plueme/wizJson huggingface dataset:
Rapid social changes and the structural reform of health systems in Thailand in the past two decades
have posed new challenges relating to how the governance of the national health system operates. Following
the establishment of the Health Systems Research Institute (HSRI) in 1992, a number of new national
health organizations were created. The emergence of these new national bodies within the old structural framework and institutional practices of the Ministry of Public Health has created ambiguity of
roles and difficulties in national health system governance.
This study was aimed at formulating a conceptual framework for National Health System Governance
(NHSG) and using this framework to analyze the system and synthesize a proposal for its improvement.
The study was conducted using document analysis, in-depth interview and participatory observation,
all of which were carried out during the period from August 2008 to July 2009.
The study found the following crucial roles for NHSG: policy guidance, intelligence and oversight;
collaboration and coalition-building; regulation; system design; and accountability. It also found that a
multi-dimensional approach was useful for making more unambiguous analysis of NHSG in contemporary
society.
The study argues for a new system to create a more effective NHSG in the Thai context. In so doing,
the Cabinet has a vital role to play in improving the structural framework and institutional practice of
government actors in NHSG, and in considering the three dimensions of governance: (1) build a strong
“governance network“; (2) develop ”good governance” for each actor, the main obstacles to which are the
crony system and bureaucratic culture; and (3) develop processes and mechanisms which engage stakeholders
from all sectors in system governance, by using a “reflexive governance“ framework.
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death in the world; it
causes 600,000 deaths globally per year. Most cases of HCC occur in Asia and developing countries. The
major risk factors for the development of HCC are viral infection (chronic hepatitis B and hepatitis C),
cirrhosis from consumption of alcohol, and the intake of aflatoxin as well as iron overload, obesity and
diabetes mellitus type II. Prevention of infection with hepatitis B and C viruses and avoidance of risk
factors are the key strategy for reducing the incidence of HCC. This communication describes a summary
of interrogatory questions frequently compiled for potential research study.
Obstructive sleep disordered breathing (OSDB) is a collective term that encompasses a spectrum of
disorders which can range from primary snoring and upper airway resistance syndrome (UARS) to
varying levels of severity of obstructive sleep apnea syndrome (OSAS). Snoring is a common problem
encountered in Thailand and indicates upper airway obstruction. It is very annoying to patients’ bed
partners since it could deprive them of proper and restful sleep, which is essential to good health. If the
degree of such an obstruction is severe, it can lead to OSAS, which is a life-threatening condition. Recognition
of OSAS is important since it causes daytime somnolence, neurocognitive defects, chronic fatigue,
and depression. In addition, it can increase the risk of having traffic accidents, hypertension, cardiovascular
disease, stroke, pulmonary hypertension, and cardiac arrhythmia. The treatment options for OSDB
include weight loss, positional therapy, oral devices, continuous positive airway pressure (CPAP), and
surgery.
Thailand has used silica and asbestos for years, but there have been few reported cases of silicosis
and asbestos-related diseases such as mesothelioma. There are several reasons for this. Registration of risk
groups exposed to silica and asbestos will serve as the key initial step in surveillance for silicosis and
asbestos-related diseases. This article describes the system in the United States as an example. It also
suggests three approaches to the registration system: industries using silica and asbestos, workers/occupations
exposed to silica and asbestos, and materials/products containing silica and asbestos.
The purpose of this study was to explore the implementation of the Local Administrative Organizations
(LAOs) according to a Resolution of the National Health Assembly 2008. Data were collected by using
questionnaires in September 2009. The subjects were 195 staff of LAOs. The study also involved a focus
group discussion with 20 staff members from the Provincial Administration Organization (PAO), League of
Municipalities, and Tambon Administration Organization (TAO). Descriptive statistics were used to analyze
the quantitative data and the qualitative data were analyzed by content analysis.
The results revealed that the majority of the subjects did not get information about the Resolution of
the National Health Assembly 2008, especially on item number 1.7 “Roles of Local Administrative Organizations
in Managing Health, Natural Resources and Environment”. However, they functioned in these roles
by their own plans, which conform with the resolution, because they had been funded by the National
Health Security Office.
The major problems of policy implementation were (1) lack of knowledge in assessing health impacts;
and (2) the Association of PAOs, the League of Municipalities and the Association of TAOs having taken
very little action on pushing the resolution.
The recommendations from this research are as follows: (1) The National Health Commission Office
(NHCO) and related organization should build the capacity of the local authorities, especially in health
impact assessment and using health assembly tools; (2) the Association of PAOs, the League of Municipalities
and the Association of TAOs should be core mechanisms to communicate the resolution of the National
Health Assembly, which is involved with the role of the local authorities and to analyze the rules and regulations
which constitute obstacles for managing good health within a suitable environment.
While there is an increasing need for institutional long-term care, however, there is still lack of neither good practice guideline nor registration bodies to regulate institutional long-term care. This study aims to explore the caring practice and to recommend model of institutional long –term care in Thailand.  Qualitative research method, such as focus group discussion and in-dept interviews were carried out for seeking opinion and practice experience from the academic expertise, care providers, care receivers and policy maker of 60 participants.
	It was revolved that there were 2 models of Institutional long-term care; 1) low care model for older person who need social care and assisted living with minimal health care such as, residential home and assisted living. The staff included social worker, nurse, care assistant, physiotherapist and occupational therapist and 2) high care model for older person who need continuing care, nursing care and somewhat medical care, due to being frail or chronically ill, thus the staff included nurses, care assistant and medical doctors.  This type of institution were nursing home, long-term care hospital and hospice care unit.  The caring would focus on holistic care, comfort and spiritual care.  In each model need to include philosophy of care and minimum care standard. 
 	Policy recommendation are: to divide institutional long-term care into two levels, low care and high care; assigning low care institution to register with Ministry of Social Development and Human Security and the high care facility to register with Ministry of Public Health; to develop a minimum care standard at national level; to establish nursing home by local authority and encourage the private sector to particulate in providing care; and encourage community hospital to provide intermediate care. For practice recommendation, to have a clearer criteria for nursing home setting, to develop a dependent assessment tools, to provide sufficient information related to national policy on private setting, encourage volunteer in caring for older person, and media communication in a positive way.
As a part of developing the research management system in Health Systems Research Institute (HSRI) and its alliances, the project of developing good governance index as a tool for research administration in health system is initiated to promote various research projects to be managed transparently, efficiently, and accountability.   The operation of this project will be an empowerment tool which provides good governance practices to reform organizational management system, leading to sustainability and future breakthrough.
Objectives of this project are 1) to define the framework of monitoring and evaluating the project administration in accordance with good governance practices 2) to develop good governance index 3) to study the appropriateness of the developed index, issues, and barriers for index perceived 4) to set a guideline to gather essential data for project performance evaluation which is based on good governance principle of research management team in health system.
The process of this project begins with 1) reviewing theories, concepts, and research reports related to good governance practices and its index both domestically and internationally 2) interviewing experts from related disciplines, and research managements 3) developing and testing questionnaire and then analyzing data 4) using the drafted good governance index to conduct internal pilot test with HSRI  5) reviewing index and modifying it to be more suitably.
According to study, Good Governance means “the good and fair process which diverse organizations including private and public sector, government, and civil society apply to set their own direction. It is regarded as a process to change collective moral intentions to effective and accountable institutional actions”
The result of this study has indicated that two crucial conceptual frameworks of index development has emerged and they are comprised of 1) conforming to six good governance practices including Rule of Law, Transparency, Worthiness, Participation, Quality, Accountability and 2) applying six good governance practices to five steps of the research management process including the process of defining a policy, planning of research management, gathering and allocating resources, operating research, and utilizing research.   Shown in this study are total thirty indices which are collapsed into six composite indices to evaluate holistic picture of good governance practices in research management process.
The outcome of evaluating Health Systems Research Institute (HSRI)’s good governance practices has been depicted that overall in the organizational level HSRI has high good governance practices. When considered in the perspective of five research management process, the process of gathering and allocating resources gains the highest level of engaging good governance practices and is followed by the process of planning the research management as a second.  Other research management processes are evaluated that their involvement in good governance practices are in the middle level.
Health care system in Thailand has developed rapidly during a few decades ago. Thai citizen have enjoyed universal coverage for health care since 2002. Ministry of Pubic Health as a government body is responsible to oversee health service for people in Thailand. This ministry also has responsibility to enact many health laws.

At the same time, health care expenditure has continuously increases, and will increase rapidly in the future from maturation of ageing society, changing disease pattern to chronic diseases and the most significant one, fragmentation of health care system. For instance, patients from car accidents were victims of the game between social health protection schemes and private insurance companies. Anecdotage evident showed problems of adverse selection and moral hazard both from beneficiaries and health care facilities. These problems came from different payment mechanism and different payment rate in the same treatment from different social health protection schemes. It can be said that Thailand does not have system government on health care financing. Ministry of Public Health has loosed power to governance the system from time to time, Many financing agencies e.g. Social Security Scheme, Local governments and private health insurance companies, were established under authority of other Ministries.. Promotion of health export (Medical hub policy) is another example of conflict and no system governance of Thai health policy. 

Objectives of this study aim to document and synthesis the current structure and function of institutes which play system governance role of health care financing in Thailand and developed countries which have already had universal coverage for health care. And assess how well the existing structures for system governance in Thailand measure up to the need. Finally, appropriate system governance structures for health care financing in Thailand are proposed. Analysis of this study used a framework of health system of the World Health Organisation, which health care financing is one of four missions of health system to provide universal financial risk protection, equity in finance, equity of access and use, transparency, effectiveness, and appropriate incentive for good quality providers. 

The results of study founded, a common feature of the design of system governance of the 4 selected countries; England, Canada, Germany and japan, is a governance body which locates in administration structure of central government. This governance body is responsible to decide policy direction and to prepare amendment of related laws or new bills to shape the health care financing system of the country. These countries have different in revenue collection method, pooling, purchasing and payment. Therefore structures for system governance are also different. However, there are common features among these countries. Regarding revenue collection, contribution rates are regulated in counties which sickness funds or local governments are allowed to collect contribution by themselves. Equalisation fund or resource allocation formula has been implemented
Objective: To identify the factors, including knowledge, attitudes, beliefs, values, fears, and perceptions,
which influence breast cancer screening behavior among different groups of people.
Methods: A structured literature search was undertaken, using the United States National Library
of Medicine’s PubMed database. Thirty-one breast cancer-related studies were selected; these were summarized
by applying the Health Belief Model and Knowledge, Attitudes, and Behaviors Model to the
framework.
Results: Most of the studies had been conducted in North America, and the designs used were
mostly cross-sectional studies. The percentages of women who underwent mammography ranged from
5.3 to 82. Women who had performed BSE (breast self-examination) ranged from 6.4 to 83 percent, and
women who had undergone CBE (clinical breast examination) ranged from 26 to 61 percent. The review
found that not only did knowledge of breast cancer play an important role in people’s behavior regarding
breast cancer screening, but also regarding beliefs, attitudes, cultures, values, and perceptions.
Conclusion: This literature review addresses issues regarding the importance of knowledge, attitudes,
beliefs, values and cultural awareness when implementing prevention programs. Further research
needs to explore the threshold level of breast cancer knowledge in order to achieve a higher rate of the
breast cancer screening.
The Bureau of Drugs and Narcotics, Department of Medical Sciences, conducted a five-year longitudinal
study that monitored the physical deterioration of drug products in 829 hospitals nationwide,
supervized or owned by the Ministry of Public Health, as well as some other hospitals in Bangkok,
between 2003 and 2008. The study encouraged healthcare professionals to voluntarily observe and report
defects or physical deterioration problems found in marketed drug products, available in government
hospitals. A total of 2,407 reports were gradually received. The results revealed the major problems: 37.1
percent of the total reports were related to container and packaging defects, 14.5 percent of which were
chipped, cracked, or splitting tablets, followed by discoloration or abnormal odor (11.5 percent) and suspected
product contamination and/or labeling concerns (6.2 percent). In terms of dosage forms, 47.4
percent were tablets, whose major issue was incomplete/missing amounts in original packages. The
percentages for other forms, including injections, solutions, capsules and inhalers, were also included.
Finally, the information regarding the physical deterioration of drug products obtained from this study is
helpful for healthcare providers in making decisions on product selections and for the quality assurance
of drug schemes, as well as for use in identifying standards in pharmaceutical development.
When adverse events occur in the hospital the patients or their relatives often bring cases to court or
submit claims for compensation from the National Health Security Office (NHSO). A descriptive study
was carried out to determine the trend relating to claims for compensation in order to obtain information
for designing a new and better system.A survey employing questionnaires was used to obtain information at 230 hospitals in the country;
the response rate was 70 percent, among which 21 percent had experienced in 2008 claims for compensation
owing to adverse events occurring in the hospitals. The findings showed that community hospitals
were subjected to such claims more often than regional general hospitals, e.g., 23.4 vs. 15.7 percent. As
many as 43.1 percent of the studied cases were related to pregnancy and delivery. The median of the
compensation amounts was Baht 200,000; the highest claim was for Baht 15 million. The median amount
of money allowed was Baht 100,000. The main source of compensation was from NHSO (49.0%). Among
the claims, 13.3 percent of the cases were brought to court. Community hospitals had a higher chance for
claims brought to court than general/regional hospitals (14.3% vs. 10.0%).
The study concluded that 21 percent of the hospitals surveyed experienced claims for compensation.
Most cases were related to pregnancy and delivery. The money received was smaller than the claims
submitted. Therefore, some claimants brought their cases to court in lawsuits.
Objectives: To evaluate and review the tuberculosis situation in various populations at high risk of
contracting tuberculosis, at various periods of time and general tuberculosis control outcomes in northern
Thailand.
Methods: Data on various high-risk populations were analyzed from the DOTS database and special
project paper-based record systems for various high-risk populations in areas of northern Thailand in
various periods of time.
Results: The 2003 and 2004 reports showed 30 and 60 percent of multidrug-resistant tuberculosis
respectively with cure rates of less than 60 percent of the registered cases. The 2004 report revealed that
tuberculosis was the most common opportunistic infection (38.9%) among the HIV-seropositive/AIDS
cases. Reports of isoniazid therapy for tuberculosis prevention among HIV-seropositive/AIDS populations
showed that 78 percent of them had not developed tuberculosis at the end of the 24th month since
starting therapy. The 2005 report demonstrated that only 3.2 and 37.1 percent of the suspected childhood
tuberculosis cases were diagnosed as tuberculosis and latent infection cases, respectively.
There were no statistically significant correlations between the types of the patient observers and the
cure rates among the general tuberculosis population analyzed from the 2003 report (Pearson correlation
coefficients > 0.01, 2-tailed). There also were no statistically significant changes or improvement in the
treatment outcomes (sputum conversion rates, default rates, death rates, and treatment success rates),
when comparing the 2003 and 2004 reports (p > 0.01).
Conclusions: These findings indicate the DOTS program implementation was not well-developed
for various populations at high risk of tuberculosis in these areas. Recording and reporting systems for
childhood tuberculosis cases in this area still were not well-developed and this contributed to
underreporting of this section of the high-risk population.
The concept and perspectives of administrators can reflect the direction of development. This research
was aimed at studying the concept and perspectives of administrators regarding the issue of attempting to
extend community pharmacy services under the National Health Security Scheme (NHS). The study was
conducted using in-depth interviews of the administrators responsible for the status of pharmacies with regard to the possibility of providing pharmacy services under NHS, the direction of development for pharmacies,
the value of pharmacies in NHS, stakeholders and factors for success in extending pharmacy services
under the system. Data were gathered and analyzed by content analysis. The results showed that the
administrators agreed with the idea of incorporating community pharmacy services within NHS, but the
standard of practice and the quality of service first had to fulfill NHS criteria. Community pharmacy had to
have a clear status and position in the system. Reimbursement of the services would have to be specified.
The administrators saw the value of extending private pharmacy services as it would increase the accessibility
of the patients to another dimension of health care. Accredited pharmacy services may be an option for
increasing patients’ accessibility to health. To be successful, the administrators said that every stakeholder
would have to take part in his or her own roles according to the context. However, every partner would
have to aim for benefiting the patient, as the system is patient-centered.
Influenza is one of the most important respiratory infections of humans; it is responsible for an
estimated half million deaths worldwide each year. Recently, the influenza pandemic caused by a new
strain of influenza A (H1N1) 2009 virus was declared by the World Health Organization, whereby the
pandemic level has been raised from phase 5 to phase 6, as defined by a widespread human-to-human
transmission and sustained community level outbreaks in more than one region of the world. The guidelines
for prevention include routine recommendations on basic personal hygiene and annual vaccination,
which by far is considered the best possible method of prevention especially for high-risk populations.
Influenza vaccines, mostly trivalent, are indicated for the active immunization of individuals against seasonal
influenza caused by influenza viruses subtypes A and type B contained in the vaccine. However,
the protection is transient and yearly immunization is thus necessary. In addition, the antigenic changes,
i.e., antigenic drift and antigenic shift, in influenza viruses necessitate yearly surveillance for emergent
strains and incorporation of such strains into the current year’s vaccines. At present, two types of vaccines
are available, namely, inactivated (killed) vaccines administered by injection and cold adapted, liveattenuated
vaccine administered by nasal inhalation. This mini-review provides a brief description of
influenza vaccines with respect to their types, composition, method of manufacture, indication and usage;
a list of USFDA-approved commercial vaccines is also included.