Scopus 2024
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Item Metadata only Revitalizing the state of primary healthcare towards achieving universal health coverage in conflict affected fragile northeastern Nigeria: Challenges, strategies and way forward(2024-12-01) Musa S.S.; Ibrahim A.M.; Ogbodum M.U.; Haruna U.A.; Gololo A.A.; Abdulkadir A.K.; Ukaegbu E.; Agyapong J.; Shallangwa M.M.; Adamu N.A.; Muhammad B.A.; Lucero-Prisno D.E.; Musa S.S.; Mahidol UniversityThe Alma-Ata Declaration of 1978 defined primary healthcare as a critical way to obtain universal health care and 'health for all.' In Nigeria, the National Health Policy (NHP) and the subsequent formation of the Primary Health Care (PHC) system aim to modernize healthcare delivery, at the grassroots level. In recent decades, however, the status of primary healthcare in Nigeria, particularly in the northeastern region, has significantly deteriorated, further posing significant threats to health equity and universal access to healthcare. Armed conflicts, humanitarian crises, insufficient finance, inadequate infrastructure, and labor shortages have negatively impacted the region's PHC facilities. This article discusses the poor state of primary healthcare in northeastern Nigeria and its implications for achieving universal health coverage in the region. In addition, the article elaborates on the historical context, highlights the difficulties and challenges in the development of primary healthcare, and explores potential solutions to improve the system.Item Metadata only Enhancing primary healthcare delivery in Nigeria through the adoption of advanced technologies(2024-12-01) Umar A.B.; Sani S.K.; Aliyu L.J.; Hassan M.; Imam M.; Haruna U.A.; Ibrahim A.M.; Lucero-Prisno D.E.; Umar A.B.; Mahidol UniversityEnhancing primary healthcare delivery in Nigeria by adopting advanced technologies holds substantial promise for improving healthcare accessibility, quality, and efficiency. Primary healthcare focuses on community-based, essential care that is practical, socially acceptable, and affordable. Despite efforts to improve healthcare delivery, challenges persist, particularly in rural and underserved areas. The aim of this study was to explore the transformative potential of technologies such as telemedicine, electronic health records (EHRs), health information systems (HIS), artificial intelligence (AI), and medical drones in addressing these challenges. Telemedicine facilitates access to healthcare in remote areas by overcoming geographical barriers. EHRs streamline administrative and clinical processes, enhancing patient care and safety. HIS improves data management, patient safety, and provider communication. AI revolutionizes diagnostics, treatment personalization, and operational efficiency. Medical drones offer innovative solutions for delivering medical supplies to remote locations. The paper also addresses the challenges associated with these technologies, including infrastructure limitations, regulatory issues, and data privacy concerns. Recommendations include investing in infrastructure, developing regulatory frameworks, building capacity, fostering public-private partnerships, engaging communities, and implementing robust data security measures. By addressing these recommendations, Nigeria can leverage advanced technologies to enhance healthcare delivery and achieve better health outcomes.Item Metadata only Kaempferia noctiflora var.Thepthepae (Zingiberaceae), a New Taxon from Thailand(2024-03-07) Nopporncharoenkul N.; Jenjittikul T.; Somnoo T.; Meewasana J.; Tanming W.; Nopporncharoenkul N.; Mahidol UniversityTaxonomic study of Kaempferia subgen. Protanthium (Zingiberaceae) is difficult due to a high degree of intraspecific morphological variation in several species and the implied morphological overlap among the currently recognized species. Herein, we clarify the taxonomic circumscription of K. noctiflora, a rare species endemic to Chiang Mai Province (N Thailand), by describing K. noctiflora var.Thepthepae Noppornch. & Somnoo, var. nova. It differs from K. noctiflora var. noctiflora especially by the labellum colouration and flowering time. The diagnostic characters of this novel variety are discussed and compared with those of morphologically similar taxa. Images of the plants, habit and dissected flowers, and information on the phenology, distribution and ecology are provided. Kaempferia noctiflora var. noctiflora and var.Thepthepae are considered Vulnerable and Endangered, respectively.Item Metadata only Historical Legends of the Buddha in the Region of Bongabhumi(2024-01-01) Chowdhury S.B.; Chowdhury S.B.; Mahidol UniversityIn the region of Bongabhumi, Buddhism has an extensive tradition of elegance, history, and heritage from over 2,600 years ago. This chapter centers on the Buddha’s footprint in the soil of ancient Bongabhumi, revealing a connection between the Buddha and the people of ancient Bengal from its inception. Additionally, it focuses on two historical Buddhist pilgrimage sites: Chakrashala Phratara Cetiya and Ramu Rangkut Banasram Bouddho Bihar of Bangladesh. To clarify the historical legend of Buddhism in the region of Bongabhumi, this chapter also discusses Buddhist transmissions in the Bengal Delta up to the modern period, as well as illustrates how Buddhist communities and their contemporary practices express lived Buddhism in Bongabhumi.Item Metadata only Burmese American Youth Experiences with Theravada Buddhism in the San Francisco Bay Area(2024-01-01) Saruya R.; Saruya R.; Mahidol UniversityHow do children and young people in the Burmese diaspora learn Buddhism? What strategies do teachers use? And how do the students themselves view their experiences? This chapter attempts to answer these questions through the cases of two young lay females who both had short-term but highly impactful experiences: one as a temporary nun, and the other as a repeat attendee at a Buddhist youth camp. These experiences are contextualized, in the first instance with descriptions of the monastic space and the Burmese-language classes that prompted the subject’s choice of monastery, and in the second, with the history of the camp and exploration of its monastic spaces. In both these cases, Buddhism was not always taught directly by monks; that is, while they physically recalled the Buddha and Buddhism in terms of aesthetics, comportment, and the practice of sīla or “morality,” they were not usually the ones teaching Buddhism in the strictest sense. Thus, this research demonstrates the importance of studying lived Buddhism and how the laity—and especially the female laity—serve as active agents in the maintenance of Burmese Buddhism, and of Burmese culture more generally.Item Metadata only One Health Implementation Cycle, Stakeholder Analysis and Engagement(2024-01-01) Rüegg S.R.; Traore T.; Pettan-Brewer C.; Figueroa D.; Becerra N.C.; Ormea V.; Ratanakorn P.; Plangsangmas T.; Queenan K.; Häsler B.; Maassen C.B.M.; Thys S.; Rüegg S.R.; Mahidol UniversityThe chapter introduces the One Health implementation cycle with all steps that occur during the implementation of a project or policy. We start with an introduction to the implementation of activities in socio-ecological systems (SES), which are, by definition, complex and dynamic. We then explore the kind of challenges we encounter in SES and how these determine the importance of engaging stakeholders in the problem statement, in the understanding of the SES itself and in the co-production of solutions. The cycle starts with stating the problem in an inclusive way and exploring the stakeholders systematically, to leave no one behind. Then, we start a community of practice by co-producing a common understanding of the SES and the challenge. We then reach out and will discover what conflicting perspectives and interests we may encounter and how to deal with them to align behind a common theory of change. This forms the basis for other parts in the implementation cycle, which are covered in Chapters 11, 12 and 13.Item Metadata only Racial disparities in the immunotherapeutic outcomes of patients with non-small cell lung cancer (NSCLC): An in-depth systematic review and meta-analysis(2024-01-01) Wannaphut C.; Saowapa S.; Polpichai N.; Wattanachayakul P.; Lalitnithi P.; Tanariyakul M.; Siladech P.; Wannaphut C.; Mahidol UniversityBackground: The utilization of immunotherapy has become prevalent in the therapeutic approach to non-small cell lung cancer (NSCLC), owing to its association with enhanced survival outcomes. Nevertheless, a notable gap exists in the available information regarding potential variations in the survival benefits of immunotherapy based on the racial demographics of NSCLC patients. Methods: A systematic search for articles published until January 2023 was performed on PubMed, EMBASE, and Google Scholar databases. Articles that aligned with the research objective were included, while non-English articles, case reports, conference abstracts, studies combining immunotherapy with other cancer therapies, and studies on small-cell lung cancer were excluded. Data required for review and analysis was independently abstracted into separate Excel files by two reviewers. Furthermore, Statistical analyses were performed using the Review Manager software, and the methodological quality evaluation was done using the Newcastle Ottawa Scale. Results: Seven cohort studies were used for review and analysis. A subgroup analysis of data from these studies showed that Black/African American and Asian NSCLC patients receiving immunotherapy had improved overall survival (OS) than White patients (HR: 0.84; 95% CI: 0.75 – 0.95; p = 0.006 and HR: 0.53; 95% CI: 0.30 – 0.93; p = 0.03, respectively). However, the difference in OS is statistically insignificant when Hispanic patients are compared with white patients (HR: 0.68; 95% CI: 0.46 – 1.00; p = 0.05). On the other hand, the subgroup analyses did not demonstrate any significant difference in progression-free survival (PFS) when comparing Black/African American, Asian or Hispanic patients to White patients (HR: 0.93; 95% CI: 0.79 – 1.09; p = 0.35, HR: 0.89; 95% CI: 0.51 – 1.55; p = 0.69, and HR: 1.01; 95% CI: 0.82 – 1.23; p = 0.96, respectively). Conclusions: Among non-small cell lung cancer (NSCLC) patients undergoing immunotherapeutic interventions, it is discerned that Black/African American and Asian individuals exhibit superior overall survival (OS) outcomes compared to their White counterparts. However, it is noteworthy that the observed racial disparity does not appear to exert a discernible influence on the progression-free survival (PFS) of NSCLC patients subjected to immunotherapy. Research Sponsor: None.Item Metadata only Child sexual abuse/exploitation and LGBTQI+ children: Context, links, vulnerabilities, gaps, challenges and priorities(2024-04-01) Capaldi M.; Schatz J.; Kavenagh M.; Capaldi M.; Mahidol UniversityChild sexual exploitation and abuse (CSEA) is a pervasive issue affecting children globally, cutting across socio-economic, ethnic, and cultural lines. While much research has historically emphasized the victimization of girls, emerging studies highlight the vulnerability of boys and underscore the neglected intersections of CSEA with LGBTQI+ statuses. LGBTQI+ youth are particularly susceptible to CSEA due to societal discrimination, stigmatization, and biases stemming from socio-cultural, religious, and family contexts. Notably, transgender children and youth face exacerbated risks, marked by alarming rates of stigma, violence, and discrimination, often termed transphobia. From an examination of the academic, evidence-based literature, this discussion paper sheds light on harmful cultural practices (such as the ‘dancing boys’ of South Asia who may exhibit feminine characteristics and are frequently exposed to the risk of sexual violence); myths (surrounding homosexuality); religious doctrines (which generally approach these issues within a discourse of morality and sin); and socio-ecological factors that collectively increase the risk of CSEA for LGBTQI+ children - with a focus on the developing world. Furthermore, while the socio-ecological and resilience frameworks offer promising avenues for understanding and addressing these vulnerabilities, glaring data gaps persist, especially beyond developed countries. The paper concludes with identifying the compelling need for robust research and a comprehensive understanding of how CSEA impacts LGBTQI+ children worldwide, which can guide targeted interventions and support.Item Metadata only Resolution of optic neuritis and probable multiple sclerosis after long-term ingestion of very high doses of vitamin D3: A case report(2024-12-01) Charoenngam N.; Holick M.F.; Charoenngam N.; Mahidol UniversityA 36-year-old male presented with 2 months of left-eye visual disturbance and was diagnosed with optic neuritis due to probable multiple sclerosis (MS). He was advised to undergo periodic ophthalmology follow-up without immunosuppressive treatment. Due to persistent symptoms, he expressed interest in very high-dose vitamin D3 therapy of 54,000 IUs/day (1,000 IUs/kg/day) along with a zero-calcium diet. After starting the therapy, he experienced sustained symptomatic improvement of visual symptoms over 4 years, along with radiological stability of the optic neuritis lesion without developing hypercalcemia. This case supports the potential therapeutic efficacy of very high-dose vitamin D for MS.Item Metadata only General Characteristics of Eastern Indonesian Household Dietary Diversity Score(2024-08-01) Maretalinia; Suryani D.; Angriani Y.; Maretalinia; Mahidol UniversityHousehold dietary diversity score (HDDS) is a crucial indicator of food security and nutritional outcomes. The data collection was done from 2017 to 2018 in Eastern Indonesia. This study aimed to capture the characteristics of HDDS based on district, province, religion, and head of household age. This study used secondary data from the Coastal Community Development Project (CCDP), IFAD Impact Assessment Survey 2018. The total sample of this study was 2,884 households. The HDDS was calculated based on the score of 12 food groups and presented in a bar graph using STATA version 17. The result revealed that the lowest HDDS was found in the Kupang district, East Nusa Tenggara Province, Confucianism or Konghucu Religion, and 15 to 25 years of head of household age. Household dietary diversity score is a critical measure of food security and nutritional status, reflecting a household's access to a variety of foods. Understanding and addressing these determinants are essential for improving household dietary diversity and ultimately enhancing nutrition outcomes.Item Metadata only Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report(2024-12-01) Donsakul N.; Jerasutus S.; Tubtieng I.; Assavanatenapa R.; Vejjabhinanta V.; Donsakul N.; Mahidol UniversityUndifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue sarcoma with a poor prognosis. The patients are usually found to have metastasis when the primary tumor is diagnosed. Eccrine syringofibroadenoma (ESFA) is a rare cutaneous adnexal lesion of eccrine duct origin. There are five subtypes, one of which is reactive ESFA, known to occur in reaction to an inflammatory or neoplastic process. In this article, we report a case of the co-existence of both UPS and ESFA in a 70-year-old male patient, presenting with a painless, erythematous, irregular surface nodule with a peripherally extended brownish hyperkeratotic plaque on the right palm. The histologic findings revealed an ill-defined dermal tumor of atypical epithelioid and spindle-shaped cells with large pleomorphic hyperchromatic nuclei and abundant eosinophilic cytoplasm. Some of those cells were multinucleated giant cells in the stroma with vascular proliferation and mixed inflammatory cell infiltrate. The tumor cells, which were only positive for vimentin, supported the diagnosis of undifferentiated pleomorphic sarcoma (UPS). Meanwhile, the overlying epidermis demonstrated hyperkeratosis, papillated epidermal hyperplasia, and proliferation of anastomosing slender cords and strands of cuboid cells within loose fibrovascular stroma. These findings are the characteristics of eccrine syringofibroadenoma (ESFA). We describe here a patient in whom reactive ESFA occurred on and surrounded the UPS tumor.Item Metadata only Ectopic Cervical Thymic Tissue Mimicking Parathyroid Hyperplasia: A Rare Occurrence Linked to Graves Disease(2024-11-01) Chatchomchuan W.; Thewjitcharoen Y.; Nakasatien S.; Suvikapakornkul R.; Keerawat S.; Himathongkam T.; Chatchomchuan W.; Mahidol UniversityThymic hyperplasia has occasionally been reported in patients with Graves disease (GD). However, ectopic cervical thymic hyperplasia in the setting of hyperthyroid GD is exceptionally rare. We describe a case of a 54-year-old Thai woman who presented with hyperthyroidism, diplopia, and pretibial myxedema. She underwent a total thyroidectomy because of diplopia caused by Graves ophthalmopathy. During the surgery, 3 macroscopically abnormal enlargements of parathyroid gland-like tissue were identified and removed. Histopathology revealed hyperplastic thymic tissue mixed with 1 normal-sized parathyroid gland at the location of the left upper parathyroid gland, and thymic tissue was found in the sample labeled as the right upper parathyroid gland. Notably, the sample labeled as the right lower parathyroid gland was actually determined to be a lymph node. Preoperative blood samples showed normal serum calcium and parathyroid hormone levels. Postoperatively, computed tomography of the chest showed thymic hyperplasia in the anterior mediastinum, which slightly regressed at the 9-month follow-up. The patient had transient hypoparathyroidism requiring oral calcium and active vitamin D supplements for 6 months postoperatively. Ectopic cervical thymic hyperplasia can be found in GD and might be indistinguishable from parathyroid hyperplasia. Biochemical evaluations are required to exclude concomitant hyperparathyroidism, and a conservative approach should be considered.Item Metadata only Chemical properties and sensory preference related to umami flavor from crude hydrolysate of Indonesian snails (Filopaludina javanica)(2024-01-01) Kongpichitchoke T.; Rosida D.F.; Havanapan P.O.; Putra A.Y.T.; Priyanto A.D.; Kongpichitchoke T.; Mahidol UniversityFlavor enhancers are considered important in the food industry for their ability to add umami taste, which is recognized as the fifth basic taste. Although monosodium glutamate (MSG) is the most common umami provider, it contains a sodium molecule that can negatively affect consumer health. This made flavor enhancers derived from natural resources to become an interesting alternative. Therefore, this study aimed to examine the potential of peptides produced from the digestion of the Filopaludina javanica (FJ) snails using two enzymes, particularly, bromelain and trypsin, to determine their umami characteristics. Several enzymatic digestion conditions, including enzyme-to-substrate ratios (E/S) of 1/10, 1/20, and 1/00 (w/v), as well as hydrolysis times of 3, 6, 9, 10, 12, 15, and 18 hours, were examined. The study also assessed the degree of hydrolysis (DH), total peptides, and amino acid content. To evaluate the sensory properties of the resulting peptides, hedonic testing, and principal component analysis were conducted to determine taste, aroma, and color attributes. The results showed that the highest total acceptance was obtained from bromelain and trypsin hydrolysis with an E/S ratio of 1/10 but at different hydrolysis times of 18 and 15 hours, respectively. These samples had DH values of 51.26% and 56.10%, total peptide contents of 8.26 mg/mL and 6.63 mg/mL, and amino acid contents of 88.16 ppm and 79.85 ppm, respectively. The most preferred samples were subjected to liquid chromatography-tandem mass spectrometry (LC-MS/MS) and database-assisted identification to determine their peptide compositions. Among the peptides identified, the top three from bromelain digestion were GPLGPLGPQGIPG, GLPGLPGLPGPKG, and PKEVNVAMIVGL VVAG, while the peptides from trypsin hydrolysate included FDNAGAMMSV, LGGSLLGL, and ATKALAMD CEMVGVGRNGEESVLARVSLVNQHGNCIYDKFVKA. In conclusion, the results showed that snail hydrolysate peptides held promise as natural flavor enhancers.Item Metadata only Optic Neuritis(2024-01-01) Padungkiatsagul T.; Padungkiatsagul T.; Mahidol UniversityItem Metadata only Factors Associated with Violence of Persons with Disabilities in the Thai Context(2024-01-01) Auemaneekul N.; Seesaet S.; Lagampan S.; Sujirarat D.; Auemaneekul N.; Mahidol UniversityThis study used an analytical descriptive research approach, focusing on violence against people with disabilities, the types of violence experiences, and the factors related to the violence among people with disabilities in the Thai context. This study applied the Ecological model for understanding interpersonal violence from the World Health Organization as the theoretical guideline. The calculated samples consisted of 201 people who have a disability aged 20 years old and over. Descriptive statistics were used to describe the general characteristics, and logistic regression was applied for the data analysis. The results revealed that people with disability experienced overall violence at 98%, psychological violence 96.5%, physical violence 77.1%, violence from being neglected 75.6%. Factors influencing violence against people with disabilities composed of younger age, being female, low income, living with illness, poor relationships within the family, less family members, and social values to violence. The result of this study could be beneficial in developing awareness and prevention programs to protect human rights violations against people with disabilities in the Thai context.Item Metadata only Established and Emerging Risk Factors of Stroke in Asian Countries: A Systematic Review(2024-05-01) Jarintanan P.; Singh N.; Suthienkul O.; Boonkrong P.; Jarintanan P.; Mahidol UniversityThis paper aims to review the stroke situation regarding its risk factors in 16 Asian countries. From the stroke incidence in 2016 and 2019, it was found that the number of stroke cases per 100,000 people increased in 10 and decreased in 6 Asian countries. Low-middle income countries (LMICs) tend to have lower service and quality of healthcare compared to high-income countries (HICs), this significant difference in healthcare might be what causes the difference in stroke incidence. A systematic review was conducted for identifying and rating the frequency of stroke risk factors. Reviewing 15 selected papers, there are eight risk factors for stroke ranging from hypertension15, diabetes12, hypercholesterolemia/dyslipidemia12, smoking11, physical inactivity7, obesity7, air quality2 to family history1. Age remains a significant risk factor for stroke, underscoring the importance of targeted preventive measures and healthcare interventions for older populations. China, as an example, has spread awareness and shown commitment to health issues and factors, adding institutions, and establishing a healthcare service for locations with more than 300,000. Studies have shown that women in LMICs are more likely to have a stroke at a young age compared to those in HICs, and could be influenced by cultural and social factors on women’s health. Therefore, individuals could decrease stroke risk through healthy lifestyle choices, preventing hypertension, diabetes, and hypercholesterolemia/dyslipidemia. Lifestyle modifications including not smoking, maintaining a healthy diet, and exercising regularly should lower the risk of stroke occurrence in individuals. Simultaneously, national policies could lower stroke incidences by strengthening the stroke care ecosystem.Item Metadata only Cytotaxonomy of Kaempferia subg. Protanthium (Zingiberaceae) supports a new limestone species endemic to Thailand(2024-06-28) Nopporncharoenkul N.; Sukseansri W.; Nopun P.; Meewasana J.; Jenjittikul T.; Chuenboonngarm N.; Viboonjun U.; Umpunjun P.; Nopporncharoenkul N.; Mahidol UniversityThailand is the biodiversity hotspot of genus Kaempferia (Zingiberaceae) and harbours 14 species belonging to K. subgenus Protanthium. To better understand the taxonomic circumscription and verify the taxonomic status, the present characterization of cytogenetic characters included all recognized and one undescribed species of K. subg. Protanthium from Thailand. Overall, 88 accessions of plant materials were analysed cytogenetically: 84 and 42 accessions were subjected to flow cytometry and karyology, respectively. Based on genome size and mitotic chromosome numbers, 74 accessions from all species investigated were putative diploid, whereas the others were putative polyploid: triploid (three accessions) and tetraploid (11 accessions). The cytogenetic evidence indicates that 2n = 2x = 22 is the diploid number and x = 11 is the base chromosome number for K. subg. Protanthium. The genome sizes among the diploid accessions ranged from 3.687 to 6.412 pg while high intraspecific variation in genome size was observed with up to 19.4%. Two species included accessions with different ploidy levels: K. rotunda L. (diploid, triploid and tetraploid) and K. takensis Boonma & Seansouk (diploid and tetraploid). The increase in genome size of tetraploid K. rotunda is nearly in correlation to the increase in ploidy level, whereas the triploid plants represent genome expansion with an approximately 11% larger than expected genome. Interestingly, tetraploid K. takensis displays genome downsizing of 15.3% compared to their diploids. The cytogenetic characteristics, together with morphology, unequivocally clarify the taxonomic status of a new species, named Kaempferia calcicola Noppornch. A revised identification key to species of K. subg. Protanthium is provided.Item Metadata only Relationship between Perceived Organizational Support, Empowerment and Organizational Commitment of Health Workers at Sub-District Health Promoting Hospitals in Suphanburi Province, Thailand(2024-05-01) Matvijit T.; Tadadej C.; Kittipichai W.; Matvijit T.; Mahidol UniversityThis cross-sectional study aims to explore the relationship between personal characteristics, perceived organizational support, empowerment, and organizational commitment. Data were collected using self-administered questionnaires from health workers at Sub-district Health Promoting Hospitals (SHPHs) in Suphanburi Province from June to July, 2023. A total of 374 out of 542 participants 69% were completed the questionnaires for data analysis. Pearson’s Product Moment Correlation Coefficient and Stepwise Multiple Regression Analysis statistics were used for data analysis. The findings revealed that most health workers perceived organizational commitment, empowerment at a moderate level (54%, 52.4%), and perceived organizational support at a high level (39.04%). Additionally, perceived organizational support, and empowerment showed statistically significant relationships with organizational commitment (r = 0.622, 0.614). Perceived organizational support and empowerment were crucial predictors accounted for 44.1% of the variance in the organizational commitment. To increase the health workers’ organizational commitment, the SHPHs supervisors should focus on improving perceived organizational support and empowerment for SHPHs to retain them within the organization.Item Metadata only Association between Personal Burnout and Depression after First Stroke of Working-age patients in Thailand: A one-year follow-up study(2024-01-01) Naknoi S.; Ramasoota P.; Phuanukoonnon S.; Soonthornworasiri N.; Kaewboonchoo O.; Naknoi S.; Mahidol UniversityBackground: Personal burnout is characterized by physical, emotional, and mental exhaustion due to prolonged stress or excessive demands. Individuals recovering from a stroke often experience significant physical and cognitive challenges during their recovery process, which can lead to increased fatigue and emotional strain. This physical and emotional exhaustion can contribute to the development or worsening of depressive symptoms. Objective: To investigate the relationship between personal burnout at baseline and depressive symptoms after stroke over one-year Methods: The study enrolled 103 participants who experienced their first stroke during working-age patients. The study period was 12 months. Personal burnout was assessed using the Copenhagen Burnout Inventory (CBI) at baseline, while depressive symptoms were measured using the Thai Hospital Anxiety and Depression Scale (HADS) at baseline, six months, and 12 months during the follow-up period. The study employed Generalized Estimating Equations to investigate the longitudinal relationship between personal burnout at baseline and depression over the course of one year. Results: High personal burnout showed a significant association with depression scores over a 1-year period, (coefficient 3.257; 95% CI: 2.299, 4.215). Conclusions: The high personal burnout score predicted worsen depressive symptoms after stoke onset. These results suggest that healthcare workers, families, and co-workers should prioritize mental health support and early detection of depressive symptoms, treatment, and coping strategies among working-age individuals who have experienced a stroke.Item Metadata only Associations between Hunger and Mental Health among Adolescents in Bangladeshi Slums Amid COVID-19(2024-01-01) Yasmin S.T.; Yasmin S.T.; Hong S.A.; Sultan S.; Yasmin S.T.; Mahidol UniversityObjective: Identify the prevalence of hunger, anxiety, and depression, while also exploring the association between hunger, sociodemographic factors, and the presence of anxiety and depression among adolescents in Dhaka's urban slums during the Covid-19 pandemic Methods: This cross-sectional study was conducted during April to May 2022 among 324 adolescents living in slums in Dhaka division, Bangladesh. Data collection was done onsite using a structured questionnaire. Anxiety and depression were assessed using pre-validated and reliable Bangla translated versions of Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Hunger was measured using the Household Hunger Scale (HHS). Binary logistic regression was used to find associations. Results: 61.7% of the adolescents suffered from moderate – severe hunger. The prevalence of moderate to severe levels of anxiety and depression were high at 46.3% and 63.3% respectively. In logistic regression, hunger showed significant association with both anxiety (AOR= 2.345, 95% CI= 1.474-3.731) and depression (AOR= 1.852, 95% CI= 1.166-2.941). Additionally, early adolescence was associated with anxiety, and adolescents who were school going and lived in a household with >5 family members had more likelihood of both anxiety and depression. Conclusion: Hunger during the Covid-19 pandemic was associated with increased risk of anxiety and depression. In crisis situations, public health measures should ensure that poor communities have access to at least basic meals to minimize impact on mental health of adolescents. Apart from this, they should also focus on living situations in slums and enhance their efforts in the national school feeding program.