Crystalline silica exposure and air quality perception of residents living around home stone factories

Stone factories containing harmful inhalable crystalline silica that can penetrate deep into the respiratory system causing silicosis. People living around stone factories should be concerned about the risk of dust pollutants. This study aimed to assess the crystalline silica concentrations and air quality perception (AQP) among residents living around home stone factories. Forty samples of PM10 and crystalline silica concentrations were collected from 11 home stone factories and measured following the NIOSH methods 0600 and 7601. A cross- sectional study was carried out into 325 subjects who were interviewed using the AQP and respiratory symptoms questionnaires, and a Geographic Information System technique for distance from stone factories was measured. The average crystalline silica concentrations of all stone factories were higher than the recommendation. Bivariate analyses showed that the subjects’ age, income, occupation, smoking, distances, and number of respiratory symptoms were associated with AQP. Interestingly, those with distance from stone factories lower than 50 m had a poorer AQP than those whose distance from stone factories was more than 100 m (cOR 2.5, 95%CI: 1.3-4.9). An increasing number of respiratory symptoms was associated with a poor quality of air perception (B = 0.752, SE = 0.242) and those which had chest pain, nose irritation and stuffy nose were associated with a poor AQP. All home stone factories produce inhalable dust pollutants. The AQP can be used to link distances from pollutant sources and have a relationship with respiratory symptoms. Periodically monitor dust pollutants exposure, AQP and surveillance of respiratory illness should be done

Translation and validation of the PACIC+ questionnaire: the Thai version

Background: The number of patients with chronic illness is increasing worldwide. These patients usually receive care from a primary care facility. The Patient Assessment of Chronic Illness Care (PACIC) is a tool that is increasingly used in several countries to measure how the patients perceive the care they receive. The goal of this validation study is to provide and validate an extended version of the tool, the PACIC+ questionnaire, in Thailand. Methods: In this observational validation study, patients with type 2 diabetes from the outpatient clinic at a university hospital in Thailand completed the PACIC+ at the clinic. For follow-up, they received the questionnaire per mail after four weeks. The Thai PACIC+ comprises 26 items, which map onto 5 subscales and a summary score related to the Chronic Care Model (CCM) and 5 subscales and a summary score related to the 5A model, a counseling model for behavioral changes. Data-analysis focused on the use of most extreme answering categories (> 15%), internal consistency (Cronbach’s alpha), and test-retest reliability. An exploratory factor analysis (EFA) was performed for the CCM and the 5A model separately to examine the factor structure. Results: A total of 151 patients participated. The average age of the sample was 63 ± 9 years (range 29–86 years). Fifty-three percent of the respondents were female. In the Delivery System subscale, 20% of patients reported the highest possible value; in all other subscales, relative frequencies of the most extreme categories did not exceed 15%. Cronbach’s alpha per subscale varied from 0.58 to 0.81, while that of the summary scores were 0.89 and 0.91. The mean difference from the test-retest varied from − 0.06 to 0.17 across subscales. The Kaiser-Meyer-Olkin criterion for sampling adequacy (KMO) was good for both models as well as the Bartlett’s test for sphericity p. While the factor loadings in rotated factor solution showed good concordance with the CCM, concordance was not as good for the 5A model, especially for the subscales “Assess” and “Advice”. Conclusion: A validated Thai version of the PACIC+ is now available to measure how the patients perceive the care they receive

Early life urban exposure as a risk factor for developing obesity and impaired fasting glucose in later adulthood: results from two cohorts in Thailand.

BACKGROUND: Obesity and obesity related conditions, driven by processes such as urbanization and globalization, are contributing to pronounced cardiovascular morbidity and mortality in developing countries. There is limited evidence on the influence of living in an urban environment in early life on obesity and obesity related conditions later in life in developing countries such as Thailand. METHODS: We used data from two cohort studies conducted in Thailand, the Thai Cohort Study (TCS) and the Chiang Mai University (CMU) Health Worker Study, to investigate the association between early life urban (vs rural) exposure and the later development of obesity. We additionally explored the association between early life urban exposure and impaired fasting glucose in adulthood using data from the CMU Health Worker Study. RESULTS: Among 48,490 adults from the TCS, 9.1 % developed obesity within 4 years of follow-up. Among 1,804 initially non-obese adults from CMU Health worker study, 13.6 % developed obesity within 5 years of follow-up. Early life urban exposure was associated with increased risk of developing obesity in adulthood in both cohorts. Adjusting for age and sex, those who spent their early lives in urban areas were 1.21 times more likely to develop obesity in the TCS (OR 1.21, 95 % CI 1.12 to 1.31) and 1.65 times more likely in the CMU Health Worker study (OR 1.65, 95 % CI 1.23 to 2.20). These associations remained significant despite adjustment for later life urban exposure and current household income. No evidence for an association was found for impaired fasting glucose. CONCLUSIONS: Early life urban exposure was associated with increased risk of developing obesity in adulthood. These findings support public health intervention programs to prevent obesity starting from early ages

Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand.

BACKGROUND: Within the sphere of diabetes self-management, much emphasis has been placed on medication adherence. There has been a shift in thinking about medication adherence, moving from "compliance" and historically paternalistic models of care, to seeking better ways of characterizing dynamic and complex relationships that determine medication adherence and diabetes control. This study sought to understand the relationship between patient's attitudes and medication adherence for oral anti-diabetics in Thailand. METHODS: In-depth interviews of patients with type 2 diabetes mellitus, taking oral anti-diabetic drugs, at the out-patient clinic run by the Department of Family Medicine, Chiang Mai University between May and December 2016. Thematic analysis followed the WHO framework for medication adherence in chronic disease to explore patient's attitudes and their influence on medication compliance. RESULTS: Of 24 patients, 9 were men. The mean age was 62 years (SD 8.9 years). 67% had high compliance. Four themes were identified as important factors related to medication adherence: attitudes toward disease, attitudes toward treatment, attitudes toward family support and attitudes toward health care team. Specifically, symptoms at diagnosis, understanding and acceptance in taking medication, the presence of family support and the perception of concern by the doctor relate to improved medication compliance. CONCLUSIONS: Medication adherence in Thai patients with diabetes requires support from both the health care providers and the family. The patient's perception of the doctor's concern creates greater patient trust in the health care team. This trust, along with family support, helps deepen patients' understanding of the disease, accept the chronic nature of their disease, and engenders a positive attitude towards taking medication that can improve medication adherence

Chiang Mai University Health Worker Study aiming toward a better understanding of noncommunicable disease development in Thailand: methods and description of study population.

BACKGROUND: Urbanization is considered to be one of the key drivers of noncommunicable diseases (NCDs) in Thailand and other developing countries. These influences, in turn, may affect an individual's behavior and risk of developing NCDs. The Chiang Mai University (CMU) Health Worker Study aims to provide evidence for a better understanding of the development of NCDs and ultimately to apply the evidence toward better prevention, risk modification, and improvement of clinical care for patients with NCDs and NCD-related conditions. METHODS: A cross-sectional survey of health care workers from CMU Hospital was conducted between January 2013 and June 2013. Questionnaires, interviews, and physical and laboratory examinations were used to assess urban exposure, occupational shift work, risk factors for NCDs, self-reported NCDs, and other NCD-related health conditions. RESULTS: From 5,364 eligible workers, 3,204 participated (59.7%). About 11.1% of the participants had high blood pressure (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) and almost 30% were considered to be obese (body mass index ≥25 kg/m(2)). A total of 2.3% had a high fasting blood glucose level (≥126 mg/dL), and the most common abnormal lipid profile was high low-density lipoprotein (≥160 mg/dL), which was found in 19.2% of participants. DISCUSSION: The study of health workers offers three potential advantages. The first is that the study of migrants was possible. Socioenvironmental influence on NCD risk factors can be explored, as changes in environmental exposures can be documented. Second, it allows the investigators to control for access to care. Access to care is potentially a key confounder toward understanding the development of NCDs. Lastly, a study of health personnel allows easy access to laboratory investigations and potential for long-term follow-up. This enables ascertainment of a number of clinical outcomes and provides potential for future studies focusing on therapeutic and prognostic issues related to NCDs

Additional file 1: of Translation and validation of the PACIC+ questionnaire: the Thai version

Pacicplus. The original PACIC+ questionnaire. (PDF 110 kb

Additional file 2: of Translation and validation of the PACIC+ questionnaire: the Thai version

Thai pacicplus. The Thai version of the PACIC+ questionnaire. (PDF 71 kb