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To determine contributions of previously incarcerated persons to tuberculosis (TB) transmission in the community, we performed a healthcare facility-based cohort study of TB patients in Thailand during 2017-2020. We used whole-genome sequencing of Mycobacterium tuberculosis isolates from patients to identify genotypic clusters and assess the association between previous incarceration and TB transmission in the community. We identified 4 large genotype clusters (>10 TB patients/cluster); 28% (14/50) of the patients in those clusters were formerly incarcerated. Formerly incarcerated TB patients were more likely than nonincarcerated patients to be included in large clusters. TB patients within the large genotype clusters were geographically dispersed throughout Chiang Rai Province. Community TB transmission in the community was associated with the presence of formerly incarcerated individuals in Thailand. To reduce the risk for prison-to-community transmission, we recommend TB screening at the time of entry and exit from prisons and follow-up screening in the community.

As a child growing up in Cambodia, Ronnie Yimsut played among the ruins of the Angkor Wat temples, surrounded by a close-knit community. As the Khmer Rouge gained power and began its genocidal reign of terror, his life became a nightmare. In this stunning memoir, Yimsut describes how, in the wake of death and destruction, he decides to live. Escaping the turmoil of Cambodia, he makes a perilous journey through the jungle into Thailand, only to be sent to a notorious Thai prison. Fortunately, he is able to reach a refugee camp and ultimately migrate to the United States, where he attended the University of Oregon and became an influential leader in the community of Cambodian immigrants.Facing the Khmer Rougeshows Ronnie Yimsut's personal quest to rehabilitate himself, make a new life in America, and then return to Cambodia to help rebuild the land of his birth.

This study examined the ability of the following five dynamic models for predicting pulmonary tuberculosis (PTB) incidence in a prison setting: the Wells–Riley equation, two Rudnick & Milton-proposed models based on air changes per hour and liters per second per person, the Issarow et al. model, and the applied susceptible-exposed-infected-recovered (SEIR) tuberculosis (TB) transmission model. This 1-year prospective cohort study employed 985 cells from three Thai prisons (one prison with 652 cells as the in-sample, and two prisons with 333 cells as the out-of-sample). The baseline risk of TB transmission for each cell was assessed using the five dynamic models, and the future PTB incidence was calculated as the number of new PTB cases per cell and the number of new PTB cases per 1,000 person-years (incidence rate). The performance of the dynamic models was assessed by a four-step standard assessment procedure (including model specification tests, in-sample model fitting, internal validation, and external validation) based on the Negative Binomial Regression model. A 1% increase in baseline TB transmission probability was associated with a 3%–7% increase in future PTB incidence rate, depending on the dynamic model. The Wells–Riley model exhibited the best performance in terms of both internal and external validity. Poor goodness-of-fit was observed in all dynamic models (chi-squared goodness-of-fit tests of 70.75–305.1, 8 degrees of freedom, p < .001). In conclusion, the Wells–Riley model was the most appropriate dynamic model, especially for large-scale investigations, due to its fewer parameter requirements. Further research is needed to confirm our findings and gather more data to improve these dynamic models.

Existing studies of mental health interventions in low-resource settings have employed highly structured interventions delivered by non-professionals that typically do not vary by client. Given high comorbidity among mental health problems and implementation challenges with scaling up multiple structured evidence-based treatments (EBTs), a transdiagnostic treatment could provide an additional option for approaching community-based treatment of mental health problems. Our objective was to test such an approach specifically designed for flexible treatments of varying and comorbid disorders among trauma survivors in a low-resource setting. We conducted a single-blinded, wait-list randomized controlled trial of a newly developed transdiagnostic psychotherapy, Common Elements Treatment Approach (CETA), for low-resource settings, compared with wait-list control (WLC). CETA was delivered by lay workers to Burmese survivors of imprisonment, torture, and related traumas, with flexibility based on client presentation. Eligible participants reported trauma exposure and met severity criteria for depression and/or posttraumatic stress (PTS). Participants were randomly assigned to CETA (n = 182) or WLC (n = 165). Outcomes were assessed by interviewers blinded to participant allocation using locally adapted standard measures of depression and PTS (primary outcomes) and functional impairment, anxiety symptoms, aggression, and alcohol use (secondary outcomes). Primary analysis was intent-to-treat (n = 347), including 73 participants lost to follow-up. CETA participants experienced significantly greater reductions of baseline symptoms across all outcomes with the exception of alcohol use (alcohol use analysis was confined to problem drinkers). The difference in mean change from pre-intervention to post-intervention between intervention and control groups was -0.49 (95% CI: -0.59, -0.40) for depression, -0.43 (95% CI: -0.51, -0.35) for PTS, -0.42 (95% CI: -0.58, -0.27) for functional impairment, -0.48 (95% CI: -0.61, -0.34) for anxiety, -0.24 (95% CI: -0.34, -0.15) for aggression, and -0.03 (95% CI: -0.44, 0.50) for alcohol use. This corresponds to a 77% reduction in mean baseline depression score among CETA participants compared to a 40% reduction among controls, with respective values for the other outcomes of 76% and 41% for anxiety, 75% and 37% for PTS, 67% and 22% for functional impairment, and 71% and 32% for aggression. Effect sizes (Cohen's d) were large for depression (d = 1.16) and PTS (d = 1.19); moderate for impaired function (d = 0.63), anxiety (d = 0.79), and aggression (d = 0.58); and none for alcohol use. There were no adverse events. Limitations of the study include the lack of long-term follow-up, non-blinding of service providers and participants, and no placebo or active comparison intervention. CETA provided by lay counselors was highly effective across disorders among trauma survivors compared to WLCs. These results support the further development and testing of transdiagnostic approaches as possible treatment options alongside existing EBTs. ClinicalTrials.gov NCT01459068 Please see later in the article for the Editors' Summary.

This study aimed to assess and compare the probability of tuberculosis (TB) transmission based on five dynamic models: the Wells–Riley equation, two Rudnick & Milton-proposed models based on air changes per hour (ACH) and liters per second per person (L/s/p), the model proposed by Issarow et al , and the Applied Susceptible-Exposed-Infected-Recovered (SEIR) TB transmission model. This study also aimed to determine the impact of model parameters on such probabilities in three Thai prisons. A cross-sectional study was conducted using data from 985 prison cells. The TB transmission probability for each cell was calculated using parameters relevant to the specific model formula, and the magnitude of the model agreement was examined by Spearman’s rank correlation and Bland–Altman plot. Subsequently, a multiple linear regression analysis was conducted to investigate the influence of each model parameter on the estimated probability. Results revealed that the median (Quartiles 1 and 3) of TB transmission probability among these cells was 0.052 (0.017, 0.180). Compared with the pioneered Wells–Riley’s model, the remaining models projected discrepant TB transmission probability from less to more commensurate to the degree of model modification from the pioneered model as follows: Rudnick & Milton (ACH), Issarow et al ., and Rudnick & Milton (L/s/p), and the applied SEIR models. The ventilation rate and number of infectious TB patients in each cell or zone had the greatest impact on the estimated TB transmission probability in most models. Additionally, the number of inmates in each cell, the area per person in square meters, and the inmate turnover rate were identified as high-impact parameters in the applied SEIR model. All stakeholders must urgently address these influential parameters to reduce TB transmission in prisons. Moreover, further studies are required to determine their relative validity in accurately predicting TB incidence in prison settings.

Our world is under pressure, with growing inequalities in wealth and access to food and clean water. We depend too heavily on polluting fuels and diminishing natural resources. Traditional cultural practices are being swamped by global popular culture.The Thai model of sufficiency thinking aims to transform the mindset of a whole population to achieve the seemingly impossible: enriching everyone's lives in a truly sustainable way.Innovative management practices developed by King Bhumibol Adulyadej of Thailand have been applied across Thailand in agriculture, education, business, government and community organisations for over two decades.In this book, chapters written by eminent Thai scholars explain sufficiency thinking and review its implementation in different sectors including community development, business, agriculture, health care, schools, and even in prisons.Is Thailand unique in having discovered the holy grail of a more responsible form of capitalism? No, it is not, but it is the first country whose government has adopted this kind of thinking as national policy.'...we obviously need to revise dramatically our thinking about the outlines of a just economy and a decent society in which everyone can lead dignified lives. Sufficiency Thinking provides creative approaches to this quandary and this important volume is a brilliant addition to the growing literature critical of mainstream business-as-usual ideology.' - John Komlos, Professor Emeritus, University of Munich

HIV spread rapidly among people who inject drugs in Bangkok in the late 1980s. In recent years, changes in drug use and HIV-associated risk behaviors have been reported. We examined data from the Bangkok Tenofovir Study, an HIV pre-exposure prophylaxis trial conducted among people who inject drugs, to assess participant risk behavior and drug use, and to identify risk factors for HIV infection. The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial. HIV status was assessed monthly and risk behavior every 3 months. We used generalized estimating equations logistic regression to model trends of injecting, needle sharing, drugs injected, incarceration, and sexual activity reported at follow-up visits; and proportional hazards models to evaluate demographic characteristics, sexual activities, incarceration, drug injection practices, and drugs injected during follow-up as predictors of HIV infection. The proportion of participants injecting drugs, sharing needles, and reporting sex with more than one partner declined during follow-up (p<0.001). Among participants who reported injecting at enrollment, 801 (53.2%) injected methamphetamine, 559 (37.1%) midazolam, and 527 (35.0%) heroin. In multivariable analysis, young age (i.e., 20-29 years) (p = 0.02), sharing needles (p<0.001), and incarceration in prison (p = 0.002) were associated with incident HIV infection. Participants reporting sex with an opposite sex partner, live-in partner, casual partner, or men reporting sex with male partners were not at a significantly higher risk of HIV infection compared to those who did not report these behaviors. Reports of HIV-associated risk behavior declined significantly during the trial. Young age, needle sharing, and incarceration were independently associated with HIV infection. Sexual activity was not associated with HIV infection, suggesting that the reduction in HIV incidence among participants taking daily oral tenofovir compared to those taking placebo was due to a decrease in parenteral HIV transmission.

In feminist criminology, there is a growing body of research exploring pathways to prison, but few studies have specifically sought to map women’s journeys into the criminal justice system for crimes of physical violence and sex offending. Gender comparative research is sparse, and, to date, we know little about women and men imprisoned in Thailand for these types of crimes. Subsequently, in this paper, we report findings from a gender comparative feminist pathways study conducted in Thailand, with a specific focus on violence and sex offending; namely, homicide, sexual assault, human trafficking, and sex work-related offences. We utilise a qualitative analysis of life-history interviews to centre and value these women’s and men’s voices, establish their backstories, and thematically map their imprisonment trajectories. Three pathways to prison emerged: (1) lifestyles of contravention, (2) harmed and harming, and (3) destructive masculinity. Utilising the participants’ descriptions, we highlight similarities and variance by gender within and between these pathways.

Thailand has one of the highest incarceration rates of women in the world. With an increasing prison population overall as well as an increasing proportion of female inmates, the country faces one of its most challenging tasks in penitentiary administration: reforms to its legal landscape and its correctional practices in line with international standards. A response to such a crisis is to undertake a prison evaluation project to ensure proper implementation of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (also known as the 'Bangkok Rules'). The primary objective of this research article is to assess and identify a prison model that can inspire the development of other prison facilities, while supporting a firm commitment to maintain and improve the status of current model facilities.

Purpose>This study aims to measure the prevalence of pulmonary tuberculosis (PTB), its association with imprisonment status and to document the treatment success rate (TSR) among prisoners in Songkhla province, Southern Thailand.Design/methodology/approach>A retrospective cross-sectional study was conducted in five prisons in Songkhla province, including all prisoners in the fiscal of year 2019, who had an annual chest radiography (CXR) screening result. Information of prisoners who had been imprisoned from 1 October 2018 to 30 September 2019, were reviewed for PTB diagnosis. Imprisonment status and other associated factors with PTB were analyzed using multiple logistic regression.Findings>The prevalence of PTB was 2.72%. Prisoners having new or transfer-in status were more likely to have PTB. Those aged 40–80 years, who had smoked for ten years or more, or who were underweight, had higher odds of having PTB. TSR among prisoners with PTB in this study was 94.9%.Originality/value>The prevalence of PTB among prisoners having annual CXR screening was high. Detection of PTB was higher among new or transfer-in prisoners; therefore, the CXR for PTB screening before admission to prison should be performed to prevent transmission to other prisoners.