Shift work was associated with burnout in this sample. Increased years of work as a shift worker were associated with more frequent burnout. Adequate sleeping hours and days off were found to be possible protective factors. Policies on shift work should take into account the potential of such work for contributing towards increasing burnout.

Many environmental factors contribute to the rise in prevalence of obesity in populations but one key driver is urbanization. Countries in Southeast (SE) Asia have undergone rapid changes in urbanization in recent decades. The aim of this study is to provide a systematic review of studies exploring the relationship between living in an urban or rural environment (urbanicity) and obesity in Southeast Asia. In particular, the review will investigate whether the associations are uniform across countries and ages, and by sex. The literature search was conducted up to June 2014 using five databases: EMBASE, PubMed, GlobalHealth, DigitalJournal and Open Grey. Forty-five articles representing eight of the eleven countries in SE Asia were included in the review. The review found a consistent positive association between urbanicity and obesity in countries of Southeast Asia, in all age groups and both genders. Regional differences between the associations are partly explained by gross national income (GNI). In countries with lower GNI per capita, the association between urbanicity and obesity was greater. Such findings have implications for policy makers. They imply that population level interventions need to be country or region specific, tailored to suit the current stage of economic development. In addition, less developed countries might be more vulnerable to the negative health impact of urbanization than more developed countries.

Purpose:This study aimed to explore the associations between learning styles and high academic achievement and to ascertain whether the factors associated with high academic achievement differed between preclinical and clinical students.Methods:A survey was conducted among undergraduate medical students in Chiang Mai University, Thailand. The Index of Learning Styles questionnaire was used to assess each student’s learning style across four domains. High academic achievement was defined as a grade point average of at least 3.0.Results:Of the 1,248 eligible medical students, 1,014 (81.3%) participated. Learning styles differed between the preclinical and clinical students in the active/reflective domain. A sequential learning style was associated with high academic achievement in both preclinical and clinical students. A reflective learning style was only associated with high academic achievement among preclinical students.Conclusion:The association between learning styles and academic achievement may have differed between preclinical and clinical students due to different learning content and teaching methods. Students should be encouraged to be flexible in their own learning styles in order to engage successfully with various and changing teaching methods across the curriculum. Instructors should be also encouraged to provide a variety of teaching materials and resources to suit different learning styles.

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Introduction. Electronic health records offer a valuable resource to improve health surveillance and evaluation as well as informing clinical decision making. They have been introduced in many different settings, including low- and middle-income countries, yet little is known of the progress and effectiveness of similar information systems within Asia. This study examines the implementation of EHR systems for use at a population health level in Asia and to identify their current role within public health, key success factors, and potential barriers in implementation. Material and Methods. A systematic search process was implemented. Five databases were searched with MeSH key terms and Boolean phrases. Articles selected for this review were based on hospital provider electronic records with a component of implementation, utilisation, or evaluation for health systems or at least beyond direct patient care. A proposed analytic framework considered three interactive components: the content, the process, and the context. Results. Thirty-two articles were included in the review. Evidence suggests that benefits are significant but identifying and addressing potential challenges are critical for success. A comprehensive preparation process is necessary to implement an effective and flexible system. Discussion. Electronic health records implemented for public health can allow the identification of disease patterns, seasonality, and global trends as well as risks to vulnerable populations. Addressing implementation challenges will facilitate the development and efficacy of public health initiatives in Asia to identify current health needs and mitigate future risks.

BackgroundReducing physical inactivity among the population is a challenge for many nations. Targeting leisure time physical activity (LTPA) may be useful in increasing overall physical activity as it is assumed it is associated with a higher degree of free choice and personal preference than physical activity at work and during travel. The study explored the prevalence of physical inactivity and focused on the overall level of energy expenditure and energy level spent during leisure time among those who were physically inactive and assessed the stages of change for LTPA among those who were physically inactive.MethodsA population-based survey was conducted in 2014 in Chiang Mai, Thailand using a stratified two-stage cluster sampling technique. The Global Physical Activity Questionnaire (GPAQ) was used to collect the data on physical activity. Sufficient levels of physical activity (PA) were defined as ≥150 min/week of moderate-intensity PA or ≥75 min/week of vigorous-intensity PA or ≥600 metabolic equivalent of task (MET)-minutes/week. Weighted analyses were used to estimate the prevalence of physical inactivity, the total energy expenditure and expenditure during LTPA as well as stages of change among the physically inactive population.ResultsA total of 1744 people (808 men and 936 women), aged 15 to 64 years, participated in the study. We estimated that a quarter (26%) of the population were physically inactive. Physical inactivity was more commonly found among women than men in most age groups. LTPA contributed a small proportion of overall PA. On average, physically inactive men spent 132.8 MET-minutes/week and inactive women spent 208.2 MET-minutes/week in overall PA which is well below the 600 MET-minutes/week recommend by the World Health Organization. Around 75% of physically inactive people had no intention of engaging in regular LTPA.ConclusionAbout a quarter of the investigative population were physically inactive. Most physically inactive members of the population participate in low levels of LTPA, but the majority has no intention of increasing PA during leisure time. A large-scale health promotion program is needed, and it should focus on an approach for the pre-contemplated population.

Health literacy is increasingly recognized as an important determinant of health outcomes, but definition, measurement tools, and interventions are lacking. Conceptual frameworks must include both individual and health-systems domains which, in combination, determine an individual’s health literacy. Validated tools lack applicability in marginalized populations with very low educational levels, such as migrant worker communities on the Myanmar-Thailand border. We undertake a comprehensive health literacy assessment following a case study of a recent public health campaign promoting preconceptual folic acid uptake in this community. A mixed-methods design utilized quantitative analysis of the prevalence and predictors of low Health literacy, and focus group discussions to gather qualitative data from women about proposed and actual posters used in the campaign. Health literacy was measured with a locally developed tool that has been used in surveys of the population since 1995. Health literacy was low, with 194/525 (37.0%) of tested women demonstrating adequate health literacy, despite 63.1% (331/525) self-reporting being literate. Only one third of women had completed 4th grade or above and reported grade level attained in school was more predictive of health literacy than self-reported literacy. Focus group discussions revealed that low literacy, preconceived associations, and traditional health beliefs (individual domain) interacted with complex images, subtle concepts, and taboo images on posters (health-systems domain) to cause widespread misunderstandings of the visuals used in the campaign. The final poster still required explanation for clarity. Low health literacy is prevalent among pregnant women from this migrant community and barriers to communication are significant and complex. Public health posters need piloting prior to implementation as unanticipated misperceptions are common and difficult to overcome. Verbal communication remains a key method of messaging with individuals of low health literacy and educational system strengthening and audiovisual messaging are critical for improvement of health outcomes.

BackgroundSexual health is one of the key dimensions of health across all ages. Understanding risky sexual behaviors remains an important area of public health research. This study aimed to explore sexual health, risky sexual behaviors and factors associated with recent condom use as condom use is considered a main intervention proven to reduce negative health consequences of risky sexual behaviors, specifically related to sexually transmitted infections and unintended pregnancies. A stratified two-stage cluster sampling technique survey was conducted in Chiang Mai, Thailand. Information was obtained about age of first sexual intercourse, sexual activity, condom use, number of partners and history of drug/alcohol use prior to sexual activities within the past 3 months. A weighted analysis was performed to account for data clustering.ResultsIt is estimated that most men (93%) and women (86%) in Chiang Mai have engaged in sexual intercourse. More than 70% of the people in Chiang Mai over age 30 remained sexually active in the past 3 months, even for populations over age 50. Eight percent of male teenagers reported having more than one sexual partner in the past 3 months. Regular condom use was reported in less than 5% of the population (6.6% men and 3.1% women).ConclusionsOur study demonstrated that sexual health is an important public health issue across all age groups. Condom use has been promoted as one way to minimize and prevent unintended consequences of sexual behavior but overall use remains low.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-3055-1) contains supplementary material, which is available to authorized users.