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Accessible summary: What is known on the subject?: Established research from the United States and other Western countries has found that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide.Suicidality among LGBT individuals is understudied in Thailand and other Asian countries, warranting additional research to better understand risk factors and to create effective treatment and suicide prevention interventions. What the paper adds to existing knowledge?: The study examined rates and predictors of suicidality in Thai LGBT adults.Study findings suggest that general (e.g. stress and loneliness) and minority stressors (e.g. discrimination and victimization) played important roles in predicting lifetime and past‐year suicidal ideation, while socio‐demographic and health‐related factors (e.g. living in high poverty area and having chronic diseases) were associated with suicide attempts among LGBT individuals. What are the implications for practice?: Changes in the nursing curriculum and continuing education resources are needed to improve knowledge and core competencies in the mental health and treatment needs of LGBT individuals in Thailand.Among LGBT serving practitioners, routine assessment of suicidality is needed to increase the early identification and treatment of individual at risk for suicidal behaviours.Standardized measures of sexual orientation and gender identity should be included in all patient intake forms.In conducting research on strategies to improve mental health outcomes among LGBT populations, standardized measures of sexual orientation/gender identity and minority‐specific stressors should be used.Suicide prevention interventions aimed at reducing general and minority stress among LGBT populations should be a priority in mental health nursing. Introduction: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists. Aim: To examine rates and predictors of suicidality among Thai LGBT adults (N = 411). Method: Data collection was conducted via online and in‐person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health‐related factors, general and minority‐specific stressors and suicidality were completed. Results: Thirty‐nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12‐month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR = 1.12, 1.16, 2.75, and 1.46, p ≤.05, R2 = 0.327). Past‐year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR = 1.52, 1.20, 2.34, and 4.89, p <.05, R2 = 0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR = 1.44, 1.06, 1.59, 1.45 and 0.95, p ≤ 0.05, R2 = 0.187). Discussion: General and minority‐specific stressors negatively impacted suicidality among LGBT participants. Implication for practice: Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals. [ABSTRACT FROM AUTHOR]

Targeted environmental and ecosystem management remain crucial in control of dengue. However, providing detailed environmental information on a large scale to effectively target dengue control efforts remains a challenge. An important piece of such information is the extent of the presence of potential dengue vector breeding sites, which consist primarily of open containers such as ceramic jars, buckets, old tires, and flowerpots. In this paper we present the design and implementation of a pipeline to detect outdoor open containers which constitute potential dengue vector breeding sites from geotagged images and to create highly detailed container density maps at unprecedented scale. We implement the approach using Google Street View images which have the advantage of broad coverage and of often being two to three years old which allows correlation analyses of container counts against historical data from manual surveys. Containers comprising eight of the most common breeding sites are detected in the images using convolutional neural network transfer learning. Over a test set of images the object recognition algorithm has an accuracy of 0.91 in terms of F-score. Container density counts are generated and displayed on a decision support dashboard. Analyses of the approach are carried out over three provinces in Thailand. The container counts obtained agree well with container counts from available manual surveys. Multi-variate linear regression relating densities of the eight container types to larval survey data shows good prediction of larval index values with an R-squared of 0.674. To delineate conditions under which the container density counts are indicative of larval counts, a number of factors affecting correlation with larval survey data are analyzed. We conclude that creation of container density maps from geotagged images is a promising approach to providing detailed risk maps at large scale. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to demonstrate that both leisure and sustainability objectives can be achieved via Buddhist economics informed agritourism. Buddhist economics differs significantly from mainstream (neoclassical) economics in its ontological underpinning. This means that assumptions about human nature are different: the core values of mainstream economics are self-interest and competition in the pursuit of maximum welfare or utility; while in Buddhist economics, “self” includes oneself, society and nature, which are all simultaneously interconnected. The core values of Buddhist economics are compassion and collaboration through which well-being is achieved, leading to higher wisdom (pañña). Because of this, the interconnectedness of activities and relationships, even those not initially obviously so linked, is crucial. Design/methodology/approach – The theoretical argument is illustrated by a pilot study of an agritourism, package tour to visit the properties of Thai farmers involved with a project known as “running a one rai farm to gain a one hundred thousand baht return”. The research is exploratory in character. Findings – A result of this study is to reveal agritourism as a significant market channel to promote sustainable agriculture. Originality/value – Agritourism can be considered an instrument for rural development with its contribution to positive economic impacts, providing economic opportunities to sustain financial security for the farming family, maintaining viability of the agricultural sector and local communities and creating jobs for rural residents together with sustainable agriculture. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine Family Development Centre (FDC) staff’s[1] perspectives on their roles and capacity to promote early childhood language learning through good parenting.Design/methodology/approach This research employed in-depth interviews with 30 FDC coordinators and volunteer staff, supported by limited field observations.Findings Identifying risk, surveillance of at-risk families, building community solidarity and activities to support parenting and children, emerged as key components of FDC work. Volunteers softened their surveillance role by emphasising their social support function and personal links to local communities. Most activities aimed to strengthen family bonding and relationships, with fewer specifically addressing early childhood language deficits. Volunteers found the latter challenging, and generally sought to work in cooperation with education, public health and child care staff where projects involved language development.Practical implications Most volunteers said they lacked the capacities to promote early language development effectively and required additional training in such areas as partnerships and collaboration, family and parenting support, and project management. The authors argue that the importance given to partnerships reflects volunteers’ recognition that they need to draw on outside expertise to address children’s language problems. Given resource constraints, volunteers will remain central to family support work for the immediate future. Even with training lay volunteers will not become language experts, and future policy should centre on building a framework of professional support for the community teams.Originality/value This study fills a gap in knowledge about FDC volunteer roles and suggests a need for training that focuses on teamwork rather than specialist language expertise. [ABSTRACT FROM AUTHOR]

Research interest in residential property consumer purchase decision has widely conducted over the past years. The majority of the research was conducted based on the external influencing factors such as marketing mix and product attribute. It has overlooked the importance of the internal or psychological factors that play an important role in a customer mind before making a purchase decision. The purpose of this paper is to study the factors that influencing a residential property purchase decision in another perspective, which focuses on psychological factors including attitude, motivation, personal value and belief in Thailand context. The quantitative approach was used to conduct this research. The data were gathered from 178 respondents and translated into a useful knowledge though the statistical techniques such as descriptive statistic, independent t-test and chi-square. The result reveals that two main psychological factors that impact purchase decision are motivations and personal values. The consumers purchase a residential property with the intention to satisfy their self-esteem and self-actualization needs. Furthermore, seven out of nine personal values were involved in decision to purchase residential property. The personal values include Sense of belonging, Self-fulfilment, Security, Self-respect, Sense of accomplishment, and fun and enjoyment in life. The customer tends to emphasize on their self-interest over the others. The value of warm relationship with others and being wellrespect were not important to their purchase intention. However, belief and attitude have not influenced the purchase decision. Findings of this study will benefit the developers and marketers who have an interest in the residential property business in Thailand as it provides guidance for better understanding customer insights in order to formulate an effective strategic decisions on product development and marketing strategies. Psychological factor might interpret purchase decision and intention. However, the purchase decision of a residential property is tied heavily with the financial ability of that person which were not take into consideration in this research. [ABSTRACT FROM AUTHOR]

This research is comparative research based on the interactionism model and theories in psychology both domestically and internationally. The aim is to discover what factors are related to the quality of life of adolescent mothers. The sample consisted of 620 adolescent mothers aged 15-19 year old which is considered a vulnerable group according to statistics from Thailand. Multiple linear regression was deployed to analyze the quality-of-life score of adolescent mothers using psychological traits, situational factors, psychological states, self-independence behavior, and life satisfaction as predictors. It was able to predict 78.7% of the overall group. The most important predictors in descending order were social comparison, life satisfaction, attitude towards self-independence behavior, and core self-evaluation which have beta values of .29, .26, .17, and .13 respectively. That means adolescent mothers with a higher level of social comparison, life satisfaction, attitude towards self-independence behavior, or core self-evaluation tend to have a good quality of life. The results of this research can be a practical contribution to relevant authorities to improve adolescent mothers' quality of life. This research also contributes to the future study of self-independence behavior, life satisfaction, and quality of life of adolescent mothers. [ABSTRACT FROM AUTHOR]

This study explored theory of mind (ToM) development in school-aged deaf children. To address new questions, we gave a standard, well-controlled false-belief test to a large (n  = 200) sample of severely-to-profoundly deaf children aged 8–15 years in a non-Western culture (Thailand). There were 190 deaf children of hearing parents and 10 deaf native signers with signing deaf parents, consistent with overall population ratios. Comparing our Thai sample's ToM performance on standard tests of false-belief understanding with that reported in past studies, our results showed a 67% ToM success rate for Thai severely-to-profoundly deaf children of hearing parents similar to collective findings from past research on smaller samples in Australia, Estonia, France, Great Britain, Sweden, and the United States. Our Thai deaf native signers likewise performed equivalently to native signers of similar age studied in past research in Australia and the United States. Collectively, the detailed findings of our study suggest promising new directions for future studies to pursue in order to build upon this novel and theoretically provocative evidence about how ToM development and ToM delay unfold for school-aged deaf children growing up in varied cultures, school settings, and family circumstances. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco smoking is often more prevalent among those with lower socio-economic status (SES) in high-income countries, which can be driven by the inequalities in initiation and cessation of smoking. Smoking is a leading contributor to socio-economic disparities in health. To date, the evidence for any socio-economic inequality in smoking cessation is lacking, especially in low- and middle-income countries (LMICs). This study examined the association between cessation behaviours and SES of smokers from eight LMICs. Methods: Data among former and current adult smokers aged 18 and older came from contemporaneous Global Adult Tobacco Surveys (2008–2011) and the International Tobacco Control Surveys (2009–2013) conducted in eight LMICs (Bangladesh, Brazil, China, India, Mexico, Malaysia, Thailand and Uruguay). Adjusted odds ratios (AORs) of successful quitting in the past year by SES indicators (household income/wealth, education, employment status, and rural-urban residence) were estimated using multivariable logistic regression controlling for socio-demographics and average tobacco product prices. A random effects meta-analysis was used to combine the estimates of AORs pooled across countries and two concurrent surveys for each country. Results: Estimated quit rates among smokers (both daily and occasional) varied widely across countries. Meta-analysis of pooled AORs across countries and data sources indicated that there was no clear evidence of an association between SES indicators and successful quitting. The only exception was employed smokers, who were less likely to quit than their non-employed counterparts, which included students, homemakers, retirees, and the unemployed (pooled AOR≈0.8, p<0.10). Conclusion: Lack of clear evidence of the impact of lower SES on adult cessation behaviour in LMICs suggests that lower-SES smokers are not less successful in their attempts to quit than their higher-SES counterparts. Specifically, lack of employment, which is indicative of younger age and lower nicotine dependence for students, or lower personal disposable income and lower affordability for the unemployed and the retirees, may be associated with quitting. Raising taxes and prices of tobacco products that lowers affordability of tobacco products might be a key strategy for inducing cessation behaviour among current smokers and reducing overall tobacco consumption. Because low-SES smokers are more sensitive to price increases, tobacco taxation policy can induce disproportionately larger decreases in tobacco consumption among them and help reduce socio-economic disparities in smoking and consequent health outcomes. [ABSTRACT FROM AUTHOR]

We study in-group favouritism and out-group discrimination in a multiplayer dictator game in a naturally occuring group setting. An allocator divides a large sum of money among three groups of around 20 recipients each and also to themselves. The groups are supporters of two rival political movements in Thailand and politically neutral subjects. The non-rival out-group acts as a reference point and allows us to measure in-group favouritism and out-group discrimination. A treatment with artificial groups serves as a control. We find both in-group favouritism and out-group discrimination among the naturally occurring groups. In artificial groups, favouritism is observed, but not discrimination. Our results suggest that the two behaviours are not driven by the same motive, and only when groups are in conflict that out-group discrimination is likely to occur. [ABSTRACT FROM AUTHOR]

Background: The Pint of Science festival is the biggest annual international science festival. In May 2017, we coordinated the first Pint of Science festival in Thailand and reported our initial reflections. Building on this work, we set out to evaluate more systematically events conducted in 2018. Methods: In 2018, we conducted Pint of Science events at four different locations in Bangkok. Overall, there were 18 talks held over six event-days in 2018. We administered 180 self-reported questionnaires as well as conducted 11 semi-structured interviews and a focus group discussion with audience members and speakers. Results: Of the 180 questionnaires handed out, 125 attendees completed the questionnaire. The majority of attendees came because they were interested in science (68.0%), to learn something new (46.4%) and to enjoy themselves (44.8%). Our qualitative results confirm the quantitative findings. In addition, speakers viewed that they benefited by improving their communication skills and having the opportunity to network with scientists and non-scientists. Speakers also mentioned that such events were a good means to engage with the public, can improve the visibility of their work and potentially attract more funding. To improve the Pint of Science activities, audience members suggested to include a more diverse range of topics, more collaborations with other local research institutions and to hold the event at larger venues. Conclusions: We conclude that Pint of Science was well received in Bangkok with recommendations to improve minor issues related to practicalities and logistics. [ABSTRACT FROM AUTHOR]

There is limited research surrounding the effectiveness of program implementation, and the research that does exist often considers culture as a minor contributing factor. In this study, culture is re-framed as a major contributing factor of program implementation using an international adaptive sports program as an example. The program was planned and implemented by a team of U.S. facilitators for a group of Thai students and professors in Thailand. The purpose of this study was to understand the cultural processes that influence program implementation in the context of adaptive sport. The research team conducted observations of the program delivery and semi-structured interviews with the U.S. program facilitators. Guided by Hofstede's Cultural Dimensions, the findings consider how culture influenced program implementation. Building from existing program implementation models, this study proposes a modified model of program implementation in which culture is positioned as a factor influencing all aspects of program implementation. [ABSTRACT FROM AUTHOR]

This ethnographic study explores the perceptions of the causation of stigmatization of mental illness in Thailand. This article begins with an overview of the current state of mental health in Thailand and a description of the stigmatization of those suffering from mental health conditions. This is followed by the findings that emerged from interviews with forty college students from an undergraduate Social Science faculty. The forty participants were separated into two groups based on their educational program. The first group consisted of twenty students from a Social Science Faculty at Mahidol University International College, and the second group of twenty students represented a Social Science Faculty from a Thai program at Mahidol University. The findings indicate that while the participants in both groups claimed that they do not stigmatize mental health sufferers, they felt that as a whole, Thai society still does. The participants argued that most Thais still hold negative perceptions of mental illness due to the influences of family, media, and education. The study is descriptive in nature and aims to illustrate the participants' perceptions of the causes of mental health stigmatization. [ABSTRACT FROM AUTHOR]

This article explores how Thai culture, gender and age influence sex education in Thailand, and how online sources and social media have emerged as an alternative source of sex education among young people. Qualitative data was gathered by means of in-depth interviews and focus group discussions from 99 young people aged 15-24 years of various genders and sexualities living in Bangkok. Age and gender/sexuality have a powerful influence on how students perceive sex education in Thailand. Younger people of all genders/sexualities were interested in the changes occurring in puberty and defining their gender/sexual identity, while older informants were more interested in sexual health issues including prevention and self-assessment. With respect to sexual relationships, different genders/sexualities showed varying interests, some were interested in the emotional aspects, while others were more interested in the physical dimensions of sex. Overall, Thai culture constrains the success of sex education by limiting learning opportunities and discussion, and by the provision of inauthentic knowledge to students. Online sources and the social media offer possible solutions to these inadequacies in sex education. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers are a main cause of morbidity related to type 2 diabetes. Living with a diabetic foot ulcer has a significant impact on health-related quality of life and has a negative impact on daily living among people with the condition. The aim of this study was to explore the experiences of Thai adults living with diabetic foot ulcers using a descriptive qualitative design. Participants were recruited from the outpatient diabetes and foot clinic at a tertiary teaching hospital in Northern Thailand from January to April 2017. In-depth interviews were conducted with 13 participants using a semi-structured interview guide. Thematic analysis was used to identify the participants' experiences and two themes were identified: 1) living with a diabetic foot ulcer and 2) managing a diabetic foot ulcer. The findings enhance the knowledge of healthcare professionals and the public to understand the experience of having diabetic foot ulcers and contribute to understanding how to manage a diabetic foot ulcer based on the participant's experiences in the Thai context. Nurses must provide knowledge and self-care skills as part of routine care to improve health-related quality of life for people with diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Grandchildren are sometimes left in the care of their grandparents when parents migrate to find work. Using open-ended interviews with 48 grandparents, this study examines intergenerational relationships in “skipped generation households” in rural Thailand. The qualitative analyses identified several ways in which intergenerational relationships were characterized by solidarity (i.e., emotional closeness, instrumental helping, and financial assistance) as well as conflict (i.e., financial tension, grandchildren’s misbehavior, role confusion). These findings have important implications for practitioners and policymakers that could improve intergenerational relationships in skipped generation households. [ABSTRACT FROM AUTHOR]

Background: Rotavirus diarrhea is a major health problem among young children worldwide with potential negative impacts on health-related quality of life (HRQoL). This study assessed the impact of rotavirus diarrhea on HRQoL of children and their caregivers.Methods: We performed a cross-sectional study among 460 hospitalized children with diarrhea aged under 5 years and their family caregivers at three hospitals in Phetchabun province, Thailand during May 2013 and February 2014. The severity of diarrhea was assessed using the Vesikari severity scoring system while the HRQoL was assessed using the EQ-5D-3L.Results: The mean EQ-5D utility of children with all-causes diarrhea was 0.604. The utility of the rotavirus diarrhea group was significantly lower than that of the non-rotavirus diarrhea group (0.593 vs. 0.612; p-value = 0.040). The family caregiver's utility was 0.964 at baseline and significantly decreased to 0.620 (p-value = 0.041) when their children were hospitalized with diarrhea. In multiple regression analyses, severity but not rotavirus infection had significant negative impacts on the utility of both the children and their caregivers.Conclusion: Diarrhea, either caused by rotavirus or non-rotavirus infection, resulted in substantial negative impacts on the quality of life of both the children and their caregivers. [ABSTRACT FROM AUTHOR]

Background: Many people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients' parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals' family-focused knowledge and practices when working with parents with mental illness and their children and families.Methods: This cross -sectional survey study examined the attitudes, knowledge and practices of a sample (n = 349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ).Results: The majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families.Conclusions: The findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice. [ABSTRACT FROM AUTHOR]

Aims: To document the prevalence of various negative effects from others’ alcohol drinking in Thailand and to examine their relationship with demographic variables and the respondents’ drinking behaviors. Setting, design, and participants: A cross-sectional household survey using multistage sampling and face-to-face interviews of 1695 Thai respondents aged 18–70 years. Measurements: Respondents’ experiences of adverse effects of others’ drinking in psychological, social, economic, and physical aspects and their relationships with sociodemographic data and drinking patterns of respondents. Results: Seventy-nine percent of the respondents reported experiencing this problem within the last 12 months. The percentages experiencing psychological harm, social harm, economic harm, and physical harm were 76.8%, 42%, 22.6%, and 6.2%, respectively. Sources of harm makers included drinking neighbors, the husbands’ respondents, and friends, especially of younger male respondents. Personal predictors include being a woman and being a drinker him- or herself. Conclusions: Harms from others’ drinking are prevalent. This indicates a need for stronger alcohol control program. [ABSTRACT FROM PUBLISHER]

For transnational migrant populations, securing birth documents of newly born children has crucial importance in avoiding statelessness for new generations. Drawing on discussions of sovereignty and political subjectivization, I ask how the fact of birth is constituted in the context of transnational migration. Based on ethnographic data collected from an antenatal clinic in Thailand, this article describes how Shan migrant women from Myanmar (also known as Burma) utilize reproductive health services as a way of assuring a safe birth while acquiring identification documents. Paying close attention to technologies of inscription adopted for maternal care and birth registration, I argue that enacting bureaucratic documents offers a chance for migrant women to bridge the interstice between human and citizen. Birth certificates for migrant children, while embodying legal ambiguity and uncertainty, epitomize non-citizen subjects' assertion of their political relationship with the state. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders (MSDs) are a major public health problem among registered nurses (RNs) in Thailand. Information on their burdens at a national level is limited. This study estimated the prevalence of MSDs among RNs using the 2009 Thai Nurse Cohort, a nationally representative sample of RNs in Thailand. Methods: This study is part of the first wave survey of the Thai Nurse Cohort Study (TNCS) conducted in 2009. Members of the cohort consisted of 18,756 RNs across Thailand. A 13-page self-administered questionnaire was sent to participants where MSDs were measured by self-reported answers to questions related to experiencing MSDs during a previous year. However, 1070 RNs were excluded from this study since they were unemployed during a previous year, therefore the final sample size was 17,686 RNs. A 12-month prevalence of MSDs and its 95% confidence interval (95% CI) were estimated based on normal approximation to binomial distribution. Chi-square test for trend was used. Results: Of the 17,686 RNs, 47.8% (95% CI: 47.0-48.5) reported having MSDs during the previous 12 months. The prevalence of MSDs significantly increased with age, body mass index, and working duration (all P < 0.001). Compared to the non-MSD group, RNs with MSDs had a higher proportion who perceived MSDs as a long-term, chronic medical condition (78.1% vs 20.7%; p < 0.001), being currently on medication (49.4% vs 14.7%; p < 0.001), using pain relief medication almost every day (9.0% vs 1.9%; p < 0.001), experiencing sickness absence (15.7% vs 1. 1%; p < 0.001), seeking medical specialist consultations (odds ratio, OR 2.2; 95% CI: 2.0-2.3; p < 0.001), and seeking alternative medications (OR 2.5; 95% CI: 2.3-2.7; p < 0.001). Conclusions: Musculoskeletal disorders affected almost half of the RNs in Thailand annually. They placed a major healthcare burden and were a major cause of working days lost due to sick leaves, diminished productivity and quality of patient care. More attention should be paid to the prevention and effective management of MSDs in RNs in Thailand. Further study on ergonomics related to MSDs and its prevention are needed. [ABSTRACT FROM AUTHOR]

Background: Grandmothers are important to successful breastfeeding because their knowledge, attitudes and experiences influence adolescent mothers' decision to initiate and to continue breastfeeding. The purpose of this study was to assess the effectiveness of an experiential learning with empowerment strategies and social support (ELESSS) programme for grandmothers according to improvements in the rate and duration of exclusive breastfeeding (EBF); knowledge and attitude (KA) regarding breastfeeding; and perceived social support among adolescent mothers. Methods: A quasi-experimental study was conducted in two hospitals, Banmi as an intervention hospital and Inburi as a control hospital, between May 2015 and March 2016. Forty-two pairs of adolescent mothers and grandmothers were recruited from each hospital. At the baseline, grandmothers in the intervention group attended 2 days of an ELESSS programme, and they attended a refresher course 2 and 4 months after delivery. The grandmothers in the control group and adolescent mothers in both groups received the routine programme. Participants were assessed at the baseline and at two and 6 months after delivery to determine the rate and duration of EBF, KA regarding breastfeeding and perceived social support. Results: Adolescent mothers in the intervention group had the EBF rate at 6 months of around 29%, whereas the control group had the EBF rate at 6 months of about 5%, and the proportion of EBF in the intervention group was six times that of the control group. The median EBF duration in the intervention group was 90 days, while the control group was 0 day. A repeated measure ANOVA analysis showed that the intervention group's participants had significantly better knowledge and attitudes towards breastfeeding, while the adolescent mothers in the intervention group had a significantly higher perceived level of social support. Conclusion: The ELESSS programme proved to be effective in increasing the rate and duration of EBF in adolescent mothers. Grandmothers are key to promoting, protecting and supporting breastfeeding. [ABSTRACT FROM AUTHOR]

Scleroderma, particularly systemic sclerosis, is a chronic illness that affects a person's physical, emotional, psychosocial, and spiritual dimensions. To investigate self-care deficits, health behaviours, and trajectory management of Thai people with systemic sclerosis, an exploratory case study method was used through interviews and patient records. Self-care deficit nursing theory and the chronic illness trajectory framework guided the research. Twelve patients with systemic sclerosis were purposively recruited at a hospital clinic in the northeastern region of Thailand. Thai people living with systemic sclerosis developed specific self-care agencies in each of 3 identified trajectory patterns to improve their health and well-being. By applying the theory and framework that guided the research, nurses can promote self-care behaviours and recognize situations along an illness trajectory that require intervention and management. The results extend the understanding of how people live and cope with systemic sclerosis. [ABSTRACT FROM AUTHOR]

Objective: Palm oil is a cheap and versatile edible oil in widespread use as a food ingredient that has been linked to negative health and environmental outcomes. The current study aimed to understand the prospects for future health-focused policy development to limit food use of palm oil and promote a greater diversity of oils in Thailand's food system. Design: Eighteen semi-structured interviews were conducted with a range of stakeholders. The interviews probed views on the economic, health and environmental dimensions of the issue, the prospects for health-focused policy development and the policy development process. Transcripts were analysed using a health policy analytical framework. Setting: Thailand. Subjects: Stakeholders from a range of ministries, regulatory agencies, the private sector, non-governmental organizations and academia. Results: There are several impediments to the emergence of strong regulation, including the primacy of economic considerations in setting policy, doubt and misperception about health implications and a complex regulatory environment with little space for health-related considerations. At the same time, some sections of the food industry producing food for domestic consumption are substituting palm with other oils on the basis of consumer health perceptions. Conclusions: Strong regulation to curb the growth of palm oil is unlikely to emerge soon. However, a long-term strategy can be envisaged that relies on greater policy support for other indigenous oils, strategic rebalancing towards the use of palm oil for biofuels and oleochemicals, and harnessing Thailand's food technology capabilities to promote substitution in food production in favour of oils with healthier fatty acid composition. [ABSTRACT FROM AUTHOR]

Background: HIV-related stigma and discrimination (S&D) are recognized as key impediments to controlling the HIV epidemic. S&D are particularly detrimental within health care settings because people who are at risk of HIV and people living with HIV (PLHIV) must seek services from health care facilities. Standardized tools and monitoring systems are needed to inform S&D reduction efforts, measure progress, and monitor trends. This article describes the processes followed to adapt and refine a standardized global health facility staff S&D questionnaire for the context of Thailand and develop a similar questionnaire measuring health facility stigma experienced by PLHIV. Both questionnaires are currently being used for the routine monitoring of HIV-related S&D in the Thai healthcare system.Methods: The questionnaires were adapted through a series of consultative meetings, pre-testing, and revision. The revised questionnaires then underwent field testing, and the data and field experiences were analyzed.Results: Two brief questionnaires were finalized and are now being used by the Department of Disease Control to collect national routine data for monitoring health facility S&D: 1) a health facility staff questionnaire that collects data on key drivers of S&D in health facilities (i.e., fear of HIV infection, attitudes toward PLHIV and key populations, and health facility policy and environment) and observed enacted stigma and 2) a brief PLHIV questionnaire that captures data on experienced discriminatory practices at health care facilities.Conclusions: This effort provides an example of how a country can adapt global S&D measurement tools to a local context for use in national routine monitoring. Such data helps to strengthen the national response to HIV through the provision of evidence to shape S&D-reduction programming. [ABSTRACT FROM AUTHOR]

Background: In populations with a high prevalence of glucose-6-phosphate dehydrogenase deficiency, practices that can induce haemolysis need to be identified to raise awareness of preventable risks. The aim of this survey was to determine the proportion of prospective mothers using haemolytic agents and their knowledge and practice surrounding neonatal jaundice.Methods: Pregnant mothers were invited to participate in a cross-sectional survey conducted at Shoklo Malaria Research Unit on the Thailand-Myanmar border.Results: From 12 April 2015 to 12 June 2015, 522 pregnant women completed the survey. Mothball use in the household was reported by 41.4% (216 of 522) of prospective mothers and menthol containing products on baby skin by 46.7% (244 of 522).Conclusion: Just over 40% of the households reported use of naphthalene-containing mothballs. Future health promotion activities that focus on reducing naphthalene mothball and menthol-containing products use have the potential to reduce rates of severe neonatal jaundice in this population. [ABSTRACT FROM AUTHOR]

This study examines age ingroup and outgroup communication perceptions of older Thai and American adults to assess whether communication perceptions of self and others are associated with mental health outcomes such as personal self-esteem, collective self-esteem, and life satisfaction. Results suggest that more accommodation by same-age older others leads to greater personal self-esteem, greater group esteem, and greater life satisfaction, while more nonaccommodation by younger others leads to less life satisfaction for the Thais and Americans. More overaccommodation by younger others was found to lead to less personal self-esteem and less life satisfaction for the sample as a whole. Discriminant loadings show life satisfaction was the most important variable in distinguishing between the prototypical older Thai and American respondent. The overall profile shows the typical Thai older adult participants as perceiving members of their own age ingroup as communicatively avoidant and overaccommodating while also experiencing lower collective self-esteem and life satisfaction. Typical older Americans tended to be associated with higher collective self-esteem and life satisfaction. [ABSTRACT FROM PUBLISHER]

Drawing on fieldwork in a neonatal intensive care unit (NICU) in Chiang Mai during 2010 and 2012, I examine neonatal care as a contingent entanglement of technological and ethical relationships with vulnerable others. Along the continuum of universal antenatal and delivery care, neonatal medicine becomes a normative part of reproductive health care in Chiang Mai. As the NICU opens its door to sick newborns whose belonging to kinship and the nation-state is uncertain, neonatal care requires deliberate practices to incorporate them into life-sustaining connections. By tracing medical staff’s effort to be accountable to their fragile patients, I show that withdrawing of intensive care is relational work that requires affective involvement and distancing through commensality, prosthetic extensions, and karmic network. This specific mode of care, which is premised on the combination of unconditional openness and careful detachment, offers insight into a possible enactment of hospitality within biomedical institutions. [ABSTRACT FROM PUBLISHER]

Rectal microbicides (RMs) may offer substantial benefits in expanding HIV prevention options for key populations. From April to August 2013, we conducted Tablet-Assisted Survey Interviewing, including a discrete choice experiment, with participants recruited from gay entertainment venues and community-based organizations in Chiang Mai and Pattaya, Thailand. Among 408 participants, 74.5 % were young men who have sex with men, 25.5 % transgender women, with mean age = 24.3 years. One-third (35.5 %) had ≤9th grade education; 63.4 % engaged in sex work. Overall, 83.4 % reported they would definitely use a RM, with more than 2-fold higher odds of choice of a RM with 99 versus 50 % efficacy, and significantly higher odds of choosing gel versus suppository, intermittent versus daily dosing, and prescription versus over-the-counter. Sex workers were significantly more likely to use a RM immediately upon availability, with greater tolerance for moderate efficacy and daily dosing. Engaging key populations in assessing RM preferences may support biomedical research and evidence-informed interventions to optimize the effectiveness of RMs in HIV prevention. [ABSTRACT FROM AUTHOR]

Objectives: To measure the proportion of backpackers engaging in unprotected sex while travelling in Thailand and to identify predictors of unsafe sexual behaviour.Methods: A cross-sectional study using an anonymous questionnaire was performed. English-speaking backpackers, excluding US and Thai citizens, were recruited while travelling through the piers of Koh Tao and Koh Phangan between 25 January and 13 March 2013.Results: 61.5% (1238/2013) respondents were travelling without a long-term sexual partner, of whom 39.1% (29.4% females; 51.9% males) reported intercourse with a new partner. 36.8% of these reported inconsistent/no condom use. Inconsistent condom use was independently associated with age <25 years, UK (vs Canadian) nationality and not bringing condoms from home. Backpackers who brought condoms from home were more likely to have sex with a new partner. Male gender and longer trip length increased the likelihood of new partner acquisition and overall risk of unsafe sex but were not associated with inconsistent condom use. New partners were most commonly backpackers from other countries. Men were more likely than women to have sex with a local person.Conclusions: Backpackers visiting Thailand frequently report unsafe sex. Partner demographics demonstrate a mechanism of international sexually transmitted infection (STI) transfer. In an era of growing antibiotic resistance and continuing HIV transmission, targeting unsafe sex in backpackers has the potential to reduce STI incidence internationally. These data highlight the need for innovative public health intervention. To focus such measures, future research may elucidate why certain groups are at higher risk. [ABSTRACT FROM AUTHOR]

Mothers who use drugs face much discriminatory action as society in general finds female drug users' modes of caring for their children unacceptable. In this article, I explore the ways in which Thai women's injecting practices revolve around the role of mother 'maae' and the ways they employ tactics to challenge the motherhood discourse. This article draws on in-depth interviews with 30 Thai mothers injecting drugs. Thai mothers injecting drugs struggled with stigma and self-blame. They internalise the values of the mother 'maae', that is, what the mother is supposed to be; attempting to combine their drug use with their parental responsibilities. Having a child is treated as a means for many women to manage the hostile social impacts of being an addict mother as well as anxieties about the future of their children. To maintain identity as a mother, as gender norms dictates, the mothers employ several tactics to defend that identity from the threats. In conclusion, the findings have implications for harm reduction and reproductive services for women using drugs in Thailand; health care providers need to appreciate the ramifications of the lived experiences of the women who take drugs. [ABSTRACT FROM AUTHOR]

Background: Thailand continues to attract an increasing number of migrant workers (MW) from neighboring countries including mainly Myanmar, Cambodia, and Laos; however, little is known about the extent to which MWs from these countries have access to HIV prevention, treatment, and care services. We used data from the baseline survey of the Prevention of HIV/AIDS among MWs in Thailand (PHAMIT-2) project to document the prevalence of, and factors associated with, HIV testing among MWs from Myanmar, the largest group of MWs in Thailand. Methods and Findings: The baseline survey of PHAMIT-2 was conducted in 2010 among MWs from Myanmar, Cambodia, and Laos in 10 purposely-selected provinces of Thailand. Of the 1,034 participants who qualified for the analysis to identify correlates of HIV testing, only 5.3% reported ever having been tested for HIV. Factors associated with HIV testing included having a secondary or higher education level (AOR, 2.58; CI, 1.36–4.90; P = 0.004), being female (AOR, 1.96; CI, 1.05–3.66; P = 0.033), knowing someone who died of AIDS (AOR, 1.81; CI, 1.00–3.27; P = 0.048), working in the fishery sector (AOR, 2.51; CI, 1.28–4.92; P = 0.007), and not having a work permit (AOR, 3.71; CI, 1.36–10.13; P = 0.010). Conclusion: Our study, in addition to revealing significantly low HIV testing among MWs from Myanmar, identifies important barriers to HIV testing which could be addressed through interventions that promote migrants’ culturally-sensitive and friendly service, for example by facilitating flow of information about places for HIV testing, availability of language assistance, and ensuring confidentiality of HIV testing. [ABSTRACT FROM AUTHOR]

Thailand has undergone rapid modernization with implications for changes in sexual norms. We investigated sexual behavior and attitudes across generations and gender among a probability sample of the general population of Nonthaburi province located near Bangkok in 2012. A tablet-based survey was performed among 2,138 men and women aged 15-59 years identified through a three-stage, stratified, probability proportional to size, clustered sampling. Descriptive statistical analysis was carried out accounting for the effects of multistage sampling. Relationship of age and gender to sexual behavior and attitudes was analyzed by bivariate analysis followed by multivariate logistic regression analysis to adjust for possible confounding. Patterns of sexual behavior and attitudes varied substantially across generations and gender. We found strong evidence for a decline in the age of sexual initiation, a shift in the type of the first sexual partner, and a greater rate of acceptance of adolescent premarital sex among younger generations. The study highlighted profound changes among young women as evidenced by a higher number of lifetime sexual partners as compared to older women. In contrast to the significant gender gap in older generations, sexual profiles of Thai young women have evolved to resemble those of young men with attitudes gradually converging to similar sexual standards. Our data suggest that higher education, being never-married, and an urban lifestyle may have been associated with these changes. Our study found that Thai sexual norms are changing dramatically. It is vital to continue monitoring such changes, considering the potential impact on the HIV/STIs epidemic and unintended pregnancies. [ABSTRACT FROM AUTHOR]

Thai lottery gamblers won prizes after betting on numbers they obtained from newspaper stories. We hypothesized that Thai lottery gamblers' superstitious beliefs were related to their problem gambling through the mediation of number search and gambling intensity. In a study among 380 Thai lottery gamblers, superstitious beliefs were operationally defined as the beliefs in events or objects that seemed to reveal numbers, number search as an attempt to identify numbers to bet, gambling intensity as the frequency and amounts of lottery gambling, and problem gambling as the symptoms of problems relating to lottery gambling. Results support the hypotheses. There is a statistically significant indirect relationship between Thai lottery gamblers' superstitious beliefs and their problem gambling through the mediation of number search and gambling intensity. Thai lottery gamblers need to be reminded that their superstitious beliefs and number search are precursors of their problem gambling. [ABSTRACT FROM AUTHOR]

Background: Karen refugees have suffered traumatic experiences that affect their physical and mental health in resettlement. The United States Centers for Disease Control and Prevention recommends assessing traumatic histories and mental health symptoms during initial public health screening. This article reports the traumatic experiences that Karen refugees were able to describe during a short screening and contributes knowledge to existing human rights documentation systems. Methods: Four semi-structured and open-ended items asked about lifetime experiences of war trauma and torture. Interviews were completed with adult, Karen refugees during their initial public health screening. Experiences of war trauma and torture were coded using the extensive Human Rights Information and Documentation (HURIDOCS) Micro-thesauri coding system. Additional codes were created to describe experiences not captured by existing codes. Results: Over 85% of 179 Karen people interviewed experienced life-threatening war trauma. All participants who reported war trauma or torture stories were able to describe at least one event. New war trauma codes proposed include: widespread community fear, systematic destruction/burning of house or village, exposure to dead bodies, orphaned in the context of war, injury caused by a landmine, fear of Thai police or deportation from Thailand, and harm or killings in the context of war. New torture codes include: forced portering; forced to be a human landmine sweep; forced to be a soldier, including child soldier; forced contact with a dead body; and removal of the eyes. Conclusion: Karen refugees were able to report traumatic experiences in the context of a brief health screening. The findings confirm existing reports of human rights violations against Karen people and suggest that additional codes be added to the HURIDOCS Micro-thesauri system that is used by torture treatment centers. Understanding the nature of traumatic experiences of this group is important for health providers working with resettled Karen refugees in their countries of resettlement. Health providers may need specialized training to understand the traumatic histories of this new refugee group, learn how to initiate conversations about trauma and its impact on health, and make appropriate mental health referrals in the context of a brief public health screening. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore how Buddhism is associated with well-being among Thai Buddhists via an application of stress process theory. Survey data were collected in 2012 from 314 Thai citizens and analysed with structural equation modelling to assess how the association between socio-economic status (SES) and well-being is mediated by stressors and resources, in particular, religious resources. The results reveal that low SES is associated with greater financial hardship and household crowding and lower sense of control, which in turn are associated with worse well-being. Furthermore, income is associated with happiness via belief in Dharma control, whereas education is associated with unhappiness via its negative association with public religiosity. Lastly, the positive influence of religious beliefs on well-being is contingent upon having a relatively high sense of control, whereas the positive influence of religious behaviours is contingent upon having a relatively low sense of control. [ABSTRACT FROM AUTHOR]

Why do many human beings find bugs repulsive? Disgust, a psychological factor, is believed to be the main reason why consumers would not consider eating foods containing insect ingredients. This study aimed to understand specific consumers' behaviors toward insect based products. A global survey was launched in 13 different countries. The participants (n = 630 from each country) completed the survey that included demographic questions and questions about why they would or would not eat insect-based products. The results show, particularly for some of the Asian countries, that it is necessary to start exposing and familiarizing the populations about insects in order to diminish the disgust factor associated with insects. It is strongly recommended that an insect-based product should not contain visible insect pieces, which trigger negative associations. The exceptions were consumers in countries such as Mexico and Thailand, evaluated in this study, which did not show significant negative beliefs associated with including insects in their diets. Additional research to promote insect-based product consumption with popular product types might be the first strategy to break the disgust barriers and build acquaintance about insect-based products. The need to educate consumers that not all insects are unhygienic is crucial to eliminating the potentially erroneous concepts from consumer mindsets. [ABSTRACT FROM AUTHOR]

The advantages of exclusive breastfeeding for the first 6 months are well‐known. Unfortunately, adolescent mothers have lower rates of breastfeeding exclusivity and shorter duration of breastfeeding. There is limited evidence regarding exclusive breastfeeding determinants in adolescent mothers. The purpose of this study was to obtain adolescent mother‐generated factors related to exclusive breastfeeding at 6 months. A mixed‐methods design was conducted through concept mapping. Thirty adolescent mothers aged 15–19 years who had wide range of exclusive breastfeeding experiences brainstormed about specific factors. They then sorted and rated the statements into key clusters. Finally, half of the participants were involved in the interpretation of the mapping results and the creation of pathway diagrams. Data were analysed by multivariate statistics in the Concept System Global MAX program. The results showed that the adolescent mothers brainstormed about 104 statements on the factors related to exclusive breastfeeding at 6 months. These factors can be categorized into the following six key clusters: (a) breastfeeding advantages; (b) facilitating factors and necessary skills; (c) promotion and support needed; (d) community and social influence; (e) internal and external barriers; and (f) key problems in families. The pattern matching provided understanding of how key clusters are important to successful breastfeeding through comparing three groups of exclusive breastfeeding durations. Finally, the relationships of the stated factors were drawn in pathway diagrams. Exclusive breastfeeding experiences among Thai adolescent mothers showed complexity involving multilevel influences of social systems. The promotion of optimal breastfeeding should recognize the influences of both personal and environmental factors. [ABSTRACT FROM AUTHOR]

Background: Under- and over-nutrition during pregnancy are known risk factors for pregnancy complications and adverse pregnancy and infant outcomes. Understanding perceptions around nutrition in pregnancy can create culturally appropriate interventions for improved health outcomes. Objective: A mixed-methods study was performed to explore local perceptions and practices of diet and physical activity in pregnancy in a marginalised population along the Myanmar-Thailand border. Methods: From April to July 2017, a cross-sectional survey and focus group discussions were conducted with pregnant women reporting to antenatal care; in-depth interviews were conducted with senior midwives at participating organisations along the Myanmar-Thailand border. Results: A total of 388 pregnant women were interviewed at two clinic sites along the Myanmar-Thailand border. A high proportion of women had limited knowledge of and poor dietary practices. Consuming a sweetened drink in the last 24 hours as well as being a non-teenage, multigravida woman was significantly associated with high body mass index (BMI) compared to normal BMI. Qualitative analysis combined focus group discussions (n = 66) and in-depth interviews (n = 4) summarising emergent themes: common foods eaten or avoided and rationale; benefits of nutrition; perceptions of overweight and weight gain during pregnancy; barriers to a healthy diet; and sources of diet information. Conclusions: There is limited awareness about healthy diets and lifestyle in these marginalised, migrant communities along the Myanmar-Thailand border. This study suggests that simple, culturally appropriate messaging should be provided to women and communities with low health literacy to generate awareness about healthy lifestyles and their effects on pregnancy outcomes as an important element of a broader strategy to address maternal nutrition in this population. However, more studies to determine the effectiveness of a broad range of interventions in low- and middle-income countries (LMIC) are needed, especially in marginalised migrant populations. [ABSTRACT FROM AUTHOR]