plueme/wizJson huggingface dataset:
The aims of the present descriptive study of foreigners being employed as hospital workforce in Thailand were to explore the characteristics of foreign hospital employees, factors influencing decision making of foreigners seeking employment in Thailand, the process of being employed as foreign hospital employees, and problems or obstacles encountered while working in Thailand. One hundred foreign hospital employees in both government and private hospitals in Thailand were recruited using snowball sampling. A questionnaire was used for data collection. The data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. The results revealed that most participants were females with the mean age of 31.23 years. One-third of foreign hospital employees were the Filipinos. Success factors of being employed in Thailand included level of education (68%), competencies/special skills in needed fields (64%), and ability to communicate in Thai (55%). Factors influencing foreigners making decision to work in Thailand covered both push factors (such as low wages, limited career progression, unfair benefits, and high living expenses) and pull factors (including gaining new experience, job opportunities, and opportunity to improve career). The processes for being employed as foreign hospital employees included 1) preparation phase: foreigners prepared on language, working knowledge and employment laws, and health check-ups 2) application phase: most foreigners applied for a job themselves after receiving information. A tourist visa was initially granted at first arrival in Thailand and then changed to a non-immigrant visa “B”. The expenses of application phase included a visa, passport, work permit, and travel. Most participants (93%) were working as medical service assistants, such as interpreters and 7% were qualified to work as health care providers as described under the mutual recognition arrangement (MRA). Communication in Thai, adjusting to social and cultural differences, unfair wage, visa and work permit renewal were indicated as problems or obstacles encountered while working in Thailand. The recommendations from the present research were as follows: 1) stakeholders should revise the process of work permit renewal, and MRA; 2) the organization or employer should provide a basic training program in healthcare competencies, and improve workplace culture, including setting up appropriate remuneration system as international standard and equity basis.
Smartphone is used widely by children and adults. Previous studies have shown that using smartphone can lead to certain struggles, especially for university students. However, there has yet to be evaluated on the effect of muscular pain while using smartphone in other age groups. The evidence gathered from this current study could be useful in preventing adverse health problems caused by smartphone usage in all age groups. The purpose of the study was to examine pain at the neck, shoulder, upper back and arm areas after smartphone use for 20 minutes. Smartphone was used in 3 positions during the study (on the chest level, on the table, and on the lap). Seventy-five asymptomatic users aged 10-48 years old were recruited into this study. The participants were assigned to use smartphone in random orders of each position. Location and severity of pain were measured by using a body pain chart and visual analog scale (VAS), respectively. The results showed that 1) After smartphone use for 20 minutes, pain at the neck, shoulder and upper back areas increased significantly and the pain increased in all age groups (p-value<0.05). 2) Office workers had higher pain significantly in the neck and shoulder; higher than high school and elementary school students (p-value<0.05). 3) Neck pain was found 164 times in the overall 225 studies, followed by shoulder, upper back and arm pain. 4) Neck pain showed the highest severity in the lap position in high school students, whereas it showed the highest severity of pain in the chest position level in elementary school students and office worker groups. 5) Smartphone use on lap caused the highest number of participants (96-100%) reporting pain in various regions of the body. In addition, using the device on lap led to the highest intensity of pain in the marked region, and also the highest pain level, overall. In conclusion: smartphone use caused pain at neck, shoulder and upper back areas in 3 separate positions in all age groups.
Effective human resources for health (HRH) planning require evidence-based information to support the decision making. HRH requirement projection in line with desired health service system could therefore be compared with HRH supply projection in order to identify gaps. Gap analysis leads to the development of the HRH plan in order to solve those problems. HRH requirement projection could be carried out both at national level as well as at health facility level. The approaches used to forecast the HRH requirements at national level are: population ratio method, health needs method, health demand method, and service target method. Each approach has its strengths and limitations. At health facility level, the HRH forecast emphasizes on task and functional, skill mix, productivity, etc. Approaches used for the HRH projection include: skill mix, workload indicators of staffing need (WISN), task and functional analysis. Recommendations to strengthen HRH requirement projection to support effective HRH planning include: 1) HRH projection should be revised often to be in line with the changing context, 2) HRH information to support HRH projections should be updated, 3) HRH requirement projections should be done at national level as well as at facility level, 4) HRH requirement projections should not be done separately by each profession, but should be rather forecasted interrelated among health teams, 5) choosing appropriate method of HRH projection.
The Ministry of Education (MoE) and Ministry of Public Health (MoPH) have been jointly implementing the health-promoting school (HPS) program since 1998. This program aimed to improve students’ health and education simultaneously. The Department of Health established operating standards and evaluation processes for accrediting schools in four categories (from lowest to highest): bronze, silver, gold and diamond. One of the operating standards, School Health Services (SHS), required schools to maintain student health records and reports used to evaluate the performance of the schools. However, the quality and use of the health data collected as a result of implementing the SHS had not been assessed since the inception of the program. The purpose of this study was to evaluate the situation of students’ health data management system in the SHS. The study focused on data collected from four physical exams namely, growth assessment, vision testing, hearing testing and dental examination, and vaccinations for primary school students. The study design was a descriptive in nature and applied mixed-methods. A stratified sampling approach was used with three strata: the first strata comprised two provinces; the second, nine schools; and the third, 118 informants from the education and health sectors, parents, and students. The data collection approach included in-depth interviews, a questionnaire, reviews of students’ health data and related documents. Descriptive statistics and content analysis were employed for data analysis. The results indicated that the students’ health data collected in both, diamond and bronze level HPSs, was incomplete. This may be because multiple tools were used for recording and reporting students’ health data in sample schools. Furthermore, many of these tools had overlapping content thus increasing the burden of the staff. In addition, it was found that schools did not maintain students’ health data systematically and continuously after receiving the accreditation. Finally, a difference in the priorities of the data collected by the school staff and health workers was observed. While school staff only recorded weight and height data by the MoE, health workers focused on recording health data related their key performance indicators and not those specified by the operating standards of the program. Therefore, students’ health data was not clearly communicated and exchanged between the education and health sectors. This shows that there was no system for managing the data under this program, especially the system for monitoring and collecting data.
This research aimed to evaluate effective coverage in the prevention, control and treatment of type 2 diabetes, a case study from Dansai Hospital, Dansai District, Loei Province. Firstly, the diabetes longitudinal database was created to keep track of the population and patients. Secondly, the effective coverage of type 2 diabetes care was evaluated in three dimensions, including health needs, utilization and quality of care. In addition, the diabetes screening survey was conducted to find diabetes patients who did not take part in diabetes screening project in 2016 and were not yet registered in the diabetes treatment system. The purpose of this survey was to investigate the exact prevalence of type 2 diabetes in the catchment area of Dansai Hospital. . This study used quantitative research technique involving primary and secondary data. Primary data was taken from the survey to find diabetes patients from 3,214 samples. Secondary data was taken from Health Data Center and 43 Health Data Standard datasets of the Ministry of Public Health from 2014 to 2016. The criteria used for diagnosing diabetes were Hemoglobin A1c (HbA1c<7%) and Fasting Blood Sugar (FBS = 70 to 130 mg/dl). The results showed that the diabetes longitudinal database consisting of population, screening, treatment database and effective coverage results in My SQL format could be used for surveillance of 23,333 people and keep track of diabetes patients. In 2014, 2015 and 2016, 45.4%, 46.0% and 44.9% of total population aged 30-59 years, respectively. Moreover, in this 3-year period, the percentage of screening was 85.9%, 88.1% and 89.5%, respectively. This figure was 3.4% higher than it was in Loei Province, 0.6% lower than it was in Health Eight Region, and 15.5% higher than it was for the whole country. The diagnosed diabetes patients that received the treatment were 93.7%, 91.1% and 93.4%. 45.4%, 34.1% and 31.9% of the patients were able to control HbA1c. 40.5%, 41.8% and 38.0% of the patients were able to control FBS for 2 times. Moreover, the effective coverage in HbA1c condition was 31.9%, 23.6% and 23.1%; while 32.6%, 33.5% and 31.7% in the FBS condition. According to the diabetes screening survey, 33 persons with risk for type 2 diabetes were found which accounted for 1.2 % of the sample. Moreover, the risk group needs to have a re-check at the hospital to confirm the level of blood sugar. If 33 persons were diabetes patients, the prevalence would be 11 patients per 100 populations.
This collaborative action research aimed to develop a health service system for delaying dialysis in patients with chronic kidney disease (CKD). The research was conducted from January to December, 2017 at the outpatient department of Chumphae Hospital, Khon Kaen. Participants consisted of two groups: (1) the patients who had a diagnosis of chronic kidney disease (not more than stage 3b), had the underlying diseases of diabetes and hypertension, and received treatments at the study setting; and (2) The multidisciplinary team including physicians, registered nurses, and pharmacists. The process of conducting the research consisted of situation analysis, development of health service system model, and outcome evaluation. Data were analyzed through quantitative and qualitative methods. The results revealed that from the situation analysis and based on the chronic care model (CCM), the Chumphae model for delaying dialysis in CKD patients (Chumphae DDCKD model) was developed which has four components, including delivery system design, self-management support, clinical information system, and decision support. After the model was implemented at the 3rd and 6th month, the patients in a treatment group performed self-management behaviors better than before and better than those in a control group. Also, their eGFR declined only 27.1%, comparing to the control group 75% or 7.89 times of the treatment group (95% CI 4.79-12.77). Patient satisfactions of health service system in the treatment group were higher than the control group, comparing between mean 23.8 (SD 0.05) and mean 16.3 (SD 1.7). In conclusion, the Chumphae DDCKD model can help to improve self-management behaviors and effectively delay dialysis at the 3rd and 6th month in patients with CKD.
Aim/ Hypothesis: Caloric restriction in patients with type 2 diabetes mellitus and obesity can induce diabetes remission but the beneficial effects often disappear after discontinuation of caloric restriction.  Intermittent caloric restriction may be beneficial in the long term.  This study aims to examine the effects of intermittent caloric restriction by means of very-low calorie diet (2 and 4 days/week) on diabetes remission, glucose homeostasis, metabolic and anthropometric changes, quality of life, as well as beta cell function and insulin resistance.  Method: Forty-two patients with type 2 diabetes and obesity (mean age 40.6 years, BMI 36.9 kg/m2) were enrolled. Participants were randomly assigned into 3 groups (control [n=12], intermittent VLCD 2 days/week [n=14] and intermittent VLCD 4 days/week [n=14]) for 20 weeks.  They received blood tests, anthropometric measurement and answered the quality of life questionnaire at weeks 0, 2, 10 and 20.  Results: At 20 weeks, diabetes remission was found only in the intermittent VLCD 2 days/week and the 4 days/week groups (4 each).  Anti-diabetic medications were successfully withdrawn in 7, 9 and 12 subjects, representing 58%, 63% and 86%, in the control, the intermittent VLCD 2 days/week and the intermittent VLCD 4 days/week groups, respectively.  In both the intermittent VLCD 2 days/week and the intermittent VLCD 4 days/week groups, there were significant decreases in FPG, 2 hr glucose after a 75 gm OGTT, and HbA1C.  In addition, triglyceride level, body weight, BMI, body fat percentage, fat mass, fat free mass and muscle mass were significantly decreased.  Improvement in glycemic control was associated with a reduction in a decrease in insulin resistance. Quality of life was also significantly increased in borth VLCD groups.  No serious adverse events were observed.  Moreover, in the intermittent VLCD 4 days/week group, there were significant decreases in SBP, DLP, AST and ALT.  Conclusion: Intermittent dietary caloric restriction (2 days/week and 4 days/week) for 20 weeks was highly effective in rapidly achieving glycemic control without serious adverse ecvents.  Improvements in the intermittent VLCD 4 days/week were more pronounced than those in the intermittent VLCD 2 days/week.
Objectives: To evaluate the efficacy of adjuvant chemotherapy (ACT) in locally advanced stage cervical cancer after concurrent chemoradiation (CCRT) comparing to CCRT alone in terms of response rate, progression-free survival (PFS), and overall survival (OS).  Methods: Patients with FIGO stage IIB to IVA, aged between 18-70 years, had ECOG performance score 0-2, had histopathology of squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma, and had no para-aortic lymph node enlargement were randomized to CCRT (arm A) or CCRT and ACT (arm B). The patients in both arms had concurrent cisplatin weekly along with pelvic radiation. After a 4-week period after CCRT, the patients in arm B had paclitaxel plus carboplatin every 4 weeks for 3 cycles.  Results: Data analysis of 259 patients showed no significant difference of complete responses: 94.1% in arm A vs 87.0% in arm B (p=0.154). With the median follow-up of 27.4 months (range 3.2 – 49.0 months), 15.5% of patients in arm A and 10.8% in arm B experienced recurrences: (p=0.123). There were no significant differences regarding the loco-regional failure but the patients in arm B had significantly lower systemic recurrences, 10.1% vs 5.4% (p=0.029). The 3-year PFS and 3-year OS of the patients in arm A were not significantly different from those of arm B: 66.6% (95% CI, 57.4-75.8%) vs 63.4% (95% CI, 54.6-72.2%) for PFS and 80.1% (95% CI, 71.9-88.3%) vs 69.5% (95% CI, 59.3-79.7%) for OS. The hazard ratio of PFS and OS arm B compared to arm A were 1.26 (95% CI 0.82-1.96) and 1.42 (95% CI 0.81-2.49) respectively.  Conclusions: Adjuvant chemotherapy with 3 cycles of paclitaxel plus carboplatin after CCRT did not improve response rates and survivals compared to CCRT alone. There were no differences of loco-regional failure but a significant decrease of systemic recurrences by adjuvant chemotherapy.
Malaria is one of the major mosquito-borne diseases especially in tropical and sub-tropical countries, including Thailand. The weather in this area is suitable for living and producing offspring for mosquito, so it causes illness and died in people, who live in that area. Although it has few cases in Thailand yearly, Malaria is difficult to get rid of from Thailand. To make more understanding of behavior and environment of the disease, computational can be utilized to study disease. This research aims to make the reputation of mosquito-borne illness, so-called mABMs-MAR, which is a hybrid of combination for computational and mathematical methods. In term of computational, Agent-Based Modeling plays as the major method of simulation with the corporation with another model, such as the Global Stochastic Contact Model (GSCM). To make the relationships between hosts, humans and mosquitos. For a mathetical method, it will be used to shorten the processing time for small objects, which is the mosquito.
Health Literacy refers to individual competences to access, understand, appraise and apply health information and services to make appropriate health decisions. Studies show that health literacy has crucial influence on one’s health status. For Thailand, there is no a standard tool to assess health literacy at the regional and national level. The present study aimed to develop and validate a Thai health literacy questionnaire for Thai people aged 15 years and above for assessing health literacy at the regional and national level. A cross sectional design was employed to collect data with a developed questionnaire in six provinces. The provinces were Chiang Mai, Nakornsawan, Nakornratchasima, Bangkok, Chonburi and Nakornsrithammarat. The questionnaire was drafted based on Nutbeam’s and European Health Literacy survey framework. It was pre-tested for plain language with experts and 35 general people. For the validation, the questionnaire was administered through face to face interviews. Focus groups were conducted for qualitative analysis. The internal consistency reliability was confirmed by the Cronbach’s alpha. The construct validity was confirmed by the confirmatory factor analysis. Correlations between health literacy scores and health outcomes were also explored. There were 722 people participating in the study. The Cronbach’s alpha was .88 for access, .86 for understanding, .90 for asking and .79 for deciding. All the Cronbach’s alphas are above .70 which indicates a satisfactory internal consistency reliability for the whole questionnaire. The confirmatory factor analysis also shows a good construct validity. Health literacy scores also correlated significantly with health outcomes which included having a chronic disease and metabolic syndrome. Those health outcomes were more prevalent among people with lower health literacy. The Thai Health Literacy Questionnaire (THL-Q) is thus appropriate to assess health literacy at the regional and national level.
Wheezing is an important health problem in Thailand. This study aimed to estimating costs of hospitalization of preschool children with acute wheezing under societal, provider and patient’s perspectives were also studied. The study recruited 240 children, aged 6 months to 5 years, who were admitted with acute wheezing at Thammasat hospital, King Chulalongkorn Memorial hospital, Bhumiphol hospital and Saraburi hospital. Data were collected from the hospital financial database and interviewing caregivers for the expenses. Cost-to-charge ratio method was employed for valuation of direct medical costs. Informal care cost was determined by human capital approach. It is found that societal, provider and patient costs per admission were 20,269±20,537, 18,126±16,898 และ 3,020±6,632 THB, respectively. The costs during hospitalization were the maximal proportion of 94.59 percents with the direct medical costs นด 88.83 percents. The main cost component in all perspective was hoteling cost during admission. The costs in medical school hospitals were higher than other type hospitals. The prognosis of these wheezing children was studied to determine the clinical outcomes including emergency visits and hospitalization due to recurrent wheeze during the follow-up period of 24 months. Patients’ characteristics and non-invasive biomarkers including serum specific IgE to common allergens, serum 25-hydroxy-vitamin D, and urinary leukotriene E4 reflecting airway inflammation were collected at entry to determine the association with the clinical outcomes. According to the results, the participants were boys (62.7 %) and having history of recurrent wheezing at entry (59.1%). According to laboratory results, atopy was found in 75.9 percent. Vitamin D insufficiency was found in 24.8 percent. The one-year incidences of emergency visits with recurrent wheezing during the first and second years of follow-up were 67.5 percent (95% confidence interval: 60.4% to 74.2%) and 12.2 percent (95% confidence interval: 7.8% to 17.9%) respectively. The one-year incidence of hospitalization with acute wheezing during the first and second years of follow-up were 32.3 percent (95% confidence interval: 25.4% to 39.9%) and 3.9 percent (95% confidence interval: 1.6% - 7.8%) respectively. Passive smoking from household (p=0.045) and atopy (p=0.038) were significant factors associated with emergency visits of recurrent wheezing.