plueme/wizJson huggingface dataset:
Introduction: Working in primary care pharmacy in the community Pharmacists have to work with village health volunteers (VHVs) because VHVs are people who are very close to the community. Impact of COVID-19 Happened to many countries around the world and in many ways, Including the public health system very much. Healthcare workers must deal with epidemics and service delivery needs to be adjusted. Therefore, it is necessary to develop long-distance village health volunteers (VHVs) to connect the primary care pharmaceutical service system. To be in line with the normal situation, the new normal. Objective: 1. Develop a platform for remote village health volunteers for village health volunteers to use in primary care pharmaceutical services in the community. 2. Develop village health volunteers to have the ability to use a remote platform to connect the primary care pharmaceutical service system. 3. Design a remote primary care pharmacy service system to connect the work of pharmacists and village health volunteers. 4. Synthesize current primary pharmaceutical policy recommendations to relevant agencies. The research model was a participatory action research divided into 3 phases as follows Phase 1: Develop a Tele Village Health Volunteer Platform (TeleVHV Platform) for village health volunteers to use in primary care pharmacy services in the community. Phase 2: Develop village health volunteers to have the ability to use remote platforms to connect primary care pharmaceutical service systems. Design a remote primary care pharmacy service system to connect the work of pharmacists and volunteers, including risk screening smoking cessation service home visit Addressing the problem of improper drug distribution in the community and pilot a service system designed in the target area. Phase 3: Evaluation in terms of access and use of the platform by pharmacists and village health volunteers, in terms of the effectiveness of services in the developed form. Satisfaction and opinions on the use of the remote village health volunteers platform in primary care pharmaceutical services. and take lessons. Conclusion: The tele village health volunteers platform can enable pharmacists and village health volunteers work together in primary care pharmaceuticals effectively. It should be practiced so that villagers can take advantage of the platform more and there should be further policy push Including the expansion of research results to be applied in primary care pharmaceutical services to achieve sustainability and benefit in a wider area.
The proposal to conduct a situational assessment on disease prevention and control for the establishment of a Southeast Asia Centre for Infectious Disease Control (SEACID) was an academic study, led by the Saw Swee Hock School of Public Health, National University of Singapore (NUS) and the Health Intervention and Technology Assessment Program (HITAP). This project was funded by Health Systems Research Institute (HSRI), Thailand. The project aimed to offer recommendations to operationalise the establishment of a regional centre for disease control in the Association of Southeast Asian Nations (ASEAN) region and beyond. This initiative was conceptualised as a collaborative research endeavour, drawing on qualitative data such as inputs from scoping review and key informant interviews of regional health experts. The findings showed that there were many factors facilitating the operationalisation of the regional centre for disease prevention and control with the main ones included having strong governance, effective management and participation of stakeholders, as well as creating collaboration from external organisations. To have an effective regional centre for disease control and prevention, this initiative required mutual understanding of benefit, trust in sharing information, and collective work among member countries. These enablers would support the integration of differences of all country members, promote a sense of coownership, increase workforce capacity through training and knowledge sharing, and facilitate clear communication. A key risk factor to consider for the operationalisation of the centre was the political sensitivity of each area. This context could cause complications, jeopardising certain activities, such as information sharing and the implementation of public health projects which required working across borders. Therefore, the operationalisation of the centre should focus on supporting and working together with local organisations, rather than directing and intervening by setting the rules for member countries. Capacity building and support for knowledge transfer both within and among countries should be encouraged as it invigorated the efficiency and capability of the organisation. These actions would help start a cycle, where success would build image and confidence for the organisation, which, in turn, would help attract other donors to invest more in the organisation. Moreover, financial factor was considered very important for the sustainability of the management and operationalisation of the regional centre.
The disease model is crucial for discovering a new drug and therapy. Currently, organoid technology allows the generation of a self-assembled, 3-dimensional cellular structure. We aimed to use innovative tissue culture to create cancer organoids from cancer tissues of retinoblastoma and breast cancer patients. The success rate was 80 and 32 % for retinoblastoma and breast cancer organoids, respectively. Cancer organoids faithfully recapitulated genetics, gene expression, and histogenesis in the parental cancer tissues. For retinoblastoma, a candidate cancer drug exhibited high efficacy and potency for all subtypes of retinoblastoma in drug screening. The drug signature of retinoblastoma organoids suggested that the candidate drug had dual inhibition of retinoblastoma and angiogenesis. Retinoblastoma growth was inhibited via drug-induced cell cycle arrest and apoptosis. Of note, the candidate drug for retinoblastoma exhibited low toxicity to the retina compared with clinically used drugs. For breast cancers, the drug response profiles were alike between breast cancer organoids and the patients. Nine candidate drugs were more effective for killing cancer cells when compared with the drugs that failed to cure breast cancer of the patients. Generating and collecting cancer organoids would benefit the discovery of universal or personalized therapeutic agents for cancer treatment.
Objective: To review the literatures and lessons learnt from foreign countries in implementing a comprehensive psychiatric service system, and preliminarily assessing the feasibility of comprehensive psychiatric service system in Thailand. Methods: Searching for literatures, policy documents, research related to the keyword “comprehensive psychiatric service system” for the provision of comprehensive psychiatric services in various countries over the past 5 years were 127 copies, then reviewed and selected based on objectives, leaving final to be reviewed 29 documents. Result: Comprehensive psychiatric service system is a collaboration between policy makers and budget health agencies, as well as personnel specialists in psychiatry, relevant network partners, people involved in community mental health, and including participation of psychiatric patients and relatives. This study presents examples of policy implementation and guidelines for organizing a comprehensive psychiatric service system in various countries, where considered as a recognized prototype such as Australia, United Kingdom, Canada, etc. The situation of psychiatric service system in the Thai context, which still encountered obstacles to development both at the national policy level that should focus on transition to human rights-based approach following the international guidelines, including manpower problems, mental health / psychiatric personnel knowledge and understanding of mental health/psychiatry among health personnel. The policy gap also found on linking systems between psychiatric service units in various affiliations and transferring policies into practice Including participation in policy formulation of stakeholders at each level. Summary: The development of comprehensive psychiatric service system emphasis on developing the potential of public health personnel and related agencies in caring for people with mental/psychiatric problems. Together with the development of the community's potential (including school and workplace) to care for and rehabilitate people with mental/psychiatric problems so that they can live life to the fullest possible.
In Thailand, the devolution of subdistrict health promoting hospitals to provincial administrative organizations (PAOs) depends on the readiness and willingness of each PAO. In Fiscal Year 2022, six PAOs took full responsibility of all the subdistrict health promoting hospitals in their provincial areas: Khon Kaen PAO, Nongbua Lumphu PAO, Mukdahan PAO, Prachinburi PAO, Roi-et PAO, and Suphanburi PAO. This study sought to develop a model of primary care for the PAOs that possess limited revenue streams and have agreed to take charge of all the subdistrict health promoting hospitals. A strategic framework for citizen engagement and intersectoral collaboration in primary care was also formulated for these PAOs. The research instruments used in this study included focus group discussions, in-depth interviews with primary care experts and local government scholars, workshops, and a survey of subdistrict health promoting hospital personnel and health volunteers in Prachinburi and Suphanburi provinces. Based on the research findings, Prachinburi province has more administrative capacity and social capital than Suphanburi province. Administrative capacity and social capital enabled the Prachinburi PAO to manage the transition period much more effectively. The Prachinburi PAO executives and leaders in the provincial health system followed the “shared leadership” style, while their counterparts in the Suphanburi province used the “paralleled leadership” style. Also, the PAO and provincial health authority in Prachinburi had a more robust working relationship prior to the devolution of subdistrict health promoting hospitals. When we used the “six building blocks” concept and the “ten building blocks of a high-performing primary care” concept to assess the two PAOs’ readiness to run their primary care systems, we found that the Prachinburi PAO performed better than the Suphanburi PAO in terms of service plans, personnel, medicine, information system, financial resources, and leadership and governance. In the end, we developed a model of primary care, which consists of the primary care management unit within the PAO Public Health Department, as well as three alternative models of primary care operations at the sub-provincial level. In addition, policy recommendations for other PAOs, the Ministry of Public Health, the Decentralization Commission, and the Department of Local Administration Promotion were offered.
Cause of death statistical information is important for health planning. The information enables policy planners to understand the medical nature of fatal health problems of the country. Priority can be set based on the information, which can also be baseline for evaluation of various health programs. However, in Thailand, the standard of death registry is still poor. My deaths took place outside the hospital and registered by non-medical personnel. The information is therefore not accurate enough for planning. In 2019, in order to solve this problem, a research team from the International Health Policy Program (IHPP) did a survey on causes of deaths using so-called ‘verbal autopsy’ method. After the data were analyzed, IHPP invited relevant experts to review the report. Tuberculosis (TB) was reported to be the 10th cause of death in male and 17th cause of death in female population. These figures indicated that TB is still a very important health problem. However, the above findings are in contrast with reports from the National TB registry, which show that TB notification rate is rapidly and steadily declining. To solve this problem of inconsistency, our research team carried out the current study with the following objectives: 1. The primary objective is to review the records of the verbal autopsy of the so-called TB deaths in order to check the accuracy of the reports 2. The subsidiary objectives include to assess clinical cause of these deaths Our research team were kindly supported by the IHPP team who provided the verbal autopsy data Our team consist of the following experts: (1) Senior Medical Epidemiologist who conceptualized and designed the study. (2) Senior Infectious Disease Expert (3) National Senior Expert on Tuberculosis (4) Statistician Experts No (2) and No (3) initially independently reviewed the data, write their comments and finally scored how much they agreed with the verbal autopsy reports. The score could be one of these 5 levels 1 Not agree 2 Somewhat disagree 3 Indecisive 4 Somewhat agree
5 Agree Out of 198 records provided by IHPP, the 63 duplicated records were removed, leaving 135 unique records. Frequency of the 1, 2, 3, 4 and 5 scores given by the National TB expert were 10, 12, 94, 11 and 8 Frequency of the 1, 2, 3, 4 and 5 scores given by the Infectious Disease expert were 14, 7, 21, 21 and 72. Weighted kappa statistic = 0.226, indicating fair agreement between the two experts. There were 3 types of weighting scheme were applied. The unweighted, linear weighted and quadratic weighted kappa statistic were 0.86, 0.141 and 0.226 respectively, which can be concluded as relatively low. In conclusion, the revision of history of cause died from TB in the verbal autopsy result got inconsistent rate of likelihood from two independent experts. The findings suggest the need to improve such data in the future.
Mycophenolic acid (MPA) is an immunosuppressant medication used to prevent rejection following organ transplantation and is under investigation for its efficacy against osteosarcoma. We investigated the genetic variability of whole-exome sequencing (WES) data from 15 osteosarcoma patients who receive mycophenolate mofetil (MMF), a prodrug of MPA. Using whole-exome sequencing (WES), we found 48 variants from the 15 genes which are related to MPA and its metabolite (MPAG) metabolism. Three variants were found to significantly correlate with the pharmacokinetic parameters of MPA after single-dose MMF administration including SLCO1B3 (rs4149117, T>G), SLCO1B1 (rs2306283, A>G) and ABCG2 (rs2231142, G>T). Moreover, five variants were found to significantly correlate with the pharmacokinetic parameters of MPA after multiple doses of MMF administration (at steady state) including SLCO2B1 (rs2306168, C>T), ABCG2 (rs2231137, C>T), UGT1A8 (rs3755323, T>C), UGT1A8 (rs3755321, T>C) and UGT1A8 (rs4148323, G>A). All of these variants are missense mutations. In addition, in this study, we could build the population pharmacokinetic models for MPA in Thai osteosarcoma patients and healthy volunteers, which include genetic covariates. It was found that the pharmacokinetics of MPA in both populations can be described by a two-compartment pharmacokinetic model with 1st order drug elimination. Furthermore, the addition of the absorption lag time in the model for drug absorption following multiple doses of MMF (steady state) could significantly reduce the objective function value. Based on the population pharmacokinetic study, genetic factors affecting the pharmacokinetic parameters of MPA have not been identified. Based on the results of this population pharmacokinetic study, the pharmacokinetic parameters of MPA are different between healthy volunteers and osteosarcoma patients. Osteosarcoma patients had lower CL/F and Vc/F of MPA compared to healthy volunteers. Moreover, in osteosarcoma patients, it was also found that MPA pharmacokinetic parameters differed between post-administration of MMF in a single dose and multiple doses (steady state). After a single dose of MMF administration, the CL/F and Vc/F of MPA were approximately 2-fold and 1.4-fold higher than after multiple doses of MMF administration (steady state), respectively.
Background: The global rise in non-communicable diseases (NCDs), particularly type 2 diabetes, is a major concern. Existing literature highlights the effectiveness of non-pharmaceutical interventions, such as weight reduction, in reducing the risk of diabetes among pre-diabetic individuals. Grounded in the integrated people-centered care concept and recent behavior change theories, researchers developed a peer-coaching program led by health professionals. Methods: The program was implemented across primary care settings in four districts, representing four regions of Thailand. A total of 423 pre-diabetic patients were enrolled in the experimental group, while 443 were assigned to the control group. Participants in the experimental group engaged in five behavior change activities. To evaluate the program's effectiveness, BMI, waist circumference, blood pressure, health behaviors, and blood glucose levels were measured pre- and post-activity. Satisfaction and perspectives were collected from healthcare professionals and patients using quantitative and qualitative methods. Program delivery costs were assessed, and a cost-benefit analysis was conducted. Results: A 97.2% attendance rate was recorded for the experimental group, who demonstrated statistically significant reductions in BMI, waist circumference, blood glucose levels, and diabetes risk scores compared to the control group. The 10-year diabetes risk score for the experimental group decreased by 12.65% after attending the program. The benefit-cost ratio was 2.96, indicating the program's value. High satisfaction levels were reported among both healthcare professionals and patients. Discussion and conclusion: The behavior change program designed for pre-diabetic patients, emphasizing people-centered care and modern behavior change concepts, proved effective and worthwhile for primary care settings. After minor revisions, the diabetes prevention program package should be included in benefit package of Thailand health insurance schemes to promote its widespread adoption and utilization.
Background: There is a growing variety of pharmacogenetic tests that can be used to predict how someone would respond to different drugs. This will result in increased health care costs, compared to standard treatment without pre-treatment pharmacogenetic testing. However, healthcare resource and budget are limited. Consequently, it is important to prioritize pharmacogenetic testing and select pharmacogenetic testing in Thailand in order to be suitable to the Thai context and can be used for economic evaluation in the future. Objectives: This study aimed to prioritize and select pharmacogenetic testing in Thailand, perform economic evolution of selected pharmacogenetic testing, and 3) evaluate budget impact of pharmacogenomics testing, if included in the benefit package under the Universal Health Coverage (UHC). Methods: Prioritization and selection method for drug-related pharmacogenetic tests (gene-drug pairs) that are important in the Thai population were used to select pharmacogenetic testing for evaluating their cost-effectiveness through reviewing the literatures and recommendations from pharmacogenetic experts to be used as scoring criteria and selection. Apart from this, the cost-utility and budget impact analyses of HLA-B*13:01 testing before initiation of co-trimoxazole treatment to prevent DRESS and dapsone treatment to avoid SCAR compared to no testing were undertaken using a decision tree and Markov model. Results: From the prioritization of gene-drug pairs according to the prioritization criteria, in HLAs group, it was found that gene-drug HLA-B*15:02–phenytoin, HLA-B*57:01-abacavir, HLA-B*13:01-co-trimoxazole and HLA-B*13:01-dapsone should be considered for economic evaluation in Thailand. In non-HLA group, gene-drug CYP2B6- efavirenz, SLCO1B1-simvastatin และ NAT2-ethambutol, isoniazid, pyrazinamide, rifampin should be selected as a candidate for economic evaluation in Thailand. Results of economic evaluation showed that HLA-B*13:01 testing before initiation of co-trimoxazole treatment to prevent DRESS and dapsone treatment to avoid SCAR was not cost-effective, compared with the group without pharmacogenetic testing. The provision of HLA-B*13:01 testing resulted in the budget impact of 2,246,000 baht per year. Conclusions: The results of the study of the prioritization of gene-drug pairs can be used to consider the selection of gene-drug pairs for future economic evaluation in Thailand. HLA-B*13:01 testing prior to initiation of co-trimoxazole and dapsone was not cost-effective and therefore is not proposed to be included in the UHC Benefit Package.
The prevalence of substance use among adolescents has been increasing and found in lower age, twelve years. It creates impacts on their health and future lives, as well as society at large. In Thailand, although there are laws and policies that supportive for problems solving but the implementation has been rather inefficient. Petchaboon province has actively put these policies into practice using integrative and collaborative concepts among all stakeholders since 2015. A community-based approach has been used particularly with school settings. However, it cannot mitigate the problems in terms of magnitude and access to treatment and rehabilitation services. This study aimed at developing a comprehensive treatment and rehabilitation model of adolescents’ drug and substance abuse at a provincial level which enhances access to care and improves retention until outcomes achievement. Community-based participatory action research approach was employed using both qualitative and quantitative data. The review of related literature and policy context, as well as an analysis of situation about drug use and access to treatment and rehabilitation of school adolescents in Petchaboon province were conducted. The participatory action case studies of community-based model were done in nine subdistrict units (Tumbol) and four school-based sites. All action sites were under supervised by the Family Medicine Unit of Petchaboon hospital. It was found that both community-based and school-based comprehensive treatment and rehabilitation model for school adolescents who use drug could be codesigned and operated by using interventions included a Low-intensity Cognitive behavioral therapy, (Li-CBT) and Motivational Interviewing (MI). The mechanism of changes at individual level could be explained while at a system level might need for further study in term of improving access and retention. It also suggested that school-based psychosocial therapy model would be an opportunity to bring in school students to actively participate as peers.