plueme/wizJson huggingface dataset:
Objectives: Peripheral arterial disease (PAD) in diabetic patients is associated with high morbidity and mortality. The mortality rate in such patients is 56.5% in 3 years follow up period in Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University. Therefore the incidence and predictive factors to determine the mortality, myocardial infarction, stroke and worsening PAD is of paramount important. Researchers aimed to explore these outcomes in our population. 

Method:  500 diabetic patients with being diagnosed as PAD between June 2014 to July 2016, were followed up in 18 months follow up period. Primary end point was major adverse cardiovascular event (MACE), which composed of non fatal myocardial infarction, non fatal stroke, worsening PAD and death. The potential clinical predictors were entered into a Cox proportional hazard model with backward stepwise regression was performed.  Researchers also evaluated the adequacy of treatment by assessing the risk factor control for atherosclerosis. The target of the risk factor control for atherosclerosis has been using the criteria of American Heart Association (AHA) and the Royal College of Physicians of Thailand.  

Result: During a mean follow-up of 18 months period, 95 MACE events occurred, corresponding to the incidence of 19.0%. The number of death was 43 patients. The predictive factors, that were significantly associated with MACE, were history of chronic kidney disease (hazard ratio (HR) 2.32, 95% confidence interval (95% CI) 1.41-3.80), gangrene or chronic ulcer (HR 3.03, 95%CI 1.82-5.06), history of aortic surgery (HR 24.07, 95%CI 5.28-109.71), patients with history of taking clopidogrel (HR 2.16, 95%CI 1.13-4.12), patients with history of taking warfarin (HR 3.24, 95%CI 1.50-7.02), patients with history of taking sulfonylureas (HR 0.44, 95%CI 0.24-0.83). In terms of risk factor for atherosclerosis management, patients had reach the target in majority (>50%) in the control of diastolic blood pressure (73.10%) and stop smoking (91.83%).

Conclusion: The incidence of MACE was 19%. The predictive factors for high MACE in the first 18 months in diabetic patients with PAD was chronic kidney disease, gangrene or chronic ulcer, history of having aortic surgery, patients with history of taking clopidogrel, patients with history of taking warfarin. This may be used to identify high-risk patients for MACE to assist optimize medical treatment and intensive risk factor control for atherosclerosis to increase life expectancy and to decrease vascular event.
This research aims 1) to know the difference in locomotor skills classified by causes and levels of
amputation in persons with lower limb amputation, 2) to know the difference in quality of life classified
by causes and levels of amputation. The research population was people with lower limb amputation
who are older than 18 years living in Lamphun. The samples were selected by stratified random sampling from 82 people by using questionnaire developed by Locomotor Capabilities Index-5 and the World Health
Organization’s WHOQOL-Bref-Thai quality of life version. Validity was examined by experts and a reliability
test was obtained from 30 cases excluded from the study samples. Data were analyzed by frequency,
percentage, mean, and t-test.
Results of this research showed that 1) overall locomotor skills classified by amputation causes were
different at the significant level (0.05) but there was no difference in overall locomotor skills classified by
amputation levels; 2) overall quality of life scores classified by amputation causes and levels were not
different but physical domains classified by amputation causes were different at the significant level (0.05).
Research results indicated the differences in locomotor skills and physical domains were by causes rather
than levels of amputation. Thus, rehabilitation teams should design interventions carefully for different
groups of amputation causes, to encourage amputees to have better locomotor skills in prosthetic use and
to have better quality of life.
This paper aimed to study the elderly families situations and factors contributing to the elderly
families hardship in 10 provinces of Thailand. The study applied quantitative and qualitative methods to
collect data; from selected 4,561 elderly families using quantitative method and another 214 using focus groups interview with community officers and families with home dwelling elderly. The collected data
was analyzed using descriptive statistics and content analysis.
Overall, the study found that half of the surveyed families were families with the elderly who looked
after children in the families, following elderly living alone and living with their spouse respectively.
There were more than half of the elderly who had ability for self-caring and moderate caring for other
members. Level of relationship among other families members were no significant different at all levels;
good/moderate/bad. There was 1 in 3 of the elderly who responded that they had poor economic selfreliance.
For the type of support, the elderly dwelling with disabled person reported the highest hardship
and the need of dietary/feeding was the most expected support; whilst the elderly dwelling with children
reported highest need on financial support. Factors having high impact on hardship of the elderly families
were residential area, family profile, income, asset, saving, debt, and burden of caring on any family
member of elderly/child/disabled (p-value <0.001), including mental state, 4 basic needs of life, family/
community relationship, ability to access rights and social welfare.
The study recommended that social welfare should be fair, systematic including enhancing community
participation in promoting health and well-being among aging people. Lastly, further in-depth study
on factors influencing family health and caring for the elderly ought to be accelerated to promote better
quality of life for the elderly.
Objective: To synthesize lessons learned from the existing community-based health interventions
for vulnerable populations in Thai contexts in order to create policy recommendations for further health
systems development and response to health needs of vulnerable populations. Methods: This study utilized
qualitative study design to investigate and compare community-based health interventions for vulnerable
populations in eight district health systems (DHS) of Thailand, including Umphang, Ubolratana,
Dan Sai, Khon Buri, Kuchinarai, Lam Sonthi, Kong Rha, and Khlong Khlung. Qualitative data were collected
from the local practitioners by semi-structured interviews, focus-group interviews, and non-participant
observations, and were synthesized by thematic content analysis. Results: Content analysis reveals
four emerging themes. First, sense-making of the vulnerable population concept was challenging
for practitioners in Thai contexts. Second, effective community interventions for vulnerable populations
were initiated by local practitioners, not from policy and planning at the national level. Third, effectiveness
of community interventions for vulnerable populations depends on services design being customized
to the nature of vulnerability. Lastly, traits of local leadership, not authority, are necessary for creating
and implementing sustainable community-based health interventions for vulnerable populations.
Discussions: Despite no mutual understanding of the vulnerable population concept in Thai contexts,
we found strong evidence of innovative community-based health interventions in Thailand. To
scale up such programs, policymakers should create criteria to help practitioners identify vulnerable populations
in their contexts, allow for contextualizing health needs of different vulnerable populations, and
put more emphasis on developing information systems at both the national and the local level, so there
will be more systematic monitoring and evaluation of community-based health interventions for vulnerable
populations in Thailand.
Parasitic helminth infection remains to be a public health problem of the students and children in
remote rural areas, especially in the Northeastern part of Thailand. This survey was aimed to find out the
parasitic helminth infection rate, to analyze the spatial distribution with the application of geographic
information system (GIS), and to study the risk behaviors of parasitic helminth infection amongst students
in eight schools under the responsibility of the Border Patrol Police (BPP) Sub-division 21. The
survey was conducted during October 2014 to July 2015. The instrument for the survey was modified Kato-Katz technique for examining stool samples, and in-depth interview. The results showed that the
infection rate of helminth parasites was 8.27% (72 cases from overall 871 cases). The most common species
of helminth parasites found was hookworm at 51.39%. Others were Opisthorchris viverini 25.00%, Echinostoma spp. 12.50%, Enterobius vermicularis 5.56%, Trichuris trichiura 2.78%, Ascaris lumbricoides 1.39%, and co-infections of O. viverrini and hookworm 1.39%. When applying the GIS to analyze the parasitic helminth infection’s spatial distribution of the 8 BPP schools, the results showed that the parasitic helminth infection was higher than target limit of less than 5% in every school (14.71%, 12.30%, 10.00%, 8.96%, 6.43%, 6.14%, 6.00% and 5.41%). The distribution and the concentration of helminth parasite species were different in each habitat of the students. Most of the infections were caused by soil-transmitted helminths (STHs). Bad sanitation and inappropriate food consumption habits increased risk of infections. The findings of this research can be used to estimate helminth infection situation of the community and also can be applied to create strategic plans which focus on changing behaviors of students, their parents and their teachers to solve this problem.
This article aims to apply the concept of social stratification to explain social inequality. This will
help understand who is vulnerable population in the society. The authors have reviewed the literature of
concepts and theories in social sciences that can explain and rank the social stratification. Moreover, this
first phase of the big research project “Social Stratification in the Context of Thai Society and Health Status”
applied in-depth interviews and meetings with experts from March 2015 to March 2016 to select indicators of social stratification measurement appropriate to the context of Thai society. The research finding explains that social stratification and social inequality are conceived from the life chances concept as the beginning point of differences of human being. Life chance either by nature, by culture, or by social situation, leads to social differentiation, social stratification and eventually social inequality. Social stratification measures can be used to rank people by two approaches: 1. Objective measures of social stratification cover five indicators; 1) Birth origins 2) Standard of living in household 3) Economy 4) Education and 5) Health, and 2. Subjective measures of social stratification also cover five indicators; 1) Social status 2) Freedom and liberty 3) Fraternity 4) Consumption and lifestyle and 5) Class awareness. All of the above indicators of social stratification will be utilized to find populations who are the most disadvantaged, or the “vulnerable populations.” This finding has contributed to help build life chance guarantees, social equality and social equity for the vulnerable in Thai society in the future.
Television advertising is an effective medium for reaching young children and influencing their
food purchasing and intake. The objective of this study is to explore food and beverages advertising during children’s television programs.Methods: Records of children’s free television programs on channels 3, 5, 7 and 9 was the main data
collection method. Data was collected during March 24-April 7, 2014 on Monday-Friday at 03:00 p.m. to
08:00 p.m. and on Saturday-Sunday at 06:00 a.m. to 10:00 a.m. and 03:00 p.m. to 08:00 p.m. A total of 42
programs from top three programs that had the most food and drinks advertisement were selected into
this study. Unhealthy food and beverages advertisement was included in the analysis. Food advertisement was organized according to the food group classification from the Nutrient Profile. The study found that the majority of the advertising of food and drink is unhealthy food and drinks
advertisement. The most popular form of advertisement used by the food industry was using presenters
such as celebrity children and adults, athletes, and cartoon characters. Moreover, food and beverages industries used a loophole of regulations for advertising and did not comply with the law. Inappropriate forms and contents of the advertisement for children were observed. Considering the law enforcement, there is currently no comprehensive control of forms and contents of advertisement targeting on children. Therefore, government should seriously develop the law enforcement and should prepare including update regulations and guidelines to control forms and contents of unhealthy food and beverages advertising in order to protect the health of children and youth.
The objectives of this study are to identify, evaluate and prioritize risks of Ban Paew hospital and to evaluate financial risks and their impacts to the hospital in the future. We used both qualitative and quantitative techniques to help identifying the risks of the Ban Paew hospital. We classified hospital’s risks into 4 categories: strategic, operational, financial and external factors. Each risk was evaluated and prioritized by staff members of the Ban Paew hospital. This study employed the usage of financial ratio analysis to evaluate the future financial risks. The statistics used in this study were descriptive statistics. We found that the important risks are the ability to expand new branches of Ban Paew hospital, insufficient marketing plans, insufficient welfare providing to its staff members, unclear strategic goal on medical revenue management, unbalanced growth of incomes and expenses, the revenue without donation was not adequate to compensate for the depreciation of the hospital assets, lack of funding channels can create liquidity issues for future investment and its operations, the policy of keeping reputation might not impact on hospital’s revenue, and the external risk such as a change in disburse rules of National Health Security Office.
In addition, the financial risks might consist of the followings. Ban Paew hospital should aware that future revenue might not be adequate to replace the current fixed assets and their depreciations. The money donated to the Ban Paew hospital might create money illusion. The growth of salary was higher than the growth of the hospital‘s revenue. The inadequacy of funds to open new branches in the future. It also might face customer risks due to hospital’s targeting niche customers. To prevent and deal with the risks mentioned above, the cooperation between the Ban Paew hospital, the Ministry of Public Health and the National Health Security Office and the Bureau of the Budget are very encouraged.
The objective of this study was to develop the management model of referral coordination center in provincial and region level. The conceptual framework is 4M; Management, Man, Material and Money. The sampleswere divided into 3 groups. The first groups are 8 executive of referral coordination center, 9 directors in general hospital and 15 directors community hospital. The second group is 24 operational personnel inreferral coordination center. The third groups are 40 patients. The instruments are observational formsand semi-structured form, data collection from in-depth interviews and focus group. Analysis data by descriptive statistic and content analysis. The study found that; 1. All Provincial Referral Coordination Centers (PRCC) has a similar management pattern. 1) Management mostly has chain of command clearly and be unity. There has a target work, referral practice guideline, but the structure of referral coordination center that still unclear. There are no strategy, no plan and no project that specific problems or role of PRCC. The PRCC operation was not beneficial to the community hospital. The database of PRCC has quality problem and can’t to analyze.2) The operational budget of PRCC from hospital subsidy but no project support. There is a full-time nurse who operated PRCC only 08.30-16.30.The executive of PRCC has not build
employee morale process. Allmaterial of PRCC join with emergency accident department but it wasn’t enough to work.
2.The Region of Referral Coordination Centers (RRCC) has a similar PRCC management pattern. There have a regional referral practice guideline and a full-time nurse who operated work only 08.30-16.30but still implementation problem, i.e., no strategies or plan to develop work and personnel skill, lack of development to make the strengthening in network hospital, technology computer was used but can’t link the data, no pattern for regional referral data analysis. 3.The Management model of reasonable, have 3 figure; 1) high level of Provincial Referral Coordination Center Model : H model 2) moderate level of Provincial Referral Coordination Center Model : M Model 3) level of Region Referral Coordination Center Model : R Model.
Diabetes mellitus (DM) is the major public health burden in Thailand. DM is the significant risk factors of cardiovascular disease, end stage renal disease and cancer. Therefore, to decrease morbidity and mortality from diabetic complications, prevention of DM is an important issue. Insulin resistance and pancreatic β-cell dysfuction are the major mechanisms of developing DM. These 2 mechanisms lead to abnormal glucose regulation, called prediabetes that comprises of impaired fasting glucose or impaired
glucose tolerance. Previous evidences found that prediabetes is a significant risk factor of DM. Around 60% of diabetic patients had prediabetes 5 years before developing DM. Until now, there has been no study that investigate about the progression rate to DM in Thai prediabetes patients. In addition, currently, there is new proposed risk factors of DM such as serum uric acid and sleep factors. Therefore, this study aims to estimate the progression rate to DM and assess the association between sleep factors, serum uric acid, and HbA1C level.
Executive Functions (EF) is a higher-order, self-regulatory cognitive processes that aid in the monitoring and control of our thought and action for goal-directed behaviors.  EF is related more to success in school from preschool to university, than the IQ.  In Thailand, there is no information regarding the current situation of EF skill in young children.  The main objective of the present study is to develop tools and to construct the normative criteria for assessing EF skill in Thai preschooler age between 2-6 years.  Thirty-two items of behavioral checklists that indicated development of EF related behaviors (i.e., inhibit, shift/cognitive flexibility, emotional control, working memory and plan/organize) were designed to be appropriate with the Thai social context.  The behavioral checklist is friendly for teacher to observe their student’s behavior in the class room by using the rubric scales (0-5) which indicate the frequency of behaviors that has been observed during the past 3 months.  For construction of the normative criteria, children age between 2-6 years (N=2,965) both boys (51.6%) and girls (48.4%) from all regions across the country were participated in this study. They were selected by 3 steps simple random sampling.  First, sampling the child development centers in each region of the country, then sampling the rooms and finally sampling the number of children in each room.  Teachers were asked to rate child’s behavioral in the questionnaire. Data were collected and the T scores were constructed separately by sex and age of the children using the SPSS software. Our results show that children gradually improve their behavior related with EF skill during 2-6 years old. Although boy and girls have similar development at 2-2.11 years in their behavior related to EF skill, girls are more advance in EF development than boys at the age between 3-6 years.  Nearly 30% of children demonstrate the delay development in behaviors related to EF skill (T score<45). Moreover, 30% of children have behavioral problems related to EF dysfunctions (T score>55).  Delay EF development and/or EF dysfunction in childhood is associated with worse inhibitory control. They were more likely to be failure or drop out of school at adolescents, and less likely to be successful as adults. Thus, a child’s level of EF in early childhood likely contributes to a trajectory of success or failure in the future. Our results suggest that delay development of EF in 30% of Thai preschooler should not be ignored as EF skill can predict the quality of Thai people in the next 10-15 years, which can hinder the country's development in the long term. It’s time to re-thinking about how to scaffold EF development in young children in order to create a new generation of Thai people who can self-directed towards the success, who have the ability to cope with the dynamics change of the world in the 21st century, and who can leads the country successfully toward the Thailand 4.0 national policy.
Background : The idea of developing communication assistive device for disable persons who have lost their motor functions and cannot communicate is challenging.  Some paralyzed persons are aware of themselves and environments but cannot move their body parts except their eyes. With the use of an assistive device that can detect an eye or mouth status, these people can partially interact with the surrounding environments. Objective : The purpose of this present study was to develop a machine vision based system for a real-time eye or mouth status detection which can be further applied to be used as assistive controlling or communication device for patients. Material and method : This system composed of a web camera connected to a computer running with the developed software to detect the status of eye or mouth. The software prototype was developed in C++ on an MS Windows 7 PC using OpenCV and Dlib libraries and KNN classification technique. Result : The result showed that the accuracy of eye detection was at the highest accuracy (98%) at the middle distance (140cm), whereas the same distance result also observed with the mouth detection (94%). The results from the satisfaction questionnaire demonstrated that all users-healthy volunteers (n=20), dysarthric patients and caregivers (n=20) satisfied with the developed apparatus and software. The satisfaction score in the using of developed equipments was 4.02 (healthy subjects) and 4.21 (patients) from the highest score of 5. The satisfaction score in software using were 3.91, 4.14 (function test); 3.83, 4.09 (usability test) and 4.18, 4.28 (security test) in healthy subjects and patients, respectively.  Summary: In conclusion, our developed system can be efficiently used for further development of a communication or controlling assistive device for disable persons