plueme/wizJson huggingface dataset:
Study and Development of Indicators for Evaluating Risk Behaviour of Sexual Intercourse in High School and Technical College Students in Nakornrachasema ProvinceThe study objectives were to develop techniques of how to find risk behaviour indicators of sexual intercourse in high school and technical college students in Nakornrachasema. The technique which was used in this study was literature review in addition to organising brain storming meeting in order to determine the indicators. The study was grouped into 2 parts, 1) studying in high school and technical college students to find risk indicators by interviewing 1314 students sampled by multi-stage technique, 2) interviewing 12 school administrators to assess their interests in using the indicators.The study showed that 1 in 5 high school students and 46.7% of technical college students had had sexual intercourse while in female students, 10.5% of technical college students, 2.9% of high school students in Muang district and 3% of high school students in other districts had done so. Factors which were related to risk behaviour in male group, were drinking, independent living from their family, family income, age and inappropriate attitude for example having sex with their friends not risking AIDS infection. Sensitive indicators which were positive to high risk, were drinking, their living conditions, being technical college students, attitudes and family income.The results from interviewing educational administrators were some of them considered this issue as important whereas they were more interested in drug and learning problems. They expressed concern over independent living, less taken care by their family and lots of entertaining places where students were easily led to risk life behaviour. Most of them agreed with the use of indicators but felt hesitate to collect data by themselves. The study recommended that;the results of this study should be presented to all involved to promote issue awareness and process of exchanging views,high risk group which was the technical college students should be first targeted,process of data collection should be developed.
Development of indicators for the achievement of consumer protection on health products according to the eight National Socio-economic Development planThe objectives of this research were to develop reliable and valid set of indicators measuring the effectiveness and fairness of the health consumer protection activities as well      as to develop tools to evaluate the practicality and of the designed indicators prior to their application. This activity is in accordance with the Eighth National Socio-economic      Development Plan (1997-2001) on the Consumer Protection on Health Products. Sets of indicators were developed and subject to test of their validity and reliability in the field. Thus, the working group set the guideline of theoretical indicators. Suggestions from the chief of health consumer protection and pharmacy all aver the country of 76 provincial health offices regarding the indicators via questionnaire were made, after that brainstorming the stakeholders in health consumer protection and carried out empirical indicator. Then setting the questionnaire to test validity and reliability by health officers and health volunteer groups in twelve districts, of four regions and retest by consumer groups in Anything province. Effectiveness and fairness were the two areas of the seven sets of indicators which had been found. The reliability was between 0.6784 and 0.9754. The effectiveness indicators had four sets; skill to know how to consume (11 items), known how to develop themselves (8items), quality of products (8 items) and proper distribution of products (10 items). The fairness indicators had three sets; fair price (8 items), equality (10 items) and product liability (3 items). Tools for measuring were questionnaires, survey and data  collection from.
The Scoping of Health Impact Assessment of the Eastern Seaboard Development Program:A Case Study of Mab Ta Put Industrial Estates and their VicinitiesMr. Decharut SukkumnoedFaculty of Economics, Kasetsart University						decharut@hsrint.hsri.or.th	The Eastern Seaboard Development Program is the most obvious case showing “the Two Sides of the Coin” from Thai development experiences. On one hand, this development program is the most successful story of industrialization program in this country. On the other hand, it is also the most visible example of terrible environmental and health impacts in Thailand development experiences. The HIA from the Eastern Seaboard Development program aims to gain more experiences and knowledge on health impact assessment, as well as, to find the better ways in protecting and promoting local people’s health.	The WHO’s health and environment cause-effect framework has been applied to this study. According to this model, the industrial development is the driving force causing hazardous chemical uses and pollution in this area. The increasing in chemical uses and pollution becomes the pressure for local environmental quality. The air pollution and related health impacts, chemical accident, illegal hazardous waste dumping and chemical contamination in water resources and food web have been the most serious environmental problems in this area. The three epidemiological studies during 1997 to 2000 show the association between the exposure to air pollution and acute health impacts, especially in respiratory and central nervous systems. 	The state of socio-economic factors and social supports in these local communities has also been degraded. The changes in economic, social, and demographic structure cause local people to live with higher uncertainty, both in economic and social senses. The rate of out-patient per population in mental disorders, in this area, has been significantly increased, from slightly lower than regional and national average in the past to almost three times higher than regional and national average at present. The situation has become more serious after Thailand economic crisis in 1997.	The WHO’s health and environment cause-effect framework can be applied as a hypothetical model for assessing health impacts. To understand the complexity of health impacts, the combination and triangulation of qualitative and quantitative analyses are highly recommended. As a participatory learning process, it is also very important to ensure meaningful public participation within HIA process, specifically, by avoiding technical barriers.
The effectiveness of Structural Shared Care for patients with epilepsyin Nakhonratchasima ProvinceThis study aims to evaluate outcomes of treatment in terms of patient with seizure free and with regular follow-up between the conventional care and shared care with specialist's advice given to GP and letter reminder given to the patientsMaterial and Method: The study was conducted between June 1999 and September 2001. Two community hospitals were chosen: one for control and the other for intervention group. Before the beginning of the study, guideline of management for GP was created between GP and specialist. All patients with informed consent were treated and asked to fill data in the registration and follow-up form. All the data was sent to the investigator to register and audit the treatment only for intervention group. Advice (if any) would be sent to the GP and the patients would be received the letter reminder for the next coming schedule appointment. After one-year study, all data recorded in the forms and in the OPD card would be gathered for analysis with SPSS version 8. Some information not presented both in the forms and the OPD card would ask to the patients by letter. Results: The number of patients in control group and intervention group was 45 and 55, respectively. All each patient's characteristics between two groups was not different but patient's age, number of mentally retard patients and type of seizure (p-value < 0.05, 0.05 and 0.01, respectively). At the beginning of the study, patients with seizure free in the previous 3 month in control group were 46.7% (21 cases) and 56.4 % (31 cases) in intervention group. After the study, this figure has an increase to 72.7 in intervention group and 60% in control group. For follow-up analysis, the factors which might influence patient’s regular follow-up were not different between two groups including Univariate and Multivariate Analysis (Cox proportional hazards regression). There was no statistical difference in an average of the duration of follow-up (mean in control group = 9.61 months; in intervention group = 10.31 months) and in the proportion of patients with regular follow-up (64.4% in control and 67.3% in intervention) (p-value = 0.87 and 0.86, respectively). However, for survival analysis, no difference in proportion of patient with regular follow-up between two groups (p = 0.46, Log rank statistic).   Limitation and suggestion: Too small samples and few interventions might be the reason for no difference between two groups. The system should be corrected as a whole.
Child-Care Situation in Thailand: A Synthesis ReportThis reports aims at synchronizing the state of knowledge of child care situation in Thailand. The analysis is basically derived from the existing documents such as research reports, theses, the government white papers and academic articles. It was revealed that changes in child care patterns are associated with demographic factors. The most outstanding factors is change in family structure from the extended family to the nuclear family. An increase in labor force participation of women affects their domestic role and this results in child development physically, emotionally and socially. The emergence of child care centres does not help to mitigate child development problems due the inadequate experience of personnel in stimulating child development. A lack of qualified personnel and the participation from parents and community become problematic. Moreover, the influence of the media affects the development of children in both negative and positive ways.  Based on 150 research studies, it is obvious that the main points of research concentrate on the input factors of child rearing process. While the studies on output factors and the impacts are limited in numbers due to the complicated process of research design and assessment. The need of intensive research to investigate the interaction between family and child development is a priority.  An endeavor to combine the qualitative research with the the qualitative research will be the alternative to improve the quality of data for program implementation. There is a need for research at the national level ot provide useful information for action. Epidemiological research in physical      development with a strong emphasis on the preschool children in quite useful and more reliable to understanding the magnitude of the problems while research in emotional and mental development is quite limited. The only existing studies focus on the children with mental health problem who seek treatment at the the government hospitals and the mental counseling units are available but not sufficient. This research should be expanded in size in order to cover the whole population.        Research with an emphasis on skill  and intellectual development is also important. The previous research studies concentrate on  the assessment of the learning process and attitude test rather than the evaluation of the effectiveness of the teaching process and attitude test rather than the evaluation of the effectiveness of the teaching process. Those studies test do not reflect a sharp and clear direction for the effective resolution due to the improper standardized tools used for measurement. Research in policies for  implementation, law and plans for children and youth are rare. Most studies focus on evaluation and monitoring the effectiveness of law, policies and plans for child development.  Research in child investment, policy evaluation, data system for indicators of child development should be a priority.   Insofar, research in those components have been carries out by the small institutions and cannot be applies effectively for the national programs.
The study aimed to develop a new rehabilitation service system for stroke patients at Maharaj Hospital, Nakorn Ratchasima Province. The situation analysis showed some pitfalls of the existing system. For instances: there were underserved for occupational therapy services; the routine services and information given were not responsive to clients’ needs, in terms of supporting their self-concept; inadequate system to follow up discharged patients; and the increasing need for home rehabilitation service because of the inconvenience of client transportation. Participatory action research (PAR) was applied to work out among other related service providers or stakeholders to identify an alternative system. Those were physicians, physiotherapists and community nurses. Duration of the study was during The modified service was described as follows; The rehabilitation services would cover physical therapy and occupational therapy for every consulted case, even though it was not mentioned by physician. The essential rehabilitation guidelines had been set up to fit with Isan context. The follow up system was set up, and had to correspond with physician appointment date. Making linkages with community nurses to provide rehabilitation home care. Setting up the record and report systems for continuity of care between hospital and home care. Recommendations from this study were that this system should be applied for patients with other chronic conditions, such as paralysis or cerebral palsies, to whom rehabilitation services were needed. However, implementation of the recommended system should take personnel existing workloads for granted.
Information system of most hospitals in Thailand have increasingly been computerized mainly to improve administrative works without adequate concerns about quality of care. This study aims to explore major issues related with the use of computerized information system in hospital and quality of care. There were 4 phases: literature review, hospital survey, stakeholder analysis, as well as in-depth analysis of some famous systems. It was found that information system in at least 80% of the hospitals, especially private and large public hospitals were already computerized. Report production for various health insurance systems was the major reason. At least 44 different systems were available in Thailand without appropriate and effective information exchange mechanism both nationally and locally. IT-related investments by hospitals were found to be quite large despite the lack of evidence to prove their return. In addition, many problems including IT-related clinical risks were not efficiently taken care of. Nationally, the most important problem was hospital readiness, especially the inadequacy and poor competency of IT-related healthcare personnel. Moreover, the inefficiency of cooperation among central organizations forced most hospitals to solve major problems with their limited resource and comprehension.
The objective of this study is to empower subdistrict administrative committee (SAC). The concept of empowerment is interpreted as ability to solve community problems. Through the process of participatory action research (PAR), the researchers worked with the studied SAC to develop 5-year subdistrict plan on which community participation was emphasized. AIC (Appreciation, Influence and Control) and FSC (Future Search Conference) concepts were applied. Additionally, case study analysis method and study visits were conducted. Qualitative data collection techniques and were used content analysis was used in data analysis. The study period was during January – August 2001.	The result showed that by using participation concept the SAC could be empowered which was assessed by improvement of their ability in; understanding their problems and needs, causes of such problems, problem solving skill, analysis skill and self determination. Consequently, they developed positive self – esteem, self and other- acceptance and self –confidence. Case study method, dialogue, and field study facilitated the SAC to broaden their vision as well as to realize the necessary of data. Most of all, they became aware of listening to people, getting people to participate in solving community problems led to better understanding of their roles and functions. Recommendations are made in two folds. Firstly, this empowerment process goes in line with the national health care reform policy. It helps those who are involved to be reoriented about broader concept of health, holistic view of approaching community problems and community competence. Such orientation requires changing roles of health personnel working with community. The new roles should concentrate on facilitator concept, resource coordinator. Health personnel should work with and learn from community rather than imposing. However, clear guidelines to bring policy into practice as well as changing budgeting policy are needed. Secondly, it is aware that here is no one empowerment process to fit all situations. Such process is highly context-bound. Furthermore, this process needs them and continuity of activity. Suggestion for further study is on application of PAR to be implemented in monitoring the subdistrict plan.
Development and administration of community health fund were studied to explore factors and conditions which were involved in its administration. A number of major issues were;changes and development of circumstances at micro and macro level, thoughts, definitions and administrative system of community,strengths of health fund particularly financial viability,community health activities andlinkages of health funds to health benefits and development of other community activities.	Comparison of 6 community funds was used in this study. Three regions in which the sampled community funds were located were the central, the North-eastern and the Southern region. Data were collected from existing Thai and international document and research, surveying socio-economic status of communities, interviewing key persons, discussing in group and participating community activities if opportunity available. Data were grouped into three levels, individual, family and group / community. The results showed certain differences and similarities in sampled communities, which were predisposed by community circumstances, development and goals of community funds.
Diagnosis related group (DRG) has been researched and developed in Thailand since the implementation of the Traffic Accident Protection Act 1992 with support from the Health Systems Research Institute (HSRI). It was aimed to be an alternative of payment apart from fee-for-service and capitation payments. The first research in public and private hospitals in 10 provinces gave about 100 DRGs covered injuries. Later research activities expanded to cover all diseases in the low income patients and finally cover all inpatients by using electronic patient data from well developed hospitals. Success of these activities proved that Thailand was able to use DRG for health financing. In 1998, the Health Insurance Office, Ministry of Public Health adopted DRG as payment method for high cost care for the low income card scheme. This decision has stimulated the flows of individual patient data from hospitals to provincial health offices and the ministry. The information assets have increased from 1.5 million patients in 1998, to 3.0 million in 1999 and more than 3.6 million in 2000.It can be concluded that DRG has brought big changes in health care in Thailand. Information technology has been used for promoting efficiency, equity and quality in health delivery. The first Thai DRG Grouper was launched in 1998 followed by version 2 in 2000. The tests of these groupers against the international groupers showed lots of improvements. When the government made a big decision to provide universal coverage to cover all Thai population in April 2002, the researchers and developers of DRG decided to develop the third version that is compatible with the patterns of diseases in Thailand, especially the tropical diseases. This activity got financial supports from the HSRI, Thailand World Health Organization Office, the Health Insurance Office, and got technical helps from more extensive groups consisting of the royal colleges, colleges and societies of health professionals. It was hoped that the 500 DRGs in version 2 would be expanded to 1,000 DRGs to better reflect different disease severity. Since DRG is the only one case mix being researched in Thailand, DRG is good only for acute inpatient episodes. There are many complex issues in health care reforms or health system developments; e.g. information technology, increasing efficiency within public sector, health care accreditation, health care decentralization, autonomous hospital, and the universal health coverage of the new government (30 baht medical care policy), etc. In the implementation of the 30 baht policy, many issues of health care reforms have been dumped to ride the wave of change. DRG was used inadvertently with decentralization policy but with less understanding. This conflicts with the recommendations of the Working Group on Universal Coverage of HSRI. The working group recommended the split of budget between ambulatory and inpatient care. The capitation payment is good for ambulatory care and DRG for inpatient care. To increase access to efficient and good quality inpatient services to all, DRG should be managed with unity at the central level under the reasonable global budget cap.