Associations between frailty and mild cognitive impairment in older adults: Evidence from rural Chiang Mai Province.

Thailand entered an aged society phase in 2000, with mild cognitive impairment (MCI) and frailty becoming prevalent among the older adult population. However, no studies have yet examined these issues specifically within rural communities. This study aims to explore the relationship between frailty and MCI among older adults in rural Thailand. It was a cross-sectional study conducted between December 2022 and June 2023. A questionnaire was administered by trained village health volunteers. The survey targeted older adults aged 60 years and above, residing in rural Chiang Mai, Thailand, with those having a history of dementia, depression, and brain injury being excluded from participation. Nine hundred eighty-four participants among the older adults were available for analysis. The mean age was 69.8 (SD 7.9) with 62.2% females (n = 612). The median frequency of exercise was three days (0-7). The prevalence of MCI and frailty among rural older adults in the community was 35.6% (n = 350) and 8% (n = 79), respectively. There were four factors associated with an increased risk of MCI, including age (aOR = 1.07, 95% CI 1.04-1.09, p < 0.001), smoking cigarettes (aOR 1.95, 95% CI 1.27-2.98, p = 0.002), feelings of loneliness (aOR 1.43, 95% CI 1.01-2.03, p = 0.043), and the presence of frailty (aOR 1.92, 95% CI 1.10-3.35, p = 0.022). There were two factors associated with a lower risk of MCI: a higher education level (aOR 0.90, 95% CI 0.86-0.94, p <0.001) and engaging in frequent exercise (aOR 0.9, 95% CI 0.86-0.95, p < 0.001). Frailty exhibited an association with an elevated risk of MCI among older adults in rural communities. Enhancing screening through health volunteers and primary healthcare professionals, coupled with bolstering community-driven health promotion initiatives, becomes imperative.

Exploring the adverse effect of fine particulate matter (PM2.5) on wildland firefighters' pulmonary function and DNA damage.

Chiang Mai encounters severe pollution during the wildfire season. Wildland firefighters encounter various hazards while engaged in fire suppression operations, which encompass significant exposure to elevated concentrations of air pollutants resulting from combustion, especially particulate matter. The adverse effects of wildfire smoke on respiratory health are a significant concern. The objective of this study was to examine the potential adverse effects of PM2.5 exposure on the respiratory function and DNA damage of wildland firefighters. This prospective cohort study conducted in Chiang Mai from January to May 2022 planned to evaluate the health status of wildland firefighters during the pre-peak, peak, and post-peak ambient air pollution seasons. The measurement of PM2.5 was done at every forest fire station, as well as utilizing data from the Pollution Control Department. Participants received general health examinations, spirometry evaluations, and blood tests for DNA damage analysis. Pair t-tests and multiple regression models were used to examine the connection between pulmonary function parameters (FVC, FEV1) and PM2.5 concentration, with a significance level of P < 0.05. Thirty-three peak-season and twenty-one post-peak-season participants were enrolled. Four pre-peak-season wildland firefighters had FVC and FEV1 declines of > 15%. Multiple regression analysis showed a negative association between PM2.5 exposure and FVC% predicted (- 2.81%, 95% CI - 5.27 to - 0.34%, P = 0.027) and a marginally significant negative correlation with FVC (- 114.38 ml, 95% CI - 230.36 to 1.59 ml, P = 0.053). The remaining pulmonary measures showed a statistically insignificant decline. There were no significant changes in DNA damage detected. Wildland firefighters suffered a significant decline in pulmonary function associated with PM2.5 exposure. Spirometry is crucial for monitoring and promptly identifying respiratory issues that occur during wildfire seasons. Further research is recommended to explore DNA damage alterations and their potential association with PM2.5.

Socio-demographic, agricultural, and personal protective factors in relation to health literacy among farmers from all regions of Thailand.

Introduction: Farmers are vulnerable to adverse health effects from pesticide exposure due to their health literacy (HL). Therefore, this study aims to investigate HL among farmers in four main regions of Thailand, investigating socio-demographics, agricultural, and personal protective factors to their HL. Methods: This cross-sectional design study was conducted on 4,035 farmers from January to July 2023. The European Health Literacy Survey Questionnaire-47 items were used to measure HL. Results: Thai farmers had a mean HL score of 34.7 ± 8.7, and the farmers in the North region of Thailand had the highest frequency of limited HL (75.8%). Socio-demographic factors that were associated with HL included gender, region of living, marital status, education level, co-morbidity, and number of family members. Agricultural factors associated with HL included planting status, working hours on farm, spraying pesticides, harvesting crops, pesticide use of >1 type, access information from government officers, access information from posters/brochures, information from online multimedia, and access information from neighbors. Personal protective factors that were associated with HL included wearing a hat, goggles, a rubber apron, and a long-sleeved shirt. Discussion: Our study recommends that strategies and interventions to enhance the HL of farmers should be focused on the target populations, which include men, widows, or divorced, those with low levels of education, those who have co-morbidities, and those who applied pesticides of more than 1 type and improper personal protective equipment (PPE) use. The primary emphasis needs to be on the North region of Thailand, making that the target area to improve health equity in Thailand. These efforts would enhance the HL of farmers and sustainably improve pesticide safety behavior. Additionally, there is an urgent need for supportive measures aimed at altering on-farm practices and promoting education on alternative pest management strategies, particularly non-chemical crop protection, to ensure sustainable agriculture.

Unveiling the road to safety: Understanding the factors influencing motorcycle accidents among riders in rural Chiang Mai, Thailand.

Background: Motorcycle accidents pose a significant threat to traffic safety in Thailand, particularly in rural areas where the severity of these accidents often results in prolonged medical treatment and a reduction in the quality of life of the affected individual. Objectives: To investigate the prevalence and the factors associated with motorcycle accidents among motorcycle riders in rural areas in Chiang Mai, Thailand. Method: A cross-sectional study was conducted from December 2022 to March 2023 via an anonymous survey in Chiang Mai, Thailand. A total of 308 participants engaged with the survey. The data about background information, motorcycle details, personal protective equipment, risky behaviors, attitude toward riding, and history of motorcycle accidents in the prior six months were collected and analyzed by binary logistic regression. Results: Of 308 participants, the mean age was 56 years old (SD = 14.2), females were 56.8 % (N = 175), 51 % had co-morbidity, and 40.6 % were active alcohol drinkers. The prevalence of individuals who experienced a motorcycle accident within the previous six months was 57.1 %. Notably, the most unsafe riding behavior was not wearing a helmet while riding, which had a prevalence of more than 80 % in both the accident and non-accident groups. The study found significant associated factors for motorcycle accidents in rural communities, including the history of alcohol consumption (aOR 1.71, 95 % CI: 1.05,2.79), changing lanes without using turn signals (aOR 1.93, 95 % CI: 1.07,3.48) and those who strongly disagree with the notion that listening to music while riding is dangerous (aOR 2.80, 95 % CI: 1.06, 7.43). Conclusion: Over half of motorcycle riders have been in accidents. These findings emphasize the need to enforce drunk-driving and traffic laws. Comprehensive motorcycle rider education and safety training are needed to encourage responsible riding.

Important role of the government in reducing pesticide use and risk sustainably in Thailand: Current situation and recommendations.

Agriculture is an important aspect of Thailand's GDP and development. It ranks as the 8th largest exporter in the world, however, pesticide use associated with the agriculture is ranked 18th in the world and 5th in Asia. Previous studies have clearly stated that pesticides are a threat to human health and the environment. The government is now making efforts to address pesticide use and the health impacts of pesticide use, however, these efforts are still in need of completion. This paper aims to summarize: (1) the current situation with regard to pesticide use in Thailand; (2) the current situation with regard to pesticide poisoning in Thailand; and (3) important role of government in reducing pesticide use and risk sustainably in Thailand: current situation and recommendations. This article suggests that government is a significant driver for reducing pesticide use and risk sustainably and the establishment of push and pull policies, legislation, and strategies. The government needs to strictly adhere to international conventions. Introducing a pesticide tax is essential to reduce redundant pesticide use. Updating of the current act, specific regulations with regard to pesticides and strict enforcement are urgently required. Licensing pesticide applicators should be implemented continuously. Promotion of alternative pest management is needed by supportive production inputs, technology, and markets as well as the development of a monitoring and certification system. Educating consumers on how to choose safe agricultural products and reduce risk from pesticide residues in the products is also necessary. All approaches should be implemented simultaneously and instantly. Importantly, the government needs to cooperate with agricultural sectors, health and environmental sectors, private sectors, as well as food industries to tackle complicate issues in a sustainable manner and lower pesticide use and risk sustainably in Thailand.

The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand.

Wildland firefighting is a high-risk occupation. The level of cardiopulmonary fitness can indicate whether wildland firefighters are ready to perform their job duties. This study's objective was to determine wildland firefighters' cardiopulmonary fitness using practical methods. This cross-sectional descriptive study aimed to enroll all 610 active wildland firefighters in Chiang Mai. The participants' cardiopulmonary fitness was assessed using an EKG, a chest X-ray, a spirometry test, a global physical activity questionnaire, and the Thai score-based cardiovascular risk assessment. The NFPA 1582 was used to determine "fitness" and "job restriction". Fisher's exact and Wilcoxon rank-sum tests were used to compare cardiopulmonary parameters. With a response rate of 10.16%, only eight wildland firefighters met the cardiopulmonary fitness requirements. Eighty-seven percent of participants were in the job-restriction group. An aerobic threshold of eight METs, an abnormal EKG, an intermediate CV risk, and an abnormal CXR were the causes of restriction. The job-restriction group had a higher 10-year CV risk and higher systolic blood pressure, although these differences were not statistically significant. The wildland firefighters were unfit for their task requirements and were more at risk of cardiovascular health compared to the estimated risk of the general Thai population. To improve the health and safety of wildland firefighters, pre-placement exams and health surveillance are urgently needed.

The possible role of particulate matter on the respiratory microbiome: evidence from in vivo to clinical studies.

Environmental pollution, which contains ambient particulate matter, has been shown to have a significant impact on human health and longevity over the past 30 years. Recent studies clearly showed that exposure to particulate matter directly caused adverse effects on the respiratory system via various mechanisms including the accumulation of free radical peroxidation, the imbalance of intercellular calcium regulation, and inflammation, resulting in respiratory diseases. Recent evidence showed the importance of the role of the respiratory microbiome on lung immunity and lung development. In addition, previous studies have confirmed that several chronic respiratory diseases were associated with an alteration in the respiratory microbiome. However, there is still a lack of knowledge with regard to the changes in the respiratory microbiome with regard to the role of particulate matter exposure in respiratory diseases. Therefore, this review aims to summarize and discuss all the in vivo to clinical evidence which investigated the effect of particulate matter exposure on the respiratory microbiome and respiratory diseases. Any contradictory findings are incorporated and discussed. A summary of all these pieces of evidence may offer an insight into a therapeutic approach for the respiratory diseases related to particulate matter exposure and respiratory microbiome.

Acute health symptoms related to perception and practice of pesticides use among farmers from all regions of Thailand.

Introduction: Occupational exposure to pesticides may cause acute health effects for farmers and agricultural workers. Therefore, this study aims to investigate the prevalence of poisoning symptoms related pesticide exposure among farmers from all regions of Thailand, as well as factors linked to poisoning symptoms of neurological and neuromuscular systems, the respiratory system, and eye and skin disorders. Methods: A cross sectional study was conducted in 4,035 farmers who lived in four regions of Thailand. The samples were chosen using stratified random sampling, with 746 for the Central region, 2,065 for the North-East, 586 for the North, and 638 for the South. Results: The results found that the highest prevalence of poisoning symptoms was found in association with neurological and neuromuscular systems (75%), followed by the respiratory system (60.4%), the eyes (41.2%), and skin (14.8%). The most prevalent symptoms were muscle pain (49%) for neurological and neuromuscular symptoms, burning nose (37.6%) for respiratory symptoms, itchy eyes (26.3%) for eye symptoms, and rashes (14.4%) for skin symptoms. The remarkable findings were that types of pesticide use, task on the farm, types of pesticide sprayers, and perception are the crucial factors affecting all poisoning symptoms. Discussion: The findings are also beneficial to the Thai government and other relevant organizations for launching measures, campaigns, or interventions to lower modifiable risk factors, resulting in reducing health risks associated with pesticide exposure.

Respiratory Symptoms and Skin Sick Building Syndrome among Office Workers at University Hospital, Chiang Mai, Thailand: Associations with Indoor Air Quality, AIRMED Project.

Sick building syndrome (SBS) is the term used to describe the medical condition in which people in a building suffer from symptoms of illnesses for no apparent reason. SBS was found to be associated with indoor air quality (IAQ) but there are a variety of determinants (buildings, in particular). Identifying and controlling factors related to SBS is crucial for improving worker health and efficiency. A cross-sectional study was conducted to investigate (1) the prevalence of respiratory symptoms and skin SBS and (2) their associations with IAQ among office workers in administrative offices in an academic medical institute. A self-reporting questionnaire assessing the worker's characteristics, working conditions, and perception of working environments was used. The building assessment was via a walk-through survey and IAQ measurement. Of 290 office workers, 261 (90%) in 25 offices of 11 buildings took part in the survey. The highest prevalence of SBS was nasal symptoms (25.3%). We found that to reduce the risk of SBS, optimal air temperature levels in air-conditioned offices should be lower than 23 °C, with relative humidity between 60% and 70%. Lowering indoor CO2 levels below 700 ppm may be indicative of adequate ventilation to prevent SBS by reducing worker discomfort and indoor contaminants (e.g., formaldehyde).

Focus on High School: Factors Associated with Creating Harmony between the Educational Transition and Adolescents' Well-Being.

The transition from online to on-site education was difficult due to a lack of standardized school guidance for school reopening. Even though schools have reopened, uncertainty about the COVID-19 situation and the capacity of the school to maintain safe school operations to mitigate risks may increase hesitancy among students and parents to participate in on-site studying. Rapid-response surveys of students and parents can provide information to stakeholders on how learning and well-being can best be supported during the educational transition in each context. The aim of this study was to explore the hesitancy of high-school students and the factors that influenced their hesitancy to return to school on site. An online cross-sectional survey was distributed to high-school students in an urban district of Chiang Mai, Thailand, during the fourth wave of the pandemic from 17 November to 13 December 2021. A multivariable logistic regression was performed to explore factors related to the students' hesitancy to attend on-site education. With a response rate of 10.2% of the targeted study population, the 1266 participants revealed that 15.9% of them had very-high- and extremely high-level hesitancy to study on site, which was associated with less negative moods while studying online (aOR, 1.69; p, 0.016) and a greater fear of infection after returning to school (aOR, 2.95; p, 0.001). Increased readiness to return to school on site (aOR, 0.28; p, 0.001) and discussing COVID-19 prevention with family or friends (aOR, 0.71; p, 0.016) were also associated with a lower hesitancy of students. Only 5.6% of the students reported being hesitant to receive the COVID-19 vaccination. However, no significant associations were found between schooling hesitancy and their willingness to get vaccinated, nor the frequency of students' outside activities. High-school students who experience negative moods during online studying should be monitored and receive additional support if the reopening is postponed. More opportunities to discuss COVID-19 prevention with family or friends, as well as a higher level of readiness, may increase the willingness to return to school on site. Local authorities and schools need to strengthen communication and coordination mechanisms to reduce parents' and students' schooling hesitancy by providing explicit information about the COVID-19 situation and risk-mitigation measures, along with normalizing messages about fear and anxiety.

Effect of N95 Respirator on Oxygen and Carbon Dioxide Physiologic Response: A Systematic Review and Meta-Analysis.

During the COVID-19 pandemic, N95 respirators were commonly used in many situations. Respiratory problems from prolonged use of respirators were discussed in many studies, which show varied results. From the inconclusive results, the current systematic review and meta-analysis discerned the effects of the N95 respirator by assessing the oxygen and carbon dioxide changes in both high- and low-to-moderate-intensity physical activities in a healthy population. Thirteen studies were identified for inclusion in the study. In high-intensity physical activities, our meta-analysis showed borderline lower oxygen saturation and higher carbon dioxide partial pressure, but oxygen saturation did not change in low-to-moderate physical activity. The use of N95 respirators could statistically affect the physiologic changes of carbon dioxide and oxygen in high-intensity physical activity among healthy participants, but this may not be clinically significant. Some users who have certain health conditions, such as respiratory problems, should be informed of the clinical symptoms related to hypercarbia and hypoxia for the early detection of adverse effects of N95 respirators.

COVID-19 vaccine hesitancy and influential factors among Thai parents and guardians to vaccinate their children.

Background: The ongoing COVID-19 has had a huge worldwide influence. Vaccinations are a crucial component of illness prevention. Thailand's vaccination program for children above the age of five is in its initial stages. Many Thai parents are still unwilling to vaccinate their children with the COVID-19 vaccine. The purpose of this study was to analyze the rate of parental hesitancy and influential variables among Thai parents and guardians living in Thailand. Methods: This was a cross-sectional survey in Thailand during October and November of 2021. Through online social media networks, an online survey (REDcap) was distributed. Thai parents and guardians with at least one child under the age of 18 were invited to participate. Results: A total of 1064 responses for analysis. One thousand and sixty-four were available for analysis with 74.4% of those who participated being female. The results found that the parental COVID-19 vaccination hesitancy rate was higher among parents with children under the age of 12 than among parents with children over the age of 12. (56.9% vs 17.1%, p-value < 0.001). Parents were more concerned about vaccination side effects (82.5%), safety (60.0%), and vaccine efficacy (37.2%). Low vaccine reluctance among parent with children age less than 12 years old was associated with higher education (aOR = 0.35, 95 %CI = 0.13-0.93, p-value = 0.036) and a favorable attitude regarding covid-19 immunizations (aOR 0.16, 95% CI 0.04-0.67, p-value 0.012). Conclusion: The majority of Thai parents with children under the age of 12 were hesitant to vaccinate against COVID-19. To minimize Thai parent vaccination hesitancy and increase vaccine uptake among children, the government and health care providers should target this population with evidence-based information, promote positive attitudes toward COVID-19 vaccinations, and encourage educated parents to vaccinate their children at first.