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In this article, the conceptions of variability held by samples of Japanese and Thai senior high school mathematics teachers were identified, based on the framework proposed by Shaughnessy (2007), using a comparative survey study. From contrasting the results of the two groups, relative tendencies of insufficient statistical knowledge for variability were found in both samples, such as a tendency of Japanese teachers to overgeneralize equiprobability, whereas Thai teachers tended to overgeneralize estimation. Based on these findings, the use of well-known tasks from the research literature for this comparative study seems useful to clarify the relative tendencies and insufficiencies in teacher knowledge and conceptions regarding variability held by both groups.

Worldwide, electronic learning (E-learning) has become an important part of the education agenda in the last decade. The Suan Dusit Rajabhat University (SDRU), Thailand has made significant efforts recently to use Internet technologies to enhance learning opportunities. The results reported here are part of a pioneering study to determine the effectiveness of a new online learning course in the subject "Business Statistics". This paper compares two groups of students, one studying using a traditional lecture-based approach, and the other studying using e-learning. The comparison is based on students' attitudes towards statistics measured using a validated questionnaire, both before and after the 16-week course, and for each of the modes of study. Comparisons are also made with students studying by distance, although the numbers in these groups are too small for sensible statistical analysis. The questionnaire data are augmented by material from interviews and other student reports of their experience. The results showed highly significant differences in attitudes towards statistics between the students studying online and the students using a traditional approach. (Contains 3 tables and 1 figure.)

This paper reports on a study carried out in Thailand investigating the relationship between students' use of an e-learning system and their learning outcomes in a course on Business Statistics. The results show a clear relationship between accesses to the e-learning system, as measured by number of "hits", and outcomes, as measured by final results. While the results do not establish a direct casual connection, they indicate that under appropriate conditions a component of online study provides significant benefits to learning. In this, it contrasts with the results of recent studies that find no relationship between access and results. Quotes taken from interviews with some of the students illuminate the relationship between the online learning environment and their own learning. (Contains 2 figures.)

Background: Acetaminophen (APAP)-induced hepatotoxicity is a potentially life-threatening condition. Gardenia jasminoides fruit extract (GJE), which contains geniposide (Gen) as its major active constituent, possesses anti-inflammatory and antioxidant properties and may help address the underlying pathogenesis of APAP-induced hepatotoxicity. This study aimed to evaluate the effects of GJE in a mouse model of APAP-induced hepatotoxicity. Methods: Twenty-four male ICR mice were divided into 4 groups (n = 6/group): [1] Control group, mice were given distilled water; [2] APAP group, mice received a single dose of 600 mg/kg APAP; [3] APAP + low-dose GJE group, mice received APAP followed 30 min later by 2 doses of low-dose GJE (0.44 g/kg/dose, containing Gen 100 mg/kg/dose) 8 h apart; [4] APAP + high-dose GJE group, mice received APAP followed by 2 doses of high-dose GJE (0.88 g/kg/dose, containing Gen 200 mg/kg/dose). All mice were euthanized 24 h after APAP administration. Liver tissue was used for histological examination and to measure glutathione (GSH) and malondialdehyde (MDA) levels. Serum was used to determine levels of ALT and inflammatory cytokines (tumor necrosis factor- α (TNF-α) and interleukin-6 (IL-6)). Results: Liver histopathology showed moderate to severe hepatic necroinflammation in the APAP group, whereas only mild necroinflammation was observed in both treatment groups. Serum ALT levels were significantly elevated in the APAP group compared to the control group but were significantly reduced after low- and high-dose GJE treatment. Serum TNF- α levels were significantly higher in the APAP group than in the control group and were significantly lower after high-dose GJE treatment (135.5 ± 477.2 vs. 35.5 ± 25.8 vs. 74.7 ± 47.2 vs. 41.4 ± 50.8 pg/mL, respectively). Serum IL-6 followed a similar pattern. Hepatic GSH levels were significantly lower in the APAP group compared to the control group but significantly increased after both low- and high-dose GJE treatment (19.9 ± 4.5 vs. 81.5 ± 12.4 vs. 71.4 ± 7.8 vs. 82.6 ± 6.6 nmol/mg protein, respectively). Conversely, hepatic MDA levels were significantly elevated in the APAP group compared with the control group but significantly decreased after high-dose GJE treatment (108.6 ± 201.5 vs. 40.5 ± 18.0 vs. 40.5 ± 16.8 nmol/mg protein, respectively). Conclusions: Treatment with G. jasminoides fruit extract can alleviate APAP-induced hepatotoxicity, likely through its anti-inflammatory and antioxidant properties. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome is a chronic illness that influences physical and psychological health and well-being and requires continuous treatment and effective self-care. This two-group quasi-experimental study investigated the effectiveness of the Self-Care Support Program for People with Acute Coronary Syndrome. Sixty participants were purposively recruited from medical wards of a university-affiliated hospital in Bangkok, Thailand. A Self-Care Support Program based on Orem's self-care theory was integrated with a motivational interviewing approach. The experimental group (n = 30) received the 4-week intervention program with the usual care, while the comparison group (n = 30) received only usual care. Instruments for data collection included a Demographic and Health Data Form, the Self-Care Behavior for Acute Coronary Syndrome Questionnaire, the Veterans Specific Activity Questionnaire, and the Rehospitalization Record Form. Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test, and two-way repeated measures analysis of variance. Results revealed that the experimental group had significantly improved self-care behavior and functional ability immediately and four weeks after program completion (week 8), compared to the comparison group. There was no difference in rehospitalization between the two groups. Nurses with advanced skills in motivational training can use this program to promote effective self-care practices, improve functional ability, and reduce rehospitalization. Further study using randomized controlled trials and other settings is needed before it can be widely used. [ABSTRACT FROM AUTHOR]

Introduction: Despite being initially perceived as a local infectious disease, COVID-19 has emerged as one of the most perilous global health threats, significantly impacting the psychological well-being of individuals worldwide. Objective: This cross-sectional descriptive study investigates the psychological distress, fear, and coping mechanisms among Thai people residing in Thailand during the COVID-19 pandemic. Methods: This online cross-sectional survey targeted Thai individuals during the first and third waves of the COVID-19 pandemic. Participants aged 18 and above who provided consent self-reported their responses to the Kessler Psychological Distress Scale, Fear of COVID-19 Scale, and Brief Resilient Coping Scale. Data collection occurred between November 2020 and January 2021 across four regions of Thailand. Univariate and multivariate logistic regression analyses explored associations between contextual factors and the variables of interest. Results: Out of 498 survey respondents, with an average age of 43.07 (SD = 13.69) years, 81.9% were female, and 61.6% self-identified as healthcare workers, with 47.59% identified as frontline healthcare workers. Findings revealed that 46% of participants experienced moderate-to-very high levels of psychological distress, 14.3% reported high levels of fear of COVID-19, and 35.1% exhibited low resilient coping. Factors such as changes in employment status or financial situations, comorbidities, contact with known or suspected COVID-19 cases, recent healthcare utilization for COVID-19-related stress, and elevated fear of COVID-19 were associated with higher levels of psychological distress. Conversely, being nurses and perceived better mental health status were linked to more effective coping strategies. Conclusion: These results emphasize the critical importance of government interventions to safeguard the psychological well-being of healthcare workers and the broader Thai population. Urgent measures to bolster resilience among these groups during and after the pandemic are imperative. [ABSTRACT FROM AUTHOR]

Background: Chronic respiratory diseases are becoming a more prominent cause of morbidity and mortality worldwide. Street sweepers are commonly found in low- and middle-income countries. This job involves outdoor work that exposes workers to various health hazards and air pollution, particularly affecting respiratory health. There is still limited research focusing specifically on street sweepers. The study aims to examine the prevalence of chronic respiratory symptoms and the associated factors in street sweepers in Bangkok, Thailand. Materials and Methods: We undertook a cross-sectional survey between February and April 2023. A multi-stage sampling technique was employed, stratifying the sample according to district locations within Bangkok, Thailand. Data were collected through a questionnaire assessing demographic characteristics, occupational and environmental factors, and respiratory symptoms using a modified version of the Medical Research Council questionnaire. Data analysis included bivariate analysis and multiple logistic regression. Results: The response rate was 98.0% (n = 341). The prevalence of chronic respiratory symptoms among street sweepers in Bangkok, Thailand, with at least one respiratory symptom was reported by 33.7% of the participants, specifically cough (22%), phlegm (20.2%), dyspnea (17.6%), and wheeze (7.0%). The average age of the sample group was 43.2 years, with a majority being female (85.9%). Among the participants, 88.3% were non-smokers, while 37.2% reported exposure to secondhand smoke. All participants reported the use of respiratory protective equipment, with face masks used at 78.9%. 7.3% of the participants lived near sources of pollution, and 12.0% were involved in household pollution activities. An average annual air quality index in the workplace area was categorized as 'good' at 57.8%. Multiple logistic regression analysis revealed significant associations of chronic respiratory symptoms with the following factors: exposure to secondhand smoke [odds ratio (OR) = 2.3, 95% confidence interval (CI) 1.3-4.2] and household activities (OR = 3.0, 95% CI 1.3-6.6). Conclusion: Exposure to secondhand smoke and indoor air pollutants in household environments are significant factors associated with the symptoms. Raising awareness about secondhand smoke hazards in household and environmental settings and promoting self-care practices related to various activities with potential exposure to indoor air pollution is crucial. [ABSTRACT FROM AUTHOR]

Background/Objectives: The current study compared Self-Figure drawings from Thai and Indian adolescents to assess the cross-cultural applicability of a child abuse assessment tool. The research aims to understand the extent to which distinctions or similarities arise in Self-Figure drawings among adolescents from two culturally similar yet distinct backgrounds characterized by differences in religious affiliations, socioeconomic contexts, and political environments. Methods: Employing a mixed-methods approach, the study utilized quantitative measures, including the Traumatic Events Checklist (TEQ-5) and Medical Somatic Dissociation Questionnaire (MSDQ), alongside a qualitative analysis of Self-Figure drawings. Ethical approval was obtained with waived informed consent, and a convenience sample of 386 adolescents aged 13–18 years (193 from Thailand [M = 14.8, SD = 1.73; 135 females (69.9%) and 58 males (30.1%)], and 193 from India [M = 15.2, SD = 1.64; 135 females (69.9%) and 58 males (30.1%)]), who reported experiencing child abuse, participated in the study by completing questionnaires and drawing themselves. Results: The analysis revealed that Thai adolescents had higher MSDQ scores, while Indian adolescents exhibited more prominent pictorial indicators. Indian participants reported experiencing a broader range of event types, whereas Thai adolescents predominantly depicted verbal or emotional abuse. Variations in pictorial indicators were found significant, except for hair, cheek or chin, omitted legs or feet, and omitted eyes. Conclusions: These findings contribute to the understanding of how cultural factors influence adolescents' self-representations through drawing. The differences in pictorial indicators highlight the nuanced variations within similar cultures, emphasizing the cultural specificity of self-expression. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the etiologies of non-surgical root canal treatment (NS-RCT) in a Thai population and examine their association with risk factors. Methods: A cross-sectional observational study was performed to examine the etiologies of NS-RCT and risk factors among Thai-nationality patients treated at a tertiary care dental hospital in Thailand from 2019–2023. Treatment records and radiographs were retrospectively reviewed to identify NS-RCT etiologies, and associated contributing factors were analyzed. Statistical analysis used univariate logistic regression followed by multivariate logistic regression, with a significance level set at P < 0.05. Results: The data from 1500 teeth were analyzed, comprising 59.1% females and 40.9% males, with ages ranging from 7–91 years (mean = 48.56 years). The most prevalent age group was 61–70 years-old. Among the treated teeth, the mandibular first molar was the most frequently involved (13.9%), followed by the maxillary first molar (9.9%) and mandibular second premolar (9.7%). The primary etiologies of NS-RCT were dental caries (53.7%), old and large restorations (7.9%), and attrition (5.9%). Analysis of etiology of NS-RCT due to caries revealed that the most commonly affected sites were the occlusal (32.6%), distal (31.6%), and mesial (17.2%) surfaces. In immature teeth requiring NS-RCT, the predominant etiologies were dens evaginatus (32.1%), dental caries (28.6%), and traumatic injury (21.4%). The association between the etiology of NS-RCT and investigated associated factors were identified. Conclusions: The etiologies of NS-RCT in the selected Thai population were mainly attributed to dental caries, with additional factors being old and large restorations and attrition. Notably, due to the aging society, the elderly population experiences a higher demand for NS-RCT, particularly due to attrition, non-carious cervical lesions, and erosion. In contrast, in immature teeth, the most common etiologies leading to NS-RCT comprise dens evaginatus, dental caries, and traumatic injuries. The distinct etiological patterns observed in different age groups emphasize the importance of specific oral health prevention programs to address individual needs. [ABSTRACT FROM AUTHOR]

Background: This study aimed to: (1) assess healthcare providers' opinions on e-cigarette safety and compare them across professions; (2) evaluate providers' recommendations for e-cigarettes as a tobacco product cessation tool and identify any associations with their safety perceptions. Methods: A self-administered questionnaire was completed by 760 healthcare professionals (January–March 2020). The survey included eight opinions on e-cigarette safety with five Likert-scale answers and a question on recommending them for tobacco product cessation. Results: Among 760 healthcare providers (173 physicians/dentists, 69 pharmacists, and 518 nurses), only 20% reported prior experience with tobacco product cessation counseling. Providers expressed uncertainty regarding e-cigarette safety (mean ± SD: 2.5 ± 0.7 on a 5-point Likert scale), with no significant differences between professions (p = 0.836). Similarly, e-cigarette recommendations for tobacco product cessation remained low across professions (13%, 85/637), with no significant differences found (p = 0.072). The recommendation of e-cigarettes for tobacco cessation is associated with perceived safety, lower respiratory irritation, lower coughing, a lower risk of cancer, and a lower risk for secondhand smokers when compared to traditional cigarettes (p < 0.05). Conclusions: Most healthcare providers were unsure about the safety of e-cigarettes; about 13% of providers suggested using them for tobacco product cessation, with safety perceptions influencing recommendations. [ABSTRACT FROM AUTHOR]

Background: Enoxaparin is one of the widely used injectable anticoagulants requiring dose adjustment based on body weight and renal function. Unadjusted or inappropriately adjusted doses can lead to thromboembolic or bleeding events, particularly in patients with advanced age. Objectives: This retrospective chart review study primarily aimed to evaluate enoxaparin use, along with exploring factors associated with inappropriate use and bleeding in the elderly population. Methods: Baseline characteristics, along with bleeding and thrombotic events, of the patients receiving enoxaparin in the fiscal year 2018-2019 at a secondary care hospital were extracted from the electronic medical record. Prescribed enoxaparin regimens were evaluated against the recommended dose in the package insert, pertinent guidelines, and hospital guidance. Univariate and multivariate analyses were performed to explore factors associated with inappropriate use and bleeding. Results: Two hundred and fourteen patients were included. The majority (66.8%) were female, and 39.7% were 80 years or older, with an average age of 74.4 years and a body mass index (BMI) of 24.0 kg/m2. Most patients (82.7%) had a creatinine clearance ≥30 ml/min. Seventy-six initiations (35.5%) were inappropriate, and 83 problems were found. Underdosing was the most common problem (39.8%), followed by undocumented body weight (22.9%), and inconsistent prophylactic dose per hospital guidance (20.5%). BMI ≥25kg/m2 (odds ratio [OR] 2.04 [95% confidence interval [CI] 1.04:3.98]; p=0.04) was the only factor associated with inappropriate use. There were 48 bleedings (22.4%), 21 minor (9.8%), and 27 major (12.6%). Hemoglobin (Hb) <10g/dL was associated with bleedings across all indications (OR 4.25 [95%CI 2.03:8.91]; p<0.01). Conclusions: In the predominately middle-, and oldest-old population, inappropriate use of enoxaparin was common. Those with BMI ≥25kg/m2 and Hb<10g/dL were at increased risk of underdosing and bleedings, respectively; these patients should be closely monitored [ABSTRACT FROM AUTHOR]

It is estimated that globally, millions of adolescents experience mental health problems, especially anxiety and depression. Adolescents with high perceptions of stress often encounter mental issues, have negative thoughts or are dissatisfied with daily life events. This study employed a quasi-experimental design with two groups and repeated measures to test an innovative nursing intervention, the Be Aware of Stress Smartphone Application. This application aims to increase positive thinking and reduce perceived stress among at-risk adolescents aged 13 to 16, and we sought to determine their satisfaction with its usability. The study was conducted with 44 junior high school students from an opportunity expansion high school in Eastern Thailand, who were randomly assigned to experimental and comparison groups (22 each). Data were collected between December 2023 and February 2024 using the General Information Questionnaire, Positive Thinking Test, Perceived Stress Questionnaire, and Satisfaction of Application Usability scale. The outcomes were measured at baseline, after completing the program at week 4, and at week 8 after using the application. The chi-square test and repeated measures analysis of variance were used to analyze the data. The results of this study have important implications for future research. They indicate a significant improvement in positive thinking and a reduction in perceived stress within the experimental group, compared to the comparison group, at weeks 4 and 8. Moreover, the experimental group reported high satisfaction with the application's usability. These findings suggest that the Be Aware of Stress application is beneficial for community nurses and others to prevent adolescent stress. The study also highlights the need for future research to enhance the application's functionality and compatibility with various phone operating systems to ensure widespread and effective use. [ABSTRACT FROM AUTHOR]

Physical activity is considered a fundamental component of cardiac rehabilitation programs and is recommended to improve the secondary prevention outcomes of people with acute coronary syndrome after percutaneous coronary interventions. However, the physical activity levels of this population are often low. Most research studies have primarily focused on older populations and chronic diseases. This descriptive cross-sectional study aimed to test a causal model of physical activities among adults based on the Health Action Process Approach. Four hundred twenty-four people were recruited using multi-stage sampling from the outpatient departments of seven tertiary hospitals in Thailand. Data were collected using a demographic data form, the International Physical Activity Questionnaire-Long form, the Self-Efficacy Questionnaire, the Outcome Expectation Questionnaire, the Risk Perception Questionnaire, the Behavioral Intention Questionnaire, the Planning Questionnaire, and the Action Control Questionnaire. Data were analyzed using descriptive statistics and structural equation modeling with Mplus software. The findings of our study hold significant promise for patient care. The model we tested, which accounted for 46% of the physical activity variance, underscores the crucial role of self-efficacy, planning, and action control in directly influencing physical activity. Notably, self-efficacy was found to exert the most profound effect. Outcome expectation was shown to influence physical activity indirectly through intention and planning. This highlights the potential for nurses to design interventions that foster self-efficacy, planning, and self-regulatory strategies. These strategies can empower patients to overcome challenges in cardiac rehabilitation and maintain physical activities, thereby improving their health outcomes. However, it is important to stress that our proposed intervention should be rigorously tested for effectiveness before implementation. [ABSTRACT FROM AUTHOR]

Background: Healthy dietary behaviors are fundamental for maintaining optimal health. Understanding the dietary behaviors of dentists is vital for designing effective interventions to foster healthier behaviors. However, investigations into dietary behaviors and their associations among dental professionals have been limited. Objective: To investigate the dietary behaviors of dental professionals, along with the associated factors influencing their dietary options. Materials and methods: A self-administered online questionnaire was constructed to collect data from three groups of dental professionals: undergraduates (UG), postgraduates (PG), and practicing dentists (DT). The questionnaire encompassed inquiries regarding demographic characteristics, knowledge assessment, evaluation of attitudes, and examination of dietary behaviors. Data analysis procedures included descriptive statistics, Spearman's rank correlation, and multiple linear regression. Results: A total of 842 individuals participated in the study (UG: 264, PG: 247, DT: 331). Attitude emerged as the strongest association of healthy dietary behaviors across all groups (UG: ß=0.370, PG: ß=0.512, DT: ß=0.642; P < 0.001), while alcohol consumption showed a negative correlation with healthy dietary behaviors (UG: ß=-0.135, PG: ß=-0.220, DT: ß=-0.216; P < 0.001). Conclusion: Significant variations in dietary behaviors across diverse educational levels of dental professionals were observed. Attitude emerged as the predominant factor influencing dietary behaviors, while knowledge was found to have a weak association. Tailored interventions addressing individual challenges at different career stages should be considered to enhance dietary behaviors and overall well-being in dental practice settings. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HAIs) pose a grave threat to patient safety, morbidity, and mortality, contributing to antimicrobial resistance. Thus, we estimated the point prevalence, risk factors, types, and pathogens of HAIs in hospitalized pediatric patients. Methods: A point prevalence survey (PPS) of HAIs in hospitalized pediatric patients < 18 years old was conducted from March to May 2021. Outcomes, risk factors, and types of HAIs associated with HAIs in 41 hospitals across Thailand were collected. Results: The prevalence of HAIs was 3.9% (95% CI 2.9–5.0%) (56/1443). By ages < 1 month, 1 month–2 years, 2–12 years, and 12–18 years, the prevalence of HAIs was 4.2%, 3.3%, 4.1%, and 3.0%, respectively (p = 0.80). Significant independent risk factors were extended hospital length of stay (LOS) and central venous catheter (CVC) use. Compared to an LOS of <4 days, LOSs of 4–7 days, 8–14 days, and >14 days had adjusted odds ratios (aORs) of 2.65 (95% CI 1.05, 6.68), 5.19 (95% CI 2.00, 13.4), and 9.03 (95% CI 3.97, 20.5), respectively. The use of a CVC had an aOR of 2.45 (95% CI 1.06–5.66). Lower respiratory tract infection (LRTI) was the most common HAI type (46.4%: 26/56). The highest prevalence of HAIs was predominantly observed in LRTI diagnoses, with the highest among these in the <1 month age category at 2.3% (17/738). Conclusion: The prevalence of HAIs in hospitalized pediatric patients was 3.9%. Extended LOS and use of CVC were HAI risk factors. A strategy for reducing LOS and reviewing insertion indications or the early planned removal of a CVC was implemented. The surveillance of HAIs stands as a cornerstone and fundamental component of IPC, offering invaluable insights that enhance hospital IPC interventions aimed at preventing HAIs. [ABSTRACT FROM AUTHOR]

Anthropometric assessments are commonly used to diagnose sarcopenia in older adults. However, the ongoing exploration of novel approaches aims to improve the early detection of sarcopenia. This study investigated the association between the height-changing score (HCS) and the risk of sarcopenia defined by anthropometric measurements in 340 older adults (mean age: 66.2 years). The HCS derived from the difference in height and demi-span equivalent height (DEH) was used as an indicator of declining height in the older adults. Multivariate logistic regression analysis revealed a significant association between the HCS and the risk of sarcopenia in both male and female older adults (OR = 1.146, 95% CI [1.021, 1.286], p = 0.021). In addition, income, BMI, and nutritional status were significantly associated with the risk of sarcopenia (OR = −1.933, 95% CI [0.271, 0.986], p = 0.045; OR = −2.099, 95% CI [0.386, 0.587], p < 0.001; OR = −1.443, 95% CI [0.555, 0.866], p = 0.001, respectively). The white blood cell count, lymphocyte count, and HDL cholesterol were blood biomarkers significantly correlated with calf circumference. It can be suggested that the HCS acts as an indicator and screening tool for sarcopenia risk in older adults, highlighting the potential impact of decreased height on muscle mass loss. Encouraging nutritional support can help mitigate the risk of sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Mental illness poses a substantial global public health challenge, including in Thailand, where exploration of access to mental health services is limited. The spatial and temporal dimensions of mental illness in the country are not extensively studied, despite the recognized association between poor mental health and socioeconomic inequalities. Gaining insights into these dimensions is crucial for effective public health interventions and resource allocation. Methods: This retrospective study analyzed mental health service utilization data in Thailand from 2015 to 2023. Temporal trends in annual numbers of individuals visiting mental health services by diagnosis were examined, while spatial pattern analysis employed Moran's I statistics to assess autocorrelation, identify small-area clustering, and hotspots. The implications of our findings for mental health resource allocation and policy were discussed. Results: Between 2015 and 2023, mental health facilities documented a total of 13,793,884 visits. The study found anxiety, schizophrenia, and depression emerged as the top three illnesses for mental health visits, with an increase in patient attendance following the onset of the COVID-19 outbreak. Spatial analysis identified areas of significance for various disorders across different regions of Thailand. Positive correlations between certain disorder pairs were found in specific regions, suggesting shared risk factors or comorbidities. Conclusions: This study highlights spatial and temporal variations in individuals visiting services for different mental disorders in Thailand, shedding light on service gaps and socioeconomic issues. Addressing these disparities requires increased attention to mental health, the development of appropriate interventions, and overcoming barriers to accessibility. The findings provide a baseline for policymakers and stakeholders to allocate resources and implement culturally responsive interventions to improve mental health outcomes. [ABSTRACT FROM AUTHOR]

Background: As the anatomical variations of the foot, enlarged peroneal tubercle (EPT) and accessory anterolateral talar facet (AALTF) have attracted the attention of foot surgeons in recent years. However, EPT and AALTF have not been examined for a relationship with calcaneus spur (CS) as a common osteophyte. Methods: The subjects were 369 individuals who died in northeastern Thailand and were preserved as skeletal specimens. The authors examined for the presence of left and right EPT, AALTF, and calcaneus spur (CS). We divided the EPT (+) group with EPT and the EPT (-) group without it and also divided the AALTF (+) group with AALTF and the AALTF (-) group without it. The age at death and the presence of CS were compared statistically between the EPT (+) and EPT (-) groups and between the AATLF (+) and AALTF (-) groups. Results: Out of the total 369 cases, EPT was found in 117 cases (31.7%), AALTF was positive in 91 cases (24.7%), and CS was found in 194 cases (52.3%). In comparison between EPT (+) and EPT (-) groups, CS was significantly higher (p < 0.0001) in the EPT (+) group, but there was no significant difference in age at death. In comparison between AALTF (+) and AALTF (-) groups, there was no significant difference in age at death or CS. Conclusion: This study showed a strong relationship between EPT and CS, and the prevalence of EPT and AALTF by age in Thailand was first reported. We believe it helps to know the pathogenesis and biomechanism of EPT and AALTF. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking stands as a primary contributor to preventable deaths globally and is linked to an increased risk of developing kidney failure and other diseases. A few studies have focused on the negative correlation between serum cotinine and estimated glomerular filtration rate (eGFR), indicating decreased kidney function. This study investigated the associations between urinary cotinine metabolite concentration and serum eGFR among active smokers in urban households. METHODS This was a cross-sectional study of active smokers in urban households' community Bangkok, Thailand from January to April 2023. The study involved 85 participants aged ≥18 years who were active smokers. Both urinary cotinine and serum eGFR concentrations were used as biomarkers. Independent sample t-tests were used to compare the urinary cotinine metabolite based on differences in the characteristic variable. We used multiple linear regression to test the association between cotinine metabolite and characteristics variables. Spearman's analysis was used to test the correlation between cotinine metabolite and eGFR concentration. RESULTS The association between urinary cotinine metabolite and serum eGFR concentration decreased with increasing cotinine concentrations (r= -0.223, p=0.041), suggesting a decline in kidney function. However, this study found no significant difference between urinary cotinine metabolite and characteristic variables (p>0.05). Additionally, those who smoked for ≥10 years (117.40 ± 89.80 ng/mL), smoked ≥10 cigarettes per day (117.40 ± 89.80 ng/mL) and used conventional cigarettes (124.53 ± 115.10 ng/mL). The results of the multiple linear regression models analysis indicated that those who were smokers for ≥10 years (β=0.076; 95% CI: -31.575--59.715) and those who were smoked ≥10 cigarettes/day (β=0.126; 95% CI: -65.636--18.150) were not associated with urinary cotinine metabolite level. CONCLUSIONS This study shows that the urinary cotinine metabolite level is associated with serum eGFR concentration among active smokers in urban households. The current study suggests that clinical identification and a prospective cohort study are needed before robust conclusions about how tobacco affects kidney efficiency. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a persistent health concern in numerous regions, including Thailand. The adverse effects of tuberculosis (TB) treatments, particularly liver injuries, can complicate treatment protocols, thereby increasing the likelihood of treatment discontinuation and the risk of subsequent drug resistance. Objective: This study was conducted to investigate the incidence, predisposing factors, and treatment outcomes associated with antituberculosis drugs induced liver injury (ATDILI) in Northeastern Thailand. Methods: A retrospective analysis was conducted at Mahasarakham Hospital in 2019. Patient data were retrieved from hospital records and databases. Inclusion criteria included receiving a first-time TB diagnosis, starting a standard TB regimen, and having normal liver function. To compare baseline characteristics between ATDILI patients and controls, Chi-square tests and T-tests were used. Bivariate and multivariable regression analyses were conducted to identify factors associated with drug-induced hepatitis. Results: 346 of 602 TB patients (57.5%) were enrolled. The study found an incidence of ATDILI at 14.45% (50 cases), which is notably higher than the Thai average of 4.8%. Risk factors were identified as malnutrition (adjusted OR=6.71, 95%CI 3.11:14.45), concurrent diseases (adjusted OR=2.42, 95%CI 1.20:4.89), and alcohol consumption (adjusted OR=4.24, 95%CI 1.45:12.38). In terms of therapeutic outcomes, only 18 patients were cured (36.0%). The probability of hepatotoxic events was addressed during the initial treatment phase, emphasizing the critical need for rigorous liver function monitoring during the first month of TB therapy. The ATDILI group had a mortality rate of 16%, which was higher than the national TB-related average of 8.2%. Conclusion: The marked presence of ATDILI in the cohort under study accentuates the immediate need for enhanced clinical monitoring, especially among susceptible groups. It is imperative to implement strategies aimed at early detection, prompt intervention, and holistic management of ATDILI, complemented by endeavors to boost cure rates for the affected population. [ABSTRACT FROM AUTHOR]

Adolescents with depression often experience negative automatic thoughts, which contribute to the development of suicidal ideation. Internet-based cognitive behavioral therapy has now become a treatment to address negative automatic thoughts to prevent suicide. This quasi-experimental study aimed to assess the effects of an Internet-based Cognitive Behavioral Therapy Program on the depression of Thai adolescents. The participants consisted of 60 adolescent students with a deviation from their usual mood who were enrolled in public high schools in a province adjacent to Bangkok. The participants were conveniently selected, paired based on gender and grade point average, and randomly assigned into two groups. The experimental group received the program, while the control group received usual care (n = 30 each). Data collection instruments included a personal data form and the Healthrelated Self-report Scale. One-way repeated measures ANCOVA was used to compare the mean depression scores between the two groups while controlling for baseline depression scores. The results indicate that the participants' depression scores decreased over time in both groups. However, a significant group effect suggests that being in the experimental group was associated with a greater decrease in depression scores both immediately after the intervention and at the two-week follow-up compared to the control group. These findings shed light on the potential benefits of implementing this Internet-based Cognitive Behavioral Therapy Program by school nurses, teachers, or primary care nurses to prevent extreme depression and suicidal ideation among adolescents. Further investigation with longer follow-up is recommended. [ABSTRACT FROM AUTHOR]

Sadhukarn, a sacred music composition performed ritually to salute and invite divine powers to open a ceremony or feast, is played in Thailand, Cambodia, and Laos. Different countries have unique versions, arranged based on musicians' skills and en vogue styles. This study presents the results of multivariate statistical analyses of 26 different versions of Sadhukarn main melodies using non-metric multidimensional scaling (NMDS) and cluster analysis. The objective was to identify the optimal number of parameters for identifying the origin and relationships among Sadhukarn versions, including rhyme structures, pillar tone, rhythmic and melodic patterns, intervals, pitches, and combinations of these parameters. The data were analyzed using both full and normalized datasets (32 phrases) to avoid biases due to differences in phrases among versions. Overall, the combination of six parameters is the best approach for data analysis in both full and normalized datasets. The analysis of the 'full version' shows the separation of Sadhukarn versions from different countries of origin, while the analysis of the 'normalized version' reveals the rhyme structure, rhythmic structure, and pitch as crucial parameters for identifying Sadhukarn versions. We conclude that multivariate statistics are powerful tools for identifying relationships among different versions of Sadhukarn compositions from Thailand, Laos, and Cambodia and within the same countries of origin. [ABSTRACT FROM AUTHOR]

Background: The potent antiplasmodial activity of 1-hydroxy-5,6,7-trimethoxyxanthone (HTX), isolated from Mammea siamensis T. Anders. flowers, has previously been demonstrated in vitro. However, its in vivo activity has not been reported. Therefore, this study aimed to investigate the antimalarial activity and acute toxicity of HTX in a mouse model and to evaluate the pharmacokinetic profile of HTX following a single intraperitoneal administration. Methods: The in vivo antimalarial activity of HTX was evaluated using a 4-day suppressive test. Mice were intraperitoneally injected with Plasmodium berghei ANKA strain and given HTX daily for 4 days. To detect acute toxicity, mice received a single dose of HTX and were observed for 14 days. Additionally, the biochemical parameters of the liver and kidney functions as well as the histopathology of liver and kidney tissues were examined. HTX pharmacokinetics after intraperitoneal administration was also investigated in a mouse model. Liquid chromatography triple quadrupole mass spectrometry was used to quantify plasma HTX and calculate pharmacokinetic parameters with the PKSolver software. Results: HTX at 10 mg/kg body weight significantly suppressed parasitemia in malaria-infected mice by 74.26%. Mice treated with 3 mg/kg HTX showed 46.88% suppression, whereas mice treated with 1 mg/kg displayed 34.56% suppression. Additionally, no symptoms of acute toxicity were observed in the HTX-treated groups. There were no significant alterations in the biochemical parameters of the liver and kidney functions and no histological changes in liver or kidney tissues. Following intraperitoneal HTX administration, the pharmacokinetic profile exhibited a maximum concentration (Cmax) of 94.02 ng/mL, time to attain Cmax (Tmax) of 0.5 h, mean resident time of 14.80 h, and elimination half-life of 13.88 h. Conclusions: HTX has in vivo antimalarial properties against P. berghei infection. Acute toxicity studies of HTX did not show behavioral changes or mortality. The median lethal dose was greater than 50 mg/kg body weight. Pharmacokinetic studies showed that HTX has a long elimination half-life; hence, shortening the duration of malaria treatment may be required to minimize toxicity. [ABSTRACT FROM AUTHOR]

Background: Surface remineralization is recommended for the management of active non-cavitated interproximal carious lesions in primary teeth. According to the American Academy of Pediatric Dentistry, a recently recognized category of materials called bioactive restorative materials can be used for remineralization. This study aimed to evaluate the release of fluoride (F), calcium (Ca) and phosphate (P) ions from Predicta® Bioactive Bulk-fill composite compared with EQUIA Forte® and Filtek™ Z350 and to determine the remineralization effect of these 3 restorative materials on adjacent initial interproximal enamel carious lesions. Methods: The release of F, Ca and P ions from 3 groups ((n = 10/group) (Group 1- Predicta®, Group 2- EQUIA Forte® and Group 3- Filtek™ Z350)) was determined at 1st, 4th, 7th and 14th days. After creating artificial carious lesions, human enamel samples were randomly assigned into 3 groups (n = 13/group) which were placed in contact with occluso-proximal restorative materials and exposed to a 14-day pH cycling period. Surface microhardness was determined using a Knoop microhardness assay at baseline, after artificial carious lesions formation and after pH cycling. The difference in the percentage of surface microhardness recovery (%SMHR) among groups was compared. Mineral deposition was analyzed with energy-dispersive x-ray spectroscopy (EDS) and the enamel surface morphology was evaluated with scanning electron microscopy (SEM). Kruskal-Wallis's test with Dunn's post hoc test and one-way ANOVA with Tukey's post hoc test were used for data analysis. Results: EQUIA Forte® released the highest cumulative amount of F and P ions, followed by Predicta® and Filtek™ Z350. Predicta® released higher amount of Ca ions than EQUIA Forte® and Filtek™ Z350. Predicta® demonstrated the highest %SMHR, followed by EQUIA Forte® and Filtek™ Z350. There was a significant difference in the %SMHR between Predicta® and Filtek™ Z350 (p < 0.05). However, EQUIA Forte® demonstrated the highest fluoride content, followed by Predicta® and Filtek™ Z350. The SEM images of EQUIA Forte® and Predicta® revealed the greater mineral deposition. Conclusion: Predicta® demonstrated a marked increase in surface microhardness and fluoride content of adjacent initial interproximal enamel carious lesions in primary molars compared with Filtek™ Z350. Predicta® is an alternative restorative material to remineralize adjacent initial interproximal enamel carious lesions in primary molars, especially in high-risk caries patients. [ABSTRACT FROM AUTHOR]

The PCLake model has not previously been used for tropical reservoirs. This study attempted to apply the PCLake model to predict the chlorophyll a concentrations (Chl-a) in a tropical reservoir in Thailand. Sensitivity analyses were performed for the constants affecting the prediction of Chl-a in the phytoplankton module. The model calibration was performed by using the adjusted value of the most sensitive constant with the observed data from July to December 2020. The effects of the initial trophic state of the reservoir on the simulated Chl-a were evaluated. The results showed that Chl-a were sensitive to six constants. Among these constants, the value of the specific extinction of detritus (cExtSpDet) was adjusted using the calculated values from the typical limnological parameters of the studied reservoir. Statistical analyses of the results of calibration and the subsequent validation with the observed data from February to September 2022 were listed as follows: NSE=0.55 and 0.37, RSR=0.67 and 0.79, and PBIAS=27% and 9%, respectively. The initial trophic state of the reservoir had no influence on the long-term prediction of Chl-a. This preliminary effort indicates that the PCLake model can be used to predict Chl-a, which is representative of algal biomass in tropical reservoirs and is essential to water quality models, without complex modifications. [ABSTRACT FROM AUTHOR]

Introduction: Bystander cardiopulmonary resuscitation (CPR) reduces mortality from out-of-hospital cardiac arrest. The willingness to perform CPR (W-CPR) is also critical. Uncertain effects of the coronavirus disease 2019 (COVID-19) pandemic on W-CPR were reported. Our objectives aim to examine W-CPR during the COVID-19 pandemic, including the influence of the bystander-victim relationship, bystander characteristics, and CPR background on the W-CPR of laypeople and healthcare providers (HCPs). Methods: A cross-sectional online survey was conducted between August 2020 and November 2020 among Thai laypeople and HCPs. A structured questionnaire was given to volunteers as an online survey. We recorded W-conventional CPR (W-C-CPR), W-compression-only CPR (W-CO-CPR), chest compression, automated external defibrillator (AED), mouth-to-mouth, face shield, and pocket mask ventilation on family members (FMs), acquaintances, and strangers during the study (pandemic) and in nonpandemic situation and analyzed. Results: We included 419 laypeople and 716 HCPs. During the pandemic, laypeople expressed less willingness in all interventions (P < 0.05) except W-CO-CPR in FMs and AED in FMs and acquaintances. HCPs were less willing to any interventions (P < 0.05). Laypeople showed comparable W-C-CPR and W-CO-CPR between FMs and acquaintances but less among strangers (P < 0.05). HCPs' W-CPR differed significantly depending on their relationship (P < 0.05), except W-CO-CPR between FMs and acquaintances. CPR self-efficacy, single marital status, CPR experience, and HCPs reported higher W-CO-CPR in FMs. Conclusion: Participants were less W-CPR during the COVID-19 pandemic on all recipients (laypeople: 2.8%-21.0%, HCPs: 7.6%-31.2%), except for laypeople with FMs. The recipient's relationship was more critical in W-C-CPR than in W-CO-CPR, especially in HCPs. [ABSTRACT FROM AUTHOR]

Background: Social activity has long been recognized as an essential component of active aging. How- ever, an overlooked dimension is cross-national comparison within Asia on social activity and its relationship to the functional decline. This study examined functional decline among older Thai and Japanese adults over a two-year period and compared associated social and other factors. Methods: We collected data from two waves of a longitudinal cohort survey administered in Nakhon Pathom, Thailand and the city of Tosa, Japan, covering community-dwelling adults aged ≤ 65. The data cover basic activities of daily living (ADL), sociodemographic traits, health status, depression, and social activities. A total of 338 Thai and 869 Japanese participants with no functional limitations participated at baseline, and 216 Thai and 480 Japanese participants completed the follow-up study after two years. Results: At follow-up, Thai participants reported a higher percentage of functional decline than Japanese participants (22.2% vs. 13.5%). Risk factors associated with functional decline in Thai participants were increased age, female gender, low economic satisfaction, and low social activity levels. Functional decline among Japanese participants was associated with increased age, low social activity levels, and arthropathy. Low social activity was a strong predictor of decline in ADL, and the association was significant even after adjusting for related factors in Thai and Japanese individuals. Conclusion: Although there were differences in the variables associated with ADL decline between Thai and Japanese participants, our results support the promotion of social activities for older adults to preserve a healthy functional status. [ABSTRACT FROM AUTHOR]

Introduction: A health literacy promotion program in drugs and health products was collaboratively developed and evaluated for effectiveness by researchers and stakeholders. Methods: A Solomon four-group randomized study was conducted in 2022. The participants were people aged ≥60 years enrolled at senior schools in Northeast Thailand. One hundred and eighty older people were randomly selected using multistage sampling and allocated into four groups, 45 members. The designed program covers six skills: access to health information, cognition, communication, decision-making, media literacy, and self-management. ANOVA and t-test were used. Results: One hundred percent response rate, participants of the program (Group 1) showed a significant improvement (pre-post) of 62.2% in their health literacy in drugs and health products use (151.54 ± 37.88, 245.73 ± 9.33, P < 0.001). Group 3, older people who joined the program with posttest only showed health literacy of 248.67 ± 11.54. In contrast, Group 2 and Group 4 with no program showed less health literacy of 149.02 ± 32.08 and 145.22 ± 34.14, respectively. On each item, the older people with the program consistently scored significantly higher across all domains (P < 0.001). The average score was 247.20 ± 10.54, which showed a high level of health literacy (≥75%). Among areas, decision-making skills revealed the highest score of 45.97 ± 1.81 out of 50. The overall satisfaction score on the program was 47.60 ± 1.50. Conclusion: The program demonstrated its effectiveness in improving the older population’s health literacy regarding drug and health product use. It holds potential as a strategy to encourage older people to rational drug use. Participants expressed a significant satisfaction with the program, recommended for the broader Thai older people community. [ABSTRACT FROM AUTHOR]

Registered nurses must possess patient safety expertise regardless of their level. However, patient safety skills are the most crucial competency for new graduate nurses, which they must accomplish before working autonomously. Nevertheless, assessing these competencies is difficult due to the need for quality assessment tools to improve their competence in providing safe care. This study aimed to develop and test the Thai-Patient Safety Competency Scale for new graduate nurses, according to Thailand Nursing and Midwifery requirements. A descriptive design with two phases and eight steps was applied. The new instrument was examined for construct validity, known-group validity, and internal consistency reliability using factor analysis, t-test, and Cronbach's alpha coefficient. The sample comprised ten experts, 403 new graduate nurses, and 56 registered nurses. The results showed 58 items composed of eight domains: ethical and legal aspects of patient safety, nursing practices to prevent or minimize harm from healthcare errors, professional characteristics regarding patient safety, risk management and quality improvement, academic and research skills regarding patient safety, effective communication in healthcare teams, use of technology and informatics for patient safety, and policy and networks regarding patient safety. This Thai-Patient Safety Competency Scale had good construct validity. In addition, the tool could discriminate the patient safety competency between new and experienced graduate nurses. It had good internal consistency and reliability. Thus, it can be used to assess and train new graduate nurses to increase their competency for patient safety. However, the scale needs further testing with different groups of nurses. [ABSTRACT FROM AUTHOR]

Older adults with chronic obstructive pulmonary disease frequently visit the emergency department due to an acute exacerbation of the disease or symptoms after discharge from the hospital. Therefore, providing programs that enable caregivers to recognize and manage alert signs and symptoms in caring for older adults with chronic obstructive pulmonary disease at home is essential. This feasibility study is a part of emergency health management in a transitional care program to reduce emergency department visits in older adults with dyspnea and aims to develop and test the Transitional Care Based e-Health Program. The program was tested using one group pre-test and post-test design with 50 family caregivers of older adults living with chronic obstructive pulmonary disease. Data were collected from November 2021 to May 2022. The ability to manage dyspnea symptoms among family caregivers and patient emergency department visits was assessed 30 days after hospital discharge. Data were analyzed using the Wilcoxon Signed Rank Test to compare the pre- and post-score differences. After implementation, it was found that the program was feasible and could improve the ability to manage dyspnea. Only three of 50 cases had emergency department visits within 30 days after discharge, accounting for 6% compared to the earlier report of 27.18%. The findings provide potential transitional care based on an e-health program to enhance the ability of dyspnea symptom management among family caregivers. Nurses can use this program in practice. However, further study is needed with randomized controlled trials before it can be widely used nationally. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify factors associated with the onset time of diabetic complications in patients with type 2 diabetes mellitus (T2DM) and determine the best-fitted survival model. Methods: A retrospective cohort study was conducted among T2DM patients enrolled from October 1, 2016 to July 15, 2020 at the National Health Security Office (NHSO). In total, 388 T2DM patients were included. Cox proportional-hazard and parametric models were used to identify factors related to the onset time of diabetic complications. The Akaike information criterion, Bayesian information criterion, and Cox-Snell residual were compared to determine the best-fitted survival model. Results: Thirty diabetic complication events were detected among the 388 patients (7.7%). A 90% survival rate for the onset time of diabetic complications was found at 33 months after the first T2DM diagnosis. According to multivariate analysis, a duration of T2DM =42 months (time ratio [TR], 0.56; 95% confidence interval [CI], 0.33-0.96; p=0.034), comorbid hypertension (TR, 0.30; 95% CI, 0.15-0.60; p=0.001), mildly to moderately reduced levels of the estimated glomerular filtration rate (eGFR) (TR, 0.43; 95% CI, 0.24-0.75; p=0.003) and an eGFR that was severely reduced or indicative of kidney failure (TR, 0.38; 95% CI, 0.16-0.88; p=0.025) were significantly associated with the onset time of diabetic complications (p<0.05). Conclusion: Patients with T2DM durations of more than 42 months, comorbid hypertension, and decreased eGFR were at risk of developing diabetic complications. The NHSO should be aware of these factors to establish a policy to prevent diabetic complications after the diagnosis of T2DM. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is a prevalent comorbidity in patients with COPD that is usually underrecognized and hence, undertreated. Compared to the gold standard dual-energy X-ray absorptiometry (DXA), calcaneus quantitative ultrasound (QUS) is less expensive, more portable, and more accessible, especially in less developed countries. The aim of this study was to investigate the ability of calcaneus QUS to screen and prescreen for osteoporosis in patients with COPD. Methods: This cross-sectional study enrolled 67 males older than 50 years with clinically stable COPD. DXA scans of the lumbar spine (L2–4) and femoral neck were performed. QUS of the right calcaneus (AOS-100) was used to assess the broadband ultrasound attenuation (BUA), speed of sound (SOS), osteo sono-assessment index (OSI), and T-score. When the T-score was ≤ − 2.5, osteoporosis was diagnosed by both DXA and QUS. Results: Forty-eight patients (71.6%) had DXA T-scores ≤ − 2.5 at either the lumbar spine or femoral neck. All QUS parameters (BUA, SOS, OSI, and T-score) could discriminate DXA-determined osteoporosis (the area under the curve varied from 0.64 to 0.83). The QUS T-score was significantly moderately correlated with the DXA T-score at both the femoral neck (r = 0.55) and lumbar spine (r = 0.52). The sensitivity and specificity of QUS in identifying osteoporosis were 10.4% and 94.7%, respectively. The positive and negative predictive values were 83.3% and 29.5%, respectively. When a QUS T-score of 0.09 was used as the cutoff, the sensitivity exceeded 90%, and 15% of the DXA scans were not warranted. Conclusions: The sensitivity and specificity of calcaneus QUS were not sufficient for QUS to be used as an alternative to DXA for osteoporosis screening. However, QUS may be useful for prescreening before DXA to identify COPD patients who have either a high or low likelihood of osteoporosis. Consequently, QUS reduces the need for DXA referral. [ABSTRACT FROM AUTHOR]

Background: To compare the prevalence of aneurysmal sac expansion in type II endoleak (T2E) presenting on CTA phase with T2E presenting on delayed phase. Methods: A retrospective study at a single tertiary care center in Bangkok, Thailand. Serial measurement of aneurysmal sac diameters was obtained and the prevalence of aneurysmal sac expansion was compared. Results: 130 patients were enrolled from January 2005 to December 2019. The prevalence of aneurysmal sac expansion in T2E patients presenting in the CTA phase and delayed phase in this 2-year observational study were 16% and 0%, respectively (P = 0.065). Age > 80 years (25.8% vs. 8.8%; P = 0.028) and initial aneurysmal sac diameter (71.3 mm vs. 57.7 mm; P = 0.035) were associated with the aneurysmal sac expansion. Aneurysmal sac expansion occurred in 18.3% of patients with patent IMA and 6% of patients with occluded IMA (P = 0.053). The number and diameter of lumbar artery feeder, and the presence of intrastent thrombus were not associated with aneurysmal sac expansion. T2E presenting on CTA phase resolved in 9.2% of cases compared with 7.14% of delayed phase cases (P = 1.0). Conclusions: The prevalence of aneurysmal sac expansion in T2E patients presenting on CTA phase was not statistically significantly higher than in patients on delayed phase. Age more than 80 years and initial aneurysmal sac diameter were significantly associated with aneurysmal sac expansion. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity has become a global concern, with its prevalence steadily increasing over the past decade. This condition negatively impacts the cardiovascular system, increasing the risk of morbidity and mortality in adulthood. This study aimed to identify cardiac function abnormalities and related risk factors among overweight and obese Thai children. Materials and Methods: A cross sectional observational study of 70 children with body mass index (BMI) >1 standard deviation above the mean for Thai children was conducted at Naresuan University Hospital. Body fat percentage (%Fat) was measured, and standard transthoracic echocardiography was performed. Metabolic profiles were collected from medical records. Results: The thickness and diameter of the Left ventricle (LV) wall, including the LV posterior wall, LV internal diameter, and interventricular septum (IVS), were significantly increased in both systolic and diastolic phases in obese children. LV concentric hypertrophy and an abnormal E/E' ratio were found in 27% and 34.3% of participants, respectively. Right ventricular systolic dysfunction indicated by abnormal tricuspid annular plane systolic excursion values was found in 55.7% of all participants. In addition, 27.1% of all obese children had pulmonary hypertension. Significant differences in BMI and %Fat were detected between children with abnormal and normal IVS diastolic (IVSd) (P = 0.016). Our univariate and multivariate correlation analyses revealed a significant positive association between abnormal IVSd and %Fat, with an odd ratio (OR) of 1.13 (95% confidence interval [CI]: 1.01-1.27; P = 0.047) and an adjusted OR of 1.17 (95% CI: 1.01-1.36; P = 0.04). Conclusions: Cardiac function abnormalities in childhood obesity exhibit a significant positive correlation with BMI and various cardiac dimensions, including ventricular wall thickness. One important related risk factor for increased IVS thickness is %Fat. Therefore, multidisciplinary management of obesity should be initiated as early as possible to prevent future cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Despite the World Health Organization declaring COVID-19 no longer a public health emergency, reports of long COVID persist globally, raising concerns about its impact on individuals. Objective: This retrospective study aimed to explore the symptom experiences of individuals with long COVID-19 and examine the relationship between those experiences and perceived negative health status in Thailand. Methods: The study focused on individuals with moderate to severe COVID-19 infections. Between July 3, 2022 and December 1, 2022, we conducted telephone interviews with 86 individuals who tested positive for SARS-CoV-2 and received outpatient care in Bangkok. The COVID-19 Yorkshire Rehabilitation Screening was utilized to measure symptom occurrence, duration, severity, and health status on an 11-point numerical rating scale from 0 (none or excellent) to 10 (the worst). A Spearman rank correlation was used to analyze the relationships between long COVID symptoms and negative perception of health status. Results: Among the participants, 75.6% had long COVID, with a median of three symptoms lasting for a median duration of 5.6 months. Difficulties in performing daily activities were most common, reported by 50.8% of participants. The majority (80.0%) experienced itching, headache, cognition, muscle pain, continence, and sleeping problem for 6 months. Loss of taste was the most severe symptom, with a mean severity rating of 8.8. There were significant positive relations between a negative perception of health status and multiple symptoms, symptom severity, functional disability, and additional symptoms. Conclusion: Individuals with moderate to severe COVID-19 infection who experienced long COVID had poorer perceived health status. To effectively manage and improve the health status of individuals with long COVID, nurses should provide follow-up care, assess not only the occurrence of symptoms but also their duration and severity, and evaluate performance outcomes. [ABSTRACT FROM AUTHOR]

Navy officers working on the coastal guard vessels risk hearing loss due to repeated exposure to high noise levels from ship engines. Therefore, proper use of hearing protection devices is important. In this study, a web-based hearing loss prevention program was developed to promote the behavior of the use of hearing protection devices among Thai navy officers working on coastal guard vessels. In total, 152 navy personnel were recruited based on selection criteria and randomly assigned to the experimental (n = 76) and control groups (n = 76). The participants in the experimental group received the hearing loss prevention program via a website over four weeks. After completing the program, hearing protection device behavior was evaluated by a self-report questionnaire immediately after and at eight weeks follow-up. The results showed significantly increasing scores of the use of hearing protection devices behavior within the experimental group, both immediately and eight weeks after the program completion. However, there were no significant differences in the scores when comparing between groups, even though the scores of the experimental group were better than those in the control group. The restrictions could be explained by some emerging events during the implementation period, including the COVID-19 pandemic followed by a massive oil spill incident at sea. These put an extra workload on the study participants. Most importantly, there was a problem with the network connection that might have affected the continuation of participant attention to the program. Although this study found no effective results of the developed program due to some limitations, nurses can adopt this protective intervention to reduce the risk of occupational noise-induced hearing loss among Navy officers. Therefore, a recommendation for further study is to develop an intervention program that considers both the working context of the coastal vessels and appropriate participation methods that require more challenging efforts. [ABSTRACT FROM AUTHOR]

Background: The number of older adults with a high risk of frailty and severe illness continues to increase. Moreover, physiological change and multiple comorbidities are challenging to triage in geriatrics. Therefore, we aimed to evaluate variables to predict 28-day mortality and develop a screening tool to predict mortality and lifesaving intervention among geriatric patients in the emergency department (ED). Methods: This study was a retrospective, single-center, observational study at the ED of Ramathibodi Hospital, Bangkok. Patients aged ≥ 65 years who visited the ED between January 2018 and December 2019 were enrolled. In the development cohort, univariable logistic regression was used to identify predictors of 28-day mortality in older patients. A predictive model for mortality and the need for lifesaving intervention was developed by multivariable logistic regression. In addition, the score was validated with internal validation and compared between development and validation set by chi-square. Results: We enrolled 1393 patients. In the development cohort, among these 1002 patients, 103 (10.3%) of whom died within 28 days. Malignancy, shock index (SI), systolic blood pressure (SBP) < 100 mmHg, and altered mentation were independent risk factors of 28-day mortality. We developed new screening tools named the S-TRIAGE score, which has the respiratory rate (< 11, > 22 breaths/min), the ratio of pulse oximetric saturation to the fraction of inspired oxygen (< 420, 420–450), SI (> 1, 0.6–0.99), SBP < 100 mmHg, body temperature (< 36, > 37.5 °C), and mental change. The area under a receiver operating characteristic (ROC) curve of the S-TRIAGE score in the validation cohort was 0.826 [95% confidence interval (95%CI) 0.773–0.879] in predicting mortality and lifesaving intervention, and the clinical score classified patients into five groups. Conclusion: This study showed malignancy, hypotension, increased SI, and mental status change were predictive factors for 28-day mortality in older adults in the ED. The screening tool risk score for geriatrics used in this study is potentially a good predictor of mortality and lifesaving intervention in high-risk older patients in the ED. [ABSTRACT FROM AUTHOR]

INTRODUCTION The use of e-cigarettes has steadily increased, and vocational students are one primary target of e-cigarette marketing. This cross-sectional survey research aimed to explore e-cigarette use and examine the factors associated with it. METHODS Multistage cluster random sampling was employed to select 1536 students in vocational education institutions. A self-administered questionnaire was used to collect the data from September to December 2019. Multinomial logistic regression analysis was used to obtain the adjusted odds ratio (AOR) to determine the associated factors of e-cigarette use. RESULTS Altogether, 28.7% of the subjects were currently e-cigarette users, 7.4% used e-cigarettes only, and 21.3% were dual users. Various factors were found to be significantly associated with e-cigarette use by 43.7%. Those consisted of sex (male) (AOR=2.183; 95% CI: 1.510-3.157), grade point average (GPA) of <2.5 (AOR=2.363; 95% CI: 1.502-3.717), having neutral attitudes toward e-cigarette use (AOR=2.676; 95% CI: 1.499-4.779) and positive attitudes toward e-cigarette use (AOR=4.171; 95% CI: 2.250-7.734), moderate level of perceived behavioral control on e-cigarette use (AOR=3.520; 95% CI: 2.287-5.418) and low level of perceived behavioral control on e-cigarettes use (AOR=4.959; 95% CI: 3.274-7.511), moderate price of e-cigarettes (AOR=1.436; 95% CI: 1.009-2.044), and e-cigarette use of their parents (AOR=1.827; 95% CI: 1.137-2.938), close friends (AOR=4.327; 95% CI: 2.954-6.338) and idols (AOR=4.604; 95% CI: 1.844-11.497). CONCLUSIONS Students should be encouraged to develop negative attitudes toward e-cigarette use and increase their self-confidence to control the use of e-cigarettes. This can be achieved by regularly distributing information on the product's risks. Moreover, students can find inspiration and guidance from peers, close friends, or their idols, who will act as positive role models and inspire them not to initiate e-cigarette use. [ABSTRACT FROM AUTHOR]

Background: Dental technologies have increasingly been implemented in orthodontic practice to offer better experiences for orthodontists and patients, however, there is no scientific evidence yet whether which technologies should be implemented into the postgraduate programs. Objectives: To investigate perceptions of orthodontic residents toward the confidence and importance of dental technologies, as well as to determine their necessity in postgraduate programs. Materials and methods: The online questionnaire was designed to collect data from residents from all accredited orthodontic postgraduate programs in Thailand. The questionnaire consisted of four sections, which were (1) demographic data, (2) self-perceived importance of orthodontic technologies, (3) self-perceived confidence toward orthodontic technologies, and (4) the necessity of orthodontic technologies in postgraduate programs. The data were analyzed using descriptive statistics, Spearman correlation, and a chi-square test. Results: Intraoral scanner was found to be an orthodontic technology with the highest scores for both self-perceived importance (4.37 ± 0.59) and confidence (4.23 ± 0.75), followed by cone-beam computed tomography, digital treatment planning software, and lab-produced aligners. These orthodontic technologies were also considered as mandatory in orthodontic postgraduate programs. CAD/CAM technologies appeared to be least important, and their training may be arranged as short course training. There was no significant influence of training locations on the necessity of all orthodontic technologies (P > 0.05), except CBCT. Self-perceived importance and confidence in all technologies were found to have significant positive correlations (P < 0.05), except teledentistry and in-office aligners. Conclusion: Orthodontic technologies were perceived as important in clinical workflow. Intraoral Scanners, CBCT, digital treatment planning software, lab-produced aligners, and digital modeling software appeared to be necessary for clinical practice and should be considered for orthodontic postgraduate programs, while other technologies may be arranged as short course training. Further research should investigate how to arrange and organize training sessions in orthodontic postgraduate programs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the incidence of intraparotid lymph node metastasis in parotid malignancies and its association with overall survival. Methods: This study retrospectively reviewed the charts and histopathological findings of 43 patients with parotid malignancies who underwent surgery between 2008 and 2015. Epidemiological and pathological data were recorded. Overall survival was calculated, and univariate and multivariate analyses were used to determine the role of metastasis intraparotid lymph node as a prognostic factor. Results: The incidence of metastasis intraparotid lymph node was 46.5%. Advanced-stage and high-grade tumors were associated with a higher metastasis intraparotid lymph node risk. Survival was significantly decreased in the metastasis intraparotid lymph node group, overall cohort (hazard ratio, 7.52), and advanced-stage group (hazard ratio, 4.62). No significant prognostic factor was revealed by multivariable analysis. Conclusion: Metastasis intraparotid lymph node is common and may negatively affect survival in parotid malignancies. [ABSTRACT FROM AUTHOR]

Background: The prevalence of uncontrolled type 2 diabetes has been increasing, and the nurse is a primary healthcare provider to patients when health professionals are scarce in the community setting. A feasible intervention delivered by nurses is necessary to fulfill patients' needs to help them achieve glycemic control. Aim: To investigate whether Thai adults with uncontrolled diabetes in community hospitals lack self-care competency and whether a nurse-led supportive education program can enhance their self-care skills, change behavior, and control HbA1C levels. Methods: We employed a multi-community hospital cluster randomized controlled trial design. Participants were randomly selected in the experimental group (2 hospitals) and control group (2 hospitals), with 30 patients from each hospital. One hundred twenty adults with HbA1c 7—10% treated by oral glycemic medication were recruited. Using Orem's Theory as a framework, nurses implemented self-care deficit assessments and supportive-educative nursing programs into their work. Participants in the control group received usual care, and those in the experimental group underwent a nurse assessment and supportive education measures. Data were collected at baseline, with 4-week and 12-week follow-ups. Data analysis were a repeated measures ANOVA with post hoc analysis, and Independent t -test. Results: One hundred three patients completed the trial (51 in the experimental group and 52 in the control group). At 12 weeks, there were statistically significant improvements in HbA1c (P <.001), fasting plasma glucose (P =.03), knowledge (P <.001), diabetes self-care agency (P <.001), diet consumption (P <.001), physical activity (P <.001), and medical adherence (P =.03) in the experimental group significantly greater than those in the control group. Also, the between-group effect sizes were 0.49 or greater. Conclusion: The self-care deficit assessment and supportive education program were essential to the nursing intervention that effectively improved knowledge, changed behavior, and HbA1c levels among adults with uncontrolled blood glucose. [ABSTRACT FROM AUTHOR]

Background: The success rate of surgical treatment for rotator cuff (RC) tear ranges from 16% to 94%. The Rotator Cuff Healing Index (RoHI) is a system for predicting failure after RC repair and is based on a combined score of factors, including age, anteroposterior (AP) tear size, tendon retraction, fatty infiltration of the infraspinatus muscle, bone mineral density (BMD), and level of work activity. Purpose: To determine the factors leading to RC repair failure in a Thai population, to test the reliability of the RoHI in this population, and to compare the RoHI with a modified RoHI (m-RoHI) based on the factors for repair failure as determined. Study Design: Case-control study; Level of evidence, 3. Methods: This study included 133 Thai patients who underwent arthroscopic RC repair between February 2012 and February 2021. Postoperative magnetic resonance imaging was performed at 6 to 24 months to evaluate RC healing. Variables that might affect failure rates were evaluated, including demographic characteristics, AP tear size and retraction, radiographic measurements, and magnetic resonance imaging findings. The m-RoHI was created using factors that significantly predicted repair failure on multivariate analysis. The area under the receiver operating characteristic curve was calculated to determine the reliability of the RoHI and to compare the reliability of the RoHI and m-RoHI to predict failure rates. Results: Multivariate logistic regression analysis revealed that body mass index ≥23 (adjusted odds ratio [OR], 9.02; P =.034), high work activity (adjusted OR, 19.53; P =.008), AP tear size ≥2.5 cm (adjusted OR, 19.04; P =.001), and a retraction size of 2 to <3 cm (adjusted OR, 20.36; P =.013) were the independent factors that predicted repair failure in our population. BMD was not independently predictive of repair failure. We used these 4 significant independent factors to generate the m-RoHI. The area under the curve of the final adjusted m-RoHI was slightly improved as compared with the original RoHI, but this difference was not significant (0.827 [95% CI, 0.741-0.913] vs 0.780 [95% CI, 0.686-0.875], respectively; P =.447). Conclusion: The m-RoHI had a similar predictive value for repair failure to the original RoHI in our study population, but it did not require obtaining BMD. The m-RoHI may be useful in populations where BMD is not routinely obtained. [ABSTRACT FROM AUTHOR]

Background: Inadvertent perioperative hypothermia is an unintentional drop in core body temperature to less than 36 °C perioperatively and is associated with many negative outcomes such as infection, a prolonged stay in a recovery room, and decreased patient comfort. Objective: To determine the incidence of postoperative hypothermia and to identify the associated factors with postoperative hypothermia in patients undergoing head, neck, breast, general, urology, and vascular surgery. The incidences of pre- and intraoperative hypothermia were examined as the intermediate outcomes. Materials and methods: A retrospective chart review was conducted in adult patients undergoing surgery at a university hospital in a developing country for two months (October to November 2019). Temperatures below 36 °C were defined as hypothermia. Univariate and multivariate analyses were used to identify factors associated with postoperative hypothermia. Results: A total of 742 patients were analyzed, the incidence of postoperative hypothermia was 11.9% (95% CI 9.7%-14.3%), and preoperative hypothermia was 0.4% (95% CI 0.08%-1.2%). Of the 117 patients with intraoperative core temperature monitoring, the incidence of intraoperative hypothermia was 73.5% (95% CI 58.8–90.8%), and hypothermia occurred most commonly after anesthesia induction. Associated factors of postoperative hypothermia were ASA physical status III-IV (OR = 1.78, 95%CI 1.08–2.93, p = 0.023) and preoperative hypothermia (OR = 17.99, 95%CI = 1.57-206.89, p = 0.020). Patients with postoperative hypothermia had a significantly longer stay in the PACU (100 min vs. 90 min, p = 0.047) and a lower temperature when discharged from PACU (36.2 °C vs. 36.5 °C, p < 0.001) than those without hypothermia. Conclusion: This study confirms that perioperative hypothermia remains a common problem, especially in the intraoperative and postoperative periods. High ASA physical status and preoperative hypothermia were associated factors of postoperative hypothermia. In order to minimize the incidence of perioperative hypothermia and enhance patient outcomes, appropriate temperature management should be emphasized in patients at high risk. Registration: Clinical Trials.gov (NCT04307095) (13/03/2020). [ABSTRACT FROM AUTHOR]

An effective rehabilitation program is essential for patients having surgery to regain full physical functions and improve their quality of life. This quasi-experimental study aimed to examine the effectiveness of a rehabilitation program on functional recovery and gastrointestinal quality of life among people with colorectal cancer undergoing surgery. This program was developed using integrated concepts from the Symptom Management Model and Self-Regulation Theory and involved nurse-patient co-operation. Sixty-four participants undergoing colorectal cancer surgery admitted at three tertiary hospitals in Bangkok, Thailand, were recruited into the experimental (n = 32) or control group (n = 32). The experimental group received the Rehabilitation Program after Colorectal Surgery in addition to usual care. The control group received only usual care. The instruments used for data collection were a demographic data record, a Pain Rating Scale, the Abdominal Distension Assessment Scale, the Gastrointestinal Function and Eating Record Form, a Six-Minute Walk Test, a digital spirometer for forced vital capacity, and the Gastrointestinal Quality of Life Index. The outcomes were measured before starting the program, on postoperative days 1 and 3, and two weeks after discharge. Data were analyzed using descriptive statistics, chi-square test, paired t-test, independent t-test, and repeated measures ANOVA. Results showed that the experimental group had significantly less pain severity and higher functional walking capacity than the control group. For the gastrointestinal quality of life, the experimental group achieved significantly better results in the symptom and physical function domains two weeks after discharge. In conclusion, the Rehabilitation Program after Colorectal Surgery could control symptoms, promote postoperative activities, and enhance recovery and some gastrointestinal quality of life domains. Nurses can use this program to increase functional ability and improve the quality of life among people with colorectal cancer receiving surgery. However, further testing using randomized controlled trials is needed before it can be widely used in practice. [ABSTRACT FROM AUTHOR]

Background: The body of evidence on surgical intensive care unit (SICU) mortality and its predictors is still being determined. This study analyzed the significant predicting factors for mortality in SICU patients. Materials and Methods: The medical records of patients in SICUs at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, from June 2020 to July 2021, were retrospectively reviewed. Patients were excluded if transferred from other hospitals and not undergoing orthopedics, otolaryngology, obstetrics, and gynecology surgeries. Results: A total of 276 patients admitted to SICUs were included in this analysis, and 60.5% were men. The mean age was 60.07 ± 17.19 years. The average length of SICU stay was 8.1 ± 10.79 days, and the mortality rate was 23.6%. By univariate analysis, significant predictive factors for mortality rate in SICU patients were acute physiology and chronic health evaluation II (APACHE II) (p < 0.001), Glasgow coma scale (GCS) = 8 (p < 0.001), sequential organ failure assessment (SOFA) score (p < 0.001), serum albumin < 2.5 (p = 0.013), and sepsis or septic shock (p < 0.001). From receiver operating characteristics (ROC) curve analysis to predict mortality, the best cut-off point of APACHE II and SOFA scores were 15.5 and 5.5, respectively. The multivariate logistic regression analysis significantly identified APACHE II > 15, GCS = 8 and SOFA score > 5 as significant predictive factors associated with the mortality rate in SICU patients. Conclusions: APACHE II > 15, GCS = 8, and SOFA score > 5 are predictive mortality factors in SICU patients. Patients with these factors should be given priority for admission to the SICU when there is a discrepancy between the demand and the supply for SICU beds. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the convergent validity of the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) in Thai pregnant and postpartum women, using the 12-item WHO Disability Assessment Schedule (WHODAS) as the reference standard. Participants completed the EPDS, PHQ-9, and WHODAS during the third trimester of pregnancy (over 28 weeks in gestational age) and six weeks postpartum. The sample included 186 and 136 participants for the antenatal and postpartum data analyses, respectively. The antenatal and postpartum data showed moderate correlations between both the EPDS and the PHQ-9 scores and the WHODAS scores (Spearman's correlation coefficients = 0.53–0.66, p < 0.001). The EPDS and PHQ-9 were moderately accurate in distinguishing disability (WHODAS score ≥ 10) from non-disability (WHODAS score < 10) in pregnant and postpartum participants, but the area under the curve of the PHQ-9 receiver operating characteristic curves in postpartum participants was significantly larger than that of the EPDS, with a difference (95% CI; p-value) of 0.08 (0.16, 0.01; p = 0.044). In conclusion, the EPDS and PHQ-9 are valid for assessing PND-related disability in pregnant and postpartum women. The PHQ-9 may perform better than the EPDS in distinguishing disability from non-disability in postpartum women. [ABSTRACT FROM AUTHOR]

Background: The phytochemical study of medicinal plants is rapidly gaining popularity with many pharmacologic effects. This study aims to determine the antioxidant capacity as well as anticancer and antimigration activities of Clear belongs Plus extract (CBL-P) which consisted of five medicinal plants namely, Alpinia galanga, Piper nigrum, Citrus aurantifolia, Tiliacora triandra, and Cannabis sativa on human colon cancer cells SW620 and HCT116 cell lines, and human non-small cell lung cancer cells A549 and NCI-H460 cell lines. Methods: In this study the dried-plant powder was extracted using 90% ethanol. Additionally, CBL-P was studied antioxidative activity via DPPH and ABTS assays and anti-inflammatory activities using nitric oxide assay using Griess reaction. Antiproliferation and antimigration of CBL-P were investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and scratch assay. Results: The results showed that CBL-P had potent antiproliferative activity with IC50 values in a concentration- and time-dependent manners for all four cell lines. CBL-P also possessed potent antimigration activity against all studied cancer cells. CBL-P demonstrated antimigration activity on four different types of cancer cells (A549, NCI-H460, HCT116, and SW620) after 48 h of incubation, with the greatest effect seen at the highest concentration tested (15 μg/mL) in A549 cells (10.23% of wound closure) and NCI-H460 cells (9.16% of wound closure). CBL-P was also effective in reducing migration in HCT116 and SW620 cells, with a range of closure area from 10—50%. In addition, CBL-P had antioxidant activity with IC50 values of 8.549 ± 0.241 mg/mL and 2.673 ± 0.437 mg/mL for DPPH and ABTS assays, respectively. CBL-P also showed anti-inflammatory activity with the best inhibitory activity on NO production at a concentration of 40 μg/mL. Conclusion: In conclusion, the mixture extract possessed antioxidant and anti-inflammatory activity. Furthermore, the mixture plant extract significantly exhibited antiproliferative and antimigration activities on SW620, HCT116, A549, and NCI-H460 cells (P ≤ 0.05). Taken together, our results suggest that medicinal plants may have synergistic effects that could potentially enhance the effectiveness of cancer treatment when used as adjuvants. These findings provide a solid scientific foundation for future efforts to explore the mechanism of action. [ABSTRACT FROM AUTHOR]

Background: The number of older adults in Thailand is increasing. Better chewing ability is associated with healthy aging. Although numerous studies have demonstrated the relationship between social backgrounds, dental service utilization, oral status and chewing difficulty, there is no study in Thailand using national oral health data to identify the variables involved with chewing difficulty among Thai older adults. Therefore, the aim of this study was to determine the association between oral status, and chewing difficulty, adjusting for social backgrounds, and dental service utilization among Thai older adults. Methods: This cross-sectional study used data from the eighth Thai National Oral Health Survey (TNOHS). A stratified multi-stage method was used for sample selection. The eighth TNOHS was conducted from June–August 2017. Data were collected using interviews and clinical oral examinations by trained interviewers and trained dentists, respectively. The bivariate analysis, chi-square test was used to explore the associations between social backgrounds, dental service utilization, oral status, and chewing difficulty. Dependent variables with p-values of < 0.2 for their association with independent variables in the bivariate analysis were entered into the multiple logistic regression models. Results: This study found that older adults with at least 27 teeth (p < 0.05), or at least eight occlusal pairs (p < 0.05) or income exceeding 15,000 baht per month (p < 0.05) were more likely to have less chewing difficulty (p < 0.001), while the elderly who utilized dental services in the past 12 months were associated with more chewing difficulty than those who did not utilize dental services in the past 12 months (p < 0.001). Conclusions: We suggest that policymakers increase the number of preventive plans and set a goal for more than 20 remaining natural teeth and four posterior occlusal pairs in young and working aged people, especially in the low income group. [ABSTRACT FROM AUTHOR]