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Validation and comparison study of three urbanicity scales in a Thailand context.

ABSTRACT: Validity and reliability of an urbanicity scale is of utmost importance in developing effective strategies to minimize adverse social and health consequences of increased urbanization. A number of urbanicity scales for the quantitative assessment of the "static" feature of an urban environment has been invented and validated by the original developers. However, their comparability and robustness when utilized in another study context were not verified. This study aimed to examine the comparability, validity, and reliability of three urbanicity scales proposed by Dahly and Adair, Jones-Smith and Popkin, and Novak et al. in a Thailand context.Urban characteristics data for 537 communities throughout Thailand were obtained from authoritative sources, and urbinicity scores were calculated according to the original developers' algorithms with some modifications to accommodate local available data. Comparability, dimensionality, internal consistency, and criterion-related and construct validities of the scores were then determined.All three scales were highly correlated, but Dahly and Adair's and Jones-Smith and Popkin's were more comparable. Only Dahly and Adair's scale achieved the unidimensionality assumption. Internal consistency ranged from very poor to high, based on their Chonbach's alpha and the corrected item-scale correlation coefficients. All three scales had good criterion-related validity (when compared against the official urban-rural dichotomy and four-category urbanicity classification) and construct validity (in terms of their relation to the mean per capita monthly income and body mass index).This study's results ensure the utility of these three urbanicity scales as valid instruments for examining the social and health impacts of urbanicity/urbanization, but caution must be applied with comparisons of urbanicity levels across different studies when different urbanicity scales are applied.

SUBMITTER: Jiamjarasrangsi W

PROVIDER: S-EPMC4712519 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Project description:BackgroundPostoperative delirium (POD) is a frequent and serious complication after surgery. Evidence of a relationship between anticholinergic medication and the development of delirium is inconclusive, but studies on POD are rare.ObjectivesThe objective of this study was to evaluate the anticholinergic load of preoperative medication in older adult patients and its association with the development of POD.MethodsThis investigation was part of the European BioCog project ( http://www.biocog.eu ), a prospective multicenter observational study in older adult surgical patients (ClinicalTrials.gov identifier: NCT02265263, 15 October 2014). Patients with a Mini-Mental State Examination score ≤ 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method and a patient chart review. The preoperative anticholinergic load was calculated using the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS) and the Anticholinergic Cognitive Burden Scale (ACBS), and associations with POD were analyzed using logistic regression analysis adjusting for age, comorbidities, duration of anesthesia and number of drugs used.ResultsIn total, 837 participants were included for analysis, and 165 patients (19.7%) fulfilled the criteria of POD. After adjusting for confounders, we found no association between preoperative anticholinergic load and the development of POD (ADS [points] odds ratio [OR] 0.928; 95% confidence interval [CI] 0.749-1.150; ARS [points] OR 0.832; 95% CI 0.564-1.227; ACBS [points] OR 1.045; 95% CI 0.842-1.296).ConclusionThis study found no association between the anticholinergic load of drugs used preoperatively and the development of POD in older adult patients without severe preexisting cognitive impairment. Future analyses should examine the influence of intra- and postoperative administration of anticholinergic drugs as well as dosages of and interactions between medications.

Project description:BackgroundThe wide use of pesticides raises concerns on the health risks associated with pesticide exposure. For developing countries, like Thailand, pesticide monitoring program (in vegetables and fruits) and also the maximum residue limits (MRL) regulation have not been entirely implemented. The MRL is a product limit, not a safety limit. The MRL is the maximum concentration of a pesticide residue (expressed as mg/kg) recommended by the Codex Alimentarius Commission to be legally permitted in or on food commodities and animal feeds (Codex Alimentarius Commission, 2015; European Commission, 2015). MRLs are based on supervised residue trial data where the pesticide has been applied in accordance with GAP (Good Agricultural Practice). This study aims at providing comparison data on pesticide residues found in three commonly consumed vegetables (Chinese kale, pakchoi and morning glory) purchased from some local markets and supermarkets in Thailand.MethodsThese vegetables were randomly bought from local markets and supermarkets. Then they were analyzed for the content of 28 pesticides by using GC-MS/MS.ResultsTypes of pesticides detected in the samples either from local markets or supermarkets were similar. The incidence of detected pesticides was 100% (local markets) and 99% (supermarkets) for the Chinese kale; 98% (local markets) and 100% (supermarkets) for the pakchoi; and 99% (local markets) and 97% (supermarkets) for the morning glory samples. The pesticides were detected exceeding their MRL at a rate of 48% (local markets) and 35% (supermarkets) for the Chinese kale; 71% (local markets) and 55% (supermarkets) for the pakchoi, and 42% (local markets) and 49% (supermarkets) for the morning glory.DiscussionThese rates are much higher than those seen in developed countries. It should be noted that these findings were assessed on basis of using criteria (such as MRL) obtained from developed countries. Our findings were also confined to these vegetables sold in a few central provinces of Thailand and did not reflect for the whole country as sample sizes were small. Risk assessment due to consuming these pesticide contaminated vegetables, still remains to be evaluated. However, remarkably high incidence rates of detected pesticides give warning to the Thai authorities to implement proper regulations on pesticide monitoring program. Similar incidence of pesticide contamination found in the vegetables bought from local markets and supermarkets raises question regarding the quality of organic vegetables domestically sold in Thailand. This conclusion excludes Thai export quality vegetables and fruits routinely monitored for pesticide contamination before exporting.

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Validation and comparison study of three urbanicity scales in a Thailand context.

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