BackgroundGlobal sodium intake remains above the recommended levels to control blood pressure (BP). We aimed to evaluate the efficacy of a dietary intervention on BP through salt reduction among community‐dwelling participants with high risk of cardiovascular disorders (CVD).MethodsThis cluster randomized trial (February 2012 to January 2013) included cooking instruction using the pocket salt meter among patients with diabetes and/or hypertension who were treated at health center in Thailand. Based on health centers, 8 clusters of eligible participants were randomly allocated to the 4 intervention and 4 control groups. Dietary intervention was performed at baseline, 1 month, and 3 months in intervention group. In both groups, systolic and diastolic BPs, and estimated 24 hours salt intake based on overnight urine samples were measured at baseline, 6 months, and 12 months.ResultsA total of 753 participants were enrolled (374 in the intervention group and 379 in the control group). In the mixed‐effects model, there were significant difference in SBP and estimated salt intake after adjusting covariates at 6 months (adjusted differences between groups [95% CI]; −7.55 [−5.61 to −9.49] mm Hg P < .01; −0.66 [−0.40 to −0.92] g/day P = .03). However, these differences were not observed at 12 months (adjusted differences between groups [95% CI]; −1.83 [0.34 to −4.00] mm Hg P = .48; −0.42 [−0.17 to −0.67] g/day P = .16). There were no differences in DBP in both follow‐ups.ConclusionsThese results may suggest the effectiveness of a visually based dietary intervention targeting salt intake reduction in short term, but the effectiveness discontinued in long term.Clinical trial number: The International Standard Randomized Controlled Trial Number Register (ISRCTN39416277) on January 3, 2012.

Adsorption characteristics and polymerization of pyrrole on Y-zeolites of different cation types (NaY, HY, and CuY) have been investigated in connection with adsorption behavior, in situ IR spectroscopy, and EPR spectroscopy. Adsorption of pyrrole on NaY is physisorption giving no significant changes in IR and EPR spectra. In the adsorption on HY and CuY, the formation of pyrrole oligomers or polymers is observed. Pyrrole oligomer formed on HY is a nonconjugated one, which gives no EPR signal. In the case of CuY, EPR signal assigned to polaron of polypyrrole was observed at g = 2.008 by the pyrrole adsorption. The relationship between the amount of the spin of g = 2.008 and the adsorbed amount of pyrrole was linear even at the number of pyrrole exceeding that of Cu2+, which suggests that the polymerization giving conjugated polypyrrole would take place on Cu2+ sites and the polypyrrole of aromatic form would be oxidized to quinoid form to give polaron on CuY surface.

Background Smoking cessation is an achievable behavioral change, which reduces the risks of cardiovascular diseases, cancers and tobacco-related diseases. There is a need for an effective smoking cessation service for low and middle income country settings where the smoking rate is generally very high whilst a cessation service is not usually accessible. This study devised a new smoking cessation service package and assessed its effectiveness in the primary health care setting of northern Thailand. Methods This randomized controlled trial was centered at Maetha district hospital, Lampang province, Thailand, and its network of mobile non-communicable disease clinics at seven primary care units. A total of 319 eligible patients who consented to participate in the study, were randomly allocated to an intervention arm (160) and a control arm (159), applying block randomization. The multi-component intervention service consisted of: regular patient motivation by the same nurse over a 3-month period; a monthly piCO+ Smokerlyzer test for 3 months; continual assistance from a trained family member, using a smoking-cessation- diary; and optional nicotine replacement chewing gum therapy. The control group received the routine service comprising of brief counseling and casual follow-up. Smoking cessation, confirmed by six months of abstinence and the piCo+ Smokerlyzer breath test, was compared between the two services after a year follow-up. The trial is registered as an international current control trial at the ISRCTN registry. ISRCTN89315117. Results The median age of the participants was 64 years, with females constituting 28.84%. Most of the participants smoke hand-rolled cigarettes (85%). The intervention arm participants achieved a significantly higher smoking cessation rate than the control arm 25.62% vs 11.32%, with an adjusted odd ratio of 2.95 and 95% confidence interval 1.55–5.61. Conclusion In relation to accessing smoking cessation services within the primary health care setting, participants who received the evidence-based intervention package were about three times more likely to succeed in giving up smoking than those who received the routine service. Utilizing community resources as major intervention components, the evidence from this trial may provide a useful and scalable smoking cessation intervention for low and middle income countries. Trial registration Current controlled trials ISRCTN89315117 . WHO international clinical trial identifier number: U1111–1145-6916; 3/2013.

BackgroundDecreasing salt consumption can prevent cardiovascular diseases (CVD). Practically, it is difficult to promote people’s awareness of daily salt intake and to change their eating habits in terms of reducing salt intake for better cardiovascular health. Health education programs visualizing daily dietary salt content and intake may promote lifestyle changes in patients at high risk of cardiovascular diseases.Methods/DesignThis is a cluster randomized trial. A total of 800 high-CVD-risk patients attending diabetes and hypertension clinics at health centers in Muang District, Chiang Rai province, Thailand, will be studied with informed consent. A health center recruiting 100 participants is a cluster, the unit of randomization. Eight clusters will be randomized into intervention and control arms and followed up for 1 year. Within the intervention clusters the following will be undertaken: (1) salt content in the daily diet will be measured and shown to study participants; (2) 24-hour salt intake will be estimated in overnight-collected urine and the results shown to the participants; (3) a dietician will assist small group health education classes in cooking meals with less salt. The primary outcome is blood pressure change at the 1-year follow-up. Secondary outcomes at the 1-year follow-up are estimated 24-hoursalt intake, incidence of CVD events and CVD death. The intention-to-treat analysis will be followed.Blood pressure and estimated 24-hour salt intake will be compared between intervention and control groups at the cluster and individual level at the 1-year follow-up. Clinical CVD events and deaths will be analyzed by time-event analysis. Retinal blood vessel calibers of CVD-risk patients will be assessed cross-sectionally. Behavioral change to reduce salt intake and the influencing factors will be determined by structured equation model (SEM). Multilevel regression analyses will be applied. Finally, the cost effectiveness of the intervention will be analyzed.DiscussionThis study is unique as it will recruit the individuals most vulnerable to CVD morbidity and mortality by applying the general Framingham CVD risk scoring system. Dietary salt reduction will be applied as a prioritized, community level intervention for the prevention of CVD in a developing country.Trial registrationISRCTN39416277

This study attempted to identify the factors associated with the access to antiretroviral therapy (ARV) among HIV/AIDS patients in Khon Kaen Province, Thailand. We collected medical and sociodemographic data from the medical charts of adult patients living in the province who received medical services at two public hospitals in the province. The study period was from December 1, 2001 to February 28, 2002. Total 593 outpatients were included in the analysis. One hundred and forty-six patients (24.6%) received ARV. A logistic regression analysis was conducted to identify the factors associated with the use of ARV. Patients who were covered by the Civil Servant Medical Benefit Scheme were significantly more likely to receive ARV than those who were covered by the Universal Coverage Scheme (UC), a publicly-funded medical insurance (OR = 12.43; 95% CI = 6.03-25.62). The results of this study indicated that there were inequalities in access to and use of ARV among HIV/AIDS patients by health insurance status. The current government announced that they would include ARV in the benefits package of UC. It would be important to monitor how this policy will improve the access to ARV among HIV/AIDS patients.