plueme/wizJson huggingface dataset:
Pufferfish belong to two families of marine and estuarine fish: Tetraodontidae and Diodontidae. The term
Tetraodontidae refers to the four large teeth fused into the upper and lower plates of the fish’s mouth, which are
used for crushing the shells of crustaceans and mollusks; the Diodontidae, as denoted by the name, possess only
two cutting teeth.
Poisoning by consumption of the members of puffer fish families is one of the most violent intoxications
caused by marine species. The ovary, liver, intestine and skin of pufferfish can contain levels of tetrodotoxin
sufficient to produce rapid and violent death. Treatment of the victims consists of supportive care and intestinal
decontamination with gastric lavage and activated charcoal concurrently with diuretic drugs. On the other
hand, the flesh of many pufferfish is not usually dangerously toxic and may be beneficial, producing a feeling of
well-being for the consumer. A pharmaceutical product derived from tetrodotoxin called Tectin is a potent pain
reliever and helper in opiate addicts going through withdrawal, when administered in very small quantities.
Both events conform to the mechanism exercised by hormesis, i.e., the effect of small doses of a toxic substance
that at higher doses has an adverse effect. A less powerful biotoxin of the puffers, named saxitoxin, the cause of
paralytic shellfish poisoning (PSP), can also be found in these fish. It should be noted that puffer toxins seem
not to be synthesized by the fish itself, but can be traced to the food chain through the ingestion of toxin-bearing
organisms, such as starfish, gastropods, crustaceans, flatworms, and ribbonworms.
Nevertheless, the meat of some pufferfish species is considered a delicacy in both Japan (as fugu) and
South Korea (as boh-guh). The good news for staunch pufferfish eaters is that non-toxic pufferfish have been
produced in netcages or land culture; even the formerly toxic liver is now available as a Japanese traditional
dish “fugu-kimo” (puffer liver).
The refilling of prescriptions for patients with chronic diseases under Thailand’s Universal
Coverage Scheme (UCS) by a private community pharmacy was developed as the model for a
health-care network linking the pharmacy and primary care units under the UCS. The objective of
this study was to compare the outcomes of the pharmacy providing health-care services for stablechronic patients, including those with diabetes mellitus, hypertension and dyslipidemia, between
those of the community pharmacy and primary care units. The quasi experimental study and
qualitative study were conducted during the period from December 1, 2005 to November 30, 2006.
Data collection was performed using pluralist methodology, including patient clinical data, questionnaire,
observation and telephone interview. The percentile, mean, standard deviation were
calculated. Levene’s test for equality of variances, paired t-test, and independent t-test were used
for comparing the clinical data. The patients were divided into a treatment group (n=27) and a
control group (n=69). The treatment group repeatedly refilled their prescriptions at the pharmacy
whereas the control group obtained normal services at the Phra Samuth Jadee Hospital, the main
contractor. After six months, clinical outcomes were compared between both groups. The results
revealed that the fasting blood sugar level, systolic blood pressure and diastolic blood pressure
between the treatment and the control group were not significantly different (p-values = 0.875,
0.770 and 0.706, respectively). The results of a telephone interview with the treatment group indicated
that the overall satisfaction with the services was 63.5 percent. Interestingly, the satisfaction
in the fast and convenient services among the patients who refilled their medications at the pharmacy
was 100 percent. These results indicated that the refill prescription service by the pharmacy
is as effective as that by the hospital. This study confirms the distinct and important roles played by
community pharmacists in delivering pharmaceutical care to chronic patients. In addition, the
pharmacy could be a health-care provider serving as a subcontractor in the health-care network
under the Universal Coverage Scheme in Thailand. This could improve and develop the quality of
the overall health-care services. This health-care service model provides more access to care and
increases the treatment quality of patients.
A study was carried out to evaluate the impact of local wisdom on safety, occupational health, and
the working environment among metal handicraft workers in Bangkok Metropolis. The objectives were
to survey the variety of the population and their problems; to analyze the data and construct a model; and
to evaluate the safety, occupational health and working circumstances. The sample group for this study
comprised 48 people in five communities. The data-collection instruments were questionnaires and interview
questions. The study methodology compared the risk assessment of a production process without
using the model, and the risk assessment (TISI.18001) of the process, using the constructed model.
The data were analyzed by job safety analysis (JSA).
The findings were as follows:
Baan Bu Community making brown bowls. The process of melting and hammering metal posed a high
occupational risk (82.7 percent); this was reduced to 50.6 percent by using the model and the level of
danger was acceptable.
Baan Bart Community producing food bowls for monks (batr phra). The blowing process to make bowls
showed a high occupational risk of 93.59 percent; this was reduced to 48.14 percent by using the model
and the level of danger was moderate.
Baan Nern Community producing “khong wong” (a musical instrument). The process of polishing and
cutting metal in making a khong wong poses a high danger risk (85.18 percent); this was reduced to 46.9
percent by using the model and this level of danger was low.
Baan Tee Tong Community producing gold leaf. The process of melting and hammering gold leaf poses
a high danger risk (86.42 percent); this was reduced to 64.19 percent by using the model and the level of
danger was acceptable.
Baan Chang Tong Community producing gold ornaments The process of melting gold for making ornaments
poses a high danger risk (67.9 percent); this was reduced to 37.03 percent by using the model and
the level of danger was acceptable.
Overcrowding in hospitals’ out-patient sectors is a chronic problem of public hospitals in Thailand.
Patient visitors have to wait for a long time no matter how serious their illnesses. A reasonable step in
solving this problem is to understand the nature of the attendants, i.e., who they are and why they come.
It is known that over half of the visitors live in the local district; they come with every type of problem;
most of the problems could be taken care of by practical nurses and general practitioners. The reasons for
attending the hospital include ineffective treatment at primary care units, and inconvenience because
there are not enough primary care units to cover the areas, and their quality is not well accepted. Therefore,
an important approach to solving hospital overcrowding is strengthening the function of primary
care units and forming them into a hospital network. Further, management is needed to find out which
outpatient sections are crowded and when, so that supplemental services could be organized accordingly.
Among the top five outpatients are those with diabetes mellitus and hypertension; these are chronic lifetime
patients. Thus, the service system for this group should be organized specifically and efficiently by
linking the provision of care with primary care units and/or private dispensaries to relieve the patient
pressure on big hospitals. Ultimately, owing to the complexity and variability of the problem, ad hoc
teams should be established specifically to be responsible for managing and monitoring the system effectively
The research manager is an essential component of the research system. This article describes the
academic capacity of the research manager, which should at least comprise 1. neutrality, 2. program
evaluation skills, 3. knowledge of research methodology, 4. ability to systematically review existing
knowledge, 5. research mapping skills, and 6. ability to conduct research on research management.
Decentralization has fully materialized in the Philippines over a period spanning
almost two decades. In Thailand, decentralization was initiated as early as 1932, but
materialized only in 2007. However, decentralization process in the health sector has been
delayed in the devolution of health service facilities from the central to local government
levels.
Lessons learned from the Philippines, which has fully implemented decentralization
for 17 years, will be very valuable lessons for learning about the positive and negative impacts
arising from decentralization in order to provide policy options for Thailand so that it
can avoid negative impacts and follow successful policy measures in support of the decentralization
process of health services to the local government level.
Good governance in the health system generally refers to the exercise of political authority and the
use of institutional resources to manage health problems and affairs. There are eight dimension of governance:
participation, rule of law, transparency, responsiveness, consensus orientation, equity and inclusiveness,
effectiveness and efficiency, and accountability. The enhancement of stewardship functions and
the improvement of management support systems of the government in terms of collective responsibility
for overall performance of the health system are aspects of good governance. In addition, good governance
is the responsibility of other stakeholders outside of the public sector. Therefore, the principles of
good governance will be used by the National Health Organization to enhance accessibility to care, the
quality to care, equity rights, and stakeholder participation.
Primary care providers have the pivotal role in the care of people with diabetes; therefore, improving
care in this setting is an imperative. This review illustrated issues concerning diabetes management in
primary care including the following: aim and provision of diabetes care; organization of care; and education,
training and skill of the health-care team. The situation of diabetes management in primary care,
both in Thailand and other countries, predictors of high-quality care, and barriers to control of diabetes
were described. Suggested indicators for auditing the quality of diabetes care and the strategies utilized
for improving diabetes management in primary care were also described.
The purpose of this descriptive study was to explore health promotion processes of Local Administrative
Organizations (LAOs). Data were collected by using mail questionnaires from May to December
2007. The subjects were 950 executives of LAOs obtained by stratification and simple random sampling. Five hundred and thirty-two LAOs responded to the questionnaires (56.0 %). The results showed that the
scores of LAOs’ health promotion processes were at a moderate level (54.5 %). The majority of LAOs did
not have a division of public health in their organization’s structure (62.8 %), had a health promotion
policy (51.7 %) but the specified policy constituted a real policy for only 7.5 percent of them, had health
promotion plans/projects (95.7%), and supported budgets and materials for other institutes for health
promotion processes (89.5%). However, health promotion processes were evaluated and used for improvement
in only 38.9 percent of the LAOs. The majority of LAOs did not receive materials and budgets
from other institutes in 78.0 and 61.7 percent, respectively, but did receive mass media and knowledge in
70.3 and 65.4 percent of them, respectively. The LAOs needed support from the Thai Health Promotion
Foundation, National Health Security Office and Provincial Public Health Offices in 94.0, 91.0, and 89.5
percent, respectively. Major problems in the health promotion processes of LAOs were a lack of public
health personnel, budget and knowledge of health promotion.
The recommendations from this research are to integrate policies at the ministerial level, and to set
the standards of health processes and evaluation in the same direction for all provinces, districts and
subdistrict. The LAOs should establish a division of public health in their structure, enact local legislation
concerning health promotion, support budget and health personnel, and train the leaders of LAOs about
the vision of health promotion. Moreover, public health organizations should promote self-care, give
advice and vigorously act as advisor of the LAOs in terms of health promotion.
The survey research was aimed at determining the retention rate of medical graduates of Khon Kaen
University in Northeastern Part, after their compulsory three-year bonded period. The population under
study were physicians who graduated from Khon Kaen medical school during the period 1979-2000. The
list of alumni was colleted from the Alumni Association and Medical Education section. The list of alumni
and their workplaces was investigated from Provincial Health Offices and the GIS of the Ministry of
Public Health. The incomplete list of alumni and their workplaces was investigated by searching telephone
numbers and asking questions of the alumni deputy. The list of alumni was verified by teachers
who had to visit the alumni at their workplaces. The data were analyzed using percentages. The research
findings were as follows:
1. The medical graduates remaining in the Northeast (70%) was higher than the quota rate (60%) by
10 percent.
2. The distribution of alumni was as follows: in the Northeast 70 percent and in Bangkok 11.65 percent.
Compared with findings in 1992, the distribution in the Northeast decreased by 3 percent whereas in
Bangkok it increased by 1.85 percent.
3. The alumni were stationed in large hospital (51%) more than community hospitals (49%).
4. The alumni in the Northeast worked at community hospitals 26.88 percent, regional hospitals
25.48 percent and private hospital 3.46 percent.
5. The production of the Collaborative Project to increase the production of rural doctors (CPIRD)
was higher than the target by 29.66 percent for 1999 graduates and by 21.63 percent for 2000 graduates.
6. The retention rate in the Northeast (70%) was higher than the target (60%); 19 years out of 22 years
had higher than quota rate. The three highest retention rates were 1998 graduates (92.45%), 1994 graduates
(92.45%), and 1999 graduates (92.45%) respectively. The three lower rates were 1983 graduates (48.78%),
1982 graduates (51.16%), and 1979 graduates (54.55%) respectively.
Medical graduates from Khon Kaen University were retained in the community. The retention rate
was in line with the intention and philosophy of three medical curricula, which emphasize that medical
doctors should improve the public health of the community, have a positive attitude toward serving and
working with others in the health team. The research findings confirmed the objective of the Faculty of
Medicine, Khon Kaen University.
According to the 1997 Constitution of the Kingdom of Thailand, all Thai people’s rights are protected.
Particularly, older adults have the right to access health-care services equally as other populations.
Therefore, the Thai Government passed the 2003 Act on Thai Older Persons as law. The purpose of this
study was to describe the satisfaction of older persons with medical and health-care services, according to
the 2003 Act on Thai Older Persons, as those services relate to the Public Health Unit of Pakchong District,
Nakhon Ratchasima Province regarding disease prevention, medical services, and medical treatment. The
study sample consisted of 200 older persons recruited by cluster random sampling and simple random
sampling from a total of 14,135 older adults in Pakchong District, Nakhon Ratchasima Province. A structured interview was used to collect the data, which were analyzed with descriptive statistics and t- test.
The results revealed that the majority of the sample had a high level of satisfaction with overall
services and with services on disease prevention (3.51-4.50, p = 0.05), while they had a moderate level of
satisfaction with medical services and medical treatment (2.51-3.50, p = 0.05). In addition, non-significant
differences in overall satisfaction with medical and health-care services between males and females, occupation
(government officer/non-government officer), and dwelling location (municipal/non-municipal)
were found.
The results of this study are expected to provide useful information for health-care providers in
improving medical/health-care services for older persons, such as annual dental care service, annual
physical examination, elderly club activities, special-track services, and environmental safety. These services
should be established to serve the needs of older persons fairly according to the goal of the 2003 Act
on Thai Older Persons.
This study was carried out with the intention of obtaining and providing knowledge in developing
policy to promote the growth of private hospitals with least negative effect on government health care. By
studying the literature about private hospital segments and the impact of government policy together
with questionnaires sent to most private hospitals in Thailand about their resources and services back to
five years previoustly, the financial resources of the hospitals were analyzed using the data from the Ministry
of Commerce and the Stock Exchange of Thailand. Quantitative data obtained by interviews were
also analyzed. From these processes, we found that the rapid growth of private hospitals during the past
three decades has a strong relationship with the economic status of the country. The Government’s investment
promotion policy has had both negative and positive impacts on the income of hospitals. Largescale
hospitals earn more income than small-scale hospitals. Hospitals in Bangkok earn more income than
hospitals in rural areas. Three factors, namely price, quantity and quality, together with quality assurance
by the Ministry of Public Health, the National Health Security Office and the Social Security Office
synergized the working process to reform the health infrastructure of Thailand.
Community participation is an essential strategy for improving community health in the context of
Namkao Subdistrict, which has strong community organizations was considered suitable as a model for
the development of a participatory community health fund at the subdistrict level.
The study was divided into two periods: the first for formulating a model by collecting data about
the existing social fund and the situation of organizations in the community, and the second for assessing the real operations of the Namkao community health fund and evaluating the administration processes
designed.
The results showed that all three sectors (community sector including groups of community savings
organizations, health-care sector and subdistrict administrative organizations) agreed with establishing
the fund. The contribution from the community sector is the key to community ownership of the fund.
The community health fund board consisted of people from every sector. Approval for budgets of any
projects is considered by its linkage to the Namkao health plan in that it would have a wider perspective
of health than a bio-medical model.
For the second step, the Namkao community health fund was established in 2007; a contribution
was provided by the National Health Security Office, which funded 37.5 baht per capita every year (about
140,287 baht in 2007), while the local government provided 100,000 baht, the community sector 14,000
baht and the health-care sector 100,000 baht. Currently, the community is developing a community healthplan
for allocating budget to health-promoting projects.
The participatory process is the core concept in establishing community health. A community health
fund at the subdistrict level is an important participative strategy that can support real operations. This
innovation promoted the concept of good health, which should not be limited to health organization staff
only but a task shared by everyone.
In order to achieve the standard and effectiveness of care and finally to enhance the quality of life of
people, strategies to improve the quality of services is an important approach for both public and private
health sectors. Mayo Hospital is one of many hospitals that has implemented the TQM/CQI, as recommended
by the Hospital Accreditation (HA) standard for a health promotion Hospital. In addition, Mayo Hospital has applied the criteria for the TQA award in order to evaluate the outcome of implementation.
The purposes of this study were to describe the strategies and outcomes related to the implementation of
quality improvement of services at Mayo Hospital based on the six aspects of the TQA criteria. Both
qualitative and quantitative methods were used in this study. A questionnaire was sent to health personnel
asked about the working atmosphere and organizational environment. In addition, in order to gain
better understanding about the organization’s vision, facilitating and inhibiting factors and lessons learned,
in-dept interviews were held with seven administrative staff and document analysis of a self-assessment
form was conducted. Content analysis was applied for assessing the qualitative data, while quantitative
data were analyzed using percentage, mean, and standard deviation.
The results of this study revealed that, based on six aspects of TQA, leaderships and patient-customer
focused aspects were at the level of improving, while strategic planning and internal process were
at the level of awareness to improving. In addition, the MIS and human resource, development and
administration were at the level of “awareness”.
The strengths of Mayo Hospital were that the administrative team had good understanding about
quality development while the health personnel were involved in determining the directions and goals of
the organization. In addition, patient and customer centered care is their priority of the services. The
coordination among departments was well developed. However, there were areas that needed improvement,
including dissemination of the organizational mission so that it could be transformed into practice,
the information system, the development of practice guidelines or standards of patient-centered care in
all departments, human resources developments, and collaboration and coordination across departments.
Hospital health-care workers are vulnerable to occupational hazards from dangerous workplaces;
however, there has been little concern about this issue in the Thai governmental hospitals. The purpose of
this health service system research was to develop the occupational health system in Rayong Hospital in
two steps: first, reviewing the generally accepted standard guidelines instituted by the National Institute
for Occupational Safety and Health, and the World Health Organization, in tandem with those advocated
by the Thai Bureau of Occupational and Environmental Health, the Hospital Accreditation System and
the Health Promoting Hospital Program; second, implementing those guidelines into the hospital’s strategy. The result was the successful establishment of the occupational health system into policy, network
and knowledge in the hospital.