An interactive intervention to impact adherence to antiretroviral treatment among treatment-naive HIV-infected adults in Thailand: A pilot randomized controlled study

Background. Consistent adherence to antiretroviral treatment is necessary for a treatment success. Improving and maintaining adherence rate >95% are challenging for health care professionals. This pilot randomized controlled study aimed to evaluate the impact of the interactive intervention on adherence to GPO-VIR, to describe the feasibility of the interactive intervention in Thailand, and to illustrate the adherence self-efficacy concept among HIV treatment-naïve patients in Thailand who were starting antiretroviral treatment. ^ Methods. The study took place at three HIV clinics located in Phayao, Thailand. Twenty-three patients were randomly assigned into the experimental (n=11) and the control groups (n=12). Each participant in the experimental group and a significant person to the patient received 5 educational sessions with a nurse at the clinics and at their homes. They also received 3 follow-up evaluations during the 6-month period of the study. The participants in the control group received the standard of care provided by HIV clinical personnel plus three follow-up evaluations at the clinic. ^ Results. Seventeen patients (7 in the experimental and 10 in the control group) completed the study. The 4-day recall on the Thai ACTG Adherence Scale demonstrated adherence rate >95% for most participants from both groups. After the first measurement, no experimental group patients reporting missing ART, while one control group participant continuously skipped ART. Participants from both groups had significantly increased CD4 cell counts after the study (F(1, 15) = 29.30, p = .000), but no differences were found between two groups (F(1, 15) = .001, p = .98). Examination of the intervention showed limitations and possibilities to implement it in Thailand. Qualitative data demonstrated self-efficacy expectations, resignation and acceptance as related concepts to improve adherence outcomes. ^ Conclusions. This interactive intervention, after appropriate modifications, is feasible to apply for Thai HIV-treatment naïve patients. Because of limitations the study could not demonstrate whether the interactive intervention improved adherence to ART among HIV-treatment naïve in Thailand. A longitudinal study in a larger sample would be required to test the impact of the intervention. ^ Keyword: antiretroviral treatment, adherence, treatment-naïve, Thailand, randomized controlled study ^

CIGARETTE SMOKING AMONG HIGH SCHOOL STUDENTS IN RURAL AREAS OF THAILAND

The purpose of this study was to identify the smoking prevalence among high school students in rural areas of Thailand and the factors associated with their smoking habits. The sample population was comprised of 946 volunteer students of both sexes enrolled in the twelfth grade classes of the 1981-82 school year in randomly chosen regional public high schools throughout the country. Data were obtained from a formal self-administered questionnaire survey. The comparisons were treated by classified smoking habits as "non-smoker," "trier," "ex-smoker," and "smoker."^ The study presented the low rate of cigarette smoking habits among female students, compared to male students. Significant differences of smoking-related habits were found among those who had exemplar models for smoking habits; fathers, siblings and peers were their reference groups. Parental approval was found to be a significant factor associated with students' smoking habits. The awareness of health hazards, the perceptions of the influence of cigarette advertisement, and the attitudes toward the concerns of government in cigarette manufacturing were also factors associated with cigarette smoking habits of high school subjects. ^

THE EVALUATION OF PUBLIC HEALTH COMPONENTS OF INTERNATIONAL DISASTER RELIEF OPERATIONS: INDOCHINESE REFUGEES IN THAILAND, 1979-1982

Refugee populations suffer poor health status and yet the activities of refugee relief agencies in the public health sector have not been subjected previously to comprehensive evaluation. The purpose of this study was to examine the effectiveness and cost of the major public health service inputs of the international relief operation for Indochinese refugees in Thailand coordinated by the United Nations High Commissioner for Refugees (UNHCR). The investigator collected data from surveillance reports and agency records pertaining to 11 old refugee camps administered by the Government of Thailand Ministry of Interior (MOI) since an earlier refugee influx, and five new Khmer holding centers administered directly by UNHCR, from November, 1979, to March, 1982.^ Generous international funding permitted UNHCR to maintain a higher level of public health service inputs than refugees usually enjoyed in their countries of origin or than Thais around them enjoyed. Annual per capita expenditure for public health inputs averaged approximately US$151. Indochinese refugees in Thailand, for the most part, had access to adequate general food rations, to supplementary feeding programs, and to preventive health measures, and enjoyed high-quality medical services. Old refugee camps administered by MOI consistently received public health inputs of lower quantity and quality compared with new UNHCR-administered holding centers, despite comparable per capita expenditure after both types of camps had stabilized (static phase).^ Mortality and morbidity rates among new Khmer refugees were catastrophic during the emergency and transition phases of camp development. Health status in the refugee population during the static phase, however, was similar to, or better than, health status in the refugees' countries of origin or the Thai communities surrounding the camps. During the static phase, mortality and morbidity generally remained stable at roughly the same low levels in both types of camps.^ Furthermore, the results of multiple regression analyses demonstrated that combined public health inputs accounted for from one to 23 per cent of the variation in refugee mortality and morbidity. The direction of associations between some public health inputs and specific health outcome variables demonstrated no clear pattern. ^

The Relationship of Provincial Economic Level and Child Injury Mortality in Thailand: A Cross-Sectional Analysis in a Middle Income Country

The objective of this cross-sectional study was to examine the relationship of provincial economic development indices with incidences of child injury mortality in Thailand from 1999 - 2001. All injury deaths among children age 1-14 years were included. The independent variables included gross provincial product per capita (GPP/c), poverty and inequality indices, material and social deprivation indices, population in rural/ urban areas, and migration. Due to multicollinearity of such variables, the 76 provinces were categorized by GPP/c quartile, and means of overall injury, drowning, and transport-related mortality rates were compared among quartile groups. Spearman’s rho correlation between GPP/c and injury mortality rates was also performed. Finally, factor analysis was employed to create a set of factors to be treated as uncorrelated variables and stepwise multiple regression was carried out for the effects of the factors on injury mortality rates. A significant direct relationship was observed between GPP/c and overall injury mortality among children age 1-4 years, and 10-14 year-olds of both genders. Drowning was the main cause of this relationship among children age 1-4 years, and transport-related injury was the principle cause among children age 10-14 years. Conversely, provinces with lower GPP/c experienced higher injury mortality rates among school-age children 5-9 years old for both genders, mostly due to drowning. Factor analysis, and multiple regression results confirmed the relationships between economic development and injury mortality rates. These findings revealed that economic development had an adverse impact on injury-related mortality among children 1 to 4 and 10 to14 in Thailand.

"Pues doy Fe de que son tenidos como tales" : Prácticas y discursos legitimantes en el intento de conformación de una posible nobleza rioplatense

A mediados del siglo XVIII los grandes comerciantes de distintos espacios hispanoamericanos, acumulan suficientes caudales que les permiten comprar títulos de nobleza, distinciones o formar mayorazgos que relumbren sus nombres y perpetúen sus bienes adquiridos. Este proceso es mayormente evidente en los espacios mexicanos y peruanos; pero no se conocen casos concretos para el espacio rioplatense. Como planteó José Torre Revello, esto no implica que los comerciantes rioplatenses no intentasen ennoblecerse. El presente estudio de caso detalla como Don Vicente de Azcuénaga intenta fundar un mayorazgo en la ciudad de Buenos Aires a favor de su primogénito Miguel. A través de este estudio basado en las "probanzas" se puede observar como la familia Azcuénaga pretende resaltar su nombre frente al resto de sus contemporáneos, pero las relaciones entre padre e hijo nos conducen a la vez a replantearnos interrogantes referentes a las tradiciones de acumulación y conservación de patrimonios

Exilio y autotraducción en la narrativa testimonial concentracionaria argentina : El caso de The Little School. Tales of Disappearance and Survival in Argentina, de Alicia Partnoy (1986)

Algunos escritores exiliados a partir de la última dictadura militar argentina (1976-1983) tradujeron ellos mismos sus textos para publicarlos en el país de exilio. Un ejemplo es el de Alicia Partnoy, autora de The Little School. Tales of Disappearance & Survival in Argentina, quien habiendo escrito un testimonio en español sobre su paso por el campo de concentración La Escuelita, ubicado en Bahía Blanca, se dedicó a traducirlo al inglés para su publicación en Estados Unidos en 1986. Sus numerosas ediciones, primero en el extranjero y más tarde en Argentina, lo ubican entre una de las obras más importantes de la narrativa testimonial concentracionaria argentina. Una forma de abordarlo reside en el análisis sobre el proceso y el resultado de la autotraducción, lo cual permite aportar elementos de reflexión acerca de la necesidad de los supervivientes exiliados de dar a conocer su experiencia en el exilio, algo que sobrepasa, incluso, las barreras lingüísticas

"Pues doy Fe de que son tenidos como tales" : Prácticas y discursos legitimantes en el intento de conformación de una posible nobleza rioplatense

A mediados del siglo XVIII los grandes comerciantes de distintos espacios hispanoamericanos, acumulan suficientes caudales que les permiten comprar títulos de nobleza, distinciones o formar mayorazgos que relumbren sus nombres y perpetúen sus bienes adquiridos. Este proceso es mayormente evidente en los espacios mexicanos y peruanos; pero no se conocen casos concretos para el espacio rioplatense. Como planteó José Torre Revello, esto no implica que los comerciantes rioplatenses no intentasen ennoblecerse. El presente estudio de caso detalla como Don Vicente de Azcuénaga intenta fundar un mayorazgo en la ciudad de Buenos Aires a favor de su primogénito Miguel. A través de este estudio basado en las "probanzas" se puede observar como la familia Azcuénaga pretende resaltar su nombre frente al resto de sus contemporáneos, pero las relaciones entre padre e hijo nos conducen a la vez a replantearnos interrogantes referentes a las tradiciones de acumulación y conservación de patrimonios

Exilio y autotraducción en la narrativa testimonial concentracionaria argentina : El caso de The Little School. Tales of Disappearance and Survival in Argentina, de Alicia Partnoy (1986)

Algunos escritores exiliados a partir de la última dictadura militar argentina (1976-1983) tradujeron ellos mismos sus textos para publicarlos en el país de exilio. Un ejemplo es el de Alicia Partnoy, autora de The Little School. Tales of Disappearance & Survival in Argentina, quien habiendo escrito un testimonio en español sobre su paso por el campo de concentración La Escuelita, ubicado en Bahía Blanca, se dedicó a traducirlo al inglés para su publicación en Estados Unidos en 1986. Sus numerosas ediciones, primero en el extranjero y más tarde en Argentina, lo ubican entre una de las obras más importantes de la narrativa testimonial concentracionaria argentina. Una forma de abordarlo reside en el análisis sobre el proceso y el resultado de la autotraducción, lo cual permite aportar elementos de reflexión acerca de la necesidad de los supervivientes exiliados de dar a conocer su experiencia en el exilio, algo que sobrepasa, incluso, las barreras lingüísticas

"Pues doy Fe de que son tenidos como tales" : Prácticas y discursos legitimantes en el intento de conformación de una posible nobleza rioplatense

A mediados del siglo XVIII los grandes comerciantes de distintos espacios hispanoamericanos, acumulan suficientes caudales que les permiten comprar títulos de nobleza, distinciones o formar mayorazgos que relumbren sus nombres y perpetúen sus bienes adquiridos. Este proceso es mayormente evidente en los espacios mexicanos y peruanos; pero no se conocen casos concretos para el espacio rioplatense. Como planteó José Torre Revello, esto no implica que los comerciantes rioplatenses no intentasen ennoblecerse. El presente estudio de caso detalla como Don Vicente de Azcuénaga intenta fundar un mayorazgo en la ciudad de Buenos Aires a favor de su primogénito Miguel. A través de este estudio basado en las "probanzas" se puede observar como la familia Azcuénaga pretende resaltar su nombre frente al resto de sus contemporáneos, pero las relaciones entre padre e hijo nos conducen a la vez a replantearnos interrogantes referentes a las tradiciones de acumulación y conservación de patrimonios

Exilio y autotraducción en la narrativa testimonial concentracionaria argentina : El caso de The Little School. Tales of Disappearance and Survival in Argentina, de Alicia Partnoy (1986)

Algunos escritores exiliados a partir de la última dictadura militar argentina (1976-1983) tradujeron ellos mismos sus textos para publicarlos en el país de exilio. Un ejemplo es el de Alicia Partnoy, autora de The Little School. Tales of Disappearance & Survival in Argentina, quien habiendo escrito un testimonio en español sobre su paso por el campo de concentración La Escuelita, ubicado en Bahía Blanca, se dedicó a traducirlo al inglés para su publicación en Estados Unidos en 1986. Sus numerosas ediciones, primero en el extranjero y más tarde en Argentina, lo ubican entre una de las obras más importantes de la narrativa testimonial concentracionaria argentina. Una forma de abordarlo reside en el análisis sobre el proceso y el resultado de la autotraducción, lo cual permite aportar elementos de reflexión acerca de la necesidad de los supervivientes exiliados de dar a conocer su experiencia en el exilio, algo que sobrepasa, incluso, las barreras lingüísticas

Bringing Non-governmental Actors into the Policymaking Process: The Case of Local Development Policy in Thailand

During the past two decades in Thailand, non-governmental actors, such as NGOs, intellectuals, and people's organizations, have found widening opportunities to participate in policy formation and in the implementation of local development. The government has facilitated the formation of civil society forums, in the expectation of influencing local-level governance. The last two national five-year development plans were formulated after taking into account the voices of people in the provinces. Even though they may seem petty, some state funds are now transmitted through non-governmental institutions for policy implementation at the grassroots level. These changes have their origin in a reformation of rural development administration in early 1980s. This reformation in due course led to policies that have allowed the participation of non-governmental actors. Meanwhile, rural people have proved their ability to engage in participatory development by forming various local organizations, while NGOs have grown to be proficient facilitators of local development. This paper describes the process whereby three leading actors, namely the government, local people, and the NGOs, have interacted to bring about a more participatory system of local development administration.

Organizational Capability of Local Societies in Rural Development: A Comparative Study of Microfinance Organizations in Thailand and the Philippines

The importance of organizing local people for development work is widely recognized. Both governmental and non-governmental agencies have implemented various projects that have needed and encouraged collective action by people. Often, however, such projects malfunction after the outside agencies retreat from the project site, suggesting that making organizations is not the same as making a system of making organizations. The latter is essential to make rural organizations self-reliant and sustainable. This paper assumes that such a system exists in local societies and focuses on the capacity of local societies for creating and managing organizations for development. It reveals that (1) such capability differs according to the locality, (2) the difference depends on the structure of the organizations that coordinate people's social relations, and (3) the local administrative bodies define, at least partly, the organizational capability of local societies. We compare two rural societies, one in Thailand and the other in the Philippines, which show clear contrasts in both the form of microfinance organizations and the way of making these organizations.

The Regional Development Policy of Thailand and Its Economic Cooperation with Neighboring Countries

Thailand has recently strengthened its economic policy toward its neighboring countries in coordination with domestic regional development. It is widely recognized that economic cooperation with neighboring countries is essential in preventing the inflow of illegal labor and effectively utilizing labor and resources through the relocation of production bases. This direction is strengthened by elaborating the GMS-EC and the ECS (Economic Cooperation Strategy). In addition, economic dependency of the neighboring countries on Thailand is generally high. In this report, firstly, Thai regional development policy will be made clear in relation to its economic policy toward neighboring countries as well as the status quo of the industrial estates. Secondly, Thai policy toward the neighboring countries is examined referring to the concept of wide-ranging economic zones, regional economic cooperation and special border economic zones. Thirdly, the paper will discuss how closely the economies between Thailand and the neighboring countries are related through trade and investment. Lastly, some implications on Japan's economic cooperation will also be explored.