Inclusion of Social Work in Comprehensive Palliative Care to Address Psychosocial Needs of Advanced Cancer Patients in Vietnam.

The need for psychosocial care among patients with serious illnesses and available social work services continues to be great, especially in low- and middle-income countries. To evaluate the specific needs of Vietnamese cancer patients' quality of life (QOL), prevalence and severity of symptoms including depression and anxiety, and caregiver burden were assessed. Data on QOL, mood, caregiver burden, and other parameters were collected through face-to-face and phone- interviews. The QOL assessed by European Quality of Life scale version 5D (EQ5D) was poor but consistent with other studies of cancer patients. Assessed by the Hospital Anxiety and depression Scale (HADS), borderline or severe anxiety and depression were prevalent. Caregiver burden was high for one third of study participants. These results confirm the need among cancer patients for psycho-social support services that currently are rarely available in Vietnam. In light of this need, a comprehensive palliative care (CPC) service, including social work, was created to improve the quality of life (QOL) of Vietnamese cancer patients.

Sleep duration and risk of high blood pressure in Thai adolescents: the Thai National Health Examination Survey V, 2014 (NHES-V).

BACKGROUND: Sleep duration has been proposed to be associated with high blood pressure. However, nationwide studies regarding this association in adolescents remain limited. This study aimed to explore the national prevalence of high blood pressure among Thai adolescents and to determine the association between sleep duration and high blood pressure. METHODS: Data from adolescents aged 10-19 years from the Thai National Health and Examination Survey V were included. We collected demographic data (including age and gender), height, weight, waist circumference, blood pressure, fasting blood chemistries and sleep duration data. Sleep durations were categorized as short, normal or long for each age group based on the United States National Sleep Foundation's recommendations. High blood pressure was diagnosed using the 2017 guidelines of the American Academy of Pediatrics. Factors associated with high blood pressure were analyzed using multivariate logistic regression. RESULTS: A total of 3505 adolescents (1785 female) were included. The prevalence of high blood pressure was 9.4% (95% CI 8.5-10.4%). The high blood pressure group had higher BMI z-score, LDL-C, triglyceride and lower HDL-C than the normotensive group. In the multivariate analysis, BMI z-score, LDL-C and HDL-C were independently associated with high blood pressure. However, there was no association between sleep duration and high blood pressure. CONCLUSIONS: High blood pressure risk was increased in adolescents with high BMI z-score. Neither short nor long sleep duration was associated with an increased risk of high blood pressure.

Metabolic syndrome in Thai adolescents and associated factors: the Thai National Health Examination Survey V (NHES V).

BACKGROUND: Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outcome later in adulthood. There is limited data regarding MetS among Thai adolescents. This study aimed to estimate the prevalence of MetS and related factors in Thai adolescents. METHODS: Data on MetS components of 1934 Thai adolescents aged 10-16 years were obtained from the 5th National Health Examination Survey. Age at first screen time exposure, duration of screen time, frequency of food intake and physical activities were collected from interviews. MetS was defined according to 3 definitions: International Diabetes Federation (IDF), Cook's, and de Ferranti's. RESULTS: The prevalence of MetS was 4.1% by IDF, 8.0% by Cook's, and 16.8% by de Ferranti's definition. The overall prevalence was higher in male (19.0%) than female adolescents (15.3%). The most common MetS components composition among Thai adolescents was high waist circumference with high serum triglyceride and low HDL-cholesterol (40.0% for IDF, 22.6% for Cook's and 43.5% for de Ferranti's definition). Exposure to screen media during the first 2 years of life had a 1.3- fold increased odds of MetS by 1 out of 3 definitions (OR 1.30, 95% CI. 1.01-1.68). Duration of physical activity associated with decreased odds of MetS by Cook's definition (OR 0.96, 95% CI. 0.92-0.99). CONCLUSIONS: The prevalence of MetS among Thai adolescents was higher than previously reported by other studies. Screen media exposure during the first 2 years of life should be discouraged and measures to promote physical activity among children and adolescents should be strengthen.

Socio-economic inequalities in the association between alcohol use disorder and depressive disorder among Thai adults: a population-based study.

BACKGROUND: Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups. METHODS: We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged > 20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0-7), hazardous drinking (score 8-15), and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels. RESULTS: The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5, 10.3, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR = 8.68, 95% CI: 5.34, 14.11) and lowest (AOR = 7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR = 1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR = 16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR = 1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR = 8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR = 4.73, 95% CI: 3.31, 6.77). CONCLUSION: Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.

A Comparative of Ginger Extract in Nanostructure Lipid Carrier (NLC) and 1% Diclofenac Gel for Treatment of Knee Osteoarthritis (OA).

Objective: To compare and evaluate the efficacy of ginger (Zingiber officinale Roscoe) extracts in NLC for treatment of osteoarthritis of knee compared to 1% diclofenac gel as an active control. Material and Method: One hundred twenty patients age 50 to 75 years with OA knee, based on the American College of Rheumatology (ACR) criteria were randomized into two groups receiving ginger extracts in NLC and control 1% diclofenac gel for 12 weeks. The efficacy of treatment was monitored at 4, 8, and 12 weeks by using the WOMAC composite index and the Patient Global Assessment (PGA). The t-test was used to compare the mean scores at baseline in each group. Repeated ANOVA was used to compare the mean scores, and Chi-square test was used to compare the dichotomous variables between the two groups at 4, 8, and 12 weeks. Results: One hundred eighteen participants completed the study and were included in the ITT efficacy analysis. Both ginger extract in NLC and diclofenac gel could significantly improve knee pain, stiffness, physical function, and PGA following 12 weeks of treatment. In the repeated ANOVA, there were no differences in the result between these two groups. The response rate for at least a 50% reduction in pain was significantly greater following Ginger extract in NLC treatment compared to topical diclofenac [40/59 (67.7%) vs. 27/59 (45.7%) p<0.05]. There were no significant adverse events. Conclusion: Ginger extract in NLC relieves pain, improves function, and improves the Patient Global Assessment in OA knee during a 12-week treatment.

Effectiveness Of A School-Based Multicomponent Intervention On Nutritional Status Among Primary School Children In Bangkok, Thailand.

BACKGROUND: Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adults and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thais is the 5th highest in Asia. The present study objective was to evaluate the effectiveness of a life-skills, multicomponent, school-based intervention on child nutritional status. METHODS: A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The interventions included education, diet, physical activity (PA), food-environment, school builtenvironment, and life-skills components. Subjects were measured at baseline and at 6 months post-treatment. RESULTS: The intervention group had significant differences in overall healthy practices (+1.5 mean difference, p=0.048), dietary habits, physical activity, lower total cholesterol (TC) levels (-2.43 mean, p=0.019) and higher high density lipoprotein cholesterol (HDL-C) levels (+4.06 p=0.028) as compared to the control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetables increased while consumption of high-caloric snacks and fast foods decreased in children after the intervention. CONCLUSIONS: This study indicated that a multidisciplinary approach in school-based interventions is most likely to be effective in preventing children from becoming overweight in the long term. More research should be conducted on school-based interventions with longer intervention periods and higher sustainability.

Lifestyle Change Plus Dental Care (LCDC) program improves knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus among the elderly with type 2 diabetes.

BACKGROUND: Currently, there is an increased prevalence of diabetes mellitus among the elderly. Chronic inflammation from diabetes mellitus effects glycemic control and increases risk of diabetes complications. OBJECTIVE: To assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program by improved knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus among the elderly with type 2 diabetes. MATERIAL AND METHOD: A quasi-experimental study was conducted in two Health Centers (HC 54 intervention and HC 59 control) between October 2013 and April 2014. Sixty-six diabetic patients per health center were recruited. At baseline, the intervention group attended a 20-minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing, application of self-regulation manual, and individual oral hygiene instruction. At 3-month follow-up, the intervention group received individual lifestyle counseling and oral hygiene instruction. The intervention group received booster education every visit by viewing a 15-minute educational video. The control group received the routine program. Participants were assessed at baseline, 3-month, and 6-month follow-up for knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus. Data was analyzed by using descriptive statistic, Chi-square test, Fisher's exact test, and repeated measure ANOVA. RESULTS: After the 6-month follow-up, repeated measure ANOVA analysis showed that participants in the intervention group had significantly higher knowledge and attitude toward oral health and diabetes mellitus. The participants in the intervention group were more likely to exercise, modify diet, have foot examinations, always wear covered shoes, participate in self-feet screening, use dental floss, and use inter-proximal brush than the control group with statistically significant differences. CONCLUSION: The combination of lifestyle change and dental care in one program improved knowledge, attitude, andpractice (KAP) toward oral health and diabetes mellitus in the elderly with type 2 diabetes. Trial registration: ClinicalTrials.in.th: TCTR20140602001.

Improving of Knee Osteoarthritic Symptom by the Local Application of Ginger Extract Nanoparticles: A Preliminary Report with Short Term Follow-Up.

OBJECTIVE: An evaluation ofthe efficacy and safety of Ginger (Zingiber officinale Roscoe) extract nanoparticlefor treatment of osteoarthritis (OA) of the knee. MATERIAL AND METHOD: Sixty patients at the age range of 50 to 75 years old who were diagnosed with OA knee based on the American College of Rheumatology (ACR) diagnosis criteria were included in the present study. Participants received ginger extract in Nanostructure Lipid Carrier (NLC) rubbed three times a day for 12 weeks. Efficacy was assessed by Knee Injury and Osteoarthritis Outcome Score (KOOS), Index of Severityfor Osteoarthritis (ISOA), and patient's global assessment (PGA). A series of biochemical tests in serum and hematological parameters were established the safety of ginger extract in NLC. The paired t-test was used to compare the score before and after treatment. The comparisons of baseline and the 4-, 8-, and 12-week used repeated ANOVA. RESULTS: Ginger .extract nanoparticles improved, with statistical significance, the patient's global assessment, knee joint pain, symptoms, daily activities, sports activities, and quality of life measured by KOOS, ISOA, andPGA, following 12 weeks of treatment (p<0.05). There were no safety issues, adverse events, or laboratory values. CONCLUSION: Ginger extract nanoparticles relieves joint pain and improves problematic symptoms and improves the quality of life in osteoarthritis knees during a 12-week treatment.

Energy and Macronutrient Intakes and Food Sources in Preschool Children: Thai NHES IV.

OBJECTIVE: Examine intakes of energy and macronutrients, and identify their food sources, in Thai preschool children. MATERIAL AND METHOD: Data from the Thai National Health Examination Survey (NHES) IV were used. Mothers/caregivers were interviewed regarding their children's 24-hour-dietary intake. Dietary data were analyzed for energy and macronutrients, and their food sources were investigated. Due to skewed data, Mann-Whitney U test was used to compare energy and macronutrient intake between sexes and age groups. RESULTS: Among 256 preschool children, more than 90% had protein intakes higher than the recommended level. Only 12.7 to 29.0% met the recommended intake for energy. Amounts of carbohydrate and fat consumed varied from below to above the Dietary Reference Intake (DRI) recommendation. Intakes of carbohydrate in boys and fat in girls were statistically different between age groups (p < 0.05). Fifty to 60% of energy came from dairy products, grains and starchy products. The major carbohydrate contributors were grains and starchy products. Dairy products were the main source of protein. Important food sources of fat were dairy products for one- to three-year-old children and fat and oils for four- to five-year-old children. CONCLUSION: Thai preschool children have inappropriate intakes of energy and macronutrients. Dairy products and grains and/or starchy products were the main sources of energy, carbohydrate, and protein. Dietary fat sources varied by age group.

Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes.

BACKGROUND: Currently, there is an increased prevalence of diabetes mellitus among the elderly. To minimize adverse effects on glycemic control, prevention and management of general and oral complications in diabetic patients is essential. The purpose of the present study is to assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program to improve glycemic and periodontal status in the elderly with type 2 diabetes. METHODS: A quasi-experimental study was conducted in Health Centers 54 (intervention) and 59 (control) from October 2013 to January 2014. 66 diabetic patients per health center were included. At baseline, the intervention group attended a 20 minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing (MI), application of self regulation manual, and individual oral hygiene instruction. The intervention group received booster education every visit by viewing a 15 minute educational video. The control group received a routine program. Participants were assessed at baseline and 3 month follow up for glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), periodontal status, knowledge, attitude and practice of oral health and diabetes mellitus. Data were analyzed by using descriptive statistic, Chi-square test, Fisher's exact test, t-test, and multiple linear regression. RESULTS: After the 3 month follow up, a multiple linear regression analysis showed that the intervention group was significantly negatively correlated in both glycemic and periodontal status. Participants in the intervention group had significantly lower glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), plaque index score, gingival index score, pocket depth, clinical attachment level (CAL), and percentage of bleeding on probing (BOP) when compared to the control group. CONCLUSIONS: The combination of lifestyle change and dental care in one program improved both glycemic and periodontal status in the elderly with type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.in.th: TCTR20140602001.

Sodium intake and socio-demographic determinants of the non-compliance with daily sodium intake recommendations: Thai NHES IV.

OBJECTIVE: To estimate daily intake of sodium and examine the relation of socio-demographic factors with sodium intake exceeding the recommendations. MATERIAL AND METHOD: Data from the Thai National Health Examination Survey IV (NHES IV) conducted during 2008-2009 were used. The 24-hour-dietary-recall data were available for a subsample of 10% of the total participants. All food and beverage data were analyzed for amount of total daily sodium intake for each person. In statistical analyses, descriptive statistics were employed to describe participants' characteristics, quantities of dietary sodium and percentages of participants noncompliant with daily sodium intake recommendations. Logistic regression was used to examine socio-demographic determinants of sodium intake exceeding the recommendations. RESULTS: 2,969 participants participated in this study. Sodium intake varied by socio-demographics. Percentages of participants non-compliant with sodium intake recommendations ranged from 75.3 (> or = 1,500 mg) to 52.0 (> or = 2,400 mg) for those aged < 16 years and from 86.3 (> or = 1,500 mg) to 67.6 (2,400 mg) for those aged > or = 16 years. In the younger group, age and region were key determinants of consuming sodium exceeding all recommendations. Having family income between 5,000 and < 10,000 baht/month was significantly associated with sodium intake exceeding recommendation targets. In the older group, being female and increasing age reduced a risk of non-compliance with some recommendations; oppositely, region and residential area participants lived significantly, increased non-compliant risk. CONCLUSION: Most participants consumed dietary sodium exceeding current recommendations. Effective programs to reduce sodium intake in Thais are critical.

The Effect of a Single Bout of Chinese Archery on Core Executive Functions in Preadolescent Children in Shanghai.

BACKGROUND: Recent literature has demonstrated that acute physical activity benefits the transfer of executive functions. However, further studies indicated the type of variability in the effect of physical activity on executive functions. Therefore, this study initially explored the effect of a single bout of Chinese archery on subdomains of core EFs in preadolescent children; Method: Eligible participants were allocated either an intervention group (n = 36) or a control group (n = 36). The subjects in the intervention group received a 45-min Chinese archery session. The primary outcomes were the performance of core EFs (inhibition control, working memory, and cognitive flexibility) in preadolescent children, assessed with psychological paradigms (Fish Flanker Task, N-Back Task, and DCCS (Border version), respectively). Paired t-test and ANCOVA were used to analyze the mean difference in the performance of core EFs within and between subjects, respectively; Results: Considering reaction time and accuracy, we explored the impressive performance in three cognitive tasks with acute Chinese archery; Conclusion: The finding suggests that a single bout of Chinese archery benefited three subdomains of core EFs in healthy preadolescent children.

A qualitative study of the reasons for low patient safety incident reporting among Indonesian nurses.

OBJECTIVES: to investigate the reasons for low patient safety incident reporting among Indonesian nurses. METHODS: this qualitative case study was conducted among 15 clinical nurses selected purposively from a public hospital in Lampung, Indonesia. Interview guidelines were used for data collection through face-to-face in-depth interviews in July 2022. The thematic approach was used to analyze the data. RESULTS: in this present study, seven themes emerged (1) Understanding incident reporting; (2) The culture; (3) Consequences of reporting; (4) Socialization and training; (5) Facilities; (6) Feedback; and (7) Rewards and punishments. FINAL CONSIDERATIONS: these findings should be considered challenges for the patient safety committee and hospital management to increase patient safety incident reporting, particularly among nurses in the hospital.

Higher milk consumption is associated with a lower risk of diabetes mellitus: A case-control study.

BACKGROUND & AIMS: Studies have determined that people with genetically defined lactase non-persistence have lower dairy intake that may lead to an increase risk of various non-communicable diseases. Furthermore, lactase non-persistence itself has been associated with insulin resistance. However, data on lactase non-persistence status and dairy intake in developing countries are sparse. We therefore aimed to define 1) the prevalence of lactase non-persistence among individuals with diabetes and non-diabetes in Thai population and 2) the links between lactase non-persistence, milk consumption, and risk of diabetes mellitus. METHODS: We conducted a case-control study from participants of the National Health Examination Survey. DNA was isolated from the blood for LCT -13910C>T (rs4988235) polymorphism and processed using the Bio-rad c1000 touch thermal cycler and MALDI-TOF Mass Spectrometry MassARRAY Typer v4.0 (Agena Bioscience, San Diego, CA, USA) at the Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital. Cases were participants with previously diagnosed diabetes mellitus or fasting plasma glucose ≥126 mg/dL (n = 1,756) vs. the controls (n = 2,380). RESULTS: We included 4,136 participants, 62% female, and 98.8% were > 30 years old. Homozygous CC genotype (i.e., lactase non-persistence) was noted in 98.6% and only 1.4% carried heterozygous CT. Most (76%) consumed milk <1 portion/month. Participants with either CC or CT genotype had comparable milk consumption and the risk of diabetes mellitus. Males, older adults, and lower education had a lower chance of consuming milk at least one portion per month. Besides various baseline variables, we found that higher milk consumption was associated with a lower DM risk (P = .01). CONCLUSION: The prevalence of lactase non-persistence in Thai population is very high. A significant difference in milk consumption frequency in relation to the lactase non-persistence status was not found. However, higher milk consumption is associated with a lower risk of diabetes mellitus.

Ideal cardiovascular health and all-cause or cardiovascular mortality in a longitudinal study of the Thai National Health Examination Survey IV and V.

The relationship of ideal cardiovascular health (CVH) and health outcomes has been rarely assessed in middle-income countries. We determined the ideal CVH metrics and association with all-cause and cardiovascular (CVD) mortality in the Thai population. We used baseline data from two rounds of the National Health Examination survey (15,219 participants in 2009 and 14,499 in 2014), and assessed all-cause and CVD deaths until 2020. The prevalence of 5-7 ideal CVH metrics in 2009 was 10.4% versus 9.5% in 2014. During a median follow-up of 7.1 years, the all-cause and CVD mortality rates were 19.4 and 4.6 per 1000 person-years for 0-1 ideal CVH metrics, and 13.0 and 2.1, 9.6 and 1.5, 6.0 and 1.0, and 2.9 and 0.4 per 1000 person-years for 2, 3, 4, and 5-7 ideal CVH metrics, respectively. Participants with 2, 3, 4, or 5-7 ideal metrics had a significantly lower risk of mortality than those with 0-1 ideal CVH metrics (adjusted hazard ratios: 0.75, 0.70, 0.60, and 0.47 for all-cause, and 0.54, 0.52, 0.50, and 0.31 for CVD, respectively). Individuals with a higher number of the modified ideal CVH metrics have a lower risk of all-cause and CVD mortality.

Practice, confidence and continuity of breast self-examination among women in Thailand during COVID-19 pandemic: a cross-sectional study.

OBJECTIVE: Breast self-examination (BSE) is the most feasible screening tool compared with clinical breast examination and mammography. It is crucial to address the associated factors of practising BSE to develop a targeted BSE promotion programme and improve the BSE quality in Thai women, particularly during the COVID-19 pandemic. DESIGN AND SETTING: We conducted a cross-sectional study in Thailand's north and northeast region from March 2020 to November 2022. PARTICIPANTS: This study involved 405 women aged 30-70 years old. VARIABLES AND OUTCOMES: Demographic information, health status and BSE were collected using a modified questionnaire based on the Champion Health Belief Model. The outcomes were ever-practising BSE, BSE practice within the last 6 months, continuity of BSE and confidence in doing BSE. Logistic regression and decision tree analysis identified the associated factors. RESULTS: 75.55% of participants ever performed BSE. Around 74.18% did BSE within the last 6 months. Diploma graduates (adjusted OR (aOR) 25.48, 95% CI 2.04 to 318.07), 21-40 reproductive years (aOR 4.29, 95% CI 1.22 to 15.08), ever pregnant (aOR 3.31, 95% CI 1.05 to 10.49), not drinking alcohol (aOR 2.1, 95% CI 1.04 to 4.55), not receiving hormone replacement (aOR 5.51, 95% CI 2.04 to 14.89), higher knowledge (aOR 1.29, 95% CI 1.09 to 1.52), attitude (aOR 1.15, 95% CI 1.05 to 1.26) and practice/cues of action towards BSE were associated with ever-practising BSE. Frequent high-fat diet, high awareness of breast cancer, lower knowledge of BSE and lower attitude toward BSE were associated with not practising BSE within 6 months and BSE discontinuation. Only high knowledge of BSE was associated with absolute confidence in BSE (p<0.05). CONCLUSION: Despite having a higher percentage than other studies in different countries prior to the pandemic, it is still crucial to improve knowledge of BSE to encourage BSE practice, confidence and continuity of BSE in Thai women. Moreover, the BSE campaign should target women with prolonged exposure to oestrogen and sedentary lifestyle.

Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6th Thai National Health Examination Survey (NHES VI).

Background: Thailand has an ongoing action plan to reduce human immunodeficiency virus (HIV) discrimination and stigma. We aimed to monitor the level of stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among the general adult population and to investigate its related factors. Methods: This study was based on data from the 6th Thai National Health Examination Survey, a large-scale country-wide survey in 2019-2020. We used a multistage sampling technique and included 11 843 adults aged 20 to 59. We collected data through face-to-face interviews which included six items related to HIV stigma domains. We weighted all analyses to account for the probability of sampling the Thai population aged 20 to 59 years. Results: We found that anticipated stigma had the highest percentage of negative stigmatizing attitude responses (78.5%), followed by perceived stigma (66.6%), fear of HIV infection (54.4%), and social judgment (28.2%). Regarding the UNAIDS global indicator for discriminatory attitude, 48.6% of respondents had negative perceptions to questions about experienced stigma or discrimination. Multiple logistic regression showed that factors associated with discriminatory attitudes toward PLWHA were being aged 20-39 (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.18-1.47) or 50-59 (aOR = 1.23, 95% CI = 1.09-1.40) compared to being aged 40-49, being Muslim compared to Buddhist (aOR = 1.73, 95% CI = 1.46-2.06), being married compared to being single (aOR = 1.15, 95% CI = 1.04-1.28), holding certificate degree or higher compared to not studying or studying at a primary level (aOR = 0.81, 95% CI = 0.68-0.97), living in the Northeast (aOR = 1.27, 95% CI = 1.12-1.45) and Bangkok (aOR = 1.30, 95% CI = 1.12-1.51) compared to living in the North, having no HIV/AIDS infected relative or acquaintance compared to having an HIV/AIDS infected relative or acquaintance (aOR = 1.56, 95% CI = 1.41-1.73), and not obtaining an HIV test compared to obtaining it (aOR = 1.10, 95% CI = 1.02-1.19). Conclusions: We found that HIV stigmatizing and discriminatory attitudes toward PLWHA decreased, but remained concerning among Thai adult people. A public education and awareness campaign, as well as an intervention to reduce HIV-related stigma and discrimination in the country's health care facilities, must still be maintained.

Health behaviors among short- and long- term ex-smokers: results from the Thai National Health Examination Survey IV, 2009.

BACKGROUND: Although numerous studies have shown the health behaviors of ex-smokers to be better than those in regular smokers, the differences in health behaviors among ex-smokers at varying durations of cessation have not been investigated. This study aims to examine the relationship between different durations of smoking cessation and health behaviors. METHODS: Data on dietary intake, alcohol consumption, physical activity, and smoking behavior from the Thai National Health Examination Survey IV for subjects aged 15-98 years (n=19 371) were included in the analysis. Trends between health behaviors among regular smokers, ex-smokers with different durations of smoking (<1 year, 1-10 years, >10 years), and never smokers were tested. Logistic regression models adjusted for sex, age, and economic status were used. RESULTS: The prevalences of regular smoking, ex-smoking, and never smoking were 22.3%, 12% , and 65.7%, respectively. A trend was found for consumption of fruit, beans and meats, dairy and soy milk, whole-grain products, nutritional supplements, and eating habits. Average daily alcohol consumption (g) was lowest among ex-smokers who had quit for>10 years ex-smokers (16.4) followed by 1-10 years ex-smokers (27.2), and <1 year ex-smokers (33.7). CONCLUSION: A longer duration of smoking cessation correlated with better health behaviors.

Cost and effectiveness evaluation of prophylactic HPV vaccine in developing countries.

BACKGROUND: Approximately 80% of cervical cancer cases occur in developing countries. In Thailand, cervical cancer has been the leading cancer in females, with an incidence of 24.7 cases per 100,000 individuals per year. OBJECTIVES: We constructed a decision model to simulate the lifetime economic impact for women in the context of human papillomavirus (HPV) infection prevention. HPV-related diseases were of interest: cervical cancer, cervical intraepithelial neoplasia, and genital warts. The two strategies used were 1) current practice and 2) prophylactic quadrivalent vaccine against HPV types 6, 11, 16, and 18. METHODS: We developed a Markov simulation model to evaluate the incremental cost-effectiveness ratio of prophylactic HPV vaccine. Women transition through a model either healthy or developing HPV or its related diseases, or die from cervical cancer or from other causes according to transitional probabilities under the Thai health-care context. Costs from a provider perspective were obtained from King Chulalongkorn Memorial Hospital. Costs and benefits were discounted at 3% annually. RESULTS: Compared with no prophylactic HPV vaccine, the incremental cost-effectiveness ratio was 160,649.50 baht per quality-adjusted life-year. The mortality rate was reduced by 54.8%. The incidence of cervical cancer, cervical intraepithelial neoplasia grade 1, cervical intraepithelial neoplasia grade 2/3, and genital warts was reduced by up to 55.1%. CONCLUSION: Compared with commonly accepted standard thresholds recommended by the World Health Organization Commission on Macroeconomics and Health, the nationwide coverage of HPV vaccination in girls is likely to be cost-effective in Thailand.