Role of drowsy driving in traffic accidents: a questionnaire survey of Thai commercial bus/truck drivers.

OBJECTIVE: The authors assessed the relationship between traffic accidents and drowsiness. MATERIAL AND METHOD: A self-answered questionnaire survey of 4331 commercial bus/truck drivers was done. RESULT: Sixty-nine percent of the drivers reported accidents and one third of these accidents was attributable to drowsiness. Drowsy driving and microsleeps were experienced by 75% and 28% of drivers respectively. Forty-five percent of drivers had excessive daytime sleepiness based on the Epworth Sleepiness Scale (ESS score > or =11). This excessive daytime sleepiness was strongly associated with feeling drowsy, microsleeps, and accidents. The major causes of drowsiness were sleep deprivation (90%), medications that caused sleepiness (78%), drinking alcohol the previous night (23%), and chronic loud snoring with or without obesity (17%). 61% of drivers worked longer than 12 hours with no days off The feeling of drowsiness at the wheel was also closely related to long hours of driving (>4 hours). Countermeasures that drivers used to keep them awake were talking to someone, drinking coffee or caffeinated-energy drinks, chewing snacks or gum and pulling over to have a nap. CONCLUSION: There is a strong relationship between accidents and drowsiness in commercial bus/truck drivers. The main cause of drowsiness was sleep deprivation. The authors hope that this information will help the public authority develop a policy to reduce the traffic accidents attributable to drowsy driving in commercial bus/truck drivers.

Reliability and validity of a Thai version of the General Practice Assessment Questionnaire (GPAQ).

BACKGROUND: The Assessment Questionnaire (GPAQ) is a questionnaire for patients to evaluate primary care in a number of key areas ranging from the access to care, the helpfulness of receptionists, the continuity of care, the doctors'communication skills, the patient's knowledge of self the General Practice care plans after consultation, and overall satisfaction. All questions can be calculated as a GPAQ score allowing services to be analysed, developed, and improved. OBJECTIVE: The General Practice Assessment Questionnaire (GPAQ) was developed in the United Kingdom to evaluate the quality of general practice (i.e. primary care or family medicine). The aim of the present study was to translate and validate a Thai language version of GPAQ. MATERIAL AND METHOD: Cross-sectional study: the content validity was examined by three experts in the Family Medicine field, and then the original GPAQ was translated into Thai with permission from the National Primary Care Research and Development Centre, University of Manchester and Safran. The translation process followed the guidelines for cross-cultural adaptation of self-report measures, including forward translation, synthesis of the translation, back translation, cross-cultural adaptation and pre-testing. The pilot study was done by distributing the questionnaire to a sample of 30 people before revision of the questionnaire. The reliability and validity of the translated version was then examined by distributing the questionnaire to 2,600 people visiting the out-patient clinic at the Department of Family Medicine, Ramathibodi Hospital in October, 2005. RESULTS: The response rate is about 70 percent. The results of the present study showed that the Thai version of GPAQ achieved good levels of reliability and validity, with the range of Cronbach's alpha coefficients being 0.7293-0.8324 in each aspect of GPAQ, namely access, doctor's communication skills, and patient enablement (understanding of self care after the consultation). However, a question about telephone consultations had to be excluded from the questionnaire to reach Cronbach's alpha coefficient of 0.8221. CONCLUSION: After translation and cross-cultural adaptation the Thai version of GPAQ can be used as a patient-administered instrument to evaluate the quality of primary care in Thailand.

Clinical response of depressive patients in a Thai psychiatric care setting.

OBJECTIVE: To obtain data on the clinical outcome of patients with depressive disorders after three months psychiatric care in a Thai psychiatric unit. MATERIAL AND METHOD: A prospective descriptive study of 96 patients followed up for 3 months. The severity of depression was measured with the Thai version of the Hamilton rating scale for depression (HAM-D Thai). RESULTS: The response rate following 3-months psychiatric care was 67.7% (95% CI = 58.18-77.23). Fifty percent of the patients had a HAM-D Thai score of < 7 at week 12. CONCLUSION: The treatment outcome in the Thai psychiatric setting described is comparable to that reported in other countries.

Lower urinary tract symptoms in Thai women attending the menopause clinic: prevalence and associated factors.

OBJECTIVE: To determine the prevalence of lower urinary tract symptoms and associated factors in women attending the menopause clinic. METHOD: Nine hundred and fifty-six women attending the menopause clinic, Ramathibodi Hospital were interviewed regarding their general health issues and lower urinary tract symptoms by means of an anonymous questionnaire. Demographic data, obstetric history, and underlying diseases were analysed by using Student t-test, Chi-square and Fisher exact test. P < 0.05 was considered as a level of significance. RESULTS: A total of 956 women, mean age 52.89 +/- 5.80 years, completed the questionnaire. The prevalence of stress incontinence, nocturia, urgency, frequency, and urge incontinence were 58.3%, 40.3%, 33.9%, 22.7%, and 6.6%, respectively. Lower urinary tract symptoms was found to be associated with marital status, coexisting medical diseases, menopausal status, previous term delivery, and vaginal delivery (P < 0.05). CONCLUSIONS: Lower urinary tract symptoms was a common problem among women attending the menopause clinic. Marital status, coexisting medical diseases, menopausal status, parity, and mode of delivery were associated with this problem.

An epidemiological study on insomnia in an elderly Thai population.

The authors investigated the one-month prevalence and associations of insomnia in an elderly Thai population. A random sample of 40,111 individuals was selected from those of persons over 60 years of age by multiple stage sampling. The subjects were interviewed using a sleep questionnaire. Prevalence of insomnia of the population was 46.3 per cent. Depression and poor perceived health were factors strongly associated with insomnia. On the basis of these findings, the authors consider the prevalence of insomnia among the Thai elderly to be rather high. The implications of this study are of great importance for the design and development of preventive strategies and community-based interventions.

The association between television viewing and childhood obesity: a national survey in Thailand.

OBJECTIVE: To determine the relationship between television viewing and obesity among Thai children. DESIGN: A one-stage cross-sectional national survey. SETTING: National communities in Thailand. SUBJECTS: Four thousand one hundred and ninety-seven children aged 6 to 12 years old. RESULTS: By using the new national growth reference as a normative data, 262 (6.2%) children in this survey were obese. According to the caregivers, 62 per cent of children watched television I to 3 hours per day. Children who spent more than 3 hours per day watching television were more likely to be obese than the children who watched television less with the odd ratio of 1.8 (95% confidence interval = 1.2-2.8). CONCLUSION: With a one-stage design for determining the association between television viewing and childhood obesity, Thai school age children who watched television more than 3 hours per day were more likely to be obese with statistical significance.

Accuracy of glucose meters in measuring low blood glucose levels.

BACKGROUND: Hypoglycemia is an emergency condition requiring treatment as soon as possible. Therefore, rapid and reliable blood glucose measurements are necessary. There are 2 systems of glucose meters (GMs), the reflectance photometer system (RPS) and the electrochemical biosensor system (BSS). GMs are widely used in monitoring blood glucose (BG) in patients with diabetes. BG values measured by GMs have been confirmed to be accurate especially in measuring normal and high BG levels. However, the data on the accuracy of GMs in measuring low BG levels are limited. OBJECTIVE: To compare accuracy and reliability of different systems of GMs in the measurement of low BG values. PATIENTS AND METHOD: Venous and capillary whole blood specimens were collected from patients who were investigated for pituitary dysfunction. The patients underwent an insulin-induced hypoglycemia test by intravenously administering human regular insulin. The low BG level was defined as having venous plasma glucose (PG) of less than 60 mg/dl (mean +/- SD = 36.59 +/- 9.19, n = 54). Capillary blood samples were obtained from fingertips. Venous BG (vBG) and capillary BG (cBG) were measured by GMs. Venous PG which considered a reference value was measured by the glucose dehydrogenase method. RESULTS: The correlation coefficient (r) between vBG measured by GMs-RPS and PG was 0.86 (p < 0.001), whereas, that between vBG by GMs-BSS and PG was 0.75 (p < 0.001). Similarly, the r between cBG by GMs-RPS and PG was 0.73 (p < 0.001), whereas, that between cBG by GMs-BSS and PG was 0.69 (p < 0.001). The mean difference between vBG by GMs-RPS and PG values was 0.01 +/- 4.90 mg/dl, whereas, that between vBG by GMs-BSS and PG values was 10.50 +/- 7.07 mg/dl which was significantly greater than the former (p<0.001). Moreover, the mean difference between cBG by GMs-RPS and PG values was 14.45 +/- 8.76 mg/dl, whereas, that between cBG by GMs-BSS and PG values was 23.87 +/- 9.48 mg/dl which was also significantly greater than the former (p < 0.001). These results demonstrated that vBG measured by GMs-RPS was comparable to PG values. In addition, cBG values by GMs-RPS and GMs-BSS were approximately 14 mg/dl or 38 per cent and 24 mg/dl or 65 per cent greater than PG values, respectively. CONCLUSION: In measuring low blood glucose levels, glucose meters using the reflectance photometer system are more accurate than those using the electrochemical biosensor system.