Mahidol University's Institutional Repository
คลังสารสนเทศสถาบันของมหาวิทยาลัยมหิดล
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To collect Mahidol University's academic publications and intellectual properties more than 39 faculties
To present over 50,000 items of information in digital formats
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Recent Submissions
Spatial Green Space Assessment in Suburbia: Implications for Urban Development
(2024) Sura Pattanakiat; Sirasit Vongvassana; Thamarat Phutthai; Pisut Nakmuenwai; Theerawut Chiyanon; Voravart Ratanadilok Na Bhuket; Thunyapat Sattraburut; Pathomphot Chinsawadphan; Kajornsak Khincharung
Nonthaburi, a suburban province adjacent to the Bangkok Metropolis, has experienced a reduction in green spaces due to urban expansion. This study quantified Nonthaburi’s green space through visual interpretation of land use and land cover (LULC) using THEOS and Sentinel-2. Areas of green space were extracted using remote sensing indices and pixel-based classification based on THEOS. The extracted green area was then integrated with the existing LULC patterns to align with the green space characteristic established by Thailand’s Office of Natural Resource and Environmental Policy and Planning. This includes public services, functional utility, median strips, community economics, fallow, and natural green space. The analysis of green space management and planning utilized the Urban Green Space Index (UGSI), Per Capita Green Space (PCGS), and accessibility to public green space. The results revealed that Nonthaburi comprises a green space area of 465.29 km2 or 73.06%, exhibiting a higher prevalence within its western region while displaying a relatively lower extent in the urban zone adjacent to the Bangkok Metropolis. The per capita green space is 367.71 m2 but decreases to 255.82 m2 when accounting for the latent population, meaning it still meets the World Health Organization (WHO) criteria. Currently, only six parks (single and clusters) meet the criteria for public green space. Additionally, both fallow and median strip green spaces (at road interchanges) need to be considered for their potential use in new public service. Furthermore, very high-resolution imagery from unmanned aerial vehicles (UAVs) should be used for green space planning by the organization.
Factors in Community Adaptation for Climate Change Mitigation in Thailand
(2024) Tipmol Traiyut; Patranit Srijuntrapun; Wee Rawang
This study reflects the experiences of communities who have adapted to climate change in three different geological locations in the country of Thailand: by the riverside, coast, and in the mountains. The communities presented the lessons learned and identified key adaptation factors. The study used in-depth interviews and focus group discussions, with results showing that the community’s learning and adaptation to climate change were at a high level. The results broaden understanding of climate change in these locations and provide information for resource management approaches. Among the seven factors, five factors illustrated that they were highly adapted, including: (1) applying knowledge about nature, ecosystems, and traditional wisdom; (2) management that allowed the use of adaptations; (3) a shared vision of success; (4) collaboration; and (5) having a variety of options and approaches. Two factors that illustated that the community was only moderately adapted included: (1) learning about violent events and disasters; and (2) following government guidelines. It was found that a lack of information about the ecosystems and environmental resources they required for large-scale infrastructure construction caused issues. This is a problem, and the government must consult with local communities when setting long-term plans and assessing needs, because communities have diverse livelihoods and depend on natural resources. Hence, future studies should include climate change awareness and understanding of what is required by adding community needs linked to climate change adaptation into state development plans as well as utilizing the wisdom and traditional knowledge involving ecology held by these communities into sustainability plans.
Safety of leadless versus transvenous pacemakers in patients with low body surface area: a matched-pair analysis
(2026-12-01) Apiyasawat S.; Soontornmanokati N.; Ngarmukos T.; Methachittiphan N.; Apiyasawat S.; Mahidol University
Background: Leadless pacemakers (LPs) avoid lead- and pocket-related issues but require large venous access, which raises safety concerns in patients with a small body surface area (BSA), particularly in Asian populations. We defined low BSA as < 1.46 m², based on validated 3D-derived anthropometric standards for Chinese adults. Objective: To assess procedural complication rates of LP implantation in patients with low BSA. Methods: We analyzed LP implantations from 2016 to 2025 at a single center in Thailand. Of 59 patients, 25 (42.4%) had low BSA. We conducted two comparisons: (1) low- vs. normal/high-BSA LP patients and (2) low-BSA LP patients with a 1:2 age-, sex-, and BSA-matched transvenous pacemaker (TVP) cohort. The primary outcome was major device-related complications. Results: LP patients were elderly (median 79 years) with high comorbidity (median Charlson Comorbidity Index [CCI], 7.0). In the matched analysis, low-BSA LP patients had a significantly higher comorbidity burden than TVP controls (median CCI, 7.0 vs. 5.0; P = 0.002). The 3.8-year cumulative incidence of major complications did not differ between low- vs. normal/high-BSA LP patients (8.0% vs. 8.8%, P = 0.39) and between low-BSA LP patients vs. matched TVP controls (8.0% vs. 14.0%, P = 0.91). Adjusted analyses revealed no significant association between device type and complications, although the confidence intervals were wide. Conclusion: In this exploratory analysis, patients with low-BSA showed no increased risk of major complications following LP implantation. However, given the small sample size and pronounced selection bias, these findings should be interpreted with caution.
Assessing the operational effectiveness of village health volunteers in Thailand: A structural equation modeling analysis
(2025-12-30) Ounprasertsuk J.; Wannapaschaiyong P.; Tipwong A.; Ounprasertsuk J.; Mahidol University
Background: Village health volunteers (VHVs) play an essential role in Thailand’s primary healthcare system by promoting health, preventing diseases, and ensuring community wellbeing. However, their operational effectiveness is influenced by several key factors, including transformational leadership, employee commitment, and job satisfaction. This study investigates these relationships and their implications for sustainable community health systems. Methods: A mixed-methods approach was utilized, combining quantitative data from 280 VHVs across Thailand’s lower central region with qualitative insights gained from focus group discussions (FGDs). Structural Equation Modeling was employed to evaluate the relationships among transformationalleadership, employeecommitment, jobsatisfaction, andoperational effectiveness. Results: The findings reveal that transformational leadership significantly predicted employee commitment (β= 0.80, P< 0.001) and job satisfaction (β = 0.65, P< 0.001). Operational effectiveness was significantly predicted by employee commitment (β= 0.49, P< 0.001), transformational leadership (β = 0.26, P < 0.001), and job satisfaction (β= 0.13, P = 0.04). Together, these variables explained 68.0% of the variance in operational effectiveness. A new model termed T-E-J Performance (where T =Transformational Leadership, E = Employee Commitment, and J = Job Satisfaction) has been developed to guide strategic improvements. Conclusion: To sustain effective community health programs, it is vital to enhance leadership capabilities, improve job satisfaction, and foster commitment among VHVs. These findings offer actionable insights for policymakers to create leadership training programs, enhance incentives, and implement strategies for workforce retention. Strengthening VHV systems can significantly contribute to sustainable healthcare delivery and health equity in Thailand.
Risk, burden, and trend of infectious disease hospitalisations associated with floods: a multicountry, time-series study
(2026-01-01) Yang Z.; Huang W.; McKenzie J.E.; Xu R.; Yu P.; Chen G.; Yu W.; Wu Y.; Liu Y.; Wen B.; Hales S.; Lavigne E.; Ye T.; Zhang Y.; Coelho M.d.S.Z.S.; Matus P.; Tantrakarnapa K.; Kliengchuay W.; Saldiva P.H.N.; Zhou S.; Xu Z.; Ju K.; Zhang Y.; Guo Y.; Li S.; Yang Z.; Mahidol University
BACKGROUND: Infectious disease outbreak is one of the most concerning issues in the aftermath of floods. However, knowledge gaps exist in the risk, burden, and trend of infectious disease hospitalisation associated with floods. Therefore, we aimed to quantify the risks, burden, and temporal changes of infectious disease hospitalisations associated with flood exposure during 2000-19. METHODS: In this multicountry, time-series study, hospitalisation data for all communities in Australia, Brazil, Canada, Chile, New Zealand, and Thailand from Jan 1, 2000, to Dec 31, 2019, were collected from local authorities of each country. We retrieved flood events data from the Dartmouth Flood Observatory. Meteorological, population, and gross domestic product data were collected from the European Centre for Medium-Range Weather Forecasts Reanalysis version 5, Landscan, and a previous study. Associations between flood exposure and weekly hospitalisation risks were estimated using a two-stage analytical approach. To examine temporal changes in the associations and the corresponding burden, we estimated relative risks (RRs) and excess rates of hospitalisations from infectious diseases that were attributable to floods for the communities in each country in two periods (2000-09 and 2010-19) using the two-stage analytical approach. FINDINGS: 27 million infectious disease hospitalisation records from 709 communities were included in the analysis. Hospitalisation risks of all-cause infectious, foodborne and waterborne diseases, airborne diseases, skin and mucous-membrane infections, and sexually transmitted infections increased for up to 26 weeks following flood exposure. For each 1-week flood exposure, the associated RR (mean across 26 weeks) after flood exposure was 1·006 (95% CI 1·002-1·009) for all-cause infectious diseases, 1·008 (1·003-1·012) for foodborne and waterborne diseases, 1·004 (1·001-1·008) for airborne diseases, 1·010 (1·005-1·015) for skin and mucous-membrane infections, and 1·032 (1·025-1·039) for sexually transmitted infections. Changes in RRs were observed between 2000-09 and 2010-19 across countries. In 2010-19, the excess rate of all-cause infectious disease hospitalisations was the highest in Australia, which was 150·0 (95% empirical CI 115·8-183·2) admissions per million person-years. INTERPRETATION: Flood exposure was associated with increased hospitalisation risks for foodborne and waterborne diseases, airborne diseases, skin and mucous-membrane infections, and sexually transmitted infections, lasting for up to 26 weeks after flooding. With the projected increases in severity, duration, and frequency of floods under climate change, greater efforts are warranted to review and improve the current adaptation strategies, disaster response protocols, health system resilience, and disease surveillance systems. FUNDING: Australian Research Council, Australian National Health and Medical Research Council, National Research Council of Thailand.