depression, anxiety and predictors for these mental illnesses among the staff of the academic institution is sparse. Hence, this study aimed to determine the prevalence of these mental illnesses and investigate possible predictors. Depression, Anxiety and Stress Scale 21-item and pro forma questionnaires were used to assess the presence of depression, anxiety, sociodemographic, personal and job-related factors. Of 278 participants, 27.7% had depression, and 26.7% had anxiety. Predictors for depression include inadequate workplace facilities, low-tier job category, working in urban campus and low income. Predictors for clinical anxiety were high workplace responsibility and low-tier job category. Keywords: Depression; Anxiety; Academic Institution; Staff 2398-4279 © 2019 The Authors. Published for AMER ABRA CE-Bs by E-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.  DOI: https://doi.org/10.21834/ajqol.v4i17.19

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Illness Perception of Patients with Familial Hypercholesterolaemia varies with Level of Education and Presence of Cardiovascular Disease

Illness perception determines the healthy lifestyle of patients with Familial Hypercholesterolaemia (FH).  Despite the availability of advanced treatment and preventive measures, there is still sparse data on illness perception of FH patients. Hence, this study aimed to describe the illness perception of FH patients and investigate its association with sociodemographic and illness-related factors. 100 FH patients were assessed using Pro forma questionnaires and revised illness perception questionnaire (IPQ-R). Illness perception of FH patients varies according to the level of education and the presence of cardiovascular disease (CVD). These findings may help clinicians to improve the interventions suitable for FH patients.  Keywords: Familial hypercholesterolaemia; illness perception; sociodemography; cardiovascular diseaseeISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i10.162

Quality of Life and Its Contributing Factors in Patients with Familial Hypercholesterolaemia in Malaysia

Familial hypercholesterolaemia (FH) causes severe complications including cardiovascular diseases (CVDs) and stroke, leading to poor quality of life (QoL). Despite the availability of advanced treatment, data on QoL and its contributing factors is sparse. Hence, this study aimed to describe the pattern of QoL among FH patients and investigate its association with sociodemographic factors and illness characteristics. Hundred FH patients were assessed using Pro forma questionnaires and World Health Organization QoL questionnaire (WHOQOL-BREF). Significant contributing factors including level of education, income, and the presence and type of CVDs. These findings may help to inform more effective interventions for FH patients.   Keywords: Familial hypercholesterolaemia; quality of life; sociodemography; cardiovascular diseaseeISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i10.162

Depression and Its Contributing Factors: A study among staff of an academic institution in Malaysia

Information on depression and its contributing factors among the staff of the academic institution is sparse. Hence, this study aimed to determine the prevalence of depression among them and investigate its contributing factors. We used the Depression, Anxiety and Stress Scale 21-item and pro forma questionnaires to assess the presence of depression, sociodemographic factors, personal factors and job-related factors. Of 278 participants, 27.7% had clinical depression. Contributing factors include inadequate workplace facilities, low-tier job category, working in urban campus and low income. Addressing factors underpin depression among staff in the academic institution is crucial to ensure early interventions can be offered.Keywords: Depression; Academic Institution; Workers; Contributing FactorseISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.1894

Delta- and gamma-tocotrienol isomers are potent in inhibiting inflammation and endothelial activation in stimulated human endothelial cells

Background: Tocotrienols (TCTs) are more potent antioxidants than α-tocopherol (TOC). However, the effectiveness and mechanism of the action of TCT isomers as anti-atherosclerotic agents in stimulated human endothelial cells under inflammatory conditions are not well established. Aims: 1) To compare the effects of different TCT isomers on inflammation, endothelial activation, and endothelial nitric oxide synthase (eNOS). 2) To identify the two most potent TCT isomers in stimulated human endothelial cells. 3) To investigate the effects of TCT isomers on NFκB activation, and protein and gene expression levels in stimulated human endothelial cells. Methods: Human umbilical vein endothelial cells were incubated with various concentrations of TCT isomers or α-TOC (0.3–10 µM), together with lipopolysaccharides for 16 h. Supernatant cells were collected and measured for protein and gene expression of cytokines (interleukin-6, or IL-6; tumor necrosis factor-alpha, or TNF-α), adhesion molecules (intercellular cell adhesion molecule-1, or ICAM-1; vascular cell adhesion molecule-1, or VCAM-1; and e-selectin), eNOS, and NFκB. Results: δ-TCT is the most potent TCT isomer in the inhibition of IL-6, ICAM-1, VCAM-1, and NFκB, and it is the second potent in inhibiting e-selectin and eNOS. γ-TCT isomer is the most potent isomer in inhibiting e-selectin and eNOS, and it is the second most potent in inhibiting is IL-6, VCAM-1, and NFκB. For ICAM-1 protein expression, the most potent is δ-TCT followed by α-TCT. α- and β-TCT inhibit IL-6 at the highest concentration (10 µM) but enhance IL-6 at lower concentrations. γ-TCT markedly increases eNOS expression by 8–11-fold at higher concentrations (5–10 µM) but exhibits neutral effects at lower concentrations. Conclusion: δ- and γ-TCT are the two most potent TCT isomers in terms of the inhibition of inflammation and endothelial activation whilst enhancing eNOS, possibly mediated via the NFκB pathway. Hence, there is a great potential for TCT isomers as anti-atherosclerotic agents