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OBJECTIVESThis study aimed to characterize the prevalence of poor sleep quality and to identify associated factors among community-dwelling elderly individuals in northern Thailand.METHODSA cross-sectional study was conducted among 266 randomly selected elderly people in a sub-district in rural Chiang Rai Province, northern Thailand. The participants were interviewed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI).RESULTSRoughly 44.0% of the participants had poor sleep quality (PSQI score, >5), 9.4% used sleep medication, 27.1% had poor family relationships, and 12.0% had mild depression. Multiple logistic regression analysis indicated that being female (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.10 to 3.02), a higher education level (OR, 3.03; 95% CI, 1.34 to 6.86 for primary school; OR, 2.48; 95% CI, 1.31 to 5.44 for higher than primary school), mild depression (OR, 2.65; 95% CI, 1.11 to 6.36), and poor family relationships (OR, 3.65; 95% CI, 1.98 to 6.75) were significantly associated with poor sleep quality.CONCLUSIONSThe prevalence of poor sleep quality among the elderly was moderately high. Healthcare providers should regularly conduct screenings for sleep quality and depression; provide sleep health education; and conduct interventions to encourage participating in family activities, resolving conflicts, sharing ideas, and making compromises within the family.

Serum Cholinesterase Levels of Thai Chilli-Farm Workers Exposed to Chemical Pesticides: Prevalence Estimates and AssociatedFactors: Prasit KACHAIYAPHUM, et al. Faculty of Public Health, Mahidol University, Thailand-Objective: To estimate the prevalence of, and factors associated with, abnormal serum cholinesterase (SChE) levels among chilli-farm workers in Chatturat District, Chaiyaphum Province. Methods: A total of 350 chilli-farm workers aged 18-60 yr were randomly sampled and interviewed. A reactive-paper finger-blood test was used to assess SChE levels. Results: The prevalence of abnormal SChE levels was 32.0%. The most common pesticide-related symptoms were dizziness (38.0%), headache (30.9%), nausea/vomiting (26.9%), and fever (26.9%). Multiple logistic regression analysis revealed 7 factors were independently associated with abnormal SChE level: male gender, single/separated/ divorced, being a permanent worker, spraying pesticide more than 3 times per month, having moderate or poor pesticide-use behaviors, and low perceived susceptibility and severity of pesticide use. Conclusions: The prevalence of abnormal SChE levels among chilli-farm workers was quite high. It would be beneficial to decrease pesticide use and encourage alternative measures. Effective preventive interventions to increase correct perceptions of pesticide use, the use of personal protective measures and continuing monitoring for blood cholinesterase, especially for male permanent farm workers, are recommended. (J Occup Health 2010; 52: 89-98)

This cross-sectional study is aimed to measure the prevalence of patient adherence to treatment regimens and factors affecting glycemic control among Type 2 diabetes patients. 243 diabetes patients seeking care at a tertiary hospital diabetic clinic in Bangkok were interviewed. HbA1c was used as an index of glycemic control. The proportions of cases with good adherence to physical exercise and diet regimen were 31.7 and 54.3%, respectively. About 46.5% reported receiving good social support for diabetes from his/her family. The median of HbA1c was 8% (normal range 4.7-6.3%). Approximately 33.3% achieved good glycemic control (HbAlc < or =7%), while 50.2% had poor control (HbAlc >8%). Multiple logistic regression analysis indicated two variables were significantly associated with glycemic control: adherence to diet control and exercise. Interactive health education should be introduced to increase patient adherence to treatment regimens. Family members should be informed about their important roles in encouraging patients' glycemic control.

High HIV incidence has been reported in young men who have sex with men (YMSM) in North America and Western Europe, but there are limited data from Southeast Asia suggesting MSM may be the driver of the HIV epidemic in this region. We described HIV incidence and risk factors among 494 YMSM enrolled in a cohort study in Bangkok, Thailand. The HIV incidence was 7.4 per 100 person-years. In multivariable analysis, reporting use of an erectile dysfunction drug in combination with club drugs, having receptive or both insertive and receptive anal intercourse with men, having hepatitis A infection, having rectal Chlamydia trachomatis, having hepatitis B infection prior to HIV seroconversion, and reporting not always using condoms with male steady partners were significantly associated with HIV incidence in YMSM. Reduction in new HIV infections in YMSM are critical to reach targets set by Thailand and the region.

We examined the influence of work-related effort–reward imbalance and overcommitment to work (OC), as derived from Siegrist's Effort–Reward Imbalance (ERI) model, on the hypothalamic–pituitary–adrenocortical (HPA) axis. We hypothesized that, among healthy workers, both cortisol and dehydroepiandrosterone (DHEA) secretion would be increased by effort–reward imbalance and OC and, as a result, cortisol-to-DHEA ratio (C/D ratio) would not differ by effort–reward imbalance or OC. The subjects were 115 healthy female nursery school teachers. Salivary cortisol, DHEA, and C/D ratio were used as indexes of HPA activity. Mixed-model analyses of variance revealed that neither the interaction between the ERI model indicators (i.e., effort, reward, effort-to-reward ratio, and OC) and the series of measurement times (9:00, 12:00, and 15:00) nor the main effect of the ERI model indicators was significant for daytime salivary cortisol, DHEA, or C/D ratio. Multiple linear regression analyses indicated that none of the ERI model indicators was significantly associated with area under the curve of daytime salivary cortisol, DHEA, or C/D ratio. We found that effort, reward, effort–reward imbalance, and OC had little influence on daytime variation patterns, levels, or amounts of salivary HPA-axis-related hormones. Thus, our hypotheses were not supported.

The serious shortage of registered nurses (RNs) in Thailand has made the Thai government tentatively propose a policy to extend the working life of Ministry of Public Health nurses. This study aimed to estimate the proportion of those RNs who intend to extend their working life and analyzed the associations between general characteristics, quality of work life, and job characteristics of the RNs and their intention to work past retirement age. This cross-sectional study was conducted from October 2016 to April 2017. Self-administered questionnaires were distributed nationally to 3,629 RNs in the age group 55-59 years and working for the Ministry of Public Health (MoPH), Thailand. The response rate was 85.0% (3,092 RNs). Due to the small number of male participants (n=74), males were excluded from the study. The analysis was limited to the 3,018 participants who returned the questionnaire and met the inclusion criteria. Descriptive statistics and multiple logistic regression were used for data analysis. Of the 3,018 participants, the proportion of RNs intending to extend their working life from 60 to 65 years was 30.5%. In the Service Department, the factors significantly associated with intention to extend working life were perceived good or very good health status, no shift work, monthly income more than 50,000 THB (1,595 USD), and having moderate or good working resources (p<0.01). In the four Academic Departments, perceived good or very good health status, monthly income more than 50,000 THB, family members not against the working life extension, and moderate or good working resources were the factors affecting intention to extend working life (p<0.01). This study indicated that understanding the various factors related to the intention to extend working life among RNs could lead to the design of appropriate programs to encourage them to continue working after the current retirement age.

Job strain has become a major concern because of its potential impacts on worker well-being and performance. This cross-sectional study aimed to assess the prevalence of, and examine factors associated with, job strain among workers in a rubber-glove factory, in a central province of Thailand. A total of 200 workers aged 18-55 yr, who had worked at the factory for at least 6 months, completed the Job Content Questionnaire (JCQ) (Thai Version). Two of 5 scales in the JCQ were used to measure job strain, i.e.; job control and psychological job demand. The prevalence of job strain was 27.5%. Multiple logistic regression analysis indicated two variables significantly associated with job strain: low supervisor social support (adjusted OR=3.08; 95%CI: 1.38-6.91) and high job insecurity (adjusted OR=2.25; 95%CI: 1.04-4.88). Effective training for supervisors, to create good relationships among workers and supervisors, and ensuring steady and secure jobs for good employees, are necessary.