1.Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population.
Jiang Ming FAM ; Chun Yuan KHOO ; Yee How LAU ; Weng Kit LYE ; Xinzhe James CAI ; Lina Hui Lin CHOONG ; John Carson ALLEN ; Khung Keong YEO
Singapore medical journal 2021;62(6):300-304
INTRODUCTION:
There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society.
METHODS:
A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years.
RESULTS:
274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE.
CONCLUSION
Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.
2.Challenges, Attitudes and Skills of Occupational Therapists towards Pre-Driving Assessments Practices in Malaysia (Cabaran, Sikap Dan Kemahiran Ahli Terapi Cara Kerja Terhadap Amalan Penilaian Pra-Pemanduan Di Malaysia)
YUAN HUI LAU ; RASDI MOHD HANIF FARHAN ; HARUN BINTI DZALANI ; XUN YUN CHANG
Malaysian Journal of Health Sciences 2022;20(No.1):139-149
A pre-driving assessment usually involves standardised and non-standardised tests to examine the skills for safe driving
of people with disabilities. However, it is still unknown to what extent the pre-driving assessments are being practised
among occupational therapists in Malaysia. Therefore, this study aims to investigate the association of challenges,
attitudes, and skills of occupational therapists towards practising driving rehabilitation and explore the most used predriving assessment. A cross-sectional study had been conducted from July to September 2020. The convenient sampling
method was used to recruit experienced occupational therapists in driving rehabilitation. A total of 53 therapists had
completed an online survey. According to the results, the bivariate correlation between skills and challenges was positive
and strong (rѕ = 0.680, p < 0.05). A multivariate analysis of variance (MANOVA) indicated that workplace variables
had a significant effect on the combined dependent variables of challenges, attitudes, and skills, F(3,49) = 4.521 p =
0.007, partial Ƞ² = 0.217. This study found that the most used standardised assessment was the range of motion (n = 39,
73.6 %) and the right and left discrimination (n = 40, 75.5 %). The findings of this study identified that occupational
therapists challenges and attitudes are significantly associated with the skills to practice driving rehabilitation.
Malaysian occupational therapists working in the government sector reported better skills than those working in the
private sector. Furthermore, numerous types of pre-driving assessments were used and vary from setting to setting. This
study hopes to benefit occupational therapists and related rehabilitation practitioners towards a holistic understanding
of Malaysia's driving rehabilitation practices.
3.Driving Rehabilitation by Occupational Therapists in Malaysia: What are the Current Practices? (Pemulihan Pemanduan oleh Ahli Terapi Cara Kerja di Malaysia: Apakah Amalan Semasa?)
YUN XUN CHANG ; HANIF FARHAN MOHD RASDI ; DZALANI HARUN ; HUI YUAN LAU ; WEN XIN LIM
Malaysian Journal of Health Sciences 2022;20(No.2):129-137
Occupational therapists have a significant role in driving rehabilitation by helping clients with disabilities to return to
driving. To date, the services for driving rehabilitation are still limited in Malaysia. Furthermore, the current practice
of driving rehabilitation in Malaysia is still underreported. Therefore, this study aims to assess occupational therapists’
challenges, attitudes, and skills towards driving rehabilitation, the sociodemographic differences, and associations
between the developed constructs. A cross-sectional study was conducted from June to September 2020. A convenience
sampling method was used to recruit 177 occupational therapists with at least one year of working experience in
Malaysia. The questionnaire consists of three constructs: the challenges, attitudes, and skills related to driving
rehabilitation. The content validity of the questionnaire was good (S-CVI/Ave= 0.992; S-CVI/UA= 0.950; modified
kappa= 0.812 to 1.000). Based on the Exploratory Factor Analysis (EFA), three items had been deleted due to low
communalities. The Cronbach’s alpha for all constructs was acceptable (Cronbach’s alpha > 0.7). Experience in
practicing driving rehabilitation, workplace settings, and educational level had significant differences in at least one of
the constructs. Age and years graduated had a significant positive correlation with skills. This questionnaire proved to
be a tool with good content validity and reliability to assess occupational therapists’ challenges, attitudes, and skills
related to driving rehabilitation. In the future, qualitative studies are recommended to better understand the occupational
therapists towards driving rehabilitation, especially from their personal experience.