plueme/wizJson huggingface dataset:
This literature review aimed to investigate clinical outcomes and physical therapy indicators in 4 physical therapy fields, i.e. 1) musculoskeletal system, 2) neurological system, 3) pulmonary and cardiovascular system, and 4) pediatrics. Systematic reviews were searched from start to 15 July 2019 in several databases, including PubMed, ScienceDirect, Web of Science, Scopus, and PEDro. Relevant systematic reviews with full report published in English were retrieved. Data from included studies were extracted, analyzed, and synthesized. The results showed that 151 papers were included in this study. Clinical outcomes and physical therapy indicators were categorized into 22 groups. In general, assessing patient’s clinical outcome required more than one clinical tool or form to cover all aspects of patient’s problems, including signs and symptoms, functional ability, and social participation. Most common clinical outcomes and physical therapy indicators used were pain, body movement, functional ability, and quality of life. Physical therapists can apply this information to set treatment goal, planning treatment program, and evaluating treatment progression in order to improve quality of service to patients and to establish goals for service from a multi-professional team.
Walking and cycling are common physical activities if performed regularly in daily life will return health, environmental and economic benefits. This study aimed to 1) assess built environments that encourage walking and cycling in communities, 2) assess levels of physical activity and energy consumption, and 3) investigate the amount of carbon dioxide emission and cost of transport. Quantitative method was employed. Data collection techniques comprised direct observation and questionnaire survey in three communities: 1) King Taksin community in Bang Khla district, Chachoengsao province, 2) Suksabaijai community in Mueang Kalasin district, Kalasin province, and 3) Ban Thatsopwaen community in Chiang Kham district, Phayao province. The results showed that King Taksin community had the highest scores on walking, cycling and use of public transport as the community center was close to the district shopping center with a well-managed public transport system. Samples from King Taksin and Ban Thatsopwaen communities had the highest levels of physical activity due to frequent walking and cycling in their daily life. Suksabaijai community had the highest level of carbon dioxide emission from motorcycles and cars, and the highest transport cost as the community center was far from the shopping center with its built environments of having a high-speed road passing through the community center hence discouraged walking and cycling. This study recommends that all agencies promoting physical activity should work with local community in designing built environments and evaluating effectiveness of walking and cycling promotion programs that fit with each community.
Thailand national steps challenge policy has been developed in 2019 by the physical activity policy development subcommittee according to Thailand Physical Activity Strategy 2018-2030. The policy has been implemented through Thailand Virtual Run Season 1 Fiscal Year 2020 by the Division of Physical Activity and Health, Department of Health, Ministry of Public Health. This article reviewed details of the policy formulation and implementation in order to get deeper understanding on the process of policy development, implementation gaps, and to make further recommendations. Lessons learnt led to deeper understanding on policy formulation at national level that required concurrent assembling of problem, policy, political streams with proper window of opportunity. Policy implementation needed context and situation adjustment for smooth management. Lastly, learning policy gaps from the past could shape better policy implementation in the next stage.
The world is in the grip of the novel coronavirus or COVID-19 pandemic. Since it was first identified in Wuhan, a city in China at the end of 2019, the disease has rapidly spread to countries around the world. This pandemic is likening to occur once in a century. In Thailand, there were 3,000 accumulative cases from 68 out of 77 provinces. This article reviewed the essence of COVID-19 prevention and control activities by Angthong municipality in Angthong province from 1 February to 12 May 2020 that led Angthong as 1 out of 9 provinces that had no provincial inhabitants infected. The aim of the study was to understand COVID-19 prevention and control highlighting collaboration of community-level stakeholders. Lessons learnt from this study provided an insight on Angthong provincial disease control committee mechanism, the arts of implementation of Angthong municipality, importance of local leadership, and dynamic of daily life shifting of local people for further development on disease control policy at both local and national levels.
Background: Technology transfer involved the transfer of knowledge and technical know-how, as well as physical devices and equipment. There have been several factors influencing success. Objective: This study aimed to draw the lesson learned from the Government Pharmaceutical Organization (GPO) and Mylan technology transferring to achieve accreditation by the WHO Prequalification Programme (WHO PQ). Methods: Qualitative research was used. The information was collected by studying the documents published officially and non-officially, and in-depth interviews were conducted with selected key informants relevant to this technology transfer. Then a content analysis was performed. Results: GPO has inherited technology from Mylan, India's leading generic company. Until GPO can produce and control the quality of antiretroviral drugs Efavirenz and certified by the World Health Organization. The important conclusions of this study were as follows 1) The important policy decisions included the policy that impels GPO to be accredited by WHO PQ and the one that GPO decided to collaborate with the Mylan. 2) The success factor was the good relationship between the technology transferor (Mylan) and the technology transferee (GPO). This relationship motivated the intent teamwork between GPO and the Mylan in production as well as quality control that led to accreditation by WHO PQ. The country's supporting factors included the universal health coverage policy, the support of AIDS problem solving by producing HIV antiretroviral drugs in the country, GPO's capacity, and implementing the ‘Sustainable Potential Development Plan in Thailand, Section: WHO Pre-qualification Scheme ’in B.E. 2554. The international context also contributed. For instance, WHO has the Global Fund's approval to support the developing countries with a pharmaceutical production capacity in terms of technical assistance. So those countries can enhance the quality to the level recognized to provide antiretroviral drugs for the projects in several countries in which the procurement can be made using the Global Fund budget. 3) The obstacles that made GPO spent over 17 years to be accredited by WHO PQ, including the GPO's lack of readiness in several aspects. Such as locations, new facility procurement process, designs, technology choice, human resources as well as the GPO management system, causing the executives and committee in some periods paid attention to other issues. According to the lesson learned, forming a new team combining with a new work culture that developed effective teamwork where every member harmoniously works towards goal as well as the support from executives in several periods have contributed to the eventual WHO PQ project accomplishment. That momentum empowers GPO to set up high quality and vigorous work system for pharmaceutical products in the overall appearance of the organization and its personnel until GPO can create an image in the international market for earning trust in the GPO’s products.
Background: Tuberculosis preventive therapy (TPT) among HIV-infected patients are not well established in Thailand and may be due to multifactorial reasons. One of the most crucial reasons is because most physicians are convinced that antiretroviral therapy (ART) alone can decrease the incidence rate of active tuberculosis (TB) to the incidence rate of the general population. However, the incidence of TB data among Thai HIV-infected patients on ART is also scant. This information is very important because HIV-infected patients can have latent tuberculosis infection (LTBI) which can later progress to active TB. Therefore, TPT is crucial among HIV-infected patients to prevent active TB. Method: We conducted a cross-sectional, multi-center study in HIV-infected patients from 14 hospitals throughout Thailand between 2009 and 2018. This study compared the incidence of active TB among HIV-infected patients with different CD4 cell count after ART has been initiated. Results: A total of 9,179 HIV-infected patients were enrolled; 442 (4.8%) were diagnosed with active TB after ART was initiated and 8,738 had HIV mono-infection. According to the multivariate analysis, the significant risk factors associated with active TB post ART initiation were the male sex, CD4 less than 350, body weight less than 50 kg and have a prior history of active TB. When ART was initiated at low CD4 cell count, the incidence of active TB was high (Table) compared to the general population (about 150-200 per 100,000 persons-year). Furthermore, when ART was started when the CD4 count was more than 500, the incidence rate of active TB was 2-3 times higher than the general population (394 per 100,000 persons-year). The incidence of TB for the first 2-5 years after ART was initiated decreased to 7,251, 4,083, 2,661 and 1,957 per 100,000 persons-year, respectively. However, these numbers were much higher than the general population in Thailand even when these patients were on ART for many years. Conclusions: The incidence of TB among HIV-infected patients with various CD4 cell count and on ART were high. The incidence of active TB was 2.5 times higher than the general population even when ART was initiated when CD4 was more than 500. For this reason, HIV-infected patients who have had TB infection should benefit from TPT which can decrease the incidence and mortality rate of TB.
Mobile application development for aging society during health services; A case of the urban community surround Sirinthorn Hospital, Bangkok is studied from the study of health situations, aging society and travel problems for health services; A case of the urban community surround Sirinthorn Hospital, Bangkok. They are related to the environment and problems from the deterioration of the body with age and disease by age as making the older person need to receive health services for the older person to have a good quality of life. There are factors related to the service system of the hospital which access to nursing homes public transport and personal vehicles of the older person themselves Including technology to promote travel. The objective of mobile application development for aging society during health services; A case of the urban community surround Sirinthorn Hospital, Bangkok are to develop applications on mobile phones Promote health service travel skills for the older person in urban communities and to assess the effectiveness and efficiency of mobile applications for travel, health services for the older person in urban communities. Methods of conducting the study were quantitative and qualitative research processes. Which is divided into 3 steps which are; Step 1 Design tools, applications and interviews 4 professionals in the production of media applications on communication devices. Step 2 Develop and evaluate application tools by 5 experts in content and technical production Step 3 Develop and evaluate applications for testing and evaluation by selecting older person volunteers from the phase 1 research as develop and evaluate instruments, test and evaluate application tools. By traveling from home to Sirindhorn Hospital, 30 samples. The results of the research on the development of mobile applications to promote health service travel for the older person in urban communities can be concluded that; 1. Factors Related to Getting to Health Services The travel patterns of the older person include 1) The older person group can walk easily 2) The older person group on a wheelchair 3) The older person group sleeps on the bed It is a key factor in mobile application design and development to promote health service travel skills for the older person in urban communities. 2. The convenience of data transmission in the application on the mobile phone. It is a key component used to assess the effectiveness and efficiency of mobile applications to travel to receive health services for the older person in urban communities Mobile application design and development are a factor supporting traveling with ease and quality. Especially map analysis in the information system for convenient travel save traveling time and able to communicate preliminary health information of the older person to the destination sanatorium, prepare the area management which health services that are most suitable for the needs of the older person group.
Scedosporium spp. are human pathogenic fungi causing infections among non-Aspergillus spp. especially in immunocompetent and immunocompromised individuals. Moreover, these pathogenic fungi are highly resistant to standard antifungal drugs whereas effective drugs are highly expensive and give several side effects. Co-treatment drugs have begun to be developed to increase the effectiveness of treatment against Scedosporium infections. One of them is the quorum sensing molecules (QSMs). These QSMs are produced from fungi and play a role in reducing the growth of fungi, especially in the drug resistance group. One of the substances that are increasingly being studied for their role in fungi is Tryptophol (TOH). This research aimed to investigate the role of TOH in the inhibition of fungal infections that were common in Thailand including Scedosporium apiospermum, S. boydii, S aurantiacum, and Lomentospora prolificans. Our study revealed that TOH exhibits an MFC of 8 mM, which is able to stimulate THP-1(Macrophage) and Jurkat cells (T cells) at different time point, 3 and 6 hours post treated respectively. The up regulated cytokines after co-culture with TOH including M1 cytokine , which play a role in the elimination of microorganisms as IL-6 (2, 2.2 folds). T-helper cells cytokines such as คือ IL-17 (4.2, 1.9 folds) and IL-23 (3.8, 2.1 folds), as well as the specific eumycetoma IL-1β (1.7, 2.7 folds), IL-12(3.2, 3.2 folds), IL-37(3.0, 2.6 folds), and IL-35(2.7, 1.9 folds), but not induce apoptosis in both fibroblasts and macrophages. Instead, TOH induced fungal apoptosis as determined using Ethidium bromide/Acridine orange, which corresponded to a 2.2-fold decrease in CARD-9 and a 2.6-fold increase in BCL-2 expressions. After obtaining the laboratory results, our research team began a series of experiments to develop a prototype of neutropenic mouse model of eumycetoma. To produce neutropenic mice, injection of cyclophosphamide at 150 mg/kg were administered. Then, eumycetoma formation was observed in day 3 after intradermal injecting 1x106conidia of Scedosporium spp. at the back of neutropenic mouse. Moreover, our team also developed a prototype emulsion-gel product containing TOH and tested the effectiveness against Scedosporium spp. infection. Our study revealed that the tumor size was reduced after treating with TOH emulsion-gel in infected mice. Moreover, we also expanded our study using an invertebrate in vivo model of Caenorhabditis elegans. Our preliminary results revealed that life span virulence tests and the efficacy of TOH against all four Scedosporium spp. infections exhibited similar promising results to neutropenic mouse model of eumycetoma, suggesting that C. elegans can be used as a powerful alternative model for researchers in microbiology, pathology, and pharmacology in the future.
Extravasation is a condition of extravasated drug was leaked and potentially damaged the site of infusion. In serious injury cases can cause permanent loss of tissue organ. As a clinical workflow in Thailand, nurses have to define the grading and management of extravasation after intravenous (IV) infiltration. But this procedure also has a limitation by the traditional nurses’ shift schedule, which is make the grading and management of extravasation not continuously by the same person. So, this research project proposes an automated screening of extravasation for surveillance, assessment and monitoring during IV therapy. These included 4 steps: data collection, image labeling, convolution neural network modeling, and application development. Total of 1,084 extravasation images were collected from 5 hospitals: Rajavithi Hospital, Nopparatrajathanee Hospital, Rayong Hospital, Songkhla Hospital, and Thammasat Hospital using our own data collecting application. All images were labeled by three dermatologists by locating the skin lesion and rating the severity of extravasation. If no majority vote of any images, the fourth dermatologist will decide the severity of extravasation. After image labeling, all of image data was used to train a densely connected convolutional neural network (DenseNet-121) model, using five-fold cross validation and transfer learning with data augmentation technique. The results from hold-out testing set have a sensitivity and specificity of 96.30% and 93.90% in normal control images, 80.00% and 88.41 in mild extravasation images, 83.33% and 74.12% in moderate extravasation images, 90.91% and 86.74% in severe extravasation images, and 71.43% and 78.43% in others images, respectively. The results from the model were combined to the final application for surveillance, assessment and monitoring extravasation during IV therapy for providing an ease of extravasation management and increasing the efficiency of clinical workflow to reduce the economic cost spent on patient with extravasation in Thailand.
A series of research projects to develop a model of the information technology system to provide a service of diabetes and hypertension in the primary healthcare system in Thailand has an operational plan for 3 years. In this first year, the study is divided into 2 parts. The first is studying the situation and the need for health information to provide a service for diabetes and hypertension patients/risk groups. Another is developing a model of the information technology system by using standard health information and connecting such information between primary care units and community hospitals in a specific area where there is good data management. The team studied the need for the information on diabetes and hypertension from different groups namely family physicians, patients/risk groups, policy makers and technical officers, and found that they all required the same kind of information including medical records, a display in the form of a time series to reflect and analyze the patients’ behaviors, as well as an effective data transmission system between primary care units and community hospitals which is essential to long-term care and treatment. The team also developed the information technology system model to provide a health service in Kamphaeng Phet Hospital and its primary care units using HL7 FHIR. The program was used to set a standard of data for the users to be able to exchange and access the patients’ information while the patients can also reach their own health records from different places.
Background: Type 2 diabetes metallis (T2DM) is one of the public health problem that burden worldwide including Thailand. Presently, T2DM patients were 4.6 million and health expenditures for T2DM treatment were 35 – 84 billion Baht. SGLT-2 inhibitor was new hypoglycemic drug and clinical studies reported that SGLT-2 inhibitors reduce cardiovascular mortality and cardiovascular events. SGLT-2 inhibitor has not been included in National List of Essential Medicine (NLEM) in Thailand. Economic evaluation studies of SGLT-2 inhibitors showed cost effective of SGLT-2 inhibitor in other countries but there was no study in Thailand. Method: The objectives of this study were to evaluate cost-utility and budget impact analysis of SGLT-2 inhibitors for T2DM treatment in high risk cardiovascular disease patients. Markov model was conducted to estimate costs and health outcomes for life time horizon with 1 year cycle. Parameters were derived from literature reviews, meta-analysis, standard costing guideline and data collections. The results were presented as incremental cost effectiveness ratio (ICER) in Thai Baht per LY or QALY gained as societal perspective. One-way sensitivity and probabilistic sensitivity analyses were performed to investigate effects of model variable uncertainties on the results. Result: The results showed that life year (14.32) and QALYs (11.88) of patients who received SGLT-2 inhibitors were longer than patients who received placebo (life year 13.83 and QALYs 11.46). The ICERs showed that SGLT-2 inhibitors were not cost effective in Thailand at willingness to pay 160,000 Baht per QALY gained. Empagliflozin was most cost-effective compare to Cangliflozin and Dapagliflozin which the ICERs were 259,000, 485,000, 921,000 Baht per QALY respectively. Moreover, SGLT-2 inhibitors group compared to placebo, the ICERs was 475,000 Baht per QALY. Policy recommendation: 1. The price of SGLT-2 inhibitors should reduce to be cost-effective at willingness to pay at 160,000 Baht per QALY gained for 63% reduction. 2. Empagliflozin Cangliflozin and Dapagliflozin were not cost-effective at willingness to pay for 160,000 Baht per QALY gained) but should be negotiated to be costeffective by 38%, 64% and 79% reduction, respectively.
The aims of this study were: First, to review the experience of health insurance management for non-Thai including migrant workers, refugees, stateless and people with citizenship problems. Second, to explore the organization of health insurance and benefit sets for non-Thai living in Thailand. Giving highlights on problems, obstacles, and the direction of future development in both general cases and C188 Case. Third, a synthesis of alternative forms and reforming the public and health insurance systems to cover to those people. Qualitative research has been applied along with documentary survey, in-depth interviews with semi-structured, and focus group to collect and analysis the data. The results indicated that the major problems for health insurance management for non-Thai derived from structural problem, politics and attitude. The structural problem caused by the identifying status inequitably of non-Thai. And the lack of national regulations to unite the status of non-Thai and health insurance legally, leading to the work fragmentation with no “authority” from central coordination to supervise. Besides, the status of non-Thai has been considering at the dimensions of nation state rather than an “individual”. Consequently, there is imbalance between security issues and human rights. This research has suggested 4 alternative policies to create sustainable health coverage for non-Thai citizen as follows: 1) Discontinuing health insurance system provided by Ministry of Public Health. All non-Thai must register to the social security system. 2) Applying both health insurance card and social security system as the parallel system. 3) Proposing inclusively health care law for non-Thai in the form of new public funding. 4) Amending or reinterpreting National Health Security Act B.E.2545 article 5 in order to cover Thai and non-Thai.