The association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand: a cross-sectional study.

Background: Pesticide toxicity is an important health problem in Thailand due to the intensive use of hazardous pesticides.  This study aimed to determine and discuss patterns of pesticide use, health literacy, pesticide use behaviors and whether there is an association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand. Methods: This work was carried out between May 2017 and July 2017 and 161 participants were enrolled. Participant questionnaires were completed during face-to-face interviews. Results: 161 sweet corn farmers (89.98%) were interviewed about patterns of chemical pesticide use. Two of the pesticides used in the pre-planting phase were moderately toxic: paraquat (used by 55.2% of farmers) and imidacloprid (used by 15.5% of farmers). In the pre-emergence phase, participants reported using two moderately toxic pesticides: alachlor (used by 48.8% of farmers) and chlorpyrifos (used by 2.4% of farmers). At the post-emergence phase, participants reported using six moderately toxic pesticides: chlorpyrifos (used by 60.7% of farmers), paraquat (used by 38.1% of farmers), imidacloprid (used by 7.2% of farmers), 2-4D (used by 3.6% of farmers), abamectin (used by 3.6% of farmers) and cypermethrin (used by 1.2% of farmers). Health literacy levels were moderate level (Mean score = 91.62, SD = ± 7.06) and pesticide use behaviors were low level (Mean score = 67.80, SD = ± 4.04). When examining the association between health literacy and pesticide use behaviors, we found that functional literacy was significantly associated with pesticide use behaviors. These findings suggest that health literacy, which includes self-management and decision-making skills, should be given greater attention as pesticide use behaviors were unsafe. Conclusion: It may be necessary to develop approaches to reduce pesticide use and promote health literacy, thereby protecting farmers, consumers, the environment (soil, water, and air) and ecosystems from pesticide-related hazards.

Simplified Berlin Questionnaire for Screening of High Risk for Obstructive Sleep Apnea Among Thai Male Healthcare Workers.

Obstructive Sleep Apnea (OSA) is a common disease associated with major cardiovascular diseases. Male subjects are more at higher risk for OSA than female subjects. The Berlin questionnaire is a beneficial screening tool for OSA and has 14 items. The Berlin questionnaire may need some adjustment for Thai or Asian populations. We aimed to find items that should be asked in the Berlin questionnaire to identify high risk for obstructive sleep apnea among Thai male healthcare workers. This study was performed in Thai male healthcare workers over the age of 35 and currently working at the Faculty of Medicine, Khon Kaen University. The Thai version of the Berlin questionnaire was randomly distributed. A study population of 273 subjects was required to provide a confidence value of 95%. An item analysis of the Berlin questionnaire was evaluated as independent factors for being high risk of OSA by using a multivariate logistic regression analysis. Of the 273 distributed questionnaires, 135 subjects returned then (49.5% response rate). Of those, 41 (30.4%) were identified as being at high risk of OSA. Only three items of the Berlin questionnaire, including frequent snoring, high body mass index and hypertension, were independently associated with being at high risk for OSA. In conclusion, the Berlin questionnaire can be shortened to identify high risk for OSA by itself; not polysomnography.

The Stop-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea-Induced Hypertension in Asian Population.

Obstructive sleep apnea (OSA) is a common public health issue. If left untreated, OSA may cause a large health economic burden from cardiovascular complications particularly stroke. The diagnosis of OSA can be made by polysomnography, but its availability is limited in the developing countries in Asia. STOP-BANG questionnaire is a good screening tool but may need some adjustment for Asian population. STOP-BANG stands for: Snoring history, Tired during the day, Observed stop breathing while sleep, High blood pressure, body mass index (BMI) more than 35 kg/m(2), Age more than 50 years, Neck circumference more than 40 cm and male Gender. We compared clinical features in STOP-BANG questionnaire between 42 OSA induced hypertension patients and 82 healthy control subjects in the Faculty of Medicine, Khon Kaen University, Thailand. The best cutoff point for the BMI and the neck circumference were 24.5 kg/m(2) and 36 cm, respectively. The sensitivity and specificity of the BMI cutoff point were 97.2% and 91.40, while those of the neck circumference were 94.7% and 82.9%. In conclusion, the appropriate cutoff points of BMI and neck circumference for Thai STOP-BANG questionnaire were 25 kg/m(2) and 36 cm.

Effects of an influenza prevention program using non-pharmaceutical prevention measures to improve the knowledge, attitudes and practices of elementary school students in Nakhon Phanom province, Thailand.

We evaluated an influenza prevention educational program using educational media, e-books and cartoons conducted among students in grades 4 through 6. The course was 8 hours long. The study was conducted at 4 schools; 230 students at each school were in the experimental group and 224 students at each school were in the control group (no educational intervention). The data were analyzed using the Wilcoxon matched-pair signed-rank test. The students in the experimental group had significantly greater knowledge (p<0.001), attitudes (p<0.001) and practices (p<0.001) scores after the intervention. However, the control group also had significantly greater knowledge (p<0.001) and attitudes (p<0.001) scores but not practices scores (p = 0.326). Further studies are needed to determine the factors that influenced these differences.

An exploratory study on association between family relationship and relapse among methamphetamine users in Compulsory Treatment System of Khon Kaen and Yasothon Provinces.

BACKGROUND: It was estimated that 3.5 million Thais have ever used "Yaba (methamphetamine)" at least once in their entire life. The Northeastern region had the highest number of Yaba users with a high relapse rate after treatment. OBJECTIVE: The authors aimed to explore the association between relapse, among methamphetamine users in the Compulsory Treatment System of Khon Kaen and Yasothon Provinces, and family relationship as well as other contextual factors. MATERIAL AND METHOD: An exploratory study was conducted from all cases of post-treatment methamphetamine users in the databases of Khon Kaen Drug Dependence Treatment Center and Yasothorn Provincial Probation Office during October 2007 and February 2008. Interviews and observations were done for data collection. Double data entry was applied. Pearson Chi-square, Fisher's exact test and odds ratio were used to assess the associations. RESULTS: Sixty-five users were found (13 relapses and 52 abstainers). Family relationship revealed no significant association with relapse of the methamphetamine users. Other contextual factors, however, did. They were social acceptance [acceptance by community leader (p = 0.006), acceptance for working or studying (p = 0.049)], risky community situations [using Yaba of close friend, existence of Yaba users and Yaba trading in community (p = 0.014, p < 0.001 and p = 0.038 respectively)] and risky personal behaviors [ever selling or being a Yaba agent and drinking of alcohol to reduce Yaba desire (p = 0.012 and p = 0.013)]. CONCLUSION: Effect of family relationship on relapse among post-treatment methamphetamine users could not be demonstrated in the present study. But several contextual factors had significant relationship with the relapse.

Missed appointments at a tuberculosis clinic increased the risk of clinical treatment failure.

We investigated the charts of 381 new smear-positive tuberculosis patients at Khon Kaen Medical School during 1997-2001 using World Health Organization definitions to evaluate associations among treatment success or failure (defaulted, failed, died, or not evaluated) and tuberculosis clinic contact, demographics and clinical characteristics of the patients. Multinomial logistic regression was used for three-category outcome analysis: treatment success, transferred-out and clinical treatment failure. The treatment success and clinical treatment failure rates were 34.1% and 34.4%, respectively. About 46.5% and 85.8% of patients missed appointments at the tuberculosis clinic in the treatment success and treatment failure groups, respectively. The results show that patients who were absent from the tuberculosis clinic were 5.95 times more likely to have clinical treatment failure than treatment success, having adjusted for the effect of transfering-out and the effect of the treatment regimen and the sputum conversion status (adjusted odds ratio = 5.95; 95% CI: 2.99 to 11.84). The review showed that absence from the tuberculosis clinic was an independent risk factor for clinical treatment failure. We recommended that all new smear-positive tuberculosis patients should be followed closely at a tuberculosis clinic.