plueme/wizJson huggingface dataset:
Health care reform movements in Thailand have occurred during three main overlapping periods.
The first wave of health care reform focused on increasing the geographical coverage of the health care
infrastructure, while the second wave focused on reforming health care financing mechanisms. The third
wave shifted its focus to strengthening primary care. This paper is aimed at exploring the third wave of
health care reform in Thailand using literature and document review. It was found that, among five areas
of reform initiatives to strengthen primary care, there was an imbalance of investment in the primary care
infrastructure and capacity building of health staff. An insufficient number of health centre staff, along
with their limited capacity, is a major constraint affecting the ability to improve health centre performance.
The development of a referral system has been neglected and could reduce confidence of the
people in primary care. Although health care financing reform has improved financial status of the health
centres, it still needs continuous development in order to promote the responsibility and productivity of
health centre staff toward its registered population. Finally, there is a need to develop and adapt the
concept and practice of family medicine to fit with the country-specific context and to promote it to be
well recognized by the general public as well as by physicians. New challenges for the development of
primary care in Thailand include its governance system, in the context of health care devolution, and the
provision of health services for chronically ill patients and the elderly.
This research is a matched case-control study, the objective of which was to determine the association
between couples’ alcohol consumption and the violence of husbands against their wives, in Khon
Kaen Province. A structured interview questionnaire was used to elicit data from 47 women attending the
One- Stop Crisis Center of Khon Kaen Hospital, who experienced violence at the hand of their drinking
husbands. Ninety-four married women living in the same neighborhood and in the same age group
served as controls. The results revealed that non-drinking wives whose husbands drank alcohol and
drinking wives and husbands were of risk of spousal violence (4.27 times (adjusted OR=4.27, 95%CI=1.10-
16.62) and 8.55 times (adjusted OR=8.55, 95%CI=1.75-41.90) respectively), compared with non-drinking
couples. Drinking more than five glasses (adjusted OR=4.17, 95%CI=1.14-15.28) and substance abuse
(adjusted OR=3.97, 95%CI=1.04-15.07) were also significantly associated with spousal violence.
In conclusion, alcohol consumption is an important activating factor in spousal violence.
The global temperature has increased by 0.74 ± 0.18 °C (1.33 ± 0.32 °F ) during the past century. The
same period has seen an increase in natural disasters and disease outbreaks. Reviews of the evidence of
links between climate change and human health suggest that a warmer climate could result in increases in
mosquito-borne diseases like malaria due to increased reporting of malaria cases in temperate climates
and malaria epidemics in upland areas. Within the range of survivable temperatures, warmer temperatures
reduce the duration of the extrinsic cycle of malaria parasites in mosquito vectors. Therefore, higher
temperatures should result in higher rates of malaria transmission. Mathematical-model estimations suggest
that more deaths will be attributable from malaria. However, during the past decade, the number of
malaria cases has not changed markedly, with 300-500 million cases per annum and > 1-3 million deaths.The complex natural history of malaria transmission involves interactions between humans, anopheline
vectors, and malaria parasites. Many different factors influence these three primary components, including
climatic, ecological, environmental, socio-economic and human behavioral factors. Thus, malaria transmission
may not simply be affected only by global warming; the relative importance of all the factors
involved should be considered jointly. Measures to control malaria–developing new preventive methods,
improving diagnosis, more effective treatment should all be encouraged and supported. An analysis of
the impact of global warming on malaria has implications for the effects of global warming on other
disease outbreaks, i.e., that they may not occur, or if they do, they may not be as serious as some predict.
However, disease surveillance systems must be closely monitored by epidemiologists if global warming
persists. There is an urgent need for ongoing public debate regarding what, if any, action should be taken
to reduce future global warming, and the development of more holistic information about the epidemiology
of disease in this context.
Art therapy is a form of expressive therapy that uses art materials, such as paints, chalk and markers.
Art therapy combines traditional psychotherapeutic theories and techniques with an understanding
of the psychological aspects of the creative process, especially the affective properties of different art
materials. Its psychotherapeutic modality is based on the disciplines of “art” and “psychology” involving
Sigmund Freud’s psychoanalytic theory, relying on the human person’s symbolic expression as a
means of communication as an alternative to verbal communication.
The term was coined by Margaret Naumburg in 1947 in the United States of America (some have
mentioned that Adrian Hill did so in Britain in 1945). Art therapists have generated definitions of art
therapy split into two categories. The first involves a belief in the inherent healing power of the creative
process of art making, embracing the idea that the process of making art is therapeutic, which is referred
to as “art as therapy” (Edith Kramer’s theory). The second definition of art therapy is based on the idea
that art is a means of symbolic communication, referred to as “art psychotherapy,” emphasizing the products
– drawings, paintings and other art expressions – as helpful in communicating issues, emotions, and
conflicts. The art image becomes significant in achieving insight, resolving conflicts, solving problems,
and formulating new perceptions that in turn lead to positive changes, growth, and healing. In reality,
both approaches are used together in varying degrees.
Occupational Health and Safety Assessment Series (OHSAS) 18001:2007 is an occupational health
and safety management system utilized in the United Kingdom. This article addresses the importance of
health and safety in today’s legal milieu, as well as establishing, implementing and maintaining procedures
for ongoing hazard identification, risk assessment, and determination of necessary controls. It also
explains the managment and control of workplace and occupational risks, and gives some successful
examples.
Research management is a key supporting factor for systems research investment. The main objective
of research management is essential linkage between researchers and research users. This article describes
points of view in health systems research management from the authors’ direct experience in
reviewing and analyzing three issues: the research management concept, the research management process
and the role of the research manager.
Good research management helps in building qualified researchers, formulating interesting research
questions, and obtaining acceptable research results leading to suitable utilization. The key success factor
of research management depends on the linkage capacity of all partnerships within the research system.
The principal roles of health research management may be summed up in four major functions: (1) facilitating
formulation of the research scope by identifying problems and setting priorities; (2) facilitating
research involvement among researchers and stakeholders in the health system for selecting research
proposals; (3) facilitating research monitoring; and (4) facilitating research assessment for knowledge
utilization. Certainly, the key person in this process is the research manager. For this reason, research
managers should be strengthened both in terms of academic capacity and in management skills for qualified
research administration.
Road traffic injuries are a significant problem in developed and developing countries. The trend of
mortality owing to traffic accidents is increasing in Thailand. The objective of this descriptive study is to
describe the trend and characteristics of risky behavior related to road traffic injuries in Thailand during
the period 1998-2007. The study was conducted by using and analyzing data from the national injury
surveillance database within 28 sentinels, these were reported during the period 1998-2007.
The results show that the proportion of road traffic injuries was the highest of all injuries (51.6%).
The percentage of injuries in the age groups between 15 and 24 years was the highest (33.29%). Most of
the injuries occurred among laborers and student groups (35.0% and 20.1%); 75.7 percent of them were
motorcycle injuries and tended to increase. The highest incidence of injury occurred during the evening
between 6 and 8 o’clock (37.7-40.2%). The most severely traumatized parts of the body were the head and
neck (29.3%). The percentage of alcohol use while driving was 36.4 percent and it was highly used in the
age group 20-29 years (40.1%). The high-risk behavior occurred over the New Year holidays and during
the Thai new year (Songkhran festival) during the months of December-January and April. Further, the
drivers and riders had not used seatbelts and helmets while driving and riding . Only 13 percent used
helmets and 18.6 percent used seatbelts. Those injured were referred by a relative or others in 56.2 of the
cases; only 10.4 percent were referred by EMS, although the tendency is increasing.
This study identified the problem of injuries, especially motorcycle injury in younger persons, which
tends to increase every year. The higher fatality rate may relate to risk behavior involving alcohol use, not
wearing a helmet, or using seatbelts and driving at high speed. Traffic accident prevention requires that
drivers be educated and that the laws be enforced in the high-risk group (mainly younger men).
Oroantral fistula (OAF) is a pathological connection between the maxillary sinus and the oral cavity.
The condition mostly follows extraction of postcanine teeth in the maxilla because of the close relationship
between the apex of those teeth and the floor of the maxillary antrum. An accurate history and
physical examination and proper investigation should be performed to rule out possible contributing
factors, e.g. previous sinonasal infection and inflammation, benign or malignant neoplasms or osteomyelitis.
If these are present, appropriate treatment should be performed before closure is attempted.
Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always
require surgical closures. Procedures involving local flaps are usually adequate to close minor-to-moderate-
size defects. The buccal mucoperiosteal advancement flap is the simplest and most effective way of
closing OAF. The palatal rotation flap has also been a popular choice. Wound breakdown and flap necrosis
are the most common complications of OAF repair. Careful preservation of the flap’s blood supply
and tension-free wound closure are the keys to avoiding these complications.
Cryptosporidium parvum is one of the leading causes of opportunistic infections among HIV/AIDS
patients. Due to the small size of its oocysts, detection of this protozoan requires special staining and
laboratory expertise. In this study, we compare the effectiveness of the three leading parasitology laboratories
in Mahidol University, Thailand. Serial concentrations of Cryptosporidium parvum oocysts from 6 to
1,500 oocysts per 10 μl were added to stool samples and distributed to the study laboratories. Conventional
microscopy and special staining, using dimethyl sulfoxide (DMSO) modified acid-fast stain and
modified cold Kinyoun’s acid-fast techniques were applied. The sensitivity of both techniques was similar.
All three laboratories could detect at least as many as 20 oocysts per 10μl with no statistically significant
difference (p= 0.998). Either staining method could be applied at any laboratories serving HIV patients
with opportunistic infections. However, training laboratory technicians to acquire such expertise
and standardize it is necessary. Effective laboratory diagnosis would be very helpful for physicians, leading
to patients’ appropriate management.
The chemical 1, 3-butadiene is used primarily in the production of synthetic rubber and polymers. It
is a carcinogen, although the International Agency for Research on Cancer has not determined the affected
organ(s). This article reviews the production, exposure, exposure assessment, biomarker of exposure
and biomarker of effect of butadiene.
Objectives: This study aims to determine the maximum cost of HIV vaccination at which the vaccine is still cost-effective under the Thai healthcare setting and to identify the possible relative importance of several vaccine characteristics and subsequent impact of risk behavior changes among vaccine recipients. on its value for money.
Methods: A semi-Markov model was developed to estimate the relevant costs and quality-adjusted life year (QALY) over the patients’ lifetime based on the government perspective of providing prime-boost combination HIV vaccines (ALVAC-HIV® and AIDSVAX B/E®) in conjunction with the existing HIV prevention programs compared to existing HIV prevention programs. The analysis focused on the general population aged 18 to 30 years as well as high-risk populations (i.e. female sex workers, injecting drug users, men who have sex with men, and military male conscripts). Threshold analysis was carried out to determine the maximum cost of cost-effective HIV vaccination at a Thai ceiling threshold of 100,000 Thai baht per QALY gained. One-way and probabilistic sensitivity analyses were performed to examine the uncertainty of all input parameters. The study also employed an analysis of expected value of perfect information (EVPI) to determine the relative importance of input parameters and prioritize future HIV vaccines studies.
Results: The highest cost of HIV vaccination given to the general population was identified at 12,000 Thai baht with 70% efficacy, lifetime protection, and unchanged in terms of risk behaviour post-vaccination. The vaccine would be cost-ineffective at any price if it demonstrated relatively low efficacy (30%) and increased risk behaviours by 10% or more of the population. This is especially true among those high risk populations. This study also found that incremental cost-effectiveness ratios were the most sensitive to the change in risk behavior post-vaccination, followed by vaccine efficacy, duration of vaccine protection, and vaccine acceptance rate. The analysis of EVPI indicated the need to quantify several parameters, namely risk behavior changed post-vaccination, vaccine efficacy, and costs of community engagement and vaccine delivery. 
Conclusions: The results are useful and important for both researchers conducting future HIV vaccine research, as well as policy decision makers who, in the future, will consider the vaccines adoption in Thailand.
This study used qualitative and quantitative methods to explore the use of alternative medicine in term of meaning, prevalence and predictors of alternative medicine usage. The sample was taken from 8 provinces in 4 regions of Thailand. The qualitative study consisted of 40 cases that were purposely selected, using different measures, to reflect different social backgrounds and use of alternative medicine. The quantitative sample consisted of 1,099 that were randomly withdrawn using different random sampling methods.
This study found that for lay people the meanings of alternative medicine were: Integrated self-care, the decision of choice to care, holistic care, naturalistic care, non-western medicine, the inferior medicine, the preventive medicine and the cultural wisdom medicine. The most popular therapies are exercise, herbs, massage, natural nutrition, lifestyle management. 
The predictive factors of alternative use that were found in this study included :  Memberships of health group together with health status and sex. In addition, satisfaction from the effectiveness and safety were also predictors of using alternative medicine. The reason of using alternative medicine in term of ability to self-care and promotion and maintaining of health and balance to health were also found to be the predictors of alternative medicine use. 
Following these results, we suggest strategies for developing alternative medicine and integrating it into national health care systems and national insurance programs, to develop mechanism to ensure appropriate, safe and effective use of traditional medicine which include: Increasing access to alternative medicine information and the development of health network in all social levels.
The study of information system in occupational and environmental health is a project under the development of information system in occupational and environmental health project. The aims of the study were to review knowledge on information system in occupational and environmental health field and study the situation of such system in the country. The steps of the study included literature review, information collection, and seminar for information and experience sharing among experts and relevant organizations
 	The results of the study showed that there are 2 issues concerning the study: the information system for occupational health and the other for environmental health. There are at least 2 important databases for both information systems, including environment database and health database. Environment database consists of data from measurement of hazardous levels in various setting such as working environment, or pollution level in communities. On the other hand, health database consists of exposure data in population from health screening and disease information from hospitals and other health service centers. Apart from the database, the proper information system should include data collection, data analysis and interpretation, and dissemination systems.  
	In this study, only occupational health information system under the responsibility of the Ministry of Public Health was selected for analysis. The study found that such information systems are mainly responsible by two agencies such as the Bureau of Health Strategy and Planning and the Bureau of Epidemiology. Both agencies have established and developed their own information system, e.g. data collection, analysis, and interpretation. They focus on not only occupational diseases but also general diseases, depending on their mandates. 
	Regarding health service centers, several hospitals and health centers throughout the country have provided occupational health services. The occupational health services include pro-active and passive approach (or service at health service stations). The information collected includes data from walk-through survey, environmental assessment, health screening, and disease diagnosis and treatment. Up to now, several health service centers have developed their own occupational health information system to manage information they collected.
	In conclusion, the development of information system in occupational and environmental health is very important for occupational and environmental health service system. However, the system faces many obstacles and problems, such as no information available, data accuracy, data sharing among relevant organizations, and supportive system for system maintenance. Therefore, responsible agencies have to co-operate to tackle the problems and to improve the information system.
Plague, an infectious disease caused by the bacillus Yersinia pestis, is primarily a disease in rodents
and is carried by fleas. Humans accidentally contract the disease via flea bites or exposure to infected
animals. There are records of several plague pandemics in the past that produced enormous mortality.
Today the incidence of plague has been substantially reduced owing to the effectiveness of antimicrobials,
improved sanitation and effective pest control. Currently, however, the disease seems increasingly to be
re-emerging, especially in Africa. Climate change and the global fluctuation in politics and poor economics
may be related partly to the migration of human populations into plague endemic areas. Also,
plague bacilli can be used for modern-day bioterrorism. Because the tendency of plague epidemics to
occur is increasingly alarming, the World Health Organization has categorized plague as a re-emerging
disease.
This communication may serve as a refresher course on plague so that those in Thai medical circles
may prepare for future outbreaks.
The impact of global warming on everything on Earth has been observed and reported by scientists
from every corner of the world for an extended time. Among those phenomena have been the correlation
of sex ratios at birth to increasing global temperatures. From known biological facts, sex determination
can be genotypic (GSD) or temperature-dependent (TSD). A number of previous studies have suggested
that TSD may be very common in many species of lower vertebrates, especially fish and reptiles, with
increasing temperatures generally affecting the sex ratio of a species (leading to many males and few
females). The most frequent citation is noted in a study directed by two Spanish researchers, Natalie
Ospina-Alvarez and Francese Piferrer, reported under the title “temperature-dependent sex determination
in fish revisited: prevalence, a single sex ratio response pattern, and possible effects in climate change,”
published in the July 30, 2008 edition of the scientific journal Public Library of Science (PLoS ONE). They
show that even small changes of just 1-2°C can significantly alter the sex ratio from 1:1 (males : females) to 3:1 in both freshwater and marine species. It is already known that high temperatures inhibit the synthesis
of estrogens, which are essential for female sex differentiation in fish and reptiles.
In mammals, under circumstances of ordinary temperature, male live births exceed those of females.
In humans, the ratio of male births to total births also favor the same trend. It has been hypothesized that
levels of steroid hormones (testosterone and estrogen) in both parents around the time of conception are
positively associated with the offspring sex ratio (proportion of males at birth) of mammals, including
humans. Some people, particularly women, in suboptimal health produce an excess of sons; thus, gonadal
hormones are responsible for adaptive variation.
While our findings of the comparative analysis on the secondary data obtained from the Thai Meteorological
Department and from the National Statistical Office in the 16-year period 1993-2009 show that
increasing temperatures result in an increased prevalence of newborn females over males. Details of
complex analytic patterns are elaborated in the text.