plueme/wizJson huggingface dataset:
The objective was to examine vegetables and fruit consumption patterns
among Thai population across four regions and Bangkok.  This study was a part
of the National Health Examination Survey III in Thailand conducting between
2003 and 2004.  A total of 39,290 individuals aged ≥ 15 years were interviewed by
using a set of questionnaire including information on sociodemographic and
vegetables and fruit consumption.  Employing descriptive statistics, Wilcoxon
rank-sum test and Kruskal-Willis test at 0.05 level of confidence.  The findings
demonstrated that overall, an individual had average frequencies of vegetables
and fruit consumptions equal to 5.97 and 4.56 day per week, respectively.  Individuals living in the Central and Northeastern regions had the highest number of
days per week for vegetables consumption, while those living in Bangkok had
the highest number of days for fruit consumption.  On average, numbers of
servings of vegetables, fruit, and both vegetables and fruit consumed a day were
1.78 (median = 1.14), 1.46 (median = 1.00), 3.24 (median = 2.86), respectively.
People in Bangkok ate more vegetables, fruit, and both vegetables and fruit than
those in other regions.  There were significantly differences in median number of
days per week and the amount of servings per day for vegetables and fruit consumed across four regions and the metropolitan (p< 0.05). Proportion of individuals who met the recommendation for vegetables, fruit, and both vegetables
and fruit consumptions were 26.9 percent, 35.4 percent, and 26.6 percent, respectively.  In conclusion, frequencies and amount of vegetables and fruit consumptions in Thai people varied by regions of residence. Majority of Thais had an
inadequate daily amount of vegetables and fruit consumption.
As part of the National Health Examination Survey III, the objectives of
this study were to determine the health problems of Thai elderly in 4 dimensions; self-reported health status, prevalence of behavioral risks, biological risks
and examine an awareness, treatment and control of the leading chronic
diseases.
The samples of 19,372 respondents aged 60 years and over were drawn
from those included in the multi-staged sample national survey during JanuaryAugust 2004.  Methods of data collection were interview, physical examination
and laboratory findings. Descriptive analysis was used to estimate the size of the
conditions and prevalence at the national level, base on standard criteria for diagnosis of chronic diseases and levels of their effective control.
With regard to behavioral risks, prevalence of cigarette smokers decreased
with ages, the rate among males was nine times over that of females. Alcohol
drinking decreased in a small proportion. Insufficient physical activities as well
as fruit and vegetables intakes based on standard criteria were observed at high
rates (80-90percent), increased with advanced ages and the oldest females were
the worst.  For biological health risks, anemia and underweight appeared to increase with advanced ages and lower proportion of obese elderly respondents
with advanced age was observed.  Selected chronic diseases were hypertension,
hypercholesterolemia and Diabetes Mellitus, of which known as high risks associated with major cardiovascular events for example, stroke, ischemic heart, and
long- termed diabetic consequences.Age-adjusted prevalence of hypertension
were at 51.6 percent, diabetes 14.8 percent and high cholesterol 25.4 percent.  While
overall proportion of unawareness of those chronic diseases were reported to be
56.8 percent for hypertension, 41.2 for diabetes and 81.5 percent for high cholesterol.  The proportions of those treated and control of blood pressure, blood sugar
and blood cholesterol were12.4, 26.4 and 10.3 percent respectively.  Women were
found to be more aware of their illnesses, received treatment with effective control than their men counterparts. An ineffective control group was observed
among the oldest - 80 years and over- of both genders.
In conclusion, there were high prevalence of hypertension and diabetes
in the Thai elderly with high percentage of unawareness and inadequate control
of those treated.Screening program for early detection was essential.  Treatments
of these diseases to maintain adequate control should be improved
The violence in the Southern provinces in Thailand took a toll on physical, psycho-social and spiritual health.  Data collection began from March 2004
to March 2007 using questionnaires, face to face interview including group seminars and brainstorming sessions.  It was found that the frequency of chaotic events
occured 5,460 times during January 2003 to August 2006.  About 1,730 have been
killed and 2,513 injured.  These victims included 22 health workers and 31 health
volunteers.
In the prime of the violence, every single hospital has prepared itself to be
ready to cope with those crises.  Health workers, for example, suddenly changed
their behaviors substantially such as adjusting their work schedules, not
wearing uniform, taking more precautions, decreasing or avoiding their proactive roles in field works, particularly health promotion and health prevention.
These were remarkable changes in health care roles which would have long term
serious effects on the communitiy health.  In addition, security in hospitals has
been tightened while stocks of food became critically necessary.  Some local health
offices rearranged their teams by having village health volunteers working closely
with their health officers.  These actions could boost their morale and ensure
their safety. Community faith in them and being natives inspired health workers
to remain in their posts.
It was interesting that the number of cases of out-patient and in-patient
departments had not changed much but the number of patients visiting local
health offices clearly decreased.  Nevertheless, the number of patients in labor
departments increased and the chronic disease cases increased as well.  Besides,
the number of cases with psychosis or having mental problems sharply increased.
Eventhough, the turn over and replacement of health workers became even but
the lack of medical specialists in some areas remained.  Number of registered
nurses would become the major concern in the near future if the violence is not
restrained.
The crisis dictates requirements on short-term measures to focus on security, life protection, creating the supporting systems about counseling, referring,
transferring and maintaining the systems.  In the long run, measures include
peace restoration, then, create health participatory system of people in communities, self-care system and enhance effectiveness of health system.  It should be
concerned about the opportunity to build Muslim medical curriculum and
agenda.  Having a specific team work to monitor the situation closely, connecting and communicating with the government and developing the participatory
management of data system and solving the problem may gradually decrease
the violence.  In addition, research and development on the consequences of the
health system of the restive southern provinces are required in order to cope
with the drastic change.
The prevalence and burden of chronic diseases, particularly diabetes, are
rapidly increasing in Thailand and worldwide. Yet in a national survey, it was
reported that 41 percent of those diagnosed with the diabetes were unaware of
the condition and only 26 percent had their blood glucose controlled effectively.
The national health care cost for the  3 million cases is estimated to amount to
350-840 billion baht in 2007. Several studies have been reported that microvascular complications existed prior to the diagnosis of diabetes and later resulted in
retinopathy (10-29%), proteinuria (10-36%) and neuropathy (9%). Furthermore,
risk of macrovascular complications and their death rates of those with prediabetes were equal to those with diabetes and twice of those without. Studies
showed that among those with high risk, the chance of developing to diabetes
can be reduced by changing to  of healthy life style - nutrition, physical activity,
and weight reduction - which cut down the incidence of diabetes by 58 percent.
It was reported that risk factors among Thais that might be related to diabetes were   high blood pressure, over weight, high blood cholesterol, inadequate
fruit and vegetables intakes, limited physical activity and malnutrition.
In Thailand, among those with diabetes, the prevalence of diabetic complications were nephropathy 43.9%, cataract 42.8%, retinopathy 30.7%, ischemic
heart disease 8.1% and stroke 4.4%. In Finland, the major causes of death among
over half of cases with diabetes type 1 and 2, were myocardial infarction and
ischemic heart disease.
Review of national diabetes prevention and control programs of the United
State of America, Canada, England, Finland and Australia shows that programs
on prevention of diabetes type 2 by changing of life style were commonly endorsed. Advocacy on early diagnoses by screening service for high risk group
and underserved population were clearly spelled out. However, the program in
Finland used a screening questionnaire focusing on risk factors to identify those
with high risk rather than depending alone on laboratory test. Similarities were
reported on the efforts of the 5 developed nations to provide high quality service, continuing care and forming networks at all levels reaching communities
in particular. Many of them underlined the essential of adequate information for
general population in order to increase awareness and commitment in changing
life style. Likewise diabetic patients need this continuing health information pertinent to their participation in treatment and self-care. The national health plans
always underline strategies to strengthen infrastructure and capability of the
health services and health manpower development.
Second opinion is one of the efficient medical procedures to enhance
quality and reliability of health care system, particularly from the patient’s point
of view. To be applied in Thailand, this will provide evidence of Thai patient’s
rights enhancement as well as consumer empowerment, in terms of allowing
consumers to receive better quality of health care services.  The objective of this
study is to review the literatures related to second opinions and people’s access
to public health information, with the aim to find out preliminary information
required for a proper development of second opinion system in Thailand.
Outstanding labour migration has been reported in the northern region
of Thailand leading to changes in physical and social aspects.  Subsequently effects on health status at individual, household and eventually community level
shall be witnessed.  This article was aimed at presenting situation, recommended
research issues and strategies in order to develop preventive measures and reassurance of adequate health services accordingly.
Presently, labour is classified as formal and informal.  Whereas, the latter
is not yet entitled to legal protection and benefits of the social security scheme.
These discriminations exist among some industrial labors undergoing unfairly a
series of probation periods.  As such, the phenomena calls for research related to
situation and pattern of employment; classificaiton of labor and required health
care/insurance; their health behaviors and proper health promotion measures.
Safety regulations and guidelines in working place, particularly in small,
and medium enterprises have often been neglected and the premises can avoid
monitoring of the public sector.  It may critically call for strong participation of
community and local health facility.  Research effort should, then, be made on;
development on tripartite monitoring and surveillance on safety work place,
labor protection system by community, and labor in home industries, guideline
for labor protection from occupational health risk, guideline on rehabilitation of
vulnerable labor with participation of family and community, an of health status
and safety of labor in service sector.
Haphazard movements of labor on provincial, regional and national
levels do not accommodate registration, provision and coverage of health care
and insurance with respect to their health needs.  Further development of health
care system, hence, should focus on accessibility.
Health and safety regulation information should also be disseminated.
The research issues should cover on an effective model for disseminating health
and safety regulation information at community level, life skill for adapting in
cross cultural environment, community and health facilities roles and functions
on surveillance on health, and self-care empowerment of labor Based on information synthesis and brain storm of experts and stakeholders, research strategies and issues were formulated as follows: strategic I promotion health of labor at community and strategic II self-care empowerment of migrant labor.  The research issues of strategic I include situation of labor health,
classification of labor based on health care system, effect and impact of Free Trade
Act (FTA) and new production pattern on health, monitoring and surveillance
on safety work place and labor health problem, labor protection at community
industries, health protection and rehabilitation of labor with high risk, and perception on labor’s right at community.
The objective of the study is to study the mechanism of human subject protections focusing on ethics committee in central part of the Ministry of Public Health. The methodologies include literature review, questionaire, and indepth interview. The study revealed that most of Departments in the Ministry had established ethics committee, i.e., Ministry of Public Health, Department for the Development of Thai Traditional and Alternative Medicine, Department of Medical Service, Department of Disease Control, Department of Medical Science, Department of Mental Health and the Health System Research Institute. There are institutional ethics committee in Department of Medical Service, e.g., the National Neurological Institute and the Queen Sirikit National Institute of Child Health. Most of members of the committees acquainted with the international ethical principles and guidelines for research involving human. The composition of the committees are in line with international guidelines. Each committee have their own guidelines and standard operating procedures. Only one committee has been surveyed, evaluated, and recognized by SIDCER/ FERCAP Recognition Program, i.e., the Ethics Committee for Thai Traditional and Alternative Medicine. Since the research is not the first priority of the Ministry of Public Health, there are some shortcomings that need consideration for correction and improvement. Most of medical and health journals have no policy for requirement of ethical clearance of the studies submitted for publication. Most of the ethics committee focussed only on preview of the protocol, no proactive activities on continuous review and site visit. Most of the committees review both scientific and ethical aspects meanwhile most members of the ethics committee have limited knowledge and experience in research on advance and complicated sciences. The supports of most committees are insufficient. The information  technology are not fully used in most committees. Some committees have problems in timely review and may have doubt of independence in some cases.
The objective of the study is to review ethical considerations for research in routine practices. The main question is whether these researches need ethical review or not. The study concluded that, first, there is need to distinguish among practice, experiment and research. Any works that contain research element in part or whole should be submitted for review by Ethics Research Committee, if the researches involving human subjects, which included biomedical, behavioral and social sciences researches. The rationale is to ensure that  human subjects or research participants are appropriately protected in dignity, rights, safety and well-being according to international ethical principles in human research. However, the burden of ethical review should be appropriately managed. The researches should be categorized by their risks. The researches that contain minimal risks should be considered for expedited review.
In late 2006 and early 2007, the Thai government announced its intention to introduce the use by the
government of patents for three pharmaceutical products: two antiretrovirals (ARVs) and an anti-thrombotic
drug. This action, which was aimed at improving access to essential medicines in the public sector,
complied with the flexibilities of the Agreement on Trade-related Aspects of Intellectual Property Rights
(TRIPS). By employing qualitative approaches, this study assesses the involvement of key stakeholders in
the policy process. This analysis suggests that the idea of enforcing TRIPS flexibilities for expanded access to essential
medicines in Thailand was adopted as a public policy when the new government took office after a change
in the political system in September 2006. This policy obtained significant support from non-governmental
organizations in the health sector, patient groups and academics, both inside and outside the country.
However, the action by Thailand was strongly opposed by patent-holding companies, the multinational
medical industry and their national governments. The contributions from civil society were managed in
several forms, such as technical and information support and demonstrations to advocate the policy. Meanwhile,
powerful nations introduced trade retaliation and put political pressure on the Thai side. Global
concern about the unaffordable costs of patented medicines that hampered access to essential health care
in the South was beneficial to the enforcement of the government use provision. The potential diffusion of
this policy from Thailand to other developing countries triggered serious opposition from stakeholders
who lost their benefits.
Recent studies on catastrophic health expenditures often use arbitrary and universally cut-off shares
(e.g., 10 percent) of health expenditures on household income (or on total household expenditure) as the
main indicator of catastrophic health expenditure. However, some empirical studies in Thailand which
employed such indicators ended up with counter-intuitive findings, e.g., a substantial percentage of households
in the richest quintile were found to be prone to catastrophic health expenditures, and more often
than not, at higher rates than those with lower income.
This paper uses the same set of data to demonstrate that the counterintuitive results resulted from
such faulty indicators. Using sophisticated household-specific poverty lines as a measure of household catastrophic expenditure, the study finds that, unlike households in the two lowest quintiles, it is extremely
rare for those with higher-than-median income to have their post-health-expenditure income fall
below the poverty line, a result which is completely opposite to those derived from the former indicator.
However, since the head count of health-related impoverished households is not sentitive for those
households that are already below the poverty line, the study proposes a supplemental indicator, that is,
changes in the normalized poverty gap due to health expenditure, as an indicator that measures the healthexpenditure
impact on poverty.
Capacity-building for health policy and systems research (HPSR) is a vital component in supporting
health system capacity in order to achieve certain health goals. Currently, a number of obstacles prohibit
the use of HPSR in real policy decision-making. These include selective use of evidence to support previously
set policy agenda, inadequate funding and support for HPSR, inadequate human resources and
poor research capacity, resulting in low-quality research. It is belived that capacity-building for HPSR
would help break the above-mentioned vicious cycle.
This paper is aimed at informing all stakeholders about the potential approaches to build up HPSR
capacity. It was conducted by (a) reviewing the literature, (b) using a questionnaire survey of existing
research capacity within the Health Systems Research Institute (HSRI) network aimed at identifying capacity
gaps and the current practices in building up research capacity, and (c) in-depth interviews with
key persons of leading research institutes, namely, the International Health Policy Program (IHPP), Epidemiology
Unit of the Prince of Songkhla University, and the Thai Research Fund, to learn from their
experiences in capacity-building.
Definitions of capacity-building and HPSR, and the potential approaches for building research capacity
were given. Results from the survey indicated that there is an urgent need to build up research
capacity at both the individual and research institute levels through formal and informal education, networking,
involvement of policy actors and the public in setting up research agendas, conducting research
and disseminating the research results. Lessons learned from the leading research institutes revealed
several key successes, including leadership, long-term and flexible research grants, critical mass,
multidisciplinary teams, and relevant policy research. At the end of the paper, the information gathered
was used to construct recommendations for HPSR capacity-building in health research institutes.
The importance of primary care has increased since the recent health-care reform but no systematic
evaluation has been done. This study was aimed at assessing primary care in Thailand. The primary-care
system questionnaire originally developed by Barbara Starfield was used to assess nine primary-care
domains, namely, resource allocation, adequacy of facilities, first contact and co-payment requirement, longitudinality, comprehensiveness, coordination, family-centeredness, community orientation, and professional
personnel. Respondents were 77 primary care practitioners from 13 different provincial hospitals.
The findings showed a response rate of 53.25 percent. Providers stated that (1) the resource allocation
was not appropriately based on intimate needs, although there were some special provisions for
underserved segments of the population, (2) basic equipment and supplies were not adequate in some
regions, (3) consultation with a provider at the primary-care level was required before assessing to seek
other care, whereas the co-payment requirement was low, (4) most patients were seen by the same provider
team on every visit, (5) primary-care services are comprehensive although regional variations were
evident, (6) coordination, family-centeredness, and community orientation were satisfactory, and (7) nurses
were key providers at primary-care facilities.