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Copyright of Austrian Journal of South-East Asian Studies / Österreichische Zeitschrift für Südostasienwissenschaften is the property of South-East Asian Studies / Gesellschaft fur Sudestasienwissenschaften and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND AND OBJECTIVES: Although the deleterious effects of air pollution from fossil fuel combustion have been demonstrated in many Western nations, fewer studies have been conducted in Asia. The Public Health and Air Pollution in Asia (PAPA) project assessed the effects of short-term exposure to air pollution on daily mortality in Bangkok, Thailand, and in three cities in China: Hong Kong, Shanghai, and Wuhan. METHODS: Poisson regression models incorporating natural spline smoothing functions were used to adjust for seasonality and other time-varying covariates that might confound the association between air pollution and mortality. Effect estimates were determined for each city and then for the cities combined using a random effects method. RESULTS: In individual cities, associations were detected between most of the pollutants [nitrogen dioxide, sulfur dioxide, particulate matter ≤ 10 µm in aerodynamic diameter (PM10), and ozone] and most health outcomes under study (i.e., all natural-cause, cardiovascular, and respiratory mortality). The city-combined effects of the four pollutants tended to be equal or greater than those identified in studies conducted in Western industrial nations. In addition, residents of Asian cities are likely to have higher exposures to air pollution than those in Western industrial nations because they spend more time outdoors and less time in air conditioning. CONCLUSIONS: Although the social and environmental conditions may be quite different, it is reasonable to apply estimates derived from previous health effect of air pollution studies in the West to Asia. [ABSTRACT FROM AUTHOR]

The article presents a survey on evaluating the required levels of mastery in core public health competencies and relevant skills in Thailand. Respondents were made to assess whether the 70 public health skills was a core or non-core skill. Each core skill was assigned a three-level ranking of awareness, knowledge and proficiency. Inconsistencies in the degree of detail in skill descriptions and lack of distinction among attitudes, skills and knowledge were noticed. Findings show that the core competency model needs to be refined further.

While the effects of particulate matter (PM*) on mortality have been well documented in North America and Western Europe, considerably less is known about its effects in developing countries in Asia. Existing air pollution data in Bangkok, Thailand, indicate that airborne concentrations of PM < or = 10 pm in aerodynamic diameter (PM10) are as high or higher than those experienced in most cities in North America and Western Europe. At the same time, the demographics, activity patterns, and background health status of the population, as well as the chemical composition of PM, are different in Bangkok. It is important, therefore, to determine whether the effects of PM10 on mortality occurring in this large metropolitan area are similar to those in Western cities. The quality and completeness of Bangkok mortality data have been recently enhanced by the completion of a few mortality studies and through input from monitors currently measuring daily PM10 in Bangkok. In this analysis, we examined the effects of PM10 and several gaseous pollutants on daily mortality for the years 1999 through 2003. Our results suggest strong associations between several different mortality outcomes and levels of PM10 and several of the gaseous pollutants, including nitrogen dioxide (NO2), nitric oxide (NO), and ozone (O3). In many cases, the effect estimates were higher than the approximately 6% per 10 microg/m3 typically reported in Western industrialized nations-based on reviews by the U.S. Environmental Protection Agency (U.S. EPA) and the World Health Organization (WHO) (Anderson et al. 2004). For example, the excess risk (ER) for mortality due to all natural causes was 1.3% (95% confidence interval [CI], 0.8 to 1.7), with higher ERs for cardiovascular and respiratory mortality of 1.9% (95% CI, 0.8 to 3.0) and 1.0% (95% CI, -0.4 to 2.4), respectively. Of particular note, for this warm, tropical city of approximately 6 to 10 million people, is that there is no covariation between pollution and cold weather, with its associated adverse health problems. Multiday averages of PM10 generated even higher effect estimates. Our analysis of age- and disease-specific mortality indicated elevated ERs for young children, especially infants with respiratory illnesses, children less than 5 years of age with lower respiratory infections (LRIs), and people with asthma. Age-restricted analyses showed that the associations between mortality due to all natural causes and PM10 concentration increased with age, with the strongest effects among people aged 75 years and older. However, associations between increases in PM10 concentration and mortality were observed for all of the other age groups. With a few exceptions, relatively similar results were observed for several of the other pollutants-sulfur dioxide (SO2), NO2, O3, and NO, which were highly correlated with PM10. However, many of the effects from gaseous pollutants were attenuated in multipollutant models, while effects from PM10 appeared to be most consistent. In addition, there was some evidence of an independent effect of O3 for certain health outcomes. We conducted substantial sensitivity analyses to examine whether our results were robust. The results indicated that our core model was generally robust to the choice of model specification, spline model, degrees of freedom (df) of time-smoothing functions, lags for temperature, adjustment for autocorrelation, adjustment for epidemics, and adjustment for missing values using centered data (see the description of the centering method used in the Common Protocol found at the end of this volume). Finally, the concentration-response functions for most of the pollutants appear to be linear. Thus, our sensitivity analyses results suggest an impact of pollution on mortality in Bangkok that is fairly consistent. They also provide support for the extrapolation of results from health effects studies conducted in North America and Western Europe to other parts of the world, including developing countries in Asia.

This pilot study was undertaken to determine the impact of team-based learning (TBL) on graduate students of public health in a Thai context. The pilot project adopted Michaelsen's approach with the aim of improving learning among Thai graduate students enrolled in public health ethics. This TBL approach attempted to motivate students to do pre-class reading and be active "in-class" learners. Pre-class preparation allowed teachers to address and concentrate on learning gaps, while team work promoted peer interaction and active learning. TBL was found to be useful in fostering student preparedness and to transform "passive" into "active" learning, which especially benefited students "academically at risk" through peer teaching opportunities. With TBL, students valued the relevance of the course content and learning materials. They had positive opinions regarding the effect of TBL on individual and group learning. TBL was perceived to be instrumental in translating conceptual into applicable knowledge, and stimulated individual efforts as well as accountability. This study should be useful to those considering using TBL for public health education.

The purpose of the present study was to investigate the factors that affect short-term memory dysfunction among children, 6 to 13 years of age, residing near the Petrochemical Industrial Estate, Map Ta Phut sub-district, Rayong province. A population-based cross-sectional study was employed for collecting data on neurobehavioral effects using the Digit Span Test. The present study found one-third of 2,158 children presented with short-term memory dysfunction. It was found an inverse association between short-term memory dysfunction with 2 out of 25 communities; Islam (adjusted OR 0.382) and Taladmabtaput (adjusted OR 0.297). In addition, short-term memory dysfunction was also found an inverse association with distance from residential areas to the industrial park (adjusted OR 0.871). It was also found that an association between short-term memory dysfunction and length of living period in study areas was not clear The finding on short-term memory dysfunction indicated that children with short-term memory dysfunction were affected by the distance from residential areas to source of pollution and community.

Unplanned pregnancy is one of the most difficult life experiences for young women. Women are often confused and seek help and support. When the problem occurs, a woman has three choices: parenting the baby, planning for adoption, or terminating the pregnancy. Choosing one of these three options is often difficult. This study aimed to identify the factors (variables) influencing women's decision making when choosing the options available to them. The study was conducted in five shelters and low-income communities in the Bangkok area. Data were collected for five months, November 2003 to March 2004. Young women, age 13-24, who experienced an unplanned pregnancy at least once, or currently experiencing an unplanned pregnancy, were recruited into the study. One hundred and twenty volunteer cases were recruited. Discriminant analysis was used to determine the factors that affecting the choices of young women with unplanned pregnancies. There were 6 potential influencing variables, in three broad categories of factors that influenced their choices. In this study, the influencing factors from the personal history variables were, age of the most recent unplanned pregnancy. The individual psychosocial variables were: attitude towards unplanned pregnancy, attitude towards contraception, and making a decision without consultation. The relationship variables were: relationship with partner, and consulting partner when having a problem. The results from discriminant analysis yielded 68.3% predictive accuracy. This result was satisfactory compared with a 33% chance of accuracy (classified as chance alone would yield a 33% accuracy). Knowing the influencing factors for the choices of young women with unplanned pregnancies allows us to understand the women's decisions and their utilization of services with some degree of confidence. The program managers or implementers should do as much as possible to support the decision making process in these young women in order to provide better information and services to reduce the impact, both physical and mental, of the selected choice.

Several epidemiological studies have demonstrated the association of short-term exposure to air pollution with transient declines in pulmonary function. Although the magnitudes of declines in pulmonary function found in these studies are relatively small, the effects vary among children. This study examined whether the variation is evidence of biological heterogeneity or due to random variation by analyzing data from a panel study of 83 asthmatic school children exposed to SO2 and PM10 in the Mae Moh district of Thailand. Daily pulmonary function testing was performed on the children for 61 days. General linear mixed models were used to examine and test for the null hypothesis of no variation in the subject-specific slopes of pulmonary functions in response to the air pollutants. The individual daily pulmonary functions measured were FVC, FEV1, PEFR, and FEF(25-75%). These were used as an outcome to compare with air pollutant concentrations as random effects, adjusting for height, gender, time, and temperature. The results indicate evidence of inter-individual variation for subject-specific changes in FVC, FEV1, and PEFR due to the effects of SO2 and PM10 on children. In conclusion, even at low concentrations of daily SO2 and PM10 in the study area, there is evidence of a heterogeneous response to short-term exposure to SO2 and PM10 in children.

Epidemiological studies to evaluate the acute effects of ambient SO2 on the respiratory health of children provide inconclusive results. A panel study to examine the association of short-term exposure to ambient SO2 and respiratory symptoms of 196 children for a period of 107 days was conducted in Thailand. Generalized Estimating Equations were used to examine the association of daily variation of air pollution with daily respiratory symptoms. During the study period, SO2 was not associated with respiratory symptoms in either asthmatics or non-asthmatics, whereas a 10 microg/m3 increase in PM10 was modestly associated with increases of lower respiratory symptom incidence (OR=1.03, 95%CI=0.98, 1.09) and cough (OR=1.04, 95% CI=1.00, 1.08) in asthmatics. At the low ambient air pollution concentrations observed, particulate matter rather than SO2 was associated on a microg/m3 basis with acute daily respiratory symptoms.