plueme/wizJson huggingface dataset:
OPD reports from hospitals and health centers in Khamsakaesang District in 2007  
  showed that 52.78 percent of the outpatients were in the age group 60 years and older; of that  
  proportion of elderly patients, the cause of their seeking medical care in 62.53 percent of the  
  cases was improper self-care behavior. The objective of the present quasi-experimental research  
  study was to assess the effectiveness of the self-care health promotion program for the elderly.  
  The study samples were selected from the total database population numbering 5,252 persons.  
  Using multi-stage random sampling, 60 cases were identified for this study.  The descriptive  
  data were analyzed by the STATA program, version 10, to obtain percentages, means and  standard deviations; paired sample and independent sample t-tests, with statistical significance at  
  the 0.05 level, were used for the data analysis. The qualitative data were analyzed according to  
  the content of the questionnaire interviews on self-care behaviors for health promotion, together  
  with observations and personal discussions. The results showed increased statistically significant  
  behavior in the control groupûs test, i.e.,  the patientsû paired sample t-tests showed mean  
  differentials of 0.49 ± 0.05,  t = 48.00.  A comparison between the groups showed that the  
  control group acted more properly than the comparison group (t=40.32, p value 0.001).  
  Qualitative data showed that family lifestyles, and economic and traditional beliefs influenced  
  their behavioral change. The results of this study could be used to integrate and adapt care for  
  the elderly and other patient groups in primary care or clinic promotions. At least they could be  
  used to increase efficiency in protecting the elderly against untimely illness and from  
  developing complications from improper self-care behaviors.
Diabetes mellitus is a chronic disease and a major health problem in Thailand. The objective 
 of this study was to develop a problem-solving model for diabetes mellitus in a community, in the  
 hope that it could reduce hemoglobinA1C and increase the quality of life of diabetes mellitus  
 patients. The diabetes mellitus problem-solving activity was operated in six villages of Ubonratana  
 District in Khoan Kaen Province. Fifty-two diabetes mellitus patients participated for six months in  
 the problem-solving activity, which was operated by health volunteers; it involved promoting exercise,  
 controlling diet and optimizing drug compliance. The problem-solving patterns were monthly  
 meetings, home visits and health education. The average hemoglobinA1C of the diabetes mellitus  
 patients was 9.9 percent, but after their participation it dropped to 8.7 percent. The quality-of-life  
 score (WHO QOL short form 26) was 88.7; it increased to 101.1 after the activity. The changes in  
 the average HbA1C and quality-of-life scores are statistically significant. The conclusion of this study  
 was that a diabetes mellitus problem-solving activity in a community may be able to reduce HbA1C  
 and increase the quality-of-life score.
The purpose of this study was to determine the effectiveness of healthcare services of
doctors and nurses in the Primary Care Network of Na Klang Hospital, Nongbua Lamphu Province,
under the Universal Health Care Program (UC). The study was conducted as a quasi-experimental
research in the period August›December 2004. The experimental group consisted of 48 networked doctors and nurses working at the Na Klang Primary Care Unit (Na Klang PCU) and the control group consisted of 47 networked doctors and nurses working at the Sri Boon Reung Primary Care  
Unit (Sri Boon Reung PCU). Subjects in the experimental group received training using a problem based approach in order to improve their service effectiveness; there was no intervention for the control group. A questionnaire was used to gather general information, information on the health
promotion service, medical treatments, disease prevention, and rehabilitation. Data were gathered twice: pre and post experimental period and were analyzed using percentage, arithmetic mean,
standard deviation, and paired sample t-test. The results showed that, after the experimental period,
the Primary Care Unit networked doctors and nurses in the experimental group had higher
effectiveness in providing healthcare services, which was higher than that of the control group at a
statistically significant level. It was concluded that the advantage of this study includes the
application of the research results as a guideline in improving healthcare services, health promotion
service, medical treatments, disease prevention, and rehabilitation of the Na Klang Hospital
Network in order to make the services more effective.
Community hospital care providers have the pivotal role in the care of people with dengue  
 hemorrhagic fever, and it is imperative that such care be improved. This short review describes the  
 following issues concerning dengue hemorrhagic fever management in a community hospital : the  
 goals and provision of care for dengue hemorrhagic fever, organization of care, and the education,  
 training and skill of the health-care team. It also describes the current situation of dengue  
 hemorrhagic fever management in community hospitals, both in Thailand and other countries, the  
 predictors of high-quality care, and the barriers to control of dengue hemorrhagic fever, while  
 suggesting indicators for auditing the quality of dengue hemorrhagic fever care and the strategies to  
 be utilized for improving dengue hemorrhagic fever management in a community hospital.
The social and health related problems of construction workers in the northern regionThis study was a part of the research collaboration project of the same study conducted throughout the country, using the same research framework, format, and methodology.  Its aim was to acquire social and health-related information of construction workers.  It consisted of both quantitative and qualitative study.  This paper is a report of the quantitative study, using a cross-sectional survey to collect information on the social, environmental, and health-related problems of construction areas and the workers in the northern region.  The survey was conducted in Muang Chiangmai and Muang Pitsanulok Municipalities.  It included 40 small and large construction areas that employed more than 20 workers and were in the early stage of construction.  The contractors and the workers were interviewed.  The study showed that the mortality rate was about 1.17 per 1000 and injury rate was 8.9/1000/month.  Safety, sanitation, environment and living condition of the workers were poor.  Most of the workers were male, aged between 20 – 49, completed primary level of education, and were from agricultural background.  90% of them were from the northern region, and more than 50% resided in the same province as their workplace.  80% of the workers were married, 20% living separately from their children, and 10% had children with no opportunity for education.  The study also reported that 90% of the workers earned less than 5,000 Baht/month and most of them were satisfied with their job although their living condition was poor, including the employment status, the right and benefits, and the safety issues.  It was rare to see the workers gathering for the protection of their right and benefits.  There was also little support and supervision from government.No less than 25% had such serious illness that they had to stop working during the past year.  The major cause of illness was fever of unknown origin and influenza.  While on sick leave, only one-third of them received wages and support from employer.  Female workers were in worse condition than male, with lower wages, less career opportunity, and more family responsibilities.Recommendation for further studiesSet up guidelines for the protection and reduction of mortality and injury rateConduct a long term study of the family of the workersStudy an organization structure of workers that is suitable for employment status and working conditionStudy problems associated with alien workers and its effect to Thai workers
Health Promotion in the Support Services Department’s Personnel and their Families	The pilot project of health promotion for the military personnel in the Support Services Department and their families is aimed for altering health behavior, physical environment and social environment. The expectations are hoping them to have better health, delightful office work, warm families and peaceful community without temptation by letting the personnel and member of their families to take part in the activities as much as possible. There were 997 personnel and 1,227 member of their families took part in this program.	The research was assessed by comparing the variation in 3 target groups which are administrators, military personnel and medical staffs, whose in charge of looking after their health, by hold on interview and answer questionnaires collaborating with the activities for brain storming in searching problems and answers, including physical environment survey around their office and their living area.	After collecting data for 1 year, the project was succeeded according to the 18 steps plan. 3 target groups were identified as follows: the military personnel has better knowledge how to keep healthy e.g., smoking was reduced from 26.90% to 24.82%; health problem survey is improving e.g., excess BMI was reduced from 18.21% to 9.43%, high blood lipid was down  from 11.27% to 10.36%; the administrators decided to improve their welfare, accident prevention and alter policy, rules and orders  facilitating healthiness. The promising result from this research can be used as a guideline promoting health to a military personnel at any other Thai Armed Forces’ units.
Health Impact EvaluationFast development of socio-economic environment was regarded as a promoting factor to environmental changes particularly air, water, soil pollution. This change had impact on life quality of Thais and huge expenditures for health care. For example, in 1998, economic value of life loss and injuries caused by road accidents was estimated at 100,000 million Baht. Overall, expenditure for health care represented about 6% of GDP.To reduce that loss, preventative measures and initial correction must be emphasised by all parties in our society. Health impact assessment (HIA) was a new measure to determine level of consequent impact on health. Development of the HIA system was considered important and should be stated in National Health Act.  Issues which should be available in the Act were health impact assessment or environment health impact assessment covering both acute and chronic diseases, injuries, crimes and society violence. The implementation of HIA should not be taken by sole party. Instead, working in alliance form or networking must be promoted with accountability and transparency. HIA was composed of two parts which were HIA under analysis of environment and risk management. Organisations responsible for HIA can be grouped into 3 types. The first group was the organisation responsible for determining policy, measures, standards, regulations and mechanisms for HIA. The second group was the organisations which were evaluated, involved in using information for making decision, the evaluators, trainers, responsible for accreditation, registration and monitoring standards. The third group was the organisations providing community information and performing research and development.Main issues for research and development in short term were as following:preparation for system development, education and human resource development should be firstly done,manual of risk management and health risk management should be developed,HIA under analysis of environmental impact should be strengthened.
Effectiveness and appropriateness of the LEPTO-SCORE for decreasing severity of suspected leptospirosis cases referred to Khon Kaen Hospital: A randomized-controlled field trial in a northeastern province of Thailand	The objective was to evaluate the effectiveness and appropriateness of LEPTO-SCORE for decreasing severity of suspected leptospirosis cases referred to treat at Khon Kaen Hospital. A stratified randomized-controlled field trial was conducted at 4 district hospitals in Khon Kaen province. The suspected leptospirosis patients admitted from July 2000 to February 2001 were included for study. The patients in intervention group who had LEPTO-SCORE of at least 8 on admission or of at least 10 at 12 hour apart was assigned to refer to Khon Kaen Hospital. The severity of referred patients were assessed by using Modified APACHE II score at Khon Kaen Hospital (score of < 10 was accounted to be an appropriate refer). In all, six hundred and eight patients were recruited, 241(39.6%) in intervention group and 367 (60.4%) in control group. Most patients were male (67.9%) with the mean age of 38 years and 86.7 percent were farmers. Twenty-nine patients were referred. The Modified APACHE II score of patients in intervention group (7.5 ( 3.6) was lower than that of control group (10 ( 5.3) without statistical difference (difference = 2.5, 95%CI: -1.9 to 6.4, p = 0.28). There was no significant difference of rate of appropriated refer between both groups (57% in intervention group, 50% in control group, p = 0.73). We concluded that the LEPTO-SCORE trended to be useful for decreasing severity of suspected leptospirosis cases referred to treat in tertiary care center and for development of proper referral system.
Family Violence State of the Art Review and Research Promoting System in the Future. This paper reviews research on domestic violence internationally and nationally and suggests the direction of research promoting system in the future. The analysis of this literature considers historical context, methodology issues, concepts and theories related to domestic violence and situational reviews on wife abuse, dating violence and child abuse. As domestic violence is emerging as a significant social problem all over the world, there is a growing body of multidisciplinary research on domestic violence. However there are key issues of controversies in the study of domestic violence including definition, method of measuring and data sources. The review suggested to create the structure and the process of domestic violence research. It is suggested to develop a National Research Center that could collect, process and disseminate reliable information, which can support policy and practice efforts in the field. It will develop data from practice and return it to practice. The Center will cover several areas of study including violence against women and all forms of spousal violence; child abuse and neglect and dating violence.
Genetically Modified Organisms have a great potential in national economic development. However, the global market acceptance is presently yet quite limited. Intellectual property, ecological risk, organization, rule and regulation as well as economic analyses indicated that Thailand should impose the so-call “Safe Use of Forefront Technology” policy on GMOs issue. Prior to the acceptance of the technology for the enhancement of the country competativeness, the enacting process to have a complete legal system on biosafety must be accelerated in order to have the system fully implemented within 3 years. Capacity building for government officials who will responsible in controlling GMOs must also be urgently executed. The knowledge on the risk from using and consuming GMOs as well as the responsibility of GMOs developers and producers should be disseminate nationwide. Policy organization and regulatory organization must be permanently established to oversee the GMOs issue. The component and the role of these organizations must be stated in an Act. The above action has to be fully in place before the policy organization starts working. The policy organization will consider and determine the national direction on research, study and utilization of GMOs, especially in an open system. For the time being, capacity building in science and technology must be emphasize on biosafety management. Other research works must aim to obtain a patent able result as well as to serve the demand of Thai society and her markets. A unit in the Ministry of Natural Resource and Environment should be assigned to implement the biosafety regulation. The expense arising from GMOs utilization shall be born to the producer, on polluter – pay principle. The above suggestion is based on the present evidence that cannot yet confirm that GMOs do not pose higher risk than ordinary organisms.
The Development of Public Health Budget System for Efficiencyand Equity of Budget Allocation and Administration at the Policy Level	The current public health budgeting system is largely determined by the Budget Bureau, the Ministry of Finance. Its obvious weak points are the existence of budget ceiling which responds neither people’s demand nor needs, lack of outcome-based activity evaluation, and the use of historical base budgeting system in which new activities are less likely to initiate. Two main objectives of the public health budgeting system should be on improvement of resource use equity and efficiency. It is suggested that health services be grouped into their hierarchies to lessen the existing current problems in addition to using health service information for categorizing such services.
Samut Sakhon, a small province in Central region has three districts, Muang, Banphaeo and
Krathumbaen. Banphaeo hospital, the first autonomous hospital in Thailand through Public
Organization Act, 2542 BE. will be financed through capitation according to population size in the
district. This will have significant changes to financing mechanism at provincial health office and
health centers in the district. The objective this study is to assess unit cost (covers labor and material
costs, excludes capital depreciation costs) of services provided by health centers in order that
Banphaeo hospital could fairly purchase care from health centers. We assess operating cost in fiscal year 2542 BE., among all health centers in the province. Staff time allocation survey was done to
allocate labor cost to various key activities of health center, material cost was directly collected for
each activities. Cost from general administration and reporting function were allocated to service
activities using simple allocation method.
Results: operating expenditure per capita population at health center was 120 Baht per year, (110
Baht from health centre and 10 Baht from District Health Office). Annual operating expenditure was
834,136 Baht per health centre, of which 56% was labor and 44% material cost. Each health center
was staffed by 4.16 health workers. Time allocation reported 22% contributed to curative services,
27% to administrative function, 18% on health promotion activities and 30% community based
services. Curative services consumed 40% of total operating expenditure, most were drugs and
supplies. Unit operating cost for curative service at health center was 59 Baht per visit (range 53 to
65), health promotion and mother child health services was 100 Baht per visit (range 88 to 120). If
cost from District Health Office was included, unit cost would increase by 9%. Unit cost was
influenced by staffing intensity, magnitude of labor cost and productivity. Unit cost is one of several
tools for proper resource allocation.
This study provides evidence on how hospital could purchase services from health center that reflects
operating cost. Several options are capitation base on population size, total cost inclusive for each
group of activities, or unit cost per service rendered. It depends on how to stimulate proper service
behavior by health center. However, current funding available at health center from central
government and local administration should be taking into account to purchase services from health
centers.
Objective: To establish a national registration of acute coronary syndrome (ACS) registry in Thailand in order to study clinical epidemiology, determine the demographic, management practices and in-hospital outcomes of patients with ACS.Methods and results: Thai ACS registry is a multi-center prospective project of nationwide registration in Thailand. The enrollment of the patients started in August 2002. After one year, records of 3025 patients were collected from 16 hospitals. The patients were classified as ST elevation myocardial infarction (STEMI) (38.9%), non-ST-elevation myocardial infarction (NSTEMI) (35.6%) and unstable angina (UA) (25.5%). The mean age was 64.5 years old with 59.8% of male and 40.2% of female. The cardiovascular risk factors were 44.8% of diabetes mellitus, 62.1% of hypertension, 68.9% of dyslipidemia, and 31.9% of smoking. About 52% of the STEMI patients received reperfusion/revascularization therapy. The median time of door to needle was 100 minutes in patients received thrombolytic treatment and only 11% of them were received within 30 minutes after admission. The most complication of congestive heart failure was found 42.1% in ACS group. The total mortality rate was high in STEMI (16.2%) followed by NSTEMI (11.7%) and UA (3.1%) respectively. The mean length of hospital stay was 10 days.Conclusion: Thai ACS registry provides a detail of demographic, management practices and in-hospital outcomes of the patients with ACS. These data may have an impact on our health care system and alert the government to make a policy for these problems
This  study  is  an  action  research  phase I :  situational  analysis.  The  objective   is to    study   about   the   inappropriate   behavior  to  injection   between   a   provider  and patients at  out  patient  department  of  Rasrisalai  District   Hospital.  The  study   units are  composed   of  6   doctors,   5  ER  nurses ,  and   403   patients  who  got    the  1  out  of  12  common  injection    drugs and 517 oatrenh who did not get injected dngs.  Data  collection   had  been   corrected    since   1 st    April    1998  until  30th     November  1998. The  instruments  are  the standard  criteria  for   12  injectable  drugs ,  questionnaire, medical  record  and  the  treatment  assessment  format.  Data  analysis tool are  percentage ,   mean  and  Odd  Ratio.         The  study  shows  that  48.9 %  of   the  providers  (doctors  and  nurses) have the  inappropriate  injectable   behaviors.  Gentamycin   and  Vitamin  B  complex  are  the  most  common   drug   to  be  use  (92.3%).  Over   use    is   the  most  common   pattern.  Patients  have   the  good  attitude  for  injection ;  for  instance  rapid  action  and   recovery,   comfort  and  clean.          The   study  indicate   that  there  is  the  overuse  of  injection  drug in  Rasisalai Hospital .    So  we  should  have  the  standard  process  to  treatment assessment ,  in order to   get  the   basic   data  to   change  for  good behavior.   In  the  same  time ,  we   should  create   same guidelines  to  change  the  patient, s  belief  and  value.