Core competencies to prevent and control chronic diseases of Tambol Health Centers' head in Thailand.

OBJECTIVE: To assess the core competencies to prevent and control chronic diseases of the head of Tambol Health Centers (THC) in Thailand. MATERIAL AND METHOD: This cross-sectional survey research was carried out with 2,049 heads of THC from the total population of 9,985. The samples were selected randomly from all provinces of every region. The data were collected through mail questionnaires and the reliability values of the three competency domains questionnaire were found to be between 0.75-0.93. Data analysis was done by computing frequency, percentage, arithmetic mean, Independent's t-test and One-way ANOVA. RESULTS: The total core competency values of prevention and control of diabetes and hypertension of the THC heads were found at the high and moderate level (3.0% and 78.7%) respectively The similar finding was found in the competency domains in regard to "personal attribution", "intellectual capacity" while 8.0 percent and 46.2 percent of the respondents had the high and moderate level of "work skill" domain respectively. In addition, the differences of competency domains were found in accordance with the regions where the THC located, ability to develop a plan for disease prevention and readiness for changing behaviors of the risk groups. But the personal attributions with regard to gender age, family's economic status, and the location of the THC were not found to affect every competency domain. Except for the intellectual capacity domain found that the male THC heads had the higher level than the females and work skill domain of those THC heads working in the municipal areas had the higher level than those who worked outside the municipal areas. CONCLUSION: Core competencies of the heads of THC in chronic disease prevention and control were found at the "somewhat good" level except for the work skill domain which needed to be developed. Thus, the Ministry of Public Health should establish a specific policy and strategy on human resource development by using core competencies on chronic disease prevention and control as the core performance indicators.

Cigarette consumption among foreign tourists in Thailand.

OBJECTIVE: To explore the cigarette consumption among foreign tourists in Thailand. MATERIAL AND METHOD: The data in this cross-sectional survey is collected by interviewing 655 foreign tourist smokers with questionnaires in congested areas including Suvarnabhum International Airport, Khao San Road, shopping centers and tourist attraction sites. The data was collected in October, 2010, analyzed by descriptive statistic and the crude magnitude of cigarette consumption was calculated. RESULTS: The findings indicated that 62.9% of tourists were male and 58.9% were from European countries and 22.7% were from Asian countries. 59.2% smoked cigarettes sold in Thailand and were taxed legally. In that amount, 55.7% smoked imported cigarettes and only 3.5% smoked Thai cigarettes. 40.8% had brought cigarettes from their countries or bought cigarettes from Duty Free shops with the amount allowed by Thai law. The top 2 popular brands were Marlboro and L&M. The main reason why they bought imported cigarettes in Thailand was that the price was cheaper or the same when compared with that in their countries. The cigarette consumption share crudely calculated was around 8.90 million packs. CONCLUSION: Foreign tourists smoked imported cigarettes distributed in Thailand and cigarettes brought from abroad. So, Free Trade Agreement in bilateral level or multilateral level need to be reviewed and should separate cigarettes from other goods. The tax barrier excise tax measure and permission law of carrying in 200 sticks should be reviewed in order to control cigarette consumption effectively.

The Effects of Foot Reflexology for Smoking Cessation on Brain Activities with Functional Magnetic Resonance Imaging (fMRI): A Pilot Study.

Background: Foot reflexology is a treatment with the hypothesis that such massage stimulation on the feet may cause a therapeutic effect which should be helpful for smoking cessation. However, its mechanism of action in the brain of smoking people remains unknown. Functional magnetic resonance imaging (fMRI) is helpful for real-time brain activity detection. We aim to compare the brain activity effects of foot reflexology with fMRI between smoking and nonsmoking subjects. Materials and Methods: We divided participants into experimental (smokers) and control groups (nonsmokers). Both groups received similar foot reflexology under the fMRI examination. Then, we compared the mean response score in each brain area before and after foot stimulation among groups and between groups. Results: Five nonsmokers and fifteen smokers had completed the study. All participants were right-handed males, with a mean age of 38.6 years. The fMRI brain response in the areas correlated with foot stimulation, including the precentral gyrus of the frontal lobe and the postcentral gyrus of the parietal lobe, was present for all participants. The fMRI response outside the correlated area, including other parts of the frontal and parietal lobes, the temporal and occipital cortices, and the thalamus, was also found in all participants, but was not consistent. Conclusions: The fMRI of the brain is feasible and safe for demonstrating foot reflexology reactions. The response signal outside the correlated motor-sensory cortical area with foot reflexology may have clinical significance and may be helpful for smoking cessation. We suggest conducting a large-scale, randomized controlled trial to confirm these findings.

Smoking prevalence among monks in Thailand.

Previous studies among Buddhist monks in Thailand have reported smoking rates to be as high as 55%. Because 95% of Thais are Buddhist, monks are highly influential in establishing normative behavioral patterns. As the first population-based study on smoking among Buddhist monks in Thailand, this study aims to determine the smoking prevalence in six regions of the country, and to examine smoking knowledge, risk perceptions, behaviors, and associated demographics among full-fledged and novice monks (n = 6,213). Results demonstrated that the overall prevalence for current smoking monks is 24.4% (95% confidence interval [24.453, 24.464]), with regional differences ranging from 14.6% (North) to 40.5% (East). Findings suggest that integrating prevention and cessation programming into religious courses may be one avenue for reaching many incoming monks. Further, involving monks in tobacco control education and setting a nonsmoking standard among them is vital to the success of reducing smoking rates among the general population in Thailand.