Effectiveness of 6 Step Prevention and Control For Dengue Hemorrhagic Fever in Rural Community of Thailand

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Effectiveness of 6 Step Prevention and Control for Dengue Hemorrhagic Fever

in Rural Community of Thailand
Conference Paper · August 2015
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Gathering to Share Hiroshima’s Desire for Peace
In Support of the 70th Hiroshima Peace Memorial and Remembrance Commemoration
The Second Asian Symposium on Healthcare Without Borders (HWB)
Proceedings
ISSN 2188-4005
August 6-8, 2015 at the Mitsui Garden Hotel

Hiroshima, Japan
Hosted by:
PRESDA
Proceedings Contents Index
Page 1 to 43: Section I Program
Page 39: Acknowledgements
Page 40: About the Event and Proceedings
Page 45 to 86: Section II Abstracts*
Page 87 to 141: Section III Full Papers*
* To find a specific abstract or full paper, please use the find option at the topic of the document
Section I
Program

The Asian Symposium on Health Informatics and Nursing Education (SHINE)
The Asian Conference on Peace, Humanitarian Aid and Service (PHASE)
Schedule & Agenda
August 6-8, 2015 at the Mitsui Garden Hotel

Hiroshima, Japan
Welcome Letter from the HWB/ SHINE/ PHASE Organizers
Dear Friends,
It is our sincere honor and privilege to welcome all of you to this three-day event held in Japan’s lovely
City of Peace, which coincides with the 70th Hiroshima Peace Memorial and Remembrance Ceremony.
August 2015 marks our fourth year of organizing events here in Hiroshima. We have tried to have
uniquely themed events every year. In 2012, the theme was energy and sustainability, which
highlighted the problems facing Japan following the 2011 earthquake, tsunami and nuclear disaster.
In 2013, our theme was human development with an emphasis on change, continuity and diversity.
Last year, our theme was healthcare with a focus on the millennium development goals.
For this year, we are drawing together the importance of peace, humanitarian aid, service, nursing and
health informatics along with healthcare. Our primary mission remains to raise awareness and bring
attention to global sustainable development, which is heavily concerned with healthcare.
Organizing events, whether large or small, is a long and arduous undertaking. We have always felt
committed, however, to the overarching goal of providing an opportunity for academics, scholars, non-
profit workers, students and others concerned with healthcare and humanitarian aid to exchange views
in a setting encouraging respectful dialogue.
The range of topics and caliber of presenters is impressive. We are confident that everyone will find
reason to be inspired by the research presented during these combined events.
It is in this spirit of friendship, peace and international cooperation that we express our warmest
welcome to every participant.
We hope you will have a memorable and fruitful experience here in Japan!
Yours most sincerely,
Takayuki Yamada
Chairman, Board of Governors
PRESDA
Polio-Plus Committee, Rotary Japan
Welcome Letter from the Event Program Director
Dear Distinguished Participants,
It is with great pleasure that I welcome each and every one of you to the Mitsui Garden Hotel for the
2nd Asian Symposium on Healthcare Without Borders, which this year is being jointly held with the
Asian Symposium on Health Informatics and Nursing Education and its sister event, the Asian
Conference on Peace, Humanitarian Aid and Service.
I’m very excited about the quality of the presentations that we have lined up as well as the fact that so
many of our participants have traveled quite the distance to be here with us for this important joint
event. My hope is that we not only come away with new knowledge and ideas from our time together,
but also to create new networks and friendships that will last a lifetime.
I would like to give thanks to PRESDA as well as everyone involved with organizing
and review of proposals for HWB / SHINE and PHASE. As you certainly will appreciate, this event
would not be possible without the efforts of these dedicated and unsung staff.
Finally, I would like to thank all of the presenters and audience members for your contributions to
these events. As members of the organizing committee, our role was to produce the program, but the
truth is, this is your event and without your participation none of this would be possible.
I hope you have a wonderful time during your stay in this wonderful city during the 70th Hiroshima
Peace Memorial and Remembrance Ceremony!
Yours sincerely,
Michael Sasaoka
Event Program Director
HWB/ SHINE/ PHASE 2015
Hiroshima, Japan
Donation in Support of the 70th Hiroshima Peace Memorial Commemoration
Although our organization supports a number of global initiatives, such as Doctors Without Borders,
we have made two gifts to two Japan-based organizations. The total amount donated was JPY 70,000
because this year is the 70th Memorial.
JPY 35,000 to the Ashinaga Foundation
Ashinaga got its start over 40 years ago. Since the "Association for Natural Disaster Orphans" (the
predecessor of today's Ashinaga) was established in April 1988, as of December 2012, the organization
has provided scholarships 35,023 orphaned students, including children who lost parents in the Great
Hanshin Earthquake in January 1995 and the March 11 Great East Japan Earthquake and Tsunami in
2011.
http://www.ashinaga.org/en/
JPY 35,000 to the City Lights Social Welfare Corporation
Establish in 1987, the City Lights Social Welfare Corporation is based in Kobe, Japan supports the
disabled and handicapped community in Kobe City by providing work in a organic food store, daycare
service, rehabilitation and counseling. City Lights is also endorsed and supported by the Kobe City
Government.
http://citylights-kobe.sakura.ne.jp/
Keynote Speaker
Thursday, August 6, 2015
16:20 to 17:00
Hakuho West Ballroom
Challenges for English Education for Healthcare Professionals in Japan
Eiko Kawagoe
Professor, School of Nursing
Kobe City College of Nursing, Japan
Former Vice President, Japan Association for Medical English Studies
Councilor, The Japan Society for Medical English Education
Eiko Kawagoe is a noted author and academic on medical English education and healthcare communication.
She is a professor in the School of Nursing at Kobe City College of Nursing. Professor Kawagoe is also the
former Vice President of the Japan Association for Media English Studies and a Councilor of the Japan Society
for Medical English Education.
Her research interests include medical English education, ESP, and current English studies. She has published
numerous books, such as “Current English (Medical Version) – The Daily Yomiuri” (Daigaku Kyoiku Pub.,
2011), “Travelers’ First Aid Kit” (Cengage Learning, 2008), “Mimikara Manabu Tanoshii Nurse Eigo”
(Kodansha, 2002), “Nursing Terms and Expressions Everybody Uses” (Medical View, 2007) and “15 Points in
Reading English for Nursing Purposes” (Medical View, 2005).
Special Thanks to the Chair of the HWB/ SHINE Editorial Committee
Natthawut Kaewpitoon, Ph.D.
Faculty of Public Health, Vongchavalitkul University, Nakhon Ratchasima, Thailand

Suranaree University of Technology Hospital, Nakhon Ratchasima, Thailand
PhD in BioMedical Science, Khon Kaen University, Thailand

MSc in Medical Parasitology Khon Kaen University, Thailand
BSc in Public Health Khon Kaen University, Thailand
We are honored to have Nattawut Kaewpitoon chairing the editorial committee for the HWB proceedings. Dr.
Kaewpitoon joined the Inaugural Symposium on Healthcare Without Borders in 2014 here in Hiroshima.
His research interests include: Parasitology, Epidemiology, Public Health, Bioinformatics, Genetic,
Gastroenterology. Past and current work includes:
Certificated - Applied Epidemiology Chulalongkorn University, Thailand 2011

- Community Research Chulalongkorn University, Thailand 2010
- Tropical Research Khon Kaen University, Thailand 2010
- Medical Education Princess of Songkla Naradhiwas University, Thailand, and University of Illinois at
Chicago, USA 2009
- Molecular Biology Techniques, Helminth Laboratory, Queensland Institute of Medical Research, Brisbane,
QLD, Australia 2007-2008
- Bioinformatics Khon Kaen University, Thailand 2005
- The Application of SEM&TEM Khon Kaen University, Thailand 2004 Experience record
- Assistant Professor in Medical Parasitology, Department of Pathology, Institute of Medicine, Suranaree
University of Technology, Nakhon Ratchasima Province, Thailand 2010 to present
- Head of Parasitic Disease Research Unit, Department of Pathology, Institute of Medicine, Suranaree
University of Technology, Nakhon Ratchasima Province, Thailand 2010 to present
- Vice Dean in Research Affair, College of Medicine and Public Health, Ubon Rajathanee University (UBU),
Ubonratchathani Province, Thailand 2009 to 2010
- Head of Parasitic Infectious Disease Research Center, College of Medicine and Public Health, Ubon
Rajathanee University (UBU), Ubonratchathani Province, Thailand 2009 to 2010.
Special Thanks to the Chair of the PHASE Editorial Committee
Suman Chakrabarty, M.Sc., Ph.D. (Calcutta University)

Assistant Professor and Head of Department of Anthropology
Mrinalini Datta Mahavidyapith (Gov’t aided degree college under West Bengal State University), West Bengal,
India
He is a bio-cultural Anthropologist working in the Central and Eastern Parts of India. His research generally
explores the bio-social & bio-cultural aspect of health and nutritional status among the scheduled tribes in India.
Dr. Suman Chakrabarty’s specific research interest investigates the inter-relationship between forest
conservation, rehabilitation/displacement issues and its impact on food security among the Indian tribes living in
different protected areas in India. Currently, his research projects include household food security and
nutritional status among the Rabha Tribe living in Northern Part (Jaldapara and Buxa Wildlife Sanctuary in
Dooars) of West Bengal, India. He has published several articles on the themes of chronic energy deficiency and
its correlates among the scheduled tribes in Central and Eastern India. Specifically, he has published few articles
on the current livelihood condition (Socio-economic aspect of health and nutritional status) of Indian tribes
living inside protected areas and their rehabilitated counterparts.
August 6-8, 2015 at the Mitsui Garden Hotel in Hiroshima, Japan
70th Hiroshima Peace Memorial & Remembrance Commemoration
Thursday, August 6, 2015
Memorial Overview:
07:00 to 09:00 (Optional) The 70th Hiroshima Peace Memorial and Remembrance Ceremony
Location: Hiroshima Peace Memorial Park Cenotaph
 The ceremony format will be as follows:

 Dedication of Water (by the citizen representatives of Hiroshima)
 Opening of the 70th Hiroshima Peace Memorial
 Dedication of the Names of the Fallen Atomic Bomb Victims
 Introductory Address and Dedication of Flowers
 Silent Prayer and Peace Bell (for one minute from 8:15am)
 Peace Declaration (by Mayor of Hiroshima)
 Release of Doves
 Commitment to Peace (by Children's representatives)
 Addresses (by Prime Minister of Japan and other visitors)
 Hiroshima Peace Song
 Closing
Please note that the morning Peace Ceremony is one of many events held throughout the day. In the
evening, there is the very poignant Riverside Lantern Memorial. Also, we will have a guided tour of
Peace Park on August 9th for interested participants.
1
Day 1: Plenary & Welcome Overview

The Asian Symposium on Health Informatics and Nursing Education (SHINE)
The Asian Conference on Peace, Humanitarian Aid and Service (PHASE)
14:00 to 16:00 Participant Check-in

(Name Badge, Schedule, tour information, etc.)
Official certificates and receipts will be given after your presentation
Location: Mitsui Garden Hotel Hiroshima (3rd Floor)
16:00 to 16:20 Commencement with Opening Remarks and Welcome from Organizers
Room: 3rd Floor, Hakuho West
16:20 to 17:00 Plenary Presentation

Professor Eiko Kawagoe, Kobe City College of Nursing, Japan
Challenges for English Education for Healthcare Professionals in Japan
17:00 to 17:15 Gather in Mitsui Garden Hotel lobby (wear name badges)
17:30 to 19:00 Welcome Reception (registered participants only)*

Departing from Mitsui Garden Hotel Main Floor, Lobby at 17:15
* Name badges required
**Due to limited seating the welcome dinner is FULL and for registered
participants only.
***Non-registered participants wishing to join the dinner will be charged JPY 4000,
which must be paid at the registration desk PRIOR TO the dinner.
19:00 to 20:00 (Optional) Riverside Lantern Memorial Ceremony
2
Day 2: Oral Sessions Overview

Friday, August 7, 2015
Day 2: General Overview

(Name Badge, Schedule, Miyajima Tour information, etc.*)
Location: 3rd Floor
12:00 to 14:00 Poster Sessions A and B in Ballrooms Hakuho East and Hakuho West
12:00 to 14:00 Luncheon in Ballroom Hakuho East and Hakuho West
14:00 to 15:00 Poster Session C in the Asagi Ballroom
09:00 to 17:00 Oral Sessions in Ballrooms Asagi, Moegi and Hakuho West
Day 2: Morning and Afternoon Sessions Overview
09:00 to 10:30 Oral Session A: Oral Health, Pharmacology and Toxicology

0130, 0155, 0165
Location: Asagi Ballroom (3rd Floor)
10:45 to 12:15 Oral Session B: (Featured Panel) Global Health Concerns

0150, 0198
Location: Hakuho West Ballroom (3rd Floor)
12:30 to 14:00 Oral Session C: Clinical Information Systems and Healthcare Education
0502, 0504, 0527
12:00 to 12:15 Poster A setup

12:15 to 13:00 Poster Session A (see session page for full listing)
13:00 to 13:15 Poster B setup
13:15 to 14:00 Poster Session B (see session page for full listing)
Lunch Overview
12:00 to 14:00 Light lunch snacks with coffee and tea will be served during the poster session
Location: Hakuho East and West Ballrooms (3rd Floor)
Day 2: Late Afternoon Sessions Overview
14:00 to 15:00 Poster Session C / Location: Asagi Ballroom (3rd Floor)
15:00 to 17:00 Oral Session D1: Health Panel: Public, Community, Mental and Sexual
0183, 0184, 0186, 0192, 0193
15:00 to 17:00 Oral Session D2: Access to Healthcare

0113, 0175, 0177, 0197
Location: Moegi Ballroom (3rd Floor)
15:00 to 17:00 Oral Session D3: Health Informatics and Nursing Education
0163, 0529, 0549, 0562
3
Day 3: Sessions Overview
Saturday, August 8, 2015
Day 3 General Overview

(Name Badge, Schedule, Miyajima Tour information, etc.*)
Location: 3rd Floor
09:00 to 12:30 Oral and Poster Sessions
12:30 to 13:00 Closing Remarks

Coffee and Light Snacks will be Served
Day 3 Oral and Poster Session Overview:
09:00 to 11:00 Oral Session E: Peace, Humanitarian Aid and Service

0910, 0911, 0916, 0921
Location: Moegi Ballroom (3rd Floor)
11:00 to 12:30 Poster Session C and Lunch

12:30 to 13:00 Closing Remarks

Michael Sasaoka, Program Director
Optional Tour Day: Sunday, August 9, 2015
08:45 to 16:00 (Optional) Guided Tour to Peace Park and Miyajima: ‘The Shrine Island’
UNESCO World Heritage Site and one of the Three Views of Japan
Participants joining the tour must be in the Mitsui Garden Hotel no later than 08:45
to receive tickets. The tour will depart promptly at 09:15. Anyone arriving late will
not be able to join the tour.
We must order tickets based on the number of confirmed tour participants. Advanced
confirmation was required by Tuesday, August 4th.
Anyone who did not confirm in advance and wishes to join must pay JPY 4000 at the
registration desk.
Guests of participants that wish to join may also pay JPY 4000 at the registration
desk.
4
Day 2 and Day 3:

Poster Sessions Overview
Day 2: Friday, August 7, 2015
Overview of Poster Sessions A
Held in Hakuho East and Hakuho West

12:00 to 13:00 (12:00 to 12:15 Setup)
Posters:
0107, 0117, 0119, 0124, 0126, 0132, 0133, 0134, 0135, 0139,
0142, 0143, 0144, 0145, 0146, 0151, 0153, 0158, 0161, 0162
Overview of Poster Sessions B

13:00 to 14:00 (13:00 to 13:15 Setup)
Posters:
0166, 0169, 0172, 0174, 0179, 0180, 0190, 0191, 0195, 0203,
0204, 0207, 0506, 0508, 0512, 0517, 0518, 0519, 0523, 0525
Overview of Poster Sessions C

14:00 to 15:00 in Asagi Ballroom (3rd Floor)
Posters:
0191, 0542, 0543
Day 3: Saturday, August 8, 2015

Poster Sessions D
Held in Hakuho West

11:00 to 12:30
Posters:
0528, 0530, 0540, 0547
0550, 0552, 0554, 0557
5
Oral Sessions Overview
Oral Session A
Asagi Ballroom (3rd Floor)

09:00 to 10:30
Oral Health, Pharmacology and Toxicology
0130, 0155, 0165
Time Moderators: Vlnod C Nayak and Tu Nguyen
09:00 to 09:30
Dental Health / Oral Health

2015_130 Prevalence and risks of habitual snoring and obstructive sleep apnea symptoms in adult
dental patients
Thikriat Al-Jewair, University of Dammam, Saudi Arabia1
Mohammed Ashraf Nazir, University of Damman, Saudi Arabia2
Naif Al-Masoud, University of Damman, Saudi Arabia3
09:30 to 10:00
Toxicology
2015_155 Intentional Self harm by Paraquat Poisoning
Shankar Bakkannavar, Kasturba Medical College, Manipal University, India1
VInod C Nayak, Manipal University, India2
10:00 to 10:30
Drug Development and Pharmacology / Toxicology

2015_165 Detection of tetrodotoxin producing microorganisms in puffer fishes and the risk of
tetrodotoxin infection in food
Tu Nguyen, Hochiminh City International University, Vietnam1
Huu Nguyen, Hochiminh City International University, Vietnam2
Vinh Doan, Hochiminh City International University, Vietnam3
Dat Nghe, Hochiminh City International University, Vietnam4
6
Oral Session B
Hakuho West Ballroom (3rd Floor)

10:45 to 12:15
Featured Panel
Global Health Concerns
0150 and 0198
James McNally and Santa Romero-Jovel
10:45 to 11:30
Sharing Health Data

2015_150 Open Source Health Information: Providing equitable access to practitioners,
researchers and patients
James McNally, University of Michigan, United States1
11:30 to 12:15
Communicable / non-communicable diseases

2015_198 Chagas disease: Prevalence in public school students and their families at canton
Molineros, Verapaz, San Vicente, El Salvador
Santa Romero-Jovel, Ministry of Education, El Salvador1
Tatiana Ascencio, UJMD, El Salvador2
Maria-Auxiliadora Vargas, UEES, El Salvador3
7
Oral Session C

12:30 to 14:00
Clinical Information Systems and Healthcare Education
0502, 0504, 0527
Time Moderators: Susanha Yimyam and Suthisa Lamchang
12:30 to 13:00
Clinical Information Systems

2015_502 Effectiveness of CAI Regarding Dietary Control for Ischemic Heart Disease Prevention
on Food Consumption Behaviors in High Risk Patients
Patcharaporn Aree, Faculty of Nursing, Chiang Mai University, Thailand1
Anong Amaritakomol, Chiang Mai University, Thailand2
Malee Urharmnuay, Chiang Mai University, Thailand3
13:00 to 13:30

2015_504 Effects of Multimedia Materials and Model Practices on Knowledge and Self-confidence
in Nursing Practice Among Nursing Students
Suthisa Lamchang, Faculty of Nursing, Chiang Mai University, Thailand1
Somchit Kiatwattanacharoen, Chiang Mai University, Thailand2
13:30 to 14:00
E-learning and Education in Healthcare

2015_527 Development of multimedia electronic book on basic knowledge of breastfeeding
Susanha Yimyam, Faculty of Nursing, Chiang Mai University, Thailand1
Jantararat Chareonsanti, Chiang Mai University, Thailand2
8
Oral Session D1

15:00 to 17:00
Special Health Panel: Public, Environmental, Mental, Disease and Sexual
0183, 0184, 0186, 0192, 0193
Time Moderator: Natthawut Kaewpitoon (will decide presentation times)
Public Health / Community Health

2015_183 Effectiveness of 6 Steps Prevention and Control for Dengue Haemorrhagic Fever in Rural
Community of Thailand
Natthawut Kaewpitoon, Vongchavalitkul University, Faculty of Public Health, Thailand,
Hospital of Uranaree University of Technology, Thailand1,2
Apinya Joosiri, Faculty of Public Health, Vongchavalitkul University3
Wanpen Seubsing, Faculty of Public Health, Vongchavalitkul University4
Natnapa Padchasuwan, Faculty of Public Health, Vongchavalitkul University5
Wasugree Chavengul, Faculty of Public Health, Vongchavalitkul University6
Nusorn Kutanavanichapong, Faculty of Public Health, Vongchavalitkul University7
Jun Norkaew, Faculty of Public Health, Vongchavalitkul University8
Nutrition and Dietetics

2015_184 Assessment of quality of life and consumption behavior of hypertension elderly in rural
community of Thailand by using Whoqol-Bref-Thai
Wasugree Chawengkul, Vongchavalitkul University, Faculty of Public Health, Thailand1
Wannapa Tasoontorn, Faculty of Public Health, Vongchavalitkul University2
Praweena Nongtongta, Faculty of Public Health, Vongchavalitkul University3
Teerayut Udomporn, Faculty of Public Health, Vongchavalitkul University4

2015_186 Factors related with Behaviors Prevention to Leptospirosis
Jirawoot Kujapun, Vongchavalitkul University, Faculty of Public Health, Thailand1
Nuchara Hoothaisong, College of Medicine and Public Health, Ubonrajathanee University, Thailand2
Supitcha Pratumwapee, College of Medicine and Public Health, Ubonrajathanee University, Thailand3
Wararat Sungwalee College of Medicine and Public Health, Ubonrajathanee University, Thailand4
Wilas Kampangsee Faculty of Medicine, Mahasarakam University, Thailand5
9
Friday, August 7, 2015 (continued)
Oral Session D1
15:00 to 17:00
Special Health Panel: Public, Environmental, Mental, Disease and Sexual
0183, 0184, 0186, 0192, 0193
Time Moderator: Natthawut Kaewpitoon
Sexual Health
2015_192 Adolescent Students’ Pregnant Behavior in a Sub-district of Nakhon Ratchasima Province
in Thailand
Jun Norkaew, Vongchavalitkul University, Faculty of Public Health, Thailand1
Kantarut Titkatok, Faculty of Public Health, Vongchavalitkul University, Thailand2
Wanwipa Aukasri, Faculty of Public Health, Vongchavalitkul University, Thailand3
Kuntarut Titkatoke, Faculty of Public Health, Vongchavalitkul University, Thailand4
Environmental Health and Climate Change

2015_193 Knowledge, attitudes and practice regarding pesticide usage in agriculture from Nakhon
Ratchasima province, Thailand
Jiraporn Prathumyo, Vongchavalitkul University, Faculty of Public Health, Thailand1
Kamonthip Arsanan, Faculty of Public Health, Vongchavalitkul University, Thailand2
Saowaluck Prasungtiyo Faculty of Public Health, Vongchavalitkul University, Thailand3
10
Oral Session D2
Moegi Ballroom (3rd Floor)

15:00 to 17:00
Access to Healthcare
0113, 0175, 0177, 0197
Time Moderators: Judith Fuhrmann and Ravikan Nonkhuntod
15:00 to 15:30
Developing countries: access to healthcare

2015_113 Improving Access to Quality Healthcare Services through Health Insurance? Lessons
Learnt from a Comparative Case Study from South India
Judith Fuhrmann, Graduate Institute of International and Development Studies, Geneva,
Switzerland1
15:30 to 16:00

2015_175 Empowering Self-Management Can Promote Disease Control for Thais with type 2
Diabetes
Preeda Kanghae, Trang Hospital, Thailand1
Chodchoi Wattana, Phra Pok Klao College of Nursing,Thailand2
16:00 to 16:30

2015_177 Lessons from Thailand: Universal Health Care Achievements and Challenges
Ravikan Nonkhuntod, National Dong Hwa University, Taiwan 1
Suchuan Yu, National Dong Hwa University, Taiwan2
16:30 to 17:00
e-Health / m-Health / Telemedicine

2015_197 Persuasiveness of Behavioral Consistency Realism in the Medical Doctor Agent of Health
Education Video
Sean Shih-hung Wu, Asia University, Taiwan, Taiwan1
Jun-Hong Chen, Asia University, Taiwan2
11
Oral Session D3
Hakuho West Ballroom (3rd Floor)

15:00 to 17:00
Innovations in Health Informatics and Nursing Education
0163, 0529, 0549, 0562
Time Moderator: Chi-Ming Liu and Lynn Killbride
15:00 to 15:30
Psychiatry / Mental Health

2015_163 Developing Resiliency in Children through a Life Skills Training: The Randomized Trial
Effects of a Family-Based Intervention.
Jeeraporn Kummabutr, Thammasat University, Thailand1
15:30 to 16:00
Public Health and Consumer Informatics

2015_529 Impact of Diabetes Mellitus on Cholecystectomy Rate: A Population-Based Follow-Up
Study
Chi-Ming Liu, Cheng-Hsin General Hospital, Taiwan 1
16:00 to 16:30
Nursing Education and Practice

2015_549 Enhancing collaboration through recognition of prior learning in nursing education
Lynn Kilbride, Glasgow Caledonian University, United Kingdom1
Andy Gibbs, Glasgow Caledonian University, United Kingdom2
16:30 to 17:00
Innovations in Nursing Education

2015_562 Lived Experiences of Mothers of Children with Autism Spectrum Disorder: Basis for
Enhanced Nursing Care
Bea-Gracia Cruz, Our Lady of Lourdes Hospital, Philippines1
12
Oral Session E in the Moegi Ballroom (3rd Floor)

15:00 to 17:00
Peace, Humanitarian Aid and Service
0910, 0911, 0916, 0921
Time Moderator: Oliver Belarga and Mutsuhisa Ban
09:00 to 09:30
Disaster Education
2015_910 Enhancing Rather than Enforcing: Effect of disaster education programs on typhoon
preparedness among school children in Leyte, Philippines
Oliver Belarga, Osaka University, Japan1
Zbigniew Piepora Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland2
Marife Carpio, Osaka University, Japan3
09:30 to 10:00
Disaster Management
2015_911 Older People led CCA-DRR initiatives to build safe and resilient communities in the
Philippines
Gaudencio Rodelas, HelpAge-COSE, Philippines1
10:00 to 10:30
Peace and Conflict Resolution

2015_916 Game Engineering for Disarmament, Demobilisation and Reintegration
Mutsuhisa Ban, Tokyo Institute of Technology, Japan1
10:30 to 11:00
Food Security
2015_921 Food security through community owned and managed institutions– A Reliance
Foundation Initiative
Mahesh Gangadharaiah, Reliance Foundation, India1
Sudarshan Suchi, Reliance Foundation, India2
DharamPal Singh, Reliance Foundation, India3
Srinu Manda, Reliance Foundation India4
13
Overview of Poster Sessions A
12:00 to 13:00 (12:00 to 12:15 Setup)
Posters:
0107, 0117, 0119, 0124, 0126, 0132, 0133, 0134, 0135, 0139,
0142, 0143, 0144, 0145, 0146, 0151, 0153, 0158, 0161, 0162
Physical Therapy
2015_107 Effects of elastic therapeutic taping and foot orthotics for individuals with plantar
fasciitis
Praneet Pensri, Chulalongkorn University, Thailand1
Pavinee Harutaichun, Chulalongkorn University, Thailand2
Duangkamol Phonwet, Chulalongkorn University, Thailand3
Sujitra Boonyong, Chulalongkorn University, Thailand4
Nursing Practice and Education

2015_117 Effectiveness of Using the Ottawa Ankle Rules by Emergency on Improving Healthcare
Outcomes among Patients with Ankle Injuries: A Systematic Review
Ka Ming Ho, The Open University of Hong Kong, Hong Kong1
Nancy M. C. Cheung, Princess Margaret Hospital, Hong Kong2
Janita P. C. Chau, The Chinese University of Hong Kong, Hong Kong3
Physical Therapy
2015_119 Predictors for chronic neck and low back pain in office workers: A 1-year prospective
cohort study
Rattaporn Sihawong, Chulalongkorn University, Thailand1
Ekalak Sitthipornvorakul, Chulalongkorn University, Thailand2
Prawit Janwantanakul, Chulalongkorn University, Thailand3
Geriatrics / Gerontology
2015_124 Comparison of the events leading to life purpose, mental health and ADL in Japan and
Thailand
Takashi Ohue, Hyogo University, Japan1
Darunee Rujkorakarn, Faculty of Nursing, Maha Sarakham University, Thailand2
Amorn Suwannimitr, Faculty of Nursing, Maha Sarakham University, Thailand3
Supaporn Aryamuang, Faculty of Nursing, Maha Sarakham University, Thailand4
14
Poster Session A (continued)
School Health
2015_126 A study on school nurse's caring behavior
Kumiko Miyazaki, The University of Tokushima Graduate School, Japan1
Pathology
2015_132 Effects of Streptozotocin-Induced Diabetes on Masseter and Digastric Muscles of Rat
Apichaya Niyomchan, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1
Chittapon Juntararussmee, Mahidol University, Thailand2
Passara Lanlua, Mahidol University, Thailand3
Sirinush Sricharoenvej, Mahidol University, Thailand4
Pathology
2015_133 Alterations of Spinal Capillaries in Lumbosacral Enlargement of Diabetic Rats
Kanokporn Plaengrit, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1
Amornrat Chookliang, Mahidol University, Thailand4
Pathology
2015_134 Histological Changes of Interneuron in Cervical Spinal Enlargement of Streptozotocin
Diabetic Rats
Paweena Sangsawee, Mahidol University, Thailand1
Sirinush Sricharoenvej, Mahidol Univesity, Thailand2
Apichaya Niyomchan, Mahidol Univesity, Thailand4
Pathology
2015_135 Morphological Changes of Microglia in Lumbar Spinal Enlargement of
Streptozotocin-Induced Diabetic Rats
Athinan Prommahom, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1

2015_139 Effectiveness of motivational interviewing on lifestyle modification of clients at risk or
diagnosed with CVDs: A systematic review
Wai Man Lee, The Open University of Hong Kong, Hong Kong1
Sek Ying Chair, The Chinese University of Hong Kong, Hong Kong2
Wai Yee Yum, The Chinese University of Hong Kong, Hong Kong3
15

2015_142 Family roles in caregiving of people with mental illness in Nepal
Shreejana Maharjan, Chiba University Graduate School of Nursing, Japan1
Yayoi Iwasaki, Chiba University Graduate School of Nursing, Japan2
Palliative Care
2015_143 The different between Anraku and comfort
Yukihiro Kitatani, Toyama University, Japan1
Michiyo Aitakei, Toyama University, Japan2
Miki Yatuzukai, Toyama University, Japan3

2015_144 Stress of elderly at Meung Distric Nonthaburi Province, Thailand
Janejira Kiatsinsap, Boromarajonani College of Nursing, Changwat Nonthaburi, Thailand1
Parichart Wanywaisart, Boromarajonani College of Nursing, Changwat Nonthaburi, Thailand2
Wilaiporn Kamwong, Boromarajonani College of Nursing, Changwat Nonthaburi, Thailand3

2015_145 Satisfaction Level Of Childbirth Patient In Primary Helath Care In Indonesia
Faisal Ridho Sakti, Faculty Medicine of Islamic University of Indonesia, Indonesia1
Hifzhan Maulana Ghifari, Islamic University of Indonesia, Indonesia2
Sexual Health
2015_146 Adolescent Attitude Related To Adolescent Premarital Sexual Intercourse in Indonesia
2011 (RPJMN-BKKBN Survey Analysis, 2011)
Ahmad Robi'ie, University of Indonesia, Indonesia1
Pathology
2015_151 Acquired Cystic Kidney Disease Associated Renal Cell Carcinoma
Dewaraj V, Manipal Univrsity, India2
Forensic anatomy
2015_153 Double non coronary aortic sinuses: an autopsy case
Raghavendra Babu YP, Kasturba Medical College, Manipal University, India1
16

2015_158 Effects of ultrasound-guided peripheral intravenous catheter placement in difficult-
access patients: A systematic review and meta-analysis
Chia-Chi Kuo, Chang Jung Christian University, Taiwan 1
Occupational Therapy
2015_161 Fine motor activities program to promote fine motor skills in a child with Down’s
Syndrome: a case study
Suchitporn Lersilp, Chiang Mai University, Thailand1
Supawadee Putthinoi, Chiang Mai University, Thailand2
Kewalin Panyo, The Northeast Institute of Child Development, Thailand3
2015_162 Home features and Assistive Technology of Home Bound Elderly in Hang Dong
District, Chiang Mai, Thailand
Nopasit Chakpitak, Chiang Mai University, Thailand3
17
Overview of Poster Sessions B
13:00 to 14:00 (13:00 to 13:15 Setup)
Posters:
0166, 0169, 0171, 0172, 0174, 0179, 0180, 0190, 0195, 0203
0204, 0207, 0506, 0508, 0512, 0517, 0518, 0519, 0523, 0525
Pediatric Care
2015_166 Feelings of mothers towards medical care who encountered positive results of
newborn screening
Yuko Matsumoto, Kagawa Prefectural University of Health Sciences, Japan1
Hisae Nakatani, Hiroshima University, Japan2
Hiroko Kokusyo, Hiroshima University, Japan3
Miki Oeki, Hiroshima University, Japan4
Akiko Kanefuji, Hiroshima University, Japan5
Atsuko Hayakawa, Hiroshima University, Japan6
Go Tajima, Hiroshima University, Japan7
Ikuko Sobue, Hiroshima University, Japan8
2015_169 Development of Cognitive Training Software for Thai Elderly with Mild Cognitive
Impairment
Achiraya Chaiyakham, Chiang Mai University, Thailand1
Anuruk Bunpun, Chiang Mai University, Thailand4
Healthcare Administration and Policies

2015_172 Health promoting lifestyle among undergraduate medical students
Shasidhara Kotian Mangalore, Kasturba Medical College, Manipal University, India1

2015_174 Using Root Cause Analysis to Reduce Fall Incidence –systematic review
Ya-Ting Ke, Kaohsiung Medical University, Taiwan 1
18
Poster Session B (continued)
2015_179 An interprofessional initiative to optimize client-centred care in gerontological
education
Janita Pak Chun Chau, The Chinese University of Hong Kong, Hong Kong1
Suzanne Hoi Shan Lo, The Chinese University of Hong Kong, Hong Kong2
Vivian Wing Yan Lee, The Chinese University of Hong Kong, Hong Kong3
Emergency Room Healthcare

2015_180 The Project of Team Resource Management for Improving Violent Incidents in
Emergency Department
I-Ying Shen, Chi-Mei Medical Center, Taiwan 1
Hui-Ling Chen, Chi-Mei Medical Center, Taiwan 2
I-Ching Yang, Chi-Mei Medical Center, Taiwan 3

2015_190 A study of use 2% Chlorhexidine in Effectiveness of the emergency room blood culture
contamination
Yi-Yi Chen, Chi-Mei Medical Center, Taiwan 1
Hsiao-Feng Chiu, Chi-Mei Medical Center, Taiwan 2
Yu-Pao Chen, Chi-Mei Medical Center, Taiwan 3
Ya-Ting Ke, Chi-Mei Medical Center, Taiwan 4

2015_195 Determinants of nurse-sensitive patient outcomes in optimizing quality health care: a
research proposal
Kai Chow Choi, The Chinese University of Hong Kong, Hong Kong3
Eric Lu Shek Chan, Caritas Bianchi College of Careers, Hong Kong4
Matthew D. Mchugh, University of Pennsylvania, United States5
Wan Yim Ip, The Chinese University of Hong Kong, Hong Kong6
Iris Fung Kam Lee, The Chinese University of Hong Kong, Hong Kong7
Diana Tze Fan Lee, The Chinese University of Hong Kong, Hong Kong8
19
Health Education
2015_203 Effectiveness of Health Communicators to Health Literacy Building for High Risk in
Caffeine Consumption of Working-age Population in Rural Community, Northeast, Thailand
Poowadol Polsripradist, Mahasarakham University, Thailand1
Kitpramuk Tantayaporn, Mahasarakham University, Thailand2
Pissamai Homchampa, Mahasarakham University, Thailand3

2015_204 Predictor of sexual risk behaviors among pre-adolescents currently studying in
primary schools, northeastern Thailand
Pissamai Homchampa, Faculty of Medicine, Mahasarakham University, Thailand1
Mingkhuan Phuhongtong, Faculty of Medicine, Mahasarakham University, Thailand2
Teabpaluck Sirithnawuthichai, Faculty of Medicine, Mahasarakham University, Thailand3

2015_207 Opisthorchis viverrini infection in a Rural of the Mekong Riverside Area, Nakhon
Phanom Province, Thailand
Songkran Nakbun, Tropical and Parasitic Diseases Research Unit, Graduates Studies Division,
Faculty of Medicine, Mahasarakham University, Thailand1
Pramote Thongkrajai, Tropical and Parasitic Diseases Research Unit, Graduates Studies Division,
Sung-Jong Hong, Department of Medical Environmental Biology, Chung-Ang University, College of
Medicine, Seoul, Korea2
Klarnarong Wongpituk, Tropical and Parasitic Diseases Research Unit, Graduates Studies Division,
Jesada Surawan, Tropical and Parasitic Diseases Research Unit, Graduates Studies Division, Faculty of
Medicine, Mahasarakham University, Thailand1
Wilas Kampangsri, Tropical and Parasitic Diseases Research Unit, Graduates Studies Division, Faculty
of Medicine, Mahasarakham University, Thailand1
Choosak Nithikathkul, Tropical and Parasitic Diseases Research Unit, Graduates Studies Division,
Bioinformatics
2015_506 Molecular interactions analysis of natural compounds from Bacopa monnieri as AchE
and BuChE inhibitor in the treatment of Alzheimer's disease
Quazi Muhammad Sajid Jamal, Buraydah Colleges, Saudi Arabia1
Mughees Uddin Siddiqui, Buraydah Colleges, Saudi Arabia2
Mohammad Abdulrahman Alzohairy, Burayadah College, Saudi Arabia3
Mohammed Abdullah Al Karaawi, Burayadah College, Saudi Arabia4
Aging and Geriatric Nursing

2015_508 Frailty before and six-month following Cardiac Surgery
Cheryl Chia-Hui Chen, National Taiwan University, Taiwan1
20
Pediatric / Neonatal / Endocrinology Nursing

2015_512 The involvement of visiting nurses in supporting families and their children who
require medical care: A report on the practical use of ICF
Chizuko Edagawa, Ehime Prefectural University of Health Sciences, Japan1
Yukari Toyota, Ehime Prefectural University of Health Sciences, Japan2
Kayo Nomura, Sanyo Gakuen University, Japan3

2015_517 Physical activity and stages of change for weight control among Korean adolescents:
A preliminary study
Sun-Mi Chae, Seoul National University, Korea1
Jiyoung Yeo, Seoul National University, Korea2
Chohee Kim, Seoul National Univeristy, Korea3
Ji-hye Hwang, Seoul National University, Korea4
Pediatric Nursing
2015_518 A scale of parental reasons for using pediatric emergency medical care services:
Development, reliability, and validity
Kimie Tanimoto, Kagawa University, Japan2
Susumu Itoh, Kagawa University, Japan3

2015_519 Effect of music on disaster-induced stress in children
Yui Shiroshita, Hiroshima University, Japan1
Yukiko Miyakoshi, Hiroshima University, Japan3
Tomie Fujii, Hiroshima University, Japan4

2015_523 An educational program based on a simulated elderly experience for nurses and
caregivers in Japan
Miwa Yamamoto, Tottori Univesity, Japan1
Yasuko Maekawa, Kansai University of Social Welfare, Japan2
Home Health Nursing

2015_525 A case study regarding the home care support of a middle-aged Amyotrophic lateral
sclerosis(ALS) patient with tracheostomy: A follow-up survey
Mariko Zensho, Saitama Prefectural University, Japan1
Koji Sugano, Div. of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Japan2
Ryo Kubota, Saitama Prefectural University, Japan3
Hajime Toda, Kitasato University Graduate School of Nursing, Japan4
21
Overview of Poster Session C
Held in the Asagi Ballroom (3rd Floor)
14:00 to 15:00
0191, 0542, 0543

2015_191 Computer information systems patient transport Ward real time two-way paging
system
Quality Assurance in Healthcare

2015_542 A model of functional perpetual resilience in adults with type 1 diabetes
Ikuko Nishio, Tottori University, Japan1
Hideyuki Kataoka,Tottori University, Japan2

2015_543 An Initial Exploration on Epidemiology And Measurement Of the Elderly Sarcopenic
Obesity
Shu-Ching Chiu, Central Taiwan University of Science of Technology, Taiwan 1
Chang, Shu-Fang, National Taipei University of Nursing and Health Sciences, Taiwan2
22
Overview of Poster Sessions D
Held in Hakuho West
11:00 to 12:30
Posters:
0528, 0530, 0540, 0547
0550, 0552, 0554, 0557

2015_528 The noise level in the NICU and newborn nursery
Hiroko Uematsu, Takamatsu Red Cross Hospital, Japan1
Yuriko Ohnishi, Takamatsu Red Cross Hospital, Japan3
Akiko Nijyou, Takamatsu Red Cross Hospital, Japan4
Yumiko Hirata,Takamatsu Red Cross Hospital, Japan5

2015_530 Experiences of single mothers with adolescent children
Kazuyo Ikeuchi, Kochi Medical School, Japan1
Ikuko Sobue, Hiroshima University, Graduate School of Biomedical & Health Sciences2
Oncology Nursing
2015_540 Relationships Between Symptom Distress and Life Quality of Postoperative Oral
Cancer Patients
Shu-Ling Tu, Changhua Christian Hospital, Taiwan1
Chin-Chi Hsiang, Changhua Christian Hospital, Changhua, Taiwan2
Yaw-Jen Lin, Central Taiwan University of Science and Technology, Taichung, Taiwan3
Shu-Yi Tseng, Changhua Christian Hospital, Changhua, Taiwan4
23
Poster Session D (continued)

2015_547 The effects of a serious game for learning the elderly dementia cares
Takayuki Fujii, Kobe University Hospital, Japan2
Miwa Yamamoto,Tottori University, Japan3
Daiki Wakayama, Osaka Prefecture University, Japan4
Tomoharu Nakashima, Osaka Prefecture University, Japan5
Bioinformatics and Biostatistics

2015_550 The risk of chronic diseases in patients with colorectal cancer: A Retrospective Cohort
Study at a Medical Center in Central Taiwan.
Chen Mei-Wen, ChangHua Christian Hospital, Taiwan 1
Tung-Hao Chang, Department of Tumor Center, ChangHua Christian Hospital, ChangHua, Taiwan2
Cheng-Hsien Chen, Department of Surgery, Show Chwan Memorial Hospital, ChangHua, Taiwan3
Yih-Jeng Lin, Department of Information Management, Chien-Kuo Technology University,
ChungHua, Taiwan4
School Nursing
2015_552 Actual Situation of the Lifestyles, Physiques, and Bone Density of Elementary School
Pupils
Hiromi Miura, Kagawa Prefectural University of Health Sciences, Japan1
Tomomi Goda, Takarazuka University School, Japan2
Kazuyo Funakoshi, Kagawa Prefectural University of Health Sciences, Japan3
Reiko Sakae, Kagawa Prefectural University of Health Sciences, Japan4
Yuko Uemura, Kagawa Prefectural University of Health Sciences, Japan5
Critical Care / ER Nursing

2015_554 A literature review on the needs of parents of children admitted to the ICU
Ai Takeoka, Hiroshima University Hospital, Japan1
Naoko Nakata,Hiroshima University Hospital, Japan2
Hiroshi Senoo, Hiroshima University Hospital, Japan3
Etsuko Fujita, Hiroshima University Hospital, Japan4
Kasumi Yamasaki, Hiroshima University Hospital, Japan5
Ryouta Iiboshi, Hiroshima University Hospital, Japan6
Ikuko Sobue, Hiroshima University, Graduate School of Biomedical & Health Sciences, Japan7
Oncology Nursing
2015_557 The experience of development of the prostate cancer support group
Chiu I Chen, Changhua Christian Hospital, Taiwan1
Tu Shu Ling, Changhua Christian Hospital, Taiwan2
24
Program and Agenda Additional Information
Post Conference Tour: Sunday, August 9, 2015
Please note that the post-conference tour is FULL.
1. The deadline for confirming participation on the tour was Tuesday, August 4, 2015.
2. Participants that confirmed in advance will receive a ticket on the tour day.
3. Participants that did not confirm in advance or family members of participants, who wish to attend
must purchase a tour ticket. The ticket fee is JPY 4000
09:15 to 17:00 UNESCO World Heritage tour of the ‘Shrine Island’ (Miyajima)*
*Includes round trip transportation, park fee, cake and tea and guidance in English
UNESCO World Heritage tour of Peace Park

*The Peace Park tour will be on the way back from Miyajima
Departing from the Mitsui Garden Lobby at 09:15
About Miyajima Island “The Shrine Island”
Miyajima Island is the popular name of Itsuku-shima Island, situated in Hatsukaichi City in
southwestern Hiroshima. It is a scenic site in which the mountains, sea, and red shrine
buildings blend together in harmony. The entire island is designated as a UNESCO World
Heritage Site. It is said to be one of the three most beautiful sights in Japan, along with
Matsushima in Miyagi Prefecture and Ama-no-hashidate in Kyoto. The origin of Miyajima is
said to date back to when the Itsuku-shima-jinja Shrine was built in 593 during the reign of
Empress Suiko; however, the island of Miyajima itself has had a long history of being an
object of worship, especially its Mt. Mi-sen that rises up at the center of the island.
HWB/ SHINE/ PHASE 2015 Acknowledgements
We extend our deepest appreciation to the following people for their input and support for the various committees
(organizing, editorial, review, etc):
Natthawut Kaewpitoon, Ph.D., Faculty of Public Health, Vongchavalitkul University, Nakhon Ratchasima,
Thailand; Suranaree University of Technology Hospital, Nakhon Ratchasima, Thailand
Soraya Kaewpitoon, M.D., Suranaree University of Technology Hospital, Nakhon Ratchasima, Thailand
Oliver Belarga, Graduate School of Human Sciences, Osaka University, Japan
Takayuki Yamada, Chairperson, PRESDA, Japan
Michael Sasaoka, PRESDA, Japan
Henry Wang, M.D., Department of Internal Medicine, Tainan Municipal Hospital, Taiwan
Zhen-Fang Lin, Ph.D., Graduate Institute of Clinical Pharmacy, National Taiwan University, Taiwan
Anna Dittfield, M.D., School of Medicine, University of Silesia, Poland
Chi Hui Bai, M.D., Department of Public Health, Taipei Medical University, Taiwan
Sri Achardi, M.D., Faculty of Public Health, Diponegoro University, Indonesia
Keiko Hiraoka, Ph.D., R.N., Faculty of Nursing, Yasuda Women’s University, Japan
Yumie Kozono, Ph.D, R.N., , Faculty of Nursing, Yasuda Women’s University, Japan
Lokesh Gupta, M.D., National Center for Polio Immunization, India
Gobind T Shahani, M.D., Ph.D., Secretary General, The Cancer Foundation, India
Professor Kyoko Monden, Yasuda Women’s University, Japan
Professor Eiko Kawagoe, Kobe City College of Nursing, Japan
Gaudencio Rodelas, HelpAge-COSE, The Philippines
Judith Fuhrmann, Graduate Institute of International and Development Studies, Switzerland
About the Events and the Proceedings
The Asian Symposium on Healthcare Without Borders and Asian Symposium on Health Informatics and
Nursing Education 2015
Rapid economic development across Asia has brought about vast improvement in the health care industry with
some traditional health metrics, such as infant mortality rate and infectious disease rate among others,
decreasing while life expectancy across the board is increasing. However, this rosy and simplified view masks
the sharp health care disparities underlying Asian nations as well as the diverse challenges they face.
Many factors from the varying levels of social, political and economic development to geology and climate
change, which have been responsible for the recent earthquakes and seasonal typhoons and floods, have been
reshaping the continent and spawning critical healthcare questions in need of tangible solutions. In Southern
Asia, 1 in 16 children die before the age of five because of the effects of poverty and the absence of quality
health care. Although life expectancy is increasing in the region, at 64 years, it desperately lags behind the rest
of Asia. How can we ensure the equitable and efficient allocation of health-related resources across all Asia to
meet basic needs and emergencies? What role can policy makers play in creating affordable universal health
care?
On the other end of the spectrum, well-developed nations like Japan, Hong Kong and Singapore boast a life
expectancy over 80 years old. This fact raises many questions concerning health policies including: How to
address the aging populations and their subsequent ballooning health care costs, as well as the rising number of
both non-communicable and dietary diseases, which severely affect all of Asia
The Asian Conference on Peace, Humanitarian Aid and Service 2015
Hiroshima, Japan serves as an ideal setting for aid workers, academics, practitioners, policy-makers, doctors,
nurses, NPO / NGO professionals and students who desire to share ideas, knowledge, research and experience in
a forum of peaceful dialog and constructive outcomes.
The 2011 devastating earthquake, tsunami and nuclear accident that struck northern Japan is recent reminder
that even technologically advanced countries can be crippled by natural and human-made disasters. It is not that
natural disasters are increasing, but rather that the growth of the global population and demand for living space
means that natural and human-made catastrophes are having a greater impact on infrastructure and the loss of
human life.
What type of governance structures, management practices, technological innovations, legal agreements or
policy tools can best bridge the needs-limitation gap in order to facilitate and accelerate humanitarian aid,
service, disaster response and management?
In the spirit of peace and working together, the theme for PHASE 2015 will be Unity in Community.
Proceedings
Due to the size of the event and our limited staff resources, it will take approximately one month to finish the
proceedings. In early to mid September, we will upload the Proceedings to our ESDFocus Library homepage
accessible at: http://esdfocus.org/library.
The Proceedings will be published in electronic format only as we strive to be a carbon neutral event.
• HWB ISSN 2188-4005

• SHINE ISSN 2189-2199
• PHASE ISSN 2188-2164
HWB/ SHINE/ PHASE 2015 General Information
Designated Hotel – Mitsui Garden Hotel Hiroshima
The designated hotel and venue site is the Mitsui Garden Hotel Hiroshima. All sessions and receptions will be
held here. The hotel is conveniently in the center of the city near the shopping and restaurant district. The hotel
is also within walking distance of Hiroshima Peace Memorial Park and Museum. Also nearby are the A-Bomb
Dome and Bell of Peace
Access to the Mitsui Garden Hotel
The most convenient means to reach the Mitsui Garden Hotel is either to take a taxi from Hiroshima Station or
to use the public transportation street car system known as ‘Hiroden’. The approximate travel times are as
follows:
• 15 minutes from JR Hiroshima Station to Fukuromachi stop by streetcar

• 10 minutes on foot from the Bus Center
• 55 minutes by shuttle bus from Hiroshima Airport to downtown Hiroshima
Venue
As one of the largest cities in western Japan, Hiroshima has been a bustling, affluent and prosperous city with a
rich history dating back to 1589, when it was established as the capital city of a powerful samurai warlord.
Today, of course, Hiroshima is most well-known as the first city in the world to have suffered an atomic
bombing, which occurred towards the end of World War II on August 6, 1945.
Around the city of Hiroshima, you will find many well-used green spaces, none of which are more important
than the poignant Peace Memorial Park, where various statues and monuments reside, as well as the A-Dome
building, which has become a symbol of peace and has been registered as a UNESCO World Heritage Site.
Apart from war memorials, Hiroshima boasts some of the best traditional Japanese landscaping, including the
beautiful Shukkeien Garden complete with tea houses, ponds and bridges.
Finally, there is the iconic Miyajima Shrine Island, which is revered as on of the “three views of Japan” with its
towering red torii gate standing in the midst of the inland sea. Built in 593, it was renovated to its current
splendor in 1168. The main hall of the shrine is furnished with vermillion-lacquered columns and Japanese
cypress bark roofing. The shrine pavilion is a unique example of Heian Period architecture and has been
designated as a national treasure of Japan. The Miyajima Shrine is also a UNESCO World Heritage Site and its
close proximity to Hiroshima makes for a wonderful afternoon visit.
Dress
During the symposium sessions and receptions, the expected dress code is business casual.
Climate
Hiroshima has a temperate climate, with average lows staying above freezing even during the coldest part of the
year. Average temperatures range from 35 degrees Fahrenheit in January to 90 degrees in August, with daily
means hovering between 45 and 75 most of the year. Rainfall averages 60 inches annually and is spread
throughout the year; June and July are the wettest months, receiving roughly 10 inches. The driest months are
December and January, with less than 2 inches of rain each. Light snowfall occurs from December to January,
averaging no more than 2 inches a month.
Equipment
Presentation rooms are equipped with PC notebook computers, screens, projectors, speakers and laser pointers.
Please note that the computers are not connected to the sound system in the room. If you intend to have an audio
track during your presentation, please let us know.
We also provide onsite technical support, if needed.
Session Time Moderators
Presentations during regular sessions have been allotted 24 to 30 minutes depending on the type of panel and the
number of panelists. We advise that presenters limit their presentation to the allotted time with time at the end of
for questions. We also ask that you allow time for the next presenter to prepare.
As it is difficult for presenters to be mindful of the time, we have selected (1-2) people from each panel to alert
the presenters when the presentation time is nearing its end.
The primary task of the moderator is simply to remind presenters when the presentation time has expired so as
to allow for a smooth transition for the next presenter.
The moderators are not required to introduce the speakers because details are included in the schedule program
regarding the name and affiliation of the speaker.
If a presenter is absent or arrives late, the moderators should start the next presentation and inform the audience
accordingly. If a moderator arrives late or is absent the panel should nominate an alternate moderator.
Any presenters arriving late must wait until the final presenter has finished, and then may use any remaining
time to present.
Internet Access
WIFI access is available in the Mitsui Garden Hotel lobby area. Please see the front desk for login and password
details.
If you are staying in the Mitsui Garden Hotel, then you can access the Internet free-of-charge in your room.
Having difficulty connecting to the WIFI inside the Mitsui Garden Hotel? Please note that the organizers have
no control over the WIFI access, so please inquire at the hotel front desk.
Printing
Photocopies can be made at one of the convenience stores located next door and behind the Mitsui Garden Hotel.
Alternatively, for larger printing needs, there is a Kinko’s located on Hon-Dori Avenue. See the Mitsui Garden
front desk for directions.
Stores Near the Mitsui Garden Hotel
The Mitsui Garden Hotel is located in the main shopping district. About 500 meters behind the Mitsui Garden
Hotel is Hondori, which is an arcade which is filled with many shops.
Banks / ATM / Currency Exchange
There is currency exchange available at the Mitsui Garden front desk as well a bank within a 5-minute walk of
the Mitsui Garden Hotel. Please ask the hotel front desk for a map and directions.
All banks in Hiroshima are open until 3:00 p.m. Monday to Friday and closed on Saturday and Sunday. Please
remember to bring your passport when exchanging money.
International ATMs with English menus are also available at 7-Eleven convenience stores, which are open 24
hours with locations throughout the city.
Section II
Abstracts
2015_139 Effectiveness of motivational interviewing on lifestyle modification of clients at risk or
diagnosed with CVDs: A systematic review
Wai Man Lee, The Open University of Hong Kong, China1
Sek Ying Chair, The Chinese University of Hong Kong, Hong Kong2
Wai Yee Yum, The Chinese University of Hong Kong, Hong Kong3
Cardiovascular disease (CVD) is a leading cause of death and is a major cause of disability around the
world. Nevertheless, most of the CVDs are preventable through lifestyle modification. However,
traditional didactic provision of advice may induce resistance to change, especially for those who are
not motivated to change. Hence, Motivational interviewing (MI) has been used recently to assist
individuals to change their unhealthy lifestyle. However, empirical evidences for its effectiveness on
changing CVD patients’ lifestyle behaviors are not conclusive. A systematic review was therefore
carried out to identify the best available evidence relating to the effectiveness of MI on lifestyle
modification in clients at risk of or with diagnosed CVDs. A total of thirteen articles describing 9
studies were included in the review, and lifestyle modification outcomes included alteration of smoking
habits, increase in physical activity, increase in fruit and vegetable intakes, and decrease in fat intake.
Among all the outcomes, meta-analysis showed that MI had a positive effect on smoking habit and
vegetable intake only. Even so, only the effect of MI on altering clients’ smoking habit was shown to
be significant with a pooled odd ratio of 3.29; 95% CI: 1.66 to 6.51, and p < 0.0006. For the other
outcomes, pooled results showed either no difference between intervention and usual care, or the
results favored usual care. Further researches exploring the most effective intervention dosage,
intervention deliverers, as well as clients’ stage of change should be carried out to address the
variability of the reviewed studies.

2015_198 Chagas disease: Prevalence in public school students and their families at canton
Molineros, Verapaz, San Vicente, El Salvador
Santa Romero-Jovel, Ministry of Education, El Salvador1
Tatiana Ascencio, UJMD, El Salvador2
Maria-Auxiliadora Vargas, UEES, El Salvador3
Chagas disease caused by Trypanosoma cruzi, a Kinetoplastid protozoan, which is transmitted to

humans primarily by blood-sucking triatomine bugs, (in El Salvador, Triatoma dimidiata), and
occasionally via blood transfusion. An estimated 8 million people in Latin America and 232,000 in El
Salvador are infected with this parasite. The work main two objectives: first, to screen, serologically by
ELISA and HAI, IgG and IgM antibody presence to T. cruzi in a group of 135 elementary and high
school students (5-17 years old), and their relatives, a total of 72. Any doubtful results were confirmed
by PCR. Second, to treat with Nifurtimox, during 3 months, those given positive ELISA and HAI tests,
carefully registering secondary ill effect (anorexia, weight loss, nausea, vomiting, epigastralgia,
cephalea and dizziness). Results: 16 of them were positive to Chagas disease, one student of the scholar
center, 16 years old; fifteen relatives, one 17 years, the rest adult. 5 (31.25%) presented EKG
alterations, right bundle branch block and defective T wave. No symptoms associated to these EKG
finding were observed of the treated patients. 10 (62.5%) of patients presented important side effects,
such as epigastralgia, dizziness or vertigo, 6 (37.5%) had to abandon their treatment, because of their
grave ill effects, and 4 (25%) their dosage had to be adjusted. PCR proved specificity and sensibility as
auxiliary technique. Recent important scientific advances on chronic Chagas disease’s pathogenesis led
to consensus every T. cruzi-seropositive patients should receive etiological treatment as Nifurtimox.
Due to significant side effects, challenge remains.
2015_195 Determinants of nurse-sensitive patient outcomes in optimizing quality health care: a
research proposal
Kai Chow Choi, The Chinese University of Hong Kong, Hong Kong3
Eric Lu Shek Chan, Caritas Bianchi College of Careers, Hong Kong4
Matthew D. Mchugh, University of Pennsylvania, United States5
Wan Yim Ip, The Chinese University of Hong Kong, Hong Kong6
Iris Fung Kam Lee, The Chinese University of Hong Kong, Hong Kong7
Diana Tze Fan Lee, The Chinese University of Hong Kong, Hong Kong8
Background: Previous studies found that nurse-to-patient ratio, practice environment, and nursing
education were significant predictors of patient outcomes. However few nurse-sensitive patient
outcomes have been measured to quantify nurses’ contribution to patient care. Previous studies were
largely cross-sectional or retrospective which were limited in explaining the casual relationships
between variables. Aim: This presentation will discuss the proposal of a funded project to examine the
determinants of nurse-sensitive outcomes, including nurse staffing levels, skill mix of baccalaureate-
prepared registered nurses, and practice environment. Methods: A multi-method research design will
be adopted. The study sample includes medical and surgical wards of four major acute public hospitals
in Hong Kong. Multiple responses from registered nurses who work in these wards will be collected
over 12 months to examine their individual characteristics and perceptions of the practice environment.
A 12-month prospective observational study will be conducted to examine the association among nurse
staffing levels, practice environment, and nurse-sensitive patient outcomes including pressure ulcers,
falls and restraint prevalence, and urinary catheter- and central line catheter-associated bloodstream
infections. Multilevel Cox proportional hazards models will be employed to examine the association
between these patient outcomes and the explanatory nursing factors of primary interest. Significance: It
is anticipated that the study results will inform the provision of quality and timely patient care. The
study will provide a landmark report of relevance and importance to patients, and to hospital
stakeholders, health policy makers, nurses, and educators who strive for enhancing nursing care
quality.
2015_179 An interprofessional initiative to optimize client-centred care in gerontological
education
Vivian Wing Yan Lee, The Chinese University of Hong Kong, Hong Kong3
A major goal of gerontological education is to equip students with a strong foundation in the theory
and practice of gerontology and the ability to practice client-centred care to promote the wellbeing of
vulnerable individuals. Gerontology students are required to support and involve older people in
making decisions about their plan of care while pharmacy students are required to help older people
better understand prescription drugs and their side effects. The ability to convey a message successfully
and understand the needs of older people with special needs is the fundamental aspect of client-centred
care. We had developed a module to facilitate gerontology and pharmacy students learning of strategies
to improve communication with older people with hearing impairment. Fourteen scenario-based
videotaped vignettes were developed. The scenarios covered good and poor practices in
communicating with older people having hearing impairment; psychological and social aspects of
hearing loss; hearing aid use; important considerations for sign language; barriers to effective
communication; and strategies to promote communication in hospitals, rehabilitative, residential, and
community settings. Interactive exercises were developed to facilitate the discussion of the
considerations and challenges relating to communicating with older people who are hard of hearing in
everyday life. Positive feedback was received from students and they commented that their
participation in the development of learning resources deepened their understanding of the diverse
challenges faced by older people with hearing impairment, and the learning resources were useful in
enhancing their skills in practicing and optimizing client-centred care.
2015_117 Effectiveness of Using the Ottawa Ankle Rules by Emergency on Improving Healthcare
Outcomes among Patients with Ankle Injuries: A Systematic Review
Ka Ming Ho, The Open University of Hong Kong, Hong Kong1
Nancy M. C. Cheung, Princess Margaret Hospital, Hong Kong2
Janita P. C. Chau, The Chinese University of Hong Kong, Hong Kong3
Background: It is difficult to differentiate between an ankle sprain and a fracture without radiographic
assistance. Accordingly, radiographic tests were requested in most patients although only a small
proportion actually sustained fractures. The Ottawa Ankle Rules appears to be highly sensitive for
predicting ankle fractures and thus the need for requesting radiographic tests. Evidence suggests that
utilisation of the Ottawa Ankle Rules by emergency nurses reduce unnecessary radiographic test
requests and patient length of stay in emergency departments. However, there continues to be some
inconsistencies of findings in existing studies. Aim: To summarize the best available evidence on the
effectiveness of using the Ottawa Ankle Rules by emergency nurses on improving healthcare outcomes
among patients with ankle injuries. Design: A systematic review was conducted. Methods: A three-step
search strategy identified 1,595 records through database searching and other sources. All identified
studies were assessed for their eligibility and methodological quality before inclusion into the
systematic review. Data of eight studies were extracted and synthesized. Results: It was found that
using the Ottawa Ankle Rules by emergency nurses reduced unnecessary radiographic test requests and
patient length of stay in traditional emergency departments. However, it was found that using the
Ottawa Ankle Rules by emergency nurses in an urgent care department could not reduce unnecessary
radiographic test requests, patient length of stay, patient wait times, and patient satisfaction.
Conclusions: A nurse-initiated radiographic test protocol could be considered a standard practice in
emergency departments if its applicability is demonstrated by a randomized controlled trial.

2015_172 Health promoting lifestyle among undergraduate medical students
Shasidhara Kotian Mangalore, Kasturba Medical College, Manipal University, India1
Lifestyle is defined as normal and conventional daily activities which are accepted by people during
their lives and these activities can affect the health of individuals. Our aim is to assess the health
promoting lifestyle amongst undergraduate medical students in Mangalore. Also to assess health
promotion of students through their lifestyle which consists of six aspects-physical activity, Nutrition,
Health responsibility, Spiritual growth, Interpersonal relations & Stress management .We would like to
compare the health promoting behavior in these six aspects between males and females and to different
cultural backgrounds. A Cross sectional study was done with 380 undergraduate medical students of a
Medical college at Mangalore. Analysis was done by students unpaired t test and ANOVA. Out of the
380 participants equal number of boys & girls were taken for the study(190) . A total of 107 NRI,s &
273 Indians were included in the study. Mean Health promoting lifestyle score(HPLP) was 130.845.
While comparing the mean HPLP score between the boys and girls it is more in girls (131.64) than
boys(130.84) but statistically insignificant.(p=0.378) While comparing mean score among the six
aspects of HPLP- we found statistically significant difference in physical activity, spiritual growth and
Inter personal relationship between boys and girls. Physical activity score is more in boys(20.105)
compare to girls(17.468) whereas Spiritual growth and Inter personal relationship score is more in girls
than boys.
Toxicology
2015_155 Intentional Self harm by Paraquat Poisoning
VInod C Nayak, Manipal University, India2
Paraquat is one of the most dangerous poisons in the medical field as Ingestion of small quantities
(>10mL) may damage lung irreversibly and also lead to renal failure causing to death. The clinical
features vary from case to case based on the amount and type of compound consumed. As it is a fatal
condition, early diagnosis and proper management is warranted which can reduce the morbity and
mortalities. But sometimes early diagnosis may not save the victim as in our case. We present a case
wherein the victim succumbed to acute respiratory distress following consumption of paraquat. Key
words: Paraquat, lung damage, renal failure, respiratory distress.
Forensic anatomy
2015_153 Double non coronary aortic sinuses: an autopsy case
Raghavendra Babu YP, Kasturba Medical College, Manipal University, India1
We report a case of anomalous origin of the right coronary artery from the left posterior aortic sinus.
This was observed routinely during a medico legal autopsy of a 58 year old male who died in a road
traffic accident. Initially it was believed that the right coronary artery was absent since there was no
obvious coronary ostium from the anterior aortic sinus. However it was found later that the right
coronary ostium was present just beside the left coronary ostium in the left posterior aortic sinus and
the right coronary artery was arising from the left posterior aortic sinus. The right coronary artery had
an intramural course between the aorta and pulmonary trunk, which is considered as very dangerous
and life threatening. We believe that the present case report will be enlightening to the cardiologist and
cardiothoracic surgeon. It is also true that the conduction of medico legal autopsies of coronary arteries
is important for the medico legal resolution. Keywords: aortic sinus, coronary ostium, left coronary
artery, right coronary artery
Pathology
2015_151 Acquired Cystic Kidney Disease Associated Renal Cell Carcinoma
Dewaraj V, Manipal Univrsity, India2
Renal cystic disease represents a wide spectrum of diseases that may be hereditary, developmental, or
acquired, in which the renal cysts are seen in the cortex, the corticomedullary junction, and/or the
medulla depending on the underlying disease process.(2) Acquired Cystic Kidney Disease (ACKD)
develops in long standing kidney disease or on long term dialysis. Acquired cystic disease predisposes
to renal cell carcinoma. We describe a patient who had received kidney transplant 7 years back with
normal allograft function who suffered sudden cardiac death at home and discovered to have acquired
cystic disease and renal cell carcinoma in her native kidneys. This case highlights the need to assess
native kidneys periodically after kidney transplant.
Food Security
2015_921 Food security through community owned and managed institutions– A Reliance
Foundation Initiative
Mahesh Gangadharaiah, Reliance Foundation, India1
Sudarshan Suchi, Reliance Foundation, India2
DharamPal Singh, Reliance Foundation, India3
Srinu Manda, Reliance Foundation India4
India being second most populous country in the world with 1.2 billion population has been witnessing
tremendous growth in Agriculture and Industrial sectors. In spite of sufficient food being produced,
there are 194.6 million undernourished people in the country (FAO report: “The state of food insecurity
in the world, 2015” ). The situation calls for attentive action from the government, NGOs and private
agencies to work towards ensuring food security. Food security is achieved when all people, at all
times, have physical and economic access to sufficient, safe and nutritious food to meet dietary needs
and food preferences for an active and healthy life. ”Reliance Foundation a philanthropic wing of
Reliance Industries Ltd under the flagship programme of BIJ (BHARAT INDIA JODO) has chosen to
ensure food security of marginal communities in selected 500 villages reaching 50000 households in 12
states. These rainfed areas fall under 19 Agro-ecological sub-regions out of total 60. Need based
location specific interventions are promoted while pursuing the principles of Participatory approach,
direct action and sustainable development through community owned village associations.
Unproductive and waste lands are brought into productive system through sustainable Agriculture
practices complimented by water harvesting structures. Nutrition gardens and orchards are integral to
the pursuit of achieving food and nutrition security. This initiative of Reliance Foundation is resulting
in establishing self –reliant, holistic and sustainable models for achieving food security of most
deprived communities there by contributing to UN millennium development goal of eradicating hunger
and poverty.
Sexual Health
2015_148 Adolescent Attitude Related To Adolescent Premarital Sexual Intercourse in Indonesia
2011 (RPJMN-BKKBN Survey Analysis, 2011)
Ahmad Robi'ie, University of Indonesia, Indonesia1
Adolescent Premarital Sexual Intercourse (APSI) can cause unwanted pregnancy that can encourage
the adolescent to have an unsafe abortion and get sexually transmitted diseases. The attitude of
adolescents towards APSI is the most dominant variable for APSI. Based on the previous studies, the
age group and the residence become confounding variables in the relationship. The purpose is to know
the relationship between the attitude of adolescents towards APSI and APSI that were controlled by the
age group (15-19-year-old and 20-24-year-old) and the residence (rural and urban) in Indonesia in
2011. In this study, RPJMN-BKKBN data in 2011 was used and analyzed by using logistic regression.
The study design is a cross-sectional. The dependent variable is APSI and the attitude is an
independent variable. The age group and the residence become confounding variables. In the final
model, the age group interacted with the attitude. The 20-24-year-old who agreed to APSI has OR:
14.74 compared the 15-19-year-old who didn’t agree in the same of residence. The 15-19-year-old who
agreed to APSI has OR: 7.65 compared the 15-19-year-old who didn’t agree in the same of residence.
Based on the result, the relationship between the attitude and APSI in the 20-24-year-old are higher
than 15-19-year-old at the same of residence. The adolescent who agreed towards APSI have a high
risk of APSI. Therefore, reproductive health promotion should be encouraged in adolescent, especially
for 20-24-year-group. Furthermore, we must ensure the equality of reproductive health quality among
urban and rural area. Keywords: adolescent, sexual intercourse, attitude

2015_145 Satisfaction Level Of Childbirth Patient In Primary Helath Care In Indonesia
Faisal Ridho Sakti, Faculty Medicine of Islamic University of Indonesia, Indonesia1
Hifzhan Maulana Ghifari, Islamic University of Indonesia, Indonesia2
Based on the Indonesian Demographic and Health Survey (IDHS) in 2012, maternal mortality
associated with pregnancy, childbirth, and postpartum are 359 per 100,000 live births. This statistic is
still far from the target of MDG's by 2015, which is to reduce maternal mortality in 2015 to 102 per
100,000 live births. Analysis of maternal mortality conducted by Indonesian Directorate of Maternal
Health in 2010 proved that maternal mortality is closely linked to birth attendants and maternity
facilities. Medical personnel attandence proved to contribute to the decline in the risk of maternal
death. Similarly facilities, if the delivery is done in health care facilities, it will reduce the risk of
maternal death. At present, the existing health care system in Indonesia are the system of primary and
secondary care. In this case, the primary health care system is the first-line for public health services,
including childbirth services. Patient satisfaction is an indication of the quality of health services.
Therefore, we want to observe the level of patient satisfaction in terms of childbirth at the primary
health care level. In this study we used a qualitative descriptive method to determine the level of
childbirth patients satisfaction in primary health care. Our study subjects were pregnant women who
had given birth in a primary health care at least one time.
Pediatric Care
2015_166 Feelings of mothers towards medical care who encountered positive results of
newborn screening
Yuko Matsumoto, Kagawa Prefectural University of Health Sciences, Japan1
Hisae Nakatani, Hiroshima University, Japan2
Hiroko Kokusyo, Hiroshima University, Japan3
Miki Oeki, Hiroshima University, Japan4
Akiko Kanefuji, Hiroshima University, Japan5
Atsuko Hayakawa, Hiroshima University, Japan6
Go Tajima, Hiroshima University, Japan7
Background and objectives: In Japan, nationwide newborn screening (NBS) was initiated in the 1970s.
Recently, NBS using tandem mass spectrometry was introduced to each local government throughout
the nation. However, its practice and support systems differ among regions. Therefore, we investigated
the feelings of mothers with NBS-positive children towards medical care, in order to establish the
effective follow-up system in the future. Methods: A qualitative descriptive study was performed using
semi-structured interviews with mothers of NBS-positive children aged. The data were evaluated by
content analysis. Results: 1. Characteristics of subjects The number of mothers according to the
suspected disease of the child was 1 for organic acid metabolism disorders, 2 for fatty acid metabolism
disorders, and 2 for carbohydrate metabolism disorders, respectively. 2. Mothers’ feelings towards
medical care Our analysis revealed 2 core categories (chasm between mothers and medical care and
affinity to medical care) with 3 subcategories each. Chasm between mothers and medical care; This
core category consisted of perplexity due to absence of experts to consult other than primary care
pediatricians, dislike for medical care, and reluctance to visit hospitals. Affinity to medical care; This
core category consisted of reliance on dedicated staff members, satisfaction with medical care, and
expectation of professional support. Discussion: Mothers’ feelings are affected by availability of the
systematic support, including not only expert pediatricians but also other specialists such as health
nurses. It is an urgent issue to establish a practical support system that is available for all mothers who
receive NBS-positive results.
Palliative Care
2015_143 The different between Anraku and comfort
Yukihiro Kitatani, Toyama University, Japan1
Michiyo Aitakei, Toyama University, Japan2
Miki Yatuzukai, Toyama University, Japan3
Anraku has equaled comfort in Nursing of Japan. The purpose of this study compared to the derivation
of Anraku and of comfort, its of definition in Nursing literature. The word Anraku derived from
Sanskrit word Sukhāvatī, meaning to “Satiarutokoro”. The word comfort derived from Latin word
confortare, meaning to strengthen. The study relates to Anraku in Japan is only twice, The subjects is
only nurses, and is only general surgery and internal but palliative and terminal care, and the research
methods is Roder’s concept analysis. Comfort is studied various dimension, research methods, subject.
The definition of Anraku in Nursing literature was state, physical and mental. The definition of comfort
in Nursing literature was not only state but also process and outcome, the physical, psychological,
social, spiritual, and/or environmental domains within a specific context and a relative state and may be
temporary or lasting. The meaning Anraku and comfort was greatly different. It is disadvantage for a
nurse and a patient to continue using it like now. We need to study Anraku.
2015_142 Family roles in caregiving of people with mental illness in Nepal
Shreejana Maharjan, Chiba University Graduate School of Nursing, Japan1
Background: In Nepal the care of people with mental illness is provided mainly by families. Various
factors like poverty, illiteracy, scarce resources, and stigma make families to engage in appropriate
caregiving roles difficult. In order to assist families, it is important to know how these factors influence
family caregiving roles. However, little is known about factors related to family caregiving. Aim: The
purpose of this study is to identify family caregiving roles and influencing factors. Method:
Unstructured interviews were conducted with personnel of mental hospital and rehabilitation center
located in Kathmandu. Permission for interview was obtained from the concerned institution. Results:
Data analysis revealed that there are few families who engage in caregiving roles. Caregiving is mainly
focused on provision of daily care, medications and outpatient care. Patients are mostly confined to
inner environment only. Moreover some families seek help to rehabilitation center when patients get
violent and visit the center to know patient’s improvement. However most families isolate mental
patients without care and lock patients in a room. Some families abandon patients so that patients
become homeless and receive no proper treatment. Isolation and abandonment are related to lack of
knowledge and stigma. Although there are mental health programs to educate community about mental
illness, program on family caregiving is lacking. Implications: The results indicate that education
should be provided to family members to help them acquire knowledge of illness and skills in
caregiving.
School Health
A questionnaire investigation was conducted sampling 403 school nurses employed at elementary
schools,junior high schools,high schools,and special-needs schools in prefecture K.Investigated were
72 assessments of school nurses'behavior to support pupils and students,which had been extracted from
earlier literature.The validity of framework concepts was reviewed by factor analysis and multiple
regression analysis through the statistical package SPSS for Windows Ver.11.The collection rate of the
403 subject persons was 60.3% and 240 answers were regarded as valid.On a rating scale of one to
five,school nurses scored withn the range of 4.79 to 3.01,which was determined to be realistic school
nurses'behavior.According to results of analysis,it has been found that caring explained by the seven
concepts including 13 care factors was present in the school nurses'behavior. 1.Building relasionships
of caring and being cared for(physical contact,concern) 2.Treating as a person with
affection(trust,staying by) 3.Having a great level of sensitivity and noticing
others'emotions(acceptance,empathy) 4.Creatively pursuing problem-solving-oriented care(appropriate
helping behavior) 5.Having hopes for capability and potentiality(hope,self-realization) 6.Manipulating
environmental factors and helping from various(support of surroundings,occasion making,support for
expansion of human relationships) 7.Supporting independence and growth(support for
independence,educational support) It has been found that caring behavior is actually expressive in the
practices of nursing with considerably high frequency.Development of conceptual framework for them
is considered to be helpful for comfirmation of the presence and significance of caring in the practices
of nursing and also enhancement for phronesis.
2015_124 Comparison of the events leading to life purpose, mental health and ADL in Japan and
Thailand
Takashi Ohue, Hyogo University, Japan1
Darunee Rujkorakarn, Faculty of Nursing, Maha Sarakham University, Thailand2
Amorn Suwannimitr, Faculty of Nursing, Maha Sarakham University, Thailand3
Supaporn Aryamuang, Faculty of Nursing, Maha Sarakham University, Thailand4
The purpose of this research is to examine the relation of the events leading to life purpose, mental
health and ADL in Japanese and Thailand elderly people. Methods: A total of 200 subjects (men and
women: 100) per country will be studied in Japan and Thailand elderly people. They were asked about
their individual attribution and maintenance of healthy condition. Moreover, 19 items were examined
as events leading to life purpose, based on the study by Hasegawa et al. (2001). These items were
measured using General Health Questionnaire (GHQ) and Instrumental Activities of Daily Living
(IADL) Scale. Results: Data from 200 elderly people (male: 67, female: 133) in Thailand and 234
elderly people (male: 49, female: 185) in Japan were used in the analysis. As a result, Educational and
cultural enrichment activities, Sports or recreational activities, Hobby activities, Volunteer, Interaction
with neighbors friends and acquaintances, Going for shopping or on a trip, Activities in a community
association, Knowledge and skills acquired so far, Spouse, Pet, and Role at home of Events leading to
purpose of life were higher than Thailand in Japan (p< 0.05). Care of grandchildren and family get
together, Grandchildren and Health were higher than Japan in Thailand (p< 0.05). Conclusion: In order
to improve older adults’ mental health and ADL, it is important to increase the events leading to life
purpose in both countries. It is thought that each culture factor had affected.
Critical Care / ER Nursing

2015_554 A literature review on the needs of parents of children admitted to the ICU
Ai Takeoka, Hiroshima University Hospital, Japan1
Naoko Nakata,Hiroshima University Hospital, Japan2
Hiroshi Senoo, Hiroshima University Hospital, Japan3
Etsuko Fujita, Hiroshima University Hospital, Japan4
Kasumi Yamasaki, Hiroshima University Hospital, Japan5
Ryouta Iiboshi, Hiroshima University Hospital, Japan6
Ikuko Sobue, Hiroshima University, Graduate School of Biomedical & Health Sciences, Japan7
In Japan, children in critical condition are not usually admitted to the PICU, but to the ICU, where
visiting hours are limited and primary nursing care is not provided, to be managed under mechanical
ventilation. We conducted a literature review using the PubMed database of articles published between
2005 - March 2015 with "(ICU or intensive care unit or critical care) and family and needs" as key
words, and found 31 original articles. Most findings were based on PICU studies. The needs of parents
included: Obtaining updated information on treatment and conditions of their children, receiving an
understandable explanation from physicians, making decisions based on information, increasing the
QOL of their children, and meeting their children whenever they wish to. We also conducted a
literature review of articles published in Japanese using "(ICU or intensive care) and family and need
(needs) and child" as key words, and found 16 articles. Forty-seven articles were found using "(ICU or
intensive care) and family nursing" as key words. However, only 2 articles which reported the needs of
families whose children were admitted to the ICU were found. There were few findings on the needs of
parents whose children were admitted to the ICU. The results indicate the need to conduct research on
the needs of parents of critically ill children admitted to the ICU in Japan.
School Nursing
2015_552 Actual Situation of the Lifestyles, Physiques, and Bone Density of Elementary School
Pupils
Hiromi Miura, Kagawa Prefectural University of Health Sciences, Japan1
Tomomi Goda, Takarazuka University School, Japan2
Kazuyo Funakoshi, Kagawa Prefectural University of Health Sciences, Japan3
Reiko Sakae, Kagawa Prefectural University of Health Sciences, Japan4
Yuko Uemura, Kagawa Prefectural University of Health Sciences, Japan5
It has been reported that it is important to increase bone density as much as possible during childhood,
in order to prevent osteoporosis. The author studied the lifestyles, physiques, and bone density of
elementary school pupils as basic data, and this paper reports on their actual situation. The subjects
were 203 fourth-year students of a public elementary school in a local city who agreed with this survey.
The survey was conducted in fiscal 2012 and fiscal 2013. For lifestyles, the author carried out a self-
completed questionnaire survey on their eating habits, exercise, sleeping hours, etc. For bone density,
the density of the right heel bone was measured, and osteo-sono assessment index (OSI) was
calculated. For analysis, SPSS23.0 was used, and simple tabulation was made. The subjects were
composed of 129 nine-year-old pupils (63.5%) and 74 ten-year-old pupils (36.5%), or 107 male pupils
(52.7%) and 96 female pupils (47.3%). Among them, 19 pupils (9.4%) sometimes do not have
breakfast, and 1 pupil rarely has an evening meal. 89 pupils (43.8%) play outdoors for less than 1 hour
on holidays, and 37 pupils (18.2%) play outdoors for over 2 hours on holidays. 21 pupils (10.2%) have
the experience of bone fracture. The average wake-up time is 6:00, and the average bedtime is 21:00.
25 pupils (12.3%) feel the lack of sleep every day. The average stature is 133.9 cm, the average weight
is 30.1 kg, and OSI is 2.6 ± 0.44.

2015_547 The effects of a serious game for learning the elderly dementia cares
Takayuki Fujii, Kobe University Hospital, Japan2
Miwa Yamamoto,Tottori University, Japan3
Daiki Wakayama, Osaka Prefecture University, Japan4
Tomoharu Nakashima, Osaka Prefecture University, Japan5
This paper investigates the effect of a serious game learning material on the understanding of dementia
cares. For this purpose, a learning system as digital game-style was developed where the user of the
system plays a role of a nurse in a hospital. An elderly woman with dementia stays in the hospital and
the user of the game is to take care of her. She expresses some symptoms of dementia and the nurse is
expected to react properly by selecting the most appropriate candidate words for what the elderly
woman says. As the game proceeds, her symptoms get either better or worse depending on the uses’
selection of the reactions. The game allows the users to experience dementia care by seeing her
changes in the virtual world. The digital learning materials also contain the test from the previous
national nursing exams. The effect of the learning system is evaluated by comparing the test
performance of two groups, A : the students from one group studied the dementia care using the digital
learning material, and B: the students from the other group studied it from the conventional text book.
The comparison results show significant differences in the test performance by paired t-tests (p < 0.05)
and Group A had more learning time and learning frequency than Group B. A questionnaire survey
was conducted for the students who had attended in the comparison test. The results of the survey
revealed the advantage and the advantage of the developed digital learning system.
Quality Assurance in Healthcare
2015_542 A model of functional perpetual resilience in adults with type 1 diabetes
Ikuko Nishio, Tottori University, Japan1
Hideyuki Kataoka,Tottori University, Japan2
In this study, we evaluated the meaning of resilience in individuals who have type 1 diabetes (T1D)
using grounded theory, and clarified a model of resilience in adults with T1D. Semi-structured
interviews were conducted with 15 adults with T1D; responses were analyzed using the constant
comparative method. We then constructed a new conceptual model of T1D. Analysis results suggested
a core category: “functional perpetual resilience.” The core category was composed of ten
subcategories. Subcategories were classified into five stages: 1st, “Avoiding death due to an injection”;
2nd, “Suffering from treatment,” “Avoiding being seen,” “Building walls around others,” “Branded as
sick”; 3rd, “Awareness of supporters”; 4th, “Active effort” or “Bridging a gap”; 5th, “Acquiring self-
protection skills” or “Strategies to manage change.” We found that resilience while living with T1D
was a function of positive experiences, and of difficult experiences related to these themes. These
results suggest that individuals with T1D use difficult experiences to motivate their resilience, and that
these individuals use resilience to make their situations more positive. Resilience was found to be
important to these individuals’ belief in their ability to face difficulties, accept their illness and insulin
therapy, and control their illness; resilience was also found to be important to these individuals’ faith in
the future and in medical care.

2015_530 Experiences of single mothers with adolescent children
Ikeuchi Kazuyo, Kochi Medical School, Japan1
Ikuko Sobue, Hiroshima Univ. Graduate School of Biomedical & Health Sciences2
Objective: The study was conducted to assess the mental strength of single mothers with adolescent
children in the rebellious phase Methods: Interviews with three mothers, who had provided informed
consent, were conducted, and the results were analyzed qualitatively. Results: The subjects were 31 to
51 years old, and their eldest child was 13 to 18 years old. Categories (stated in []) and subcategories
(stated in <>) were extracted from the interviews. [Adverse circumstances at present] consisted of
<divorce>, <rebellious attitudes>, <their children’s absenteeism>, <no one to rely on>, and <illnesses
of their children>. [Distress] consisted of <being unable to accept divorce>, <distress regarding child-
raising>, and <a sense of loneliness>. [Patience], consisting of <hardships of life>, <responsibility for
child-raising>, and <working hard>, and [patience to support themselves], consisting of <positive
feelings toward divorce>, <support provided by surrounding people>, <expectations regarding the
future of their children>, and <expectations regarding of their own future>. Discussion: As the subjects
were divorcees, they had a sense of loneliness with no one to rely on, and were worried about the
rebellious attitudes and truancy of their children. However, mothers had a strong sense of responsibility
for child-raising and worked very hard to support themselves and their children. The lives of mothers
were supported by their expectations regarding the development of their children as well as their
positive feelings toward the future, which helped them broaden their perspectives. Conclusion: Single
mothers worked hard to support themselves while coping with a sense of loneliness with their strong
mental strength. It is necessary to examine the source of their mental strength to provide them with
support.
2015_528 The noise level in the NICU and newborn nursery
Hiroko Uematsu, Takamatsu Red Cross Hospital, Japan1
Yuriko Ohnishi, Takamatsu Red Cross Hospital, Japan3
Akiko Nijyou, Takamatsu Red Cross Hospital, Japan4
Yumiko Hirata,Takamatsu Red Cross Hospital, Japan5
The environment of the NICU is considered an important factor affecting the development of preterm
infants. In this study, we investigated the noise level [dB (A)] of the NICU and newborn nursery using
sound level meters. We also evaluated the effects of a 2-week intervention during which notices
appealing to refrain from making excessive noise were posted in a hospital, using the period of
measuring noise levels as a control. [Methods] Noise levels were measured at 9 points in the NICU and
newborn nursery hourly (24 times a day) using the Rion NA-26 and NL-05, and the highest noise
levels were selected. The time zones where the noise was not measured were treated as missing values.
[Results] The use of the intervention notices, considered to promote visual attention, did not reduce the
noise level. In both groups, the mean noise level of the NICU exceeded 45 dB, the recommended
maximum, in almost all time zones. [Conclusions] The noise level was high during time zones where
many people worked in the NICU and at locations where noisy devices were placed nearby. The results
indicate the need to provide education to deepen understanding of noise exposure, conduct continuous
noise surveys, and increase the awareness of hospital staff in order to promote consideration of the
hospital environment.
Home Health Nursing

2015_525 A case study regarding the home care support of a middle-aged Amyotrophic lateral
sclerosis(ALS) patient with tracheostomy: A follow-up survey
Mariko Zensho, Saitama Prefectural University, Japan1
Koji Sugano, Division of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center,
Japan2
Ryo Kubota, Saitama Prefectural University, Japan3
Hajime Toda, Kitasato University Graduate School of Nursing, Japan4
The purpose of this paper is to investigate any home care support needs of middle-aged ALS patient
with tracheostomy (ALS). This was qualitative research using the field work approach. The
participants were; a ALS, a family-care-giver (wife), an informal supporter, six professions of home
care support, and a welfare technology researcher. The narrative data was recorded, and a word-for-
word record was created. The research took place in six months (2015). The data of home visited data
(10 times for 1-2 hours each time) and 486 emails between the participants and the writer was
collected. Data analysis was extracted and important contents from the word-for-word record were
abstracted. We performed home care support and reflected repeatedly on the many problems in home
care support extracted from the narrative data analysis. As a result of much reflection, the behaviour of
ALS and the family caregiver varied from negative expression to affirmative expression from
intervention in a half year. It was thought that the next five points brought a change in the behaviour of
ALS. Includes having an opportunity to communicate. Thinking about the means of the convincible
intention expression together, and having supported practice. Deepening mutual understanding and
having clarified home care support needs. Having strengthened interprofessional work of the home care
support team. Having collaborated with a welfare technology researcher. It was thought that the
construction of a visit investigation framework to affect the home care support needs extraction of ALS
and the making of an expertise collection system were necessary. Provided by KAKEN 25463559.
2015_523 An educational program based on a simulated elderly experience for nurses and
caregivers in Japan
Miwa Yamamoto, Tottori Univesity, Japan1
Yasuko Maekawa, Tottori University, Japan2
Objective This study aimed to evaluate the effects of a simulated elderly experience on nursing
students and caregivers in Japan. Methods We developed a program that allows nursing students and
caregivers to simulate an elderly individual as part of their dementia care education. “Simulated elderly
experience” was achieved by having participants wear equipment developed by Sanwa SEISAKU-
SHO Company that allowed them to experience the physical constraints felt by an elderly individual
aged about 80 years. Participants performed the following activities after putting on the equipment: use
of toilet, going up stairs, line drawing, and use of chopsticks. We approached nursing staff supervisors
at hospital wards and explained the objective of the study. Supervisors at two hospitals agreed to
participate, giving us a sampling pool of 78 nurses and caregivers. We developed a 26-item
questionnaire (i.e., “scale of attitudes toward elderly with dementia”) based on a scale previously
developed by Kogan (1961). Participants were administered the questionnaire before and after the
simulation. Data were analyzed by the paired t-test. Anonymity was ensured, and the study was
approved by the ethics committee of Tottori University. Results and Conclusion Participants were more
likely to have a positive attitude toward 11 of the 26 items after the simulations (p<0.05; paired t-test).
Nurses and caregivers were able to better appreciate the physical changes that result from aging
through the simulations. Thus, our elderly simulation program may be useful for nurses and caregivers
who care for elderly with dementia.

2015_519 Effect of music on disaster-induced stress in children
Yui Shiroshita, Hiroshima University, Japan1
Yukiko Miyakoshi, Hiroshima University, Japan3
Tomie Fujii, Hiroshima University, Japan4
We conducted a meta-analysis of literature on post-disaster psychological issues in children, and

examined the effect of music support. We analyzed literature from the Japan Medical Abstracts
Society, CiNii, PubMed and CINAHL. Using the keywords "disaster", "psychological", "children" and
"nursing", we identified 13 articles. We did not find any literature containing the keywords "disaster",
"stress", "children" and "music". Only one article contained the keywords "stress", "children", and
"music", and only three articles contained "psychological", "children", and "music". The 13 identified
studies contained numerous references to psychological changes and associated factors in children after
a disaster, namely "anxiety and fear", "mother-child conflict", and "lack of places to play". Some
findings showed that infants tended to conceal their physical symptoms and emotions. Children tended
not to express their emotions during early adolescence, and to exhibit disobedient and delinquent
behavior during mid-adolescence. Psychological issues manifested differently in boys and girls. This
difference was most pronounced during late childhood and early adolescence. Regarding the effect of
music on stress, three of four related studies suggested that music enables self-expression and provides
a forum for communication. The results also suggested that music enables emotional expression in
infants and emotional healing in adolescents. The study findings suggested that disasters have a
profound psychological impact on children, and the loss of places to play deprives them of a means of
emotional expression. Providing music as a tool for self-expression may encourage children to express
their feelings. Further studies should investigate the effect of music on children.
Pediatric Nursing
2015_518 A scale of parental reasons for using pediatric emergency medical care services:
Development, reliability, and validity
Kimie Tanimoto, Kagawa University, Japan2
Susumu Itoh, Kagawa University, Japan3
Objectives: In order to optimize pediatric emergency medical care services (PEMCS), it is essential to
clarify the mechanisms of multifarious risks causing non-urgent pediatric emergency department
(PED) usage, and to assess PEMCS. This study aimed to develop a scale to quantify the contents and
extent of parental reasons for using PEMCS in order to evaluate the reliability and validity of the scale.
Design: A methodological research design. Setting: 171 kindergartens, 215 nursery schools, and 21
health centers in Kagawa Prefecture. Participants: 8,910 parents with children aged 6 years old or
younger. Methods: The generation of items and domains in the construction of a scale of parental
reasons for using PEMCS (PRPEMCS) was based on an extensive literature review. Using one half of
the participants, exploratory factor analysis (EFA) was performed to generate items and factors for the
PRPEMCS, and its reliability was evaluated. Using the other half of the participants, confirmatory
factor analysis (CFA) was used to establish the construct validity. Results: The PRPEMCS
compromised 9 items and 3 factors. All reliability estimates (polychoric ordinal alpha coefficients
>0.76, item-total correlations >0.31), item discrimination (good-poor analyses P<0.0001), fit indices
for CFA (GFI: 0.99, AGFI: 0.99, NFI: 0.99, RMSR: 0.03, SRMSR: 0.03), the convergent validity (CRs
>0.75, AVEs >0.51), and the discriminant validity (Fornell-Lacker criterion) fulfilled the acceptability
thresholds. Conclusion: The PRPEMCS demonstrated satisfactory reliability and validity. The
PRPEMCS will be useful to clarify the mechanisms of risks leading to non-urgent PED usage, as well
to comprehensively assess PEMCS.

2015_512 The involvement of visiting nurses in supporting families and their children who require
medical care: A report on the practical use of ICF
Chizuko Edagawa, Ehime Prefectural University of Health Sciences, Japan1
Yukari Toyota, Ehime Prefectural University of Health Sciences, Japan2
Kayo Nomura, Sanyo Gakuen University, Japan3
With the advances in medical treatment, the number of children who can remain at home while needing
medical care is increasing. For children to continue living in their local areas and who depend heavily
on medical care, the involvement of visiting nurses is essential. The aim of this study was to shed light
on the practices of visiting nurses who support children requiring medical care and their families, and
to understand and support all aspects of their lives including social activities by using International
Classification of Functioning, Disability and Health (ICF) without any bias toward health issues. In the
study, we conducted semi-structured interviews with home-visit nurses caring for children with serious
illnesses that require medical attention, and analysed their responses. The results show that the nurses
valued subjective experiences such as the emotions and desires for and towards the children and
suggested appropriate care that accommodated mothers’ wishes. The nurses observed mothers
palpating their children, educated families to help them improve their diagnostic abilities, and cared for
the physical and mental stability of the children. They stimulated child growth and development by
improving the domestic environment to suit children’s interests and in tune with their reactions, and
created developmentally appropriate lifestyles. The study further shows the expanding of activities and
participation by determining the activities that children could do based on the children’s responses and
through active involvement with the children.
Peace and Conflict Resolution
2015_916 Game Engineering for Disarmament, Demobilisation and Reintegration
Mutsuhisa Ban, Tokyo Institute of Technology, Japan1
Implementation and execution of DDR, stands for disarmament, demobilisation and reintegration, is
one of the intricate problem for peace building and peace keeping. In this paper, we design and propose
humanitarian policies via microeconomic approach called "game engineering" (also known as
implementaiton thoery, or inverse game theory). Our model is focusing on individual decision-making
in the process including the behavioural and epistemic aspects. We demonstrate our quest for the
positive result to implement DDR with some humanitarian social choice functions.
Disaster Education
2015_910 Enhancing Rather than Enforcing: Effect of disaster education programs on typhoon
preparedness among school children in Leyte, Philippines
Oliver Belarga, Osaka University, Japan1
Zbigniew Piepora Wroclaw University of Economics, Wroclaw, Poland2
Encouraging and Enhancing, Rather than Enforcing: Effect of disaster education programs on typhoon
preparedness among school children in Leyte, Philippines Education and public awareness are the
cornerstone of approaches aimed at reducing vulnerabilities to natural hazards. The Hyogo Framework
for Action 2005-2015: Building the Resilience of Nations and Communities to Disasters, adopted at the
World Conference on Disaster Reduction, highlights knowledge and education as one of the five main
priorities of action. After Typhoon Haiyan devastated the islands in the Philippines in 2013, efforts
have been made to build school disaster resilience yet study of its effectiveness is limited. UN stresses
that schools are a fundamental institution that are very much embedded in rural communities. Thus, it
is important to develop schools to become centers for disaster risk reduction for both the school and its
community. This study examines the effect of different disaster education programs on school
children’s knowledge, risk perception, awareness and preparedness behavior. Data gathered from 210
school children (Group 1=123 and Group 2=87) in 2 elementary schools in Leyte, Philippines where
Typhoon Haiyan historically landed. Using the MANOVA analysis revealed that there was significant
difference of knowledge, risk perception, individual preparedness and school preparedness but not for
critical awareness among school children. This study provides evidence that the curriculum-based
disaster education program was effective. If young Filipino children are informed well, they will be
more vigilant during calamities and they can make more informed decisions and take better actions to
ensure their resilience to disasters.
School Health
A questionnaire investigation was conducted sampling 403 school nurses employed at elementary
schools,junior high schools,high schools,and special-needs schools in prefecture K.Investigated were
72 assessments of school nurses'behavior to support pupils and students,which had been extracted from
earlier literature.The validity of framework concepts was reviewed by factor analysis and multiple
regression analysis through the statistical package SPSS for Windows Ver.11.The collection rate of the
403 subject persons was 60.3% and 240 answers were regarded as valid.On a rating scale of one to
five,school nurses scored withn the range of 4.79 to 3.01, which was determined to be realistic school
nurses'behavior.According to results of analysis,it has been found that caring explained by the seven
concepts including 13 care factors was present in the school nurses'behavior. 1.Building relasionships
of caring and being cared for(physical contact,concern) 2.Treating as a person with
affection(trust,staying by) 3.Having a great level of sensitivity and noticing
others'emotions(acceptance,empathy) 4.Creatively pursuing problem-solving-oriented care(appropriate
helping behavior) 5.Having hopes for capability and potentiality(hope,self-realization) 6.Manipulating
environmental factors and helping from various(support of surroundings,occasion making,support for
expansion of human relationships) 7.Supporting independence and growth(support for
independence,educational support) It has been found that caring behavior is actually expressive in the
practices of nursing with considerably high frequency. Development of conceptual framework for them
is considered to be helpful for comfirmation of the presence and significance of caring in the practices
of nursing and also enhancement for phronesis.

2015_517 Physical activity and stages of change for weight control among Korean adolescents: A
preliminary study
Sun-Mi Chae, Seoul National University, Korea 1
Jiyoung Yeo, Seoul National University, Korea2
Chohee Kim, Seoul National Univeristy, Korea3
Ji-hye Hwang, Seoul National University, Korea4
Purpose: Adolescence is the period of decrease in physical activity comparing to other childhood.
Especially Korean adolescents spend most of their time sitting at school for study. They believe less
movement leads to success in admission to university. Weight control is not their priority task although
they are interested in their body shape. The purpose of this study was to explore stages of change for
weight control in Korean adolescents and their physical activity level. Method: A total of 67 Korean
adolescents in 10th and 11th grades participated in the study. Stages of Change for Weight Control
were asked through self-report questionnaires. Physical activity level was measured using activity
trackers for 6 days. Anthropometric measurements were done. Data were analyzed using descriptive
statistics and ANOVA. Results: Of the participants, female adolescents were 52.2% (n=35), and 10th
graders were 52.2% (n=35). About 20% (n=12) were overweight or obese. Only 23.9% (n=16) were in
action and maintenance stages of change for weight control. Less than a half (n=31, 46.3%) showed
greater than 10,000 steps/day. Their sedentary time during weekdays was 1,251.05 (SD 44.53)
minutes/day whereas their active time during weekdays was 144.92 (SD 35.83) minutes/day. There
were no significant differences among stages of change in daily steps, daily sitting time, and daily
active time (p<.05). Conclusion: Korean adolescents showed low levels of controlling weight and
physical activity but high level of sedentary behaviors. They should be encouraged to be more active
and less sitting so that they control their weight.
2015_562 Lived Experiences of Mothers of Children with Autism Spectrum Disorder: Basis for
Enhanced Nursing Care
Bea-Gracia Cruz, Our Lady of Lourdes Hospital, Philippines1
2
The aim of this study is to determine the lived experiences of mothers of children with autism spectrum
disorder and to increase the public awareness about their condition. The researcher used purposive
sampling in choosing the respondents. A snowball technique was used to locate the participants
through the help of Autism Society of the Philippines Manila Chapter in Up-Camp, Padre Faura,
Manila. The participant’s criteria were the following: must be a parent, able to read and write and
absence of cognitive problems. The researcher discovered that the nursing curriculum has lack of
competency in terms of dealing with autism. There is a massive need for early screening of children
with it as evident by lack of hospitals that will attend to them. As of today, there are only two hospitals
that cater to them namely: Philippine General Hospital and Philippine Children’s Medical Center. As
for the stigma of having autism, information dissemination, can be of help. Increased knowledge, skills
and attitude towards caring of a patient with it through introducing an elective subject (1.5 units)
pertaining on introductory concepts with regards to occupational therapy, speech therapy and some
communication techniques can help us give quality nursing care to children with autism. It is therefore
a must for us to put up a strategy to strengthen the early diagnosis of the said condition. Further
research study is of great importance for discovering the cause of autism thus leads to appropriate
intervention and possible cure of it.
Disaster Management
2015_911 Older People led CCA-DRR initiatives to build safe and resilient communities in the
Philippines
Gaudencio Rodelas, HelpAge-COSE, Philippines1
The effects of climate change on the Philippines are increasingly severe and Philippines is considered
the most disaster prone country regularly experiencing hazards such as typhoons, tropical storms,
floods and earthquakes. This project will focus advocating for the inclusion of older persons in Climate
Change Adaptation (CCA) and Disaster Risk Reduction Management (DRRM) initiatives and will
develop concrete age-inclusive community based CCA-DRRM initiatives by highlighting indigenous
knowledge of older people and community members of different ethnic/indigenous groups, identifying
specific vulnerabilities of communities and older people within them to disaster and climate change,
and through supporting older people and other vulnerable groups to participate in resilience action
planning and implementation to address these vulnerabilities and further build on existing knowledge
and capacities.. The over all goal of the project to reduce the risk to disaster of highly vulnerable
populations and key stakeholders in at-risk areas through community based disaster risk management
(CBDRM) and inclusion of vulnerable groups at all levels.
Dental Health / Oral Health
2015_130 Prevalence and risks of habitual snoring and obstructive sleep apnea symptoms in adult
dental patients
Thikriat Al-Jewair, University of Dammam, Saudi Arabia1
Mohammed Ashraf Nazir, University of Damman, Saudi Arabia2
Naif Al-Masoud, University of Damman, Saudi Arabia3
Objectives: To determine the prevalence and risks of habitual snoring and OSA symptoms among adult
dental patients. Methods: A total of 200 consecutive female and male dental patients attending the
dental clinics at one university were included. Subjective and objective assessments were carried out.
Patients completed self-administered questionnaires. Habitual snoring and risk of OSA were assessed
using the Arabic version of the Berlin questionnaire. The Epworth Sleepiness Scale (ESS) was used to
assess daytime sleepiness. Two trained investigators then carried out objective measurements of
anthropometric data, blood pressure, oxygen saturation, pulse rate, as well as clinical examination of
upper-airway and dental occlusion. Results: Habitual snoring was present in 18.2% of the female and
81.8% of the males (P=0.049). Breathing pauses during sleep of more than once a week occurred in 9%
(N=17) of the sample. Of the males, 78.3% were at high risk of OSA compared to 21.7% of the
females. Daytime sleepiness was more common in males than in females. Multivariate analysis for risk
of OSA revealed that obese patients were ten times more likely to report OSA symptoms than their
non-obese counterparts (OR=10.4, 95%CI=4.6-23.8). Tongue indentations, tonsil size, increased heart
rate, and a high ESS score were also independent risks of OSA. Conclusions: The finding that tongue
indentations and tonsil grades III and IV were significantly associated with risk of OSA validates the
important role of dentists in the recognition of the signs and symptoms of OSA.
Bioinformatics
2015_506 Molecular interactions analysis of natural compounds from Bacopa monnieri as AchE
and BuChE inhibitor in the treatment of Alzheimer's disease
Quazi Muhammad Sajid Jamal, Burayadah Colleges, Saudi Arabia1
Mughees Uddin Siddiqui, Burayadah College, Saudi Arabia2
Mohammad Abdulrahman Alzohairy, Burayadah College, Saudi Arabia3
Mohammed Abdullah Al Karaawi, Burayadah College, Saudi Arabia4
Keeping in view the public health related issues of Alzheimer's Disease (AD), its unpredictable
occurrence and progression indicates the need towards the best treatment option. The present
Bioinformatics study explores the binding pattern and molecular interactions between human
acetylcholinesterase (AChE) and Butyrylcholinesterase (BuChE) enzymes with natural compounds
from Bacopa monnieri. The docking analysis between natural compounds as a ligand and AChE,
BuChE as a receptor was completed using MGL tools Autodock 4.2 module. The analysis of the
hydrophobic interaction, inhibition constants and Hydrogen bonds indicates that they play a crucial role
to find out the interacting position at the active site. However, after analyzing the binding energy (∆G)
the documented data shows that bacoside X, bacoside A, 3-beta-D-glucosylstigmasterol and
Daucosterol could be good inhibitors in the inhibition of the AChE and BuChE activities. Therefore,
our study indicates that the inhibitory constants of the aforesaid natural compounds of Bacopa can be
utilized for the development of inhibitors. Keywords: AD, AChE, BuChE, docking, inhibitors.
2015_113 Improving Access to Quality Healthcare Services through Health Insurance? Lessons
Learnt from a Comparative Case Study from South India
Judith Fuhrmann, Graduate Institute of International and Development Studies, Geneva,
Switzerland1
In any discussion on ‘access to healthcare’ a variety of questions arise as to who has access, to what
kind of services and how the access is being managed and financed. Health equity plays an important
role in this regard as people with social disadvantages often face particular difficulties in accessing
quality healthcare services. India is one of the countries with the highest out-of-pocket (OOP)
expenditure for healthcare services in the world. OOP payments have been labelled by the World
Health Organization as one of the most inequitable forms of health financing, disproportionately
affecting the poor. The Indian Government has tried to address this situation throughout the last decade
via a wave of government-sponsored health insurance schemes, based on a public–private cooperation
model, for families living below the poverty line. In my doctoral research two of these schemes are
analysed in detail. It is argued that such health insurance schemes can help to improve health equity if
in the scheme design attention is paid to the particular needs of impoverished and vulnerable people;
and if the public–private cooperation mechanism is regulated in such a way that people can enjoy the
possible benefits from both sectors without fearing corrupt or unethical medical treatment from either
side. Lessons learnt from the research may not only be interesting for other countries but also
contribute a share to the discussion on achieving universal health coverage.
e-Health / m-Health / Telemedicine

2015_197 Persuasiveness of Behavioral Consistency Realism in the Medical Doctor Agent of Health
Education Video
Sean Shih-hung Wu, Asia University, Taiwan, Taiwan1
Jun-Hong Chen, Asia University, Taiwan2
Online communication is prevailing in everyday life that it has been popular to produce two or three
dimensional humanlike virtual agents for internet users’ health education and health literacy. Past
researches showed no universal rule for designing optimal, persuasive agents by maximizing realism,
even photorealism based on motion capture technology. Some researches focused on visual realistic
design, including character proportions of head-body and eye-face. Others investigated into the
influence of behavioral realism, on lip synchronization, neck and body movement. Yet, fewer were
interested in an agent’s consistency of behavioral pairing realism, especially on specific task domain.
This research therefore evaluates what degree of behavioral consistency realism in agents can improve
viewer’s healthcare awareness and cognition. An experiment was manipulated with four independent
conditions of consistency realism on a main animated character in a health education video: Consistent
High and Low Realism, and two Mixed consistency conditions of Realism (with lip synch or not, and
with body movement or not). The animated character is a moderate realistic 2-D designed, female
medical doctor. Participants were agreed to visit the experiment website, to read texts and watch the
video regarding having a cold. Before and after watching, they were requested to complete online
questionnaires. As a result, the participants in the Consistent Low Realism group are significantly
better persuaded and educated than the rest of participants. Implications on functional limitation of
higher realistic agent design are discussed, which indicates the complexity of persuasiveness relating to
the online viewers’ capacity of health information processing.
2015_191 Computer information systems patient transport Ward real time two-way paging
system, Yu-Pao Chen, Chi-Mei Medical Center, Taiwan ROC
Network information with each passing day, computers in the era of technological advancements,
medical institutes to actively promote the development of nursing information system, integrating a
variety of technologies have been applied in the health care environment, workflow simplification, in
order to make the nursing staff to provide decision-making, to enhance nursing service quality and
effectiveness of care. Combining wards and emergency information system and waiting list bed
establish ward management support system, providing management ward required information. Those
who work in emergency clinical hospital received orders, namely Internet login L2T (ward paging
system), and click when you can enter the ward and patients need to prepare with the matter, who after
receiving the clinical ward newsletter on immediate reply ward time, not only to reduce the call
forwarding time, can increase patient visits and medical treatment satisfaction. Informatization
promotion of nursing for nursing staff and properly resolve problems in a timely manner and simplify
working procedures and the limitation and control of patient status at any time and provide a more
cost-effective models of care. The mechanism of two-way communication will also open a new
feasibility of quality management practices, and for transportation of patients on her ward procedures
had a lot of help, but the technology comes from humanity, only able to meet the needs of the users
system to achieve the desired results.

2015_190 A study of use 2% Chlorhexidine in Effectiveness of the emergency room blood culture
contamination
Yi-Yi Chen, Chi-Mei Medical Center, Taiwan 1
Hsiao-Feng Chiu, Chi-Mei Medical Center, Taiwan 2
Ya-Ting Ke, Chi-Mei Medical Center, Taiwan 4
Skin disinfectant solution is one of influence blood culture specimen report the main reason. According
to the infection control business reporting units average blood culture contamination rate in 2014 3-9
average size of up to 3.4%, the current situation analysis and clinical field observations, skin
disinfectant is 75% alcohol and alcoholic Betadine, result in blood culture from acquisition process
cumbersome and time-consuming, in October to replace the skin disinfecting solution 2%
Chlorhexidine (2% CHG) to simplify the sterilization step, from November 2014 to March 2015 the
average blood culture contamination rate fell to 2.5%, with paired t test reach statistical significant
difference (p <.0001). 2% CHG simplify personnel blood culture collection step, and reached lower
blood culture contamination rate of the target, in order to provide the physician clinical infection
control and patient determine the correct medication, in order to achieve the ultimate goal of quality of
care. Keywords: blood culture stain rate, infection control, 2% Chlorhexidine (2% CHG).
2015_180 The Project of Team Resource Management for Improving Violent Incidents in
Emergency Department
I-Ying Shen, Chi-Mei Medical Center, Taiwan 1
Hui-Ling Chen, Chi-Mei Medical Center, Taiwan 2
I-Ching Yang, Chi-Mei Medical Center, Taiwan 3
Background: The rate of violent incidents in emergency departments is highest than other departments.
Violence will impact on healthcare professionals’ physical and psychological health as well as the
quality of caring. Objectives: The purpose of this project aimed at reducing the rate of violent incidents
in the emergency department. Methods: The project conducted in one of the emergency department of
medical centers in Southern Taiwan from Oct. 1st 2012 to Jun. 30th 2013. We found that lacked a
standard of managing violent incidents, education training, and violence prevention facilities caused
staff weakened competency for violence prevention and utilizing resources. Using “Team Resource
Management” as strategy designed a standard of managing violent incidents, violence prevention
education program, multidiscipline conferences, and practice in violence prevention regularly. Results:
After executing project, the rate of violent incidents decreased from 1.8% / month to 0.74% / month in
the emergency department. The percentage of satisfaction in work safety environment increased from
29% to 87% that was reported by staff. Conclusion: This project reduced the rate of violent incidents
efficiently and raising work safety in the emergency department. We suggest that medical institutions
should regard violent incidents in the emergency department as a crucial issue, to customize the proper
violence prevention strategies and a standard of managing violent incidents for different emergency
departments, and creating clinical work safety. Therefore, the quality of caring will enhance.

2015_177 Lessons from Thailand: Universal Health Care Achievements and Challenges
Ravikan Nonkhuntod, National Dong Hwa University, Taiwan 1
Suchuan Yu, National Dong Hwa University, Taiwan2
Public health care protection has covered around 99% of the Thai population since 2008. The total
health care expenditure of GDP has been only 3.9% comparing with an average of 12.9% in OECD
countries. We here establish a systematic review and meta-analysis, to discuss the advantages and
future challenges, using documents and policies which Thailand health care development has used to
achieve a successful system. Our search pool has been Pubmed, Google Scholar, and reference list of
retrieved articles, limited from 2001 until 2015. The selection is based on out- of- pocket (OOP)
expenditure and health care utilization in Thailand. We found a positive effect on OOP and health care
utilization. The magnitudes of relation were very large (standard mean difference > 0.8). Although
Thailand has achieved a successful health care system, the highlight issue has always been the financial
problem. If health care still relies on government budget, Thai citizen’s trust would be crumbled
because of poor health care quality. There are several ways to handle the cost issue: i) to relocate
allowances for economically lower groups from the others group; ii) to gather contribution from other
fee exempted-economically developed groups. Moreover, the government should promote primary care
and use pay for performance system to motivate efficient performance from medical professionals.
2015_174 Using Root Cause Analysis to Reduce Fall Incidence –systematic review
Ya-Ting Ke, Kaohsiung Medical University, Taiwan 1
Falls are a common occurrence may lead to physical injury and psychological harm. It is important that
a systematic review is conducted to explore use root cause analysis(RCA) to reduce fall incidence
experience their perceiving of fall prevent intervention or instruction by healthcare members, in an
effort to identify areas of their care can be improved. To examine the outcomes and effectiveness of
RCA strategies to reduce fall incidence and improve the quality of care in hospital through a systematic
review. The following databases were used: Index of Taiwan Periodical Literature System, Airiti
Library, CINAHL, Cochrane Library, and PubMed/MEDLINE. The search criteria included all articles
published before March 2015 and experimental and quasi-experimental studies that have adopted RCA
strategies as an intervention. Finally, 4 articles matching the requirements were collected. One hundred
and ninety-seven actions were identified from the RCA reports. Falls most frequently occurred in the
patient's home (41.7%). The most common activities the individual was engaged in during a fall
included getting up from a bed, chair or wheelchair; walking/running; bathroom related or behavior
related. The most common root causes were environmental hazards, poor communication of fall risk,
lack of suitable equipment and need for improvement of the current system for falls assessment. Staff
education, development of tools to improve falls documentation and providing falls prevention
equipment were the most frequent actions taken. Using RCA techniques, we implemented
improvement measures, including increasing nurses' sensitivity to prevention of falls, following up on
the implementation and sustaining improvements.

2015_158 Effects of ultrasound-guided peripheral intravenous catheter placement in difficult-
access patients: A systematic review and meta-analysis
Chia-Chi Kuo, Chang Jung Christian University, Taiwan 1
Purpose: Peripheral intravenous catheter placement in difficult-access patients is a challenge procedure

in clinical setting. Extensive research explored the effects of ultrasound-guided on increasing success
rate, but there is lack of systematic reviews regarding their outcomes. The purpose of this study was to
evaluate the effects of ultrasound-guided peripheral intravenous catheter placement in difficult-access
patients through meta-analysis. Methods: The research procedures were followed according to the
Cochrane systematic review guideline. Five Chinese or English databases (Cochrane library, PubMed,
CINAHL, Airiti Library, and Index of Taiwan Periodical Literature System) were searched from the
earliest year available to October 2014. The search strategies was limited to RCT or CCT by using
(“ultrasound-guided” OR “ultrasonography-guided” OR “echo-guided”) AND (“intravenous catheter”)
as key words. The Cochrane collaboration's 'risk of bias' tool was used to examine the quality of
included articles. Extracted data were entered and analyzed using Review Manager 5.3 software.
Results: Ten RCT or CCT articles regarding the effects of ultrasound-guided peripheral intravenous
catheter placement as compared to those of traditional techniques were reviewed. The results indicated
that ultrasound-guided significantly increased the overall success rate (seven trials, 430 participants,
OR=3.73, 95% CI=1.89~7.37, p=.0002) and patient satisfaction (three trials, 187 participants,
SMD=0.94, 95% CI=0.39~1.50, p=.0009). There were downward trend in procedure time (eight trials,
425 participants, MD=-4.78, 95% CI=-9.73~0.17, p=.06) in participants with ultrasound-guided, but
not reached statistically significant. Conclusion: Ultrasound-guided could effectively increase overall
success rate and patient satisfaction. Thus, we suggest apply ultrasound-guided peripheral intravenous
catheter placement in difficult-access patients.
Oncology Nursing
2015_557 The experience of development of the prostate cancer support group
Chiu I Chen, Changhua Christian Hospital, Taiwan1
Tu Shu Ling, Changhua Christian Hospital, Taiwan2
Set up a "Prostate Cancer supporting group" regularly organize health talks and tours, allow patients a
better understanding of health information prostate cancer, patients can share common experiences
with each other to enhance the quality of life. The sufferer who helps the prostate cancer understands
the medical process and promote the himself care ability, usage care the group make the sufferer come
out the disease shadow and and establish the publication, and provide the latest information and
problem solution. We held healthy lectures and tour activities for patient suffered from prostate cancer
during 2011 to 2014. According to the way of caring in daily life of disease,we invited
doctors,nutritionist and aerobics teacher to design our healthy lecture. The lecture included: The new
therapy of prostate cancer,Aerobic exercises,Health-Preserving at Home,Food and Cooking. Before the
tour activities,social worker would have site survey and toilets should be available because patients had
frequent urination. All people could relief symptom of frequent urination and uncomfortable feeling.
There were four healthy lectures and 84 participants. The satisfaction rate achieved 95% and the reason
that didn’t get 100% was due to the want of the meal indicated to the elders. There were four tour
activities and 72 participants. The satisfaction rate got 98% and the only not satisfied was that people
wished more tours could be held. With this support group people share and support to each other and
many families got rid of the shadow of the disease and faced the positive lives.
Bioinformatics and Biostatistics

2015_550 The risk of chronic diseases in patients with colorectal cancer: A Retrospective Cohort
Study at a Medical Center in Central Taiwan.
Chen Mei-Wen, ChangHua Christian Hospital, Taiwan 1
Tung-Hao Chang, Department of Tumor Center, ChangHua Christian Hospital, ChangHua, Taiwan2
Cheng-Hsien Chen, Department of Surgery, Show Chwan Memorial Hospital, ChangHua, Taiwan3
Yih-Jeng Lin, Department of Information Management, Chien-Kuo Technology University,
ChungHua, Taiwan4
The purpose of this study used a retrospective cohort design to examine whether colorectal cancer is a
risk factor of chronic diseases. The data were collected from routine outpatient service profile database,
we identified 74353 patients who are newly diagnosed individuals with colorectal cancer screening in
January 2002 and June 2013. The linkage database of cancer registry center of Changhua Christian
hospital which located in central Taiwan. We collected dates when eligible criteria included being at
least 40 years old colorectal cancer patients. We used the coding of the International Classification of
Disease Diagnoses, Ninth Revision of Clinical Modification (ICD-9-CM) include Colorectal cancer
disease (ICD-9-CM 153-150), Diabetes Mellitus disease (ICD-9-CM 250-251), Hypertension disease
(ICD-9-CM 401-405), Heart Disease (ICD-9-CM 410-414, 420-429), Hyperlipidemia disease (ICD-9-
CM 272.0-272.4), Kidney disease (ICD-9-CM 580-589), Live disease (ICD-9-CM 570-573、070-
070.53). The multivariate Cox’s proportional hazard regression analysis was used to assess the risk of
chronic diseases associated with colorectal cancer. Hazard ratio (HR) and 95% confidence interval (CI)
were calculated in the model.All analyses were performed with SPSS/Windows 15.0 statistical
software. Significance level was set to 0.05. Patients with Diabetes Mellitus (HR 2.611, 95% CI 1.655-
4.121, P value 0.001 ) and Kidney disease (HR 0.261, 95% CI 0.081-0.839, P value 0.024 ) were
significantly associated with increased risk for coloretal cancer. From these data, we conclude that
elderly colorectal cancer patients high prevalence of chronic diseases risk factors, such as kidney
disease and Diabetes Mellitus.
2015_543 An Initial Exploration on Epidemiology And Measurement Of the Elderly Sarcopenic
Obesity
Shu-Ching Chiu, Central Taiwan University of Science of Technology, Taiwan 1
Chang, Shu-Fang, National Taipei University of Nursing and Health Sciences, Taiwan2
Background. People’s average life span has increased continuously, thus the life and diseases of the
elderly are matters of concerns to organizations around the world. With the coming of aging society,
the term “sarcopenic obesity” was coined for the symptom of people with muscular reduction and
obesity. Purpose. This study introduced the epidemiology of the elderly sarcopenic obesity and
common measurement method in international research. Methods. This study uses a literature review
method. Results. The epidemiology of the elderly sarcopenic obesity is different between the countries.
Either dual-energy X-ray absorptiometry or bioelectrical impedance analyzer are often conducted in the
diagnosis of sarcopenic obesity that is a complicated process. The study suggests at least two
measurements should be used. The reasons for measurement selection should be concerned, such as the
community elderly who can walk or those sitting on wheelchair in the institutions. In addition, the
reasons for select should also be solid, such as screening of diseases or diagnosis and treatment of
sickness. Moreover, natural aging should be concerned, and the interpretation and treatment of
different cultures on aging should be respected. Finally, exercise and proper nutrition may be the main
directions of future nursing measures. Keywords: Sarcopenic obesity, epidemiology, elderly,
measurement, aging
Oncology Nursing
2015_540 Relationships Between Symptom Distress and Life Quality of Postoperative Oral Cancer
Patients
Shu-Ling Tu, Changhua Christian Hospital, Taiwan 1
Chin-Chi Hsiang, Changhua Christian Hospital, Changhua, Taiwan2
Yaw-Jen Lin, Central Taiwan University of Science and Technology, Taichung, Taiwan3
Shu-Yi Tseng, Changhua Christian Hospital, Changhua, Taiwan4
Oral cancer postoperative symptoms often occur and patients’ life quality is affected. By understanding
their symptom distress and life quality, it is helpful in developing appropriate nursing care plans and
enhance life quality. This study aimed to investigate the correlations between symptom distress and life
quality of oral cancer patients during postoperative hospitalization. The study was based on purposive
sampling and subjects were 100 oral cancer patients who received surgery from ENT Department in
one medical center in Central Taiwan. A designed questionnaire was used, including demographic
attributes, symptom distress, and life quality related to oral health. Data analyzed by SPSS/PC for
further statistic analysis. The results showed that 58 oral cancer patients (58%) perceived good health
status after surgery. The numbers of the main symptom distress were 7.99 ± 3.71, and the top two
symptom distresses were too much sputum (78%) and trismus (65%). As to oral-health-related life
quality, the lowest two scores were “Do you have to clean the oral cavity often, such as sputum or food
residue? “ (2.14 ± 0.975) and “Do you feel thick saliva?” (2.27 ± 0.973). Symptom distress and life
quality was significantly negatively correlated (p <.05). The majority of oral cancer patients percieved
good health status after surgery. The main postoperative symptom distresses were too much sputum
and trismus. Oral health based life quality was influenced by symptom distress. It is suggested that
continuous and complete oral care instruction should be provided by nursing professionals.
2015_529 Impact of Diabetes Mellitus on Cholecystectomy Rate: A Population-Based Follow-Up
Study
Chi-Ming Liu, Cheng-Hsin General Hospital, Taiwan 1
AIM: To investigate the rate of cholecystectomy in diabetic and non-diabetic patients. METHODS:
Diabetic patients without prior treatment for gallstone disease (GSD) in hospital or on an ambulatory
visit were identified and compared with age-matched and gender-matched controls, and were followed-
up for 8 years. Incidence densities (IDs) of cholecystectomy were estimated in relation to the subjects’
diabetic status. Cox proportional hazards model analysis was performed in order to assess the age-
specific and gender-specific effects of diabetes on the risk of surgery for GSD. RESULTS: Patients
who developed gallstones and underwent cholecystectomy accounted for 18.65% of the diabetic
subjects analyzed, which was significantly higher than that for control subjects (17.15%), thus the rate
of cholecystectomy was higher in the diabetic group than in the control group. Male gender and older
age were found to be associated with a higher rate of cholecystectomy regardless of diabetic status.
Hypertension, cholangitis, and Caroli’s disease were also correlated with an increased risk of
cholecystectomy in patients with GSD. Overall, diabetic patients showed a higher incidence of
cholecystectomy over the 8-year follow-up period. CONCLUSIONS: Male patients with GSD are
more likely to undergo cholecystectomy than female patients regardless of their diabetic status, thus a
more aggressive management approach to GSD in men should be considered in order to identify these
patients before there is a need for emergency surgery.

2015_508 Frailty before and six-month following Cardiac Surgery
Cheryl Chia-Hui Chen, National Taiwan University, Taiwan 1
Purpose: To evaluate the nature course of frailty six-month following cardiac surgery. Methods: This
prospective study enrolled consecutive adult patients (20 years and older) undergoing cardiac surgery
at a tertiary medical center in Taiwan. Patients were excluded if they were unable to follow protocol.
Frailty was determined by meeting three out of five Fried’s criteria: shrinking, weakness, exhaustion,
low activity, and slow walking speed. Evaluations were taken at 4 points in time: before surgery, one-,
three-, and six-month after surgery. Results: For this on-going study, 200 participants have been
enrolled with a mean age of 62.3 years and 65.8% were males. Participants primarily underwent
isolated coronary artery bypass grafting (60%), isolated valve (34.0%), and combined coronary and
valve (6%) surgery. Frailty was identified in 19% of participants before surgery, 35% at one-month
after surgery, 9.9% at three-month, and 8.8% at six-months after surgery. Age effect was evident with
rates of frailty were significantly higher in older participants (≧65 years), compared to their younger
counterparts (<65 years). Furthermore, transition to states of greater frailty was common (28%) at one
month after surgery, particularly for older participants. Although the rates of frailty consistently
reduced by three months after surgery, weakness, as one of defining criteria measured by grip strength,
had little recovery. Conclusion: Frailty before and after cardiac surgery is common. Age effect was
evident indicating that older patients might require more support to recovery from cardiac surgery.
2015_204 Predictor of sexual risk behaviors among pre-adolescents currently studying in primary
schools, northeastern thailand
Mingkhuan Phuhongtong, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1
Pissamai Homchampa,Faculty of Medicine, Mahasarakham University, Thailand2
Teabpaluck Sirithaanwuthichai, Faculty of Medicine, Mahasarakham University, Thailand3
This study aimed to explore sexual risk behaviors and predictor of sexual risk behaviors among pre-
adolescents aged 10-12 years currently studying in primary schools in one selected province in
northeastern Thailand. There were 423 participants randomly selected using multi-stage random
sampling from two primary schools included in this study. Data collection used questionnaires and
Univariate and Multiple logistic regression were performed Results showed the participants (median
age = 11.03 years, boys = 45.6%, living with parents = 68.3%, average daily allowances = 30.8 Baht)
had high levels of sexual risk behaviors. Of which were ranging from using internet to find boyfriend
or girlfriend (11.3%); having watched pornographic clip (5.9%); having used internet to communicate
with an unknown person (11.3%); having boyfriend or girlfriend (13.0%); having sexual intercourse
experience (0.2%). The predictors of sexual risk behavior were: sex, talk with a boyfriend or girlfriend,
using internet, age, self-efficacy regarding drinking alcohol behavior, having a boyfriend or girlfriend,
having multiple partners and having sexual intercourse. Findings indicate urgent needs for the
prevention of sexual risk behaviors among the pre-adolescents, particularly in using the internet to find
a boyfriend or girlfriend and having a boyfriend or girlfriend. Solutions need to further promote
appropriate attitudes towards sexual risk behaviors and relationship with family members. Their leisure
times spending on media and internet access were subject to be supervised or attenuated by outdoor or
other social activities, such as sport and social service activities at times in school and at home.
Health Education
2015_203 Effectiveness of Health Communicators to Health Literacy Building for High Risk in
Caffeine Consumption of Working-age Population in Rural Community, Northeast, Thailand
Poowadol Polsripradist, Mahasarakham University, Thailand1
Kitpramuk Tantayaporn, Mahasarakham University,Thailand2
Pissamai Homchampa, Mahasarakham University,Thailand3
This is action research to developed 55 health communicators’ ability and studied a result of health
education for 440 high risk who were working-age population and built a knowledge, understanding,
and self risk analysis by health communicators (HC). There were 8 proceeding to health
communicators’ ability developing and were evaluated by two tools--The health communicators’
ability evaluation form, and the evaluation of knowledge, understanding, and analysis thinking in
caffeine consumption of high risk form. The results shown that 88.2% were good level of HC. These
practical ability was separated on 92.7% of good speaking, accuracy and accomplished was 83.6%,
solving and explanation was 81.8%, punctual and responsibility was 94.5%. The high risk group was
evaluated and there was a significant difference on before and after be informed about caffeine
consumption information of health literacy scores. This group was increasingly in health literacy,
especially on caffeine drinking products, a quantitative of caffeine in each a product type, a suitable
caffeine consumption, and an effect to health of caffeine. These an average scores before and after of
them were 6.3±0.087 and 14.4±0.068, respectively. Although, there are diverse health media in current
and also many channel can be accessed by many people. However, this research indicated that the HC
would be still essential in rural community, because the HC's acquaintanceship was one item which
have been required to influenced for risk group who dared interaction and was developed to be a better
on their health literacy.
2015_202 The knowledge, attitude and behavior use of pesticides in Agriculturists in Mekong
Riverside Area, Nakhon Phanom Province, Thailand
Songkran Nakbun, Nakhon Phanom University, Thailand1
Banchong Phonchai, Nakhon Phanom University,Thailand2
Yuwadee Saraboon, Nakhon Phanom University, Thailand3
Anantasak Panput, Nakhon Phanom University, Thailand4
Phatcha Hirunwatthanakul, Nakhon Phanom University,Thailand6
This study investigated the knowledge, attitude and behavior use of pesticides among agriculturists in
the Mekong riverside area of Nakhon Phanom province, Thailand. A total of 377 people were
randomly sampled (multi-stage sampling) and asked to complete a questionnaire about their
knowledge, attitude and behavior. The results of study showed that most of agriculturists (83.02%) had
good knowledge . The lowest of they knew , the upwind to the dangers of chemical pesticides is less
than the downwind (71.09%). Regarding attitude towards the prevention of the use of pesticides,
almost all of agriculturists (93.37%) had a good attitude. Regarding behavior before, during, and after
pesticide use. Overall, 58.36 % of the sample participants demonstrated good behavior using
pesticides. Regarding the mixing of pesticides, 49.34% of the persons surveyed did this good behavior.
Inappropriate behaviors the preparation of pesticide mixtures that were use mouth open to the bottle
ofpesticides (65.3%).Regarding the duringuse of pesticides, 49.1% of persons did this good behavior.
The most problem, 60.7% they use pesticides without warning.Of the persons surveyed, 86.47%
demonstrated good behavior following pesticide use, whereas bad behaviors were not put up a warning
sign stating the date of pesticide use and type of pesticide use(64.5%). In summary, many of the
persons surveyed had a good knowledge, attitude and use pesticides safely but proper safety
precautions are not observed by all. Further education programs are therefore needed to increase
awareness of safety protocols, and protect human health and the environment.
Environmental Health and Climate Change

2015_193 Knowledge, attitudes and practice regarding pesticide usage in agriculture from Nakhon
Ratchasima province, Thailand
Jiraporn Prathumyo, Vongchavalitkul University, Faculty of Public Health, Thailand1
Kamonthip Arsanan, Faculty of Public Health, Vongchavalitkul University, Thailand2
Saowaluck Prasungtiyo Faculty of Public Health, Vongchavalitkul University, Thailand3
This descriptive study was aimed to assess the knowledge, attitudes and Practice regarding pesticide
usage in agriculture from Huaytau village, Sakae rat sub-district, Pak Thong Chai district, Nakhon
Ratchasima province, Thailand, during January to May, 2015. Of 122 represents who had history with
pesticide used, was selected through simple random sampling. An interviewed questionnaire was
utilized for collected the data. Descriptive statistical data were analyzed in this study. The result
indicated that most of them were male (59.02%), married (85.25%), secondary school (73.77%), an
average family income 5,001-10,000 bath/monthly (64.75%), the most of plant type was cassava
(58.20%), the most of pesticide usage was more than 7 years (42.62%). Type of pesticide usage,
herbicide was the frequently usage (79.50%). The agriculture officer (35.25%) and public health officer
(35.25%) were the main human information resources on pesticide uses. In addition, The chemical
label was the main media information resources on pesticide uses. Knowledge 92.62%, attitudes
97.54%, and practice 100%, had a high level on good pesticide usage, respectively. The findings
revealed that most agricultural workers have the high knowledge, attitudes and practice of pesticide
usage. This sustainable pesticide usage, government office should be continuous visit and monitor in
the community.
Sexual Health
2015_192 Adolescent Students’ Pregnant Behavior in a Sub-district of Nakhon Ratchasima Province
in Thailand
Jun Norkaew, Vongchavalitkul University, Faculty of Public Health, Thailand1
Kantarut Titkatok, Faculty of Public Health, Vongchavalitkul University, Thailand2
Wanwipa Aukasri, Faculty of Public Health, Vongchavalitkul University, Thailand3
Kuntarut Titkatoke, Faculty of Public Health, Vongchavalitkul University, Thailand4
This research aims to study the knowledge, attitudes, practices and the factors that lead to students’
pregnancy. The research is a qualitative research. Data is collected from who voluntary and well
cooperated in providing related data through studying their background by in-depth interviewing.
Result of the study shown that most of the pregnant teenagers are first intercourse activity between the
ages of 14-18 years old. Contraceptive method used is that use of condoms but do not applied using it
regularly. The contraceptive knowledge, the study found that the sampling group do not apply using
condom regularly. Most of them do not have sufficiency knowledge in contraceptive method or
knowledge is invalid. Had been attended health education course though cannot be applied in everyday
life. They have incorrect values, friends are highly influenced friends’ life, having boyfriend or lover
makes them sensed that they got more attention, parents accepted their relationship while they were in
school age. Before having pregnancy, associated with other gender friends easily, and admitted having
a boyfriend. Most of the adolescents concealed their pregnancy because fear of being punished which
caused delay the prenatal care. After giving birth to their children, they planned to start own family,
earn income from their work and continue studying high school, leave their children with own parents.
Factors causing pregnancy in school age, the teenage girls had opportunities to associate with other
gender friends freely. Most of the teenagers do not have sufficiency contraceptive knowledge.

2015_186 Factors related with Behaviors Prevention to Leptospirosis
Jirawoot Kujapun, Vongchavalitkul University, Faculty of Public Health, Thailand1
Nuchara Hoothaisong, College of medicine and public health, ubonrajathanee university, Thailand
Supitcha Pratumwapee, College of medicine and public health, ubonrajathanee university, Thailand
Wararat Sungwalee College of medicine and public health, ubonrajathanee university, Thailand Wilas
Kampangsee Faculty of medicine, Mahasarakam university, Thailand5, 6
Leptospirosis is an infectious disease that can be transmitted from animals to humans. The disease has
been considered as a major public health problem in Thailand. The objectives of the research were to
factors that are correlated with prevention behavior to the Leptospirosis of the people in repetitious
flood areas in Warinchamrab District, Ubonratchatani Province. This study was performed as a Cross-
sectional study. Data were collected using a questionnaire with total of 164 samples. The factors that
correlations to the prevention behaviors were analyzed by using Chi-Square and Fisher exact test. the
study found that knowledge on the Leptospirosis, illness of family members caused by Leptospirosis,
information about the disease and water supply were correlated with prevention behavior to the
Leptospirosis as statistically significant (p <0.001). Therefore, the study would suggest to focus on
changing behaviors and providing necessary information and guidelines for protection of Leptospirosis
in advance and after the flood to encourage public awareness of self-protection.
Nutrition and Dietetics
2015_184 Assessment of quality of life and consumption behavior of hypertension elderly in rural
community of Thailand by using Whoqol-Bref-Thai
Wasugree Chawengkul, Vongchavalitkul University, Faculty of Public Health, Thailand1
Wannapa Tasoontorn, Praweena Nongtongta, Teerayut Udomporn, Faculty of Public Health
Vongchavalitkul University3,4,5
This cross-sectional survey was aimed to assess the quality of life, consumption behavior of
hypertension elderly in Srirakor sub-district, Chakrat District of Nakhon Ratchasima, Thailand during
January-April 2015. 297 hypertension elderly were purposive selected through accidental sampling in
health promotion hospital of Srirakor sub-district. WHOQOL-BREF-THAI questionnaire was utilized
to collect the data from them including socio-demographic characteristics, physical, psychological,
social relationships, environmental domain, and consumption behavior. The questionnaires were pre-
tested by using Cronbach’s alpha method for attitude (0.96). The results revealed that 54.00% had
moderate knowledge, 75.20% had moderate attitude, and 61.19% of represents had high practice on
diarrhea prevention and control. Most of the represents, they were 60-65 years old, male, married,
primary school, business owner, and family income ranged from 5,000 to 10,000 Baht per month 76%
of subjects had moderate quality of life ( X =2.65, SD=0.56). Most of subjects, physical and
environmental domain were a high quality of life (X =2.65, SD=0.55). Consumption behavior, all
subjects had frequently consumed of the 5 food groups (X =2.63,SD=0.44). Carbohydrate group was
daily consumed (X =2.73,SD=0.42), followed; meat (X =2.68,SD=0.42), fruit (X =2.64,SD=0.46), fat
(X =2.63,SD=0.43) and vegetable (X =2.49,SD=0.49), consecutively. This finding shows moderate
quality of life, lack of fruit, fat, and vegetable, therefore, activities campaign on psychological and
social relationships domain, and health education on nutrition are need required.

2015_183 Effectiveness of 6 Steps Prevention and Control for Dengue Haemorrhagic Fever in Rural
Community of Thailand
Natthawut Kaewpitoon, Vongchavalitkul University, Faculty of Public Health, Thailand1
Apinya Joosiri1, Wanpen Seubsing1, Natnapa Padchasuwan1, Wasugree Chavengul1, Nusorn
Kutanavanichapong1, Jun Norkaew1, Natthawut Kaewpitoon1,2 1Faculty of Public Health,
Vongchavalitkul University, Nakhon Ratchasima 30000, Thailand 2Hospital of Uranaree University of
Technology, Thailand5, 6
This cross-sectional descriptive study aimed to assess the health behavior for prevention and control of
diarrhea in Nonghuawaen village, Kamtalaso district, Nakhon Ratchasima Province, Thailand, and to
identify related factors by using semi-KAP questionnaire. The 133 samples were purposive selected
included head or represent of houses, during January and April 2015. A semi-KAP questionnaire was
utilized to collect the data from them including socio-demographic characteristics, knowledge, attitude,
and practice. The questionnaires were pre-tested by using Cronbach’s alpha method for attitude (0.92)
and practice (0.76), and Kuder Richardson (KR20) for Knowledge part (0.85). Chi-square test was
employed to analyze the data. The results revealed that 54.00% had moderate knowledge, 75.20% had
moderate attitude, and 61.19% of represents had high practice on diarrhea prevention and control. Most
of the represents, they were 25-35 years old, female, married, primary school, and worked in
agriculture. 67.30% of represents had received information on diarrhea. 16.80% of represents had
history with diarrhea. The diarrhea prevention and control was significantly associated with
knowledge, attitude, age, education, and occupation (p-value <0.05). This finding shows a moderate
knowledge, and attitude on diarrhea prevention and control, therefore, health education is need required
in this areas.
2015_175 Empowering Self-Management Can Promote Disease Control for Thais with type 2
Diabetes
Preeda Kanghae, Khoklo Health Promoting Hospital, Thailand1
Chodchoi Wattana, Phra Pok Klao College of Nursing,Thailand2
Uncontrolled blood sugar level causes several complications in diabetic patients. The purpose of this
quasi-experimental research was to determine the effects of an Empowering Self- Management
Program on self-management behaviors and disease control among Thais with type 2 diabetes. Subjects
were 34 patients with type 2 diabetes, who attended the chronic disease clinic, Khoklo Health
Promoting Hospital. They were randomly assigned to the experimental and control groups (17 persons
per group). The experimental group received the Empowering self- management program that was
developed based on Empowerment theory and Self-management concept while the control group
received the usual nursing care. Data were collected using Self-management behaviors questionnaire.
The blood glucose level were measured at baseline and 12-week after entering the program. The
instruments were tested for their psychometric properties. The Cronbach’s alpha was 0.78. Data were
analyzed using descriptive statistics, T-test, Paired t-test, Fisher’s Exact test and Mc Nemar test.
Results revealed that at the end of the program, the experimental group had significant higher score of
self-management behaviors, and had greater number of type 2 diabetic patients who had blood sugar at
good level than baseline and than the control group. Findings indicated that the Empowering self-
management program is effective to promote self-management behaviors and disease control for type 2
diabetic patients that can be used in other diabetic clinics. The effectiveness of this program with a
larger group and strategy how to promote disease control in a long-term period is recommended for the
further study.
2015_169 Development of Cognitive Training Software for Thai Elderly with Mild Cognitive
Impairment
Achiraya Chaiyakham, Chiang Mai University, Thailand1
Anuruk Bunpun, Chiang Mai University, Thailand4
At present, Thailand is becoming to be aging society because of the gradually increasing number of the
elderly population. Aging is marked by several changes for instance physical, psychosocial and
cognition. One of the important problems of old age is the change in cognition aspect which impact the
occupational performance and quality of life of the person. Mild cognitive impairment or MCI is a type
of cognitive dysfunction disorder associate with developing of Alzheimer’s disease (AD) or other types
of dementia and commonly found in old age. The aim of this research is to investigate the problems
related to cognitive impairment in elder people in Thailand and to invent the new intervention for
improve cognitive function in elder with mild cognitive impairment in the form of web application for
computers, laptop computers or tablets. The program consists of ten sets of cognitive enhancing game;
visuospatial skill, visuoconstructional skill, recognition, memory, attention, language, abstraction,
sequencing, categorization and orientation. And to investigate the efficacy of the intervention,
subsequently. The results of this study will be developed to be an effective intervention technique for
Thai elderly people with mild cognitive impairment in the future.
2015_163 Developing Resiliency in Children through a Life Skills Training: The Randomized Trial
Effects of a Family-Based Intervention.
Jeeraporn Kummabutr, Thammasat University, Thailand1
This randomized control trial study evaluated the effects of a combined intervention program (LST-R
& PTP-RC) on the resilience of children. Children and families were assigned randomly to 1 of 2
conditions: intervention program (LST-R & PTP-RC combined) and routine program. Three schools
were randomly selected and all eligible 4th grade students recruited correspondingly their parents to
either the experimental group or the control group. The parent and student study participants, who met
the inclusion criteria and consented/assented to take part in the study, included 80 student/parent dyads
in the experimental group and only 82 student in the control group. Data were collected on all
participants prior to implementation, immediately after completed intervention, and at the second
month after completed intervention via use of the Proactive Coping Inventory (PCI-Thai version). The
repeated measures ANOVA and the independent t-test were used to test the effect of this combined
intervention program. The children in the experimental group had significantly higher resilience scores
than children in the control group over time (p < .05). The results presented the significant effects of
this combined intervention program on the resilience scores (ES=0.42). In addition, there was also
significant interaction between two group treatments and the resilience scores over time (p < .05).
These findings suggest the intervention require an active parent involvement in child skills intervention
and a longer duration of implementation, so as to improve child resilience skill. Recommendations for
further research include a larger sample size and a longer period for outcome measurements.
2015_162 Home features and Assistive Technology of Home Bound Elderly in Hang Dong
District, Chiang Mai, Thailand
Suchitporn Lersilp,Chiang Mai University, Thailand2
Nopasit Chakpitak, Chiang Mai University, Thailand3
The purpose of this study was to survey the homes and assistive technology of home bound elderly
people. The scope of this research was home bound elderly people at Sub-district Namprae, HangDong
district, Chiang Mai. The home evaluation included features of inside and outside the home and
assistive technology based on the International Classification of Functioning (ICF) concept. Methods,
observation and an interview were used for evaluation by the researcher. The study found that there
were poor features in some topics such as the width of the door being smaller than 90 cm. in 26 homes
(100.00%), the door step being higher than 2 cm. in 20 homes (76.92%), the staircases being higher
than 15 cm. in 14 homes (53.85%), no bedside rails in 23 homes (88.46%) and inappropriate height of
the toilet pan in 24 homes (92.31%). Assistive technology in houses of the elderly found 6 items; TV
remote, cane, eye glasses, false teeth, walker and wheelchair. In addition, there were 5 items that were
not found, but had demand as follows; hearing aid, wheelchair, walker, eye-glasses and cane.
Therefore, occupational therapists should suggest improving the home conditions and behavior of the
elderly and enhance security as well as introduce the use of assistive technology according to the
limitations of the person and what should be provided for the lives of the elderly.
2015_161 Fine motor activities program to promote fine motor skills in a child with Down’s
Syndrome: a case study
Kewalin Panyo, The Northeast Institute of Child Development, Thailand3
Children with Down’s syndrome are those with delayed development, particularly delayed cognitive
and motor development. Fine motor skills are mostly a motor development problem that occurs and has
impact on occupational performance in students with Down’s syndrome because it relates to
participating in school activities, such as grasping, writing, and carrying out self-care activities. This
study aimed to examine the efficiency of a Fine Motor Activities Program to promote fine motor skills
in a case study of Down’s syndrome. The case study subject is Kai, an 8 -year-old male with Down’s
syndrome, who was a first grader in a regular school that provided classrooms for students with special
needs. Instruments consisted of assessment tools and the Fine Motor Activities Program. The
assessment tools included 3 subtests of the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2),
which were Upper-limb coordination, Fine motor precision, Manual dexterity; and also the In-hand
Manipulation Checklist, and Jamar Hand Dynamometer Grip Test. The Fine Motor Activities Program
was implemented individually and consisted of 45 activities in 3 sessions a week for 5 weeks, with
each session taking 45 minutes. The results showed that the case study demonstrated obvious
improvement of fine motor skills, including Bilateral hand coordination, Hand prehension, Manual
dexterity, In-hand manipulation, and Hand muscle strength. With these positive results, occupational
therapists could consider application of the activities program in their intervention and work with
teachers and parents in providing and choosing activities that enhance fine motor skills in children with
Down’s syndrome.

2015_144 Stress of elderly at Meung Distric Nonthaburi Province, Thailand
Janejira Kiatsinsap, Boromarajonani College of Nursing, Changwat Nonthaburi, Thailand1
Parichart Wanywaisart, Boromarajonani College of Nursing, Changwat Nonthaburi, Thailand2
Wilaiporn Kamwong, Boromarajonani College of Nursing, Changwat Nonthaburi, Thailand3
Objective: This study was a descriptive study with the aim to study the level of stress in the elderly in
Thailand. Method: The subjects were 380 elderly in Meung Distric Nonthaburi Province, Thailand.
Suanprung Stress Test were used to collect data as a measure of stress and self-administered
questionnaire designed to gather data on gender, age, education, marital status, income and sufficient
revenue, source of family income and situations of illness. The research were analyzed by frequency
and percentage by a computer program. Personal data of the sample with frequency and percentage and
stress analysis of the sample with the stress level. Result: The research showed that mostly female
(66.8%), aged between 70-75 years old (38.7%), graduated higher than primary school (74.7%),
marriages status (68.9%), family income adequacy but no remaining (41.1%), sources of financial
support by themself (53.7%) and the elderly had chronic disease (71.3%). The stress level were normal
stress (16.3%), mild stress (27.6%), moderate stress (12.6%) and severe stress (43.3%). The most of
subject that had severe stress were female (63.3%), aged between 60-65 years old (27.6%), graduated
higher than primary school (17.9%), marriages status (35.5%), family income adequacy but no
remaining (31.3%), sources of financial support by themself (20.5%) and the elderly had chronic
disease (30.3%). The average score on the emotional stress was exited in not familiar events and feel
drowsiness or dizziness. The mean is equal to 1.66. Conclusion: The most of the elderly in Meung
Distric Nonthaburi Province, Thailand were severe stress.
Pathology
2015_135 Morphological Changes of Microglia in Lumbar Spinal Enlargement of
Streptozotocin-Induced Diabetic Rats
Athinan Prommahom, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1
A chronic inflammation and an activation of the immune system involve in the pathogenesis of
diabetes and associated with diabetic complications. The primary immune cells of central nervous
system are microglia. Inappropriate microglia activation implicates in diabetic neuropathy, one of the
most common complications of diabetes. There are evidences that microglia cells in the dorsal horn of
spinal cord play an important role in tactile allodynia (abnormal pain sensitivity to touch), following
peripheral nerve damage affected by diabetes. However, many studies have been mainly concentrated
on intracellular signaling pathway, little is known about the phenotypic changes of microglia in spinal
cord. Therefore, the goal of this study was to investigate the effects of diabetes mellitus on
morphological changes of microglia in the spinal cord at lumbar enlargement, that receives the
sensation from lower extremity, a frequent area of diabetic neuropathic pain. In Hematoxylin and Eosin
stained sections of normal spinal cord, only small numbers of microglia were found in control rats.
They were dark nuclei with elongated shape. The cytoplasm was poorly visualized. Four weeks after
diabetes, the number of cells increased and cells became hypertrophy with pale nuclei. These
characteristics of microglia were observed in both white and gray matters of lumbar spinal
enlargement, indicating that diabetes induced microglia changes in terms of phenotypic switching from
resting stage to activated microglia. The novel strategies from this study may provide better protection
against the development of inflammatory processes during diabetic neuropathic progression through
targeting microglia.
Pathology
2015_134 Histological Changes of Interneuron in Cervical Spinal Enlargement of Streptozotocin
Diabetic Rats
Paweena Sangsawee, Mahidol University, Thailand1
Sirinush Sricharoenvej, Mahidol Univesity, Thailand2
Neuropathy is the most common complication of diabetes mellitus, especially distal symmetric
polyneuropathy (DSP). Patients often complain pain with normal stimuli, such as burning, stabbing and
needle-like sensations in lower and upper extremities. Spinal cord is the main pathway for transmission
of neuronal signals between the brain and the rest of the body. There are supported evidences that the
spinal cord is an important target in diabetes. Diabetic patients with DSP have significant smaller size
of spinal cord. Moreover, the prolonged spinal conduction time has been observed in diabetic patients.
Thus, the aim of this study was to investigate the alterations of interneurons, an integration center for
incoming sensory information from the body and descending signals from the brain, at spinal cervical
enlargement, where sensory input comes from upper limb by using histological staining methods
(Hematoxylin and Eosin staining). The following changes of interneurons in posterior funicular gray of
spinal cord in both short- and long-termed periods of streptozotocin-diabetic rats were observed:
swollen neurons with dense nuclei and abundant pink cytoplasm in early diabetic stage (4 weeks),
whereas the neurons were shrunken in the late stage of diabetic progression (24 weeks). These results
indicate that diabetes has an effect on the interneurons in posterior funicular gray of spinal cord from
early to late diabetic states. Therefore, the knowledge from this study raises the awareness of spinal
interneuron lesion for improvement of therapeutic design to reduce life-threatening conditions in
diabetic patients with neuropathy.
Pathology
2015_133 Alterations of Spinal Capillaries in Lumbosacral Enlargement of Diabetic Rats
Kanokporn Plaengrit, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1
Amornrat Chookliang, Mahidol University, Thailand4
Uncontrolled hyperglycemia leads to diabetic vascular complications affecting several organs in the
body even on the nervous system. The spinal cord is known as the main route of information
connecting brain to body. Many researchers have investigated the effects of diabetes mainly on the
capillaries of peripheral nerve and brain, however, few reports in spinal cord have been studied. The
alterations of spinal microvessels result in malfunctions of neurons, glial cells, and nerve fibers, which
are relevant to the pathophysiology of nervous system disorders. Therefore, this study examined
whether diabetes causes morphological changes of spinal capillaries in the lumbosacral enlargement.
To prove this hypothesis, diabetes was induced by intraperitoneal injection of streptozotocin in
Sprague-Dawley rats, whereas control rats received citrate buffer alone. The segments of lumbosacral
spinal cord were removed from short-term (4 weeks) and long-term (24 weeks) diabetic rats. After that,
tissues were undergone histological processing. Under light microscope, short-term diabetes showed
that there was endothelial cell swelling. The pericytes also exhibited edematous changes. Moreover, the
swollen endothelium of capillaries reduced the luminal diameter. These alterations were severer in
long-term diabetic rats. Remarkably, capillary vessel with swollen endothelial lining, narrowed
capillaries and thickened capillary walls were observed in chronic diabetes. The study concluded that
diabetes leads to structural alterations in spinal microvessels. The knowledge from this study is an
important and beneficial for clinical development of microvascular complications from diabetes to
improve the quality of life in diabetic patients.
Pathology
2015_132 Effects of Streptozotocin-Induced Diabetes on Masseter and Digastric Muscles of Rat
Apichaya Niyomchan, Faculty of Medicine, Siriraj Hospital Mahidol University, Thailand1
Chittapon Juntararussmee, Mahidol University, Thailand2
Diabetes mellitus is a chronic metabolic disease characterized by persistent hyperglycemia. The

pathogenesis of diabetes involves in lifestyle and diet modifications. Lower masticatory performance
contributes to a higher risk for increased body fat, which in turn can be associated with an increase in
prevalence of diabetes due to the inability to chew fibrous foods and the need for soften diet, degrading
essential nutrients. Masseter muscle, a powerful jaw-closing muscle, and digastric muscle, a powerful
jaw-opening muscle, play an important role in masticatory system. Recently, many studies have been
reported an association between diabetes and myopathy. However, most of them investigate muscles of
the extremities. There are few reports on muscles of masticatory cycle. Fully functional masticatory
efficiency maintains a more balanced diet and proper nutrition. Considering poor masticating food
increases malnutrition and severity of disease, therefore, the purpose of this study was to verify the
effect of diabetes on masseter and digastric muscles in diabetic Sprague-Dawley rats, induced by
streptozotocin, using histological techniques for light microscopic study. The results showed that
chronic diabetes (24 weeks) caused a reduction in myofiber size, collagen fiber accumulations,
infiltration of lymphocytes and macrophages, and thickening of vessel wall in diabetic masseter and
digastric muscles as compared to untreated control muscles from age-matched control rats. The
declining masticatory muscle health observed in diabetic state from this present study provides new
information for physicians concerned with the progression of diabetic muscular complication and
assists in making appropriate clinical therapy.
Physical Therapy
2015_119 Predictors for chronic neck and low back pain in office workers: A 1-year prospective
cohort study
Rattaporn Sihawong, Chulalongkorn University, Thailand1
Ekalak Sitthipornvorakul, Chulalongkorn University, Thailand2
Prawit Janwantanakul, Chulalongkorn University, Thailand3
Introduction: To identify predictors for chronic neck and low back pain in a cohort of office workers.
Methods: A prospective study was carried out among 669 healthy office workers. At baseline, risk
factors were assessed using questionnaires and standardized physical examination. A symptomatic case
was defined as an individual who reported pain greater than 30 mm on a 100-mm VAS and chronic
pain was defined as experiencing ongoing neck or low back pain for greater than 3 months over the
past 6 months. Two regression models were built to analyze the risk factors for developing chronic
neck and low back pain. Results: Of the sample, 17% and 27% of office workers reporting a new onset
of neck and low back pain developed chronicity, respectively. Predictors for chronic neck pain were
high body mass index, frequent neck extension during the work day, high initial pain intensity, and
high psychological job demands. The development of chronic low back pain was associated with
history of low back pain and high initial pain intensity. Conclusion: The findings suggest that
predictors for chronic musculoskeletal pain in a subpopulation may be a subset of predictors identified
in a general population or occupational-specific. Successful management to prevent chronic
musculoskeletal pain may also need to consider the patient’s occupation.

2015_563 Community participatory roles in Solid Waste Management in Joho Sub-district
Administrative Organization, Mueang District, Nakhon Ratchasima, Thailand
Teerayuth Udomporn, Faculty of Public Health, Vongchavalitkul University, Nakhon
Ratchasima, Thailand1
The research aimed were to explore community participatory towards solid waste management in Joho
Sub-district Administrative Organization, Mueang District, Nakhon Ratchasima, Thailand. The
collection data using questionnaire from 54 represent of household. Analyses of research data
employed descriptive statistics and Chi-square. The research conducted during October - December
2014. The results showed in over all of participation were moderate (¯x= 2.12, SD = 0.52). The
relationship between social status and participation was significantly statistically related (p<.05).
Therefore, the local government should promote community participatory on effective solid waste
management, in order to avoid environmental consequences in the future.
2015_527 Development of multimedia electronic book on basic knowledge of breastfeeding
Susanha Yimyam, Faculty of Nursing, Chiang Mai University, Thailand1
Jantararat Chareonsanti, Chiang Mai University, Thailand2
Multimedia electronic book become on alternative learning approach for the 21st century learning. The
purposes of this research were 1) to develop and validate the efficiency of the multimedia e-book on
the basic knowledge of breastfeeding for nursing students 2) to compare between pretest and post-test
achievement scores of students who had studied by multimedia e-book and 3) to study the satisfaction
of students towards the multimedia electronic book. The sample of 43 was randomly selected from the
third year nursing students at the Faculty of Nursing, Chiang Mai Unversity. The research tools were 1)
multimedia e-book on the basic knowledge of breastfeeding 2) the achievement tests of the students
who had studied with the multimedia e-book and 3) the questionnaire of the satisfaction towards
multimedia e-book. The sample group was tested on the basic knowledge of breastfeeding prior to and
after their studying of the subject matter using the e-book. The data were analyzed by using descriptive
statistics and paired t-test. Results revealed that the efficiency of the multimedia electronic book on
basic knowledge of breastfeeding was at 80.23/ 83.26. Comparison showed that achievement scores of
post-test were statistically significant higher than pretest (p<.001) and students had highest satisfaction
level towards the use of the multimedia e- book on basic knowledge of breastfeeding (Mean 3.54,
S.D.=0.32). This study suggested that other topics and subjects should be developed as multimedia e-
books which will promote nursing students to better understand complex contents and to continue their
self-directed learning.

2015_504 Effects of Multimedia Materials and Model Practices on Knowledge and Self-confidence
in Nursing Practice Among Nursing Students
Suthisa Lamchang, Faculty of Nursing, Chiang Mai University, Thailand1
Somchit Kiatwattanacharoen, Chiang Mai University, Thailand2
The purpose of this quasi-experimental study was to examine the effects of multimedia materials and
model practices on knowledge and self-confidence among nursing students in nursing practice for
children with acute respiratory tract infection. A purposive sample included 76 fourth year nursing
students who were enrolled in the 2013 academic year at the Faculty of Nursing, Chiang Mai
University and were willing to participate in the study. Participants were assigned into either the
comparison or experimental group with 38 in each group. The two groups had no difference in means
and variances of grade point average (GPA). The experimental group received standard instruction
(classroom lectures) as well as multimedia materials and model practices.The comparison group
received standard instruction.The research instrument consisted of the Multimedia Materials about
Nursing Practice for Children with Acute Respiratory Tract Infection, the Knowledge Regarding
Nursing Practice for Children with Acute Respiratory Tract Infection Questionnaire, and the Opinion
of Multimedia Materials Questionnaire and the Self-confidence in Nursing Practice for Children with
Acute Respiratory Tract Infection Questionnaire, developed by the researcher. Data were analyzed
using descriptive statistics, and t-test. The results of this study revealed that the experimental group had
statistically significantly higher knowledge scores and self-confidence scores in nursing practice for
children with acute respiratory tract infection than those of the comparison group. Knowledge scores
and self-confidence scores in nursing practice for children were higher at a statistically significant level
after instruction via multimedia materials and model practices instruction than before instruction.
2015_503 Effectiveness of CAI Regarding Dietary Control for Ischemic Heart Disease Prevention
on Food Consumption Behaviors in High Risk Patients
Patcharaporn Aree, Faculty of Nursing, Chiang Mai University, Thailand1
Anong Amaritakomol, Chiang Mai University, Thailand2
Malee Urharmnuay, Chiang Mai University, Thailand3
A pretest-posttest control group quasi-experimental design was used in this study. The aim of the study
was to determine the effectiveness of tutorial teaching through computer assisted instruction (CAI)
regarding dietary control for ischemic heart disease prevention. The total number of samples were 57
cases, divided into 29 and 28 cases participated in experimental group and control group, respectively.
The research intervention instruments were CAI and handbook regarding dietary control for ischemic
heart disease prevention. Personal and food consumption behaviors questionnaires. The collecting
instruments were personal characteristics and the food consumption behaviors questionnaires. The
content validity index of the CAI and the food consumption behaviors questionnaire were 0.8 and 1,
respectively. The reliability by using Cronbach’s alpha coefficient method of this food consumption
behaviors questionnaire was .8. The providing information for the experimental group was using CAI,
and for the control group was using usual teaching according to nursing care plan of the Med-
noninvasive unit. The data were analyzed by using descriptive statistics, independent t-test, and
dependent t-test. The research results were shown as follow: 1) The food consumption behaviors score
of the experimental group at posttest period was significantly higher than that at pretest period (p<.05).
2) The difference of the food consumption behaviors scores between pretest and post-test of the
experimental group was significantly higher than that of the control group (p<.05). The results of this
study provide the appropriated CAI program that may be used as the educational aids for advice to
prevent the ischemic heart disease.
Physical Therapy
2015_107 Effects of elastic therapeutic taping and foot orthotics for individuals with plantar
fasciitis
Praneet Pensri, Chulalongkorn University, Thailand1
Pavinee Harutaichun, Chulalongkorn University, Thailand2
Duangkamol Phonwet, Chulalongkorn University, Thailand3
Sujitra Boonyong, Chulalongkorn University, Thailand4
Aim: To compare the effects of elastic therapeutic taping, prefabricated foot orthosis (PFO), and
customized foot orthosis (CFO) on heel pain and foot disability in individuals with plantar fasciitis.
Methods: Sixty-three subjects with plantar fasciitis were divided into two groups. After baseline
evaluation, all subjects were treated with one application of elastic therapeutic tape on the injured
plantar fascia. Subjects were allowed to remove the tape after day 6. All subjects then performed calf
muscle and plantar fascia stretching at home, in relation to the use of orthotic device from week 2 to
week 4. Thirty-four subjects in group A used a rubber shoe insert, while 29 in group B used a custom-
made polypropylene insole. Visual Analogue Scale and Foot and Ankle Ability Measurement were
used to assess the severity of heel pain and foot disability at the beginning, 1-week, and 5-week follow
up. Results: Pain intensity after receiving the taping for 1 week significantly decreased in both groups
(p<0.05). A significant increase in foot functional ability was also found at the 1-week follow up.
However the improvement in pain reduction and functional ability recovery were very little after the
first week. The Two-way ANOVA showed that neither PFO nor CFO had an important effect on heel
pain and foot functional ability at the 5-week follow up. Conclusion: Elastic therapeutic taping was
more likely to be an effective intervention for treating plantar fasciitis than foot orthotics since it could
promote long-lasting effect and offer inexpensive cost of treatment.
Nursing Education and Practice
2015_549 Enhancing collaboration through recognition of prior learning in nursing education
Lynn Kilbride, Glasgow Caledonian University, United Kingdom1
Andy Gibbs, Glasgow Caledonian University, United Kingdom2
This paper reviews the European experience of using learning outcomes to harmonise and make degree
programmes transparent and comparable. This has facilitated the development of collaborative
curricula and the authors discuss three key issues related to this based on their experience of designing
and delivering collaborative curricula internationally. These are; Mapping curricula for articulation,
Dual awards and professional recognition; Recognising prior, experiential and informal learning, and
Building curricula and within sound quality frameworks. The aim of the presentation is to highlight to
participants how to: Apply a template for collaborative curriculum mapping; Recognise prior,
experiential and informal learning and encompass this within collaborative programmes; Develop
collaborative curricula within a quality assured framework. The presentation will demonstrate how to
achieve effective mapping and alignment of learning outcomes using a schematic mapping framework,
taking into account quality assurance processes and professional regulations of the proposed award.
The presentation will provide guidance for mapping prior and informal learning and experience to the
learning outcomes of collaborative programmes to ascertain optimal academic credit recognition. Once
these issues have been considered, a suitable curriculum has to be proposed in line with the quality
assurance regulations associated with the programmes and the institutions involved. Guidance will be
given to evaluate and review the proposal. This presentation is suitable for any individual who is
involved in collaborative education. It will cover all aspects of collaborative curriculum development
and will provide tools to assist with this activity. People new and with curriculum development
experience will benefit from this.
Sharing Health Data

2015_150 Open Source Health Information: Providing equitable access to practitioners,
researchers and patients
James McNally, University of Michigan, United States1
Easy and equitable access to health information is a long standing goal in the health sciences. Health
providers, policy advocates and patients all benefit when health information is made available for
review and as an educational resource. In general, the open sharing of health information varies
dramatically from institution to institution, and only becomes more complex when we attempt to share
health statistics across national borders. Not only the availability and quality of such information can
differ significantly, but the capacity local computing infrastructures are far from uniform across Asia.
This presentation will present work emerging from the NACDA Program on Aging, located at the
University of Michigan in the United States that provides open sharing of international health
information at no cost to any interested user with access to a computer. The program “Online Analysis
System” OAS allows interested health professionals, researchers, policy advocates and patients to use
information stored at the University of Michigan to create informational tables and summaries of health
information maintained in our research center and data archive. This service is freely available to an
interested individual and it is rapidly growing. One of the strengths of the system is that researchers
and health professionals are also welcome to add their information to the system, expanding our
understanding of international health and building collaborative knowledge across international
borders. The proposed presentation will review the system; provide examples of how it can be used for
research and show how users can add to the knowledge base.
Drug Development and Pharmacology / Toxicology
2015_165 Detection of tetrodotoxin producing microorganisms in puffer fishes and the risk of
tetrodotoxin infection in food
Tu Nguyen, Hochiminh City International University, Vietnam1
Huu Nguyen, Hochiminh City International University, VN2
Vinh Doan, Hochiminh City International University, Vietnam3
Dat Nghe, Hochiminh City International University, Vietnam4
Nowadays, there are many cases of death due to eating puffer fishes, horseshoe crabs, terrestrial crab in
Vietnam. Moreover, tetrodotoxin has been proven to be useful compound in pharmaceutical.
Tetrodotoxin might be used as neuroprotective agent for ischemic damage of brain followed stroke,
renoprotective agent and, antinociceptive agent.Therefore, in the study, isolation and identification of
tetrodoxin producing bacteria are necessary for tetrodotoxin yield and to find out the risk of
tetrodotoxin infection in food. Puffer fishes were collected in Vietnam sea. The liver, intestine and eggs
were incubated in a suitable medium for tetrodotoxin detection. Surprisingly, Staphylococcus scuiri,
Enterococcus faecium, Providencia rettgeri were identified by biochemical test and 16S rRNA
sequencing. However, only Enterococcus faecium, Providencia rettgeri could produce tetrodotoxin
based on thin layer chromatography, mouse bioassay and high performance liquid chromatography
analysis. These bacteria were optimized for tetrodotoxin production in media prepared from the meat -
washing water of sea fishes (Auxis thazard, Megalaspis cordyla and Decapterus maruadsi) and
freshwaster fishes (Pangasius bocourti, Oreochromis sp). Interestingly, the tetrodotoxin obtained 0.055
– 0.2 mg in 10 ml of culture, except Decapterus maruadsi medium could not be detected the
tetrodotoxin present. This research could contribute to warn to the human health care system about a
possible TTX poisoning in some cases related to eating fishes.
Section III
Full Papers
Fine Motor Activities Program to Promote Fine Motor Skills
in a Child with Down’s Syndrome: A Case study
Suchitporn Lersilp
Department of Occupational Therapy
The Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
Supawadee Putthinoi
The Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
Kewalin Panyo
The Northeast Institute of Child Development, Thailand
ABSTRACT
Children with Down’s syndrome are those with delayed development, particularly delayed
cognitive and motor development. Fine motor skills are mostly a motor development problem
thatoccurs and has impact on occupational performance in school-age children with Down’s
syndrome because it relates to participating in school activities, such as grasping, writing, and
carrying out self-care activities. This study aimed to examine the efficiency of a Fine Motor
Activities Program to promote fine motor skills in a case study of Down’s syndrome. The case
study subject is Kai, an 8 -year-old male with Down’s syndrome, who was a first grader in a regular
school that provided classrooms for students with special needs. Instruments consisted of
assessment tools and the Fine Motor Activities Program. The assessment tools included 3 subtests
of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), which were Upper-
limb coordination, Fine motor precision, Manual dexterity; and also the In-hand Manipulation
Checklist, and Jamar Hand Dynamometer Grip Test. The Fine Motor Activities Program was
implemented individually and consisted of 45 activities in 3 sessions a week for 5 weeks, with each
session taking 45 minutes. The results showed that the case study demonstrated obvious
improvement of fine motor skills, including Bilateral hand coordination, Hand prehension, Manual
dexterity, In-hand manipulation, and Hand muscle strength. With these positive results,
occupational therapists could consider application of the activities program in their intervention and
work with teachers and parents in providing and choosing activities that enhance fine motor skills
in children with Down’s syndrome.
Keywords: Fine Motor Skills, Activities Program, Down’s syndrome
1 INTRODUCTION
Down’s syndrome is the most common genetic disorder causing moderate to severe mental
retardation in children [1]. Children with Down’s syndrome have a smaller oral cavity, a large
tongue, and a limitation of lip and tongue movements that can impact their speech communication.
Moreover, the musculoskeletal problems, visual problems, hearing problems, perception and
cognition problems are often found in these children. These problems influence to the children
when performing activities in daily life such as self-hygiene, education, recreation, and social
participation [1]. This information relates to Conolly & Micheal [2] who studied the comparison of
gross motor and fine motor abilities between children with intellectual disability who have Down’s
syndrome and those children who do not have Down’s syndrome. An assessment tool that was used
in this study was the Bruininks Oseretsky Test of Motor Proficiency, second edition. Results
showed that children with intellectual disability who have Down’s syndrome had significantly
lower scores of gross motor and fine motor abilities than those children with intellectual disability
who do not have Down’s syndrome. As occupational therapists, we are aware of the importance of
fine motor skills that are fundamental in enhancing children with delayed development so they are
able to reach academic achievement goals. For these reasons, in this research we are interested in
studying the effectiveness of fine motor activities program to promote fine motor skills, including
bilateral hand coordination, hand prehension, manual dexterity, in-hand manipulation, and hand
muscle strength in a case study of Down’s syndrome.
2 CASE INTRODUCTION
The case study, Kai, was an 8-year-old Asian male who was congenitally diagnosed with
Down’s syndrome. He had a vision problem but it has been corrected by using glasses. Also, he had
heart disease but was treated with a medical program. He was a first grader in a regular private
school in Chiang Mai, Thailand but he had repeated in kindergarten 3. He was a child with mild
(educable) intellectual disability (I.Q = 50). He lived with his parents and an older brother who was
studying in Grade 6. When he was in the school, there was a special education teacher that
individually helped and supported him in learning activities in the classroom. He was able to
perform basic activity of daily living, such as tooth brushing, showering, dressing, and eating.
However, he was not able to copy assignments from the whiteboard to his notebook in sufficient
time, so the special education teacher needed to help him. In terms of play behaviors, he was able to
actively play and learned social behaviors with his male and female peers. He received related
services for encouraging his developments, such as occupational therapy, physical therapy, speech
therapy, and so on. For academic services, he received Individualized Education Program (IEP) and
scheduling in a resource room for Thai language and mathematics subjects.
3 METHOD
The study is pretest-posttest design in a case study subject who is a Down’s syndrome
student. The research instruments consisted of three assessments and an intervention program. The
assessments are the Bruininks - Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) [3]
in the subtests of Fine motor precision, Manual dexterity and Upper-limb coordination, the Jamar
Hand Dynamometer, and the In-hand manipulation Checklist. The BOT-2 and the Jamar Hand
Dynamometer are standardized instruments but the In-hand manipulation Checklist is developed by
the researchers and processed for content validity by the suggestions from three related specialists.
For the intervention program, it is a fine motor activities program that includes five activity sets to
enhance bilateral hand coordination (8 activities), hand prehension (8 activities), manual dexterity
(11 activities), in-hand manipulation (9 activities), and hand muscle strength (9 activities) for the
case study subject. This activities program is analyzed and designed basing on Neurodevelopmental
Approach [4], Biomechanical Approach [5], Sensorimotor Approach [6], and Psychosocial
Approach [7].
After an approval for this research was given by the Research Ethics Committee of the
Faculty of Associated Medical Sciences, Chiang Mai University, Thailand, the case study subject
and his parents were contacted and informed about the research objectives. They were also signed
in consent form and assent form to be participants in this research. Then, demographic data,
developmental history, academic performance, general behaviours, and behaviours in classroom of
the case study subject were collected. After that, the case study subject was assessed by the BOT-2
in the subtests of Fine motor precision, Manual dexterity and Upper-limb coordination, the Jamar
Hand Dynamometer, and the In-hand manipulation Checklist. These were being the pre-test scores.
In the intervention stage, the Fine Motor Activities Program was implemented individually and
consisted of 45 activities in 3 sessions a week for 5 weeks, with each session taking 45 minutes.
Finally, the case study subject was reassessed by the same instruments for being the post-test scores.
Data were analyzed by descriptive statistics.
4 RESULT
The results indicated that the case study subject demonstrated obvious improvement of fine
motor skills; including bilateral hand coordination, hand prehension, manual dexterity, in-hand
manipulation, and hand muscle strength. In term of bilateral hand coordination, the pre-test score
was 10 (26% of total score) and the post-test score was increased to be 15 (38% of total score). For
hand prehension, the pre-test score was 17 (41% of total score) and the post-test score was
increased to be 20 (49% of total score). For manual dexterity, the pre-test score was 3 (7% of total
score) and the post-test score was increased to be 16 (36% of total score). For in-hand manipulation,
the pre-test score was 0 (0% of total score) and the post-test score was increased to be 4 (80% of
total score). For hand muscle strength, the strength of the right hand before using program was 6.5
ponds and increased to be 7 ponds after using program, and the strength of the left hand before
using program was 3.5 ponds and increased to be 4 ponds after using program. These scores are
presented in Table 1.
Table 1 Scores of fine motor skills before and after using fine motor activities program
Fine motor skills Before After

Bilateral hand coordination 10 (26% of total score) 15 (38% of total score)
Hand prehension 17(41% of total score) 20 (49% of total score)
Manual dexterity 3 (7% of total score) 16 (36% of total score)
In-hand manipulation 0 (0% of total score) 4 (80% of total score)
Hand muscle strength
- Right hand 6.5 ponds 7 ponds
- Left hand 3.5 ponds 4 ponds
When we considered the change of scores in bilateral hand coordination, hand prehension,
manual dexterity, and in-hand manipulation skills, we found that in-hand manipulation score is the
most obvious change (80%) and the least change score is hand prehension score (8%). For the hand
muscle strength, both right hand and left hand is increased 0.5 ponds.
5 CONCLUSION AND DISCUSSION
The objective of this research is to study the effectiveness of fine motor activities program to
promote fine motor skills, including bilateral hand coordination, hand prehension, manual dexterity,
in-hand manipulation, and hand muscle strength in the case study who was an 8-year-old Asian
male with Down’s syndrome. After the case study was implemented individually with the fine
motor activities program that consisted of 45 activities in 3 sessions a week for 5 weeks, with each
session taking 45 minutes, the post-test scores of all assessments are increased. This result related to
characteristics of children with Down’s syndrome that was indicated hypotonic problem influencing
to gross motor and fine motor skills [1]. On the occupational therapy perspectives, these fine motor
skills are able to be improved by an appropriated program that consists of analysis and synthesis
activities. Moreover, the activities have to be graded along with progression of the children, used
consistently with enough duration of treatments, and implemented with technique of therapeutic use
of self [4,5,6,7]. For these reasons, he demonstrated obvious improvement of fine motor skills.
Especially, the result found that in-hand manipulation score has the most obvious change but hand
prehension score has the least change. This is because the hand prehension skill is related with child
development that is gradually developed from basic pattern to be more complicated pattern [8].
However, in this research the case study was implemented with the program for 5 weeks that may
not enough to appear an obvious change. Additionally, because a child with Down’s syndrome is a
child with intellectual disability, he has a limitation of learning and performing cognitive functions
[1]. Indeed, he might need more time to learn, to integrate, to recall, and to receive feedback
response. Thus, increasing duration of intervention time will be a factor to improve his skills.
Moreover, this study has a limitation of generalization to a large population because it is a case
study research design, so that the research in the future should study in larger subjects or in other
groups of children with disabilities, such as children with learning disability, children with
intellectual disability, and so on.
REFERENCES
[1] Pueschel, SM. A Parent’s guide to Down syndrome: toward a brighter future. (2nd ed). Baltimore: Paul H.
Brookes; 2001.
[2] Connolly BH, Michael BT. Performance of retarded children, with and without Down syndrome, on the
Bruininks-Oseretsky Test of Motor Proficiency. Phys Ther. 1986, 66: 344–348.
[3] Bruininks RH, Bruininks BD. Bruininks-Oseretsky Test of Motor Proficiency (2nd ed.). Minneapolis, Minnesota:
Pearson Assessments; 2005.
[4] Dutton, R. Biomechanical frame of reference. In: Hopkins HL, Smith HD, editors. Willard and Spackman’s
Occupational Therapy (8th ed.). Philadelphia: Lippincott; 1993. P. 66-67.
[5] Dutton, R. Neurodevelopmental frame of reference. In: Hopkins HL, Smith HD, editors. Willard and Spackman’s
[6] Simon, CJ. Sensory integration frame of reference. In: Hopkins HL, Smith HD, editors. Willard and Spackman’s
[7] Amundson, SJ. TRICS for Written Communication: Techniques for Rebuilding and Improving Children’s School
Skills. AK: Homer; 1998.
[8] Danto, A & Pruzansky, M. Pediatric treatment activities. Thorofare: Slack Incorporated; 2011.
Home features and Assistive Technology of Home Bound Elderly in
Hang Dong district, Chiang Mai, Thailand
Supawadee Putthinoi
Faculty of Associated Medical Sciences
Chiang Mai University, Thailand
Suchitporn Lersilp
Faculty of Associated Medical Sciences
Naruwan Jumpasri
Petcharat Hospital
Petchaburi, Thailand
Nopasit Chakpitak
Chiang Mai University International College
……..
ABSTRACT
The purpose of this study was to survey the homes and assistive technology of home bound elderly people. The
scope of this research was home bound elderly people at Sub-district Namprae, Hang Dong district, Chiang Mai. The
home evaluation included features of inside and outside the home and assistive technology based on the International
Classification of Functioning (ICF) concept.
Methods, observation and an interview were used for evaluation by the researcher. The study found that there
were poor features in some topics such as the width of the door being smaller than 90 cm. in 26 homes (100.00%), the
door step being higher than 2 cm. in 20 homes (76.92%), the staircases being higher than 15 cm. in 14 homes (53.85%),
no bedside rails in 23 homes (88.46%) and inappropriate height of the toilet pan in 24 homes (92.31%). Assistive
technology in houses of the elderly found 6 items; TV remote, cane, eye glasses, false teeth, walker and wheelchair. In
addition, there were 5 items that were not found, but had demand as follows; hearing aid, wheelchair, walker, eye-
glasses and cane.
Therefore, occupational therapists should suggest improving the home conditions and behavior of the elderly and
enhance safely as well as introduce the use of assistive technology according to the limitations of the person and what
should be provided for the lives of the elderly.
Keywords: Assistive technology, Home bound elderly people, Home features, International Classification of
Functioning
1 INTRODUCTION
Thailand is currently an ageing society from the rapid increase of ageing population, the
challenging is to promote and maintain good health in their homes and supported in the community
for as long as. Falls associated with the environment factor are the one factor affecting of the
elderly. The problem of falls has taken on significant importance in the elderly [1] with high
possibility falling because of age-related physiological changes [2, 3]. Older people usually spent
their time at their residents [4]; therefore home environment is important factor for independent
living of the elderly. It should be provided good living condition and an enabler for ageing in place.
Ageing in place is term as meaning staying in one’s home or community to relate with sense of
identity through independence and autonomy [5]. Successfully age in place should enable the
elderly to carry out basic activities associated with daily living safely and independently, participate
in social roles, and receive personal assistance from caregivers as needed.
Fall risk factors relate with personal health and environment. The elderly have higher risk of
accident and consequences more severe than other ages. Recovery after fall takes a long time so that
preventing accidents is the best solution in the elderly. The environment can facilitate health
maintenance and management by supporting health-promoting behaviors and provision of health
care services. Environmental modifications, health care technologies and assistive technologies can
compensate for limitations in functional abilities due to reduce risk of falling and promote
independent living and well-being [6]. The application and implementation of ageing in place
concept lead to reduce environment barriers for independent functioning in daily activities of the
elderly.
In Thailand providing the elderly service in the community is classified a specific
characteristic of each into three groups; well elderly, home bound elderly and bed bound elderly [7].
This research focuses on home bound elderly who are independence or need partial assistant with
some limitation to perform activities of daily living. This group has some problem to participate
social activity mainly living in home. The environmental modifications can enhance to prevent the
home bound elderly transform into be bed bound elderly.
The International Classification of Functioning, Disability and Health (ICF) originated by the
WHO, intends to specify a useful framework of functioning and disability. Environmental Factors
as one component of contextual factors in ICF acts as a facilitator or a barrier to a person’s
successful functioning [8] that have influence of an individual performance. From the practical
manual of ICF [9] suggests the ICF can provide a structure the assessment and management of
home environment. Considering, the environment factors can apply to be assessment tools to
evaluate physical built environment to facilitate a range of activities in the area of mobility, as well
as participation in the areas of community life of the elderly. Aim of this study is to investigate the
home environments that included home features assistive technology the home bound elder in the
community by using Environmental Factors according to ICF framework.
2 LITERATURE REVIEW
Aging is not merely the passage of time. It is the manifestation of biological events that occur
over a span of time. It is important to recognize that people age differently. The aging body does
change. Some systems slow down, while others lose their "fine tuning." As a general rule, slight,
gradual changes are common, and most of these are not problems to the person who experiences
them. The dramatic age population changes might indicate serious health problems. The United
Nations Principles for Older Persons call for action encouraging governments into national
programs in many areas [10].
The environment is perceived to play a significant role in many falls experienced by older
people [11]. The World Health Organisation [12] has highlighted that falls can result from
environmental hazards and Todd et.al [13] promote a broad environmental definition encompassing
the community in which the older person lives and the environmental challenges they face. The
physical environment of a senior housing has an enormous impact upon the safety and functional
level of the older people. Understanding about risk factor of housing is very important to plan
implementing ageing friendly standards.
The framework of disability term, specified by the ICF, was more focused on the close
connection between the limitations experienced by person with disabilities, the design and structure
of their environments and the attitude of general public to provide a common language in
communications [8] Environmental factors on ICF can have the effect of improving or obstructing
an individual’s body function, ability to execute an activity, and their participation in society.
Ability of ICF is to serve as an organizing framework for assistive technology outcomes, however
Smith et al. [14] reported in using the ICF lacks of quantify assistive technology (AT) interventions
and outcomes is its lack of specificity. The aims of the study were to evaluate the environmental
factors by applying AT classification categories of ICF for more specific into treatment or
intervention.
3 METHODS AND METHODOLOGY
3.1 Subject Recruitment
The study was a cross-sectional survey of people aged 60 years and over. Lists of home
bound elderly people were obtained from Health Promoting Hospital at Sub-district Namprae, Hang
Dong district, Chiang Mai. Those of home bound elderly people were contacted and visited in their
homes. All the older people who agreed to participate in the study were inspected and assessed for
home environment factors and assistive technology. Ethical approval was given by the Ethics
Committee of Associated Medical Science faculty, Chiang Mai University.
3.2 Procedures of Data Collection
Interview personal data by face to face at their home and direct observation of the home
environment were procedures of data collection.
3.3 Measures
1. Socio-demographic information was collected on age, gender, marital status, health

condition, comorbidities and physical disability
2. To determine the home evaluation, the home assessment checklist developed for use with
the elderly and adults with disabilities living in the community. Observation tool was used the home
assessment checklist with room assessment technique to evaluate the features of hazard. Categories
of home evaluation were show in Table 1.
Table 1 Categories of Home Evaluation

Items
1. Outside of home Exterior/Entrances
2. Inside of home Floor condition
Getting around area
Kitchen
Bathroom/Toilet
Bedroom
Living / Dining room
Laundry
Furniture
3. Assistive technology of elderly people checklist was completed assessment with the
coverage listing of classification categories of ICF.
4 RESULTS AND FINDING
4.1 Socio-demographic Information
In all, 26 home bound elderly people (87% of the target population) agreed to participate.
Characteristics for the sample are presented in Table 2.
Table 2 Characteristics of the Study Sample (N= 26)
Characteristics N (%)
1. Age, years
60- 69 4 (15.38)
70- 79 11 (42.31)
> 80 11 (42.31)
2. Gender
Male 8 (30.77)
Female 18 (69.23)
3. Marital status
Single 3 (11.54)
Married 12 (46.15)
Others 11 (42.31)
4. Physical disabilities
Mobility impairment 15 (57.69)
Visual impairment 5 (19.23)
Hearing impairment 1 (3.58)
4.2 The home Evaluation
The results of home hazard evaluation in bedroom and bathroom/toilet were shown as shown
in Table 3.
Table 3 Home Environments (N= 26)

Items N (%)
1. Poor features
Width of the door being smaller than 90 cm. 26 (100.00)
Inappropriate height of the toilet pan 24 (92.23)
No bedside rails 23 (88.46)
Door step being higher than 2 cm. 20 (76.92)
Staircases being higher than 15 cm. 14 (53.85)
2. Good features
Same level floor inside of home 26 (100.00)
Non slippery floor 26 (100.00)
Flatbed with no holes or muddy ground around houses 22 (84.62)
Non obstacles walkway 19 (73.08)
4.3 Assistive Technology in Houses
The survey of assistive technology in houses of home bound elderly people was shown in
Table 4.
Table 4 Assistive Technology in Houses (N= 26)
Assistive devices N Usability Need to use
(%) None Scanty Average Frequent Yes No
1. Remote controls for TV 19 7 2 5 5 12 7
(73.08) (36.84) (10.53) (26.32) (26.32) (63.16) (36.84)
2. Cane 13 3 3 3 4 10 3
(50.00) (23.07) (23.07) (23.07) (30.77) (76.92 (23.07)
3. Spectacles 9 1 4 2 2 7 2
(34.26) (11.11) (44.44) (22.22) (22.22) (77.78 (22.22)
4. Denture 9 3 1 1 4 5 4
(34.26) (23.07) (11.11) (11.11) (44.44) (55.56) (44.44)
5. Walker 7 - - 2 5 7
(26.92) (28.57) (71.42) (100.00)
6. wheelchair 2 - - 1 1 2 -
(7.69) (50.00) (50.00) (100.00)
5 CONCLUSION
Analysis of the main findings revealed that houses of home bound elderly people had hazards.
To determine whether individuals are at risk for falling, facilities must conduct a falls risk
assessment on each individual. The intervention could have (i) made changes to their home to
eliminate hazards with implementing home modifications (ii) been living in propose-built
accommodation especially assistive technology to meet their needs. Home modifications as
handrails, stair glides, or grab bars can reduce chance of falling in older people [15]. There is also
some evidence that environmental hazards may be particularly important fall risk factors only
among frail older people who are at high risk of falling because they have mobility but instability
[16]. However, all homes had multiple hazards were found in rooms and areas where they perform
complex daily routines (kitchen, bathroom, living/dining room and laundry).
This study is one strategy for improving understanding by identifying the home hazards and
home evaluation process, and evaluates the assistive technology in home. Assistive technology as
any service or tool that helps the elderly or disabled performs activities, however assistive device is
used and the demands imposed by a particular task; and as involving the device itself.
REFERENCES
[1] National Committee on the Elderly, 2013, Situation of the Thai elderly 2012, SS Plus Media Company Limited,
Thailand
[2] National Council on Ageing, 2005, Falls among older adults: risk factors and prevention strategies. In Fall free:
promoting a national falls prevention action plan, J.A. Stevens.
[3] World Health Organisation, 2007, Global Age Friendly Cities: A Guide World Health Organisation [Online]. In
press at the WHO: Available: http://www.who.int/en/
[4] Baltes MM, Maas I, Wilms H.-U., Borchelt MF, Little T, 1999, Everyday competence in old and very old age:
Theoretical considerations and empirical findings. In: Baltes PB, Mayer K.-U., editors. The Berlin Aging Study,
Cambridge University Press, Cambridge, England.
[5] Wiles JL, Leibing AL, Guberman N, Reeve J, and Allen RES, 2011, The Meaning of “Ageing in Place” to Older
People, The Gerontologist, 7, pp. 1- 10.
[6] Ocepek, Prosič and Vidmar, 2012, Assistive Technology and Its Role among the Elderly – a Survey, Informatica
Medica Slovenica, 17(2): pp. 9-15.
[7] Health Systems Research Institute: HSRI, 2010, Practice guidelines for elderly, Sahamitr printing & Publishing
Co., LTD. Thailand.
[8] World Health Organization, 2001, International classification of functioning, disability and health: ICF,World
Health Organization, Geneva, Switzerland.
[9] World Health Organization, 2013, How to use the ICF: A practical manual for using the International
Classification of Functioning, Disability and Health (ICF): Exposure draft for comment, WHO, Geneva.
[10] United Nations ESCAP, 1999, the United Nations Principles for Older Persons; Social Development Division,
United Nations ESCAP. [Online]. Available: http://www.unescap.org/ageing/res/principl.htm /
[11] Pynoos, J., Steinman, B. A., & Nguyen, A. Q. D, 2010, Environmental assessment and modification as fall-
prevention strategies for older adults, Clinics in Geriatric Medicine, 26, 633–644.
[12] World Health Organization, WHO, 2007, WHO global report on falls prevention in older age, France: WHO
Press, World Health Organization.
[13] Todd, C., Ballinger, C., and Whitehead, S, 2007, Reviews of Socio-Demographic Factors Related to Falls and
Environmental Interventions to Prevent Falls Amongst Older People Living in the Community. [Online].
Available: http://www.who.int/ageing/projects//
[14] Smith, RO., Jansen, C., Seitz, J. and Rust, KL, 2015, The ICF in the Context of Assistive Technology (AT)
Interventions and Outcomes, the University of Wisconsin-Milwaukee, USA.
[15] ECRI Institute, 2009, Falls. The Discipline of Science, 7, pp. 1- 27.
[16] Studenski, S., Duncan., PW., and Chandler J et al, 1994, Predicting falls: The role of mobility and nophysical
factors, J Am Geriatr, 42, pp.297-302.
Development of Cognitive Training Software for
Thai Elderly with Mild Cognitive Impairment
Achiraya Chaiyakham
Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
Supawadee Putthinoi
Suchitporn Lersilp
Anuruk Bunpun
……..
ABSTRACT
Thai society is gradually aging due to an increasing number of elderly, facing various changes in, for example,
cognition, and physical and psychosocial aspects. An important problem of old age is the change in cognition, which
affects the individual’s capacity to perform activity and quality of life. Mild cognitive impairment (MCI) is a type of
cognitive dysfunction associated with developing Alzheimer’s disease (AD) or other types of dementia commonly
found in old age.
The concept of this research is investigation of the problems related to cognitive impairment in elderly people in
Thailand, and to develop a new computer-based program, containing cognitive training software for Thai elderly with
mild cognitive impairment, for improving their cognitive function by forming web applications for computers, laptops
or tablets. The program consists of six sets of cognitive enhancing games, involving visuospatial skill, working
memory, abstraction, sequencing, categorization and orientation. This research will also investigate the validity,
reliability, and efficacy of the intervention, with results being used for future development of an effective intervention
technique for Thai elderly with MCI.
Keywords: cognitive rehabilitation, cognitive training, mild cognitive impairment, mild cognitive impairment elderly
1 INTRODUCTION
Currently, Thai society is aging, and as a result, more people are presenting with mild
cognitive impairment (MCI). MCI is a type of cognitive dysfunction linked to developing
Alzheimer’s disease (AD), and elderly people with this condition develop pathological dementia at
a higher rate than normal persons [1]. MCI is characterized by the elderly having memory
problems, but they are otherwise normal in their daily living activities and general cognitive
functions, and do not suffer from dementia [2]. Although the capacity to perform activity of people
with MCI remains normal, these individuals have reduced functional abilities relating to their
cognitive decline in some tasks [3]. There are several types of treatment for people with MCI,
including pharmacological approaches, group psychotherapy, family psychotherapy and cognitive
training [4]. Cognitive training is a non-pharmacological approach and attractive intervention
technique used for treating elderly people with MCI, and it improves the cognitive functions of
individuals with cognitive impairment. This technique is based on the theory of neuroplasticity,
which states that plasticity processes could strengthen the brain and neural network, resulting in
brain function restoring sensory, cognitive, memory, motor and affected systems in aging people
[5]. Today’s technology applies several intervention techniques, including cognitive training.
Recently, some studies developed cognitive training programs in the form of software applications
that can be used on computers [6].
2 RESEARCH CONCEPT
The concept of this research is investigation of the problems related to cognitive impairment
in elderly people in Thailand, and to develop a new computer-based program, containing cognitive
training software for Thai elderly with mild cognitive impairment, for improving their cognitive
function by forming web applications for computers, laptops or tablets.
3 LITERATURE REVIEW
From the literature review, cognitive training is an effective cognitive intervention approach
for elderly people with MCI [7, 8]. Furthermore, a program that contains a multi-domain of
cognitive enhancement is more effective than those containing specific cognitive aspects, as seen by
improvements of global cognitive function and transfer of skills [9]. In 2003, Gunther et al [10]
studied the results of a computer-assisted cognitive training program for elderly people and found
significant improvements in primary working memory. In addition, verbal and visual ability and,
long-term memory, information processing speed, learning, and interference tendency improved
significantly. Cipraini and colleagues [11] studied the result of a computer-based cognitive
rehabilitation program, which compared patients with AD to those having MCI, and found that it
significantly improved global cognitive status and/or specific cognitive areas in MCI and AD
patients. Several other studies applied this technology for use as intervention for cognitive training
in elderly people with MCI, and found that it improved global cognitive function and/or specific
cognitive areas, especially memory in the intervention group [12, 13]. Additionally, some studies
found that the computer-training program could lessen affect problems of patients, such as
depression, and also improve their cognitive function [14, 15].
The followings are literature reviews of the cognitive components in this study.
3.1 Visuospatial skill
Visuospatial skill or visual spatial skill is a component of cognitive functions. The role of
visuospatial skill entails identification of a stimulus and its location. A person with MCI can
present deficits in visuospatial skills and become impaired gradually at a late stage of the disease.
The dysfunction of visuospatial skill in MCI patients may affect their capacity in doing daily living
activities, which require visual function such as visual discrimination, analysis and spatial
judgement, and perceptual organization. Furthermore, it may lead to a decline in the quality of life
for MCI patients [16]
3.2 Working memory
People with MCI commonly have memory problems, especially in declining episodic
memory, with some of them also having a working memory problem. Working memory is
involved in different complexes related to several activities of everyday living, for example, dealing
with the telephone or calculating. The study of Carretti and colleagues (2013) found that cognitive
training in working memory could of benefit by transferring to other memory and cognitive
functions, and helping MCI patients to preserve the capacity to do their daily living activities [17].
3.3 Abstraction
Cognitive components, which might be found in MCI patients, are abstract thinking
impairment. The study of Rozzini and colleagues [14] states that facilitating MCI patients with
abstract thinking training manipulates relevant semantic and perceptive characteristic concepts. In
their study, participants correlated different images semantically and perceptively or associated
couples of figures.
3.4 Sequencing
Sequencing is a component of executive functional skills, which are very important in

complex sequential tasks such as cooking, bathing or transportation. For sequencing training,
cognitive exercises provide patients with sequencing skills and they start at the simple level and
progress gradually to more complex tasks.
3.5 Categorization
Categorization skill requires cognitive ability in perceiving the concept of similarities and/or
differences in order to distinguish or organize things into groups. Categorization is applied in some
computerized cognitive training programs [7, 18].
3.6 Orientation
The meaning of orientation is awareness of an individual's environment, which requires

attention, memory and perception. Generally, orientation is divided into place, time, and person.
Wenisch and colleagues [18] provided enhancement of the orientation domain in their cognitive
training program.
4 RESEARCH METHODS
The literature was reviewed for different aspects of cognitive function, and brainstorming in
selecting some important domains that can develop exercises or games for improving cognitive
functions. Then, this study drafted a format on a storyboard for each exercise of a new computer-
based program, which consists of six groups of exercises in six cognitive domains; visuospatial
skill, working memory, abstraction, sequencing, categorization and orientation, with each group
having five different tasks at five levels of difficulty. The content of each exercise is based on the
concept of each aspect of cognitive function.
The program comprises two sections, with the first being basic personal information on the
individuals concerned, including age, gender, educational background, marriage status, occupation,
history of medication and alcohol use, and family history of dementia. The second section consists
of instructions on each exercise, exercise trials, sets of cognitive exercises and individual scores of
each access.
After the draft had been completed, five specialists were asked to consult on its content
validity before creating a computer program. After creating the program, a reliability trial was
performed and program specification verified for Thai elderly with MCI. Now, the program takes
the form of a web application in order to study the efficacy of the cognitive training program.
The inclusion criteria for the cognitive training program are Thai elderly people with MCI,
who are aged 60 years or older, as characterized by Petersen’s criteria [2], and diagnosed MCI
while meeting the following requirements; 1) memory problems, 2) ability to do daily living
activities normally, 3) having normal general cognitive function, 4) having abnormal memory for
age, and 5) having no dementia, with an individual score of 23-25 from The Mini Mental State
Examination (MMSE) – Thai version, 2002.
In order to test the efficacy of the cognitive training program, a schedule has been set for
training four times within one month, which is referenced by the study of Franco and colleagues
(2013). They examined the effectiveness of a new software technology platform for cognitive and
physical training in patients with MCI and healthy adults [19]. The samples used in the test were
60 elderly people with MCI, who were divided into 2 groups; 30 persons each in the control and
training group. The Montreal Cognitive Assessment (MoCA) [20] was applied to pre- and post-test
the efficacy of the cognitive training software for Thai elderly with mild cognitive impairment,
which was created by this study. Then, the data collected and problems found when using the
program were referenced for future program development.
5 CONCLUSION
The computer-based cognitive training program is a non-pharmacological approach for

elderly people with MCI, and needs development as alternative cognitive intervention. This
effective cognitive training program provides cognitive improvement as an approach for this group
of elderly people.
REFERENCES
[1] Morris JC, Storandt M, Miller JP, et al. Mild cognitive impairment represents early-stage Alzheimer disease.
Archives of neurology 2001;58(3):397-405.
[2] Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical
characterization and outcome. Arch Neurol 1999;56:303–308.
[3] Bangen KJ, Jak AJ, Schiehser DM, et al. Complex activities of daily living vary by mild cognitive impairment
subtype. Journal of the International Neuropsychological Society : JINS. 2010;16(4):630-9.
[4] Cooper C, Li R, Lyketsos C, Livingston G. Treatment for mild cognitive impairment: systematic review. Br J
Psychiatry 2013;203(3):255-264.
[5] Mahncke HW, Bronstone A, Merzenich MM. Brain plasticity and functional losses in the aged: scientific bases for
a novel intervention. Progress in brain research 2006;157:81-109.
[6] Gates NJ, Sachdev PS, Fiatarone Singh MA, Valenzuela M. Cognitive and memory training in adults at risk of
dementia: a systematic review. BMC geriatrics 2011;11:55.
[7] Rapp S, Brenes G, Marsh AP. Memory enhancement training for older adults with mild cognitive impairment: a
preliminary study. Aging & mental health 2002;6(1):5-11.
[8] Belleville S, Chertkow H, Gauthier S. Working memory and control of attention in persons with Alzheimer's
disease and mild cognitive impairment. Neuropsychology 2007;21(4):458-69.
[9] Gates NJ, Sachdev PS, Fiatarone Singh MA, Valenzuela M. Cognitive and memory training in adults at risk of
dementia: a systematic review. BMC geriatrics 2011;11:55.
[10] Gunther VK, Schafer P, Holzner BJ, Kemmler GW. Long-term improvements in cognitive performance through
computer-assisted cognitive training: a pilot study in a residential home for older people. Aging & mental health
2003;7(3):200-6.
[11] Cipriani G, Bianchetti A, Trabucchi M. Outcomes of a computer-based cognitive rehabilitation program on
Alzheimer's disease patients compared with those on patients affected by mild cognitive impairment. Archives of
Gerontology and Geriatrics 2006;43(3):327-35.
[12] Barnes DE, Yaffe K, Belfor N, et al. Computer-based cognitive training for mild cognitive impairment: results
from a pilot randomized, controlled trial. Alzheimer disease and associated disorders 2009;23(3):205-10.
[13] Rosen AC, Sugiura L, Kramer JH, Whitfield-Gabrieli S, Gabrieli JD. Cognitive training changes hippocampal
function in mild cognitive impairment: a pilot study. Journal of Alzheimer's disease : JAD. 2011;26(Suppl)3:349-
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[14] Rozzini L, Costardi D, Chilovi BV, Franzoni S, Trabucchi M, Padovani A. Efficacy of cognitive rehabilitation in
patients with mild cognitive impairment treated with cholinesterase inhibitors. International journal of geriatric
psychiatry 2007;22(4):356-60.
[15] Talassi E, Guerreschi M, Feriani M, Fedi V, Bianchetti A, Trabucchi M. Effectiveness of a cognitive rehabilitation
program in mild dementia (MD) and mild cognitive impairment (MCI): a case control study. Arch Gerontol
Geriatr 2007;44(Suppl)1:391-9.
[16] Quental NBM, Brucki SMD, Bueno OFA. Visuospatial Function in Early Alzheimer’s Disease—The Use of the
Visual Object and Space Perception (VOSP) Battery. PLoS ONE 2013;8(7).
[17] Carretti B, Borella E, Fostinelli S, Zavagnin M. Benefits of training working memory in amnestic mild cognitive
impairment: specific and transfer effects. International psychogeriatrics / IPA. 2013;25(4):617-26.
[18] Wenisch E, Cantegreil-Kallen I, de Rotrou J, et al. Cognitive stimulation intervention for elders with mild
cognitive impairment compared with normal aged subjects: preliminary results. Aging Clin Exp Res
2007;19(4):316-22.
[19] Franco M, Palau F, Jiménez F, et al. Examining the Effectiveness of a New Software Technology Platform for
Cognitive and Physical Training in Mild Cognitive Impairment and Healthy Older Adults. In: Pons JL, Torricelli
D, Pajaro M, editors. Converging Clinical and Engineering Research on Neurorehabilitation. Biosystems &
Biorobotics. 1: Springer Berlin Heidelberg 2013. p. 917-21.
[20] Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool
for mild cognitive impairment. Journal of the American Geriatrics Society 2005;53(4):695-9
EFFECTIVENESS OF 6 STEPS PREVENTION AND CONTROL FOR DENGUE
HAEMORRHAGIC FEVER IN RURAL COMMUNITY OF THAILAND
Sirirat Janhom, Sudarat Boonwijit, Natnapa Padchasuwan, Sukanya Pholpimai
Wasugree Chawengkul, Jun Norkaew, Nusorn Kootanavanichpong
Soraya Kaewpitoon, Natthawut Kaewpitoon*

Hospital of Suranaree University of Technology, Nakhon Ratchasima, Thailand
……..
ABSTRACT
Dengue haemorrhagic fever (DHF) is a serious health problem in tropical countries including Thailand. The
community-based approach DHF prevention and control have been challenged in rural community areas, therefore, this
cross-sectional descriptive study aimed to assess the effectiveness of 6 steps prevention and control for DHF in
Nongsruang village, Kham Thalae So district, Nakhon Ratchasima Province, Thailand. The 199 represents were
purposive selected during January and April 2015. An interview questionnaire was utilized to collect the data from
them.
The results revealed that the campaign 6 steps prevention and control for DHF was performed in this community
at year 2014. Head of village (91.00%) and news station of village (78.00%) were the main information resources. The
incident rate of DHF during 2012-2014 was 9.00, 8.58, and 2.04 per 1,000 populations. House index (HI) during 2012-
2014 was 38.66, 44.85, and 9.80. Container index (CI) during 2012-2014 was 103.61, 150.52, and 7.32, respectively.
81.91% and 70.85% of represents had high knowledge and attitude on 6 steps prevention and control for DHF. 70.35%
of represents had participated in the 6 steps prevention and control for DHF.
This finding indicates a high knowledge and attitude on 6 steps prevention and control for DHF, in addition, the
incident rate of DHF, HI, and CI were decreased in this rural community. Therefore, 6 steps model is useful tool for
DHF prevention and control.
Keywords: 6 steps model, dengue haemorrhagic fever, prevention and control, rural community, Thailand
1 INTRODUCTION
Dengue haemorrhagic fever (DHF) is now one of the most important public health problems
in tropical developing countries and also has major economic and societal consequences. In recent
years, DHF has become a major international public health concern. Globally, 2.5 billion people
live in areas where dengue haemorrhagic viruses can be transmitted. The geographical spread of
both the mosquito vectors and the viruses has led to the global resurgence of epidemic dengue fever
and emergence of dengue haemorrhagic fever (dengue/DHF) in the past 25 years with the
development of hyperendemicity in many urban centres of the tropics. DHF was first recognized in
the 1950s during the dengue epidemics in the Philippines and Thailand [1]. Since then increasing
numbers of cases and geographical locations affected by DHF in Thailand have been reported, and
intervention of prevention and control has been performed [2,3,4.5,6].
DHF is a mosquito-borne viral tropical disease caused by the dengue virus. Symptoms
include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to
measles, bleeding, low levels of blood platelets and blood plasma leakage. DHF is transmitted by
several species of mosquito within the genus Aedes aegypti, A. albopictus. Subsequent infection
with a different dengue virus type increases the risk of severe complications. As there is no
commercially available vaccine, prevention is sought by reducing the habitat and the number of
mosquitoes and limiting exposure to bites [1].
Prevention thus depends on control of and protection from the bites of the mosquito that
transmits it. The World Health Organization recommends an Integrated Vector Control program
consisting of five elements: (1) advocacy, social mobilization and legislation to ensure that public
health bodies and communities are strengthened; (2) collaboration between the health and other
sectors (public and private); (3) an integrated approach to disease control to maximize use of
resources; (4) evidence-based decision making to ensure any interventions are targeted
appropriately; and (5) capacity-building to ensure an adequate response to the local situation [2].
Many of campaign had been used for prevention and control DHF in Thailand. Several years,
the 6 steps model of prevention and control for DHF was started by Department of Disease Control,
Ministry of Public health, Thailand. Also, this campaign has used for prevention and control in
Nongsruang village among 2013 and 2014, therefore, this cross-sectional descriptive study aimed to
assess the effectiveness of 6 step prevention and control for DHF in Nongsruang village, Kham
Thalae So district, Nakhon Ratchasima Province, Thailand.
2 MATERIALS AND METHODS
2.1 Study areas and study design
This cross-sectional descriptive study was performed in Nongsruang village, Nongsruang sub-
district, Kham Thalae So district, Nakhon Ratchasima Province, Thailand. It’s locate in the
northeast region where approximately 269 kilometres from Bangkok; capital of Thailand, and 34.9
km from Nakhon Ratchasima province. This village is covered 4.24 Km2, 199 household, and has
979 population (Figure 1).
Figure 1: Map of Kham Thalae So district, Nakhon Ratchasima Province, Thailand.

(Source of map: http://www.novabizz.com/Map/img/map-36-Nakhonratchasima.gif retrieve date 28 June 2015)
2.2 Population, sample size, and sampling
The 199 represents were purposive selected included head or represent of houses, village,
village health volunteer, the district health promotion hospital, and the sub-district Administrative
Organization, during January and April 2015.
2.3 Intervention, measurement and data collection
The routine campaign for DHF prevention and control was started during 2013 and 2014 in
this rural community. The campaign comprised 6 steps with (1) covered the open resources of
water, (2) control the mosquitoes with biological control agents; fish, (3) changing a flower vase
with clean water, (4) cleaning of water reservoir; weekly, (5) household sanitation, and (6)
continuously practicum of DHF prevention and control (Figure 2).
An interview questionnaire was utilized to collect the data from subjects who were represents
of household, village, and related this community. The questionnaire was comprised 5 domain
included (1) demographic data, (2) general information for DHF; resources, incident, mosquito
larval indices, (3) knowledge, (4) attitude, and (5) participation. Reliability and validity of
questionnaire was analysed, knowledge (Kruder-Richardon-20) = 0.85, attitude and practice
(coefficient of Cronbach’s alpha) = 0.92 and 0.76, respectively.
Figure 2: The 6 steps model of prevention and control for dengue haemorrhagic fever in
Nongsruang village, Nongsruang sub-district, Kham Thalae So district, Nakhon Ratchasima
Province, Thailand, year 2014, (left; in Thai language, right; English language).
2.4 Statistical analysis
Descriptive statistical data were analysed with SPSS software.

3 RESULT
3.1 Demographic data
The results revealed that most of the represents, they were female (72.90%), 40-44 years old
(28.10%), primary school (32.70%), married (87.90%), and worked in agriculture (60.80%). On
average, they had worked for 10 years and family income ranged from10,000 to 15,000 Baht per
month (71.40%) (Table 1).
Table 1 Demographic data of represents from Nongsruang village, Nongsruang sub-district, Kham
No. of represents
Demographic data %
(n = 199)
Sex
Male 54 27.10
Female 145 72.90
Age
15-19 year old 1 0.50
20-24 year old 2 1.00
25-29 year old 17 8.50
30-34 year old 27 13.60
35-39 year old 30 15.10
40-44 year old 56 28.10
45-49 year old 34 17.10
>50 year old 32 16.10
Education
Primary school 65 32.70
Junior high school 63 31.70
Senior high school 48 24.10
High vocational certificate 7 3.50
Undergraduate 5 2.50
Graduate 5 1.00
Un-educate 9 4.50
Marital status
Married 175 87.90
Single 9 4.50
Widow 10 5.00
Divorced 4 2.00
Other 1 0.50
Occupation
Agriculture 121 60.80
Employee 45 22.60
Housewife 12 6.00
Own business 9 4.50
Government officer 6 3.00
Liberty 3 1.50
Student 2 1.00
Other (Monk) 1 0.50
3.2 General information of dengue haemorrhagic fever
The campaign 6 steps prevention and control for DHF, was performed in this community at
late of 2013 to year 2014. Head of village (91.00%) and news station of village (78.00%) were the
information resources on the 6 steps prevention and control for DHF.
The incident rate of DHF during 2012-2014 was 9.00, 8.58, and 2.04 per 1,000 populations
(Figure 3). House index (HI) during 2012-2014 was 38.66, 44.85, and 9.80. Container index (CI)
during 2012-2014 was 103.61, 150.52, and 7.32, respectively (Table 2).
Figure 3: The incident rate of dengue haemorrhagic fever in Nongsruang village, Nongsruang sub-
district, Kham Thalae So district, Nakhon Ratchasima Province, Thailand, during 2012- 2014.
Table 2 House and container index of mosquito larva were collected from Nongsruang village,
Nongsruang sub-district, Kham Thalae So district, Nakhon Ratchasima Province, Thailand during
2012-2014.
Index/year %
House index
2012 38.66
2013 44.85
2014 9.8
Container index
2012 103.61
2013 150.52
2014 7.32
3.3 Knowledge, attitude, and participation on the 6 steps model
Of 81.91% represents had high knowledge on 6 steps prevention and control for DHF. The
highest of score was found in the question of “changing a flower vase with clean water” (97.00%),
and following “covered the open resources of water” (94.00%), and continuously practicum of DHF
prevention and control (94.00%), respectively. Of 70.85% represents had high attitude on 6 step
prevention and control for DHF. The highest of score was found in the question of “all household
should be sanitary” (Mean = 4.49, S.D.=0.86), following “should be changing a flower vase with
clean water” (Mean = 4.47, S.D. = 0.83). Of 70.35% represents had high participated in the 6 step
prevention and control for DHF. The highest of score was found in the question of “Elimination of
mosquito by repellent” (Mean = 4.38, S.D. = 0.98), following “covered the open resources of
water” (Mean = 4.33, S.D. = 0.90), and “Household sanitation” (Mean = 4.11, S.D.= 0.71),
respectively (Table 3).
Table 3 Knowledge, attitude, and participatory level of represents on the 6 steps prevention
and control for dengue haemorrhagic fever in Nongsruang village, Nongsruang sub-district, Kham
No. of represents
Level %
(n = 199)
Knowledge
High 163 81.91
Moderate 36 18.09
Low 0 0.00
Attitude
Good 141 70.85
Fair 58 29.15
Poor 0 0.00
Participation
Frequent 57 28.64
Moderate 140 70.35
Few 2 1.01
Figure 4 : Rural villagers were participated the 6 steps model of prevention and control for dengue
haemorrhagic fever.
4 DISCUSSION
DHF was first recognized in the 1950s during the dengue epidemics in the Philippines and
Thailand [1]. Since then the World Health Organization recommends an integrated vector control
program consisting of five elements to eliminate this serious disease [2]. In Thailand, many of
campaign had been use, mainly the 6 steps model of prevention and control for DHF by Department
of Disease Control, Ministry of Public health, Thailand. This studied was the first report for
assessed the successful of the DHF prevention and control campaign in the rural community. The
results revealed that most of the represents, they were 40-44 years old, female, primary school,
married, and worked in agriculture. This figure indicates that this group is the main and highly
potential for their member, moreover, head of village and news station of village were the
information resources on the 6 steps prevention and control for DHF. Therefore, improvement of
knowledge and attitude is need required. An action research design was conducted in two villages
of Mueang District, Kanchanaburi Province to assess the effectiveness of a community-based
approach program. Knowledge, perceived susceptibility, self-efficacy, and regular larval survey
behaviour were measured for program outputs. CI, HI, and Breteau Index (BI) were used to confirm
program outcomes. Key community stakeholders in the experimental village were identified and
empowered through active learning in the village. The results from this study suggest that the DHF
prevention and control program at the sub-district health level should be more proactive and
emphasized at the village level. Monitoring the disease control program outputs and outcomes
should be performed regularly during monthly meetings. Finally, local health officers need to be
empowered for these matters [5,6].
General information of DHF, the campaign 6 step model was performed in this community at
year 2014. The effectiveness of this campaign was found that the incident rate of DHF during 2012-
2014 was decreased from 9.00 per 1,000 populations in year 2012 and 2.04 per 1,000 populations in
2014. In addition, HI and CI was similar to the trend of incident rate that there were decreased from
38.66 (HI) in year 2012 to 9.80 in year 2014, while CI was decreased from 103.61 in year 2012 to
7.32 in year 2014, respectively. A community-based dengue vector control trial was conducted at
transmission foci in Plaeng Yao District, Chachoengsao Province, eastern Thailand.
Implementation was done by the local community in collaboration with local administration, public
health, and school authorities. The success of this intervention was evidenced by the significant
reduction of dengue vectors and DHF cases in treated areas compared with untreated areas [4].
The represents had a high knowledge, attitude, and participatory level on the 6 steps model of
DHF prevention and control. This data indicates a high behaviour influent to decrease the DHF
occurrence and vector-borne in the community, similar to previous study [2,3,4,5,6]. A cross-sectional
study was carried out between July 1998 and June 1999 to identify dengue virus-infected patients
under age 15 admitted to seven government hospitals in Ang Thong Province, a central region of
Thailand, and to assess the knowledge, attitude, and practice (KAP) of their care takers. The
majority of them were mothers with primary school education level. Half of the caretakers were
workers. DHF knowledge of the caretakers of the dengue cases, non-cases, and healthy students
was almost the same. However, the caretakers of dengue cases recognized petechiae as a danger
sign, p-value of 0.006. They had a higher response in prevention, control and treatment of DHF
than the other two groups after their children were admitted to hospital, p-value of 0.000. The
results indicated that DHF remains a public health problem in this area and the people need more
understanding of the disease. Continuous campaigns are required for community participation so as
to prevent and control DHF successfully [3].
5 CONCLUSION
This finding shows a high knowledge, attitude, and perception on 6 steps prevention and
control for DHF, in addition, the incident rate of DHF, HI, and CI are decreased in this rural
community. Therefore, to enhance the sustainable and effectiveness of 6 steps campaign on DHF
prevention and control, the provincial health office should encourage health centre personnel to
continuously supervise, motivate and provide seminar workshops and village forums. Also,
participatory management with a horizontal command structure must be employed.
REFERENCES
[1] Normile D (2013). Surprising new dengue virus throws a spanner in disease control efforts. Science 342 (6157):
415
[2] WHO (2009). Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health
Organization 59-137.
[3] Kittigul L, Suankeow K, Sujirarat D, Yoksan S. (2003). Dengue hemorrhagic fever: knowledge, attitude and
practice in Ang Thong Province, Thailand. Southeast Asian J Trop Med Public Health 34(2):385-92.
[4] Therawiwat M, Fungladda W, Kaewkungwal J, Imamee N, Steckler A. (2005). Community-based approach for
prevention and control of dengue hemorrhagic fever in Kanchanaburi Province, Thailand. Southeast Asian J Trop
Med Public Health. 36(6):1439-49.
[5] Kittayapong P, Chansang U, Chansang C, Bhumiratana A. (2006) Community participation and appropriate
technologies for dengue vector control at transmission foci inThailand. J Am Mosq Control Assoc 22(3):538-46.
[6] Haldar A, Gupta UD, Majumdar KK, Laskar K, Ghosh S, Sen S. (2008 ). Community perception of Dengue in
slum areas of metropolitan city of West Bengal. J Commun Dis 40(3):205-10.
Assessment of Quality of life and Consumption Behaviour of Hypertension Elderly in
Rural Community of Thailand by using WHOQOL-BREF-THAI
Wannapa Tasoontorn
, Praweena Nongtongta, Wasugree Chavengul, Teerayut Udomporn

* Correspondence to Wasugree Chavengul,w_asugree@hotmail.com
……..
ABSTRACT
This cross-sectional survey was aimed to assess the quality of life, consumption behaviour
of hypertension elderly in Srirakor sub-district, Chakarat District of Nakhon Ratchasima, Thailand
during January-April 2015. 296 represents of hypertension elderly were selected through stratified
random sampling in health promotion hospital of Srirakor sub-district. WHOQOL-BREF-THAI
questionnaire was utilized to collect the data from them including socio-demographic
characteristics, physical, psychological, social relationships, environmental domain, and
consumption behaviour. The questionnaires were pre-tested by using Cronbach’s alpha method
(0.96). The results revealed that 54.00% had moderate knowledge, 75.20% had moderate attitude,
and 61.19% of represents had high. Practice on diarrhoea prevention and control. Most of the
represents, they were 60-65 years old, male, married, primary school, business owner, and family
income ranged from 5,000 to 10,000 Baht per month 76% of subjects had moderate quality of life
(x̄ =2.65, SD=0.56). Most of subjects, physical and environmental domain were a high quality of
life (x̄ =2.65, SD=0.55). Consumption behaviour, all subjects had frequently consumed of the 5
food groups (x̄ =2.63, SD =0.44). Carbohydrate group was daily consumed (x̄ =2.73,SD=0.42),
followed; meat (x̄ =2.68,SD=0.42), fruit (x̄ =2.64,SD=0.46), fat (x̄ =2.63,SD=0.43) and vegetable
(x̄ =2.49,SD=0.49), consecutively.
This finding shows moderate quality of life, lack of fruit, fat, and vegetable, therefore,
activities campaign on psychological and social relationships domain, and health education on
nutrition are need required.
Keywords: Quality of life, Consumption Behaviour, Hypertension Elderly, Thailand, WHOQOL-
BREF-THAI
1 INTRODUCTION
Thailand is the one of developing countries in the world. Recently, Thai population is
increasing in age group of elderly. In 2014, the elderly (above 60 years old) is increasing
approximately 10 million (15.30% of total population) and expectation will increased to 19 million
(29.00% of total population) in 2034 (Thailand Institute for Population and social Research, 2014).
Previously report was surveyed in Nakon Ratchasima province of Thailand and found that
10.6% elderly population from total population of data is about 5.2% of total elderly population.
Elderly age has many change mainly socio-demographic characteristics, physical,

psychological, social relationships, environmental domain, and consumption behaviour.
Hypertension is a disease that found frequently in Thailand including elderly people. In 2012 and
2014, 12.9%, 15.9% and 30.7% were hypertension disease in the elderly patient in Srirakor sub-
district, Chakarat District Nakon Ratchasima province (Health Promotion Hospital of Srirakor sub-
district, 2015). Quality of life in elderly hypertention is an important policy in Thailand. Therefore,
this finding shows the characteristics, physical, psychological, social relationships, environmental
domain, and consumption behaviour in the hypertension elderly from the Srirakor sub-district,
Chakarat District of Nakhon Ratchasima, Thailand through standard instrument with WHOQOL-
BREF-THAI.
This cross-sectional survey was performed in Srirakor sub-district, Chakarat District of

Nakhon Ratchasima, Thailand during January-April 2015 (Figure 1). This sub-district is located
approximately 313 kilometre from Bangkok (capital of Thailand) and 53.6 kilometre from Nakhon
ratchasima province.
Figure 1: Map of Chakrat district, Nakhon Ratchasima province, Thailand.

(source of map : http://www.novabizz.com/Map/img/map-36-Nakhonratchasima.gif, retrieved date 30 June 2015)
2.2 Population, sample size, and sampling
1,251 population of elderly hypertension whom were diagnosed by the doctor and registered
for non-communicable disease in health promotion hospital of Srirakor sub-district, have been
selected.
Representative sample is hypertension elderly from Srirakor Hospital and the sample size was
calculated by using Taro Yamane (Yamane, 1973. refer to Kuntri Vetchasan,2552:28). 296
represents of hypertension elderly were selected through stratified random sampling refer to rule of
three in arithmetic from elderly population of Srirakor sub-district, Chakarat District Nakon
Ratchasima province.
2.3 Measurement and data collection
WHOQOL-BREF-THAI questionnaire was utilized to collect the data from them including
socio-demographic characteristics, physical, psychological, social relationships, environmental
domain, and consumption behaviour. The questionnaires were pre-tested by using Cronbach’s alpha
method (0.96).
Researching team collected utility data and research of hypertension elderly to preparation for
the questionnaires by using 3 subject.
1. General information of representative sample by using random question in gender, age,
status, business, monthly income per month and person their living with.
2. Consumption behavior, The question is according to Likert Scale on set of regulation
score to comparative in 3 levels of frequently consumed, irregularly consumed and
never consumed
3. Quality of life of elderly The question is according to Likert Scale on set of regulation
score to comparative in 4 level of highly quality, moderately, slightly and never
consecutively.
WHOQOL-BREF-THAI (Kuntri vedchasan,2552 refer to Thitirath raungsuwan,2556:50)
questionnaire was utilized to evaluate score, quality of life are divide into 4 level of practice.
Level 4 highly practice and 1.
Level 3 moderately practice
Level 2 slightly practice
Level 1 never practice before
Result of Consumption behaviour reliance is 0.81 and Quality of life reliance is 0.961
Instrument for testing of reliance using 30 questionnaires to calculate for reliance by Coefficient of
Variation (Coefficient Alpha), (Cronbach’s Alpha Coefficient)
Complied analysis of variance adjusted by baseline data were used questionnaires from risked
elderly hypertension from Srirakor sub-district, Chakarat District Nakon Ratchasima by instant
programming refer to quality of life and consumption behaviour.
All statistical analysed were conducted using Descriptive Statistic, Mean, Frequency,
Percentage, and Standard Deviation
Result of consumption behaviour of hypertension elderly by 5 food group of Srirakor sub-
district, Chakarat District Nakon Ratchasima
3 RESULT
The results revealed that most of the represents, they were 60-65 years old, male, married,
primary school, business owner, and family income ranged from 5,000 to 10,000 Baht per month.
The results revealed that 54.00% had moderate knowledge, 75.20% had moderate attitude,
and 61.19% of represents had high. Practice on diarrhoea prevention and control. Consumption
behaviour, all subjects had frequently consumed of the 5 food groups (x̄ =2.63, SD =0.44).
Carbohydrate group was daily consumed (x̄ =2.73,SD=0.42), followed; meat (x̄ =2.68,SD=0.42),
fruit (x̄ =2.64,SD=0.46), fat (x̄ =2.63,SD=0.43) and vegetable (x̄ =2.49,SD=0.49), consecutively
(Table 1).
Table 1 Consumption behavior of hypertension elderly by 5 food group of Srirakor sub-district,

Chakarat District Nakon Ratchasima, Thailand.
Consumption behaviour S.D. Practice level
1. Meat product 2.68 0.42 regularly
2. Flour product 2.73 0.42 regularly
3. Vegetable product 2.49 0.49 regularly
4. Fruit product 2.64 0.46 regularly
5. Fat from vegetation 2.63 0.43 regularly
And animals.
Total 2.63 0.44 regularly
76% of subjects had moderate quality of life (x̄ =2.65, SD=0.56). Most of subjects, physical
and environmental domain were a high quality of life (x̄ =2.65, SD=0.55).
Table 2 Quality of life of hypertension elderly by 5 food group of Srirakor sub-district, Chakarat
District Nakon Ratchasima, Thailand.
Domain S.D Quality level
1. Physical 2.65 0.55 moderately
2. Psychological l 2.64 0.56 moderately
3. Social relationships 2.64 0.55 moderately
4. Environmental 2.65 0.57 moderately
Total. 2.65 0.56 moderately
4 DISCUSSION
Behaviour of hypertension elderly of Srirakor sub-district, Chakarat District Nakon

Ratchasima by 5 food groups showing their have been take regularly and the most consumed is
Flour product, meat product , fruit , fat from vegetation or animal and vegetable were regularly
consumed similar to Ubonwan Punta (2009) the research of consumption and food nutrition in
elderly and the research is demonstrate the result is showing rice and flour product meat egg bean
milk and milk product are in the good quantity but vegetable fruit fat sugar salt are misuse level
And the assessment of Nutrition status by BMI computation (Body mass index) is showing nutrition
status of population is over standard 55.80 on standard 42.30 and under standard is 1.90
consecutively and correspond to Nongrak Singkaew (2011) the research of Nutrition status and
Consumption behaviour of Chang kian sub district Muang Chiang Mai is demonstrate the result of
consumption behaviour we found most of consumed are vegetable fruit beverage and fat in a good
quantity but consumed of meat product whole grain product need improvement and consumption
behaviour of seasoning milk and milk product water and snack are impaired .
The quality of life of hypertension elderly of Srirakor sub-district, Chakarat District Nakon
Ratchasima, over all is in moderate Physical and environmental are on high level followed by
motional and social relationships moderate consecutively similar to Chanachoke Comwan (2010)
study of how to improve quality of life in elderly from Pla pak administer organization
Nakornphanom showing over all of quality life income also healthy are moderate there are 4
method to improvement by family associate, psychological, treatment in case of illness, earning
improvement and created welfare for elderly subsistent .
5 CONCLUSION
This finding shows moderate quality of life, lack of fruit, fat, and vegetable, therefore,
activities campaign on psychological and social relationships domain, and health education on
nutrition are need required.
REFERENCES
[1] Department of Health: Ministry of Public Health. (2014). http://www.anamai.moph.go.th/main.php?filename =

Test_Index_2014.: January 23 2015.
[2] Kuntree W. (2009). Marketing research. (4publish). Chulalongkorn University.

[3] Thitirath R. (2013). Quality of life of diabetes with feet complicacy. Wangthong hospital Phitsanulok.
[4] Nongrak S. (2011). Thesis Master degree of Public Health. Chiang Mai University.
[5] Nutrition condition and Consumption behavior elderly of Chang kian sub district Muang Chiang Mai.
[6] Normile D. (2013). Surprising new dengue virus throws a spanner in disease control efforts. Science 342
(6157): 415.
[7] Thesis Master degree of Science Chiang Mai University.
[8] Siriphan R. (2011). Quality of life waithongniwed welfare master degree of liberal arts political economy
Chiang Mai University.
[9] Institute for Population and Social Research.(2014). Senior Thai population 2014: April 22.2015
http://www.m-society.go.th/article attach/12533/16843.pdf.
[10] Bureau of Empowerment for older Persons. (2011). How to take care of elderly health. (17 publish).
Bangkok:WVO Office of Printing.
[11] Elderly Statistic. Srirakor Hospital Srirakor sub-district. (2011).Nakon Ratchasima.

FACTORS RELATED WITH PREVENTION BEHAVIORS TO LEPTOSPIROSIS
OF THE PEOPLE IN REPETITIOUS FLOOD AREAS IN WARINCHAMRAB
DISTRICT, UBONRATCHATANI PROVINCE, THAILAND
WILAS KAMPANGSRI
Faculty of Medicine Mahasarakham University, Mahasarakam, Thailand
Wararart sungwalee, Noosara Hoothaisong ,Supitchaya Pratumwapee

College of Medicine and Public Health, Ubonratchatani University, Ubonratchtani, Thailand
Jirawoot Kujapun*
……..
ABSTRACT
Leptospirosis is an infectious disease that can be transmitted from animals to humans. The
disease has been considered as a major public health problem in Thailand. The objectives of the
research were to factors that are correlated with prevention behavior to the Leptospirosis of the
people in repetitious flood areas in Warinchamrab District, Ubonratchatani Province. This study
was performed as a Cross-sectional study. Data were collected using a questionnaire with total of
164 samples. The factors that correlations to the prevention behaviors were analyzed by using Chi-
Square and Fisher exact test.
the study found that knowledge on the Leptospirosis, illness of family members caused by
Leptospirosis, information about the disease and water supply were correlated with prevention
behavior to the Leptospirosis as statistically significant (p <0.001).
Therefore, the study would suggest to focus on changing behaviors and providing necessary
information and guidelines for protection of Leptospirosis in advance and after the flood to
encourage public awareness of self-protection.
Keywords: Prevention behaviors, Leptospirosis, Repetitious Flood Areas.
1 INTRODUCTION
Leptospirosis is a globally important zoonotic disease caused by pathogenic Leptospira, and

typically spread in raining season and flooded area. The report found patients across the country,
specifically in the Northeast and South of Thailand. Number of the patients had increased 3000-
5000 cases in each year in some flooding areas. [1].
According to infectious disease surveillance by Bureau of Epidemiology, Department of

Disease Control. 1st January to 14th July 2014 found total patients of 861 cases, morbidity rate was
1.36 per 100,000 people per year and mortality rate was 0.01 per 100,000 people per years. Disease
was commonly found with in male patient more than female, and mostly were farmers, 54.2 percent
[1]
.
A report by Epidemiology of Ubon Ratchathani Provincial Health Office from 1st January to
11th July 2013 found 37 people ill with Leptospirosis disease, morbidity rate was of 2.04. 100,000
people per year mostly found in people in the age of between 55-64 years old [2]. Due to Ubon
Ratchathani Province located along with the Mae-Moon River and often flooded in each year
during rainy season (July – October). Warinchamrab district is in the north of the Ubon Ratchathani
province; share its border with Mae-Moon River. Therefore, researchers were interested in doing
research in factors that are correlated with prevention behavior to the Leptospirosis of the people in
repetitious flood areas in Warinchamrab District for prevention and control of leptospirosis
2.1 Study Areas and Study Design
A cross-sectional descriptive study was performed in Warinchamrab district, the north of the
Ubon Ratchathani province, Thailand.
2.2 Sample Size, Sample and Sampling
Population whose age between 15-59 years old were purposive selected in the repetitious
flood areas in Warinchamrab District, Ubon Ratchathani province, Thailand. Sample size was 164
people according to statistic proportion of population, during August and December 2014.
2.3 Questionnaire
(Socio-demographic characteristics, leptospirosis knowledge, illness of family member, water

supply and Leptospirosis disease information)
An interview questionnaire was utilized to collect the data from them. Chi-square test was
employed to analyse the data.
2.4 Data Collection
A standard questionnaires that include variables related with prevention behaviors to

leptospirosis. Required data collected by this questionnaire included socio-demographic
characteristics, leptospirosis knowledge, illness of family member, water supply and Leptospirosis
disease information.
2.5 Statistical Analysis
Frequencies were calculated by direct counting. The factors that correlations to the
prevention behaviors were analyzed by using Chi-Square and Fisher exact test.
3 RESULT
The result showed that, in a total sample of 164 people. There were females 55%, between
age of 45-59 years old 46.3%, illness of family members 3%, know Leptospirosis disease
information 67.7%, live in flooded house after flooding 52.4%, and water supply was piped water
65.8%
Among the knowledge on the Leptospirosis, illness of family members caused by

Leptospirosis, information about the disease and water supply were correlated with prevention
behavior to the Leptospirosis. There was a significant difference between with prevention behaviors
to leptospirosis (p <0.001).
3.1 Tables and Figures
Table 1. Demographic factors related with prevention behaviors to the Leptospirosis
Variables prevention behavior Chi- P-value

good moderate Square
test
( 50)
n= N%
(n=114)N%
Sex 0.877 0.349

Male 25(34.2) 48(65.8)
Female 25(27.5)
66(72.5)
(
Age years ) 1.403 0.496
13(31.7) 28(68.3)
15-30 30(73.2)
17(36.2)
56(73.7)
31-45
46-59 20(26.3)
Occupation 3.333 0.486*
agriculture 18(37.5) 30(62.5)
fishing 2(28.6) 5(71.4)
lancer 30(27.5) 79(72.5)
illness of family members 0.001 <0.001*
never
used to 49(30.8) 110(69.2)
1(20.0) 4(80.0)
information about the disease 15.461 <0.001*

never 27(50.9) 26(49.1)
used to 23(20.7) 88(79.3)
The shelter during flooding 5.287 0.226*
Temporary street 22(37.9) 36(62.1)
Relatives outside the community 2(14.3) 12(85.7)
Flooded house 26(30.2) 60(69.8)
Temporary home outside the community - 1(100)
Room for rent outside the community - 5(100)
water supply 26.612 <0.001*
rain 6(15.4) 33(84.6)
shop 10(58.8) 7(41.2)
piped water 34(31.5) 74(68.5)
The level of leptospirosis knowledge
good level
10.286 0.001
moderate level
19(26.0) 54(74.0)
29(43.3) 38(56.7)
improve level
2(8.3) 22(91.7)
4 DISCUSSION
In the currently study. The level of leptospirosis knowledge related with prevention behaviors
to leptospirosis. Previous study such as knowledge and behavior of Prevention and control of
leptospirosis Dong Mada’s Farmer in Mae Lao district, Chiang Rai province. Knowledge is a
person's ability to remember the story or the fact that people from different processes. Can be
applied in new situations, as well as the first stage of the behaviors[3].
The present show illness of family members related with prevention to leptospirosis. The
family patient may be receive information about disease prevention and public health office. And
may be aware of disease, so it is result into behaving better protection as well. Previous study such
as the study behaviors, prevention and control of leptospirosis in Si Bun Reung district, Nongbua
lampho province. That found a source of knowledge is associated with behaviors, protection and
control[4].
So, people need to awareness of drinking water and eating clean the container with a sealed
cover to prevent rats and dogs come with urine. Indirect exposure, which is more common, occurs
via contract with contaminated water and wet soil, when leptospira species enters the body through
abrasions in skin, intact skin, and mucosa[5].
5 CONCLUSION
Factors related with prevention behaviors to leptospirosis. There are many factors, this study
show knowledge on the Leptospirosis, illness of family members caused by Leptospirosis,
information about the disease and water supply. But people lack of awareness about prevention and
control to leptospirosis. Therefore, the study would suggest to focus on changing behaviors and
providing necessary information and guidelines for protection of leptospirosis in advance and after
the flood to encourage public awareness of self-protection. The future researcher should study the
environmental, flood area, and prevalence of rats association with prevention behaviors to
leptospirosis.
REFERENCES
[1] Bureau of Epidemiology, Department of Disease Control, (2014), the disease surveillance system reported in the
R506 Thailand.
[2] Department of Disease Control, Ubon Ratchathani Provincial Health Office, (2013), Disease Surveillance Report
Epidemiology, Thailand.
[3] Pajorntip K (2008). Knowledge and behaviors of leptospirosis prevention and control in Farmers’ Dong Mada
Mae Lao district Chiang Mai province, Chiang Mai University, Thailand.
[4] Rakwicha W, Kasaemsomboon P, (2014), Behaviors prevention and Control of leptospirosis in Sribunrung district
Nongbualumphu province, Khonkaen University, Thailand.
[5] Thangkanakul W (2000). Risk factors associated with leptospirosis in northeastern Thailand, 1998. Am J Trop
Med Hyg. 2000; 63(3-4):204-8.
Adolescent Students’ Pregnant Behavior in a Sub-district of
Nakhon Ratchasima Province in Thailand
Jun Norkaew, Kuntarut Titkatoke, Wanwipa Auksi

Abstract
This research aims to study the knowledge, attitudes, practices and the factors that lead to students’ pregnancy
in a sub-district of Nakhon Ratchasima province. The research is a qualitative research. Sampling used in this study is
a group of female teenager in a sub-district of Kham Thale Sor district, Nakhon Ratchasima. Data is collected from five
female teenagers who voluntary and well cooperated in providing related data through studying their background by in-
depth interviewing, informal discussion, observation, and interviewing persons who involved with their pregnancy.
Result of the study shown that most of the pregnant teenagers are Buddhist, graduated secondary school (grade
3), average of family income are 10,800 Baht per month, having first monthly period at the age of 12-14 years old and
first intercourse activity between the ages of 14-18 years old. Contraceptive method used is that use of condoms but do
not applied using it regularly. Therefore, as a result they were pregnant after having sexual activities for five months to
two years. Average ages of the pregnant students were 16.6 years old.
The contraceptive knowledge, the study found that the sampling group do not apply using condom regularly.
Most of them do not have sufficiency knowledge in contraceptive method or knowledge is invalid. Had been attended
health education course though cannot be applied in everyday life.
The contraceptive knowledge, the study found that they have incorrect values, thought and beliefs about
pregnancy such as associating with boy-friends, self-reserved. Moreover they admitted sexual activities as a normal one.
Friends are highly influenced friends’ life, having boyfriend or lover makes them sensed that they got more attention,
parents accepted their relationship while they were in school age.
Before having pregnancy, those teenagers were studying in secondary school, associated with other gender
friends easily, and admitted having a boyfriend. Most of the adolescents concealed their pregnancy because fear of being
punished which caused delay the prenatal care. After giving birth to their children, they planned to start own family, earn
income from their work and continue studying high school, leave their children with own parents.
Factors causing pregnancy in school age, the teenage girls had opportunities to associate with other gender
friends freely. They admitted having sexual activities as a normal one, parents accepted their relationship while they were
in school age, and most of the teenagers do not have sufficiency contraceptive knowledge.
Keywords: Adolescent Students, Pregnant, Behavior, in a Sub-district of Nakhon Ratchasima

1 INTRODUCTION
Background and importance of the issue
During the past decade, Adolescence is a period of change , both physically and mentally as well.
From childhood grow into adulthood ,using common everyday ,competition in society, Absorption traditions And
cultural changes, Impersonation to keep focused on the materialistic era, The changes in communications technology.
The development does not stop, With the economy that rely on adults to a state responsibility and self-reliance , The
body will have a change of reproductive organs in a manner that is ready to have sex. And pregnancy. If teens have a
[1]
pregnancy occurs. It is caused by many different effects. Both women teenage pregnancy , family and society.
Teen pregnancy is a major problem in the health of the baby and mother . Including the economic and social
rates of teenage pregnancy in the high- rise . Female teen pregnancy is a crisis that pregnant women face in adolescence.
Will pose a huge impact . But it also found that Many teens today are faced with the problem of pregnancy and are likely
to rise in the world. Every year there is a pregnancy in adolescent girls more than 1 million people . WHO Has set the
[2]
standard for surveillance of a premature child up to 10 percent .
Teen Pregnancy Affect pregnant women is enormous. But the situation in the country, it also found that
the rate of pregnancy in mothers under 20 years old has reached 14.7 percent.The World Health Organization ,
more than the benchmark set which must not exceed 10 percent . It also affects the rate of newborns weighing less than
2,500 grams much to 8.7 percent. The World Health Organization , more than the prescribed shall not exceed 7 percent.
Thailand now has a birth mother as a teenager, at least 140 , or about 50,000 per year which is a very high number The
situation shows that teenage pregnancy is a serious problem of society. This resulted in a decrease in the quality of life of
children with problems such as teenage mothers . Emotional instability , so there is a high risk of stress and depression
they want to cover pregnancy or having a baby to parents . There is also the issue of education and abortion as well. [1]
The pregnancy in adolescents younger than 20 years, 10-13 percent of all pregnancies In the area of public
health 14 The rate of birth mothers younger than 20 years, rising from 11.9 percent in 2550 to 19.5 percent in 2554 and
Motherhood Maternity met all 57,756 of them under the age of 20 years and mother of 11,262 cases. Childbirth 938 per
month or 31 case per days The province with the mother under the age of 20 years is the maximum maternity Buriram. Is
a minor offense Korat and Surin Found 21.1 percent , 20, 19.6 and 17.1 respectively. Birth mothers were 93.7 percent
and 2.7 percent abortion . The problem that caused the rise in teenage pregnancy Nakonchai Burin include lack of
contraception and how to prevent pregnancy. Incorrect. Such as using contraceptive methods a shed outside the vagina. [3]
From data collected in one district of Kham Thale So District . Nakhon Ratchasima, 2014 in all , 26 cases of
pregnant women That they are pregnant, under the age of 20 years 8 cases, representing 30.77 per cent . Which is higher
than the World Health Organization has defined. Not to exceed 10 percent
Thus, the importance of this issue very seriously and is interested in studying the behavior of teenage girls
who are pregnant premature the youth of the country Values are bad influence from the media or from abroad. It brings
the issue of pregnancy are premature . Pregnant mothers are not ready . Both the body and the mind the lack of
preparation for raising the baby and socially unacceptable. This study is a qualitative study of pregnant premature to
bring information to the next solution.
Research purposes
1. To know about the pregnancies of school-age girls in a Sub-district of Nakhon Ratchasima Province
2. To determine attitudes about preventing pregnancy in female adolescents aged in a Sub-district of Nakhon
Ratchasima Province
3. To study their practice on the prevention of pregnancy in school-age girls in a Sub-district of Nakhon
Ratchasima Province
4. To study the factors that make adolescents pregnancy in school
This research study The information from the interview using Qualitative Research To extend the monitoring
and verification to enhance the depth of the behaviors of premature pregnancy of teenage girls in school-age girls in a
Sub-district of Nakhon Ratchasima Province Knowledge Attitude Practice Including prevention of pregnancy are
premature.
2.2 Sample size, sample and sampling

3.1.1 population
The population in this study is that all pregnant women in a Sub-district of Nakhon Ratchasima
Province in the year 2014 26 cases.
3.1.2 Sample size
The sample used in this study is that teenage girls in a Sub-district of Nakhon Ratchasima Province
pregnant women under 20 years old in the year 2014 5 cases it will keep only those who agree to cooperate.
2.3 Tools used in research

2.3.1 Using in-depth interviews of key informants the focus on providing information about the history of life,
from birth until the first pregnancy, during pregnancy and postpartum contraception. Until the time of the study by
structuring the interview in advance focus on providing information about the history of life.
2.3.2 observation Including the actions of the informant the daily use, living facility, action Plan ,the
relationship of the individual in society, participation in community activities of the informant.
2.3.3 The second informant interviews, including parents, relatives, friends and teachers. Use the form
of an informal interview without pre- determined questions by focusing interviews to find out more those
interviewed had experienced. In looking for more information Interview older community leaders about the
community context.
2.3.4 An informal discussion an informal discussion with individuals associated with pregnant
teenagers in school. And chat with guests about education issues in a recorded conversation later to get a variety
of information in order to verify the accuracy of the information another way.
2.3.5 Taking note of the taped conversations however it must be licensed by the data.
2.4 Data collection

2.4.1 Procedure
2.4.1.1 Researchers planned meeting with mentors to the repository
2.4.1.2 Researchers appointment coordination group
2.4.1.3 Researchers recommend a friendly talk in-depth interviews and records
2.4.1.4 The data were summarized
2.4.2 Data Validation
2.4.2.1 Using observations from other evidence Such as inspection, treatment and education check
the consistency of the days the individuals concerned and informed the others
2.4.2.2 Check out how the other person Such as peer teachers or those who have relationship with
teenage girl to compare monitoring the location and time that corresponded to the primary or not
2.4.2.3 By repeatedly asking different questions or asking the same questions but different times
Using Statistics to collect data without a focus on advanced statistics. The analysis uses data
interpretation. Observations and links between information theory Classification of information by reporting on
a concept study. Patterns written report is to depict the narrative. For example, events or case studies to see the
linking of data. A simple statistical data to understand the issue, and proposed a new discovery.
3 RESULT
3.1 Personal or demographic information. Community Education It is a rural society the majority of
farmers a career in the industry Economic and employment in the community. Continuous changes parents of
adolescent girls in the age range of 35-50 years of working age. Experiencing no arable land be worked out at
the factory district Nakhon Ratchasima by the early dusk to leave children at home alone. Causing the
generation gap. Teenage girls are no Consultants Poor family relationships Parents or caregivers Lack of
knowledge and understanding of how to care for young children. Young people lacks spiritual refuge Teen girls
sought refuge of her friends or boyfriend until pregnancy problems in school. All samples five people aged
between 16-19 years Live with their parents, relatives and foster parents who send their tuition. Educational
mostly graduating high school grade 3 as in the family Poor to moderate Monthly income of an average of
10,800 baht a full parents style residential house is a private residence. It is his parents' home Buddhist having
sex for the first time between the ages of 14-18 years contraceptive methods used condoms but not always result
in pregnancy.The average age was 16.6 years old when pregnant.
3.2 The knowledge of how to prevent pregnancy contraception and the prevention of pregnancy the
study found that knowledge about the use of condoms, but not regularly. Most had little knowledge on the use
of contraceptives Parent Counseling and knowledge of heterosexual dating and sex to teenage girls
inappropriately Parents use such harsh rebuke , rebuke with the words, force generation and so on. Parents do
not teach you how to have safe sex. Preventing diseases or contraception afraid that will encourage teens. Some
even want to teach, but cannot find the right words or not Teen pregnancy is a problem when trying to cover up.
Not parental advisory Teenage girls who become pregnant at the age of most students lack knowledge about
sex. Contraception and the prevention of pregnancy or incorrect knowledge. Found that teenagers do not use the
services of the public health service the cause of the health facilities complicated steps to records and officials
with their parent cause they do not want their parents to know
3.3 Attitudes about teenage pregnancy teenage girls have values Ideas and beliefs that are wrong and
inappropriate a behavior to seek recognition from peers inappropriate such as a night out drinking. Teens admit
to having sex with a girlfriend, and that it is normal Friends influential living is very high Teenage girls who
become pregnant in school most of my friends who have or have ever had sexual intercourse. And also has a
role to encourage teenage girls to know me. Introduction to Congress. Having a girlfriend or lover makes
teenage girls feel valued pride in being female. They felt myself get attention Feel happy Teenage girls do not
want to feel this restraint they think that does not cause damage. พ่อแม่ Parents accept the love and sex in
school more the lives of teenagers , mostly girls in different schools each but teens are living similar. Is not
required to work and expenses on a daily basis the freedom to live like a loaf of friends No event featured a
group of youths in school. No athletic ability or the other guests. Results of the study were low to moderate. A
group of teenagers this feature. Is the shape of a girl the outstanding looks but look a couple a large bust and
hips the eye-catching to the opposite sex. The character is like talking to friends in the group. Not like the
expression before the community an easy smile, beauty may feel resistance, but did not show it.
3.4 Practice before pregnancy, teenage girls are studying in the school. The parents who send their
tuition. The cost of everyday life. A meeting friends and heterosexual freely Has a habit of wandering Admitted
having a girlfriend I've been lazy truancy Results of the study were low to moderate.
When you know you are pregnant female adolescent perceived lack of menstruation due to pregnancy.
Recognition of menstrual disorders associated with symptoms of pregnancy. Most will know yourself,
pregnancy, gestational age was three months pregnant, and most go on gestational age was four months
pregnant at the age of six months, some antenatal care. Parents recognize that their own children, pregnant
women most at the age of 4 months to recognize when my sister. Neighbors and grandmother say Parents upset
that her daughter was pregnant, but was taken to the hospital for antenatal care.
When recognize the emotional state of pregnancy. Groups the group wants to have children they have
felt welcomed and prepared for antenatal care and childbirth. Those who do not want to have children. A similar
mood is fear, panic, anxiety, depression, confusion, I was punished cannot solve the problem planning for
abortion covering about pregnancy When families know about the pregnancy. Teens feel more relaxed Allowing
families to solve Feel that they are doing wrong Disappointed to be out of school. Teachers fear and the fear of
being expelled. I do not find friends and the family frustrated Friends embarrassed to pregnancy while studying
or parents do not want to go to school let out parenting teen new born babies. The emotional state of the family
When the pregnancy to preschool. The man was frustrated, angry and angry teenage girls. Disappointed at not
being able to care for teenage girls as well. Let pregnancy when emotions can adjust it. Family together to find
solutions. Wedding Responsible for life Revenues some men came together. Teen pregnancy, prenatal care,
mostly concealed pregnancy. Because of fear of being punished making it to delay prenatal care does not meet
the standard of care the designated hospitals but there were no young women with complications during
pregnancy, prenatal care, however, when he received it. With antenatal care themselves to the service of the
state recommended.
Most prenatal, childbirth and caesarean sections due to a premature baby. Most maternal and infant
feeding beyond six months with one who must eat milk powder. Because no milk Postpartum maternal and
infant health. The family is overwhelmed and needs of children. Postpartum not raise children to others.
Teenage girls want to raise their own children. Teenage girls whose husbands are felt to have a child.
Strengthened family relationships some families feel that the baby is the increased load. But willing to raise
baby Maternity leave school adolescents. Lose the opportunity to study and improve themselves. The problem
of the occupation the youngest It does not apply to work in the system. Bearing the cost increases. To create a
new family with 4 home of the parents of the woman because her husband was not in the manner expected. 1
patient required a divorce divorced husband and baby two months since her husband was addicted friends
wander into the house late at night and have a relationship with another woman. And some families have to live
apart. The husband had to work to earn money.
After maternity and contraceptive use condoms, contraceptive injection and contraceptive pills
planning life after childbirth. Adolescent Family Planning Study in the formal education system. Planning to
leave the care of their parents. To Workers In To aid costs Help children Families are responsible for the
increased load the cost of the baby and the husband of the female adolescents who have moved in the same
family.
3.5 The factors that make pregnancy in school. The girls had the opportunity to meet the masses.
Heterosexual teens freely admit to having sex with a girlfriend, and that it is normal. Parents accept the couple.
Congress is not protected by contraception and contraception or the wrong way and teenagers, mostly girls, lack
of knowledge about contraception correctly.When pregnancy problems in school. Teenage girls are affected
both the social, physical and psychological teenage girls to leave school. Some raise the baby alone
Opportunities to improve quality of life. Some are not ready to take on life, resulting in divorce.
4 DISCUSSION
Study of Adolescent Students’ Pregnant Behavior in a Sub-district of Nakhon Ratchasima Province in

Thailand, found that between the ages of 16-19 years are living with their parents, relatives. Graduated from
junior high school. Most Buddhist parents were living together in a relationship with a loving family well.
Knowledge of the samples were found. The sample is known about the use of condoms, but not regularly
Parents do not teach you how to have safe sex. Preventing diseases or contraception. I 'm afraid that will
encourage teens some even want to teach, but cannot find the right words or not Teenage girls who become
pregnant at the age of most students lack knowledge about sex. Contraception and the prevention of pregnancy
or incorrect knowledge. The data do not truly know they learned about sex education, but cannot be used
effectively. This is consistent with the research of Kmonpun Chewapunsri (2014).[4] We have studied various
factors Affecting pregnant adolescents antenatal care at health centers, 34 Pho Si use study Qualitative Research
the results showed that the factors that affect pregnancy. In adolescence, as is knowledge about sex and
pregnancy is low negligence within the family environment were fed improperly. Parents have no time for their
parents ' divorce
Watch the external environment, including the condition of the housing friend as a bad precedent.
Loneliness and curious to try risk behaviors of adolescents and closer are having sex without protection loafing
and drinking alcohol.The attitude about teen pregnancy in female fish Showed that the values , ideas and beliefs
are wrong and inappropriate. A behavior to seek recognition from peers. Inappropriate do not value their own
Friends influential living is very high. Teenage girls who become pregnant in school most of my friends who
have or have ever had sexual intercourse this is consistent with the research of Prajim Sisuwan et al (2011). [5]
Conducted Measures to prevent pregnancy, premature youth municipal district Thap Krit Chum Saeng district,
Nakhon Sawan to determine the causes of premature pregnancies of minors the study found that Pregnancy
causes premature youth. The development of the body and mind. Youth frantic changing rapidly. There are
thought to be himself. I do not like to be forced gregariousness. Lack of Sex Education Pregnancy and
contraception Youth get warm little family. The parents need to be busy from work to raise children or their
families have not deserted to split the children had to find the warmth of friends. The development of Internet
technology and to encourage young people acquainted met more easily. Friends are encouraged to access the
media, Congress. Ultimately leading to premature pregnancy.
Practice showed that before pregnancy are heterosexual female friends and meet freely. Has a habit
of wandering Love the clay reserves Fans and accept the idea that having sex is normal. When pregnancy groups
are thought to have an abortion but decided not to have an abortion. Because of fear during pregnancy Prenatal
care is delayed A child care information from the internet. During pregnancy, not drinking alcohol. After
childbirth, most samples will help parents and child care plan in the study. This is consistent with the research of
Kmonpun Chewapunsri (2014). [4]
Factors that were pregnant at the school. The group had the opportunity to meet a different sex freely.
The privately together Moonlighting Sex and unprotected. Parents leave children at home alone. Causing the
generation gap. Lack of love and warmth Teenage girls are no Consultants Poor family relationships his is
consistent with the research of Chalermsri Arnkampang (2009). [2] Conducted Forecasts premature pregnancy of
teenage girls. In one district of Nakhon Ratchasima province. Results of research Found that premature
pregnancies of teenage girls. With the aggravating factor of a change with age of puberty. Who are looking to
learn naturally while other environmental factors. Plays a key role in encouraging young pregnant women,
premature including economic prosperity and modern communications. Encourages teens to have sex earlier.
Incomplete family characteristics Teens do not live with their parents. Young people lack the warmth
psychological. The party does not have the skills to care for adolescents. The improper parenting Teenagers with
behavior problems when pregnancy does not resolve the issue.
5 CONCLUSION
In today's society, one must be open to that. Today's teens have sex early Teens think Congress is
normal. The naturally occurring Parents should teach teens how to refuse to have sex. Taught restraint Know
how to have safe sex and preventing pregnancy properly. Parents should know how to teach the right way
appropriate to the era. Parents should warm the hearts and solve problems with understanding, not aggravate
them.
One solution pregnancies in school. Must have knowledge about the prevention of sexual faster. The
processes involved in the community as volunteers for village women to exchange knowledge between adults
and adolescents. By focusing on the issues of adolescent misbehavior. Teens must have a role in their
involvement to resolve the issue before the car hit the target, and the issue is sustained.
Tambon Administration Organization Which play a role in dividing a good role model and budget
activities. Should prepare a training plan to educate teens and budgeting to buy condoms or condom dispenser
coin operated. To distribute condoms and adolescent access to contraception.
One major problem of pregnant teens in school is lack of knowledge and understanding. About
preventing pregnancy. Public hospitals need to modify the way to reach teens. The implementation plan with the
school. Training for contraception correctly. Communication that children can easily understand how to practice
correctly and friends of the opposite sex. Denied having sex with the teenager.
6 REFERENCES
[1] Petkaung D ( 2012). Impacts

of pregnancy and factors affecting pregnancy
among teens who received prenatal
care at Phayo hospital . Research funded by the College of Nursing Phayao, August (2012).
[2] Arnkampang C (2009). Forecasts premature pregnancy of teenage girls in one district of
Nakhon Ratchasima province. Research Dissertation Master of Public Health , Community
Health Development. Graduate School Nakhon Ratchasima Rajabhat University .
[3] Department of Health. (2012) . Nakonchai Burin county health situation. (Online).
Search on December 11, 2014, from http://203.157.71.139/group_sr/allfile/1421727 401.pdf.
[4] Chewapunsi K ( 2014 ). Factors that affect pregnancy in adolescents. Research Report 34 Pho Si Health
Center Health Department Bangkok.
[5] Sisuwan P et al (2011). Measures to prevent pregnancy, premature youth municipal district Thap Krit
Chum Saeng district, Nakhon Sawan. Degree in political independent research report Master of
Science in Administration Department of Local Government College of Local Administration Khon-kaen
university.
KNOWLEDGE, ATTITUDES AND PRACTICE REGARDING PESTICIDE USAGE
IN AGRICULTURE FROM NAKHON RATCHASIMA PROVINCE, THAILAND
Kamonthip Arsanan, Saowaluck prasungtiyo, Atcha Khetbumrug

Jiraporn Prathumyo
…………………………………………
ABSTRACT
This descriptive study was aimed to assess the knowledge, attitudes and practice regarding
pesticide usage in agriculture from Huaytau village, Sakae rat sub-district, Pak Thong Chai district,
Nakhon Ratchasima province, Thailand, during January to May, 2015. Of 122 represents who had
history with pesticide used, was selected through simple random sampling. An interviewed
questionnaire was utilized for collected the data. Descriptive statistical data were analysed in this
study.
The result indicated that most of them were male (59.02%), married (85.25%), Primary
(73.77%), an average family income 5,001-10,000 bath/monthly (64.75%), the most of plant type
was cassava (58.20%), the most of pesticide usage was more than 7 years (42.62%). Type of
pesticide usage, herbicide was the frequently usage (79.50%). The agriculture officer (35.25%) and
public health officer (35.25%) were the main human information resources on pesticide uses. In
addition, The chemical label was the main media information resources on pesticide uses.
Knowledge 92.62%, attitudes 97.54%, and practice 100%, had a high level on good pesticide usage,
respectively.
The findings revealed that most agricultural workers have the high knowledge, attitudes and
practice of pesticide usage. This sustainable pesticide usage, government office should be
continuous visit and monitor in the community.
Keywords: Knowledge, Attitudes, Practice, Pesticide preventive behaviour, Agriculturists
1 INTRODUCTION
Thailand is an agricultural country which the most people have a career or existence without
having a connection to agriculture. Farmers produced traditional folk wisdom and links to
resources. Later developments in the guidelines of the National Economic and Social Development
Plan for five years from the first to ninth in the last 40 years. Which is developing the concept "The
development of the mainstream" focused on economic development to marketing and exporting. It
contributes to the development of both positive and negative [1]. Farmers also need to increase
productivity to meet the needs of the market, a number of pesticides used even more. The
affordable and easy to use pesticides more quickly[2]. Data from the Department of Agriculture
Ministry of Agriculture and Cooperatives Found that between the years 1997- 2010 were imported
chemical pesticides up to 120,000 tons. Chemical pesticides that are used are herbicides (74%),
insecticides (14%), fungicides (9%) and other plant (3%)[3]. When farmers use chemical pesticides
increased as a consequence harm to health and ecological destruction. Including pest problems that
can create resistance to chemical pesticides that farmers use. As a result, farmers must increase the
use of chemical pesticides increased. Causing chemical pesticide residues in the environment is
increasing. Adversely affect the farmers themselves, the community and consumers.
Huaytau village, Sakae rat sub-district, Pak Thong Chai district, Nakhon Ratchasima
province the community has a population composed mostly of farmers, planting crops such as
cassava, sugar cane, corn, rice, peanuts and vegetables. That is an area where farming is most
common. With the use of chemical pesticides is a disposal volume. So, from the above data allow
researchers studied the importance of knowledge, attitudes and practices in the prevention of the
use of chemical pesticides disposal of farmers in Huaytau village, Sakae Rat sub-district, Pak
Thong Chai district, Nakhon Ratchasima province.
This descriptive study was performed in Huaytau village, Sakae rat sub-district, Pak Thong
Chai district, Nakhon Ratchasima province, Thailand. It’s locate in the northeast region where
approximately 269 kilometres from Bangkok; capital of Thailand, and 50 km from Nakhon
Ratchasima province. This village is covered 4.32 Km2, 175 household, and has 620 population
(Figure 1)
Figure 1: Map of Huaytau village, Nakhon Ratchasima Province, Thailand

(Source of map: http://www.novabizz.com/Map/img/map-36-Nakhonratchasima.gif retrieve date 28 June 2015)
2.2 Sample size, sample and sampling
The 122 samples represents who had history with pesticide used, was selected through simple
random sampling during January and May 2015.
2.3 Questionnaire
An interview questionnaire was utilized to collect the data from subjects who were represents
of household, village, and related this community The questionnaire was comprised 4 domain
included (1) demographic data, (2) knowledge, (3) attitude, and (4) participation. Reliability and
validity of questionnaire was analysed, knowledge (Kruder-Richardon-20) = 0.80, attitude and
practice (coefficient of Cronbach’s alpha) = 0.80
2.4 Data collection
The data were collected by questionnaires head of household or household represents in

Huaytau village, Sakae rat sub-district, Pak Thong Chai district, Nakhon Ratchasima province,
Thailand
Data analyses were descriptive statistics with percentage, mean and standard Deviation.
3 RESULT
Demographic and pesticide use characteristics of the 122 participants are presented in
Tables 1. The result indicated that most of them were male (59.02%), married (85.25%), Primary
(73.77%), an average family income 5,001-10,000 bath/monthly (64.75%). There were no missing
data for any of the variables included in the descriptive statistics.
Table 1: Demographic Features of the represents in Huaytau village, Sakae rat sub-district, Pak
Thong Chai district, Nakhon Ratchasima province, Thailand (n=122)
Demographic feature n (%)
Gender
Male 72 (59.02)
Female 50 (40.98)
Age (years)
20-30 9 (7.36)
31-40 24 (19.68)
41-50 49 (40.16)
51-60 26 (21.32)
>60 14 (11.48)
Marital status
Single 13 (59.02)
Married 104 (59.02)
Divorced 4 (59.02)
Widowed 1 (59.02)
Education
Primary 90 (73.77)
Secondary school 28 (22.95)
High school 1 (0.82)
College 3 (2.46)
Average monthly revenue (Bath)
Demographic feature n (%)
<5,000 14 (11.48)
5,000-10,000 79 (64.75)
10,000-15,000 26 (21.31)
15,001-20,000 3 (2.46)
The most of plant type was cassava (58.20%), the most of pesticide usage was more than 7
years (42.62%). Type of pesticide usage, herbicide was the frequently usage (79.50%). The
agriculture officer (35.25%) and public health officer (35.25%) were the main human information
resources on pesticide uses. In addition, The chemical label was the main media information
resources on pesticide uses.(Table2)
Table 2 The percentage of the use of pesticide of represents in Huaytau village, Sakae rat
sub-district, Pak Thong Chai district, Nakhon Ratchasima province, Thailand (n = 122)
Information n (%)
The type of crop planted
Cassava 71 (58.20)
Sugar cane 5 (4.10)
Corn 15 (12.30)
Rice 26 (21.30)
Vegetables 4 (3.28)
Other 1 (0.82)
The types of chemicals
Pesticide 7 (5.74)
Herbicide 97 (79.50)
Bio pesticide 3 (2.46)
Fungicides 6 (4.92)
Chemical Plant Disease 9 (7.38)
The duration of Chemicals (years)
<1 6 (4.92)
1-3 18 (14.76)
4-6 46 (37.70)
>7 52 (42.62)
Information resources (Human)
Agriculture officials 43 (35.25)
Public health officer 43 (35.25)
Neighbour 36 (29.50)
information resources (Media)
Radio 2 (1.64)
Television 21 (17.21)
The chemical label 99 (81.15)
Knowledge, attitude and practice

Levels of knowledge, attitude, and practice among the farmers are presented in Table 3. The
findings revealed that most agricultural workers have the high knowledge (92.62%) The highest of
score was Always read the label attached to the packaging material to understand and The pest is
valid and successful completion must use chemicals properly by the timing. And types of pests
(100%), and The advantages of the use of chemical pesticides is effective pesticides highly
affordable easy to use anytime. (96.72%) respectively. Of 97.54% represents had high attitude of
pesticide usage. The highest of score was found in the question of “Wear long sleeves Wear long
pants, shoes Ankle mask or a mask while spraying..” (Mean = 5.00, S.D.=0.00), following “Shower
after pesticide exposure” (Mean = 4.53, S.D. = 0.67) and “Wear gloves while handling and spraying
chemicals all the time.” (Mean = 4.52, S.D. = 0.50), respectively. Of 100% represents had high
participated of pesticide usage. The highest of score was found in the question of “Wearing of
protective clothes and gloves (WPCG), Washing contaminated clothes separately and Annual
Check up At least once a year” (Mean = 3.00, S.D. = 0.00) This sustainable pesticide usage,
government office should be continuous visit and monitor in the community. (Table 3)
Table 3: Knowledge, attitude and practice of represent who had pesticide use in Huaytau village,
Sakae rat sub-district, Pak Thong Chai district, Nakhon Ratchasima province, Thailand (n = 122)
No. of represents
Level %
(n = 122)
Knowledge
High 113 92.62
Moderate 9 7.38
Low 0 0.00
Attitude
Good 119 97.54
Fair 3 2.46
Poor 0 0.00
Participation
Frequent 122 100
Moderate 0 0.00
Few 0 0.00
4 DISCUSSION
From this study, the median age of the sprayers showed that they were mostly from working
age groups. Their level of education was predominantly primary. The findings revealed that most
agricultural workers have the high knowledge, attitudes and practice of pesticide usage.
Consistent with the research of 4) the Study of Knowledge, Attitudes and Pesticide Usage
Behaviors among the Agricultural Workers at Huay Sam Kha Village, Tub Ruang Sub-district, Phra
Thong Kum District, Nakhon Ratchasima Province the high levels of knowledge, attitudes and
pesticide usage behaviors were presented in 88.7%, 85.2% and 86.6-97.9%, respectively [4]
5 CONCLUSION
The findings revealed that most agricultural workers have the correct knowledge and attitudes
of pesticide usage. However, some inappropriate behaviors need to be corrected. To prevent chronic
exposure and the adverse health effect, health care center together collaborated with local
administrative organizations should provide the health surveillance program and annual pesticide
exposure monitoring in farmers.
REFERENCES
[1] The Organic Agriculture Development Center. (2010). Introduction The Organic Agriculture Development Center.
(online) Search On June 20, 2558 form http://www.stou.ac.th/OADThailand/about.aspx .
[2] Chaiklieng S and Praengkrathok S. (2013). Risk Assessment on Pesticide Exposure by Biological Monitoring
among Farmers: A Case Study in Tambon Kangsanamnang, Nakhonratchasima Province. Srinagarind Med J
2013: 28(3): 382-9
[3] Siripanich S. Situation and health effects related to pesticides, 2013. Weekly Epidemiological Surveillance Report
2013; 44:689-92.
[4] Tritipsombut J, Gabklang P,Boonkerd S, Oapsuwan A. (2014). The Study of Knowledge, Attitudes and Pesticide
Usage Behaviors among the Agricultural Workers at Huay Sam Kha Village, Tub Ruang Sub-district, Phra Thong
Kum District, Nakhon Ratchasima Province. Srinagarind Med J 2014; 29 (5):429-434.
Food security through community owned and managed institutions -
A Reliance Foundation Initiative

Mahesh B.G;
Reliance Foundation – Mumbai, India
Sudarshan Suchi
Dharam Pal Singh

Srinu Manda
Ravi Bansal
Ashwini J Patil
ABSTRACT
India being second most populous country in the world with 1.25 billion population has been
witnessing tremendous growth in Agriculture and Industrial sectors. In spite of sufficient food being
produced, there are 194.6 million undernourished people in the country (FAO, IFED & WFP 2015).
The situation calls for attentive action from the government, NGOs and private agencies to work
towards ensuring food security in India. Food security is said to be achieved when all people, at all
times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary
needs and food preferences for an active and healthy life. FAO,2009).Reliance Foundation a
philanthropic wing of Reliance Industries Ltd under the flagship programme of BIJ (BHARAT
INDIA JODO) has chosen to ensure food security of marginal community in selected more than
500 villages reaching more than 50000 households in 12 states falling under 19 Agro-ecological
sub-regions. Need based location specific interventions are promoted while pursuing the principles
of Participatory approach, direct action and sustainable development through community owned
village associations. Unproductive and wasted lands are brought into productive system through
sustainable Agriculture practices and technologies supplemented by irrigation, integrated nutrient
management. Nutrition gardens and orchards are integral to the pursuit of achieving food and
nutrition security. This initiative of Reliance Foundation is resulting in establishing self –reliant,
holistic and sustainable models for achieving food security of most deprived communities there by
contributing to UN millennium development goal of eradicating hunger and poverty.
Key words: Institutions, Sustainable Agriculture, Integrated Pest Management, Soil Productivity,.
1. INTRODUCTION
1.1. Agriculture in India
Agriculture and allied sectors is the major livelihood provider contributing to 17.9% of country’s
GDP (World fact book, 2015). The recent census on socio-economic status of India revealed that
nearly 70% (83.3 crores) of total population (121 crores) lives in rural India (Agriculture Census,
2011). Of the 15.61 crores of rural households, an overwhelming 9.02 crores (57.8%) are engaged
in agriculture. But of these only 40% of the households have major dependence on agriculture.
Small and marginal operational holdings constitute 85.01% (117 million households) operational
households (Agriculture census, 2010-11) in the country. Most of these small and marginal farmers
live in the rainfed zones of the country. Of the net sown area of 143.0 million ha, rain fed area
accounts to 79.44 million ha (57%) and contributes to 44% of the total food grain production
1.2. Food availability in India
Green Revolution in the later half of 1960s brought in exponential growth in food production. From
50.83 million tonnes during 1950-51, the total food grain production has increased to 251 million
tonnes in 2014-15, while per capita net availability has increased from 144.1 Kg/year to 179.3
kg/year respectively. Inspite of the increased food production and net availability of food grains, a
large number of urban and rural poor continue to remain food in-secure. The NSSO round 540
studies shows a decrease in per capita calorie consumption in rural areas from 2153 calories in
1993-94 to 2020 calories during 2009-101. There is a steady decrease in food productivity due to
deteriorating soil health (Kakade S 2013).
1.3. Balanced and Nutritious food -a matter of concern
Inspite of numerous initiatives launched by the Indian government and its states to address food
insecurity, India is home to a quarter of the undernourished population (194.6 million) in the world.
Also 51% of women between 15 to 59 years of age are anaemic and 44% of children under 5 are
underweight. The Global Hunger Index 2014 ranks India at 55 out of 76 countries on the basis of
three leading indicators -- prevalence of underweight children under 5 years, under 5 child mortality
rate, and the proportion of undernourished in the population.( FAO, IFAD & WFP, 2015)
1.4. Farmers’ organisations
A typical small or marginal farmer in the country has 1 to 2 ha of semi-productive or unproductive

land and, often in parcels. He faces several constraints related to the small size of the operation.
These include the inability to create scale economies, low bargaining power because of low
quantities of marketable surplus, scarcity of capital, lack of market access, shortage of knowledge
and information, market imperfections, and poor infrastructure and communications (Barham and
Chitemi, 2009). PACS (Primary Agriculture cooperative Societies) have been mandated and
formed at grass roots to mitigate these issues. However, the PACS have been usurped by big and
large farmers and the services largely remain unavailable to the small and marginal farmers who are
already in severe debt.
2. RELIANCE FOUNDATION

1
NSS report, 540, Nutritional intake in India
Reliance Foundation (RF) is India’s largest philanthropic initiative and promoted Reliance
Industries Limited (RIL), a Fortune 500 company and the largest private sector corporation. RF has
mandated itself to work on the key development concerns of the country. Under its flagship rural
transformation initiative BIJ (Bharat-India Jodo), RF has taken the onus upon itself to transform
lives of small and marginal farming households in rainfed areas of the country. It works in 19 agro-
ecological sub-regions of the country which are by and large rainfed farming and have the most
poor living in the country. It works with more than 48000 farmers in 26 locations spread across 32
districts (12 states) and organised into 512 village farmers associations (VFAs).
2.1. RF BIJ interventions to ensure food security- Food availability
2.1.1. Converting waste land into productive land
In India, 46.7 million hectare of waste lands2 is available that could be brought under cultivation of
food grains that adds value to the food basket of India.
In this context, Reliance Foundation till date (from 2010) has been successful in bringing 3640 ha
of wasted lands into productive lands that has the potential to produce atleast additional food grains
of 3640 MT every year.
Table 1 Wasted lands into productive lands

Sl.no Cluster Name Culturable waste land to productive land, Ha
1 Telangana 102.00
2 Madhyapradesh 1714.46
3 Orissa 72.24
4 Rajasthan 206.62
5 Karnataka 431.49
6 Maharastra 539.17
7 Jharkhand 100.40
8 Gujarat 68.08
9 Andhrapradesh 3.09
10 Tamilnadu 325.73
11 Uttarakhand 0.00
12 Chattisgarh 76.87
Total 3640.14
Source: RF BIJ Internal Report 31st March 2015
This is in agreement with the similar results obtained through Deccan Development Society, an
NGO in Medak district of Telangana in India where in 2023 hectares of waste lands was converted
into productive land by adding 2000 MT of food grains into the food basket of India.
2.1.2 Top soil conservation

Farm lands are being ensured with bunds to conserve top soil and tank silt deposited in village tanks
and ponds is being recycled back to farm Lands. It is estimated that on an average 16 MT of soil is
lost from every hectare in India making it a total annual loss of 5334 million tonnes (Narayan and

2
Source: Waste land atlas of India, 2011
Babu, 1983). Across RF BIJ programme, bunds have been established in 25400 hectares of
marginal lands conserving 4.07 lakh tonnes of top soil.
Graph1: Top soil conserved and tank silt recycled from village level ponds and tanks
916174.99
Soil conserved and tank silt recycled( MT)
508423.14
407751.85
12 25484.49
States Bunds( Ha) Soil conserved ( MT) Tank silt applied(

Soil cM
onserved
T) and tank slit recycled(MT)

A study by Nyssen etal, 2007 concluded that a 3-21 year old stone bunds reduced soil
erosion by 68%. The fields with stone bunds recorded an average increase in grain yields by 53%
in lower part of the plot (Desta etal, 2005). Taking into account the space occupied by the bunds,
the stone bunds led to increase in mean crop yield from 0.58-0.65 tonnes per hectare. The reasons
for improved crop yields due to bunding could be due to better nutrient availability, better root
growth environment and soil water availability as per the study conducted at Iowa State University
by Craft and co-workers (Proceedings of the National Symposium on Erosion and Soil
Productivity, 1984).
More than 5 lakh tonnes of silt obtained by de-silting village level ponds has been applied in an
area of 6300 hectares. This also had a positive impact on crop yields that could be due to
improved water holding capacity of soils, increased organic carbon, available phosphorous and
potassium content in soils (Bhanavase etal, 2013).
Thus top soil conserved through bunding and tank silt applied back to fields by de-silting village
level tanks cumulatively accounts to 9.1 lakh tonnes of soil.
2.1.3 Soil health improvement
Farm Yard Manure (FYM) /compost/vermicompost are the main sources of organic manures
promoted by RF to improve soil health. Till date, around 1 lakh tonnes of
FYM/compost/vermicompost have been applied in an area of 20703 hectares at the rate of 4.8
tonnes per hectare which has contributed to increase in crop yields. This is mainly because of the
fact that organic matter facilitates the formation of soil aggregates there by increasing soil porosity.
The improved soil structure in turn facilitates water infiltration and ultimately overall productivity
of soil (Langdale etal, 1992). In addition, organic matter aids cation exchange, enhances plant root
growth, and stimulates the increase of important soil biota (Allison, 1973; Wardle et al., 2004)
2.1.4 Use of quality seeds
Non-availability of quality seeds is one of the challenges faced by farmers of India that is seriously
impacting food production. In response to this RF BIJ Program has ensured nearly 4500 tonnes of
quality seeds in more than 45000 Ha. That is instrumental in increasing the food production to
atleast 15% adding to food basket of the country. It is estimated that all other factors remaining the
same the use of quality seed of high yielding varieties increases crop yield by 10– 15 % (ICAR,
1993).
2.1.5 Water Harvesting
Till date, 447 lakh cubic meters of water has been harvested through which 11222 hectares has
been brought under irrigation for the first time benefitting 14000 households. Through double
cropping, cropping intensity has increased from earlier 100 to 200% in the area brought under
cultivation there by increasing food production in these areas.
Table 3 Water harvesting capacity and irrigation potential created

Water harvesting Area brought Number of
Sl.no Cluster Name capacity (Lakh under irrigation for Households
Cubic meters) the first time (Ha) benefitted
1 Telangana 24.32 82 151
2 Madhyapradesh 129.48 3749 4426
3 Orissa 31.21 353 703
4 Rajasthan 58.51 2644 3194
5 Karnataka 28.33 234 275
6 Maharastra 59.19 926 1133
7 Jharkhand 4.35 211 428
8 Gujarat 73.45 2126 2654
9 Andhrapradesh 8.04 372.8 407
10 Tamilnadu 25.15 132 130
11 Uttarakand 0.12 0 0
12 Chattisgarh 4.93 393 503
Total 447.08 11222 14004
The increase in production is basically due to increased availability of water due to harvesting and
recharging of ground water (Shah and Raju, 2001).
2.1.6 Crop protection: Integrated Pest Management (IPM) and Fencing
IPM measures were promoted in 12000 hectares that not only reduced the cost but also increased
the crop production apart from various ecological benefits. The systems approach minimizes
environmental degradation, sustains agricultural productivity, promotes economic viability in both
the short and long run, and maintains quality of the life (Charles and Youngberg, 1990).
Blue bulls are a menace in Sawai Madhopur and Jamwa Ramgarh regions of Rajasthan that damage
kharif crops extensively. It has been reported that extent of crop damage due to blue bulls has
reached up to 70% in these regions (Meena etal, 2012). As a strategy to protect crops from blue
bulls in Rajasthan, through RF BIJ 5393 hectares was fenced that brought entire area under double
cropping that created a potential to produce more than 11000 MT of food grains.
All the above interventions like waste lands development, top soil conservation, tank silt recycling,
soil health improvement, use of quality seeds, ensuring water for irrigation and crop protection have
cumulatively resulted in increased production by atleast 20% there by increasing the productivity
potential from country’s average of 21 qtls to 25 qtls per hectare. As a result, food grain
production potential has gone up from 105400 MT to 124882 MT every year thereby adding 19480
MT of food grains into the food basket of India. There are many cases where the production has
almost doubled.
2.2 Safe and Nutritious Food
As a strategy to ensure safe, healthy and nutritious food at the door steps of the farmers, RF BIJ
program has promoted Reliance Nutrition Gardens in the backyard of small and marginal
households. An internal study was conducted during 2014 to study the impact of RNGs on overall
nutrition status of selected 361 small and marginal households in 4 clusters namely Gangakhed,
Seoni, Agar, Sawaimadhopur and Balangir. The study revealed that there were more than 25
varieties of vegetables grown in RNGs making 230 grams of vegetables available per day per
member against 300 grams as per the Dietary guidelines for Indians, National Institute of
Nutrition,2010.Till date there are 26727 RNGs established across the programme with a production
potential of 4570 tonnes @ 170 Kgs of vegetables produced per RNG per year.
Table 4 Details of RNGs with production details
Number of Vegetables production potential @ 170

Sl.no Cluster Name
RNGs Kg/year /RNG ( Tonnes)
1 Telangana 1341 227.97
2 Madhyapradesh 6828 1160.76
3 Orissa 2977 506.09
4 Rajasthan 2658 451.86
5 Karnataka 1765 300.05
6 Maharastra 4013 682.21
7 Jharkhand 332 56.44
8 Gujarat 3004 510.68
9 Andhrapradesh 886 150.62
10 Tamilnadu 1962 333.54
11 Uttarakand 397 67.49
12 Chattisgarh 564 95.88
Total 26727 4543.59
Kitchen gardens have played a vital role in bringing down anemia and Vitamin A deficiency in
India. As a support to this, study by Devadas and Prema (1965) observed that 66 percent of the
mothers were anaemic with initial signs of vitamin A deficiency. They were given eggs and
vegetables, including leafy vegetables from the ANP (Applied Nutrition Programme) gardens in
Tamilnadu. At the end of six months the nutritional status of the mothers improved to a
considerable extent with the disappearance of all the clinical signs of vitamin A deficiency.
3. Farmer owned and managed institutions
3.1. Village Farmer Associations (VFA)
Reliance Foundation BIJ has organised more than 49000 farmers into 508 Village farmers
associations to promote collective ownership, responsibility and accountability and to be masters of
their own destiny. This initiative has been helping farmers to overcome challenges posed by scale,
predictability, timing, quality of farm inputs, farm produce and enhanced market negotiations. As a
result there has been significant improvement in socio-economic status of farmers that has directly
or indirectly contributed to food security of small and marginal households.
3.2. Capacity building of farmers
So far, 2851 training programs and 3400 exposure visits to model institutions were organised for
producers which helped in building skills and capacities of farmers to adapt newer techniques on
farm and livelihood options.
3.3. Village Development fund
Village Development fund is meant for overall development of the village by creating and
strengthening social safety net for the villagers in situations of crisis. Till date, 7.4 crores rupees
have been voluntarily contributed by VFA members for the development of their own villages.
3.4. Producer companies
Till date, nine producer companies have been registered under Company Act 1956 (Amendment
2002). This legal framework is necessary to conduct business and will act as a nodal agency for
local development of the farmers, villages and region as a whole. They have played a greater role in
input procurement, Aggregation of farm produce and price negotiations ending with a turnover of
more than Rs.65 Lakhs annually. In coming years, the Producer Companies are expected to take
way forward.
4. CONCLUSION
The paper has tried to capture initiative of Reliance Foundation BIJ programme with village level
institutions as base to achieve the goal of food security and overall development of the small and
marginal households in the villages. It is very encouraging that village farmers associations are
taking ownership and accountability in achieving food security through sustainable ways and
means. The VFAs are capacitated enough to plan and execute need based interventions and are
accountable for achieving food security and holistic development of the villages. Food production
has increased significantly through better management of land, water and other natural resources.
Farmers are able to grow and consume nutritious vegetables at the backyards at least for nine
months in a year . The site specific models of food security being developed in19 Agro-ecological
sub-regions are towards setting bench mark for large scale replication by Government, Non-
government and other private grass root level agencies in India.
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Effectiveness of 6 Step Prevention and Control For Dengue Hemorrhagic Fever in Rural Community of Thailand

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Effectiveness of 6 Step Prevention and Control For Dengue Hemorrhagic Fever in Rural Community of Thailand

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Effectiveness of 6 Step Prevention and Control for Dengue Hemorrhagic Fever

Conference Paper · August 2015

Natnapa Padchasuwan Sukanya Ponphimai

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Wasugree Chavengkun Jun Norkaew

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The Second Asian Symposium on Healthcare Without Borders (HWB)

August 6-8, 2015 at the Mitsui Garden Hotel

Page 1 to 43: Section I Program

Page 39: Acknowledgements

Page 40: About the Event and Proceedings

Page 45 to 86: Section II Abstracts*

Page 87 to 141: Section III Full Papers*

The Second Asian Symposium on Healthcare Without Borders (HWB)

Schedule & Agenda

August 6-8, 2015 at the Mitsui Garden Hotel

Yours most sincerely,

Dear Distinguished Participants,

JPY 35,000 to the Ashinaga Foundation

JPY 35,000 to the City Lights Social Welfare Corporation

Thursday, August 6, 2015

Hakuho West Ballroom

Challenges for English Education for Healthcare Professionals in Japan

Natthawut Kaewpitoon, Ph.D.

Faculty of Public Health, Vongchavalitkul University, Nakhon Ratchasima, Thailand

PhD in BioMedical Science, Khon Kaen University, Thailand

Certificated - Applied Epidemiology Chulalongkorn University, Thailand 2011

Suman Chakrabarty, M.Sc., Ph.D. (Calcutta University)

70th Hiroshima Peace Memorial & Remembrance Commemoration

Thursday, August 6, 2015

 The ceremony format will be as follows:

Day 1: Plenary & Welcome Overview

The Second Asian Symposium on Healthcare Without Borders (HWB)

14:00 to 16:00 Participant Check-in

16:20 to 17:00 Plenary Presentation

17:30 to 19:00 Welcome Reception (registered participants only)*

19:00 to 20:00 (Optional) Riverside Lantern Memorial Ceremony

Day 2: Oral Sessions Overview

Day 2: General Overview

09:00 to 14:00 Participant Check-in

Day 2: Morning and Afternoon Sessions Overview

09:00 to 10:30 Oral Session A: Oral Health, Pharmacology and Toxicology

10:45 to 12:15 Oral Session B: (Featured Panel) Global Health Concerns

12:00 to 12:15 Poster A setup

Day 2: Late Afternoon Sessions Overview

14:00 to 15:00 Poster Session C / Location: Asagi Ballroom (3rd Floor)

15:00 to 17:00 Oral Session D2: Access to Healthcare

Day 3: Sessions Overview

Saturday, August 8, 2015

Day 3 General Overview

09:00 to 11:00 Participant Check-in

09:00 to 12:30 Oral and Poster Sessions

12:30 to 13:00 Closing Remarks

Day 3 Oral and Poster Session Overview:

09:00 to 11:00 Oral Session E: Peace, Humanitarian Aid and Service

11:00 to 12:30 Poster Session C and Lunch

12:30 to 13:00 Closing Remarks

Optional Tour Day: Sunday, August 9, 2015

Day 2 and Day 3:

Day 2: Friday, August 7, 2015