Quantum chaos for nonstandard symmetry classes in the Feingold-Peres model of coupled tops

We consider two coupled quantum tops with angular momentum vectors $\mathbf{L}$ and $\mathbf{M}$. The coupling Hamiltonian defines the Feinberg-Peres model which is a known paradigm of quantum chaos. We show that this model has a nonstandard symmetry with respect to the Altland-Zirnbauer tenfold symmetry classification of quantum systems which extends the well-known threefold way of Wigner and Dyson (referred to as `standard' symmetry classes here). We identify that the nonstandard symmetry classes BD$I_0$ (chiral orthogonal class with no zero modes), BD$I_1$ (chiral orthogonal class with one zero mode) and C$I$ (antichiral orthogonal class) as well as the standard symmetry class A$I$ (orthogonal class). We numerically analyze the specific spectral quantum signatures of chaos related to the nonstandard symmetries. In the microscopic density of states and in the distribution of the lowest positive energy eigenvalue we show that the Feinberg-Peres model follows the predictions of the Gaussian ensembles of random-matrix theory in the appropriate symmetry class if the corresponding classical dynamics is chaotic. In a crossover to mixed and near-integrable classical dynamics we show that these signatures disappear or strongly change.Comment: 15 page

Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand.

BACKGROUND: Within the sphere of diabetes self-management, much emphasis has been placed on medication adherence. There has been a shift in thinking about medication adherence, moving from "compliance" and historically paternalistic models of care, to seeking better ways of characterizing dynamic and complex relationships that determine medication adherence and diabetes control. This study sought to understand the relationship between patient's attitudes and medication adherence for oral anti-diabetics in Thailand. METHODS: In-depth interviews of patients with type 2 diabetes mellitus, taking oral anti-diabetic drugs, at the out-patient clinic run by the Department of Family Medicine, Chiang Mai University between May and December 2016. Thematic analysis followed the WHO framework for medication adherence in chronic disease to explore patient's attitudes and their influence on medication compliance. RESULTS: Of 24 patients, 9 were men. The mean age was 62 years (SD 8.9 years). 67% had high compliance. Four themes were identified as important factors related to medication adherence: attitudes toward disease, attitudes toward treatment, attitudes toward family support and attitudes toward health care team. Specifically, symptoms at diagnosis, understanding and acceptance in taking medication, the presence of family support and the perception of concern by the doctor relate to improved medication compliance. CONCLUSIONS: Medication adherence in Thai patients with diabetes requires support from both the health care providers and the family. The patient's perception of the doctor's concern creates greater patient trust in the health care team. This trust, along with family support, helps deepen patients' understanding of the disease, accept the chronic nature of their disease, and engenders a positive attitude towards taking medication that can improve medication adherence

Cannabis and Kratom online information in Thailand: Facebook trends 2015–2016

Abstract Background Our study aims to evaluate the trends in online information about cannabis and kratom on Facebook in Thailand, where there is current discussion regarding legalizing these drugs. Methods Between April and November 2015, reviewers searched for cannabis and kratom Facebook pages in the Thai language via the common search engines. Content analysis was performed and the contents of each page were categorized by the tone of the post (positive, negative or neutral). Then, a one-year follow-up search was conducted to compare the contents. Results Twelve Facebook pages each were initially identified for cannabis and for kratom. Follower numbers were higher for cannabis pages. Kratom pages were less active but were open for a longer time. Posts with positive tones and neutral tones were found for both drugs, but none had negative tones. Other drugs were mentioned on the cannabis pages, but they were different from those mentioned on the kratom pages. Issues regarding drug legalization were found on the cannabis pages but not on the kratom pages during the searching period. One year later, the tone of the posts was in the same direction, but the page activity had increased. Conclusions The information currently available on the sampled Facebook pages was positive towards the use of cannabis and kratom. No information about harm from these drugs was found through our search

Is the Association between Herbal Use and Blood-Pressure Control Mediated by Medication Adherence? A Cross-Sectional Study in Primary Care

Herbs have been used worldwide for many health conditions as an alternative treatment, including hypertension. Their use might affect the use of conventional medications, as well as blood-pressure control. This study aims to determine whether the potential associations between herb use and high blood pressure in hypertensive patients was mediated by medication adherence. A cross-sectional study was conducted using questionnaires and available medical databases at a primary care clinic of a tertiary hospital in Chiang Mai, Thailand. The data were collected from 450 patients with essential hypertension. Drug adherence was assessed by the Morisky Green Levine Medication Adherence Scale. The history of herbs used in the past three months was obtained. The goal of controlled blood pressure was defined in accordance with the Thai guidelines on the treatment of hypertension. Of the total 450 patients, 42% had high adherence. Nearly 18% reported herb use in the past three months. High medication adherence was strongly associated with blood-pressure control when adjusted for age, gender, education, the presence of comorbidities, and herb use (aOR 26.73; 95% CI 8.58–83.23; p < 0.001). The association between herb use and blood-pressure control did not achieve statistical significance (p = 0.143). However, the adjusted odds ratio of the association between herb use and blood-pressure control was diluted from 0.67 to 0.83 when adding the factor of medication adherence to the model. In conclusion, herb use was associated with poor medication adherence, which was in turn associated with poor blood-pressure control. Assessing this information contributes to appropriate exploration and counseling

Learning styles and academic achievement among undergraduate medical students in Thailand

Purpose: This study aimed to explore the associations between learning styles and high academic achievement and to ascertain whether the factors associated with high academic achievement differed between preclinical and clinical students. Methods: A survey was conducted among undergraduate medical students in Chiang Mai University, Thailand. The Index of Learning Styles questionnaire was used to assess each student’s learning style across four domains. High academic achievement was defined as a grade point average of at least 3.0. Results: Of the 1,248 eligible medical students, 1,014 (81.3%) participated. Learning styles differed between the preclinical and clinical students in the active/reflective domain. A sequential learning style was associated with high academic achievement in both preclinical and clinical students. A reflective learning style was only associated with high academic achievement among preclinical students. Conclusion: The association between learning styles and academic achievement may have differed between preclinical and clinical students due to different learning content and teaching methods. Students should be encouraged to be flexible in their own learning styles in order to engage successfully with various and changing teaching methods across the curriculum. Instructors should be also encouraged to provide a variety of teaching materials and resources to suit different learning styles

Oekologisch orientierte Raumplanung

TIB: RN 5044 (98) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Associations between Family Functioning and Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD): A Cross-Sectional Study

Poor family functioning is linked with poor child ADHD symptoms. However, there are many dimensions of family functioning. Thus, this study aims to find the association between each dimension of family functioning and controlled ADHD symptoms in an Asian culture. This cross-sectional study involved caregivers of 113 Thai children with ADHD ages 4–16 years old who visited the Outpatient Department at Maharaj Nakorn Chiang Mai Hospital between October 2017 and March 2018. The caregivers completed the Chulalongkorn Family Inventory and the SNAP-IV Thai version. Logistic regression was used to examine each dimension of family functioning adjusting for potential confounders. In univariate analyses, six of the seven dimensions of family functioning were associated with controlled ADHD symptoms. In multivariate analyses, findings revealed that good family roles (aOR 7.48, 95% CI = 1.56 to 35.85, p = 0.01) and behavior control (aOR 2.56, 95% CI = 1.08 to 6.03, p = 0.03) were associated with controlled ADHD symptoms. In children with ADHD with poor symptom control, the assessment of family functioning could be helpful. Developing a more specific intervention for caregivers that promotes good family roles and behavioral control may be beneficial

Health-Risk Behaviours and Injuries among Youth and Young Adults in Chiang Mai, Thailand: A Population-Based Survey

This study aimed to identify the prevalence of health-risk behaviours (alcohol use, tobacco smoking and gambling) and the associations between health-risk behaviours and injuries among youth (15–24 years) and young adults (25–39 years). A multi-stage cluster sampling survey was conducted in Chiang Mai, Thailand. The associations between health-risk behaviours and injuries were analysed using logistic regression and adjusted for potential confounders. Sample weights were applied in all analyses. Six-hundred-and-thirty participants were included. Fifty-three percent of males and 12.3% of females drank in the past three months. Smoking in the past three months was higher among males (38.5%) than females (0.7%). About a quarter of men and a fifth of the women had gambled in the past year. A total of 6.4% of males and 4.8% of females sought medical attention in the past year due to injuries. Compared to those without any of the three health-risk behaviours, the odds ratio for injuries requiring medical attention was 3.81 (95% CI: 1.33 to 10.90, p = 0.013) for those with two health-risk behaviours and 13.8 (95% CI: 4.24 to 45.10, p < 0.001) for those with all three health-risk behaviours. Injury prevention policies may need to incorporate interventions designed to assess multiple health-risk behaviours

Including undocumented migrants in universal health coverage: a maternal health case study from the Thailand-Myanmar border

Background Many countries aspiring to achieve universal health coverage struggle with how to ensure health coverage for undocumented migrants. Using a case study of maternal health care in a Thailand-Myanmar border region this article explores coverage for migrants, service provision challenges and the contribution of a voluntary health insurance program. Methods In 2018 we interviewed 18 key informants who provided, oversaw or contributed to maternal healthcare services for migrant women in the border region of Tak province, Thailand. Results In this region, we found that public and non-profit providers helped increase healthcare coverage beyond undocumented migrants’ official entitlements. Interview participants explained that Free and low-cost antenatal care (ANC) is provided to undocumented migrants through migrant specific clinics, outreach programs and health posts. Hospitals offer emergency birth care, although uninsured migrant patients are subsequently billed for the services. Care providers identified sustainability, institutional debt from unpaid obstetric hospital bills, cross border logistical difficulties and the late arrival of patients requiring emergency lifesaving interventions as challenges when providing care to undocumented migrants. An insurance fund was developed to provide coverage for costly emergency interventions at Thai government hospitals. The insurance fund, along with existing free and low-cost services, helped increase population coverage, range of services and financial protection for undocumented migrants. Conclusions This case study offers considerations for extending health coverage to undocumented populations. Non-profit insurance funds can help to improve healthcare entitlements, provide financial protection and reduce service providers’ debt. However, there are limits to programs that offer voluntary coverage for undocumented migrants. High costs associated with emergency interventions along with gaps in insurance coverage challenge the sustainability for NGO, non-profit and government health providers and may be financially disastrous for patients. Finally, in international border regions with high mobility, it may be valuable to implement and strengthen cross border referrals and health insurance for migrants

Is Electronic Health Literacy Associated with Learning Outcomes among Medical Students in the First Clinical Year?: A Cross-Sectional Study

Medical students tend to use the internet as a primary resource when seeking health information. This study aims to assess the patterns of internet use, eHL level, and learning outcomes with eHL among medical students at Chiang Mai University. A cross-sectional study was conducted among 88 medical students in the first clinical year. The eHL level was determined using the Thai version of the electronic Health Literacy Scale or eHEALS. The patient case report scores were obtained representing the learning outcome. Linear regression was used to identify factors influencing their eHL level and case report scores. Students recognized the importance and usefulness of the internet. The mean eHEALS score was 33.45. There was a lower degree of agreement on questions regarding internet usage, having skills to evaluate the resources, and confidence in using health information to make health decisions. The eHEALS score had no statistically significant association with most variables and case report scores, but with the longer time of internet use (p-value = 0.014). Although medical students perceived that they have high eHL levels, they report lower confidence in using the information. Including critical thinking skills for electronic health information in the medical curriculum could be useful