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Publication Open Access Relationship between child rearing and child nutritional status during the first year of life in Thailand(2016) Mai Beniko; Aroonsri Mongkolchati; Jiraporn Chompikul; Rutja Phuphaibul; Mahidol University. ASEAN Institute for Health DevelopmentThis descriptive study was conducted to determine relationship between child rearing and child nutritional status during the first year of life. A total of 4,245 cohort children were collected between July 2000 and June 2002 based on the Prospective Cohort of Thai Children. 60 twin infants and 35 dead and abnormal children were excluded. Then, the remaining 4,150 children were conducted for data analysis. The statistics was used by Chi-square tests and Multiple Logistic Regressions were used for identifying influential predictor and child nutritional status (underweight, stunting and wasting) at the first year of age. The finding showed that 8.3% of the children were underweight (weight for age), 9.5% of the children were stunting (height for age) and 5.7% of the children were wasting (weight for height) according to WHO reference. After adjusting the potential confounding factors in the multiple logistic regression, this study found that birth weight was the most significant risk factor related to all three child nutritional status such as underweight (Adj. OR= 10.07, 95% CI= 2.87-35.28), stunting (Adj. OR= 4.49, 95% CI= 1.16-17.39) and wasting (Adj. OR= 3.94, 95% CI= 1.24-12.49). In addition, the significant factor associated with child underweight in the final model was controlling of sleeping time by using rational style (Adj. OR=4.71, 95% CI=1.16-19.10), and for wasting status was types of main caregivers (relative) (Adj. OR= 4.04, 95% CI=1.15-14.21). This study indicated that child rearing style age 6 months among this population effect to nutritional status for children first year of life. Therefore, health policy and education regarding to appropriate child rearing pattern toward among parents in Thailand should be promoted.Publication Open Access World Antimalarial Resistance Network (WARN) IV: clinical pharmacology(2007-09-06) Barnes, Karen I.; Lindegardh, Niklas; Ogundahunsi, Olumide; Olliaro, Piero; Plowe, Christopher V.; Randrianarivelojosia, Milijaona; Gbotosho, Grace O; Watkins, William M.; Sibley, Carol H.; White, Nicholas J.; Barnes, Karen I.; Mahidol University. Faculty of Tropical Medicine. Mahidol Oxford Tropical Medicine Research Unit (MORU).A World Antimalarial Resistance Network (WARN) database has the potential to improve the treatment of malaria, through informing current drug selection and use and providing a prompt warning of when treatment policies need changing. This manuscript outlines the contribution and structure of the clinical pharmacology component of this database. The determinants of treatment response are multi-factorial, but clearly providing adequate blood concentrations is pivotal to curing malaria. The ability of available antimalarial pharmacokinetic data to inform optimal dosing is constrained by the small number of patients studied, with even fewer (if any) studies conducted in the most vulnerable populations. There are even less data relating blood concentration data to the therapeutic response (pharmacodynamics). By pooling all available pharmacokinetic data, while paying careful attention to the analytical methodologies used, the limitations of small (and thus underpowered) individual studies may be overcome and factors that contribute to inter-individual variability in pharmacokinetic parameters defined. Key variables for pharmacokinetic studies are defined in terms of patient (or study subject) characteristics, the formulation and route of administration of the antimalarial studied, the sampling and assay methodology, and the approach taken to data analysis. Better defining these information needs and criteria of acceptability of pharmacokinetic-pharmacodynamic (PK-PD) studies should contribute to improving the quantity, relevance and quality of these studies. A better understanding of the pharmacokinetic properties of antimalarials and a more clear definition of what constitutes "therapeutic drug levels" would allow more precise use of the term "antimalarial resistance", as it would indicate when treatment failure is not caused by intrinsic parasite resistance but is instead the result of inadequate drug levels. The clinical pharmacology component of the WARN database can play a pivotal role in monitoring accurately for true antimalarial drug resistance and promptly correcting sub-optimal dosage regimens to prevent these contributing to the emergence and spread of antimalarial resistance.