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OBJECTIVES: To develop a Thai version of the American Society of Cataract and Refractive Surgery (ASCRS)-modified Standard Patient Evaluation of Eye Dryness (SPEED) II© preoperative ocular surface disease (OSD) questionnaire (ASCRS SPEED II-Thai) and evaluate its validity and reliability in Thai cataract surgery candidates. METHODS: The original English version of the questionnaire was translated and adapted cross-culturally to Thai language. The ASCRS SPEED II-Thai was evaluated for content validity, internal consistency, and test-retest reliability. Five experts in the ocular surface field critically reviewed the ASCRS SPEED II-Thai to measure the content validity indexes (CVI). A total of 105 cataract surgery candidates were recruited from an ophthalmology clinic to complete the questionnaire. Cronbach's alpha and intraclass correlation coefficient (ICC) were calculated to assess internal consistency and test-retest reliability, respectively. RESULTS: During the translation and cross-cultural adaptation processes, only two minor modifications were made to the original version for clarification without changing their meaning. All items in the ASCRS SPEED II-Thai had an item-level CVI of 1.00, representing complete agreement among content experts. The scale-level CVI was 1.00, indicating excellent content validity of the questionnaire. The participants found no difficulty in understanding each question in the pilot test. Cronbach's alpha for the ASCRS SPEED II-Thai was 0.82, indicating good internal consistency. The test-retest reliability was good to excellent, with ICC values ranging from 0.83 to 1.00 (P < 0.001). CONCLUSIONS: The ASCRS SPEED II-Thai is a valid clinical tool with adequate reliability for preoperative OSD screening among Thai cataract surgery candidates.

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INTRODUCTION/OBJECTIVES: Workplace violence against healthcare workers has been a global problem including Thailand. However, the study has been limited partly due to lack of the standardized tool in Thai context. Therefore, this study aims to translate "Workplace Violence in the Health Sector Country Case Studies Research instruments," conducted by WHO, and to validate Thai version questionnaire. METHODS: The study was conducted to translate Workplace Violence in the Health Sector Questionnaire by WHO from English to Thai. A sample of 92 participants was accidentally selected among physicians, nurses, and health-supporting workers who took part on examined the validity and reliability of the questionnaire. The internal consistency was calculated using Cronbach's Alpha Coefficient. RESULTS: The study demonstrated that the index of item-objective congruence (IOC) of Thai version questionnaire is 0.75 to 1. Cronbach's Alpha Coefficient in Physical violence is .879, Verbal abuse is .934, Bullying/mobbing is .510, and health sector employer is .842. CONCLUSION: The Thai Version of Workplace Violence in the Health Sector Questionnaire apparently shows good validity and reliability. The questionnaire could be applied to be a useful tool for studying workplace violence in the health sector.

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OBJECTIVE: Dehydroepiandrosterone sulfate (DHEAs), a prohormone secreted by the adrenal gland, plays a role in the synthesis of sex hormones, namely, androgen and estrogen. It has been found that the amount of DHEAs is correlated with age, although most studies have focused on the correlation of serum DHEAs levels with age and sex. Thus, this noninvasive, cross-sectional study aimed to investigate the correlation of urine DHEAs levels with age and sex in healthy Thai volunteers aged 20-80 years. METHODS: DHEAs levels were measured in 178 healthy volunteers using electrochemiluminescence immunoassay and then normalized by creatinine. Multiple regression was performed to determine the correlation of urine DHEAs levels normalized by creatinine with age and sex. RESULTS: The normalized DHEAs levels are correlated with age group for both sexes. Moreover, an increasing trend in DHEAs levels was found in the age group 20-29 years, and the DHEAs level peaked at the age group 30-39 years before declining with advancing age. Based on the multiple regression analyses, the significance of the interaction term (P â€‹< â€‹0.05) indicates that both age and sex significantly contribute to the prediction of ln (DHEAs/Creatinine). Our fitted model implies the following: as age increases by 1 year, DHEAs/Creatinine is expected to decrease by 3.63% in females and by 2.18% in males. CONCLUSION: This study reports more data on clinical reference value of urine DHEAs levels in healthy volunteers. Our result demonstrates urine DHEAs levels are associated with age and sex and decline by 2-3% a year.

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BACKGROUND: There is increasing evidence of a link between environmental pollution and preventable diseases in developing countries, including Thailand. Economic development has generated several types of pollution that can affect population health. While these environmental health effects can be observed throughout life, pregnant women and children represent particularly vulnerable and sensitive groups. METHODS: The published epidemiological literature investigating environmental chemical exposure in Thai children was reviewed, highlighting those that investigated associations between exposure and subsequent health outcomes. RESULTS: The majority of the Thai epidemiological studies on environmental health in children were cross-sectional in design, with some demonstrating associations between exposure and outcome. The three main types of chemical exposure in Thai children were pesticides, heavy metals, and air pollution, which resulted from agricultural activities in countryside areas, industrial zones (both registered and unregistered establishments), mining, and traffic in inner cities. Major health outcomes included detrimental effects on cognitive function and cancer risk. Pesticide exposure was focused on, but not limited to, agricultural areas. The success of the Thai environmental policy to introduce lead-free petrol can be demonstrated by the decline of mean blood lead levels in children, particularly in urban areas. However, unregistered lead-related factories and smelters act as hidden sources. In addition, there is increasing concern, but little acknowledgement, about the effects of chronic arsenic exposure related to mining. Lastly, air pollution remains a problem in both dense city populations due to traffic and in rural areas due to contamination of indoor air and house dust with heavy metals, endotoxins and other allergens. CONCLUSIONS: The increasing number of published articles demonstrates an improved awareness of children's environmental health in Thailand. Chemical hazards, including the improper use of pesticides, environmental contamination with heavy metals (lead and arsenic), and air pollution in inner cities and indoor air, continue to be growing issues.

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BACKGROUND: Data on the incidence of new onset tuberculosis (TB) infection among healthcare workers (HCWs) in Thailand was scarce and not current. OBJECTIVES: To determine the incidence of TB, as well as the impact of TB on HCWs in a teaching hospital in Bangkok, Thailand. METHODS: A time series cross-sectional study was conducted at Ramathibodi Hospital, Bangkok, Thailand. It was a teaching hospital with 9,562 employees. Medical records of personnel with TB infection between October 1st, 2010 and September 30th, 2015 were reviewed to determine the newly diagnosed TB infection. The personnel who were treated in fiscal year 2015 were interviewed about work-related issues, health status and the impact of TB. FINDINGS: In five years, 109 personnel were diagnosed with new onset TB disease. The infection rates were 2.04, 1.97, 2.85, 2.53, and 1.35 per 1,000 persons in 2011, 2012, 2013, 2014, and 2015, respectively. The most prevalent type of TB infection was pulmonary TB. The infection rate in males was higher than in females. Pharmacists had the highest proportion of infected personnel. The second highest rate of infection was in support staff related to patient care. Twenty personnel were interviewed. Most of them worked in patient care units with central-type air-conditioning system without negative-pressure rooms for TB patients. Contracting TB had an impact on productivity at work, health (physically, mentally and socially) and incomes. CONCLUSIONS: Ramathibodi HCWs had higher rate of TB infection than the general Thai population, but the incidence was noted to be decreasing from 2013 to 2015. HCWs suffered from the impact of TB on their lives in multiple ways. Due to the adverse impact of TB on the health and welfare of its employees, hospital administration should apply effective preventive measures and develop a compensation system for HCWs infected with TB.

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BACKGROUND: Introducing reflective writing to a medical curriculum requires the acceptance and participation of teachers. The purpose of this study was to explore medical teachers' views on the benefits of introducing a reflective writing exercise into an undergraduate medical curriculum, including their levels of satisfaction and their concerns. We also investigated effects on the teachers' personal and professional development arising from their roles as novice facilitators. METHODS: A qualitative approach was employed using semi-structured interviews. During an attachment to Primary Care Medicine course, fourth-year medical students (n = 180) in the Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand were assigned to write a reflective essay titled, "A Significant Event in My First Clinical Year". After reading the essays and facilitating between one to three small group discussions based on these, each of the 18 teachers enrolled in our study completed an in-depth face to face interview. Transcripts of these were studied, using thematic content analysis to identify emerging themes. RESULTS: The novice facilitators felt that facilitated reflection was both valuable and appropriate for students. They also perceived that it had a positive impact on their own personal and professional lives. In the early phase of implementing this activity, teachers expressed concerns about 1) their ability and confidence as facilitators in small group discussion 2) their ability to deal with emotions raised within their groups 3) the effectiveness of the activity 4) poor presentation and possible fabrication of student work. CONCLUSIONS: Most teachers regarded this activity as being beneficial to them, to student learning, and to the curriculum. Their insights, including concerns about the level of skill needed for facilitation, provide valuable material for planning a comprehensive faculty development programme.

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This systematic review aimed to assess the efficacy of psychosocial interventions in reducing risk of low birth weight (LBW) and preterm birth (PTB) in teenage pregnancy. Relevant studies were identified from Medline, Scopus, CINAHL, and CENTRAL databases. Randomized controlled trials investigating effect of psychosocial interventions on risk of LBW and PTB, compared to routine antenatal care (ANC) were eligible. Relative risks (RR) of LBW and PTB were pooled using inverse variance method. Mean differences of birth weight (BW) between intervention and control groups were pooled using unstandardized mean difference (USMD). Five studies were included in the review. Compared with routine ANC, psychosocial interventions significantly reduced risk of LBW by 40% (95%CI: 8%,62%) but not for PTB (pooled RR = 0.67, 95%CI: 0.42,1.05). Mean BW of the intervention group was significantly higher than that of the control group with USMD of 200.63 g (95% CI: 21.02, 380.25). Results of our study suggest that psychosocial interventions significantly reduced risk of LBW in teenage pregnancy.

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