plueme/wizJson huggingface dataset:
The purpose of this study was to examine changes in body mass index among elderly in royal denture bestowed project. The study design was a retrospective cohort study. Data collection was carried out in 436 subjects, from 6 months to 2 years after denture services. Multiple linear regression was used to analyses the relationship between denture use and body mass index adjusted for gender, age, income level and baseline body mass index.
The results showed that the denture use significantly increased body mass index of elderly in royal denture bestowed project (P < 0.05)
The methodology of this research was a Mixed method ,combination of survey research and In-depth
interview. The Objective to study medical rehabilitation services situation , to study factors relating to access
of medical rehabilitation service amongst people with mobility impairment and to utilize information for
policy planning in the aspect of development of the service system. A sample of people with mobility
impairment were drawn using multi-stage sampling from 10 provinces in 4 regions of Thailand. The samples
used in the research were 400. The questionnaire was used to collect the data from June to September
2013.The response rate was 97.25%. The data were analyzed using percentage, mean, standard deviation, t –
test, F test, chi-square test, and Forward stepwise logistic regression analysis. The study results situation of 26
items of rehabilitation services, service sectors can provide only some items. The most accessibility of service
consist of evaluation, medication and advice & councelling. While the less accessibility consist of vocational
rehabilitation, skill & knowledge training for care giver and social skill training for people with mobility
impairment. Correlation factors according to rehabilitation accessibility consist of gender, medical right, type
of impairment, onset of disability, travelling to the health service and public facilities. These factors can be
used as a predictor of rehabilitation accessibility at 14.5 percentage.
Postoperative liver failure is a life-threatening complication after hepatic resection. Because of recent advances in liver surgery technique and a better patient selection, morbidity after hepatic resection has steadily decreased, but its incidence still ranges from 1.2% to 32%. The factors of postoperative liver failure, morbidity and early mortality in major hepatic resection in the modern era should be reevaluated.
STUDY DESIGN:Demographics, extent of resection, liver fuction, ICGR15, liver volumetry, operative and transfusion data, complications, and hospital stay were analyzed for patients undergoing major hepatic resection(no less than bisegmentectomies) from January2013 to September 2013 at RajavithiHospital. Factors associated with morbidity and mortality and trends in preoperative and perioperative variables over the period of study were analyzed.
RESULTS:Of 50 patients who underwent major hepatic resections, 6 patients (14.63%) developed postoperative liver failure after hepatectomy, 18 patients (36%) had morbidity and 2 patients (4%) died within 30 days postoperatively. Amount of segmentectomy was the significant risk factor for postoperative liver failure and 30-day mortality after major hepatectomy. ICGR15, blood transfusion operative time and more than 3 segmentectomies were the significant risk factors for morbidity. The only significant risk factor for morbidity by multivariated analysis were operative time.
CONCLUSIONS:Careful patient selection based on ICGR concurrent with decreasing blood transfusion and decreasing operative time in major hepatectomy cases could help prevent the occurrence of postoperative liver failure, morbidity and 30 day mortality.
Maternal and child health (MCH) situation in three southernmost provinces has
been in a critical stage. MMR was about three times higher than country’s targets and
almost two times in MDGs Plus target, lower than the performance in almost all
indicators. Most deaths due to causes that can be prevented in the context of modern
obstetrics. There is only a small detail that seems to be absent. Prenatal care to pregnant
women with traditional midwives. The way of life, religion and cultural norms determine
the practice of pregnant women. But it is not seen as important as surveillance and health
complications. Key factors which affect the success of maternal and child in three
southmost provinces are
1. Manpower : Turnover rates are frequent, bcause it is a difficult task,
required high skills and experience. More tools and indicators and some indicators are not
consistent with the context in three southmost provinces.
2. Belief : Two believes persists that determines the norms and practices of
pregnant women are 1) do not eat more and do not take the medicine 2) seek female
personnel’s service for delivery. Including lifestyle, religious values are very high in regard
to procreation, and that the death is natural. The attitude that contraception is wrong,
against the principles of Islam.
3. Traditional Birth Attendants (TBA) : TBA is the strength of maternal and child
health in the southmost provinces. Pregnant women are faithful and believe in TBA. While
Islam still had limited access to medical services.
Suggestion and Policy Brief
1. Urgent measures : Cooperation with TBA to reduce MMR (Maternal
Mortality Rate) in three southmost provinces. Development competency TBA to learn
assessment of high risk pregnancy, refer and delivery of emergency cases safely.
Appropriate Incentive measures are important. We should also encourage Muslim
husbands to have proper attitude and to help woman during pregnancy and childbirth.
2. Medium and long term measures : Department of Health and related
agencies should review policy, strategy and tools that is flexible, affordable and possible.
Provides analysis and support capacity in maternal and child health. We should put more
ostetricians in the three southmost provinces and enhance them and their MCH team to
understand the way of truly Muslim.
This research aimed to develop optimum health promotion model of local
administrative organizations. Development process consisted of four steps. The first
step, health promotion situation of local administrative organizations was analyzed and
evaluated. The second step, impossible health promotion model of local administrative
organizations was stipulated. The third step, health promotion model was practiced in
local administrative organizations. The forth step, practical result was assessed.
Research and development study with action research was used as research
methodology. Health promotion situation and problem in operating by local
administrative organizations was collected via document study and then people, officers
and stake holder were interviewed in pilot study. Health promotion model for local
administrative organizations, which was developed in previous step, was conducted in
focus group discussion comprised of scholars, experts and stake holders to find out
additional issues for drafting development. Health promotion model for local
administrative organizations was developed by implementation and then evaluation.
Result of document study revealed that health promotion model was belonged to
type 1, policy and key performance indicator - responded model, The model was
belonged to type 2, community’s health problem solving – responded model, The model
was belonged to type 3, both policy and community – responded model. In model
drafting development, data in previous step was conducted in focus group discussion
comprised of experts and model that integrated plan, policy and community problems
and participated with network would be an optimum model.
This research would lead the suggestion for Local Government Organizations’
potential development in health promotion. All public health organizations and related
organization should stipulate ways, model, operating procedure and supporting activities
for skill and knowledge training to Local Government Organizations’ committee which
would influenced their attitude and their concrete operation.
The incidence of childhood obesity in Hat Yai District, has become increasingly
high and its effects are likely to worsen in the future. To control and prevent obesity
effectively by behavioral changes, various levels of control and factors are needed.
This quasi-experiment are two-group pretest-posttest non-equivalent control. The
main objectives of the study were to compare health behavior and weight loss among
secondary school students whose weights were higher than the standard body weights
before and after participating in the programs, and to investigate the results of the
programs in terms of policy of school administrators, school physical environments,
peer influence, health service systems, school food sellers program, overweight
students program, and parents and guardians program. The subjects consisted of
school administrators, school physical environments, peer groups, health service
systems, school food sellers, parents and guardians. The key subjects were male and
female secondary school students with body weights higher than the standard body
weights in Hat Yai District, Songkhla Province. There were 51 students in each group of
the control and the experimental groups. The behavioral change tools consisted of
administrative policy, physical environmental development, peer influence, health
service systems, parents program, food sellers program, and health behavioral change
program for overweight children. The experiment was from July 2014 to February
2015. The general data were analyzed with frequency and percentage, health
behavior and weights before and after the experiment were compared using Wilcoxon
Signed Ranks Test and Mann-Whitney U Test. Analysis was performed with qualitative
data on school administrative policy, physical environmental development, health
service system, and food sellers in the school.
The study found that after the experiment, the experimental group had a
higher level of health behavior in food consumption than the control group at a
statistically significant level of p<.05, the level of health behavior in exercise for the
experimental group was also higher than that for the control group at the level of
p=.05. The effects of the programs on weight loss revealed that the average of
ordinal scale for the experiment group decreased with a statistic significance of (p<
0.05) while that for the control group increased with a statistic significance of (p< 0.05).
The results of the study indicate that the health behavioral change program
improved health behavior among the overweight secondary school students, and
decreased their weights.
This study aimed to determine the amount of energy in total and by physical activity domains (Activity
at Work, Transportation, Recreational Activities, and Sedentary Behavior) of Thai adults, and disaggregated
by subgroups of participants. The study re-analyzed data of 22,136 Thai adults aged 15 and above from the 2007 National Physical Activity and Obesity Survey conducted by ABAC Poll Centre of
Assumption University. Descriptive statistics were defined in the analysis. The results showed that the
average total daily energy expenditure was 1,239 kcal and the average daily energy expenditure in work
domain was the highest at 523 kcal, followed by sedentary, transportation, and recreational activity domains
at 409, 180, and 126 kcal, respectively. Male participants aged 25-44 living in rural areas including
farmers and laborers, and those who had the lowest education level and income level spent the highest
total daily energy expenditure and energy expenditure in work domain. In contrary, women, elderly,
unemployed people and students spent the lowest energy.
This study aimed to explore administrative and management system of the Collaborative Project to
Increase Production of Rural Doctor (CPIRD), and the One Doctor One District (ODOD) programs by
using qualitative study methods: document reviews, in-depth interviews and group interviews of 56
stakeholders. The stakeholders consisted of the Office of Permanent Secretary, the Office of Collaborative
Project to Increase Production of Rural Doctor, medical faculties, medical education centres in affiliated
hospitals, and provincial health offices (PHOs). Content analysis was employed for data analysis.
The results showed that the Office of Collaborative Project to Increase Production of Rural Doctor
plays important roles for overall management including proposal endorsement to the cabinet, quotas and
the criteria for admissions determination, budget and procurement procedures, and student database
establishment. Medical schools are responsible for the selection of medical students and teaching medical
students in preclinical years while medical education centres have been taking care of students in clinical
years. All three units are highly coordinated and consistent. While the PHOs play vital role on monitoring
the contract and the work of the medical graduates under the project. The budget and personnel
administration are managed under the Ministry of Public Health regulations and universities.
This study recommended the Ministry of Public Health establishes long term status of the CPIRD
and ODOD program. In addition, it requires the improvement of management for overlapping location of
student recruitment by establishing the network among the program and medical schools according in
individual geographical areas. Moreover, promoting roles of PHOs in tackling with rural physician
shortage is recommended.
The objective of this study was to analyze the utilization of oral health care among Thai working age
population by using database of the Health and Welfare Surveys conducted by the National Statistical
Office in 2013. The surveys covered 27,960 households nationwide. Data were then weighted to represent
the total population. It was found that in overall, 98.7% of working age population was covered by any
health insurance scheme, of which national health insurance scheme (UC) shared 64.8 %. Among those
insured, only 9.3% reported having oral health care during the past year. Regarding area and income, it
was found that Civil Servants’ Medical Benefit Scheme (CSMBS) with high income clients from Bangkok
Metropolitan have the highest accessibility to oral health care of 22.5% compared to those national health
insurance scheme of 7.0-8.5% or 2.7-2.9 times higher. Furthermore, 45% of cases reported abstain to use of
their health insurance for oral health care and even 51.7% for UC scheme. Among UC scheme holders,
84.4% preferred seeking private services. The result reflects the challenge in access to oral health care. It is
necessary to develop measures to increase access to public services with effective and appropriate mechanisms.
Objective: This empirical study investigates hospital’s incentives in responding to the difference in
reimbursement policies. Specifically, it seeks to identify and analyze possible cross-subsidization across
health schemes within the public hospitals in Thailand.
Methods: This observational study employed a mixed-methods research design. Qualitative
contents were collected from focus-group interviews of 30 hospital administrators in three selected public
hospitals, and content analysis was primarily used to synthesize a mental model of how hospital
administrators making decisions related to the concept of cross-subsidization. Quantitative data analysis
was used to compliment the qualitative contents on the issues of unit-cost difference, difference between
charge and cost, and difference between reimbursement and cost across health schemes.
Results: Content analysis reveals four emerging themes. First, the concept of cross-subsidization
is perceived differently among hospital administrators. Second, payment policies create obstacles to
hospitals’ financial management. Third, organizational factors also create obstacles to hospitals’ financial
management. Lastly, hospitals respond to payment policies of health schemes by various measures. These
findings are supported by quantitative results, which suggest the unit costs and the differences between
reimbursement and cost vary across health schemes after controlled for other patient characteristics.
Nonetheless, no evidence suggests that hospitals cost-shift by increasing prices charged to out-of-pocket
payment patients to compensate for the loss.
Discussions: Despite no strong evidence of cross-subsidization, we found three patterns of
decision-making of hospital administrators related to cross-subsidization, including implementing no
management practices for cross-subsidy, initiating organizational practices to reduce negative financial
impacts, and attempting to negotiate with health schemes on a fair reimbursement rate. Hence, policymakers
should adjust financing policies to adequately pay for health services provided. When evaluating the
impact of any payment policies, policymakers should consider not only an impact to patients of any
particular health scheme, but also an impact to other patients groups within the hospitals. Future studies
should utilize time-series data to determine a causational relationship between payment policies and
cross-subsidization at the hospital level.
In 2010, the Dental Council has prepared Thai Dental Safety Goals and Guidelines 2010 which was
distributed to members to learn and put into practice. It could be adjusted according to different context
of use to ensure maximum safety for both service providers and recipients. The purpose of this study was
to evaluate the dental service quality in Dontan Hospital against the Thai Dental Safety Goals and Guidelines
2010. Data was collected from 240 patients using a questionnaire to access patient treatment quality
according to Thai Dental Safety Goals and Guidelines 2010. The evaluation also assessed 240 copies of
complete medical records and self-evaluation was included. The methodology used is the quantitative
analysis of frequency, percentage, mean and standard deviation. The process started from July 1 and
ended on July 30, 2014. The study found that : 1. On average, patient evaluated the quality of treatment at
92.8 percent. 2. The average of completeness of information, especially in dentistry was about 66.3 percent.
3. Self-assessment evaluation was done at 89.09 percent for patient safety, the improvement of communication,
safe dental treatment, safe infection control and complete record. Nonetheless, there are also
rooms for improvement. Written treatment plan in complicated cases needs to be recorded. Quality of
service in pediatric treatment could be improved by using the dental dam.
Chest x-ray is one of the examinations/tests of the annual check-up program in Thailand. Routine
CXR is also occasionally required of future employees, or university students before admission. However
in many countries prevalence of abnormal chest x-ray on annual checkup is low yield and high cost. Purpose: The study aims to determine the prevalence of abnormal annual check-up CXR in Pua Crown
Prince Hospital and to find out the correlation between age group and prevalence of abnormal CXR.
Methodology: Descriptive analysis and to cross sectional design were used in this study. All patients
who came for annual checkup and CXR at Pua Crown Prince Hospital during 1 January to 31 December
2013 were included. All of CXR evaluated by radiologist were analyzed by using SPSS 21. Findings:
Among 1,569 cases of annual checkup at Pua Crown Prince Hospital during 1 January to 31 December
2013, 1,446 routine CXRs were found and 21 films were technically poor. Consequently 1,425 films were
included in this study. Prevalence of abnormal CXR was 3.15% and 1.82% of abnormal CXR was cardiomegaly.
Lung abnormality was 0.63%. The remaining abnormalities were scoliosis of thoracic spine and
renal stone. Discussion: Prevalence of abnormal screening chest x-ray on annual medical checkup is low.
Most of abnormal findings were cardiomegaly. Findings of lung abnormality were low. Screening CXR
would also lead to unnecessary radiation, and false-positive screening resulting in physical risk, unwarranted
anxiety and more expenditure. Screening CXR is appropriately reserved for high-risk patients and
those with relevant clinical findings.
The first treatment option for end stage renal disease patients is dialysis. However, some patients
select non-dialysis treatment (NDT). Currently, data on clinical outcome of this treatment modality is
limited. Therefore, a retrospective cohort study was performed to evaluate clinical outcomes of chronic
kidney disease (CKD) stage 5 patients managed with NDT, including survival, factors affecting survival,
and hospitalization. The data was reviewed from the first date approaching to stage 5 (glomerular filtra-tion rate < 15 ml/min/ 1.73 m2) for at least 2 years, until death, or until the end of the study. A total of 72
patients who fulfilled the eligibility criteria were included to the study. The mean age was 65.4 years old.
The most common cause of CKD was diabetes mellitus (n = 35, 48.6%). The most common co-morbidity
was hypertension (n = 54, 38.6%). The most common reason for selecting NDT was lacking of a caregiver.
The median overall survival was 26.1 months. One-year and two-year survival rates were 80.0% and
59.0%, respectively. There were 307 occasions of unplanned visit, and 115 of these were related to renal
causes (37.5%). A total of 56 (77.8%) patients were hospitalized on 179 occasions. One hundred and two
(57.0%) of these were due to renal causes. This study demonstrates that the survival time of NDT patients
was approximately 2 years. There were high numbers of unplanned visits and hospitalization among
these patients. Therefore, NDT modality should be considered as a choice only for patients who are
contraindicated or not eligible for dialysis, or who would not be beneficial from dialysis.
A total of 517 samples Salmonella strains isolated from stool and blood patients, hospitalized in Trang,
Phathalung and Songkhla provinces in 2011-2014. The ratio of female to male was 1 : 0.98. The predominant
age group of isolates were < 1 year (137 cases 26.5 %). Serotypes of Salmonella isolated from stool were
438 samples and blood were 79 samples by Kauffmann-White scheme and Sven Gard method. Salmonella
serotype Weltevreden was the most predominant 120 samples (27.4%) followed by serotype Typhimurium
97 samples (22.1%) isolated from stool. Salmonella serotype Enteritidis was the most predominant 31 samples
(39.2%) followed by serotype Typhi 19 samples (24.1%) isolated from hemoculture Drug susceptibility of
Salmonella by the disk diffusion method with 5 antimicrobial agents such as Ampicillin, Tetracycline,
Co-trimoxazole, Chloramphenicol and Norfloxacin. Salmonella strains isolated from stool were the most
predominant resistant to Ampicillin (54.5%), followed by Tetracycline (45.2%). Salmonella strains isolated
from hemoculture were the most predominant resistant to Ampicillin (36.0%), followed by Tetracycline
and Co-trimoxazole (28.0%). All of Salmonella isolated were susceptible to Norfloxacin (100%).
The results showed serotype and drug resistance pattern of Salmonella isolated from stool and blood
for fundamental data and guidance in selecting antimicrobial agents in Trang, Phathalung and Songkhla
provinces