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1.
C Beyrer SD Baral F van Griensven SM Goodreau S Chariyalertsak AL Wirtz R Brookmeyer 《Lancet》2012,380(9839):367-377
Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world. 相似文献
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Kawichai S Celentano D Srithanaviboonchai K Wichajarn M Pancharoen K Chariyalertsak C Visrutaratana S Khumalo-Sakutukwa G Sweat M Chariyalertsak S;Project Accept Study Team 《AIDS and behavior》2012,16(5):1227-1237
Project Accept is a RCT designed to test the efficacy of community mobilization (CM), mobile voluntary counseling and testing (MVCT), and post-test support services (PTSS) in reducing HIV incidence in three African countries and Thailand. The intervention started in rural areas, northern Thailand in January 2006. CM initially included door-to-door visits during the daytime, small group discussions and joining organized meetings and followed by MVCT. In February 2007, CM strategy using HIV/AIDS "edutainment" (education and entertainment) during evening hours was introduced. After edutainment was initiated, the number of participants increased substantially. VCT uptake increased from 18 to 28 persons/day on average (t test; t = 7.87 P < 0.0001). Edutainment especially motivated younger people, as the median age of VCT clients decreased from 38 to 35 years old (median test; z = 6.74, P < 0.0001). Providing free MVCT in community settings along with edutainment during evening hours increased VCT uptake and was particularly attractive to younger adults. 相似文献
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Kevany S Khumalo-Sakutukwa G Murima O Chingono A Modiba P Gray G Van Rooyen H Mrumbi K Mbwambo J Kawichai S Chariyalertsak S Chariyalertsak C Paradza E Mulawa M Morin SF 《BMC public health》2012,12(1):459
ABSTRACT: BACKGROUND: Study-based HIV prevention interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of 'public health diplomacy' issues. We report on the adaptations development, approval and implementation process and describe adaptations from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. METHODS: We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations in terms of facilitating intervention implementation. RESULTS: Across sites, proposed adaptations were identified by field staff and submitted to project directors for review, on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approving. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa); environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of 'youth-friendly' services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand; adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). CONCLUSIONS: Adaptation selection, development and approval during multi-site HIV intervention research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a 'public health diplomacy' perspective. 相似文献
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Wiparat Manuyakorn Chalerat Direkwattanachai Suwat Benjaponpitak Wasu Kamchaisatian Cherapat Sasisakulporn Wanlapa Teawsomboonkit 《Pediatrics international》2010,52(1):118-125
Background: Dry powder inhalers (DPI) are alternative devices for delivering medication for treatment of asthma. The amount of drug delivery to the lungs is directly influenced by peak inspiratory flow rate (PIFR). A minimum PIFR of −30 L/min is needed for the Turbuhaler and Accuhaler.
Methods: In order to evaluate the sensitivity of the Turbutester and Accuhaler tester in detecting the minimum and optimum PIFR for the Turbuhaler and Accuhaler in asthmatic children, PIFR was measured using the In-Check Dial through the internal resistance of the Turbuhaler and Accuhaler and compared according to the child's ability to make a whistle sound via both testers.
Results: A total of 259 asthmatic children were studied: 20 pre-school children, aged 5–6 years; 174 school-age children, aged 7–12 years; and 65 adolescents, aged 13–18 years. The sensitivity of the Turbutester and Accuhaler tester to detect optimum PIFR were 98.40% and 97.2%, respectively. In the comparison among age groups, the sensitivity of the Accuhaler tester to detect optimum or minimum PIFR for the Accuhaler was 95%, 97.7% and 95.4%, respectively. The sensitivity of the Turbutester to detect optimum PIFR for the Turbuhaler was 94.4%, 98.8% and 98.5%, respectively. The sensitivity of the Turbutester to detect minimum PIFR for the Turbuhaler was 94.7%, 100% and 100%, respectively. There were no significant differences in percentage of having optimum or minimum PIFR among asthma severity and current device usage in all age groups.
Conclusions: Most children aged at least 5 years could generate enough PIFR to use dry powder inhaler devices. Both the Turbutester and Accuhaler tester were found to have high sensitivity in detecting optimum and minimum required PIFR. 相似文献
Methods: In order to evaluate the sensitivity of the Turbutester and Accuhaler tester in detecting the minimum and optimum PIFR for the Turbuhaler and Accuhaler in asthmatic children, PIFR was measured using the In-Check Dial through the internal resistance of the Turbuhaler and Accuhaler and compared according to the child's ability to make a whistle sound via both testers.
Results: A total of 259 asthmatic children were studied: 20 pre-school children, aged 5–6 years; 174 school-age children, aged 7–12 years; and 65 adolescents, aged 13–18 years. The sensitivity of the Turbutester and Accuhaler tester to detect optimum PIFR were 98.40% and 97.2%, respectively. In the comparison among age groups, the sensitivity of the Accuhaler tester to detect optimum or minimum PIFR for the Accuhaler was 95%, 97.7% and 95.4%, respectively. The sensitivity of the Turbutester to detect optimum PIFR for the Turbuhaler was 94.4%, 98.8% and 98.5%, respectively. The sensitivity of the Turbutester to detect minimum PIFR for the Turbuhaler was 94.7%, 100% and 100%, respectively. There were no significant differences in percentage of having optimum or minimum PIFR among asthma severity and current device usage in all age groups.
Conclusions: Most children aged at least 5 years could generate enough PIFR to use dry powder inhaler devices. Both the Turbutester and Accuhaler tester were found to have high sensitivity in detecting optimum and minimum required PIFR. 相似文献
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A retrospective study on 158 Thai patients with juvenile idiopathic arthritis followed in a single center over a 15‐year period 下载免费PDF全文
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Suwat Ramjan Weerachart Tangchirapat Chai Jaturapitakkul Cheah Chee Ban Peerapong Jitsangiam Teewara Suwan 《Materials》2021,14(6)
The alkali-silica reaction (ASR) is an important consideration in ensuring the long-term durability of concrete materials, especially for those containing reactive aggregates. Although fly ash (FA) has proven to be useful in preventing ASR expansion, the filler effect and the effect of FA fineness on ASR expansion are not well defined in the present literature. Hence, this study aimed to examine the effects of the filler and fineness of FA on ASR mortar expansion. FAs with two different finenesses were used to substitute ordinary Portland cement (OPC) at 20% by weight of binder. River sand (RS) with the same fineness as the FA was also used to replace OPC at the same rate as FA. The replacement of OPC with RS (an inert material) was carried out to observe the filler effect of FA on ASR. The results showed that FA and RS provided lower ASR expansions compared with the control mortar. Fine and coarse fly ashes in this study had almost the same effectiveness in mitigating the ASR expansion of the mortars. For the filler effect, smaller particles of RS had more influence on the ASR reduction than RS with coarser particles. A significant mitigation of the ASR expansion was obtained by decreasing the OPC content in the mortar mixture through its partial substitution with FA and RS. 相似文献
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Ellen Setsuko Hendriksen Daniel Hlubinka Suwat Chariyalertsak Alfred Chingono Glenda Gray Jessie Mbwambo Linda Richter Michal Kulich Thomas J. Coates 《AIDS and behavior》2009,13(6):1213-1221
Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence
community members’ uptake of voluntary counseling and testing. Drawing from Noelle-Neumann’s spiral of silence theory, this
study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe,
South Africa, and Thailand. Participants (N = 14,818) in 48 communities across five sites throughout the four countries completed a behavioral survey assessing communication,
prior voluntary counseling and testing (VCT) uptake, social norms, stigma, and sexual risk. Site-specific logistic regression
models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site.
Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results
indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions
should be considered. 相似文献
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W Aekplakorn R Sangthong P Kessomboon P Putwatana R Inthawong S Taneepanichskul P Sritara S Sangwatanaroj S Chariyalertsak;the National Health Examination Survey 《Journal of hypertension》2012,30(9):1734-1742
OBJECTIVE:: To determine the changes in prevalence, awareness, treatment and control of hypertension and their metabolic risk factors in Thai population between 2004 and 2009. METHODS:: The Thai National Health Examination Survey (NHES) in 2004 and 2009 data were used. Blood pressure and anthropometric measurements were performed. Prevalence, awareness, treatment and control of hypertension of Thai population aged at least 15 years were calculated. Analyses were weighted to the probability of sampling. RESULTS:: The prevalence of hypertension in 2004 and 2009 were relatively stable at approximately 21.0%. There was improvement in awareness of hypertension, from 18.2% for men and 33.0% for women in 2004 to 39.5 and 59.4% in 2009, respectively. The high blood pressure control rates improved from 4.8 to 14.4% for men and from 10.8 to 27.2% for women, respectively (all P?0.05). The improvement in awareness, treatment and control of hypertension was also observed in individuals with diabetes, obesity and hypercholesterolemia. However, among hypertensive individuals, there were increases in proportions of obesity (BMI?≥?25?kg/m) between two surveys: from 39.1 to 47.5% in men and from 54.6 to 62.9% in women, respectively (all P?0.05). CONCLUSION:: Despite improvement in awareness and control of hypertension in Thai population, a large proportion of hypertensive individuals remained suboptimally controlled. Strengthening measures to control high blood pressure and metabolic risk factors, especially obesity and hypercholesterolemia, in individuals with hypertension are needed. 相似文献