93 results
Search Results
Now showing 1 - 10 of 93
Publication Open Access Modelling malaria elimination on the internet(2011-07-14) Maude, Richard J.; Sompob Saralamba; สมภพ ศรลัมพ์; Lewis, Adrian; Sherwood, Dean; White, Nicholas J.; Day, Nicholas P.J.; Dondorp, Arjen M.; White, Lisa J.; Maude, Richard J.; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unitof policymakers in its development. There is thus an urgent need for user-friendly and accessible models purpose-designed in collaboration with policymakers to answer pertinent questions arising from the field. RESULTS: An internet site is presented with a simple.... CONCLUSIONS: By collaboration with end users, iterative development of mathematical models of malaria elimination through this internet platform will maximize its potential as an educational and public health policy planning tool. It will also assistPublication Open Access World Antimalarial Resistance Network (WARN) IV: clinical pharmacology(2007-09-06) Barnes, Karen I.; Lindegardh, Niklas; Ogundahunsi, Olumide; Olliaro, Piero; Plowe, Christopher V.; Randrianarivelojosia, Milijaona; Gbotosho, Grace O; Watkins, William M.; Sibley, Carol H.; White, Nicholas J.; Barnes, Karen I.; Mahidol University. Faculty of Tropical Medicine. Mahidol Oxford Tropical Medicine Research Unit (MORU).A World Antimalarial Resistance Network (WARN) database has the potential to improve the treatment of malaria, through informing current drug selection and use and providing a prompt warning of when treatment policies need changing. This manuscript outlines the contribution and structure of the clinical pharmacology component of this database. The determinants of treatment response are multi-factorial, but clearly providing adequate blood concentrations is pivotal to curing malaria. The ability of available antimalarial pharmacokinetic data to inform optimal dosing is constrained by the small number of patients studied, with even fewer (if any) studies conducted in the most vulnerable populations. There are even less data relating blood concentration data to the therapeutic response (pharmacodynamics). By pooling all available pharmacokinetic data, while paying careful attention to the analytical methodologies used, the limitations of small (and thus underpowered) individual studies may be overcome and factors that contribute to inter-individual variability in pharmacokinetic parameters defined. Key variables for pharmacokinetic studies are defined in terms of patient (or study subject) characteristics, the formulation and route of administration of the antimalarial studied, the sampling and assay methodology, and the approach taken to data analysis. Better defining these information needs and criteria of acceptability of pharmacokinetic-pharmacodynamic (PK-PD) studies should contribute to improving the quantity, relevance and quality of these studies. A better understanding of the pharmacokinetic properties of antimalarials and a more clear definition of what constitutes "therapeutic drug levels" would allow more precise use of the term "antimalarial resistance", as it would indicate when treatment failure is not caused by intrinsic parasite resistance but is instead the result of inadequate drug levels. The clinical pharmacology component of the WARN database can play a pivotal role in monitoring accurately for true antimalarial drug resistance and promptly correcting sub-optimal dosage regimens to prevent these contributing to the emergence and spread of antimalarial resistance.Publication Open Access Application of mobile-technology for disease and treatment monitoring of malaria in the "Better Border Healthcare Programme"(2010-08) Pongthep Meankaew; พงษ์เทพ เมียนแก้ว; Jaranit Kaewkungwal; จรณิต แก้วกังวาล; Amnat Khamsiriwatchara; อำนาจ คำศิริวัชรา; Podjadeach Khunthong; พจเดช ขุนทอง; Pratap Singhasivanon; ประตาป สิงหศิวานนท์; Wichai Satimai; Jaranit Kaewkungwal; Mahidol University. Faculty of Tropical Medicine. Department of Tropical HygieneBACKGROUND: The main objective of this study was to assess the effectiveness of integrating the use of cell-phones into a routine malaria prevention and control programme, to improve the management of malaria cases among an under-served population in a border area. The module for disease and treatment monitoring of malaria (DTMM) consisted of case investigation and case follow-up for treatment compliance and patients' symptoms. METHODS: The module combining web-based and mobile technologies was developed as a proof of concept, in an attempt to replace the existing manual, paper-based activities that malaria staff used in treating and caring for malaria patients in the villages for which they were responsible. After a patient was detected and registered onto the system, case-investigation and treatment details were recorded into the malaria database. A follow-up schedule was generated, and the patient's status was updated when the malaria staff conducted their routine home visits, using mobile phones loaded with the follow-up application module. The module also generated text and graph messages for a summary of malaria cases and basic statistics, and automatically fed to predetermined malaria personnel for situation analysis. Following standard public-health practices, access to the patient database was strictly limited to authorized personnel in charge of patient case management. RESULTS: The DTMM module was developed and implemented at the trial site in late November 2008, and was fully functioning in 2009. The system captured 534 malaria patients in 2009. Compared to paper-based data in 2004-2008, the mobile-phone-based case follow-up rates by malaria staff improved significantly. The follow-up rates for both Thai and migrant patients were about 94-99% on Day 7 (Plasmodium falciparum) and Day 14 (Plasmodium vivax) and maintained at 84-93% on Day 90. Adherence to anti-malarial drug therapy, based on self-reporting, showed high completion rate for P. falciparum-infected cases, but lower rate for P. vivax cases. Patients' symptoms were captured onto the mobile phone during each follow-up visit, either during the home visit or at Malaria Clinic; most patients had headache, muscle pain, and fatigue, and some had fever within the first follow-up day (day 7/14) after the first anti-malarial drug dose. CONCLUSIONS: The module was successfully integrated and functioned as part of the malaria prevention and control programme. Despite the bias inherent in sensitizing malaria workers to perform active case follow-up using the mobile device, the study proved for its feasibility and the extent to which community healthcare personnel in the low resource settings could potentially utilize it efficiently to perform routine duties, even in remote areas. The DTMM has been modified and is currently functioning in seven provinces in a project supported by the WHO and the Bill & Melinda Gates Foundation, to contain multi-drug resistant malaria on the Thai-Cambodian border.Publication Open Access Factors affecting computer game addiction and mental health of male adolescents in Mueang District, Si Sa Ket Province(2008) Supaket, P; Munsawaengsub, C; Chokchai Munsawaengsub; Nanthamongkolchai, S; Sutham Nanthamongkolchai; Apinuntavech, S; โชคชัย หมั่นแสวงทรัพย์; สุธรรม นันทมงคลชัยnot. The factors with a statistically significant (p-value < 0.05) effect on the computer game addicted were the availability of Internet-connected PCs in house and the inclination of friends. Those adolescents with home internet had a 2.3 times higher chance... of being addicted than those without home internet and those with higher friend inclination had a 2.2 times higher chance of being addicted than those with lower friend inclination. On the mental health status of the male adolescents, the study revealedPublication Open Access Oral health literacy among mothers of pre-school children.(2014-09) Tippanart Vichayanrat; ทิพนาถ วิชญาณรัตน์; Tashsamon Sittipasoppon; Thanatporn Rujiraphan; Napas Meeprasert; Pattareeya Kaveepansakol; Yonlada Atamasirikun; Tippanart Vichayanrat; ทิพนาถ วิชญาณรัตน์; Mahidol University. Faculty of Dentistry. Department of Community DentistryObjectives: The aim of this study was to develop and validate a new oral health literacy test for Thai mothers. This study also examined the relationship among oral health literacy, oral health knowledge, socioeconomic factors and pre-school children’s oral health status. Materials and methods: The oral health literacy (OHL) test was developed to measure 3 aspects, which were basic/functional, communicative, and critical OHL. Mothers who brought their 2-6 years old children to the Pediatric Dental Clinic at Faculty of Dentistry, Mahidol University were invited to answer a self-administered questionnaire, which consisted of socio-demographic information and oral health knowledge (OHK), and OHL test. Caries status was collected from children’s dental records. Factor analysis was used to analyze a construct validity of the OHL test. Cronbach’s alpha was utilized to evaluate the internal consistency reliability of the test. Binary logistic regression was used to analyze the relationships among caries status, OHL scores, OHK, and socio-demographic variables. Results: The factor analysis extracted 4 components instead of 3 originally proposed in questionnaire, which suggested addressing the ‘searching and using information’ OHL aspect. The 25-item OHL test showed acceptable reliability (Cronbach’s alpha = 0.76). Mothers who correctly answered OHK items had significantly higher OHL scores, except the knowledge of cariogenic food. Less than 50 percents of mothers correctly understood the words ‘periodontal disease’, ‘root canal treatment’, ‘mottled tooth’, ‘scaling’, ‘bridges’, and ‘plaque’ (in Thai). Significant factors associated with children’s caries status were mother’s education (OR=9.1, 95% CI: 1.16-71.65), and OHL score (OR= 0.87, 95% CI: 0.76-0.98). Conclusion: The newly developed OHL test had acceptable validity and reliability to measure various aspects of oral health literacy. Mother’s education and oral health literacy were significant predictors to their children’ s caries status. This study reveals the complexity of OHL and help gaining the understanding of caregivers OHL in relation to knowledge and social variables.Publication Open Access การสังเคราะห์ข้อเสนอเพื่อพัฒนาการนวดไทย มุ่งสู่มาตรฐานองค์การอนามัยโลก(2561) วันวิสาข์ ศรีสุเมธชัย; มลินี สมภพเจริญ; Vanvisa Sresumatchai; Malinee Sompopcharoen; มหาวิทยาลัยมหิดล. คณะสาธารณสุขศาสตร์. ภาควิชาชีวสถิติ; มหาวิทยาลัยมหิดล. คณะสาธารณสุขศาสตร์. ภาควิชาสุขศึกษาและพฤติกรรมศาสตร์The purpose of this study is to provide synthesis of proposals for benchmarks development of Nuad Thai toward World Health Organization’s standard. This study is a documentary review, through internet for the position of Thai masseur globally... of Thai Traditional and Alternative Medicine, Ministry of Public Health, Thailand, develops Nuad Thai for Therapy, in the form of 3 types of training. Nuad Thai type 1 consists of 400 hours, Nuad Thai type 2 and 3 consist of 1,000 hours, with standardPublication Open Access ประสบการณ์ และการเตรียมความพร้อมในภาวะภัยพิบัติน้ำท่วมของผู้ป่วยเรื้อรังและญาติผู้ดูแลในประเทศไทย(2558) จงจิต เสน่หา; Chongjit Saneha; วันเพ็ญ ภิญโญภาสกุล; Wanpen Pinyopasakul; วาสินี ชาญศรี; Wasinee Charnsri; มหาวิทยาลัยมหิดล. คณะพยาบาลศาสตร์; มหาวิทยาลัยมหิดล. คณะแพทยศาสตร์ศิริราชพยาบาลวัตถุประสงค์: ศึกษาประสบการณ์ผู้ป่วยเรื้อรังและญาติผู้ดูแลระหว่างภาวะภัยพิบัติน้ำท่วม การเตรียมความพร้อมในภาวะน้ำท่วมที่ผ่านมา และการเตรียมความพร้อมในภาวะภัยพิบัติน้ำท่วมในอนาคต รูปแบบการวิจัย: การวิจัยด้วยวิธีผสมผสานเชิงปริมาณและเชิงคุณภาพ วิธีดำเนินการวิจัย: กลุ่มตัวอย่างเป็นผู้ป่วยเรื้อรังที่เป็นโรคเบาหวานและหรือความดันโลหิตสูงจำนวน 30 คน และ ญาติผู้ดููแล 30 คน อาศัยใน 2 ชุมชนเมืองในประเทศไทย เก็บข้อมูลระหว่างเดือน กรกฏาคม ถึง ตุลาคม พ.ศ. 2556 เก็บข้อมูลโดยใช้แบบสอบถามข้อมูลส่วนบุคล แบบสอบถามการเตรียมความพร้อมในภาวะภัยพิบัตินํ้าท่วม และสัมภาษณ์แบบกลุ่ม ข้อมูลเชิงปริมาณวิเคราะห์โดยใช้สถิติร้อยละ ค่าเฉลี่ย และค่าเบี่ยงเบนมาตรฐาน ข้อมูลเชิงคุณภาพวิเคราะห์โดยการวิเคราะห์เนื้อหา ผลการวิจัย: คะแนนเฉลี่ยการเตรียมความพร้อมในภาวะภัยพิบัตินํ้าท่วมของผู้ป่วยเรื้อรัง (M = 5.40, SD = 4.24) และญาติผู้ดูแล (M = 6.56, SD = 4.65) บ่งชี้ว่ามีการเตรียมความพร้อม อยู่ในระดับต่ำ ทั้งผู้ป่วยเรื้อรัง และญาติผู้ดูแลมีประสบการณ์ลำบากทั้งทางด้านร่างกาย และจิตใจระหว่างน้ำท่วม ส่วนใหญ่กังวลเกี่ยวกับปัญหาเศรษฐกิจและบ้านพักอาศัย มากกว่าการจัดการโรคและภาวะสุขภาพ หกประเด็นที่ปรากฏจากการสัมภาษณ์ได้แก่ การเตรียมสำหรับภัยธรรมชาติและการจัดการการเจ็บป่วย การจัดการสุขภาพ การตอบสนองทางอารมณ์ ความต้องการการช่วยเหลือประคับประคองทางด้านร่างกาย และจิตใจ การมีส่วนร่วมของชุมชน และการเตรียมความพร้อมในอนาคตสำหรับการจัดการตนเอง นอกจากนี้ผู้ป่วยและญาติส่วนใหญ่ต้องการให้ผู้นำชุมชนในท้องถิ่นมีการจัดการแหล่งประโยชน์ให้มีประสิทธิภาพมากขึ้น เพื่อเตรียมความพร้อมสำหรับภัยพิบัติน้ำท่วมในอนาคต สรุป และข้อเสนอแนะ: ผู้ป่วยและญาติยังขาดการเตรียมความพร้อมสำหรับภัยพิบัติน้ำท่วม ทั้งนี้ การสนับสนุนด้านข้อมูลและการช่วยเหลือประคับประคองด้านจิตใจจากพยาบาลเป็นสิ่งจำเป็น เพื่อการเตรียมพร้อมที่ดีขึ้นในอนาคต โดยเฉพาะการส่งเสริมให้ผู้ป่วย และญาติทุกคนรวมทั้งชุมชนสร้างความเข้มแข็งในการจัดการภาวะภัยพิบัติ และพัฒนากลวิธีการเตรียมความพร้อมอย่างมีประสิทธิภาพPublication Open Access Customized-language voice survey on mobile devices for text and image data collection among ethnic groups in Thailand: a proof-of-concept study.(2014-03-06) Kasemsak Jandee; เกษมศักดิ์ จันดี; Saranath Lawpoolsri; สารนาถ ล้อพูลศรี; Pimsurang Taechaboonsermsak; พิมพ์สุรางค์ เตชะบุญเสริมศักดิ์; Amnat Khamsiriwatchara; Peerawat Wansatid; Jaranit Kaewkungwal; จรณิต แก้วกังวาล; Jaranit Kaewkungwal; Mahidol University. Faculty of Tropical Medicine. Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS); Mahidol University. Faculty of Tropical Medicine. Department of Tropical Hygiene.; Mahidol University. Faculty of Public Health. Department of Family Health.BACKGROUND: Public health surveys are often conducted using paper-based questionnaires. However, many problems are associated with this method, especially when collecting data among ethnic groups who speak a different language from the survey interviewer. The process can be time-consuming and there is the risk of missing important data due to incomplete surveys. OBJECTIVE: This study was conducted as a proof-of-concept to develop a new electronic tool for data collection, and compare it with standard paper-based questionnaire surveys using the research setting of assessing Knowledge Attitude and Practice (KAP) toward the Expanded Program on Immunization (EPI) among 6 ethnic groups in Chiang Rai Province, Thailand. The two data collection methods were compared on data quality in terms of data completeness and time consumed in collecting the information. In addition, the initiative assessed the participants' satisfaction toward the use of a smartphone customized-language voice-based questionnaire in terms of perceived ease of use and perceived usefulness. METHODS: Following a cross-over design, all study participants were interviewed using two data collection methods after a one-week washout period. Questions in the paper-based questionnaires in Thai language were translated to each ethnic language by the interviewer/translator when interviewing the study participant. The customized-language voice-based questionnaires were programmed to a smartphone tablet in six, selectable dialect languages and used by the trained interviewer when approaching participants. RESULTS: The study revealed positive data quality outcomes when using the smartphone, voice-based questionnaire survey compared with the paper-based questionnaire survey, both in terms of data completeness and time consumed in data collection process. Since the smartphone questionnaire survey was programmed to ask questions in sequence, no data was missing and there were no entry errors. Participants had positive attitudes toward answering the smartphone questionnaire; 69% (48/70) reported they understood the questions easily, 71% (50/70) found it convenient, and 66% (46/70) reported a reduced time in data collection. The smartphone data collection method was acceptable by both the interviewers and by the study participants of different ethnicities. CONCLUSIONS: To our knowledge, this is the first study showing that the application of specific features of mobile devices like smartphone tablets (including dropdown choices, capturing pictures, and voiced questions) can be successfully used for data collection. The mobile device can be effectively used for capturing photos of secondary data and collecting primary data with customized-language and voiced questionnaire survey. Using smartphone questionnaires can minimize or eliminate missing data and reduce the time consumed during the data collection process. Smartphone customized-language, voice-based questionnaires for data collection can be an alternative and better approach than standard translated paper-based questionnaires for public health surveys, especially when collecting data among ethnic and hard-to-reach groups residing in multilanguage-speaking settings.Publication Open Access ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy(2016) Pimpin Incharoen; Thanyanan Reungwetwattana; Sakditad Saowapa; Kaettipong Kamprerasart; Duangjai Pangpunyakulchai; Lalida Arsa; Artit Jinawath; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of PathologyBackground: Anaplastic lymphoma kinase (ALK) gene rearrangement is detected in 3 % to 13 % of non-small cell lung carcinoma patients, and these patients benefit from ALK inhibitors. The aim of this study was to determine the prevalence, the clinical and histological characteristics and the treatment outcomes of ALK-rearranged lung adenocarcinoma using immunohistochemistry (IHC) IHC, reverse transcription polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH) methodologies. Methods: A total of 268 pulmonary adenocarcinoma patients were screened for ALK expression by ALK IHC, which was confirmed by FISH and/or RT-PCR for ALK gene rearrangement. The treatment outcomes of ALK-rearranged patients were retrospectively reviewed. Results: ALK gene rearrangement was identified in 26 cases (9.7 %) with no EGFR co-mutation, and it showed significant associations with younger age, female sex and non-smoker status (p < 0.05). A cribriform growth pattern was identified as the dominant histologic feature, and a solid signet ring cell component was focally present in a minority of the cases. Among 12 ALK-rearranged patients with conventional treatment, seven cases in the early stage of disease were cured and alive, and five patients in the late stage of the disease progressed and died, with a median overall survival (OS) at 14 months. Of the 14 patients receiving crizotinib, all of them had clinical benefit from crizotinib treatment, with one patient having a complete response (CR), 12 patients having a partial response (PR) and one patient having stable disease (SD). On the cutoff date, six of 14 patients were continuing crizotinib treatment with a median time of response of 7.5 (3–13) months, while eight patients had disease progression, and five of them died with a median OS at 8 months. Conclusion: ALK gene rearrangement tended to occur in younger, non-smoking, female patients. ALK IHC is a reliable screening method to detect ALK gene rearrangement. Crizotinib therapy provided treatment benefit in ALKrearranged adenocarcinoma patients especially in advanced stages of the disease.Publication Open Access Asbestos exposure among mitering workers(2012-09) Wantanee Phanprasit; Dusit Sujirarat; Pirutchada Musigapong; Penpatra Sripaiboonkij; Chalermchai Chaikittiporn; วันทนี พันธุ์ประสิทธิ์; ดุสิต สุจิรารัตน์; เฉลิมชัย ชัยกิตติภรณ์; Wantanee Phanprasit; Mahidol University. Faculty of Public Health. Department of Occupational Health and Safety.; Mahidol University. Faculty of Public Health. Department of Epidemiology.The objectives are to compare the airborne asbestos concentrations resulted from mitering of abestos cement roof sheets by a high-speed motor and a hand saw, and to monitor whether other workers near the test sites are vulnerable to the fibers exceeding the occupational exposure limit. Four test cases were carried out and altogether 7 personal and 4 area air samples were collected. The NIOSH method 7400 was employed for the air samplings and analysis. Using the phase contrast microscopy, fiber counting was conducted under Rule A. The study showed that the fiber concentration medians for personal air samples gathered from the two tools were 4.11 fibers/cc (ranged: 1.33-12.41 fibers/cc) and 0.13 fibers/cc (ranged: 0.01-5.00 fibers/cc) respectively. The median for the area samples was 0.59 fibers/cc (ranged: 0.14-3.32 fibers/cc). Comparing each study case, the concentration level caused by the high-speed motor saw was more than twice that of the hand saw. According to the area samples, the workers nearby the test site are at risk from high exposure to asbestos.