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Health Impact

Laser-guided walking device

Project undertaken by: Prof. Dr. Roongroj Bhidayasiri

About research: “Parkinson’s Disease” is a neurological degenerative disease that is more found in more than 50% of patients with movement disorders. Parkinson’s patients often have trouble walking (Gait freezing), which causes walking disorders. These symptoms rarely respond to medication but can respond to visual or sound stimulations to take a step. Furthermore, while the patient is stuck, if there are obstacles in the way, the patient will be able to overcome these obstacles and move on. This then provides a solution for the abnormalities in the brain circuits.

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Researchers have developed the “Laser-guided walking device”, based on the principle of visual cues, in order to use as a tool to reduce walking problems, including frozen gait, and the incidence of falls in the elderly. By designing a proper cane and program, it improves the walking stability of the elderly. In particular, laser canes have been found to solve the walking problems in Parkinson’s disease.

Main features

  • Improves walking stability in patients, reduce issues of stumbling, pace, speed and also helps reduce falling accidents.
  • Enhances the quality of life of Parkinson’s patients and reduces the burden on relatives caring for the patients.
  • Can be used by elderly people with walking problems as well as be used as a normal walking cane.
  • The product has passed testing for real use by patients and is certified by qualified physicians.

Parkinson’s gloves to reduce tremors (device for assessing hand tremors and to then stimulate the muscles with an electric current)

Project undertaken by: Prof. Dr. Roongroj Bhidayasiri

About research: Innovative accomplishment, the Parkinson’s gloves for reducing tremors. Parkinson’s disease is a chronic disease which is common in the elderly. The most common abnormality is hand tremors, especially hand tremors while resting, which is found in approximately 70% of the patients. This symptom is usually noticeable and often causes patients to have social anxiety. The Parkinson’s gloves for reducing tremors is a medical device which has been developed to treat hand tremors in Parkinson’s patients. It can detect the patient’s hand tremors and then stimulate the muscles with an electric current to stop the tremors automatically. Currently there is no equipment to help reduce hand tremors in Parkinson’s patients using electric currents to stimulate the muscles has been developed before. The prominent feature of the device is its development in the form of a wearable and easy-to-use glove that is battery powered. According to a team of researchers from the Center of Excellence for Parkinson’s disease and related disorders in the year 2015, treatment for patients with hand tremors by stimulating the muscles with electric currents was found to reduce the patients’ tremors significantly.

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The research team has developed a prototype model of the Parkinson’s gloves for reducing tremors with tremor sensors and suppressors to use electric currents to automatically stimulate the hand muscles. Control of the device and data collection of the tremors uses a wireless connection with a mobile phone through a tremor analysis application The two systems will work together as follows:

  1. Detection and measurement of hand tremors

By using a set of sensors, the accelerometer and the gyroscope, manufactured by Invensense, act as a six-axis receiver that measures the motion. The device is widely accepted because of its high-level accuracy and low deviation. It is produced as a tremor detection device and has been published in international journals by a team of researchers from Chulalongkorn Center of Excellence for Parkinson’s disease in the year 2015.

  1. Automatic suppression of tremors by stimulating hand muscles with electric currents.

When the receiver detects (recognizes) the tremor signals from a resting hand that are characteristic of Parkinson’s disease (frequency of 4–7 Hz), the system signals via the wireless connection to transmit a small electric current to stimulate the muscles using the internal battery. The developed muscle stimulator uses a resistance, frequency and electrical current in a safe and standardized format that is used in non-injurious physiotherapy (50 Hertz and no more than 20 mA). The data, detected and transmitted via Bluetooth with a mobile phone or a computer, are stored for subsequent more detailed analysis.

Main features of the device

  1. Highly secure device for detecting tremors that is able to reduce tremors very well.
  2. The device is easy to use, light weight and has a low production cost compared to drugs and surgery.
  3. Use of the device is an alternative treatment for tremors, which can reduce side effects from medication or other treatments to reduce tremors.
  4. The device can be used to reduce tremors from other diseases as well.

Sleep motion analyzer

Project undertaken by: Prof. Dr. Roongroj Bhidayasiri and Dr. Jirada Sringuen

About research: Sleep motion analyzer for Parkinson’s patients. Bradykinesia is a major symptom in Parkinson’s patients and can occur both during day and night sleeping, but especially at night, where the patients have a hard time turning over. This causes difficulties in getting out of bed and to experience less than normal motion during sleep. Previous studies revealed that the incidence of reduced motion during sleep was principally found in Parkinson’s patients (96%), with only 4% in non-Parkinson’s elderly people. The seriously reduced motion during sleep causes major problems, such as bedsores, accidents (such as falling out of bed) and pneumonitis from suffocation, etc.

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This research has developed a linear and angular motion detector consisting of a set of sensors and transducers for sending data to be recorded in an SD card in the device for subsequent further analysis. The sensor consists of an accelerometer and a gyroscope, which is used in detecting the motion. It is widely accepted because of its high accuracy and low deviation. Measurements are performed by a set of sensors installed in five positions (the two wrists and ankles plus the midriff) in order to assess the patient’s difficulty of movement while sleeping, information that can be used to aid diagnosis of onset severity and future treatment.

Main features

  1. The device can be used to measure movements in Parkinson’s patients by being attached to the patient at all times. This makes it possible to measure movements at all stages, as well as to monitor and evaluate the Parkinson’s patients for better treatment.
  2. Non-specialist physicians in the department of abnormal movements or neurology can use this device to measure patient’s movements to help track their symptoms during the night precisely, resulting in the patients receiving more effective treatment.

Diagnostic tool for tremors

Project undertaken by: Prof. Dr. Roongroj Bhidayasiri

About research: Researchers have developed a device for analyzing abnormal movement in Parkinson’s patients and separating patients suffering from tremors that are not from Parkinson’s disease. The device helps make the diagnosis of Parkinson’s disease more accurate. It also benefits the physician in assessing the patient’s symptoms during treatment. This research is very important for the medical field. This device will help diagnose Parkinson’s patients and treat them promptly, as well as a device for diagnosing, assessing and tracking the treatment of Parkinson’s patients in hospitals without specialist physicians.

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Main features

  1. The device can measure and analyze tremors to help diagnose Parkinson’s disease and separately diagnose other diseases with similar symptoms of tremors. It can also be used in tracking and evaluating the treatment of Parkinson’s patients to provide better treatment for them.
  2. Non-specialist physicians in abnormal movements or neurology can use the device to analyze the patient’s tremors to help diagnose the disease precisely, resulting in the patients receiving proper care.

Rehabilitation robots for stroke patients 

Partner: Sawangkaniwas Rehabilitation Center, Thai Society Red Cross Rehabilitation Center, Chulalongkorn Hospital Department of Rehabilitation, Faculty of Medicine, Chulalongkorn Rehabilitation Center, Government Hospitals

About research: Chulalongkorn University Rehabilitation Robotic Exoskeleton system (CUREs) is a project supported by the National Research University Project, Office of Higher Education Commission and Chulalongkorn University. We have developed many types of rehabilitation robots for use in neurological rehabilitation, especially after strokes, such as 4-axis upper-limb, lower-limb and 3-axis wrist and hand-finger robotics. These include not just exoskeleton types but also end-effector types of rehabilitation robots. These rehabilitation robot projects illustrate not just engineering points of view but also real training results or intensive rehabilitation based on our robotic systems. Robot-assisted therapy is a promising method for promoting motor recovery in patients with a neurological deficit. Our main mission is to increase the integration of robotic controls for medical applications.

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Two main control strategies have been developed. The assistive-resistive mode, based on an impedance force control, is for a patient who has some difficulty in moving his hand or physically weak persons. An impedance model, based on the concept of a virtual wall, was designed as a torque control scheme. The resistive mode is for a patient who wants to improve his hand motion or after finishing the assistive-resistive operation training program. Each joint of the exoskeleton arm is actuated by a brushless DC servomotor. Instead of a sophisticated procedure for torque measurement, we have also developed torque measurement based on measurement of the armature current in the brushless DC servomotor. Both operation modes have been tested with patients, where the feedback from patients and medical doctors have been very positive.

Sucrose-free protein beverage added with rice bran extract

Partner: Waiting for up-scale production and commercialization

About research: Protein-fortified drinks containing easily digested and absorbed proteins have attracted considerable interest. Apart from providing essential amino acids, they may enhance cognitive functions. However, strong meaty and brothy flavors, which are characteristic flavors of hydrolyzed proteins, are not preferable. Rice bran, extracted using subcritical water, contains hydrolyzed carbohydrates and proteins, is high in antioxidants, and has characteristic coffee-like flavors. Therefore, the extract can be used to mask strong meaty and brothy flavors, providing unique flavors to the protein-fortified drink, and enhancing the antioxidant capacity of the product. Moreover, sugar alcohol is used to improve the overall taste of the drink, which is beneficial for consumers who would like to limit sucrose consumption. Petty patent of this product has already been issued (Thailand petty patent number 9644). For more information, please contact Assoc. Prof. Kanitha Tananuwong (Kanitha.T@chula.ac.th)

 

Paper-based sensors for colorimetric and electrochemical quantification of metals

About research: A highly sensitive, simple and low-cost microfluidic paper-based sensor based on the combination of colorimetric and electrochemical detection was developed to simultaneously determine the levels of Ni2+, Fe2+, Cu2+, Cr3+, Pb2+ and Cd2+. Each separating and detection layer contained unique chemistries to improve the sensitivity and selectivity. Using the developed paper-based sensor, all six metal ions could be determined simultaneously in real samples at a sensitivity that matched traditional approaches.

Highly selective and sensitive paper-based sensors for trace determination of trace levels of copper ions in food

About research: A paper-based device with a highly sensitive and selective colorimetric assay was successfully developed for the rapid detection of Cu2+ in food samples (mineral water, tomato and rice). The developed paper-based colorimetric sensor has a great potential for the low-cost, rapid, simple, portable, highly sensitive and selective determination of Cu2+ levels.

An evaluation of the usage patterns, outcomes and return of investment associated with the national smoking cessation quitline in Thailand between 2009 and 2011

Partner: Thailand National Quitline Thai Health Promotion Foundation

About research: Telephone-based smoking cessation services (quitlines) offering counselling for smoking cessation without nicotine replacement therapy may be important components of tobacco control efforts in low and middle income countries, but evaluations in such resource-limited settings are lacking. We aimed to evaluate the usage, effectiveness and cost of the Thailand National Quitline (TNQ).

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Methods: Analysis of retrospective data for callers to the TNQ between 2009 and 2012 and a follow-up survey of 1161 randomly selected callers.

Results: Between 2009 and 2012 there were 116,862 callers to the TNQ; 36,927 received counselling and at least one follow-up call. Compared with smokers in the general population, callers were younger, more highly educated, more likely to be students, and more likely to smoke cigarettes rather than roll-your-own tobacco. Continuous abstinence rates at 1, 3 and 6 months after calling were 49.9%, 38.0% and 33.1%, respectively. The predicted abstinence rate at 12 months was 19.54% (95% CI 14.55–26.24). Average cost per completed counselling was $31 and the average cost per quitter was $253. Assuming all (and two-thirds) TNQ callers who succeed in quitting would have failed to quit without the assistance of the TNQ, cumulative life years saved (LYS) for the 4-year period were 57,238 (36,733) people giving a cost per LYS of $32 (50) (about 7.93 LYS per quitter) and an estimated return on investment over 4 years of 9.01 (5.78).

Conclusions: A low-cost quitline without nicotine replacement therapy is a promising model for smoking cessation services and likely to offer good value for money in Thailand.

The quitting rate among smokers with chronic illnesses who have received smoking cessation counseling from the Thailand National Quitline (TNQ)

Partner: Thailand National Quitline Thai Health Promotion Foundation

About research: Smoking is a global health problem, a leading cause of death and chronic illness. Smokers with chronic illnesses have a higher risk of recurrence or death than those who have never smoked. This study aimed to determine the continuous abstinence rate (CAR) from smoking at one, three and six month(s), the quit attempt rate at seven days, and the motivation to quit smoking of patients with chronic illnesses after they received smoking cessation counseling from the TNQ. Secondary data sources from a study of the effectiveness of the TNQ21 were used in this study.

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The subjects were 91 smokers, and the top five chronic illnesses were allergic rhinitis (15.4%), hypertension (14.3%), asthma (9.9%), peptic ulcer (9.9%), and diabetes mellitus (6.6%). Although 37 participants (40.7%) abstained from smoking continuously for seven days, 54 participants (59.3%) had not abstained from smoking. Thereafter, the number who managed to continued to abstain from smoking declined over time to 36 (39.6%) one month, 25 participants (27.5%) and 22 participants (24.2%) continued to refrain from smoking for three and six months, respectively. Most participants (70.3%) who succeeded in quitting were motivated to quit by themselves.

In conclusion, the TNQ provides a moderately effective counseling to help people stop smoking. However, half of those who received counseling were unsuccessful in quitting. This may result from many factors influencing them. So, health care professionals need to provide effective smoking cessation intervention and continuous monitoring.

Predicting factors for smoking cessation among smokers calling the Thailand National Quitline (TNQ)

Partner: Thailand National Quitline Thai Health Promotion Foundation

About research: This correlational study aimed to examine the predicting factors for quitting smoking among smokers who called the TNQ. A secondary data source from February to July 2013 was used. A total of 194 smokers were randomly recruited from the TNQ’s database. Their data from the TNQ’s database was supplemented by telephone interviews of each of the selected recruits (performed throughout August to September 2014), and then the data were analyzed with descriptive statistics and Logistic regression.

The significant predictors of a smoking abstinence of over 6 months were the confidence to quit (OR = 1.52, 95% CI = 1.21–1.92), numbers of follow-up support calls (OR = 1.40, 95% CI = 1.10–1.76), and the mental component summary (OR = 0.30, 95% CI = 0.14–0.65). Thus, smoking cessation intervention needs to assess and encourage smokers to have the confidence to quit and to provide follow-up support calls.

Preventing Recurrent Sexually Transmitted Diseases in Sexually Active Thai Adolescents and Adults

About research: This study developed a protocol to prevent recurrent STDs for adolescents and adults diagnosed with STDs. The protocol consisted of three chapters. Chapter I provided information on recurrent STDs prevention and HIV/AIDS infection. Chapter II focused on developing motivation to prevent recurrent STDs and HIV/AIDs. Chapter III was skills building on condom use negotiation. The protocol was implemented by registered nurses from a male clinic, Bangrak STIs Cluster. It lasted for 1.30 h and at the end of the protocol, a handbook “You can do it if you want to..” and condoms packed in a bow named “Safe sex saves lives” were given to participants. At a 3 month-follow up, the subjects were asked about their condom use behavior and were subjected to a laboratory examination for STDs.

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Project undertaken by: Faculty of Nursing, Chulalongkorn University
Partner:
Bangrak STIs Cluster, Bureau of AIDS, TB and STIs, Ministry of Public Health (MOPH). The Bangrak STIs Cluster served as the setting for this study. After the project completion, the hospital realized that the protocol to prevent recurrent STDs developed by this study worked very well in their setting. It served their needs because they were looking for recurrent prevention strategies and the developed protocol was very practical for them. It could change the attitude, beliefs and sexual behavior of persons infected with STDs. Even though the project was closed, Bangrak STIs Cluster still implements the protocol as routine care in their male clinic.

 

Status and Trend of Mobile Communication and Applications Usages in Senior Citizens, Thailand: Case Study on Quality of Life and Health Effects

About research: Background. The current trend of using mobile devices among the elderly population is increasing continuously. Many adverse health effects have been detected from mobile communication devices.

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Project undertaken by: CPHS – College of Public Health Sciences Chulalongkorn University

Objective. To study the status of communication devices and application usage among elderly people in Thailand and to determine the factors associated with health effects related to mobile communication device usage among the elderly people in Thailand.

Material and Methods. A descriptive study was conducted at four regions of Thailand. The participants were comprised of 448 elderly people who regularly use smartphones or tablet computers. Face to face interview was used to collect the data by questionnaires. The study variables were described by frequency, percentage and mean and were the association between mobile usage and health effects was addressed by logistic regression.

Results. The 448 participants had an average age of 65.11 ± 5.26 y old, with an average usage time of devices of 2.70 h/d. A total of 194 (43.3%) of the participants used both application and calling equally. The reported physical, mental and social health effects of using mobile communication devices were: dim eyes (52.7%), shoulder or neck pain or sore muscles (52.5%), increased self-value and confidence (90.6%), leading to warmness with others (82.6%), social network accessing from strangers (39.5%) and changes in interactions with surrounding people, such as less talk and fewer activities (32.6%). Moreover, the results showed that the time spent using the device, type of application, and rest break of using devices were all significantly associated with health effects.

Conclusion. The finding showed that the elderly people in Thailand faced to many potentially adverse health effects from mobile communication devices. Consequently, intervention to reduce the health effects related to mobile communication devices and applications usages among elderly people in Thailand need to be considered.

Link App : https://play.google.com/store/apps/details?id=th.co.company.hepapplication&hl=en

 

Social Mobilization of Healthy Monk – Healthy Nutrition Project

Project undertaken by: The Faculty of Allied Health Sciences, Chulalongkorn University

Partner: Department of Health, Ministry of Public Health, Primary Health Services of Nakhon Ratchasima Province in 6 Ampurs: Pimai, Soong Nuen, Phra Tongkam, Non Daeng, Chok Chai, and Muang. Model of Kitchen for Monks at Maha Chulalongkorn Racha Widayalai University and many others all over Thailand

 

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About research: Healthy Monk – Healthy Nutrition Project is now in Phase IV, a continuation of Phase I (Aug 2011). It was originated by ThaiHealth concern over the increased chronic disease rate in Thai monks. A research grant to study the problem in-depth and find a practical solution was assigned to Assoc. Prof. Dr. Jongjit Angkatavanich (Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Chulalongkorn University) as the project manager, along with Mrs. Manee Zuesongdham, head of Friendship Support Center, Chulalongkorn Hospital, Asst. Prof. Dr. Wasinee Visetrit, a qualitative research expert, Dr. Watcharaporn Boonyasiriwat, an expert in communication psychology, as well as graduates and students (B.S., M.S. and Ph.D.) of Chulalongkorn University.

The project is a mixed method approach of quantitative and qualitative studies to identify the nutrition problem in Thai monks. Afterwards, innovative media for nutrition education were created, currently updated to version 4.0, and continued with an intervention trial to test the media. So far the outcomes have been quite satisfying. These results have been communicated through academic conferences, as well as international health promotion conferences and through the media (Thai PBS, Channel 3, Reuters Health, BBC, Nishi Nippon Shimbun, etc)

Determination of blood lead and cadmium levels of children in an electronic waste recycling community in Bangkok

Project undertaken by: The Faculty of Allied Health Sciences, Chulalongkorn University

Partner:  Thai PBS Television program used part of the data obtained from our study to help educate the general public about health problems associated with electronic waste.

 

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About research: Electronic waste (E-waste) often contains toxic substances that can have adverse effects on human health and the environment, including lead and cadmium salts. High blood lead and cadmium levels are associated with abnormal physical and mental development of children. This study aimed to determine the blood lead and cadmium levels and to observe the physiologic effects of lead and cadmium exposure in children in Seua Yai Uthit, the largest e-waste recycling area in Bangkok. Fingerstick blood samples were collected from 23 children from the Seua Yai Uthit area between the age of 6 months and 6 years old, the period when children have the highest growth rate. Age and sex matched control fingerstick blood samples were collected from 23 children who lived outside the Seua Yai Uthit and Chatuchak areas in Bangkok at the Queen Sirikit National Institute of Child Health outpatient clinics. Blood lead and cadmium levels from two groups were determined using Inductively Coupled Plasma-Mass spectrometry (ICP-MS) and compared using paired sample t-tests with significance accepted at the p < 0.05 level. Children living in the e-waste recycling area were found to have significantly higher blood lead and cadmium levels than those living outside the e-waste recycling communities. However, children living in the Seua Yai Uthit e-waste recycling area did not show any signs of anemia and their physical development was normal according to the Thai child developmental standards. However, high blood lead and cadmium levels may cause other physical and mental abnormalities that were not monitored in this study, including those in later adult life. Results from this study will provide an important basis for future laws and regulations required to control the e-waste recycling industry in Thailand and protect Thai children from heavy metal poisoning.

 

Size-based sorting of living cells using a microfluidic system

Project undertaken by:  Assist. Prof. Alongkorn Pimpin
E-mail:  alongkorn.p@chula.ac.th 02-218-6610

Partner:  Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University has employed the developed device in a cancer cell study

About research:  This project investigates the cell viability of white blood cells during the sorting process in a spiral microchannel using including trypan blue staining, scanning electron microscopy (SEM) and Wright’s staining. In the feeding system, between a syringe and needle, despite the high shear and extensional stresses induced in fluid stream, no reduced cell viability was found, but cells were more likely to be deformed in the case of the maximum stress at a flow rate of 8 ml/min. Normal cell morphology was decreased by about 12% or 165, as evaluated by SEM and Wright’s stain, respectively. Finally, a spiral microchannel was evaluated, where about 70% of the cells survived (as determined using Trypan Blue staining) after passing through the whole setup at 1 ml/min.

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E- Mail:  research@chula.ac.th  FAX: 02-218-0236
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