ABSTRACT
INTRODUCTION: Metabolic syndrome (MetS) is one contributing factor to cardiovascular diseases (CVD). Although there have been several reports showing MetS to be a risk factor for CVD, there are limited data available on which of the diagnostic criteria for MetS carries the greatest risk for CVD in the elderly population. This study thus aimed to evaluate these criteria in terms of risk of CVD in this population. METHODS: This was a retrospective cohort study conducted at three referral hospitals in Thailand. The study period was between January 1, 2007 and December 31, 2016. Eligible patients were identified whether presence of MetS or not at the beginning of study and followed until the end of study. The primary outcome of study was presence of CVD. Predictors for CVD were analyzed by Cox proportional-hazards regression. RESULTS: During the study period, there were 1080 patients who met the study criteria, 253 (23.42%) of whom had CVD. There were five factors significantly associated with CVD occurrence including age, smoking, SBP, FPG, and HDL-c. The two factors with the highest adjusted hazard ratio were FPG and SBP at 2.92 and 2.34, respectively. CONCLUSIONS: The three MetS criteria including SBP, FPG, and HDL-c may be predictors for cardiovascular diseases in elderly populations. Physician may need to focus on these particular factors of MetS in terms of CVD prevention in elderly patients.
ABSTRACT
BACKGROUND: There is growing evidence that the number of substance abusers have increased. Use of public health surveillance system in substance abuse at the community level is limited. OBJECTIVE: Study and develop a suitable Model for Substance Abusing Surveillance System (MSASS) in communities. MATERIAL AND METHOD: Thirty-eight volunteers, including five direct responsible officers, five local leaders, five people representatives and four university specialists participated in the development of the model. The present study utilized ten sets of database, reported on a monthly basis. These included substance abuse arrested cases, substance abuse treatment seekers, anonymous notification of drug abuse, notification of obstacles and problems of the responsible organizations and notification of substance abuse by the local community leaders. The seven approaches of the model included situational analysis, prototype design, trial test, system design, system running test, model improvement and model dissemination. The study was conducted in 47 communities in four sub-districts in Phakdichumphon District, Chaiyaphum Province. RESULTS: The MSASS model application was created at the community level. The model assessed and monitored substance abuse practices of population aged 12 to 65 years and triggered prevention and control actions in communities. The five important constituents of the model were 1) organizations of substance abuse networks, 2) indicators of substance abuse situations, 3) criteria for investigation of magnitude of the problems, 4) data collection tools and 5) dissemination of information. The model comprised of six core activities (detection, registration, confirmation, reporting, analysis and feedback) and four support activities (communication through meeting and brainstorming, training, supervision and resource-provision). After one year the authors were able to develop indicators and criteria for measuring magnitude of the substance abuse problems. The current developed MSASS was effective in terms of representativeness (93.0%), sensitivity (92.7%), timeliness (84.7%), prediction ability (84.5%), acceptability (82.5%), simplicity (82.5%) and validity (80.3%). CONCLUSION: The developed MSASS is an effective form of public health surveillance suitable for communities at a district level.
