Lack of oral health care utilization is a common problem among differently- abled children. As a result, oral diseases are often identified in this cohort. This study applied the Anderson health care utilization model to examine the... more
Lack of oral health care utilization is a common problem among differently- abled children. As a result, oral diseases are often identified in this cohort. This study applied the Anderson health care utilization model to examine the factors associated with the oral health service utilization (OHSU) among the differently-abled school children in Kathmandu city of Nepal. A cross-sectional study was conducted among 400 school children aged 7-18 years old enrolled in 7 schools for differently-abled children in Kathmandu. The OHSU data and the data on the predisposing factors, the enabling factors, and the need factors were self-reported by the parents/legal guardians of the children, using a self-administered questionnaire. An oral examination was performed to assess each child’s dental status. Logistic regression was used to assess the association of OHSU with the predisposing factors, the enabling factors, and the need factors. The results showed that the enabling factors (i.e., “affo...
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The analysis aimed to determine whether countries with indicators of robust national drug policy also have good access to medicines, suggesting that policy has a positive effect. The authors also looked into other determinants of the... more
The analysis aimed to determine whether countries with indicators of robust national drug policy also have good access to medicines, suggesting that policy has a positive effect. The authors also looked into other determinants of the variation in access to medicines across the countries. The study exploited massive data sets from World Health Organization, Health Action International, Transparency International and the World Bank. A sample of 37 low- and middle-income countries was chosen for the analysis. Multiple linear regression was used to examine the association of access to medicines with national drug policy and externality variables of governance including corruption. No relationship was found between national drug policy and access to medicines in the public sector. However, this study did find a relationship between one of the governance indicators, control of corruption, and two important variables of access to medicines: generic medicines price and availability in the p...
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The Health Promoting Hospital, Nakornsawan Province had implemented a screening test for diabetes mellitus in pregnant women since 2004. In 2009, the guideline of the screening test was adjusted and implemented in June 2009. The... more
The Health Promoting Hospital, Nakornsawan Province had implemented a screening test for diabetes mellitus in pregnant women since 2004. In 2009, the guideline of the screening test was adjusted and implemented in June 2009. The objective of this study is to examine the effectiveness of the new screening guideline by comparing the prevalence of diabetes mellitus among pregnant women diagnosed by the old and new screening guidelines; and comparing blood sugar levels of pregnant women with diabetes mellitus, before and after their participation in the nutritional counseling program as part of the screening test. We obtained data from medical records of the pregnant women attending the Health Promoting Hospital, Nakornsawan Province from October 2007 to September 2012 to assess the prevalence of diabetes mellitus, and data on blood sugar levels from June 2009 to September 2012 to evaluate the effects of nutrition counseling program on reduction of blood sugar levels of those diagnos...
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The purpose of this study was to determine the association between early pregnancy of mothers and stunting in children less than two years of age as well as the association between early pregnancy and maternal malnutrition among Bhutanese... more
The purpose of this study was to determine the association between early pregnancy of mothers and stunting in children less than two years of age as well as the association between early pregnancy and maternal malnutrition among Bhutanese refugees in Nepal. A sample of 216 mothers, with their children below 2 years of age was selected from secondary data obtained from Bhutanese refugees in Nepal. Descriptive statistics were used to determine frequencies and proportions. Logistic Regression was used to determine the statistical relationship between early pregnancy and the stunting of their children under 2 years old, adjusting for mother’s age, hemoglobin level, gestational age, and body mass index (BMI) of mothers. The same technique was applied to determine association between early pregnancy and maternal malnutrition adjusting for maternal BMI and hemoglobin levels. Results indicated a significant increased risk of stunting in children with decreasing maternal age with adjusted ra...
Research Interests: Medicine and Malnutrition
Ethical issues are greatly important in an epidemiological study as its subjects are usually human. Human right problemsdealing with the subjects such as privacy, confidentiality and participation of the eligible subjects can prevent... more
Ethical issues are greatly important in an epidemiological study as its subjects are usually human. Human right problemsdealing with the subjects such as privacy, confidentiality and participation of the eligible subjects can prevent the investiga-tors from finding valid results. To deal with the aforementioned problems, a practical guideline concerning ethical issues in conducting an epidemiological study will be discussed. The guideline puts an emphasis on the significances of protocols and ethics committee, including responsibility of investigators, consent for participation, access to personal data-sources, confidentiality of personal data, consent to approach subjects, and communication of research to subjects. จรยธรรมเปนเรองทมความสำคญมากในการศกษาทางระบาดวทยา เพราะการศกษาทางระบาดวทยามกทำการศกษาในคน ปญหาเกยวกบสทธมนษยชนของคน เชนความเปนสวนตวสทธในการปกปดขอมลสวนตวสทธในการตดสนใจยอมเขารวมในการวจย อาจเปนอปสรรคสำคญตอการคนพบขอเทจจรงทมความถกตองและนาเชอถอตามหลกวทยาศาสตรได เพอหลกเหลยงปญห...
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Millions of Myanmar migrants are residing in Thailand where they encounter daily challenges and problems. Drinking alcohol is a way to cope with these stressful situations and thus, alcohol abuse is very common among them. This study... more
Millions of Myanmar migrants are residing in Thailand where they encounter daily challenges and problems. Drinking alcohol is a way to cope with these stressful situations and thus, alcohol abuse is very common among them. This study aimed to find out factors contributing to alcohol use among Myanmar migrants in Thailand and impact of alcohol consumption on their health. A systematic literature review, based on conceptual framework was conducted through thematic content analysis of thirty relevant documents to explore the factors. Underage drinking, migration-related factors, stress and easy access to alcohol were of great concern regarding alcohol use. Health problems such as liver and heart diseases, cancer and HIV/AIDS as well as domestic violence were associated with alcohol consumption. More studies with better design are required to provide validity. To create a better atmosphere for migrants to minimize stressful conditions, support from different organizations, local communi...
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Cities are experiencing the need to protect people, natural and man-made resources and productive capacities against the risks posed by climate change related events. This descriptive study examines the flood preparedness of hospitals at... more
Cities are experiencing the need to protect people, natural and man-made resources and productive capacities against the risks posed by climate change related events. This descriptive study examines the flood preparedness of hospitals at sub-district, district, provincial, and regional levels in Thailand. In-depth interviews were conducted at fourteen hospitals in five provinces, including Nonthaburi, Pathum Thani, Nakhon Pathom, Samut Prakan, and Samut Sakhon provinces. We used content analysis for this qualitative descriptive study. The highlight findings of the study revealed that lack of disaster standard operating procedures for emergency response to flood, lack of risk mapping and vulnerability assessment, and shortage of trained risk communicators. Increasing performance in disaster and emergency preparedness and response in the hospitals is essential. We suggest that the hospitals and relevant government agencies require appropriate mechanism to enhance disaster and emergenc...
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Background Serious haze episodes have been a seasonal event in Chiang Mai province for more than a decade. In 2008, local government agencies introduced comprehensive measures to control haze and limit its impacts on public health. This... more
Background Serious haze episodes have been a seasonal event in Chiang Mai province for more than a decade. In 2008, local government agencies introduced comprehensive measures to control haze and limit its impacts on public health. This study assessed the acute effects of ambient air pollutants on all-cause mortality before and after the introduction of those haze control measures. Methods We obtained daily mortality counts and data on mass concentrations of particulate matter <10 micron in aerodynamic diameter (PM10), gaseous pollutants (SO2, NO2, O3, and CO), and meteorology in Chiang Mai Province between January 2002 and December 2016. We analyzed the data using a case-crossover approach adjusting for temperature, relative humidity, seasonality, and day-of-week. We assessed change in the excess risks of all-cause mortality associated with an increase in interquartile range (IQR) of pollutant concentration before and after control measures came into force. Results We found decr...
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While the effects of particulate matter (PM*) on mortality have been well documented in North America and Western Europe, considerably less is known about its effects in developing countries in Asia. Existing air pollution data in... more
While the effects of particulate matter (PM*) on mortality have been well documented in North America and Western Europe, considerably less is known about its effects in developing countries in Asia. Existing air pollution data in Bangkok, Thailand, indicate that airborne concentrations of PM < or = 10 pm in aerodynamic diameter (PM10) are as high or higher than those experienced in most cities in North America and Western Europe. At the same time, the demographics, activity patterns, and background health status of the population, as well as the chemical composition of PM, are different in Bangkok. It is important, therefore, to determine whether the effects of PM10 on mortality occurring in this large metropolitan area are similar to those in Western cities. The quality and completeness of Bangkok mortality data have been recently enhanced by the completion of a few mortality studies and through input from monitors currently measuring daily PM10 in Bangkok. In this analysis, we...
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The association between airborne particles and daily mortality has been reported in many locations, but mainly in western countries. There is a need to investigate the association in locations where the emission sources, weather, and... more
The association between airborne particles and daily mortality has been reported in many locations, but mainly in western countries. There is a need to investigate the association in locations where the emission sources, weather, and other environmental conditions differ from those in western countries. In this study, the acute effects of PM10 and visibility on daily mortality in Bangkok, Thailand, from 1992 to 1997, were examined. A Poisson regression model was developed to estimate the excess daily mortality associated with PM10 and visibility, while controlling for long-term trends, season, and variations in weather. It was found that increasing PM10 and decreasing visibility levels were independently associated with increasing daily mortality from all non-external causes, cardiovascular, respiratory, and other diseases. The observed associations were stronger for respiratory diseases than for cardiovascular and other diseases and were stronger for persons aged > or = 65 years...
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In recent years, Asia has experienced rapid economic growth and a deteriorating environment caused by the increasing use of fossil fuels. Although the deleterious effects of air pollution from fossil-fuel combustion have been demonstrated... more
In recent years, Asia has experienced rapid economic growth and a deteriorating environment caused by the increasing use of fossil fuels. Although the deleterious effects of air pollution from fossil-fuel combustion have been demonstrated in many Western nations, few comparable studies have been conducted in Asia. Time-series studies of daily mortality in Asian cities can contribute important new information to the existing body of knowledge about air pollution and health. Not only can these studies verify important health effects of air pollution in local regions in Asia, they can also help determine the relevance of existing air pollution studies to mortality and morbidity for policymaking and environmental controls. In addition, the studies can help identify factors that might modify associations between air pollution and health effects in various populations and environmental conditions. Collaborative multicity studies in Asia-especially when designed, conducted, and analyzed us...
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Research Interests: Environmental Science, Forecasting, Environmental Monitoring, Air pollution, Environmental Sciences, and 12 moreRegression Analysis, Temperature, Visibility, Airborne Particulates, Relative Humidity, CHEMICAL SCIENCES, Theoretical Models, Particle Size, Regression Model, Particulate Matter, Seasons, and Medical and Health Sciences
Research Interests: Geography, Statistics, Epidemiology, Developing Countries, Air pollution, and 15 moreClimate, Public Health, Mortality, Medicine, Linear models, Population, Humans, Regression Analysis, Income, Social Environment, Socioeconomic Status, Public health systems and services research, Humidity, Seasons, and Cause of death
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