plueme/wizJson huggingface dataset:
This study aims to study environmental management in household and community by elderly people and by local administrative organization (LAOs) in rural areas of Thailand, to synthesize model for the environmental management and then to assess the model. Questionnaires with four hundreds elderly people and one hundred local administrative organization and a survey of eight case studies in environmental management for elderly people from local administrative organization were used to gather data. Interviews to experts on elderly people and environmental management were also carried out.Data was analyzed in order to find out model for environmental management for elderly people.
The results showed that LAOs have allocated resources for environmental management for elderly people at high level and provided facilities for elderly people at moderate level. While, LAOs have law enforcement, measures, plans to support environment management for elderly people at moderate level. The influencing factor for enhancing quality of life of elderly people is to be a volunteer.The results from questionnaires of elderly people indicated that municipal waste, natural disasters, floods, droughts, landsides, soil subsidence and storm are major environmental and natural resource problems in community. More than half of the elderly people resemble a residential two-floor detached house, which have bed bathroom, toilet bowl and seat and handrail. There is no device or place for recreation activities for elderly people. According to elderly quality of life, they have problems about uncertain incomes. From the results mentioned above, a manual for environmental management for elderly people in rural areas is composed of 1) energy
management, 2) water management, 3) waste management in households and 4) local wisdom in organic agriculture. The manual was tested to five communities and it was found that LAOs have issued policy in environmental management especially waste management. Assessment of the model for environmental management for elderly people
in rural areas of Thailand by using the manual showed that LAOs in each rural area
have clearly issued in environmental development strategies and have carried out
projects and activities for improving quality of life of elderly people to support environmental management in the community for example the waste bank project,
the municipal waste management campaign project and the increase forest areas in
community project.
Background and significance: Peritoneal dialysis (PD)-related peritonitis is a common serious complication among PD patients leading to technical failure and a significant cause of morbidity, mortality, and healthcare costs. For the treatment of peritoneal dialysis (PD)-relatedperitonitis, intraperitoneal (IP) administration of antimicrobial agents is recommended due to its higher concentrations at the target site and more success compare to intravenous administration. Besides, prevention strategies of PD-related infection are still unclear. This research programs consists of three research topics. Objectives: 1) To (1) systematically review and meta-analyses the effectiveness of different empirical treatment options for PD-related peritonitis and (2) to examine the temporal trends, potential predictors, microbiological pattern with antimicrobial susceptibility rates, treatment patterns, and clinical outcomes of PD-related peritonitis. 2) To (1) systematically review bundles all published stability and compatibility of data on IP administration of antimicrobial agents via PD solutions and (2) to investigate the physical and chemical stability of selected antimicrobial namely: imipenem, meropenem, ertapenem, cefazolin/ceftazidime, and cefoperazone/sulbactam in 6 type of commercial PD solutions with polyvinyl chloride container that available in Thailand (Extraneal®, Dianeal® PD2: 1.36%, 2.27%, and Dianeal® Low calcium: 1.36%, 2.27%, 3.86%) at different temperatures for various time points. 3) To compare effectiveness, safety, and cost-utility of chlorhexidine gluconate (CHG)-soaked cloths to mupirocin ointment and exit site usual care (normal saline) with aseptic technique in prevention of PD-related infection. Conclusions: In contemporary review, evidence of antimicrobial for treatment of PD-related peritonitis is limited. No specific antimicrobial in terms of route, dose, schedules, and optimal antimicrobial agent or regimen appear to have superior efficacy for treatment of PD-related peritonitis. There was a downward trend in PD-related peritonitis incidence over this past 10 years to 0.39 episode per patient-years. Causative organisms for peritonitis of gram positive bacteria decreased, but gram negative bacteria increased over time. In daily practice, a combination of cefazolin and ceftazidime is suitable for mixed with icodextrin-based and glucose-based PD solutions at least 24 hours at body temperature. Carbapenems group appear insuitable for IP administration. Likewise, to concern the degradation products, a combination of cefoperazone with sulbactam should not be mixed with PD solutions. In addition, the study to compare effectiveness, safety, and cost-utility of chlorhexidine gluconate (CHG)-soaked cloths to mupirocin ointment and exit site usual care (normal saline) with aseptic technique in prevention of PD-related infection is ongoing to the second year.
Childhood is an important age for growth and continuing development. A child is more
likely to reach their full potential if they recieved adequate care. The care giver has a crucial role in raising, delveloping and making sure the child receives adequate care and health supervision to enable the child to be healthy so that they become our country's future asset . Mobile applications are becoming more popular with increase usage at affordable prices. We developed a mobile application (KhunLook Mobile Application) as a platform for parents, caregivers and health care providers. It can keep health and immunization records, eases basic child health supervision assessment, developmental screening and enables notifications. It contains health supervision and anticipatory guidance information from creditable sources made readily accessible to its users in Thai language. The information can be accessed from smartphones, tablets or computers and supports numerous and a wide range of users. It also has a back up feature and can be easily updated when health care information and child health supervision guidelines are revised KhunLook Mobile Application is easy to use and enables parents to initially assess their child’s health parameters. It is distinctive for it’s mobile and back-up features; it supports up to date health care knowledge and is scalable. There was no statistically significant difference between the agreement of parent-physician assessment of their child’s health status by using KhunLook Mobile Application or the Maternal and Child Book. KhunLook Mobile Application received higher overall scores than the Maternal and Child Book; the difference was statistically significant in all subject groups. KhunLook Mobile Application benefits parents, caregivers and health care professionals. For maximal potential it should be ongoing studies, it should be endorsed and supported for more user coverage and sustainable future development.
The second year of Healthcare Healing Environment Design project (HHED) focus on the implementation of the HHED’s Assessment tool on the 17 project member hospitals along with the environmental improvement according to the assessment tool and selecting an area or a building to improve to be a model of HHED and also develop a related research topic according to HHED concept, finally, evaluating users experience from the improvement of the physical environment in order to create academics reference and development of Thai healthcare system.  The reflection from the users on the visiting of 17 member hospitals on healthcare healing environment problem, we found problems in 2 dimensions, firstly, for the infrastructure, it is lack of functional using area, secondly is the poor environmental quality that impact work performance and user’s well-being such as heat, poor air quality, bad ventilation which cause staffs’ infection as well as the exceeded standard of carbon dioxide quantity, too many sources of noise that reduce the efficacy of staffs’ productivities, lighting with both not enough light cause the medical errors and the reflection of glare light.  From research team’s perspectives, besides those 2 dimensions of problems, we found that there are too many poor-quality media installed on the visual field that increase stress for the user such as direction signposts, room name/ department name those are too diversity and not in a unity format. Sometimes it cause confusion or even straying. While producing various media to communicate to the users, for example, the service instructions, Patients’ terms of service, etc. These badges do not work in practical, the staff still have to answer the same questions which appearing on those badges there is also a large amount of health education media board that is not designed to be interesting. On the contrary, the user refuses to consume the medical education information provided by the hospital because there is too much details that users cannot remember and apply in daily life.  From such problems, there is a key issue in selection areas/ department/ buildings as the hospital selected pilot areas for the development of environmental quality that will be caped as healing environment. It is still in the process of collecting evidence of the problem to improve physical environment and the central research team will assist on designing the area according to the context. After the improvements, the research team will collecting data to evaluate user experience according to the improvements that is in the research processes of the third-year of the research project based on user experiences from 5 aspects from the HHED assessment tools which are: 1) Function and safety, 2) Sensing and comfort, 3) Interaction and support, 4) Empowerment and informed choice, and 5) Value and spirituality.
An attempt to expand health insurance to cover ‘everybody’ on the Thai soil has been
implemented for years, as evidenced in the Vision of the National Health Security Office (NHSO) and the Border Health Plan of the Ministry of Public Health (MOPH). One of the issues that have caught political attention is a continuing growth in the volume of migrant children born in Thailand. However, the number of migrant children, who have been enrolled in the public insurance is quite limited. Such a situation creates a concern as to whether these migrant children received adequate immunization. This point also links to a risk of emerging and reemerging diseases that cause public health threats. Therefore, the objectives of this study are (1) to draw lessons from international experiences in managing health promotion and disease prevention services for migrant children, (2) to explore the current situation in managing health promotion and disease prevention services for migrant children in Thailand in terms of pros, cons, and challenges from the perspectives of policy makers, local implementers, and service users, and (3) to estimate budget impact for supporting vaccination program for migrant children in Thailand. The researchers applied parallel mixed methods design. Objective 1 employed narrative literature review approach as the main data collection tool. The majority of literature was retrieved from grey literature databases in the European Union. Objective 2 used in-depth interviews with policy makers, local implementers, and service users. Objective 3 applied quantitative analysis on secondary data (43 standard folders of the MOPH). Fieldwork was conducted in 4 provinces where migrants are concentrated.  This study still faces some limitations as follows. Firstly, a narrative literature review is more prone to bias than a systematic review. This is because the narrative literature review lacks rigorous quality screening process on the selected articles. Secondly, the interviews in Objective 2 involved a small number of participants, and other qualitative data-collection techniues, such as participant observation, were not extensively exercised. Moreover, it is difficult to blind the interviewees to the professional status and workplace of the researchers. These factors more or less affected the validity of the interviewed information. Thirdly, the study involved only 4 provinces. Thus generalization ability of the findings is quite limited. Lastly, the calculation in Objective 3 relies on many presumptions. Some postulations used fingures or numbers from previous studies that were conducted long ago, and the analysis was confined to material cost only. Hence, if the findings in this study are to be used for policy advocacy, there should be a process that allows all stakeholders to discuss and agree on the assumptions since the beginning, before delving into the calculation. Besides more updated figures should be used as references and the calculation should include other incurred costs (such as administrative cost and labour cost).
Background: End stage renal disease (ESRD) affects the quality of life and causes the high cost in health care system. The prevention of ESRD is the early recognition and appropriate treatment. Glomerulonephritis is the third most common cause of ESRD in Thailand. Thai Glomerular Disease Collaborative Network (TGCN) was established to evaluate the epidemiology and clinical outcomes in the glomerular diseases and helped to promote the good system to taking care of these patients. Methods: TGCN originally consists of 9 tertiary care centers and expands to 20 hospitals. We conducted a prospective cohort study in the adults’ native kidney biopsy proven glomerular diseases between July 2014 and Mar 2017. The clinical and laboratory parameters at the time of biopsy, pathologic findings, treatment regimens and clinical outcomes were recorded via on-line registry. Results: We recruited 1,556 patients performed native kidney biopsy during Jul 1, 2014 to Mar, 2017. The female to male ratio was 1.88:1. The average age, creatinine, albumin, and cholesterol were 43.4+16 years, 2.11+19 mg/dL, 2.9+0.8 g/dL, and 294+131 mg/dL in respectively. The median proteinuria was 3.7 (0.02-25.3) g/day. The patients presented with 40% of nephrotic syndrome, 21.7% of nephritis, 19.4% of nephrotic nephritis, and 60.8% of renal impairment (creatinine>1.2 mg/dL). The renal pathological findings showed 33.9% of LN, 13.5% of IgAN, 10.5% of FSGS, 7.4% of minimal change disease(MCD), and 7.1% of membranous nephropathy (MN). The mean age of LN, IgAN, FSGS, MCD, and MN were 34.9, 39.4, 47.7, 46.5 and 52.6 years. The median creatinine at biopsy of LN, IgAN, FSGS, MCD, and MN were 1.08, 1.76, 1.65, 1.02 and 0.98 mg/dL. Conclusion: Our study described the common renal pathological findings including LN, IgAN, FSGS, MCD, and MN. The clinical outcomes and prognosis of these diseases were described in the complete report. In the second year, we have performed the recommendation for management in glomerular disease, FSGS and MCD in adult Thai patients.
This research aims to 1) propel the handicapped elderly care in the community to
receive rehabilitation properly. 2.) developments in public health volunteers, a case
manager in the care of older people with disabilities in the community effectively 3) Create
a list of cases of people with disabilities. The cooperative research (PAR) of the research
team with the Nakean community in Nakhon-si-thammarat province using the AIC technique, which has the creation of knowledge, development guidelines, practice and evaluation. The sample are 32 village health volunteers who jointly take care of 50 elderly people with disabilities in the community. The data were collected using pre-post test. Data analysis by content analysis, mean and percentages. The study found that: The management pattern can be summarized as follows: 1) sub-district health promotion hospital explore elderly with disabilities 2) Clarify the role of case manager with public health volunteers. 3) Training course “Capacity Building of Community Volunteers to be Case Manager of Community Dwelling Elderly with Disabilities.” 4) Organize teams to take care of elderly with disabilities people in the community. 5) Record visit and sent to sub-district health promotion hospitals every month. 6) Sub-district health promotion hospitals monitor the performance of public health volunteers 7) coordinate with external agencies involved in helping and caring for the elderly disabled. Public health volunteers are trained in both theoretical and practical subjects pass 100 percent. After the training they have increased in all aspects. In terms of basic knowledge on the rights of elderly with disabilities people (97.34%), knowledge on health assessment and screening (95.78%). Thus The Department of Health Service ,Support Local administration and Subdistrict Health Promotion Hospital should a role in the health of people in the area. Especially bedside patients and should provide services that facilitate access to older with disabilities people. And should provide training for public health volunteers.
Development of data visualization system for the National Health Examination Survey data on the internet is a data presentation platform in addition to traditinal survey report. Users of the system can access via the internet and can select data and related variables for comparision as well as compare data over time between survey rounds. The National Health Examination Survey data used in this system consists of 3 rounds including the 3rd round in 2004, the 4th round in 2009 and the 5th round in 2014. This data visualization system presents 17 groups and 63 lists of outcome data. There are 3 types of outcome data consisting of proportion, multinomial proportion and mean. Data analysis for preparing data to be used in data visualization system is pre-calculated data from individual survey data for each survey round. It is a semi-automated process using ready-to-use command scripts that create summary tables to be further imported into the data visualization system. The design and development of data visualization system focuses on the flexibility of data selection and variables selection for disaggregation that can be 1 variable or 2 variables for presenting one particular round of survey data or one variable for presenting overtime comparison across 2 or 3 survey rounds. The variables for disagregation consist of sex, age group, region and administrative type of area. The data presentation is in form of bar chart for proportion and mean while stack bar chart is used for multinomial proportion. Graphs created by the system can be exported into image file, document file and spreadsheet file (Excel) for futher use in other platform. The system also provides the number of samples for each data disaggregated by selected variables for further use and reference. The aspect and use of data can be various such as indicating target population and area for each health problem, indicating distribution of severity of selected health problem and indicating trend of health problems over time. The access and use of the system covers general users as well as specific technical users related to specific health topics or health systems. Data presented in the system can be extended to further health movement and relevant policy recommendation. For system maintenance and updating of survey data in the future, the system allows modification and addition of new data by adjusting reference table and variables. The command script for preparing and analyzing data is semi-automated process creating new summary data for importing into data visualization system on the internet without need for development of new system.
The Thailand Antimicrobial Resistance (AMR) Containment and Prevention Program, utilizing a One Health approach, has been implementing the following 10 operational actions in accordance with the World Health Organization (WHO) global action plan on AMR since 2013. They are: 1) estimate the national AMR burden; 2) determine the AMR prevalence and AMR chain in Thailand; 3) develop a national AMR containment and prevention governance structure; 4) develop laboratory and information technology systems for surveillance of AMR, antibiotic use and hospital-acquired infections; 5) regulate the use and distribution of antibiotics in humans and food animals; 6) design AMR containment and prevention campaigns; 7) generate local evidence to promote responsible antibiotic use and infection prevention and control practices; 8) create the AMR campaign packages; 9) implement the AMR campaign packages in selected communities; and 10) conduct research and development of AMR surveillance, diagnostics, and therapy and prevention of AMR infections. The major outputs, outcomes and impacts of the Thailand AMR program are: the magnitude of the AMR burden in Thailand was established; AMR campaign packages for health professionals and laypeople were developed according
to the established AMR chain and AMR prevalence in Thailand; and locally-generated evidence on the responsible use of antibiotics and infection prevention and control (IPC) is available. Implementation of AMR campaign packages in 4 pilot communities revealed their effectiveness in terms of improved awareness and understanding of AMR, responsible use of antibiotics, and compliance with IPC practices. Many containment and prevention measures from the Thailand AMR program have been adopted as national policy and implemented nationally.
Irrational use of antimicrobials is a major problem that leads to antimicrobial resistance. Examining patterns and amounts of antibacterials prescribed from health facilities is one strategy to monitor antimicrobial use. Method: This study employed claims data of the National Health Security Office and pharmaceutical manufacture and imports of the Food and Drug Administration in 2013 to calculate amounts and costs of antibacterials prescribed in outpatient departments. Findings: The total amount of antibacterials prescribed to outpatients in 2013 was 117.3 million defined daily doses or 7.1 DDDs per 1,000 population per day. Prescriptions with antibacterial agents accounted for 19% of all outpatient prescriptions. Amoxicilin was prescribed the most at the amount 58.7 million DDDs and costed 215 million Baht. Health centres were the main prescribers using 52% of the overall antibacterial use. Mae Hong Son, Ayutthaya, Samut Songkhram and Phatthalung were found to have high proportions of prescribed antibacterials. Conclusion: Monitoring antibacterial uses should be integrated in the national drug surveillance in addition to the normal reporting system of pharmaceutical manufacture and imports.