Northeastern Thailand Research Articles

Effectiveness of the Preterm Labor Prevention Program for High-Risk Pregnant Women: A Randomized Controlled Trial

Preterm labor significantly impacts premature birth, influencing infant development and health outcomes. This randomized controlled trial aimed to develop and test the effectiveness of the Preterm Labor Prevention Program on primary outcomes (knowledge, attitudes, self-care practices) and secondary outcomes (preterm labor, preterm birth rates). Sixty-six high-risk participants aged 15-49 attending antenatal care clinics in Northeastern Thailand were selected using multi-stage random sampling. They were randomly assigned to either the experimental group (n = 32) receiving the Preterm Labor Prevention Program in addition to routine care or the control group (n = 34) receiving routine care. Data collection employed questionnaires on knowledge, attitude, self-care practice, preterm labor, and preterm birth rates. Data were analyzed using one-way repeated measures ANOVA for knowledge, attitudes, and self-care practice scores across three-time points at baseline before the intervention, immediately and four weeks after program completion, and chi-square tests for comparing preterm labor and premature birth rates across groups. Results indicated that the mean score of knowledge, attitude, and self-care practice in the experiment group was significantly increased over time immediately and four weeks after program completion and significantly higher than that of the control group at both time points. Furthermore, the incidence of preterm labor and the preterm birth rate in the experiment group were 6.25% and 3.10%, respectively. However, the incidence of preterm labor and the preterm birth rate in the control group were equal at 20.60%. Nurses and midwives can apply this program to increase knowledge, more positive attitudes, and practice to reduce preterm labor and preterm birth in high-risk pregnancies, but first, testing of the program is required with an increased number of participants.

2601. A 14-year retrospective study of pulmonary nocardiosis in AIDS patients, Northeastern Thailand

Abstract Background Nocardiosis is an opportunistic infection in immunocompromised individuals, particularly patients with acquired immune deficiency syndrome (AIDS). Clinical manifestations of nocardiosis are wide-ranging but the most common is pneumonia. Methods This 14 year retrospective study included Nocardia species infected adult patients (≥15 years) with at least 28 days of treatment follow-up. This study aims to compare clinical manifestations and survival analysis of cultured confirmed pulmonary nocardiosis among AIDS and non-AIDS patients. Results From 2009 to 2022, 237 patients had culture confirmed Nocardia species infection, of which 22 were excluded from this study because 13 had cutaneous nocardiosis and nine had pulmonary nocardiosis with follow-up less than 28 days. A total of 215 confirmed pulmonary nocardiosis were recruited to the analysis, 97(45.1%) were HIV-infected and 118 (54.9%) were non-HIV. All HIV-infected patient has CD4 count below 200 cell/mm3 (range 1-198, 1-15%), known as AIDS. Most of them were male with a mean age of 37 (range 15-83) years. One hundred fifty of the 215 (69.7%) patients underwent brain imaging. Sixteen cases (10.7%) had brain abscess. Disseminated nocardiosis (brain abscess, bacteremia, cutaneous abscess) was found in equal proportions in AIDS (15/97, 15.5%) and non-AIDS patients (17/118, 14.4%), while pulmonary nocardiosis with local invasion (empyema thoracis, pericardial effusion) was more common in AIDS (11/97, 11.3%) than non-AIDS patients (9/118, 7.6%). Overall and 28 days mortality were 116 (53.9%) and 88 (40.9%), respectively. In Cox’s proportional hazard analysis, AIDS was the independent factor associated with 28 days mortality in pulmonary nocardiosis (adjusted HR 2.62; 95%CI, 1.38 to 4.98) and those who underwent brain imaging (adjusted HR 2.75; 95%CI, 1.23 to 6.15) after adjusted by sex, age, duration of illness, respiratory failure, shock, multi-lobar pneumonia, disseminated nocardiosis, and combination antibiotic therapy. Conclusion Pulmonary nocardiosis is a serious opportunistic infection in AIDS patient and has shown significantly higher mortality than non-AIDS. Therefore, nocardiosis should always be considered as a cause of pneumonia in AIDS patients in order to prompt aggressive treatment. Disclosures Yupin Suputtamongkol, MD, Abbott Labs: Grant/Research Support|Abbott Labs: Mahidol University is partner in the Abbott Pandemic Defense Coalition

Assessment of greenhouse gas mitigation from rice cultivation using alternate wetting and drying and rice straw biochar in Thailand

The mitigation of greenhouse gas (GHG) emissions and water usage optimization in rice cultivation is challenging for many agricultural countries, including Thailand, who have set goals of reaching net zero emissions and coping with droughts caused by climate change. Alternate wetting and drying (AWD) and biochar application are possible practices for achieving cleaner rice production through reduction of GHG emissions and water consumption. However, these methods’ potential varies by site, especially in areas with limited control of water levels. This study assessed the effects of AWD at different drying levels (10, 15, and 20 cm below the soil surface) and rice straw biochar on GHG emissions, yield production, water use, soil characteristics, and economic aspects. This study was conducted over two rice cultivation seasons: a major season in 2022 and a second season in 2023 at a field in Kalasin Province, northeastern Thailand. Using AWD and biochar reduced annual GHG emissions by 48.2% and 8.01%, respectively. Deeper drying levels of AWD showed greater mitigation potential than shallow levels. The combination of AWD and biochar had additional potential for GHG mitigation, however, this impact did not show statistical change as compared to their separate potentials. The adoption of AWD and biochar could also maintain the amount of rice yield compared to traditional practice. All levels of AWD saved irrigation water consumption by an average of 16.8% per season; the highest potential was observed in AWD at 10 cm below the soil surface. Biochar improved soil health after two seasons by enhancing soil pH and organic carbon sequestration. The combination of AWD and biochar did not additionally augment the capacity in water saving of AWD or soil improvement of biochar. The AWD water regime also did not increase net profits, while biochar decreased net profits due to the required investment in biochar production. Using AWD is a feasible way to mitigate GHG emissions and save water without affecting rice productivity and net profits in northeastern Thailand.

An Approach for Egg Parasite Classification Based on Ensemble Deep Learning

Opisthorchis viverrini and minute intestinal fluke (MIF) infections are heavily epidemic in northeastern Thailand. Their primary cause is eating raw or undercooked cyprinid fishes, and they cause health problems in the human digestive system. In cases of liver fluke, these parasites can go through the bile duct system, which may cause cholangiocarcinoma (bile duct cancer). When a medical doctor suspects that a patient is infected with parasites, they typically request a stool analysis to determine the type of egg parasites using microscopy. Both parasites have similar characteristics, thus, it is necessary for a specialist to identify the specific type of egg parasites present. Many automatic systems have been developed using deep learning to assist doctors in diagnosing the type of egg parasite. In this study, we proposed three models of deep learning architectures and created voting ensembles to analyze egg parasite images. Images of similar liver fluke eggs and MIF eggs were taken from the Parasitology Laboratory, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Image data augmentation is used to expand images from different perspectives and assist the system in acquiring a greater variety of images. Three models performed effectively, by employing the hard voting ensemble, the accuracy increased to 86.67%, while for the second group, the accuracies reached 68.00%, 76.00%, and 77.33%, respectively. Using the soft voting ensemble, the accuracy improved to 79.33%. These outcomes highlight the potential of ensemble deep learning in image classification. Furthermore, these results align closely with those achieved by several experts in image classification. Hence, a promising ensemble approach can aid doctors in accurately classifying images of egg parasites.

Revealing genetic diversity of wild Phalaenopsis orchids in Thailand through Random Amplified Polymorphic DNA markers

Abstract. Kate-ngam S, Jantasuriyarat C, Lakote P, Promchot T, Chueakaew C. 2023. Revealing genetic diversity of wild Phalaenopsis orchids in Thailand through Random Amplified Polymorphic DNA markers. Biodiversitas 24: 5409-5417. Wild Phalaenopsis orchids are widely distributed in Thailand, especially along the banks of the Mekong River. The tremendous decrease in the population of these orchids is a matter of concern for maintaining and preventing genetic loss in the natural ecosystem. This study aimed to determine the genetic diversity of 50 wild Phalaenopsis accessions collected from the northeastern of Thailand using random amplified polymorphic DNA (RAPD) markers. The 204 polymorphic bands generated from 27 RAPD primers were employed for fingerprinting these orchid accessions. Dice’s similarity coefficients ranged from 0.43 to 0.98, with an average of 0.65. In general, a dendrogram constructed based on the unweighted pair group method with arithmetic average (UPGMA) grouped these wild Phalaenopsis accessions into two clusters, namely P. pulcherrima and P. ubonensis clusters. The UPGMA clustering pattern and principal component analysis (PCA) corresponded well with their morphological classification and ploidy level. Our results suggest that this wild Phalaenopsis orchid exhibits a moderate level of relatedness. This might be a consequence of habitat destruction and human over-exploitation which limit gene flow and cause genetic drift among populations. The present finding supports the urgent need for a systematic conservation effort of this orchid species in Thailand.

Perceptions of Service Recipients on the Roles of Community Health Nurses in Children's Primary Care During the COVID-19 Outbreak in Northeastern Thailand

To understand the roles of community health nurses in providing services to children in primary health care units during the COVID-19 pandemic. Qualitative research was employed. Data was obtained from documents, observations, and in-depth interviews. Eighty-five key informants were recruited in the study from seven groups: public sector officers, Local Administrative Organization (LAO), community leaders, teachers in child development centers, community organizations, civil groups, and family caregivers. Data was analyzed using the content analysis method. Findings showed the roles of community health nurses in primary care units categorized into eight themes: health care provider, health educator, manager, health collaborator, health coordinator, advocator, consultant, and data collector and reporter. The research reflects the crucial roles of community health nurses in caring for children, skills, knowledge gained, and preparation and engagement of community networks during COVID-19.

The knowledge management and the guidelines of learning instruction on emergency medical services by local administrative organizations in northeastern Thailand

This study aims to emergency medical services (EMS) and their efficacy within the purview of Local Administrative Organizations (LAOs) in Thailand. As the responsibility for EMS has transitioned from public hospitals to LAOs, it has prompted inquiries into their efficiency. This research endeavors to scrutinize the determinants influencing the performance of EMS managed by LAOs. To accomplish this objective, we embraced a quantitative research approach. Data was obtained from 636 individuals who had availed emergency medical services, chosen through purposive sampling. Questionnaires were used to collect data, and the IOC index was employed to ensure data integrity. Descriptive statistics elucidated and assessed various variables. Multiple regression analysis was conducted with a statistical significance level of 0.01 to unearth the associations between administrative factors and the performance of EMS by LAOs. This research uncovers a positive, moderate-level correlation between administrative factors and the performance of EMS by LAOs. Specifically, factors such as community engagement, service preparedness, operational efficiency, budget allocation, resource availability, and staffing levels were identified as noteworthy predictors of EMS success by LAOs, explaining 60.8 percent of the variance. The outcomes of this study have practical implications for EMS management by local authorities, not only in Thailand but also in other regions grappling with analogous challenges. This research contributes to the ongoing endeavors to enhance pre-hospital care and emergency response, ultimately preserving lives and mitigating the repercussions of emergency illnesses and accidents on communities.

Atmospheric Corrosivity Map of Bare Steel and Hot-Dip Galvanized Steel in Central, Northern, and Northeastern Thailand

Atmospheric Corrosivity Map of Bare Steel and Hot-Dip Galvanized Steel in Central, Northern, and Northeastern Thailand

Influence of misconceptions and inappropriate eating behaviors on Opisthorchis viverrini infection among at-risk populations undergoing cholangiocarcinoma screening in Northeastern Thailand.

Raw or undercooked freshwater fish consumption contributes to persistent Opisthorchis viverrini infection in Northeast Thailand. This study aims to assess the relationship between misconceptions, unhealthy eating habits, and O. viverrini infection. Data were obtained from the Cholangiocarcinoma Screening and Care Program in Northeast Thailand from 2019 to 2021. Participants were screened for O. viverrini annually over the following 2years using the Kato-Katz technique. Misconceptions and unhealthy eating habits were assessed through questionnaires. The relationship between these factors and O. viverrini infection was evaluated using adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) from generalized estimating equations under binomial regression framework. Of 5375 participants screened for O. viverrini over 3years, infection rates were 21.53%, 10.7%, and 4.6% each year, respectively. Out of those, 636 participants responded to questions regarding misconceptions. Results showed that participants who believed in the efficacy of putting lime or red ants in Koi pla (raw fish salad) or eating Koi pla with white whiskey to kill parasites, and early-stage cholangiocarcinoma can be cured, were 41% (ARR, 1.41; 95% CI, 1.03-1.94) and 57% (ARR, 1.57; 95% CI, 1.06-2.33), respectively, more likely to be infected with O. viverrini. Our study confirms that belief in using lime or red ants in Koi pla or eating Koi pla with white whiskey to make it cooked, or early-stage cholangiocarcinoma can be cured, increases O. viverrini infection risk in high-risk populations. Changing health beliefs and eating habits is necessary to reduce O. viverrini infection and its risk to cholangiocarcinoma.

From Pen to Pixels: Enhancing EFL Learners’ Writing Abilities Through the Use of Inquiry-Based Learning and Visual Literacy Model

Writing is one of the most crucial skills for EFL students and also one of the most difficult to acquire. Many students face difficulties when it comes to writing in English. To address this challenge, this study examined whether or not combining inquiry-based learning with visual literacy could enhance EFL students’ writing proficiency in four areas: content, organization, grammatical structures, and vocabulary. An intact group of 20 secondary school students from a private school in northeastern Thailand participated in this mixed-methods study, and data were collected using writing tests, student portfolios, and focus group interviews. Quantitative data were analyzed by means of descriptive and inferential statistics, while qualitative data were analyzed using content analysis. Results of the Wilcoxon signed rank test revealed a significant improvement in students’ writing scores (Z = -3.946*, p < .05) with a medium effect size after implementing the inquiry-based learning with visual literacy model. Qualitative analysis revealed that students actively engaged in the learning process, which helped enhance their writing ability. The study findings suggest that an inquiry-based learning with visual literacy model had a positive impact on EFL students’ writing ability, as evidenced by the improved quality of their written texts. This study contributes to the existing literature on the use of inquiry-based learning to enhance EFL writing ability and emphasizes the importance of visual literacy in promoting student engagement and learning outcomes.

First confirmed parasitism of pleasing fungus beetles (Coleoptera, Erotylidae) by a tropical rhyssine ichneumonid, and first record for Cyrtorhyssa moellerii Bingham (Hymenoptera, Ichneumonidae) from Thailand

The first record of the Darwin wasp, Cyrtorhyssa moellerii Bingham, 1898 (Hymenoptera, Ichneumonoidea, Rhyssinae) from Thailand is presented. Members of both sexes are fully described and illustrated. The biology of C. moellerii, a parasitoid of the pleasing fungus beetle Encaustes opaca Crotch, 1876 (Coleoptera, Erotylidae), is reported for the first time. Hosts were associated with standing deadwood of Anthoshorea henryana (Pierre ex Laness.) P. S. Ashton & J. Heck (Dipterocarpaceae) in dry evergreen forest, Nakhon Ratchasima province, northeastern Thailand. DNA barcodes (cytochrome c oxidase subunit 1 sequence (COI)) were generated for both host and parasitoid and phylogenetic trees constructed for these and other members of the same family and subfamily respectively. A key is provided to separate the three known species of Cyrtorhyssa. This is the first confirmed host record for a tropical species of Rhyssinae as well as the first from Erotylidae.

Characterization of the bacterial microbiota of cattle ticks in northeastern Thailand through 16S rRNA amplicon sequencing

Ticks are vectors of a variety of pathogens that can infect humans and animals. Ticks also harbor non-pathogenic microbiota. This study characterized the microbiota of the ticks infesting beef cattle in Thailand. Two species of ticks; Rhipicephalus microplus (n = 15) and Haemaphysalis bispinosa (n = 5), were collected in seven provinces in northeastern Thailand. Microbial community profile of ticks was examined based on sequences of the V3-V4 region of 16S rRNA gene. Proteobacteria (Pseudomonadota) was the most abundant phylum, followed by Firmicutes (Bacillota), and Actinobacteriota. Coxiella-like endosymbiont was the most abundant bacterial taxon overall (49% of sequence reads), followed by Anaplasma (8.5%), Corynebacterium (5.5%), Ehrlichia (3.9%), and Castellaniella (3.4%). Co-infections of the pathogenic bacteria Ehrlichia and Anaplasma were detected in 19/20 (95%) female ticks. The tick with the lowest number of bacteria had the lowest abundance of the Coxiella-like endosymbiont, and the pathogenic bacteria Anaplasma and Ehrlichia were absent. This study provides baseline information of the microbiota of cattle ticks in northeastern Thailand, suggesting that ticks carry a few dominant bacterial taxa that are primarily non-pathogenic but can co-occur with pathogenic microorganisms. The information obtained is useful for monitoring disease outbreaks in the future and informing prevention and control strategies against cattle tick-borne diseases.

Common but not connected: high genetic structure and cryptic genetic diversity in the ubiquitous biting midge Culicoides peregrinus Kieffer.

The biting midge Culicoides peregrinus Kieffer is a significant pest and vector species, and knowledge of its genetic diversity and genetic structure is critically important for designing an effective control program. However, such information is limited to only small sample-size DNA barcoding studies. Therefore, in this study, we used mitochondrial cytochrome c oxidase I (COI) to examine genetic structure and diversity of C. peregrinus from northeastern Thailand. In addition, we also inferred genetic relationships between C. peregrinus from Thailand and those reported from other countries across the geographic range of the species. Maximum intraspecific genetic divergence (3.83%) within Thai specimens was relatively high compared to other Culicoides species. Genetic structure analysis revealed that 71% (32 from 45) of population comparisons were highly significantly different. A high level of genetic structure among populations, even between those in close geographic proximity (22 km geographic distance) suggested that there has been little or no movement between local populations. This is possibly due to the ability to exploit diverse types of breeding site and a generalist feeding habit which enables C. peregrinus to complete its life cycle within cattle pens. Genetic relationships between Thai C. peregrinus and those reported from other countries revealed three genetically divergent lineages (A, B and C) associated with geographic origins. Specimens from Thailand + China formed lineage A, those from Australia formed lineage B and India + Bangladesh belonged to lineage C. These genetically divergent lineages also agree with morphological variation of the wing pale marking spots. Further investigation using independent genetic loci from nuclear genes will be very useful to resolve taxonomic status of these divergent lineages.

Living in Harmony with the Community’s Nature and Socio-culture: An Ethnography of Healthy Older People in a Northeastern Thai Rural Community

Preparing to enter old age is crucial for accommodating longevity. However, a holistic view of socio-culture and natural environments that influences the healthiness of older people is not clearly explained. This focused ethnographic study was conducted between December 2017 and July 2019 and aimed to describe the healthy ways of life of older people in a rural community of northeastern Thailand (Isan) and the influence of socio-culture and natural environment. Fifteen people 70-87 years old and 15 of the people involved were interviewed in-depth, and focus group interviews, participant observations, and document reviews were also conducted. The study found that healthiness was determined by physical strength and self-reliance and a peaceful mind and happy life. Living in harmony with the community’s nature and socio-culture was the healthy way of life indicated by natural/Isan food, modest physicalactivities, a peaceful life, community participation, and folk/modern health remedies. Their sense of healthiness was influenced by the conversion of the community in a concordant interweaving manner, including the preserved nature in the developed infrastructure,sufficiency/reliance in expanding networks, and spirituality in contemporary viewpoints. Healthy older people benefited from the community development mediated by the younger people. A holistic approach to natural resources and socio-culture with a balance between conservation and development is recommended for developing rural community nursing guidelines to achieve a healthy way of life for older people and others who are aging.

Challenges of Avoiding Congenital Disorders: Experiences of Pregnant Women in Northeastern Thailand

Maternal knowledge and behaviors attempting to prevent or avoid congenital disorders have not reached optimal levels. This qualitative descriptive study describes the challenges of avoiding congenital disorders from the experiences of pregnant women in northeastern Thailand. Data were collected between November 2017 and August 2019 from 18 pregnant women through in-depth interviews and analyzed using thematic analysis. Three themes reflecting challenges emerged. Firstly, ‘traditional beliefs’ were challenging regarding unclear and potential adverse outcomes. Secondly, the challenges of ‘contemporary beliefs’ included distinct views and inaccessible information, characterized as non-apprehension, non-comprehension, non-modernization, or non-precision to preventing congenital disorders. Finally, ‘daily life activities,’ in selectiveness in eating, attainment of mother-child healthiness, and harm avoidance were aimed at both congenital disorder prevention and fetal development promotion. Some significant challenging topics included: vulnerable periods; some taboos; nutrients for brain development; safety in food, working, and environment; concerns with dangers of physical activities, exercise, maternal stress, and medicines; and misperceived benefits of herbal drugs and fetal stimulation. Nursing and midwifery practice guidelines should integrate the concept of congenital disorders prevention into the promotion of fetal development using culturally-sensitive approaches. The found challenges should be overcome and further applied in refining the practice guidelines.

Comparison between RISC II and TRISS in predicting 30-day mortality in primary trauma patients admitted at a university hospital in northeastern Thailand

Comparison between RISC II and TRISS in predicting 30-day mortality in primary trauma patients admitted at a university hospital in northeastern Thailand

Understanding the Interactions of Climate and Land Use Changes with Runoff Components in Spatial-Temporal Dimensions in the Upper Chi Basin, Thailand

Climate and land use changes are major factors affecting runoff in regional basins. Understanding this variation through considering the interactions among hydrological components is an important process for water resource management. This study aimed to assess the variation of future runoff in the Upper Chi Basin, Northeastern Thailand. The QSWAT hydrological model was integrated into three CMIP6 GCMs—ACCESS-CM2, MIROC6, and MPI-ESM1-2-LR—under SSP245 and SSP585 scenarios for the period 2023–2100. The Land Change Modeler (LCM) was also used for future land use simulation. The results revealed that the future average long-term precipitation and temperature tended to increase while forest land tended to decrease and be replaced by sugarcane plantations. The accuracy assessment of the baseline year runoff calculation using QSWAT for the period 1997–2022 showed an acceptable result, as can be seen from the R2, NSE, RSR, and PBIAS indices. This result could lead to the temporal and spatial simulation of future runoff. Likewise, the runoff of the two SSP scenarios tended to increase consecutively, especially in the SSP585 scenario. In addition, in cases of long-term spatial changes in the subbasins scale, over 90% of the area—from upstream to the outlet point—tended to be higher due to two major factors; namely, future increased precipitation and changes in cultivation, which would be influential to groundwater and interflow components, respectively. The methodology and result of this study can be useful to stakeholders in understanding changes in hydrological systems so that they can apply it to developing a strategy for water resource management and to handling factors affecting different dimensions properly and sustainably.

Nutritional Security: Carbohydrate Profile and Folk Remedies of Rare Edible Mushrooms to Diversify Food and Diet: Thailand Case Study

The aim of this study was to explore the current knowledge and practice of agrobiodiversity to improve nutrition and health. The study focused on wild mushrooms commonly consumed in Northeastern Thailand in terms of ecology, cooking and preservation methods, and folk remedies. The monosaccharide, sugar alcohol, glucan, and carbohydrate polymer content and the glycemic index of these wild mushrooms were determined using the enzymatic method. The mushrooms collected belonged to three biological groups and were mostly saprotrophic and symbiotic. The most abundant mushrooms were Amanita, Boletus, and Russula, followed by Calostoma sp., Astraeus asiaticus C. Phosri, and Astraeus odoratus C. Phosri. Wild edible mushrooms can be used for food and medicinal purposes. Cooking methods utilized in the area consist of steaming, boiling, and grilling. Glucose was the major monosaccharide detected in all mushroom samples. Xylitol and inositol were found in all mushroom samples, while some contained mannitol and arabitol. Glucan was present in all mushroom samples, ranging from 8.03 to 31.1 mg/g DW. All mushrooms were classified as having a low glycemic index. These findings provide important information to potentially enhance and promote the utilization of wild mushrooms to improve the accessibility, availability, and sustainability of nutritious food.

“Failure to control blood sugar” experiences of persons with type 2 diabetes mellitus

ObjectivesThis study aimed to explore the experiences of persons with type 2 diabetes mellitus having poor glycemic control. MethodsA narrative qualitative study was conducted. Eight participants were recruited at a hospital’s primary care unit (PCU) in northeastern Thailand from October to December 2021. The data was collected using in-depth interviews, field notes, and non-participatory observation. It was then analyzed based on the thematic analysis guide of Braun & Clarke (2006). ResultsThe results revealed four main themes and eight sub-themes: lifestyle practice (inappropriate eating behaviors, taking diabetes drugs irregularly, exercising irregularly); perception of self-care (misperceptions about self-care practices, diabetes was a genetic disease and therefore had to be accepted); awareness regarding complications (not being aware of glycemic control, issues with social gatherings); stress from socioeconomic issues (feeling stressed in daily life). ConclusionsIt is the role of healthcare professionals to stress the importance of healthy behaviors to improve glycemic control in terms of diet, exercise, medication use, perception, awareness, culture, and beliefs. The study results could aid healthcare providers in developing innovations in nursing care or interventions to change unhealthy behaviors.

Compatibility systems and pollinator dependency in morning glory species (Convolvulaceae)

BackgroundThe Convolvulaceae is a large family containing species exhibiting a range of breeding systems and pollinated by diverse animal taxa. We studied the pollination ecology of 15 Convolvulaceae species, representing seven genera (Argyreia Lour., Camonea Raf., Evolvulus L., Hewittia Wight & Arn., Ipomoea L., Merremia Dennst. ex Endl., and Operculina Silva Manso), in northeastern Thailand, a family that is highly diverse yet understudied in the paleotropics. Specifically, we studied their compatibility systems and degrees of pollinator dependency using pollination experiments, examined pollinator composition and visitation rates using video observation, and determined if there is an association between pollinator visitation rates and degree of pollinator dependence.ResultsOur results showed that most species are self-compatible, but the degree of pollinator dependence varies. Six species were found to be highly dependent on pollinators, as two are self-incompatible and four are self-compatible but had reduced seed set when pollinators were excluded, possibly due to herkogamy. Seven species showed low dependence on pollinators and seed set remained high when pollinators were excluded. Pollinator dependence was inconclusive for two species as seed set was low in all pollination treatments. We also found an association between pollinator visitation rates and degree of pollinator dependence. Specifically, species exhibiting high pollinator dependence received frequent visits from pollinators, while species exhibiting low pollinator dependence either received frequent visits from pollinators (and received high amounts of xenogamous pollen) or infrequent visits from pollinators (and received significantly lower amounts of xenogamous pollen). Most of our study species were primarily visited by bees (e.g., Lasioglossum, Amegilla, Apis, and meliponines), with the exception of one night-blooming species that was visited primarily by crepuscular butterflies and hawkmoths.ConclusionsThe cumulative findings of this study demonstrate how pollinator dependence is influenced by breeding system, and suggest that pollinator visitation is consistently high for species exhibiting high pollinator dependence but varies across species exhibiting low pollinator dependence. Our findings are also important for assessing the conservation risks of paleotropical Convolvulaceae.