Objectives The study aimed to investigate the prevalence of physical activity (PA) and factors influencing PA behaviours among medical students in Southern Thailand. Design The study implemented a mixed methods approach. The sequential design consisted of 2 phases: a survey followed by in-depth interviews. Setting The study was conducted in the 3 campuses of a medical school in Southern Thailand. The preclinical students (years 1–3) studied general and basic science subjects at Nakhon Si Thammarat campus. The clinical students (years 4–6) received clinical training and hospital attachments at Trang or Phuket campuses. Total number of students was 285, with 46–48 students in each class. The study was conducted from September 2015 to February 2016. Participants Participants were medical students, 18 years old and above, from 3 campuses without disabilities or medical conditions which limited their ability to perform PA. Outcome measures The prevalence of the recommended levels of PA was measured using Global Physical Activity Questionnaire (GPAQ). The association between the demographic data and the recommended PA levels were analysed by univariate and multivariate analysis. In-depth interviews and thematic analysis were completed to explore PA behaviours. Results A total of 279 (response rate 97.9%) medical students participated in the study. Approximately half (49.5%) of the participants were physically active. The median total energy use was 540 metabolic equivalent-min/week (range 0–5640). Male and preclinical students were more likely to be physically active (p<0.05). Twenty-four in-depth interviews were conducted. Supportive factors included social support from friends and families. Study-related activities and overtime shift work were barriers. Conclusions More than half of the medical students have insufficient PA because of study-related activities and overtime shift work. Future studies should focus on finding ways to improve PA in clinical and female students in Thailand.

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A universal health coverage policy was implemented in Thailand in 2002 and led to an increase in accessibility to, and equity of, healthcare services. The Thai government and academics have focused on the large-scale aspects, including effectiveness and impacts, of universal health coverage over one decade. Here, we aimed to identify patients’ perspectives on hospital visits under universal health coverage. A qualitative study was carried out in four public hospitals in rural Thailand. We collected data through focus group discussions (FGDs) and in-depth interviews (IDIs). The semi-structured interview guide was designed to elicit perspectives on hospital visits among participants covered by the Universal Coverage Scheme, Social Security Scheme or Civil Servant Medical Benefit Scheme. Data were transcribed and analysed using a thematic approach. Twenty-nine participants (mean age, 56.76 ± 16.65 years) participated in five FGDs and one IDI. The emerging themes and sub-themes were identified. Factors influencing decisions to visit hospitals were free healthcare services, perception of serious illness, the need for special tests, and continuity of care. Long waiting times were barriers to hospital visits. Employees, who could not leave their work during office hours, could not access some services such as health check-ups. From the viewpoint of participants, public hospitals provided quality and equitable healthcare services. Nevertheless, shared decision making for treatment plans was not common. The factors and barriers to utilisation of healthcare services provide exploratory data to understand the healthcare-seeking behaviours of patients. Perceptions towards free services under universal health coverage are positive, but participation in decision making is rare. Future studies should focus on finding ways to balance the needs and barriers to hospital visits and to introduce the concept of shared decision making to both doctors and patients.

The present study aims to examine the association between Kratom use and serum lipid level. This study compared the serum lipid profile of Kratom users and non-users living in Nam Phu Subdistrict, a special area that allows the traditional use of Kratom. The study subjects consisted of 581 individuals aged 18 and above. Binary logistic regression was used to determine an association between Kratom use and serum lipid level. The findings revealed an association between Kratom use and an elevated HDL level (≥60 mg/dL) with an adjusted OR of 1.82 (95% CI, 1.17–2.8), and an association between Kratom use and a triglyceride level <90 mg/dL with an adjusted OR of 1.75 (95% CI; 1.17–2.63). There were no associations between Kratom use and LDL as well as total cholesterol level. This study provided additional evidence of Kratom use and a favorable lipid profile. Prevention of coronary heart disease or cerebrovascular disease via an improvement in the lipid profile may be a future pharmaceutical application of Kratom.

Preferences and Acceptance of Colorectal Cancer Screening in Thailand Colorectal cancer;screening;preference;acceptance;Thailand; Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program.

Background: Temporary drinking abstinence campaigns have emerged globally in recent years. In Western countries, campaigns usually challenge drinkers to abstain for one month. In Thailand, the campaign called the Buddhist Lent Abstinence Campaign has been organized annually since 2003. The campaign encourages Thai people to abstain from drinking for three months during the Buddhist Lent period, which coincides with the monsoon season in Southeast Asia (around July–October). This study aimed to estimate the proportion and number of drinkers changing their drinking behaviours during the 3-month Thai abstinence campaign and to examine the determinants of abstinence. Methods: The 2016 Buddhist Lent Abstinence Evaluation Survey was analysed. The survey was a national representative survey of Thai populations aged ≥15 years. Weighted data were employed throughout the analysis. The number and proportion of drinkers changing their drinking behaviours were estimated. The determinants of alcohol abstinence during the campaign were explored using weighted logistic regression. Results: The prevalence of drinking in the Thai population was 34.3% (95% CI: 32.2–36.4%). A third of the current drinkers, equal to almost six million drinkers, abstained completely during the 3-month period. Another six million drinkers partially changed their drinking behaviours (16.3% abstained for a certain period, and 18.7% decreased the quantity of alcohol they consumed). The factors associated with abstinence included religion, occupation, drinking frequency prior to the campaign, type of beverages consumed, perceived harm from alcohol, exposure to campaign media, and making a public commitment. Conclusion: This study demonstrated the effectiveness of a temporary abstinence campaign in Thailand. The work is part of the growing global evidence on the effectiveness of this type of intervention. Temporary abstinence campaigns could be a potential approach to controlling alcohol consumption and related harms. Further research should focus on the long-term effects of such campaigns.