ABSTRACT
Objectives@#This study investigated the association between baseline exposures to particulate matter with a diameter < 2.5 microns (PM2.5) and subsequent temporal changes in PM2.5 exposure with the incidence of type 2 diabetes among Royal Thai Army personnel. @*Methods@#A retrospective cohort study was conducted using nationwide health check-up data from 21 325 Thai Army personnel between 2018 and 2021. Multilevel mixed-effects parametric survival statistics were utilized to analyze the relationship between baseline (i.e., PM2.5-baseline) and subsequent changes (i.e., PM2.5-change) in PM2.5 exposure and the occurrence of type 2 diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were employed to assess this association while considering covariates. @*Results@#There was a significant association between both PM2.5 baseline and PM2.5-change and the incidence of type 2 diabetes in a dose-response manner. Compared to quartile 1, the HRs for quartiles 2 to 4 of PM2.5-baseline were 1.11 (95% CI, 0.74 to 1.65), 1.51 (95% CI, 1.00 to 2.28), and 1.77 (95% CI, 1.07 to 2.93), respectively. Similarly, the HRs for quartiles 2 to 4 of PM2.5-change were 1.41 (95% CI, 1.14 to 1.75), 1.43 (95% CI, 1.13 to 1.81) and 2.40 (95% CI, 1.84 to 3.14), respectively. @*Conclusions@#Our findings contribute to existing evidence regarding the association between short-term and long-term exposure to PM2.5 and the incidence of diabetes among personnel in the Royal Thai Army.
ABSTRACT
The purposes of this study were: to examine (a) self-reflectd unhealthy behavior and the need for behavioral change, and; (b) to evaluate the satisfaction about the “Behavioral change” learning station of the participants of the “Health behavioral change to reduce cardiovascular disease risk among the high-risk civil servants and families in Bangkok” Project (“Heart health promotion for civil workers and families” Project). The project was jointly implemented by Faculty of Medicine at Chulalongkorn University and Chulalongkorn Memorial Hospital of the Thai Red-Cross during February-August 2007. Data were collected by self-administered questionnaires. They were then analysed and presented as frequency and percentage.Results showed that 1,312 of the total 1,482 project participants responded to the questionnaires (88.5 percent). They were civil workers and family members from 175 agencies of the 20 ministries throughout Bangkok. Most of them were female (77 percent), aged between 7-86 years with the average age of 51 years. The most important self-reported unhealthy behaviors were eating behavior (33-39 percent), physical inactivity (20-25 percent), and emotional stress (14-20 percent) respectively. The 3 highest priorities of behavioral change intention were also for eating behavior (40 percent), physical inactivity (25-30 percent), and emotional stress (10 percent) respectively. Concerning the satisfaction about the “Behavioral change” learning station, 67.8-82.9 percent of the participants were rather or very satisfied to activity of the learning the station. The least and most satisfied aspects were the duration and the usefulness of the activity respectively.In conclusion, for any health behavioral change program or curriculum targeting to serve the civil workers and families in Bangkok, high emphasis should places on the in-depth activity concerning eating behavior, physical inactivity, and emotional stress.
ABSTRACT
Background: Currently, “multiple risk factor reduction program” for coronary heart disease (CHD) risk is proposed in Thailand, but there is little information about its effectiveness for Thai hypertensive patients. Objectives: To investigate the effectiveness of the CHD risk program among hypertensive patients in Thai community hospitals. Material and methods: Seven hundred eighty one hypertensive patients (aged 35-64 years) were selected from four hospitals in Sisaket, Thailand between Sept 2007 and Aug 2008. The intervention program included: a) provide training about the overview of CHD and global risk assessment, and b) patient training about risk factor modification skill. The control subjects received health education and usual care. The program effectiveness was evaluated using changes in the RAMA-EGAT heart score and risk factors, such high density lipoprotein cholesterol or serum total cholesterol, one year after the program implementation. Data analysis was conducted using “t”-test for the pre-post difference between the intervention and control groups. Results: The changes in the RAMA-EGAT heart score were -0.03 vs +0.09 for the intervention and control groups, respectively. Changes in high density lipoprotein cholesterol, waist circumference, systolic, diastolic, and serum total cholesterol were statistically significant between for the both groups. The CHD knowledge was improved significantly between the both groups, but the smoking quit-rate was not significantly different. There was a significant association of intervention with the improvement in knowledge score, HDL-C, and waist circumference, but blood pressure and serum total cholesterol levels in the control were reduced greater than those in the intervention groups. Conclusion: This program did not sufficiently reduce the change global risk score, but some risk factors were improved significantly. The global risk assessment should be integrated with behavior counseling and treatment activity for hypertensive patients.
ABSTRACT
Background: Risk assessment based on epidemiologic information is recommended as the first step for nosocomial tuberculosis control in hospital(s). Objectives and methods: To estimate nosocomial tuberculosis (TB) exposure risks for hospital personnel in central Thailand. Study samples were 42 community and general hospitals located in 42 districts of 5 provinces in central Thailand. Potential TB exposure rates in each hospital were calculated and presented as number of case-days per year. Information utilized in the calculation included numbers of registered TB and human immunodeficiency virus (HIV) infected cases at each district in 2005, prevalence of TB among HIV infected cases and prevalence of HIV infection among TB cases, admission rates of TB and HIV infected cases, duration of delayed diagnosis of outpatient and in patient TB cases. Results: The total potential TB exposure rate (median, range) at the study hospitals was 541.7 (80.3-4,126.0) case-days per year. The potential exposure rates at outpatient and inpatient departments were 207.5 (30.8-1,580.8) and 334.1 (49.5-2,545.1) case-days per year respectively. Three provinces with the highest TB exposure risk had total potential TB exposure rates (median, range), of 1,389.7 (761.7-4,126.0), 1,105.4 (362.2-2,405.4), and 861.5 (396-3263.9) case-days per year respectively. Conclusion: Based on the risk categorization of the U. S. Centers for Disease Control and Prevention, all study hospitals in Thailand had a moderate to high risk for nosocomial TB exposure. Stringent nosocomial TB control measures are obviously needed.