plueme/wizJson huggingface dataset:
This study was aimed at assessing the mortality differential according to demographic, socio-economic
and health status among the Thai elderly (aged 60 years and older) during the period 2004 and
2006. The data used were from the National Health Examination Survey III, 2004 (NHES III) and death
registry between 2004 and 2006. Area of residence, geographical area, marital status, education, house-hold income, dependence on daily activities of living and cardiovascular risk factors
were selected as demo-socioeconomic and health status indicators. The standardized
mortality ratio (SMR) was used to measure old-age mortality according to these indicators,
disaggrageted by sex.
It was found that mortality differences existed in almost all demo-socioeconomic
and health status indicators of the Thai elderly, except area of residence. Male and female
elderly people who lived in northeastern and northern Thailand had higher mortality,
while those who lived in the southern part of the country and Bangkok had lower
mortality than those who lived in the central region. Furthermore, the elderly who had
always been married, widowed, divorced or separated had higher mortality than those
who had always been single. The dependent elderly or those with cardiovascular (CV)
risk factors had higher mortality than those who were not dependent or who did not
have CV risk factors. These mortality differences could reflect health inequality among
different groups of the Thai population.
Tuberculous meningitis (TM) is associated with high morbidity and mortality. The early diagnosis
and treatment of tuberculous meningitis saves lives. Diagnosis is based on clinical features, cerebrospinal
fluid changes, and imaging characteristics. The clinical features of TB meningitis sometimes are initially
non-specific, although clinical meningitis with cranial neuropathies, cerebral arteritis, hydrocephalus and
spinal arachnoiditis are well recognized by most physicians. Bacteriological confirmation, such as microscopy
for acid-alcohol-fast bacilli, polymerase chain reaction and culture, is not possible in all cases as
those tests do not have sufficient sensitivity; however, this depends on the volume of CSF examined.
Brain imaging should be performed if the patient deteriorates. The complications of hydrocephalus, infarction,
and tuberculoma are common complications of tuberculous meningitis and a neurosurgical opinion
should be sought in those who are failing medical therapy. Early treatment with four drugs (isoniacid,
rifampicin, pirazinamide and etambutol) prevents death or disability. Adjunctive treatment with corticosteroids
improves survival but probably does not prevent severe disability.
After almost 20 years of effort, the Art Therapy Demonstration Center was established under the
Rajanukul Institute, a 48-year-old mental health hospital and academy of the Department of Mental Health,
Ministry of Public Health. The date was April 3, 2008 and the occasion was presided over by General
Wanchai Ruengtrakul, President of the Rajanukul Foundation, and Dr. Wachira Pengchan, Deputy Director
General of the Department of Mental Health, Ministry of Public Health. The co-chairpersons announced
the official opening of the “Art Therapy Demonstration Center.” The opening event was followed
by the Art Therapy Specialist Seminar on “Art Therapy Roadmap in Thailand”, which was attended
by 120 mental health personnel, some art therapists, professional artists and art educators, among
others.
The seminar comprised two sessions: “Art Therapy in Thailand” and “Art Therapy in the West.” The
first speaker, Dr. Udom Petchsangharn, the former director of the Institute, spoke of the value and status of art therapy in Thailand based on the concept of “adjunct therapy” or “essential adjunct therapy,” and
the role of “art” in human sociology, and its power in the treatment of the mind. The second speaker, Prof.
Punya Vijinthanasarn, an outstanding artist and Dean of the Faculty of Painting, Sculpture and Graphic
Arts of Silpakorn University, spoke on the historical development of fine art in association with innersubconscious
expression by using extensive examples of Western art works. Prof. Saman Supprasri, Dean
of the Faculty of Fine and Applied Arts, Burapha University, gave notes on the role of art education and
aesthetical values in relation to the therapeutic approach. Dr. Lertsiri Bovornkitti concluded the session
by addressing the role of art therapy and its value, and the characteristics and knowledge that art therapists
should formulate, i.e., the two types of art therapy in the West: “Art as Psychotherapy” and “Art as
Therapy,” and then summarized a roadmap for art therapy in Thailand.
He acted as moderator for two invited speakers, Mr. Jordan Potash from the United States and Ms.
Debra Kalmanowitzs from England, who spoke on “Art Therapy in the West.” An example of historical
practices associated with traditional and indigenous art therapy was Navajo sand-painting. They also
provided background knowledge of art therapy in the West based on the two concepts, art as therapy and
art psychotherapy, explicating the three knowledge roots of art therapy, i.e., art, psychology and therapy;
and theoretical notions on “witness/witnessing.” The presentation was followed by a question-and-answer
session related to the practice of art therapy. The presentations of the two international art therapists
provided support for the future development of art therapy in Thailand.
For further improvement of the knowledge of Thai art therapy, the authors suggest that a series of
art therapy workshops be organized by qualified international art therapists and educators for the Thai
art therapy practitioners and those who are interested in this newly developing field.
This study was carried out in the period from September 2005 to January 2006 in order to determine
the effect of the frightening pictures printed on cigarette packs on the smoking behavior of 120 Burapha
University students aged 18 to 23 years, using specially designed questionnaires. The average number of
cigarettes smoked per day was 5.2. The results of the study suggested that the warning labels on cigarette
packs had reduced the number of cigarettes by 1-7 cigarettes/day, or 32.5 percent overall. The most
frightening label, which influenced the reduction in smoking, was one showing that cigarettes would
induce lung cancer; the first runner-up in the category was the picture showing that cigarettes lead to bad
breath, followed by one showing that cigarettes cause fatal pulmonary emphysema. The other three labels,
namely smoking enhances aging, smoking is hazardous to the young, and cigarettes are potential
killers, were not effective; therefore, they should be replaced. Smokers avoided seeing the frightening
labels either by removing the cigarettes from the packs and placing them in other containers, using a cover
over the pack, smearing the labels, changing to unlabeled cigarette brands, or purchasing the packs with
less horrifying labels. Accepting the inability to change smokers’ behavior entirely , the researchers opined
that, in addition to frightening the smokers with unhealthy-looking pictures, the implementation of more
effective strategies would be useful, such as making smokers fully realize the hazards of smoking, and
carrying out anti-smoking policies unceasingly.
Village Health Volunteers (VHV) were the hallmark of primary health care during the past three
decades. The volunteer exemplifies the concept of “community participation,” one of the most important
strategies for achieving the goal of “Health for All by the Year 2000”. As the health situation and political
landscape have changed, there was a need to re-conceptualize the roles and functions of the health volunteer
in health development. This study is aimed at assessing the roles and potentials of village health volunteers in the changing contexts of Thailand. Village health volunteers in Thailand, numbering almost
800,000, are an extremely valuable health resource. Although the recruitment of village health volunteers
has occasionally been questioned as being nepotistic or incentive-driven, village health volunteers are
those chosen by their communities for not only being public minded, generous, and willing to help those
in need, but also comparatively knowledgeable and concerned about health matters.
The study found that village health workforces were still very much active and have increasingly
become femininized. More than 35 percent of existing volunteers were recruited not more than five years
ago, while the number of female volunteers rose to almost 70 percent of the total. These volunteers performed
comparatively well on short-term tasks such as taking ad hoc health surveys, collecting periodic
data, or conducting disease prevention campaigns. They did not fare well, however, in the areas of work
that need long-term, continuous dedication, such as caring for chronically ill patients. Existing volunteer
workforces were found to be from a comparatively low educational and economic background. As health
issues have become more complicated, this finding poses the question of how could a volunteer workforce
with higher attributes and economic status more prepared for dedicated work be recruited. The changing
administrative system and decentralization has resulted in the village health volunteer being increasingly
implicated in local and national politics. Changing contexts and concerns call into question the relevance
of conventional model of VHVs. Case studies, however, suggest increasingly innovative roles and forms
of volunteers in health development, ranging from volunteers in hospital settings to disaster relief volunteers.
This strongly indicates that the idea of volunteering has been progressively more accepted and will
play an increasing role in Thai society in the future.
Protective behaviors against alcohol drinking were studied in 346 students in
Kanchanaburi Technical College; the studied group was recruited by stratified random
sampling technique. Information was collected by constructed questionnaires and the
data were analyzed by means of percentage, mean, standard deviation, t-test, one-way
ANOVA and stepwise multiple regression analysis. The findings were as follows: social
support and protective behaviors against alcohol drinking were at a moderate level. Selfesteem
and self-awareness concerning the drinking of alcohol were at a high level. Protective
behaviors against drinking alcohol among students with different educational level,
grade point average and alcohol-drinking behavior in their family were significantly different
at the statistical level of 0.05. Social support and self-awareness about drinking
alcohol could predict the protective behaviors against drinking alcohol among students
in 11.3 percent of the cases, with the statistically significant level being 0.05.
The objective of this study was to assess the situation of in-patient care for chronic renal failure
patients under the Universal Coverage Scheme. The in-patient claim database for fiscal year 2005, compiled
by the Central Office for Health-care Information, was used for the analysis. All admissions with ICD-10 codes compatible with chronic renal failure were included.
There were 45,326 chronic renal failure patients who accounted for 83,734 admissions (1.84 admissions
per patient) in 929 hospitals. The average length of stay was 5.4 days. Fifty-six percent of patients
were female, with the average age being 63.9 years. One-third of the patients had multiple admissions and
95 percent had multiple morbidities. The most common diagnoses were related to hypervolemic problems
or infections. Blood transfusions were the most common treatment procedure . Hemodialysis and
peritoneal dialysis were performed on a number of the admissions even though they were not covered by
the benefit package. Total hospital charges were 917 million baht (median 4,845 baht per admission).
Approximately 82 percent of the patients were discharged with clinical improvement; the fatality rate was
9.84 percent (4,462 deaths). The validity of data was the major limitation regarding diagnostic and procedural
coding, hospital charges, and discharge status. The patient demographic information was quite
valid.
Maternal and child health is a major health concern in the lower reaches of southern
Thailand. This action research was aimed at developing an integrated, participatory model
for solving problems related to maternal and child health in Kapho district, Pattani Province.
The model incorporated several activities, namely promoting community participation
through, for example, participatory community development for solving problems
related to maternal and child health; increasing access to maternal care through, for
example, promoting the delivery of newborns in the hospital by providing incentives for the pregnant women and traditional birth attendants (TBAs); and improving the quality
of maternal care through, for example, developing antenatal care clinic (ANC) and laborroom
services to meet with the safe motherhood project standard, the arrangement of a
place for Muslim ceremonies for the newborn in the hospital, training TBAs about postpartum
care, including ancient Thai massage and hot herbal compression.
The outcomes were assessed by ANC visits at least four times and delivery in the
hospital in comparison to the Department of Health standard of 90 percent of such visits
and deliveries. During the period from 1999 to 2007, the results clearly demonstrated
continuous improvement. In that period, the percentages of pregnant women attending
ANC at least four times were 78.9, 89.0, 93.4, 94, 97.5, 97.5, 98.4, 95.4 and 98.1, respectively.
The percentages of pregnant women delivering in the hospital were 52.1, 54.6, 63.7, 72.4,
81.5, 91.8, 97.1, 97.5 and 97.6, respectively. This study has shown a successful model of
maternal and child health problem-solving using the Plan-Do-Check-Act process,
multidisciplinary integration and community participation.
The purpose of this study was to identify factors affecting the compliance of diabetes
patients and to examine the relationship between the compliance of the patients and
the levels of Hb A1c. The subjects included 274 type 2 diabetes mellitus patients attending the diabetes mellitus outpatient clinic of Somdet Prayannasangworn Hospital in Chiang
Rai Province. Patients were interviewed using a structured questionnaire. Data were analyzed
by both descriptive and inferential statistics, i.e., paired t-test, analysis of variance
(ANOVA) and the Pearson‘s product moment correlation coefficient.
The results of this study were as follows: there were statistically significant differences
in patients‘ compliance behavior regarding the relationship between the selected
relationship between doctor and patients and the patients‘ perception of self-efficacy (pvalue
< 0.01), and the relationship between the selected patients‘ compliance behavior
and the level of Hb A1c (p-value < 0.01).
There is a growing number of elderly people in Thailand nowadays. This study
was aimed at investigating the situation and problems of promoting a network of aging
groups in Sangkha district, Surin Province. The study sample consisted of 39 public health
officials in Sangkha district and committee members of Sangkha’s aging groups by staging
for survey data, planning, doing and assesing the findings on the elderly at three
community levels, i.e., village, subdistrict and district. Activities in the group emphasized
religion, occupation, economy, and health linked to physical exercise and psychological
support. Suggestions were put forward that the elderly could develop their own
group, which would enhance their pride and be the best adaptation in their lives.
The World Health Organization (WHO) has been recommending the directly observed
treatment short course (DOTS) for the management of tuberculosis since 1994.
Vachira Phuket Hospital has strengthened its education of health-care workers (HCW)
and family members to become directly observed treatment (DOT) observers in order to
improve the success rates of the treatment. This study was conducted to evaluate the
treatment outcomes that the HCW DOT or family member DOT provided to patients.
We prospectively collected epidemiologic data on TB patients treated at the TB clinic
in Vachira Hospital from 2004 to 2006. We limited our analysis to pulmonary TB patients
never previously treated for TB. We analyzed the proportion of the patients, stratified by
type of drug administrator. We used chi-square to analyze the association of successful
treatment with the type of DOT, and multivariate analysis for controlling other factors
associated with treatment success. A total of 506 TB patients were included in this analysis,
364 (72%) had treatment success, compared with 142 (28%) of patients experiencing
non-successful treatment, 90 percent received HCW DOT, and 10 percent family/other or
self-administered therapy (SAT). Smear-positive TB was diagnosed in 72 percent of the
cases, and 24 percent were infected with HIV. The type of drug administered had a
significant impact on treatment success (P<0.001). Using multivariate analysis, controlling
for confounding factors, HCW DOT was significantly associated with successful treatment
(OR 2.1, 95% CI 1.1-4.3).
Based on the results of this study, TB patients who received HCW DOT achieved
treatment success rates higher than patients receiving family member DOT.
A long-term follow-up study of mortality and morbidity in normal subjects has not
yet been conducted in Thailand owing to the limited resources available and time constraints.
This was a long-term cohort study (5 years) carried out as part of an existing
research project of Thepa Hospital, namely the Prospective Cohort of Thai Children (PCTC)
in Thepa District. In this study, the parents of these children involved were taken for a
follow-up study in a co-research project in the period 2003-2007. Out of 2,000 parents,
1,325 volunteers (mean age 30.84 years) were interviewed and underwent several medical
examinations in 2003. Although the other 675 parents did not enter the program, they
were also taken for monitoring their status throughout the study period. In addition, 75 health worker couples from the hospital (mean age 36.5 years) were included in the study
as well. The mortality rate in this five-year study was 1.9 cases per 1,000 person-years (20
deaths). The incidence of disease, as observed from closely monitoring the subjects in the
last two and a half years of the study, was 9.7 cases per 1,000 person-years. The causes of
death and of diseases varied from road accidents and violence to infectious and cardiovascular
diseases. The incidence of hypertension and diabetes mellitus was five cases per
1,000 person-years and 1.6 cases per 1,000 person-years, respectively.
This study demonstrated that health personnel in community hospitals could develop
their research skills for conducting long-term studies through a strategy using a
“routine-to-research” philosophy.
An investigation of a food poisoning outbreak in Moo 2 Village of Kambok subdistrict,
Khamcha-ee district, Mukdahan Province was carried out to confirm the diagnosis,
verify the outbreak and to determine the etiology in order to control the outbreak. The
descriptive study was conducted on seven outpatients and two hospitalized patients who
were diagnosed at Khamcha-ee Hospital on 26 February 2008. All nine patients involved
lived in two separated houses; their ages varied from 13 to 83 years, with the median age
being 38 years. The clinical features were abdominal pain (100%), headache (88.88%),
fever (88.88%), and diarrhea (77.78%). The incubation periods varied from 6 to 29 hours. The food suspected of causing the particular illness was koi (raw red-ants eggs), a kind of
native salad. Salmonella serogroup B was identified from the raw ant eggs in question,
and rectal swab cultures of all patients. This outbreak was most likely caused by Salmonella
serogroup B, based on the clinical features, incubation periods and the laboratory
findings. Health education was given to food handlers in Moo 2 village. The investigation
disclosed possible evidence of risk factors of poor sanitation and poor hygiene in the
kitchens and toilets. Active surveillance was maintained in the affected area for one week
without the emergence of new cases.
Mycobacteriosis avium (MV) is a disease rarely diagnosed in community hospitals.
The diagnosis is very difficult to make because it requires specialists and a laboratory
with full facilities for making a diagnosis of the disease. However, such specialized teams
are usually available only in medical schools. Furthermore, the microbiological examination
necessary takes several months before the results can be reported. In the meantime,
patients would inevitably suffer from the disease and the side-effects of the medication
prescribed, i.e., for a case with a provisional diagnosis of pulmonary tuberculosis.
The patient in this report had suffered from a chronic illness for almost seven years
before receiving treatment as a case of pulmonary tuberculosis based on the common
clinical features of tuberculosis coupled with the results of three consecutively positive
direct smear sputa tests. He subsequently suffered from TB drug toxicity adverse reactions,
including hepatotoxicity, renal toxicity, color blindness, nausea, flatulence, diarrhea,
itching, arthralgia, headache and shock. A correct diagnosis was obtained when he
sought an opinion in several hospitals, with a culture of the mycobacteria revealing the
fact.
This article recounts the true story of a doctor and patient written with the intention
to provide lessons for other physicians and health-care workers that mycobacteriosis avium
ought be one of the differential diagnoses for patients with signs and symptoms similar
to tuberculosis.
Hypertension is the most common cause of preventable death in developed countries
and also an important problem in developing countries. The objectives of this study
were to evaluate clinical audits and clinical outcomes of hypertensive treatment compared
with the Thai Hypertension Society guidelines, 2007. The study population included
1,274 patients who were treated in the hypertensive clinic of Thawatchaburi Hospital from October 1, 2006 to September 30, 2007. The results showed that 492 males
(38.62%) and 782 females (61.38%) with a mean age of 64 years 5 months participated in
the study and 83.31 percent of the cases were under the universal health care coverage
system. Only some risk factors associated with hypertension were recorded, ranging
from 2.51 percent to 90.66 percent. Almost all (98.74%) of the patients’ BMI levels were
recorded; 55.57 percent of them had normal BMI. There were several co-morbidities in
the records: 53.14 percent had dyslipidemia and 35.24 percent DM. The prevalence of
nephropathy and left ventricular hypertrophy was 6.59 percent and 3.77 percent, respectively.
One- third of the medical treatments used two categories of hypertensive medicines
and the other third used only one catagory. Diuretics were used in 36.50 percent of
the cases, with 29.75 percent being ACE-inhibitors, 20.15 percent beta blockers and 12.35
percent Ca channel blockers. Follow-up adherence was 76.45 percent; 23.41 percent of
the cases had well-controlled blood pressure whereas only 3.39 percent of those with DM
were well controlled.
In conclusion, a model for the development of hypertensive care should be developed
by all stakeholders, including clinicians, other health-care professionals, patients
and their families in order to improve continuously the quality of care and its outcome.