Path Analysis of Factors Influencing Smoking Behavior and Nicotine Dependence Level among Motorcycle Taxi Drivers in Songkhla Province

บทคัดย่อ วัตถุประสงค์: เพื่อศึกษาพฤติกรรมการสูบบุหรี่ และวิเคราะห์เส้นทางปัจจัยที่ส่งผลต่อพฤติกรรมการสูบบุหรี่และระดับการติดนิโคติน ในคนขับรถจักรยานยนต์สาธารณะ จังหวัดสงขลา วิธีการศึกษา: เป็นการศึกษาเชิงพรรณนาภาคตัดขวาง กลุ่มตัวอย่างคือคนขับรถจักรยานยนต์สาธารณะในอำเภอเมืองสงขลาและอำเภอหาดใหญ่ที่สูบบุหรี่ ทั้งหมด 90 คน เก็บข้อมูลด้วยแบบสอบถามการสำรวจพฤติกรรมการสูบบุหรี่ แบบทดสอบวัดระดับการติดนิโคติน และแบบประเมินบันไดของความพร้อมในการเลิกสูบบุหรี่ เครื่องมีมีความเชื่อมั่นสูง (ค่าสัมประสิทธิ์แอลฟาของครอนบาค เท่ากับ 0.859, 0.903 และ 0.969 ตามลำดับ) และวิเคราะห์ข้อมูลโดยใช้สถิติเชิงพรรณนาและวิเคราะห์เส้นทางปัจจัย ผลการศึกษา: กลุ่มตัวอย่างเป็นเพศชายทั้งหมด ส่วนใหญ่อายุ 51-60 ปี สูบบุหรี่ไม่เกิน 10 มวนต่อวัน (52.2%) และสูบทุกวัน (91.1%) มักสูบบุหรี่ขณะนั่งพักที่คิวรถจักรยานยนต์ (42.2%) พบว่าโมเดลเส้นทางปัจจัยที่ส่งผลต่อพฤติกรรมการสูบบุหรี่และระดับการติดนิโคตินสอดคล้องกับข้อมูลเชิงประจักษ์ (χ2 = 19.558, df = 21, χ2/df = 0.931, P-value = 0.549, CFI = 1.000, TLI = 1.000, RMSEA < 0.001, SRMR = 0.057, R2 = 0.686) โดยพฤติกรรมการสูบบุหรี่ในด้านระยะเวลาที่สูบบุหรี่ได้รับอิทธิพลจากอายุ การรับรู้ผลกระทบต่อสุขภาพ การรับรู้กฎหมายห้ามสูบบุหรี่ในที่สาธารณะ ส่วนพฤติกรรมการสูบบุหรี่ในด้านความพยายามเลิกบุหรี่ได้รับอิทธิพลจากการรับรู้กฎหมายห้ามสูบบุหรี่ในที่สาธารณะ และระดับการติดนิโคตินได้รับอิทธิพลจากพฤติกรรมการสูบบุหรี่ในด้านปริมาณการสูบบุหรี่ ความพยายามเลิกบุหรี่ ปัญหาทางด้านสุขภาพหรือโรคที่เกิดจากการสูบบุหรี่ ทัศนคติต่อการสูบบุหรี่ และการรับรู้กฎหมายห้ามสูบบุหรี่ในที่สาธารณะ สรุป: สามารถนำผลการศึกษาเป็นแนวทางจัดโปรแกรมเลิกบุหรี่ให้คนขับรถจักรยานยนต์สาธารณะโดยเน้นการสร้างความตระหนักเกี่ยวกับผลกระทบต่อสุขภาพ กฎหมายห้ามสูบบุหรี่ในที่สาธารณะ และส่งเสริมทัศนคติเชิงลบต่อการสูบบุหรี่ คำสำคัญ : การวิเคราะห์เส้นทาง, พฤติกรรมการสูบบุหรี่, การติดนิโคติน, คนขับรถจักรยานยนต์สาธารณะAbstract Objective: To determine levels of and factors influencing smoking behavior and nicotine dependence level of motorcycle taxi riders in Songkhla province. Method: This cross-sectional descriptive survey recruited 90 motorcycle taxi drivers in Mueang Songkhla district and Hatyai district. Data were collected by the questionnaire on smoking behavior, the Fagerstrom Test for Nicotine Dependence, and the readiness to quit ladder. These questionnaires had high internal consistency reliability (Cronbach's alpha coefficients of 0.859, 0.903 and 0.969, respectively). The data were analyzed by descriptive statistics and path analysis. Results: All participants were male. The majority were 51 - 60 years old, smoked no more than 10 cigarettes per day (52.2%), smoked daily (91.1%), and smoked at the motorcycle taxi queue (42.2%). Factors influencing smoking behavior and nicotine dependence level fit well with empirical data (χ2 = 19.558, df = 21, χ2/df = 0.931, P-value = 0.549, CFI = 1.000, TLI = 1.000, RMSEA < 0.001, SRMR = 0.057, R2 = 0.686). The smoking duration was influenced by age, health impact perception, and perception of the law prohibiting smoking. The quit attempt was influenced by perception of the law prohibiting smoking. The nicotine dependence level was influenced by smoking amount, the quit attempt, health problem or smoking related diseases, attitude towards smoking, and perception of the law prohibiting smoking. Conclusion: The results could be used as a guideline to develop a proper smoking cessation program for motorcycle taxi riders that focuses on awareness of the health issues, the law prohibiting smoking, and the negative attitude towards smoking. Keywords: path analysis, smoking behavior, nicotine dependence, motorcycle taxi drive

Comparison of Short-Term Post-Thymectomy Outcomes by Time-Weighted Dosages of Drug Requirements between Thymoma and Non-Thymoma Myasthenia Gravis Patients

(1) Background: Early thymectomy is suggested in all clinically indicated myasthenia gravis (MG) patients. However, short-term clinical response after thymectomy in MG patients has been limitedly described in the literature. This study aimed to compare the 5-year post-thymectomy outcomes between thymoma (Th) and non-thymoma (non-Th) MG patients. (2) Methods: MG patients aged ≥18 years who underwent transsternal thymectomy and had tissue histopathology reports in Songklanagarind Hospital between 2002 and 2020 were enrolled in a retrospective review. The differences in the baseline demographics and clinical characteristics between ThMG and non-Th MG patients were studied. We compared the time-weighted averages (TWAs) of daily required dosages of pyridostigmine, prednisolone or azathioprine to efficiently maintain daily living activities and earnings between the MG patient groups during 5 consecutive years following thymectomy. Post-thymectomy clinical status, exacerbations or crises were followed. Descriptive statistics were used for analysis with statistical significance set at p < 0.05. (3) Results: ThMG patients had significantly older ages of onset and shorter times from the MG diagnosis to thymectomy. Male gender was the only significant factor associated with ThMG. TWAs of the daily MG treatment drug dosages required showed no differences between the groups. Additionally, the rates of exacerbations and crises were not different, but decremental trends were shown in both groups after the thymectomies. (4) Conclusions: The daily dosage requirements of MG treatment drugs were not different. There was a trend of decreasing adverse event rates despite no statistically significant differences during the first 5 years after thymectomy in ThMG and non-ThMG patients

Association between Bell’s Palsy and Cardiometabolic Risks: An Age- and Sex-Matched Case–Control Study

Background: Bell’s palsy is possibly an ischemic cranial neuropathy, although reactivation of herpes virus infection has been proposed. Methods: This was an age-and sex-matched and 1:2 case–control study enrolling Bell’s palsy patients during 2011–2021 in a university hospital to investigate the significant associations of cardiometabolic risks (CMRs) with Bell’s palsy. We analyzed the differences in waist circumference (WC), body mass index (BMI), systolic and diastolic blood pressures (SBP and DBP), fasting blood sugar (FBS), and lipid levels at 12 weeks post-Bell’s palsy with those of the controls by descriptive statistics (p F-tests and Kruskal–Wallis tests (p < 0.05). Results: A total of 140 cases and 280 controls were enrolled. Bell’s palsy patients had significantly higher WC, BMI, SBP, DBP, FBS, and triglyceride but lower high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Moreover, high WC, elevated FBS (≥100 mg/dL), SBP (≥130 mmHg), and total cholesterol were significantly associated with Bell’s palsy cases by multivariable analysis. Only FBS in Bell’s palsy patients significantly elevated across consecutive 10-year age intervals. Conclusion: Screening and monitoring for CMRs, especially hyperglycemia, in every patient presenting with Bell’s palsy is essential despite initial normoglycemia, particularly in older-onset cases

Integrative Effects between a Bubble and Seal Program and Workers&rsquo; Compliance to Health Advice on Successful COVID-19 Transmission Control in a Factory in Southern Thailand

Applying health measures to prevent COVID-19 transmission caused disruption of businesses. A practical plan to balance public health and business sustainability during the pandemic was needed. Herein, we describe a &ldquo;Bubble and Seal&rdquo; (B&amp;S) program implemented in a frozen seafood factory in southern Thailand. We enrolled 1539 workers who lived in the factory dormitories. First, the workers who had a high fatality risk were triaged by RT-PCR tests, quarantined and treated if they had COVID-19. Newly diagnosed or suspected COVID-19 workers underwent the same practices. The non-quarantined workers were regulated to work and live in their groups without contact across the groups. Workers&rsquo; personal hygiene and preventive measures were strongly stressed. Between the 6th and 9th weeks of the program, the post-COVID-19 infection status (PCIS) of all participants was evaluated by mass COVID-19 antibody or RT-PCR tests. Finally, 91.8% of the workers showed positive PCIS, which was above the number required for program exit. Although no workers had received a vaccination, there was only one case of severe COVID-19 pneumonia, and no evidence of COVID-19 spreading to the surrounding communities. Implementation of the B&amp;S program and workers&rsquo; adherence to health advice was the key to this success

Psychosocial factors associated with adherence to COVID-19 preventive measures in low-middle-income countries, December 2020 to February 2021

Objectives: To investigate psychosocial factors associated with adherence to COVID-19 preventive measures in low- and middle-income countries (LMICs). Methods: This online cross-sectional survey included 10,183 adults (median age 45 years) from nine LMICs. Participants were asked about adhering to four COVID-19 preventive measures (physical distancing, wearing a face mask, hand, and cough hygiene); a composite adherence score was calculated, ranging from 0–4 positive responses. Psychosocial measures included worry, anxiety, depression, social and demographic, and COVID-19 related factors. Results: Factors associated with adherence to more preventive measures included being a participant from Malaysia or Bangladesh, older age, higher education, belonging to the healthcare sector (either as or worker), having health personnel as a trusted source of COVID-19 information/advice, possessing correct COVID-19 knowledge, worry or fear about being (re)infected with COVID-19, and screening negative for general anxiety symptoms. Conclusion: Moderate to high adherence to COVID-19 preventive measures was found, with significant variations across countries. Psychosocial factors (worry, anxiety, knowledge, education, age, and country) seemed determinant in predicting the number of measures to which participants adhered