Chonburi Hospital

To compare pharmacist-led telepharmacy with standard pharmaceutical care on stroke and medication knowledge, medication adherence, and clinical outcomes (blood pressure [BP], low-density lipoprotein cholesterol [LDL-C], and glycated hemoglobin [HbA1c]) in patients with post-ischemic stroke; and to characterize medication-related problems (MRPs) and their severity in the telepharmacy arm. In a randomized controlled trial, 126 hospitalized adults with ischemic stroke were assigned 1:1 to receive either standard pharmaceutical care alone or standard care plus structured telepharmacy follow-ups at 1 week, 1, and 2 months post-discharge (n = 63/arm). Outcomes were assessed using validated tools, including knowledge questionnaires; the Medication Adherence Scale for Thais (MAST); the Pharmaceutical Care Network Europe (PCNE); classification v9.1; and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) severity index. Compared with controls, telepharmacy improved post-discharge knowledge (11.75 ± 2.38 vs 9.79 ± 2.43; P < .001) and adherence (MAST 37.00 ± 3.45 vs 33.26 ± 3.76; P < .001). BP target attainment (<130/80 mmHg) was higher with telepharmacy (52.4% vs 30.2%; P = .011). Follow-up BP favored telepharmacy: systolic Δ -3.67 mmHg (95% CI -6.79 to -0.55; P = .041) and diastolic Δ -3.11 mmHg (95% CI -5.99 to -0.23; P = .040). Between-group differences were not significant for LDL-C or HbA1c. In the telepharmacy arm, 76 MRPs were identified; the most frequent problem was unnecessary drug treatment (38.16%), commonly due to patients' decision to use unnecessary drugs (28.93%). Patient counseling was the commonest intervention (40.00%); 83.64% were fully implemented and 92.10% of MRPs were completely resolved. An ~36.84% of MRPs were NCC MERP level E. Telepharmacy improved knowledge, medication adherence, and BP control after ischemic stroke, and enabled effective identification and resolution of MRPs. These findings support incorporating pharmacist-led telepharmacy into post-discharge transitional care pathways. The trial was retrospectively registered (TCTR20250401004). https://www.thaiclinicaltrials.org/show/TCTR20250401004.

Objective: Burnout syndrome is a critical concern among medical students, contributing to fatigue, reduced academic performance, and negative health outcomes. The educational environment is considered a key factor influencing burnout. This study aimed to assess medical students’ perceptions of their educational environment and its association with burnout syndrome.Material and Methods: A cross-sectional study was conducted at Chonburi Hospital, Thailand, from November to December 2023, involving 106 clinical medical students. Burnout syndrome was measured using the Maslach Burnout Inventory (MBI), and perceptions of the educational environment were evaluated using the Dundee Ready Education Environment Measure (DREEM). Data were analyzed using descriptive statistics, Pearson’s correlation, and regression analyses.Results: The mean DREEM score was 125.17±12.80, indicating an overall positive perception of the educational environment. The prevalence of burnout syndrome among participants was 50.94%. DREEM scores were significantly negatively correlated with burnout (r=-0.504, p-value&lt;0.001), emotional exhaustion (r=-0.427, p-value&lt;0.001), and depersonalization (r=-0.395, p-value&lt;0.001). Subscales such as the Students’ Perception of Learning (SPL), Students’ Academic Self-Perception (SAP), Students’ Perception of Atmosphere (SPA), and Students’ Social Self-Perception (SSP) were also significantly negatively associated with burnout (all p-value&lt;0.001). Multivariate analysis identified SPA and SSP as significantly associated factors of burnout.Conclusion: Medical students’ perceptions of the educational atmosphere and social support are significantly associated with burnout syndrome. Targeted efforts to improve these aspects of the educational environment may be effective in reducing burnout among clinical medical students.

Typically, agricultural crop production contributes to greenhouse gas (GHG) emissions, especially the use of synthetic fertilizers and, less frequently, the application of organic fertilizers. Synthetic fertilizers not only have positive effects but also have many deleterious effects on the natural ecosystem. The primary purpose of this study was to evaluate cassava root yields harvested using two different cultivation methods: synthetic fertilizers and liquid organic biofertilizers. We investigated the amount of raw material fertilizers required for each cultivation method to evaluate the effects of global warming potential (GWP) on cassava cultivation methods in northeastern Thailand. The system boundary was defined from cradle to farm gate, starting with cultivation and progressing until harvest, using life cycle assessment (LCA). The input and output data were analyzed to determine the potential impacts of global warming over 100 years. The experiments found that 1000 kg of cassava root product harvested with synthetic fertilizer released the most GHGs, 51.83 kg CO2eq/1000 kg. This was 10 times that of the experimental plot using a liquid organic biofertilizer at 2.74 kg CO2eq/1000 kg. Therefore, as farmers are challenged with everything from drought to low yields and as agriculture becomes less predictable in the face of a changing climate, it is essential to help farmers transition to practices that increase resilience and dramatically decrease reliance on fossil-fuel-based chemicals. To develop guidelines for reducing GHG emissions in cultivation, the focus should be on farmers’ cultivation activities, especially fertilizer application.

Background: Suicidality is an important problem in Thailand. Currently, a Suicide risk screening questionnaire (Q plus) has been developed and tested in psychiatric patients. However, there is limited data on the general population. This study aims to determine the accuracy of the Q plus assessment and the use of Q plus in combination with the 9Q to screen for suicide risk in the general population. Data was collected during December 2022 to May 2023. Methods: Cross-sectional study (Diagnostic accuracy research) was established in this study. Data was collected using the 2Q plus 9Q 8Q evaluation form by health volunteers in the general population aged 18 to 60 years and above. Results: The sensitivity and specificity of the Q plus questions, the 9Q assessment and the combination of Q plus and 9Q were analysed. The Q plus questions showed sensitivity and specificity values of 53.13% and 97.2% respectively. These values were close to the screening by 9Q assessment with a score greater than or equal to 7 before the 8Q suicide risk assessment, which had sensitivity and specificity values of 46.88% and 94.9% respectively. It can be concluded that both assessments have low sensitivity, but using the Q plus and 9Q screening tests together increased the sensitivity to 81.25%. Conclusions: The prevalence of suicide risk in Nonthaburi Province, Thailand, was found to be 5%. The evaluating the Q plus with the 9Q when either one is positive has a sensitivity and specificity making it useful for screening suicide risk in other people.

Carbapenem resistance caused by carbapenemase enzymes is of serious public health concerns globally, resulting in limited options for effective treatment. Rapid detection and exploring new agents are urgently required. This study aims to detect carbapenemase producers and to investigate the antibacterial potential of Pediococcus pentosaceus YTPP 02 against carbapenemase-producing Acinetobacter baumannii and Klebsiella pneumoniae. The carbapenemase producers were detected by a Nitro-beta test (NBT), a novel and rapid method, as well as by a combined disc with resazurin assay (CRA), and multiplex PCR. P. pentosaceus was isolated from pickled white radish on the MRS agar + 1 % CaCO3. The 16s rDNA-based PCR and sequencing were used for species identification. The agar overlay assay, agar well technique, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were employed to determine antibacterial activity of P. pentosaceus. The NBT successfully detected carbapenemase in all 5 clinical isolates within 20 min, and they all were positive for metallo-β-lactamases in CRA techniques within 7 h. The multiplex PCR detected VIM in A. baumannii BUU 62715, co-presence of NDM and OXA-48 like genes in both K. pneumoniae strains and NDM in A. baumannii BUU 60056 and 30899. Both A. baumannii and K. pneumoniae isolates were resistant to carbapenems. The 16s rDNA sequencing indicated P. pentosaceus. This bacterium exhibited Gram-positive cocci in pairs and quadruplets. P. pentosaceus YTPP 02 showed antibacterial activity against A. baumannii BUU 62715 and K. pneumoniae BUU 10624, with an inhibition diameter of 19 mm. The cell-free supernatant demonstrated promising antibacterial activity against A. baumannii isolates, with inhibition zones ranging from 15.3 - 18.5 mm, and a MIC of 62.5 mg/mL. P. pentosaceus YTPP 02 showed promising antibacterial activity against carbapenemase-producing bacteria. This could be a good candidate for further study and development as a new agent for carbapenem-resistant bacteria. HIGHLIGHTS A Nitro-beta test was able to detect carbapenemase producers within 20 min. A combined disc with a resazurin chromogenic agar plate identified metallo-β-lactamases within 7 h. Multiplex PCR confirmed the presence of carbapenemase-encoding genes in clinical isolates. pentosaceus inhibited the growth of carbapenemase-producing A. baumannii and K. pneumoniae. GRAPHICAL ABSTRACT

Background: Autism spectrum disorder (ASD) is a prevalent neurodevelopmental condition affecting child development and family dynamics. Sleep disturbances are common in children with ASD. This study aimed to investigate the prevalence of sleep disturbances and related factors in children with ASD. Methods: A cross-sectional descriptive study was conducted among parents of 235 children aged 4–10 years who were diagnosed with ASD between January and April 2024 in Chonburi Province, Thailand. Primary caregivers who co-sleep with their ASD child for at least five nights per week were included. Data collected included demographic characteristics, family factors, and clinical features. The Children’s Sleep Habits Questionnaire was utilized for assessment. The data were analyzed using chi-square tests, independent t-tests, and multivariable logistic regression to identify factors associated with sleep disturbances. Results: The study population (N=235) had a mean age of 64.31±20.56 months, with males comprising 81.28% of the sample. Sleep disturbances were reported in 90.21% of the children (212/235), with a mean sleep disturbance score of 50.27±7.53. The significant factors associated with sleep disturbances were having both parents as primary caregivers [adjusted odds ratio (AOR) 4.47, 95% confidence interval (CI): 1.71–11.67], having a mobile phone in the bedroom (AOR 3.21, 95% CI: 1.24–8.30), and having occasional prebedtime media use (2–4 times per week; AOR 5.15, 95% CI: 1.11–23.87). Conclusions: The prevalence of sleep disturbances in children with ASD is notably high. These findings highlight the need for targeted interventions focusing on consistent caregiving practices, limiting electronic devices in bedrooms, and reducing prebedtime media use. Further research is needed to explore the effectiveness of these interventions across diverse cultural and socioeconomic contexts in Thailand.

Renal blood flow (RBF) is regulated by an autonomic nervous system and is reduced in older adults. Massage has been previously found to increase blood flow. This two-armed double-blind, randomized controlled trial aimed to investigate the immediate effects of Thai foot massage (TFM) on RBF, psychological stress, and heart rate variability (HRV) in older adult persons. The 26 healthy older adult volunteers were recruited and randomly assigned to the TFM group (13 persons) and the control group (13 persons). The TFM group received a 15-minute Thai foot massage, and the control group received a 15-minute bed rest. Primary outcomes - RBF parameters [peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), volumetric arterial blood flow (VF)] and secondary outcomes - HRV parameters [standard deviation of the normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), high frequency (HF), low frequency (LF), and low frequency per high frequency (LF/HF)] were measured after each intervention. Results showed that the VF significantly increased after TFM (P < 0.05) but not in control. Meanwhile, the stress index significantly reduced after TFM (P < 0.05). SDNN and RMSSD, the proxies of parasympathetic activity, also significantly increased in the TFM group (p < 0.05). Only RMSSD was significantly enhanced in the control group. No side effects were observed. The TFM could increase RBF and alleviate psychological stress through parasympathetic activity actuation. Therefore, this intervention might improve RBF and relieve stress in the older population. Further study should be carried out on a larger population.

This academic article aims to study and present the application of applied humanities in developing youth potential in the context of temple schools, using the Bavorn concept (Home, Temple, School) as an analytical framework. This study demonstrates that applied humanities can be an essential tool in enhancing 21st-century skills for youth through the integration of humanities knowledge with real-life practice. Temple schools, as educational institutions with deep cultural and religious foundations in Thai society, play a crucial role in developing youth to be knowledgeable and virtuous. Applying the Bavorn concept helps connect learning among home, temple, and school in a systematic integration, resulting in comprehensive youth development across intellectual, emotional, social, and spiritual dimensions. This article proposes a youth potential development model through applied humanities consisting of four main dimensions: cognitive dimension, moral and ethical dimension, life skills dimension, and community engagement dimension. This model can be applied in temple schools and other educational institutions to develop youth to be ready to face 21st-century challenges effectively.