plueme/wizJson huggingface dataset:
Treating ischemic stroke patients with rt PA no more than 3 hours or 180 minutes after the stroke can increase the chance of recovery or improved condition.  If, however, treatment is delayed, the potential outcome may be permanent disability or death.  This descriptive study was conducted with the objective of assessing time elapsed before treatment in ischemic stroke patients and analyzing the factors influencing the amount of time elapsed before ischemic stroke patients receive hospital treatment.  The sample group was composed of 300 ischemic stroke patients treated at Sanphasitthiprasong Hospital in the province of Ubonratchathani, Thailand.  Data were collected from November 2014 to February 2015.  The following three sets of instruments were employed:  1) Demographic Data Questionnaire; 2) Ischemic Stroke Evaluation Form and 3) Time to Treatment Evaluation Form.  Data were analyzed by descriptive statistics and by finding the correlations by using Spearman's correlation coefficient.
According to the research findings, 229 of the 300 ischemic stroke patients (76.3%) had pre-hospital times of more than 180 minutes.  The median pre-hospital time from the occurrence of stroke to hospital arrival was equal to 302.5 min (S.I.Q. = 589.38). The amount of time elapsed from arrival in the emergency room at Sapphasitthiprasong Hospital until receipt of treatment (in-hospital time) was equal to 107 min (S.I.Q.= 43.125). Therefore, the median time from the initial presenting symptoms until treatment was equal to 590 min (S.I.Q.= 635.63).  Furthermore, the pre-hospital time, the distance from the site of the incident to the hospital and the in-hospital time from arrival until laboratory test results were received were found to be positively correlated with the pre-hospital time from the initial presenting symptoms until receipt of treatment (rs= .661, .185, .235, p<.01).  The severity of symptoms evaluated with NIHSS scores was found to be negatively correlated with pre-hospital time (rs= -.129, p<.05).
In summary, most ischemic stroke patients within the boundaries of Ubonratchathani receive delayed treatment in which the pre-hospital time has the highest correlation with receipt of treatment and instructing patients, people at risk for ischemic stroke and their relatives.  Moreover, the development of an emergency medical service provision system and a hospital referral system that minimizes procedures and time in transferring ischemic stroke patients is vital to helping ischemic stroke patients receive timely treatment.
Background : Quality of infection control in primary care center is very important for community health. The study aimed to develop the primary health center networks of infection control in Chiang Mai province.
Methods : An intervention study was conducted. Two hundred and sixty nine primary health centers were included the study. The interventions were a quality infection control network in Chiang Mai, group discussion for knowledge sharing and infection control guideline manual for primary health centers. Quantitative and qualitative data were collected and analyzed in order to describe impact of the intervention and factors associated successful of the network.
Result : The primary health center networks of infection control in Chiang Mai province were developed. During 17th Apr – 15th Dec 2014, The intervention was implemented to 150 of 269 primary care centers (55.78%). The intervention strengthened the network and improved infection control knowledge of study population.
Conclusion : Infection control nurses networking for knowledge sharing associated/in nosocomial infection control Chiang Mai province was developed by a quality infection control network in Chiang Mai. The effectiveness of the intervention and factors associated successful of the network are studying.
ST segment elevation myocardial infarction (STEMI) is a major cause of death. Recent evidences showed that primary percutaneous coronary intervention (PPCI) can reduce mortality rate. However, in a situation where PPCI is unavailable, facilitated percutaneous coronary intervention (FPCI) using fibrinolytic drug before patient referral could be an important life-saving solution. Since FPCI may increase the risk of major bleeding and it incurred more expenditure, the information on cost-effectiveness of FPCI is useful for policy makers.
A Markov model was used to compare the lifetime cost and quality-adjusted life years (QALYs) accrued to patients receiving FPCI before referral or PPCI at referral center from societal and health system perspective. All analyses were performed using Microsoft Excel. Input data were retrieved from literatures and electronic databases.
We found that FPCI program at community hospital is a dominant alternative given its lower cost and higher effectiveness than PPCI at referral center. This means it is a cost-effective policy option.
Therefore, community hospitals with the capacity to provide FPCI service for STEMI patients should be supported to offer such service for better access to the patients with higher overall quality of life and lower costs to the systems. We suggest that policy makers in the Ministry of Public Health and the hospital administrators should consider these findings and provide support to make FPCI available in community hospitals with existing capacity. Capacity strengthening particularly in terms of manpower, and budget should be provided especially in the areas where there is still shortage of supply.
With a promising import-substituting alternative of electromyography (EMG) needle electrodes used in spasticity treatment, this research aimed to investigate polymer types and polymer coating technologies that were suitable for coating on the needle shaft of the common hypodermic needles. Previous study of the EMG needle electrodes with accessible data of related coating products and Thailand’s commercially available raw materials data revealed a potential technique of implementing the dip-spinning process of aqueous fluoropolymer dispersion coating onto the surface of 316 stainless steel needle shaft. As a result of the former research on topic “a study of polymer coating on needle for medical application” financially supported by National Research Council of Thailand, the newly designed dip-spin coating equipment was used to coat FEP and PTFE on the needle shafts of the common hypodermic needles. Various characterizations and testing of the polymer-coated surfaces were conducted. Depended on predetermined coating parameters, thicknesses of FEP and PTFE could be coated on the needle shafts in the range of 5-10 μm. Both FEP- and PTFE- coated needles showed good adhesion with no polymer film detachment after insertion the needles into a piece of pork shoulder. In addition, the results of penetrating the FEP- and PTFE- coated needles to the injection vial stoppers showed low friction forces and good adhesion. Film adhesion qualities were in agreement with measuring adhesion by using tape test on the FEP- and PTFE- coated flat surfaces of 316 stainless steel plates that showed no detachment. As results of penetrating the FEP- and PTFE- coated needles to the injection vial stoppers, their drag forces were compared with the commercially available EMG needles. Drag forces of the FEP- and PTFE- coated needles were, respectively, 1880-1900 mN and 2650-3000 mN while the commercially available EMG needles from companies A and B were, respectively, 1450-1520 mN and 1400-1900 mN. However, the coats from company A were detached from the needle shafts during penetrating the injection vial stoppers with possible cause of poor adhesion of the coat on the needle shaft. Biological evaluation testing was complied with Thailand’s TIS-1398 sterile hypodermic needles for single use and TIS-2395 Biological evaluation of medical devices. Seven sets of the biological evaluation testing included cytotoxicity testing, irritation testing, sensitization testing, pyrogen testing, haemocompatiblity testing, systematic toxicity testing, and intracutaneous testing.
Drug-related problems (DRPs) such as overdose drug use, drug used without indication, concurrent drug use with possible drug-drug interaction may cause harm to the patients who receive healthcare service at the hospital. Therefore, DRPs are the national burden. Electronic health record (EHR) was widely adopted and used in many hospitals. However, collecting DRPs was not developed and implemented systematically. In addition, categorization of DRPs was not standardized, this could hamper pooling DRPs regionally and provincially. The objective of this research was to develop EHR, which is a part of hospital information (HI) system, to be able to systematically collect DRPs and to standardize categories of DRPs to be user-friendly and can be used in routine work. The committee for EHR and HI development of community hospitals in Ubon Ratchathani Province was met to identify management problems related to DRPs and to gather opinion towards DRPs system. Thereafter, DRPs program was developed and tested to identify any technical problem which was consequentially fixed to make the program more user-friendly and implemented in HI system. The results showed that DRPs management system was different among community hospitals although these community hospitals used the same HI system. Thus, DRPs report was dissimilar. DRPs program developed from the committee’s consensus was user-friendly and appropriated for the routine work. DRPs categories were also standardized. Pooling and reporting DRPs regionally and provincially was reliable and valid. Thus, it is possible to benchmark and evaluate the quality of medical services.
Performance Assessment of District Health System in Tak Province.The aims of this study were
to assess of the provincial and district committee level,in 9 district of Tak province. ), which will assess
the compliance of the project in the context ,input, process, output and outcome .Using the model CIPP
Model of Stoughton Waffle Beam. (Stufflebeam's CIPP Model ) Data were collected and analyzed by
quantitative method with descriptive statistics.
The results showed that the context of each area with the integration of technical development in
areas already include self-assessment. The district health system Using a model planned community with
quality development, including the development of quality guidelines HA PCA standard and are used for
process-driven application development, network management services, process know-how. The
knowledge from routine to research. The input policy, budget, personnel, equipment showed that.
Commented that there is a consistent level. The process Issue Rating Is the process of implementation
Tracking supervision and evaluation The samples of the opinion that there is consistency in the level of
output of the sample is of the opinion that there is a consistent level of results, the sample is of the opinion
that there is a consistent level. The development of district health network. The collaboration at the district
level were moderate consensus. Providing essential health The samples of the opinion that there is a
consistent level. The sharing and development groups. Commented that there is a consistent level. The
involvement of community groups. Commented that there is a consistent level. And the value of work
Sample Commented that there is a consistent level.
The National Health Security Office, region 8, Udon Thani had surveyed the perception and opinions
of health providers towards an increase of funding to facilitate appendectomy, hernia repair surgery
and tubal resection in community hospitals around the North-Eastern region; Loei, Nong Bua Lam Phu,
Udon Thani, Nong Khai, Bueng Kan, Sakon Nakhon, and Nakhon Phanom during the fiscal year of 2013.
The informants consisted of 280 people. The results demonstrated that 66.1% has never known about this
policy before, 72.9% agreed with this policy, and 40% has acknowledged that their hospitals have had the
policy to increase the operations. 76.4% has wished that this kind of policy would not be terminated. The
study revealed that the relationship between the health provider’s perception and the hospital’s policy to
increase surgeries was significant (p<0.05). Three factors influencing hospital to increase the operation
are: 1) the readiness of the operation team, 2) the availability of surgeons, and 3) the convenience of the
patients. However, the first three factors that make “No more” surgical are: 1) the capability of the team is
not enough, 2 ) no surgeon, and 3 ) the risk of being sued.
The objective of this study is to assess the situation of hospital-based smoking cessation clinics in
Thailand from 2007 to 2012 by conducting literature review and assessment in 10 sites supported by
National Health Security Office (NHSO) in order to identify success factors and good practices for scaling
up. The result shows that there are four models such as hospital-based cessation clinics, Quitline service,
cessation services in pharmacies with full-time pharmacist and by dental clinics in public health centres
under Bangkok Metropolitan Authority. Two systems were developed to achieve universal access to
cessation service such as Quitline 1600, cessation clinics supported by NHSO, including SMART Quit
Clinic. Clinical practice guidelines for treating tobacco dependence by physicians and other health professionals,
for which the contents of the guideline can be adjusted to suit each profession, were also issued. In
the ten smoking cessation sites, the structure and services differ slightly depending on the context and
size of hospital. The 5A’s system (Ask, Advice, Assess, Assist and Arrange) was fully integrated into
routine work in all departments without referring the smoker clients to the smoking cessation clinics.
Usually providing consultations and parallel medication are offered. Plans for rehabilitation and followup
with support from network outside hospitals such as health centres and volunteers are the key performance
indicators
This study recommends: 1) In collaboration with organizations involved or with capacity to be
involved in existing cessation services, make services for smokers a special program under NHSO to
improve central and regional systems. 2) To plan and integrate Thai cessation services into one system, set
up a workgroup with clear organizational policies as the responsible body for all levels from ministerial,
regional, district to provincial level. 3) To develop up-to-date educational media for use by cessation
clinics through which standardized cessation techniques can be taught. Provide channels for continuous
report and public relation including seminar, training and research dissemination where those responsible
for cessation clinics are invited. 4) To have personnel throughout the country trained under the same
system, set up a central office responsible for setting consultation and treatment training standards. 5) To
have service conditions set; for patients with chronic diseases make cessation a condition for receiving
services.
The World Health Organization recommends exclusive breastfeeding for 6 months for the baby’s
health and illnesses protection. Several studies have assessed the effect of breastfeeding on the risk of
atopic dermatitis and asthma. This study aimed to systematically review the relationship between duration
of breastfeeding and atopic dermatitis and asthma. We used relevant key words to search for studies
published during 2001-2013 in PubMed database and Cochrane library. Forty-two studies met the inclusion
criteria. The results found that infants not breastfed were at a greater risk of developing atopic dermatitis
and asthma (Relative risk (RR) or Odds ratio (OR), 1.15-11.53) than infants who were breastfed.
Breastfeeding for less than 3 months increased risk of the diseases (RR, OR =1.25-1.45) than infants who
were breastfed for 3 months or more. Breastfeeding for less than 6 months were associated with increased
risk of diseases (RR, OR= 1.15-2.00) than 6 months or more. Several studies show that breastfeeding is
likely to associate with protection against development of atopic dermatitis and asthma. However, since
the literature has a wide range of quality, further studies including meta-analysis study should be undertaken.
As older persons moving through the stage of dependence and seeking for help, some of them needed
to receive care in long-term care facilities. This transition period can be very emotional and stressful event.
This qualitative study aimed to examine the experiences of Thai elderly (n = 19) focusing in their adaptations
in the transitional period in long-term care facilities. Participants (≥ 60 years old) who moved to the
long-term care facilities for at least 6 months and had partially impaired of IADLs or ADLs, were interviewed
using open-ended questions. Example of the questions included: “How do you make the decisions
of moving?“, “What were your experiences before moving?“, “How do you feel about the new place and
come up with?” Qualitative results were analyzed by content analysis. The analysis was made to find the
similarities and differences between the experiences of participants. The results showed that the elderly
experienced their transitional period differently. Key determinant was the extent to which they were able to
control over the decision to move to long-term care facilities. Participants who preserved their autonomy
learned to adapt and accepted the transitional period better than the participants who lost their control.
Meanwhile the elderly who were forced to move and had family conflicts, tended to have depression. Facing
death and functional decline, some elders gained the concepts of life cycle and became more calm and
motivated to modify their behaviors for maintaining their capability of livings as long as they could.
This review aimed to describe the methods that have been used for workforce projections and to
explore the relevant literatures of pharmacist workforce in Thailand and other countries. Determining a
workforce is an important part of workforce projections. Several methods were used for workforce projection
which included: population ratio method, health need method, health demands method, service targets
method, adjusted service target-based method, budget driven mechanisms, workload measurement
method, work point evaluation method, and needs assessment models. The selection of methods used
depends on the availability/accessibility of data and the proposed application. Forecasting the future is a
difficult task and related situations are always dynamic. Therefore, a continuity of workforce projection
studies is essential to ensure the data accuracy in both micro and macro perspectives in order to illustrate
the problem at national and local levels.
Marketing and advertising of food and beverages with high sugar, fat, and sodium are important
environmental factors which influence on children’s eating behavior and health. In 2010, the World Health Assembly, the World Health Organization (WHO) Member States endorsed a set of recommendations on
the marketing of foods and non-alcoholic beverages to children, aiming to reduce the impact of foods high
in saturated fats, trans fatty acids, free sugars, or salts, and expecting cooperation at policy level. The
structure of this document includes a description of the background and process for the development of
the recommendations, an evidence section and 12 recommendations structured under five sub-headings:
1. rationale; 2. policy development; 3. policy implementation; 4 policy monitoring and evaluation; and 5.
research. This study describes theoretical concepts of the set of recommendations, situations, gaps, and
opportunities of food and beverages marketing and advertising regulations in Thailand which correspond
to these recommendations, and analyses 3 mechanisms: policy development; policy implementation and
policy monitoring and evaluation. The review of regulations to control food and non-alcoholic beverage
marketing and advertising to children in Thailand found that Thailand has laws related to marketing and
advertising, which can be deployed to control the marketing and advertising of foods and non-alcoholic
beverages high in saturated fats, trans fatty acids, free sugars, or salt in children. However, the law enforcement
is not as efficient and productive as it should be and there is also a lack of specific regulation to
control food and non-alcoholic beverage marketing and advertising to children.
Referring patients from community to provincial hospitals results in higher direct non-medical costs
(DNMc), which include the costs of transportation, food, accommodation, and informal caregivers. However, these costs have not yet been quantified.
This study estimates the increase in DNMc for referred ambulatory and hospitalized patients. To
approximate the DNMc of patients at community hospitals, a cross-sectional survey was conducted in
three community hospitals in Suratthani province during 16-26 February 2015. The DNMc of patients
who were referred to the Suratthani provincial hospital, were derived from previous studies which reported
the DNMc of patients at this hospital. Cost adjustment was performed using the consumer price
index, with base year 2015. T-tests were used to compare the differences between parameters, with a
significance level of 0.05.
The results showed that, for each day the patients were hospitalized at a provincial hospital, the
costs of informal caregivers were 632.90 Baht higher than those admitted to community hospitals. For
ambulatory care patients, the total DNMc of those referred to a provincial hospital were 513.40 Baht higher
than those receiving care at community hospitals.
Higher DNMc may prevent patients from accessing needed care when referred from community to
provincial hospitals. One way to mitigate this obstacle is to improve the capacity of community hospitals,
thereby reducing the need to refer patients to provincial hospitals without compromising quality of care.
The emergency medical personnel in Thailand are always challenged by the task difficulty in working
with limited resources and spaces, as well as the high risk of encountering traffic accidents. This study
aims to elaborate situation and analyze the causes and factors of the ambulance crash in Thailand.
This was a retrospective analysis of all fatal ambulance crash on Thailand public roadways in 2014, from the secondary data in three main sources, including the database of Information Technology for
Emergency Medical System (ITEMS), the records of surveillance ambulance accident of EMS from
January to December 2014, and the report of ambulance accident investigation collected from the local
network in 2014, using the Haddon’s matrix approach. The study was conducted from January to March
2015. The results are presented using descriptive statistics
According to the ambulance accident surveillance data, 61 ambulance accidents occurred in 2014,
resulting in 130 injured victims and 19 deaths. The accidents happended more frequently during June to
August (25 times). The accident rate was 0.05 with the mortality rate of 0.02 per 1,000 operations. From the
nine accident investigation reports, factors related to accident and safeness of the ambulance could be
concluded into human factors, vehicle and equipment factors, and road environment factors. Human
factors included lack of ambulance driving training, unfastened seat belts, and high speed driving exceeding
90 km/hr. Unregistered ambulance and missing GPS installation contributed to the lack of vehicle
standard. The disparity in each local road environment such as speed curve, crowded site, and missing
directive signs led to higher risk of accident.
This study found that ambulance accidents was increased, resulting in an increasing of injury and
death in emergency medical personnel. The causes of ambulance accidents and risk from the above three
factors were still prevalent. Therefore, it is necessary for the related organizations to implement new policies
and take actions towards preventing future ambulance accidents.