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This study employs a mixed-methods approach, combining quantitative and qualitative research methodologies to investigate the dynamics of leadership, management, and performance in the context of drug prevention within schools under local administrative organizations. The research pursues three main objectives: (1) to examine the key elements of leadership, management, and performance related to drug prevention in these educational institutions, (2) to analyze the direct, indirect, and combined influences of leadership on the management and performance of drug prevention efforts, and (3) to formulate policy recommendations for influential leadership development models tailored to enhance the management and performance of drug prevention initiatives. Quantitative data were collected from 400 personnel within educational institutes under the Sisaket Local Administrative Organization, utilizing stratified random sampling and a questionnaire with a high-reliability score of 0.978. Concurrently, qualitative insights were from 12 purposively selected educational institutes in the same administrative context through the focused group. The analytical toolkit included frequency, percentage, mean, standard deviation, structural equation analysis, and content analysis. Key findings indicate the appropriateness of utilizing trait-based, behavior-based, and situational leadership alongside Principles of management to construct a comprehensive structural equation model. The performance emerges as primarily influenced by Principles of management, all statistically significant at 0.01 level. In terms of policy suggestions, the focus centers on fostering a knowledgeable and collaborative team, developing leadership skills through cooperation, and creating an organizational culture that supportslearning and development. Thisintegrated leadership development approach isthe picture to significantly impact the effective management and prevention of drug abuse in schools under local administrative organizations.

The objectives of this research were (1) to assess the suitability and feasibility of participatory approaches for the prevention and solution of drug problems of schools under Sisaket Provincial Administrative Organizations and (2) to create a consensus proposing a leadership development model that influences driving effectiveness, management and performance on drug prevention of schools under the local government organization. The informants were the study administrators and teachers who were responsible for prevention and correction drug problem of school, each group of 5 people, and the total of 10 people, obtained by purposive selection. The research instrument was a semi-structured interview. The interviews were conducted during January to March 2023. The research results showed that (1) Participatory approaches for the prevention and solution of drug problems of schools under the local administrative organizations in Sisaket Province of every created item had a suitability assessment at a level higher than the specified criteria and the possibility of implementing the guidelines; and (2) leadership development model that influences management and results of drug prevention operations in schools under the local government organization can be summarized in 5 issues: (1) raising awareness and education (2) developing communication skills (3) building trusted teams (4) being a good role model, and (5) self-reflection and assessment.

BackgroundStudies of prognostication in advanced cancer use a wide range of outcomes and outcome measures, making it difficult to compare these studies and their findings. Core Outcome Sets facilitate comparability and standardisation between studies and would benefit future prognostic research. This qualitative study, the second step in a wider study developing such a Core Outcome Set, aimed to explore the perceptions and experiences of patients with advanced cancer, informal caregivers, and clinicians regarding the potential outcomes to assess the impact of prognostication.MethodsWe conducted semi-structured interviews with patients living with advanced cancer (n = 8), informal caregivers (n = 10), and clinicians (n = 10) recruited from palliative care services across three sites in London, United Kingdom. Interviews were conducted in-person, via telephone, or video conferencing, and were audio-recorded. Data were analysed using framework analysis. Findings were compared with outcomes identified in a previously published systematic review.ResultsWe identified 33 outcomes, 16 of which were not previously reported in the literature. We grouped these outcomes into 10 domains, nine from the COMET taxonomy, plus a tenth domain (spiritual/religious/existential functioning/wellbeing) which we added further to the previous systematic review. These findings highlighted discrepancies between the priorities of existing research and those of stakeholders. Novel outcomes highlight the more personal and emotional impacts of prognostication, whilst other outcomes confirm the relevance of survival length, depression, anxiety, pain, hope dynamics, emotional distress, and the quality of patient-clinician relationships for assessing the impact of prognostication.ConclusionsThis study offers valuable insights into outcomes which matter to key stakeholders, particularly patients and informal caregivers, highlights discrepancies between their priorities and those identified in previous studies, and underscores the need for a patient-centred approach in research and clinical practice in prognostication in advanced cancer. This work will contribute to developing a Core Outcome Set for assessing the impact of prognostication in advanced cancer.

Learning styles, learners’ preferred ways to learn, can be applied to design personalized learning courses for the individual learner. One of those applications is the recommender system. This study ran a systematic literature review on the recommender system utilizing learning styles from two dependable academic libraries, IEEE Xplore and ScienceDirect, which included six reviewed topics; research objective, research methodology, educational recommendation, learning styles theory, learning style identification, and recommendation algorithm. Finally, the obtained information was examined and summarized in order to develop a unique strategy for leveraging the utilization of learning style theory for a recommender system to improve learning efficiency.

BackgroundStudies exploring the impact of receiving end-of-life prognoses in patients with advanced cancer use a variety of different measures to evaluate the outcomes, and thus report often conflicting findings. The standardization of outcomes reported in studies of prognostication in palliative cancer care could enable uniform assessment and reporting, as well as intertrial comparisons. A core outcome set promotes consistency in outcome selection and reporting among studies within a particular population. We aim to develop a set of core outcomes to be used to measure the impact of end-of-life prognostication in palliative cancer care. ObjectiveThis protocol outlines the proposed methodology to develop a core outcome set for measuring the impact of end-of-life prognostication in palliative cancer care. MethodsWe will adopt a mixed methods approach consisting of 3 phases using methodology recommended by the Core Outcome Measure in Effectiveness Trials (COMET) initiative. In phase I, we will conduct a systematic review to identify existing outcomes that prognostic studies have previously used, so as to inform the development of items and domains for the proposed core outcome set. Phase II will consist of semistructured interviews with patients with advanced cancer who are receiving palliative care, informal caregivers, and clinicians, to explore their perceptions and experiences of end-of-life prognostication. Outcomes identified in the interviews will be combined with those found in existing literature and taken forward to phase III, a Delphi survey, in which we will ask patients, informal caregivers, clinicians, and relevant researchers to rate these outcomes until consensus is achieved as to which are considered to be the most important for inclusion in the core outcome set. The resulting, prioritized outcomes will be discussed in a consensus meeting to agree and endorse the final core outcome set. ResultsEthical approval was received for this study in September 2022. As of July 2023, we have completed and published the systematic review (phase I) and have started recruitment for phase II. Data analysis for phase II has not yet started. We expect to complete the study by October 2024. ConclusionsThis protocol presents the stepwise approach that will be taken to develop a core outcome set for measuring the impact of end-of-life prognostication in palliative cancer care. The final core outcome set has the potential for translation into clinical practice, allowing for consistent evaluation of emerging prognostic algorithms and improving communication of end-of-life prognostication. This study will also potentially facilitate the design of future clinical trials of the impact of end-of-life prognostication in palliative care that are acceptable to key stakeholders. Trial RegistrationCore Outcome Measures in Effectiveness Trials 2136; https://www.comet-initiative.org/Studies/Details/2136 International Registered Report Identifier (IRRID)DERR1-10.2196/49774

BackgroundThroughout the twentieth century, public health agencies and expert healthcare professionals have recognized breastfeeding as the most nutritious and appropriate option for feeding infants. The Ecuadorian government, in line with international guidelines, has therefore developed laws and initiatives to improve the initiation and maintenance of breastfeeding, especially among working mothers. However, breastfeeding rates in Ecuador are low.MethodsA qualitative methodology following social constructionist approaches was applied to explore the breastfeeding experiences of Ecuadorian women who are both mothers and healthcare professionals. Using snowball sampling, 60 healthcare professionals who breastfed their babies: 20 nurses, 20 physicians, and 20 nutritionists, took part in research interviews lasting between 30 and 92 minutes. All participants are currently offering telehealth or face-to-face consultation to their patients in Ecuador. Since Ecuador is a multicultural country, efforts were made to include participants from different regions of the country. Data gathering employed virtual semi-structured interviews including Photovoice. The interviews were carried out in Spanish, following a semi-structured topic guide. The data analysis employed constant comparative methods.ResultsThe analysis produced three overarching themes: Integrating breastfeeding in life and work; Establishing space for breastfeeding at work; Negotiations and tensions. The first theme: Integrating breastfeeding in life and work addresses participants' corporeal and emotional experiences when breastfeeding. This theme also includes the participants' experiences of how they integrated their maternal identity and adapted their breastfeeding bodies to their daily routines. The second theme: Establishing space for breastfeeding at work includes the challenges that some women encounter when incorporating and seeking to combine breastfeeding in their professional identities. The third theme: Negotiations and tensions covers how this group of female healthcare professionals had to negotiate the time and space to continue breastfeeding their children while working.

Abstract Background Primary sclerosing cholangitis (PSC) is a rare incurable disease of the bile ducts and liver which can significantly impair quality of life (QoL). No existing QoL tools are entirely suitable for people living with PSC (PwPSC). We aimed to develop a measure of QoL for PwPSC in the UK, beginning by identifying relevant QoL issues. This paper describes our approach to this first stage, and discusses related benefits and limitations. Methods Scientific consensus on how to reliably stage PSC is lacking, due to its rarity and heterogeneity. We initially hypothesised four categories for PSC severity. After beginning the study, these were revised to six. For such a rare disease, the study could not recruit sufficient participants in each of these categories, particularly the more severe, in the time available. We therefore modified the design, adapting standard methodology for identifying potentially relevant issues. We started by conducting a thematic analysis of data from a previous survey of PwPSC, and extracting QoL issues from a literature review of QoL questionnaires of relevance to PwPSC. We then conducted group and individual interviews with PwPSC and clinicians, investigating the relevance, importance, phrasing, and breadth of coverage of issues identified. We also explored the validity of our hypothesised categories for disease severity. Results We identified 1,052 potentially relevant QoL issues from the survey and literature review and took 396 of these forwards for discussion with 28 PwPSC. We found 168/396 issues were considered relevant by ≥ 60% of these participants. We then discussed this subset of 168 issues with 11 clinicians. PSC and clinician participants identified some problematic phrasing with 19 issues, due to potential upset (n = 12) or problems with understanding (n = 7). We included one new issue from those suggested. Conclusion We identified a range of QoL issues relevant to PwPSC, with a good breadth of coverage, although lacking an in-depth understanding of the PSC experience. Our strategy effectively identified relevant QoL issues for people living with this rare condition, for which there is no consensus on stratifying for its severity. This strategy should however be considered specific to such circumstances, not a general recommendation for an alternative approach.

Abstract Background Bispectral index (BIS) monitoring uses electroencephalographic data as an indicator of patients’ consciousness level. This technology might be a useful adjunct to clinical observation when titrating sedative medications for palliative care patients. However, the use of BIS in palliative care generally, and in the UK in particular, is under-researched. A key area is this technology’s acceptability for palliative care service users. Ahead of trialling BIS in practice, and in order to ascertain whether such a trial would be reasonable, we conducted a study to explore UK palliative care patients’ and relatives’ perceptions of the technology, including whether they thought its use in palliative care practice would be acceptable. Methods A qualitative exploration was undertaken. Participants were recruited through a UK hospice. Focus groups and semi-structured interviews were conducted with separate groups of palliative care patients, relatives of current patients, and bereaved relatives. We explored their views on acceptability of using BIS with palliative care patients, and analysed their responses following the five key stages of the Framework method. Results We recruited 25 participants. There were ten current hospice patients in three focus groups, four relatives of current patients in one focus group and one individual interview, and eleven bereaved relatives in three focus groups and two individual interviews. Our study participants considered BIS acceptable for monitoring palliative care patients’ consciousness levels, and that it might be of use in end-of-life care, provided that it was additional to (rather than a replacement of) usual care, and patients and/or family members were involved in decisions about its use. Participants also noted that BIS, while possibly obtrusive, is not invasive, with some seeing it as equivalent to wearable technological devices such as activity watches. Conclusions Participants considered BIS technology might be of benefit to palliative care as a non-intrusive means of assisting clinical assessment and decision-making at the end of life, and concluded that it would therefore be acceptable to trial the technology with patients.

Background: Studies of prognostication in advanced cancer use a wide range of outcomes and outcome measures, making it difficult to compare these studies and their findings. Core Outcome Sets facilitate comparability and standardisation between studies and would benefit future prognostic research. This qualitative study, the second step in a wider study developing such a Core Outcome Set, aimed to explore the perceptions and experiences of patients with advanced cancer, informal caregivers, and clinicians regarding the potential outcomes to assess the impact of prognostication. Methods: We conducted semi-structured interviews with patients living with advanced cancer (n = 8), informal caregivers (n = 10), and clinicians (n = 10) recruited from palliative care services across three sites in London, United Kingdom. Interviews were conducted in-person, via telephone, or video conferencing, and were audio-recorded. Data were analysed using framework analysis. Findings were compared with outcomes identified in a previously published systematic review. Results: We identified 33 outcomes, 16 of which were not previously reported in the literature. We grouped these outcomes into 10 domains, nine from the COMET taxonomy, plus a tenth domain (spiritual/religious/existential functioning/wellbeing) which we added further to the previous systematic review. These findings highlighted discrepancies between the priorities of existing research and those of stakeholders. Novel outcomes highlight the more personal and emotional impacts of prognostication, whilst other outcomes confirm the relevance of survival length, depression, anxiety, pain, hope dynamics, emotional distress, and the quality of patient-clinician relationships for assessing the impact of prognostication. Conclusions: This study offers valuable insights into outcomes which matter to key stakeholders, particularly patients and informal caregivers, highlights discrepancies between their priorities and those identified in previous studies, and underscores the need for a patient-centred approach in research and clinical practice in prognostication in advanced cancer. This work will contribute to developing a Core Outcome Set for assessing the impact of prognostication in advanced cancer. [ABSTRACT FROM AUTHOR]

Abstract Background Low-density lipoprotein cholesterol (LDL-C) is one of the most important types of cholesterol and has an impact on health. Certain lifestyle and dietary habits in different populations may leads to increased levels of LDL-C, particularly among those with poor education and economic statuses, such as hill tribe people in Thailand. This study aimed to estimate the prevalence of and determine the factors associated with high LDL-C levels among hill tribe people in northern Thailand. Methods A cross-sectional study was performed to gather information from six main hill tribe populations: Akha, Lahu, Hmong, Yao, Karen, and Lisu. Individuals who were aged over 30 years and living in 30 selected hill tribe villages were invited to participate in the study. A validated questionnaire and 5-mL blood specimens were used to obtain data. Correlation analyses, chi-square tests, t-tests, and logistic regression were used to detect correlations and associations. Results A total of 2552 participants were recruited into the study; 65.9% were females, and 64.1% were aged younger than 60 years old. Approximately 69.6% of participants had abnormal LDL-C levels; 33.6% had above-optimal levels, 24.3% had borderline high levels, 8.0% had high levels, and 3.7% had very high levels. A total of 17.4% of participants had low high-density lipoprotein cholesterol (HDL-C) and high LDL-C levels, while 14.9% had high triglyceride and LDL-C levels. After controlling for sex, age, religion, education, annual family income, and marital status in the multivariate model, three variables were found to be associated with high LDL-C levels: occupation, the amount of lard used in daily cooking, and glycated hemoglobin (HbA1c). Those who were working as agriculturalists had a 1.34-fold greater chance of having abnormal LDL-C than traders and others (95% CI = 1.09–1.34). Those who used moderate and high quantities of lard in their daily cooking had a 1.45-fold (95% CI = 1.15–1.82) and 1.31-fold (95% CI = 1.04–1.68) greater likelihood of having abnormal LDL-C levels than those who used low quantities, respectively. Those who had abnormal HbA1c levels were less likely to develop abnormal LDL-C levels than those who had normal HbA1c levels (AOR = 0.69, 95% CI = 0.51–92). Conclusions Effective public health programs that do not conflict with the cultures of hill tribes are urgently needed, particularly programs encouraging the use of small quantities of lard for daily cooking practices.

Abstract Background Primary sclerosing cholangitis (PSC) is a rare bile duct and liver disease which can considerably impact quality of life (QoL). As part of a project developing a measure of QoL for people with PSC, we conducted a systematic review with four review questions. The first of these questions overlaps with a recently published systematic review, so this paper reports on the last three of our initial four questions: (A) How does QoL in PSC compare with other groups?, (B) Which attributes/factors are associated with impaired QoL in PSC?, (C) Which interventions are effective in improving QoL in people with PSC?. Methods We systematically searched five databases from inception to 1 November 2020 and assessed the methodological quality of included studies using standard checklists. Results We identified 28 studies: 17 for (A), ten for (B), and nine for (C). Limited evidence was found for all review questions, with few studies included in each comparison, and small sample sizes. The limited evidence available indicated poorer QoL for people with PSC compared with healthy controls, but findings were mixed for comparisons with the general population. QoL outcomes in PSC were comparable to other chronic conditions. Itch, pain, jaundice, severity of inflammatory bowel disease, liver cirrhosis, and large-duct PSC were all associated with impaired QoL. No associations were found between QoL and PSC severity measured with surrogate markers of disease progression or one of three prognostic scoring systems. No interventions were found to improve QoL outcomes. Conclusion The limited findings from included studies suggest that markers of disease progression used in clinical trials may not reflect the experiences of people with PSC. This highlights the importance for clinical research studies to assess QoL alongside clinical and laboratory-based outcomes. A valid and responsive PSC-specific measure of QoL, to adequately capture all issues of importance to people with PSC, would therefore be helpful for clinical research studies.

Abstract Background Triglycerides are lipids in the human body that are produced from the consumption of daily food and drink. However, elevated serum triglycerides, also known as hypertriglyceridemia (HTG), are key biomarkers indicating an unhealthy status and increased risks of cardiovascular diseases (CVDs) and pancreatitis. Different groups of people have different patterns and styles of cooking and different patterns of consumption, such as hill tribe people, who have their own unique culture and cooking practices. This study aimed to estimate the prevalence of and determine the factors associated with HTG among the hill tribe population in Thailand. Method A cross-sectional study was performed. Data and a-5 mL blood sample were collected from participants who were members of one of the six main hill tribes in Thailand: Akah, Lahu, Hmong, Yao, Karen, and Lisu. People who lived in 30 selected hill tribe villages and aged 30 years over were asked to participate the study. Pearson correlation and logistic regression were used to detect the correlations and determine the associations between variables, respectively, at a significant level of α = 0.05. Results A total of 2552 participants participated this study; 65.9% were females, 72.35% were aged 40–69 years, 76.7% had no education, 48.7% worked in the agricultural section, and 71.2% had an annual income of less than 50,000 baht/family. Regarding the triglyceride level, 41.7% of participants had elevated levels of serum triglyceride or HTG; 16.4% had a borderline high level, and 25.3% had a high level. After controlling for all potential confounder factors, three variables were found to be associated with elevated serum triglycerides. Those who were members of the Lahu and Hmong tribes were 1.62 times (95%CI = 1.25–2.01) and 1.63 times (95%CI = 1.23–2.16) more likely to have elevated serum triglycerides than those who were members of the Akha tribe, respectively. Those who used a high quantity of cooking oil for daily cooking were 0.73 times less likely to have an abnormal level of triglycerides than those who used a low quantity of cooking oil for daily cooking (95%CI = 0.58–0.91), and those who had a waist circumference indicating obesity were 1.28 times more likely to have an abnormal level of triglycerides than those who had a normal waist circumference (95%CI = 1.08–1.52). Conclusion Public health programs that focus on encouraging people to have regular exercise to reduce their body weight, particularly in some tribes, such as Lahu and Hmong, should be implemented.

Abstract Background The major population vulnerable to hand, foot and mouth disease (HFMD) is children aged less than 5 years, particularly those who are cared for at day care centers (DCCs). This study aimed to assess the associations of environmental and sanitation factors with high HFMD occurrence rates in DCCs of northern Thailand. Methods A case-control study was used to gather information from caregivers and local government administrative officers. DCCs in areas with high and low HFMD occurrence rates were the settings for this study. A validated questionnaire was used to collect environmental and sanitation information from the DCCs. In-depth interviews were used to collect information from selected participants who were working at DCCs and from local government administrative officers on the HFMD capacity and prevention and control strategies in DCCs. Logistic regression analysis was used to determine the associations between many environmental factors and HFMD at the α = 0.05 significance level while the content analysis was used to extract information from the interviews. Results Two variables were found to be associated with a high rate of HFMD occurrence: the number of sinks available in restrooms and the DCC size. Children attending DCCs that did not meet the standard in terms of the number of sinks in restrooms had a greater chance of contracting HFMD than children who were attending DCCs that met the standard (AOR = 4.21; 95% CI = 1.13–15.04). Children who were attending a large-sized DCC had a greater chance of contracting HFMD than those attending a small-sized DCC (AOR = 3.28; 95% CI = 1.21–5.18). The yearly budget allocation and the strategies for HFMD control and prevention, including collaborations among stakeholders for HFMD control and prevention in DCCs, were associated with the effectiveness of HFMD control and prevention. Conclusions The number of sinks in restrooms and DCC size are major concerns for HFMD outbreaks. Sufficient budget allocation and good collaboration contribute to effective strategies for preventing and controlling HFMD in DCCs.

From its inception palliative care has been understood as addressing four dimensions: physical, social, emotional/psychological, and spiritual/religious. However, the spiritual and/or religious element is poorly understood and under-researched, and little is known about palliative care professionals’ understandings of spiritual care, or how they seek to implement spiritual care in practice. Members of the European Association of Palliative Care (EAPC) Spiritual Care Taskforce (SCTF) designed and conducted a 28-item survey, supported by the EAPC Board, investigating palliative care professionals’ understandings and attempts to implement spiritual care. Following pilot-testing with 30 participants, the survey ran for a month. It was engaged with by 527 people from 67 countries and most regions of the world, with 502 answering at least two questions, 465 people answering at least one substantive questions, 228 providing examples of spiritual care at Q24, and 115 providing further comments at Q28. We analysed the sociodemographic data descriptively, thematically analysed the diverse, detailed spiritual care examples provided at Q24, and conducted a content analysis of Q28 responses. We identified nine themes from Q24 responses. Of these nine themes, five encompassed interactions between staff and patients, one of these five addressing the character, nature, or quality of care provided by staff; the other four specific content of that care: supporting patients’ wellbeing, supporting patients’ religious faiths, enabling reflection, and facilitating focused discussions. A sixth theme covered staff roles and responsibilities, including specific input from specialist providers. Three smaller themes addressed supporting others than patients: families before patients’ deaths, families during bereavement, and staff.

Palliative care has always included spiritual care, but the provision and inclusion of spiritual care within and across palliative care services internationally is sub-optimal. In this summary overview, we address understandings and meanings of spirituality and related terms, both generally and in the context of healthcare, and outline the importance of spiritual well-being and spiritual care at the end of life. We summarise what spiritual care involves, its benefits for palliative care patients and their families, and consider how its provision might be helped or hindered. There is currently a limited evidence base for the efficacy of interventions including spiritual and/or religious care, and large-scale studies in particular are lacking. However, those mostly small-scale and/or qualitative studies which have been conducted to date show that addressing the spiritual needs of patients in palliative care is associated with many positive outcomes for both patients and their relatives. More research in this area is necessary to develop and enhance the evidence base, and optimal provision of spiritual care requires that providers explicitly recognise the need for such care, including through providing training and support for staff.

Modern scanners can perform terrestrial topographic survey with resolution of 1 cm and accuracy of 2 mm in just a few minute‘s time, from the distance of up to 100 meters. However, for surface topographical surveying of large territories or complex industrial objects, it is necessary to conduct geodetic traverses and perform their binding to the points of the geodesic basis. One method of coordinate transferring during surveying is by using the method of inverse linear-angular intersection, which involves the measuring of the respective sides S1, S2 and the β angle between them. This method is more precise than the classical one, which usually contains centring and reduction errors. The linear-angular intersection method can also be used for many applications in engineering geodesy, for laying geodetic traverses, and for binding to the wall based points of ground-surveying.

Background: Depression is a silent health problem that can lead to severe and sometimes fatal outcomes if individuals are not diagnosed and treated properly; this is particularly true in populations with limited education, low economic status and several barriers to accessing health services, such as the hill tribe people in Thailand. Methods: This cross-sectional study aimed to explore the prevalence of and factors associated with depression among hill tribe individuals aged 30 years and over. A validated questionnaire and the Patient Health Questionnaire-9 (PHQ-9) were used for data collection in an interview format in a private and confidential room. Logistic regression was used to detect the associations of variables with depression at a significance level of α = 0.05. Results: A total of 2,552 participants were recruited for the analysis; 65.9% were females, 79.9% were married, 35.8% were aged 50 years and over, and 54.2% were Buddhist. The majority were uneducated (76.7%), were agriculturalists (48.4%), and had a low family income (71.2%). The overall prevalence of depression was 12.0%. In the multivariate analysis, eight variables were found to be significantly associated with depression among hill tribe adults aged 30 years and over in Thailand. Being female, 50 years or older, married, and Christian; living with a relative; smoking; using opium; and having moderate and high stress levels were associated with depression. Conclusion: Effective public health interventions should be considered to reduce the burden of depression in the hill tribe population by focusing on individuals who are female, 50 years or older, married, Christian, and stressed and those who abuse substances.

We read with interest the article by Ramos-Rincon and colleagues about patients with COVID-19 dying in acute medical wards in a Spanish University hospital [...]

Purpose - Chiang Rai is the northernmost province of Thailand. Municipal solid wastes (MSWs) was generated 430,828.2 ton/y in this area; however, only 24 percent of waste was properly disposed, and 43 percent of waste was properly managed. The purpose of this paper is to explore knowledge, attitudes and practices (KAP) of highland residents in order to provide a basis for the development of waste management in the study area. Design/methodology/approach - A cross-sectional study was conducted in Mae Fah Luang district, Thailand, from November 2016 to January 2017. A random sample of 451 respondents constituted the study population. Data were gathered using a structured questionnaire. Pearson Correlation and χ2 were applied to identify the association among variables. Findings - Overall, 73 percent of respondents had high level of knowledge; 85 percent of respondents showed neutral attitude; and 59 percent of respondents performed moderate practice on MSW management. The results highlighted that age and education levels were statistically significant associated with KAP levels on MSW management at (p=0.05). Originality/value - The respondents who have good knowledge also have a good level of practice; and those who have good attitude also have a good level of practice. Socio-demographic factors and suitable way to promote an effective MSW management should be considered.

Histone acetyltransferases (HATs) and histone deacetylases (HDACs) catalyze the dynamic and reversible acetylation of proteins, an epigenetic regulatory mechanism associated with multiple cancers. Indeed, HDAC inhibitors are already approved in the clinic. The HAT paralogs p300 and CREB-binding protein (CBP) have been implicated in human pathological conditions including several hematological malignancies and androgen receptor-positive prostate cancer. Others have reported CoA-competitive inhibitors of p300 and CBP with cell-based activity. Here, we describe 2 compounds, CPI-076 and CPI-090, discovered through p300-HAT high throughput screening screening, which inhibit p300-HAT via binding at an allosteric site. We present the high resolution (1.7 and 2.3 Å) co-crystal structures of these molecules bound to a previously undescribed allosteric site of p300-HAT. Derivatization yielded actionable structure-activity relationships, but the full-length enzymatic assay demonstrated that this allosteric HAT inhibitor series was artifactual, inhibiting only the HAT domain of p300 with no effect on the full-length enzyme.

This study investigated municipal solid waste generation rate and its composition including the level of knowledge, attitude and practice on municipal solid waste (MSW) management of highland rural tourist area in Chiang Rai Province, Mae Salong Nok Sub-district, Thailand in order to propose the guidelines for effective MSW in rural tourist areas. Samples of MSW were collected during weekdays and several weekends, and separated into 4 categories: general, recyclable, organic and hazardous waste. About 40 % of the MSW consisted of organic waste; plastic bags were widely present, comprising more than 60 % of the mass of the general waste group. Level of knowledge, attitude and practice (KAP) on MSW was evaluated using questionnaires. While respondents scored 80 % and 76 %, respectively, on their level of knowledge of, and attitude to MSW, practice fell far short at only 37 %. The results led to a recommendation to strengthen waste separation at source, implement waste reduction and recycling concepts to reduce the volume of plastic bags, and introduce composting of food waste. The study also highlights economic and financial benefits of waste recycling. Additional value-added could be derived from the organic waste recycling program by promoting production of bioextracts and compost at household level, in order to reduce the amount of organic wastes and carbon emissions. The general and recyclable wastes could also be converted to energy as refuse-derived fuel 2 (RDF-2); the estimated average heating value of this RDF-2 was 23.56 MJ kg-1. To sustain MSW management in tourist areas, environmental education and environmental awareness campaigns are needed, using the appropriate local languages for communication, and introduction of a fairer system based on the polluter-pays principle for the business sector.

This research aims to investigate the situation of municipal waste management in the highlands of Chiang Rai, Thailand in order to formulate a preliminary strategic action plan for efficient management of municipal solid waste. In-depth interviews, questionnaires and discussions between government officers and community residents were conducted, in addition to analysis of the composition of solid waste in the municipality. SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) of current municipal waste management was performed and considered together with the assessment indicators of zero waste management: geo-administrative, socio-cultural, management, environment, economic, organization and governance and policy, in order to identify key domains and locally relevant indicators. The results pointed to two main weaknesses of municipal waste management: lack of knowledge, combined with low levels of implementation of best practice in waste management. This was attributed mainly to language barriers impeding knowledge exchange. To improve the prospects for a zero-waste community in these highland areas, there is a need to improve administration and the social attitudes by promoting the 3Rs concept and initiating waste utilization projects to raise awareness and consciousness within local communities. Importantly, imparting the knowledge of waste management using effective parent language for communication is a key success factor for enhancing the effectiveness of municipal waste management.

This research aims to study air pollution dispersion in Chiang Rai Province, Thailand. The relationship between air pollutants, meteorology and population health were considered. The levels of air pollutants were used to establish a spatial and temporal analysis by Inverse Distance Weighted (IDW) interpolation from Geographic Information Systems (GIS), involved with occurrences of disease cases in the study area. The average monthly air pollution data were collected from Thailand’s Pollution Control Department and data on respiratory disease were collected from Chiang Rai Provincial Public Health Office during 2011 to 2014. The results indicated that monthly average PM10 concentrations started to rise from December to April. PM10 concentrations peaked during the hot season of every year, when open burning is prac-ticed. During this period, PM10 levels exceeded Thailand’s national ambient air quality standards of 120 µg m-3. Accumulative influenza and pneumonia cases in Chiang Rai Province were very high in Chiang Rai city centre. The spatial temperature distribution map showed higher incidence of cases of influenza and pneumonia throughout the lower temperature area of Chiang Rai city centre. Influenza was affected by PM10, rainfall, relative humidity, and temperature, according to the following correlation ratios: 0.8217, 0.8842, 0.9375 and 0.8775, respectively. The incidence of pneumonia was affected by rainfall, relative humidity and temperature following the correlation ratios 0.7746, 0.7621 and 0.9684, respectively. Whereas PM10 was low associated with pneumonia as a significant ratio was 0.6079. Pneumonia incidence decreased when rainfall and temperature decreased, and increased when relative humidity increased.

Wetlands contribute to water quality improvement and play an important role in the global carbon cycle. As such, wetlands can sequester carbon and mitigate greenhouse gas emissions. This study utilized a survey as a preliminary investigation of the feasibility of using natural wetlands for university wastewater treatment. A total of 13 natural ponds containing water from rainfall and some discharge from the Rotating Batch Contractor (RBC) in Mae Fah Luang University (MFU) were selected. Of all the 13 ponds, the pond at the stadium was selected as the most suitable, due to the following physical and chemical parameters: slope was < 5%, maximum depth was 3.1 m, mean temperature of 24.5 °C, dissolved oxygen 6.31 mg L-1, pH 7.56, TDS 180 ppt, electrical conductivity 253 µS cm-1, and containing 2.35 % organic matter. Total cost and carbon emissions were compared between RBC and the proposed natural wetland. Construction, operation and maintenance costs of natural wetland were very low compared with RBC due to no chemical, electricity and skilled staff required. Similarly, the lower electrical consumption of the natural wetland resulted in reduced carbon emissions of 102.9 kg CO2eq per year. This preliminary result can be used to select possible options for university wastewater treatment.

A university may be compared by its size of population and activities to a small city, with high water consumption and in need of effective water conservation strategies. This study presents the results of a study of water consumption on the Mae Fah Luang University campus in Chiang Rai, Thailand. Consumption was classified by activity type, water usage and water saving behavior of students and staff. The results suggest strategies for water conservation on campus. With a water conservation plan focusing on residential areas (halls and homes), which accounted for the highest levels of consumption on the campus. The study also identified activities where water-use behavior was wasteful; hence, we propose practical strategies to reduce the university’s water use by a) raising awareness of the costs of wasting water; b) education to improve knowledge, attitude, and behavior in regard to water conservation, with examples of good practice.

The synthesis and structural characterisation of phosphine-substituted alkynylboronates is reported. A P(III)-centred alkynylboronate (2) was prepared that showed little evidence for the conjugation of the P-lone pair to the boron via the alkyne π-system, as judged by X-ray crystallography studies of 2 and a related P(V) compound, 3. In addition, corresponding alkynyltrifluoroborate salts were prepared that showed improved stability by comparison to their boronic ester counterparts. These salts undergo Pd-catalysed cross-coupling reactions with aryl halides.