plueme/wizJson huggingface dataset:
This research aimed to develop essential competencies of registered nurses in terms of nursing for emerging infectious disease COVID-19 and develop a competency development model of emerging infectious disease COVID-19 nursing of primary, secondary, and tertiary health service units in collaboration with stakeholders. Research implementation was conducted using Emancipatory Action Research. Research participants were 6 physicians and 53 registered nurses, of which 10 were from primary, 31 from secondary, and 12 from a tertiary health service unit. Research instruments consisted of 1) instruments for quantitative data collection including the questionnaire of essential competencies of registered nurses in terms of nursing for emerging infectious disease COVID-19, the questionnaire of the competency development model of registered nurses in terms of nursing for emerging infectious disease COVID-19, and questionnaire of satisfaction of competency development model of emerging infectious disease COVID-19 nursing, 2) instruments for qualitative data collection including 1) behavioral-based interview form, 2) in-depth interview form, and 3 focus group discussion form. Quantitative data were analyzed using descriptive statistics and content analysis was used for qualitative data. Research results revealed that 1) registered nurses of primary, secondary, and tertiary health service units had an overall higher mean score of essential competencies of registered nurses in terms of nursing for emerging infectious disease COVID-19 in each loop of research. A higher mean score was found on both professional and technical competencies. 2. Competency development model of registered nurses in terms of nursing for emerging infectious disease COVID-19 consisted of 3 components including practice guidelines, competency development method, and factors promoting competency development. Practice guidelines consisted of 5 main steps including 1) specification of essential performance competencies, 2) development of monitoring system, support, and empowerment, 3) specification of self-competence development guideline, 4) implementation of the competency development plan and, 5) summarization and report of development result. The Competency development method consisted of 6 activities including 1) workshop, 2) on-the-job training, 3) learning from experts, 4) coaching, 5) self-study, and 6 knowledge sharing. Factors promoting competency development included the role of nursing leaders, policy and explicit practice guidelines, and a good attitude towards the profession
Lung adenocarcinoma is the most often diagnosed cancer and the primary cause of cancer death worldwide. Chemotherapy for lung cancer is still main treatment. However, a response rate is very low. In this study, we aim to identify serum protein indicator for predicting response to a platinum plus anti-metabolite regimen through integrative analysis of transcriptomics and proteomics. Methods: A total of 27 patients with lung ADC (17 non-responders, NR and 10 responders, R) receiving a combination of carboplatin and gemcitabine treatment was included. For transcriptomic study, RNA was extracted from the frozen biopsy tissue of patients. Sequencing was performed on the Illumina/HiSeq2000 platform and differentially expressed genes were converted to proteins using UniProt database. For proteomic study, serum from 6 responders and 6 non-responders was subjected to the label-free liquid chromatography tandem mass spectrometry. Blood-based proteins reflecting the tissue-specific biomarker were obtained using Venn diagrams. Candidate proteins were validated by western blotting. Results: We found that 417 genes, including 52 up-regulated genes and 365 down-regulated genes were differentially expressed. In addition, we also showed that there were 26 up-regulated proteins and 5 down-regulated proteins. Based on integrative analysis, alpha-1-acid glycoprotein (A1AG1) and fibrinogen alpha chain (FIBA) were detected in both tissue and serum of patients, with a higher level in responders than non-responders. Additionally, serum expression level of A1AG1 and FIBA was shown to be link chemotherapeutic response. Conclusion: A1AG1 and FIBA indicating as tissue-specific biomarkers may be used for identifying ADC patients who would benefit from the platinum plus antimetabolite treatment.
Cancer is the first-leading cause of death in Thailand. Cancer is caused by gene mutations that control the cell functions in cell growth and division. The genetic mutation causing cancer can be divided into two broad categories based on the tissues of origins: somatic mutation and germline mutation. The germline mutation passes directly from parent to offspring which can be detected in every cell within the body. Cancers associated with germline mutations are called hereditary cancers. Most hereditary cancer patients have similar clinical symptoms and signs to sporadic cancer, it is difficult to distinguish the hereditary cancers for the benefit of preventing, treating and screening cancer in at-risk family members. In addition, hereditary cancers account for up to 12 percent of all cancer diagnoses. Thus, genomic medicine has the potential to make the diagnosis more accurate. This project aims to utilize genome sequencing technology to identify germline mutations and diagnose hereditary cancer syndromes among Thai cancer patients, this would also create an opportunity to build large genome database for future study of the cancer susceptibility genes and polygenic risk of cancer for Thai population. Moreover, this project has created collaborative network among medical schools, large university-affiliated hospitals and cancer centers to support and share experience, exchange knowledge, and facilitate the integration of genomic medicine in cancer care. Study by next-generation sequencing (NGS) found that approximately 16% of cancer patients participated in this study harbored germline pathogenic or likely pathogenic variants in various cancer susceptibility genes. This information was useful for further expanding to identify at-risk family members with appropriate cancer screening, early detection and prevention in the future. Genetic diagnosis, genome-guided screening and prevention of cancer were also cost-effective and would be a model of the implementation of genomic medicine in national healthcare system.
The objective of this study was to determine the risk factors during the perinatal and the first year postnatal period that were associated with metabolic syndrome at the age of 30 of offspring. Methods: We invited offspring whose mother had participated in a study of Chiang Mai Low Birth Weight Study (CMLBWS) in 30 years follow-up. History, physical exam, and blood sampling were collected to determine whether participants have metabolic syndrome. We analyzed the association between the perinatal-postnatal risk factors and metabolic syndrome (MS). The risk factors included the history of the small for gestational age (SGA), history of rapid growth in weight during the first year of life (catch-up growth), maternal body mass index, weight gain during pregnancy, gestational age, and maternal age. The Local Research Ethics Committee approved the study and participants gave written consent. Results: Three hundred and seventy mother and 418 offspring agreed to participate in the present study. Two hundred offspring were males and 218 were females. The mean age was 30.75 years old. There were 72 offspring (17.22%) with MS and 5 offspring were SGA (6.94%). There was no statistically significant difference in the incidence of MS between offspring with SGA (19.23%) and normal birth weight (17.09%) (p = 0.780). The percentage of MS in offspring with a history of catch-up growth and without catch-up growth was 22.22% and 15.83%, respectively. However, this trend was not statistically significant difference (p = 0.503). In addition, it was also found that other factors in mothers during the pregnancy had association with occurrence of MS in offsprings. Offsprings, who their mothers had a history of high body mass index, had an association with the occurrence of MS in offsprings than those without such history. Conclusion: Maternal body mass index of mothers during pregnancy were associated with MS. There was a none statistically significant trend between catch-up growth and MS. However, no association was found between birth weight and MS.
This study is a mixed method research, collecting quantitative and qualitative data in 2 districts of Yala, Pattani and Narathiwat province, in totally 6 districts. The study aimed to determine the roles of networking in primary care systems for screening and monitoring for covid-19 risk groups. Four hundred eighty-one people were collected the quantitative data using questionnaire about knowledge of practices guideline, roles of practice and the stratification of networks on screening and preventing the risk groups of covid-19. The data collection was arranged on January – March 2021. The qualitative data were collected in 270 people, using focus group and indebted interviews, running on April – December 2021. Quantitative data were analyzed using frequency and percentage, while qualitative data were used thematic analysis by Miles & Huberman (1994) conceptual framework. The quantitative results showed that most participants were middle aged with age between 36 and 45 years old, 31.2 percent. Following by, old aged was 28.3 percent. More than a half were female, 56.3 percent. The overall knowledge on screening and monitoring on covid-19 pandemic in risk group was in the high level (M=3.01, SD=.53). However each aspect of knowledge such as patient care and infection control, Monitoring of people exposed to COVID-19 and community control of COVID- 19 pandemic, and coordination and data management were rated as moderate (M=2.99, SD=.57, M=2.98, SD=.57, M=2.91, SD=.59). The scarification of roles and work on screening and monitoring on covid-19 in risk group was found a high level (M=3.29, SD=.50). The overall in roles performance for screening and monitoring of COVID-19 at risk groups was rated the high (M=3.19, SD=.51). Qualitative findings were presented in six themes: 1) role of networks in COVID-19 screening and monitoring, 2) facilitators of role performance, 3) factors influencing the spreading of COVID-19, 4) barriers for networking, 5) needs for better performance, and 6) outcomes of networking. The networks consisted of five principal organizations: health professionals, volunteers including village health volunteers, community leaders, religion leaders, and local governments. These groups of people unified their efforts in responding to the government policies and proactively implementing COVID-19 screening and control measures in these three southern provinces. These organizations created their new and voluntary role and combined these roles into their principal functions to respond to health needs of families and communities taking into account the unique cultural and religious contexts as well as ways of life. Dedicated religion leaders provided guidance on how health measures could be observed in accordance with Islamic principles.
Coronavirus disease 2019 (COVID-19) is a contagious disease which cause by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. COVID-19 epidemic first appeared in Wuhan, China in December 2019. The World Health Organization (WHO) declared a Public Health Emergency of International Concern and then on 11 March 2020 announced as a pandemic. Since there is no specific drug and treatment, the use of convalescent plasma (CP) may serve as an alternative treatment for patients with COVID-19. This study aims to determine the effectiveness of CP therapy in COVID-19 patients with moderate to severe pneumonia. In our trial, 186 patients were enrolled including 111: male and 75: female, age of 21-91 years, and 49 patients completed the trial. The primary outcome showed 95% (177 of 186 patients) of patients were discharged, whereas 5% died. Among the 49 patients, clinical assessment was evaluated using by Chest-X-Ray, COVID-19 antibody levels and laboratory parameters. the kinetics of anti-nucleocapsid, anti-spike and neutralizing antibody level of 49 patients were significantly increased in 3-, 7- and 14-days post-transfusions respectively. Moreover, IFN-β, IL-6, IL-10 and IFN-α have significant difference among the groups. These findings indicated that most patients with low SARS-CoV-2 antibody titers tended to higher recovery rate after receiving high antibody-titre convalescent plasma. Nevertheless, we could not conclude that outcomes were entirely due to only CP treatment.
Background: Acute kidney injury occurs when the kidneys lose their function over hours or days. If a pharmaceutical intervention is not available, renal replacement therapy can play an essential role in increasing patients’ survival chances. Currently, there are four methods of renal replacement therapy, and the preferred method will depend on patients’ disease indications. One of the methods is known as a continuous renal replacement therapy (CRRT), which is already included in the universal healthcare benefits package under the Universal Coverage Scheme, covered by the National Health Security Office (NHSO). However, from the annual’ s stakeholder meetings held by NHSO, there were comments regarding access and reimbursement for CRRT. Objective: The objective of this study was to analyze the incidence, cost, and budget implications for critically ill patients with acute kidney injury requiring CRRT. Specifically, this study included a survey to examine the feasibility to provide CRRT services among hospitals in Thailand and a costing exercise to investigate the unit costs of such services in selected hospitals. Methods: This study included analyses of NHSO's e-Claim databases to inform the incidence of renal replacement therapy usage, and a budget impact analysis was performed from the perspective of the public health insurance system in a 5-year timeframe. Furthermore, The feasibility and service resources survey was conducted by sending surveys to more than 280 hospitals nationwide. Results: The results showed that there were between 3,540 - 6,049 acute kidney injury patients requiring CRRT annually in Thailand, and the cost of CRRT was between 57,502 and 116,890 baht per person. As for the five-year budget impact analysis, If we are referring to the number of patients who need CRRT services at 3,540 will be between 1,017 and 2,068 million baht. In the other case, if referring to the number of patients at 6,049, the budget impact will be between 1,739 and 3,535 million baht. From the stakeholder consultation meetings, there appears to be inadequate support for hospitals to provide CRRT. Moreover, the survey results showed that 88% of hospitals currently providing CRRT could treat more patients if the reimbursement rate for CRRT were to be adjusted to more appropriate level. Conclusion: Information from this study could support policymakers to update reimbursement rate and associated processes in order to improve accessibility to CRRT among critically ill patients with acute renal injury.
This research aimed to study the problem of appropriate medical dispute resolution in Thailand. The issue between the social sciences and the medical sciences is a different science that must come together to find a solution when a dispute arises, i.e., a medical conflict. Each party has reasons to claim how fair they should be received in the probation process. Or is there any way to solve the problem? It is, therefore, interesting that What is the proper procedure for resolving medical conflicts in Thailand? Which method is best depends on different situations. What are the ways in Thailand? Further steps should be developed or taken to resolve Thailand's most impacting medical disputes. Therefore, the study of civil liability guidelines Guidelines for criminal and judicial proceedings of various physicians Dispute Resolution Methods Examples of medical treatment cases in Thailand led to the study of dispute resolution methods through group meetings in 5 areas: the North, the Northeastern region of Chiang Mai; Khon Kaen Province central area Phitsanulok Province Southern area, Songkhla province and Bangkok 2 times per area and in-depth interviews with experts in the field of medicine and public health such as doctors, nurses, etc., and people who have practiced the medical profession. Legal professionals such as judges or former judges. A civil servant or an officer of the Court of Justice, a prosecutor or former public prosecutor, Government officials or employees of the Office of the Attorney General or former police government officials or employees of Police professors of law schools of various universities and lawyers, etc., who are affected or may be affected by medical errors. Until guidelines and opinions are presented to guide the resolution of appropriate medical disputes in Thailand. So far, the process of criticizing medical arguments remains a mediation process that must continuously develop according to Dispute mediation act, B.E. 2562 (2019). There should be legal measures to establish a committee. A pre-litigation committee and court to help prove the nature of a medical case that is more acceptable to all parties.
Background: Favipiravir is an antiviral agent, mechanism of action is selective inhibition of RNA-dependent RNA polymerase and maybe effective against the SARS-CoV-2 virus. While no established treatment for COVID-19 is available, epidemiological studies conducted to date suggest a risk of further increase in patient exposure in the future. Therefore, to verify that the efficacy of Favipiravir exceeds that of the supportive care (symptomatic therapy) in mild SARS-CoV-2 infected patients (COVID-19 patients) without pneumonia, using the time required to improve clinical symptoms as the primary endpoint and it will contribute immensely to the improvement of public health in the future. Methods: To verify that the efficacy of Favipiravir exceeds that of the supportive care (symptomatic therapy) in mild SARS-CoV-2 infected patients (COVID-19 patients) without pneumonia, using the time required to improve clinical symptoms as the primary endpoint. In the case of chest imaging, no new findings and turning negative in the RT-PCR test with nasopharyngeal swab were set as the primary endpoints. Since this study is an open-label study, 96 patients to be enrolled all of the following inclusion criteria. (2:1, 64 in Favipiravir group with 1,800/800 mg twice daily) for 5-14 days and 32 in control group) The treatment period is 5 -14 days in principle and 10 patients in a clinical pharmacology study of Favipiravir. Results: This study examine the superiority of treatment of Favipiravir adding to the supportive care for mild COVID-19 patients without pneumonia, compared to those treatments without Favipiravir, to efficacy improve clinical symptoms with using NEWS Score, the treatment period is 14 days , in Favipiravir group have improved clinical symptoms rate 79% and in control group rate 32.3%. (p=0.027) Half of those treatments with Favipiravir have improved clinical symptoms on Day 2. As for in control group have improved clinical symptoms on Day 14 (p<0.001) Therefore, efficacy of Favipiravir to improve clinical symptoms than the control group. Conclusions: Coronavirus disease 2019, treatment with Favipiravir 1,800 mg is orally administered twice on Day 1, and then 800 mg is orally administered twice daily on Day 2 when you have mild symptoms.
The coronavirus disease 2019 (COVID-19) pandemic has impacted on health and well-being of the population, particularly vulnerable groups. The purposes of this study were to explore health impact of COVID-19 regarding public health measure on people with visual impairment in Bangkok, to analyze factors affecting the impact, and to make recommendations to support visually impaired people in the situation of COVID-19 outbreak. A cross-sectional survey was conducted. Questionnaires were used to collected data between June and July, 2021. A combination of purposive and snowball technique was applied to select 140 visually impaired people to the study. Data were analyzed using descriptive (percentage, mean, standard deviation) and inferential statistics (ANOVA, t-test, chi-square). Findings revealed that the outbreak and public health measures affected visually impaired people’s daily lives, occupation, and economic and emotional stress. Moreover, they faced difficulty in using public services due to social change in the new normal era. However, the government’s measures in response to the impact of COVID-19 on visually impaired group were not inclusive in design. For instance, there was a lack of system to support the constraints of the visually impaired, and health communication was inappropriate in terms of format and channel. The government should show empathy and implement comprehensive policies for visually impaired people with empathy, such as improve access for public services, improve access to health care services, as well as increase access to COVID-19 vaccine.
The National Strategic Plan on Antimicrobial Resistance 2017-2021, which is Thailand’s first strategic plan addressing AMR issue, was endorsed by the cabinet in 2016. After halfway through the strategic plan’s implementation in 2019, a mid-term evaluation was conducted to assess the progression and develop recommendations for the next step. In this evaluation qualitative approach, including document review and in-depth interview were conducted during July to October 2019 and September to November 2019, respectively. It is suggested that the strategic plan conformed to the One Health principles and provided clearer guidance for management of AMR problems. The governance structure from the national committee, subcommittees, working groups, and coordinating team for each strategy, had a high contribution to the work progression through strong collaboration between respective organizations. Most of the activities were operated as planned. However, the evaluation showed lacks of participation efforts from some government institutes. The important factors that affected the implementation of the national AMR strategy included budget availability, executives at ministry and organizational level, coordinating personnel for each strategy, sufficient supporting knowledge, and clear framework for operation. It also found that despite well-defined monitoring and evaluation mechanisms, ineffective surveillance systems and databases were identified as crucial limitations. Moreover, many of the activities under the strategic plan needed to be improved especially those responsible by the organizations relatively new to the AMR management measures. For these organizations, persistent supports in terms of budget, capacity building, academic, and executives’ cooperation were recommended.