location: , 'Thailand year: 2023 source: HSRI

title: Developing Digital Communication Tools on Mobile Application Platform for Community-led Health Impact Monitoring: A Case Study of Transboundary Pollution from Hongsa Power Plant, Lao PDR

abstract: This present study has five main objectives: 1) To develop a digital community-led health impact monitoring tools on the mobile platform application; 2) To establish communication channels for both horizontal and vertical communication within and between communities, as well as with relevant organizations and public communication regarding community-led health impact monitoring of transboundary pollution; 3) To create citizen reporters who can produce in-depth content on community-led health impact monitoring; 4) To develop a prototype public learning space for community-based health impact monitoring; 5) To utilize the research findings from the program “Development of Community-led Health impact Monitoring System in Nan Province, Thailand: A Case Study of Transboundary Pollution from Hongsa Power Plant, Lao PDR” to produce video documentary reflecting the research process, methodology, and context related to community-led health impact surveillance to mobilize knowledge to communities experiencing similar health risks. The participants consisted of teachers and students from 8 schools in Chaloem Phra Kiat District, one school in Thung Chang District, and orange farmer group in Thung Chang District. Both qualitative and quantitative research methods were used in data collection and analyses. As a result of this participatory research project, various tools and communication channels were developed to enable teachers, students, and community members in the affected areas to record, report, and communicate health impact monitoring information through the C-site mobile application developed by the Public Media Network Department, ThaiPBS. The tools and communication channels include an interactive map on the C-site communication platform, comprising 37 layers of data, including 16 GIS layers, such as administrative boundaries, forest area data, Nan river basin data, village coordinates from Khun Nan to Huai Kon, and data from four other organizations (mobile towers, Office of the National Broadcasting and Telecommunications Commission, PM2.5 dust measuring device API from the Faculty of Science, Chiang Mai University, SO2 and NO2 measuring devices from the Faculty of Engineering, Naresuan University, and community maps from the Faculty of Arts, King Mongkut's University of Technology Thonburi, as well as 14 additional survey-based data layers, such as indicator data collection, location-based storytelling in the style of users-generated contents from nearby citizen reporters, and emergency reporting. The community survey conducted in the 8 communities led to the development of community indicators that cover health and the environmental dimensions. In terms of health, two digital surveys on physical and mental health were developed, in terms of environment, monitoring surveys for water quality using the benthic macroinvertebrates, and monitoring surveys for agricultural produce for both general agricultural groups and orange farmers were developed. Two 3-day training sessions were delivered in October and December 2022 aiming at installing skills of using the C-site application, Mobile Journalism for Citizen Science or MoJo4CitSci, and riverine detective activities. The first training session was Training of Trainers (ToT) including teachers, students, local volunteers in Chalermprakiat district, and orange farmers from Thung Chang district. In the first training session, participants were extremely satisfied with all three activities. The participants showed highest satisfaction with using the C-site application for data collection (x̅ = 4.87, S.D. = 0.35), followed by nature detective activities (waterway) (x̅ = 4.86, S.D. = 0.37), and using Mobile Journalism for citizen science (MoJo4CitSci) (x̅ = 4.83, S.D. = 0.39), respectively. In the second session, participants reported that they were very satisfied with all three activities. The highest satisfaction was with nature detective activities (waterway) (x̅ = 4.13, S.D. = 0.78), followed by using Mobile Journalism for citizen science (MoJo4CitSci) (x̅ = 4.12, S.D. = 0.82), and using C-site application for data collection (x̅ = 4.04, S.D. = 0.75), respectively. The communication of health impact monitoring manifested in two important forms: horizontal communication involved knowledge transfer about using necessary knowledge and tools for monitoring, and risk communication within the community; and vertical communication, which started from bottom-up communication, where the flow of communication was facilitated by the open structure of ThaiPBS based on participatory communication. It is evident that this communication ecology is like weaving and connecting communication networks to support the community-led health and environmental impact. If this system is further developed and integrated with the national emergency communication system that may occur in the future, it will significantly enhance the efficiency of caring for the health of vulnerable population who are at risk of being affected by transboundary pollution.


location: , 'Thailand year: 2019 source: HSRI

title: A randomized, placebo-controlled house dust mite (HDM) subcutaneous allergen immunotherapy study in HDM persistent   allergic rhinitis (MITAR)

abstract: Respiratory allergy, which consists of allergic rhinitis (AR) and allergic asthma (AA), requires high cost of medical treatment. These medications can only temporally relieve the allergic symptoms without any modification of an allergic hypersensitivity status. The only option that can modify the immunologic status is the allergen immunotherapy Three hundred and forty three subjects with chronic rhinitis was screened from 13 centers in Thailand. One hundred and forty six patients had been recruited according to the inclusion criteria, in which 108 subjects was randomly assigned into the intervention group (receiving immunotherapy and standard treatment) and 36 subjects had been assigned to the controlled group (receiving standard treatment with placebo injection). The clinical characteristics between two groups were not statistically significant. After one year, the median composite score in the intervention group decreases 3.8 score comparing to the baseline (p < 0.001). But comparison between the intervention group and control group was not statistically significant. After one year of treatment, 66.7 percent of subjects in the intervention group can reduce their medication use by 50%. Moreover, 23% of subjects in the intervention group were medication-free after 1 year of allergen immunotherapy. Eighty five percent of subject tolerate the 500 allergen unit dosage of vaccine. There were 423 adverse events (AE) out of 4,444 injections, 2.31% of total AEs (77/423 events) were systemic reactions.


location: , 'Thailand year: 2018 source: HSRI

title: Expression of miRNA profile in serum of lupus nephritis patients

abstract: Systemic lupus erythematosus (SLE) is a clinically heterogeneous, human systemic autoimmune disease characterized by autoantibody formation. MicroRNAs (miRNA) have emerged as an important new class of modulators of gene expression and have been confirmed to regulate the lymphocyte tolerance and autoimmunity in SLE. In this study, we investigated the exosome of serum miRNA profile in SLE patients with miRNA array (nanosting). TaqMan-based stem-loop real-time polymerase chain reaction was used for validation. We also examined the serum cytokines of IL-29 and then analyzed the association of the upregulated of IL-29  and miRNA-548n. Microarray analysis of miRNA indicated 4 downregulated miRNAs and 2 upreguated miRNAs in SLE patients. Such upregulation of hsa-miRNA-181d 3p, hsa-miRNA-542 and downregulation of hsa-miRNA-548n, hsa-miRNA-16, and hsa-miRNA-122 and has-miRNA-183 was also confirmed by RT-qPCR. We also recognized the upregulation of serum IL-29 in those active SLE patients. The upregulated miRNA-548n contributed to the upregulation of inflammatory IL-29 in active SLE. Our findings demonstrate that miRNA-548n can be a novel biomarker for SLE, and help elucidate pathogenic mechanisms of SLE.


location: , 'Thailand year: 2001 source: HSRI

title: Autonomize process of Banphaew hospital

abstract: Autonomize Process of Banphaew Hospital	The autonomization process of Banphaew hospital is a long continuous evolution process. Initiated by community participated in hospital administration in the past to organization reform recently.	The objective of this study is to observe and analyze the interaction between each stakeholders with system transformation process. The data was obtained by literature review, questionnaire, focus group interview and in depth interview. The study revealed that there was the delay of the autonomization process and there are many important episode occurred between the process. Six issues were taken into consideration in the following aspects:Decrease administration complexity new national gazette that would establish new organization structure that is more efficient. The inventory process is to be kept easy and the organization can initiate new innovative according to the need of the population. Ex: the join venture with pharmaceutical company to manage the drug procurement and delivery process, the join venture with Banphaew municipal to construct public swimming pool.Improve resource allocation As an autonomous hospital, Banphaew hospital has freedom to manage its own human resource according to need. There was a sharply increase in accountants, public relation. There was a sharply decrease in cook, and low skill labors. The hospital is financed with capitation budget 782 baht per registered person. This excludes civil servant and people who are in social security scheme. The hospital is the main contractor of the budget; therefor the hospital allocates the budget to health centers.Increase effectiveness and efficiency As an autonomous hospital, Banphaew has freedom to design the remuneration processes that relates with performance. This maximizes organization effectiveness.  Before being autonomous, the hospital was in depth, compared to after being autonomous which the profit from four month operation was around 4 to 6.4 million baht. However, after investigation we found that there was some revenue from special ex-province project; such as physical examination of the immigrant, which brought 6.7 million baht to the hospital.Increase accountability the autonomization process included the commitment to service with continuous quality improvement. The public acknowledgement about the new autonomous hospital commitment was due to universal coverage policy of the government that emphasizes the evaluation process. Because of the delay of the whole process, the executive board accountability cannot be evaluated as intended. The accountability that the other supported government agency should commit to the autonomization process of Banphaew was related to political agenda.Political compliance before the gazette was approved there was a split between the pro and the con, which create the day of the whole process. However, the hospital was autonomized by the support from several public agencies. At district level, there formed controversial groups and there was a demonstration at district level due to autonomous process. The chaos period within the hospital during the transformation was also related to the ex-hospital controversial. However, after the 6th of January election, the government that was led by Tasking Chinawatra announced health policy that highly supported autonomous hospital and the other stakeholder pay more attention as well as being more supportive to Banphaew hospital.Increase community participation Banphaew community was participated a hospital administration board even before autonomization process and there was a good relation between the hospital and the Rotarian. Four months after autonomization, the executive board from community is still under searching and appointing process. The uncertainty of the other stakeholder prohibited Banphaew hospital from running the public campaign about the change. The change of the government to government that won landslide vote by universal health coverage campaign created public health concern in the country, which was the best propaganda for Banphaew hospital.The autonomization process Banphaew hospital should be investigate more to follow the change systematically to answer the question whether the change to autonomous hospital was really good for the organization, policy, and the health of the whole population.


location: , 'Thailand year: 2022 source: HSRI

title: Development of Benefit Package for Diagnosis, Treatment, and Prevention of Mucopolysaccharidosis (MPS) for Patients Under Universal Health Coverage Scheme

abstract: The objective of this study was to develop the benefit package for diagnosis, treatment/rehabilitation, and prevention for MPS patients under universal coverage scheme. According to the medical record review from 7 rare disease centers, in November 2564 there were 81 MPS patients in Thailand (both alive and unsure status). Of these 10 were MPS I, 35 were MPS II, 11 were MPS III, 13 were MPS IV, 10 were MPS VI, and 2 were MPS VII. Proposed benefit package after stakeholder meetings include the followings; 1) Benefits for diagnosis a. Diagnosis with enzyme activity assay and molecular testing b. Carrier-testing for at-risk family members c. Prenatal diagnosis (in case that the couple desire to have another child) The 5-year budget impact for diagnosis with enzyme activity assay was estimated at 85,714 – 214,286 Baht (Average approximately 17, 143 – 42, 857 Bath per year) while those of molecular testing, carrier testing for at-risk family members, and pre-natal diagnosis were 450,000 Baht (average 90,000 baht per year), 300,000 Baht (average 60,000 baht per year), and 75,000 Baht (average 15,000 baht per year), respectively. 2) Benefit for supportive treatment. We proposed continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP) for MPS patients who were in medical need. This is based on the evidences that MPS patients are at risk of severe respiratory insufficiency and these patients will get benefit from CPAP and BiPAP. This was also consistent with our interview, which found that MPS patients were in need for CPAP/BiPAP. However, both CPAP/BiPAP are not included in the benefit package. The estimated budget for inclusion of CPAP/BiPAP for MPS patients is approximately 300,000-750,000 Baht for the first year (estimate budget for year 2 onwards is approximately 40,000 to 100,000 Baht annually). 3) Benefit related to treatment system. We proposed that affected patients can receive treatment and monitoring at rare disease centers without the need for referral for every visit. We also proposed for the development of co-ordinate care so that patients could receive routine and continuous care at the local hospitals. This was based on the fact that patients with MPS requires continuous care while the number of geneticists were limited and mostly available at rare disease centers. According to the interviews, patients were facing with difficulty in transporting to get treatment. 4) Benefit related to specific treatment with HSCT: We proposed the development of the payment mechanism that reimbursed for HLA Matching cost before translation. The new payment mechanism is expected to improve patients access to HSCT care. 5) Benefit related to specific treatment with ERT Our rapid review indicated that the efficacy of ERT in terms of mortality reduction, quality of life, and important clinical outcomes were unclear and that most studies were of moderate to low quality due to small sample size. Due to the challenges in conducting studies in very limited number of patients, most studies had no comparison group and emphasized on the change on surrogate outcome after short term use of ERT. While MPS is a rare disease that profoundly affects socio-economic status, and quality of life of patients and family and that ERT is the only specific treatment available (besides HSCT) treatment with ERT is very costly. During the 2nd and 3rd stakeholder meetings, it was suggested to firstly propose ERT for MPS II into the benefit package as ERT for MPS II is currently under consideration of National List of Essential medicine committee and that there is a proposed criteria for starting, stopping, and monitoring ERT treatment for MPS II. On the other hand, ERT for MPS VI and VII are not currently approved in Thailand. Based on the expert opinion, the use of ERT among MPS II can delay disease progression and improve quality of life of the patients. Therefore, ERT for MPS II is proposed to be included in the benefit package. Nevertheless, there should be an expert committee to effectively monitor its use. If government could manage the budget in the future, the stakeholders propose to include ERT for treatment of MPS I, IV, VI, and VII, respectively.


location: , 'Thailand year: 2018 source: HSRI

title: Hearing Aid Use in People with Hearing Loss under the Universal Coverage Scheme and the Recommendations for Hearing Aid Provisional Services

abstract: In Thailand, people with hearing impairment under the Universal Coverage scheme (UCS) are entitled to having hearing aid free of charge from accredited hospitals. This cross-sectional survey aims to describe the situation regarding hearing aid usage and economic loss from discontinuing usage of hearing aid in people with hearing impairment under the UCS. Data were collected from 364 persons in five provinces (Phayao, Khon Kaen, Chonburi, Samut Prakan, and Songkhla) through face-to-face structured interviews. Descriptive statistics were used for data analyses. The results showed that 54% of the sample experienced improvement in quality of life and 39% were satisfied with hearing aid use. Out of the 164 persons who were interviewed at hospitals, three stopped wearing hearing aid. For the 200 persons who were interviewed in the community, 29% stopped hearing aid use, to whom 50% used for less than one year. The most common reasons for discontinuing usage were high background noises and faulty devices. The economic loss from discontinuing usage up to third year was estimated to be 19.4 million baht. For subjects who were still using the hearing aid, 71% wore the hearing aid daily for 9 hours on average, whereas 44% occasionally wore approximately 3-4 days a week for four hours per day. For persons who used hearing aid with zinc-air battery, around 1-2 batteries were used per month, costing 65-96 baht a month. 43% stated that the cost of batteries was a burden as they were only able to pay approximately 32 baht per battery. Therefore, the National Health Security Office should: 1) set up a follow-up system for hearing aid users; 2) provide training or guideline to hearing aid users, their relatives, and primary care unit officer regarding the service, procedure of treatment, and basic maintenance of hearing aid; 3) set up mobile service for hearing aid maintenance in community; 4) support zinc-air battery in order to match the ability to pay of users and increase distribution channels to sell hearing aid battery; and 5) raise the awareness to hearing aid users and their relatives regarding the government subsidized cost of hearing aid.


location: , 'Thailand year: 2014 source: HSRI

title: New perspectives of dementia prevention and treatment

abstract: Dementia is a common condition in clinical practice. Its prevalence has been on
the rise, due to the rapid increase of elderly population. Alzheimer’s disease is the
most common cause of dementia syndrome. It often presents with progressive
cognitive decline and followed by behavioral and psychological symptoms. Patients
always had cognitive impairment in many aspects which impact their daily livings.
Therefore, proper evaluation and diagnosis are very important in the patient’s care.
Certain systemic and psychiatric diseases need to be excluded prior the diagnosis of
neurodegenerative disease. Further investigation is often needed for specific diagnosis
according to the standard criteria for each disease. During the past decade, the criteria
have been changed significantly due to better understandings in their pathophysiology.
Biological markers are incooperated to aid in earlier diagnosis. This will eventually
hasten the research and development for more effective treatment, or at least slowing
the disease progression.
New understanding in its pathophysiology has paved the way to potentially
more effective therapy. Pharmacological treatment for Alzheimer’s disease has been
progressing for the past decade. However, the currently approved therapy is still
limited to acetylcholinesterase inhibitors (AchEI) and memantine. AChEI (donepezil,
rivastigmine and galantamine) is mainly indicated for mild to moderate disease. Each
medication may have additional indication, according to its individual study.
Memantine is indicated for moderate to severe disease and may be used as
monotherapy or combination therapy with AChEI. They should be started and slowly
titrated up to the recommended dosage. Treating physician should periodically
monitor their side effect as well as efficacies. Even though their efficacy is modest,
they are helpful in maintaining the patient’s cognitive function and possibly delaying
the disease progression.
Other drugs such as antioxidants and anti-inflammatory agents were not proven
to be effective. Immunotherapy is the novel treatment strategy which may directly
affect Alzheimer’s pathology. It either inhibits the accumulation or eliminates Abeta or
amyloid protein in the brain.


location: , 'Thailand year: 2018 source: HSRI

title: Randomized controlled trial comparing concurrent chemoradiation versus concurrent chemoradiation followed by adjuvant chemotherapy inlocally advanced cervical cancer patients

abstract: Objectives: To evaluate the efficacy of adjuvant chemotherapy (ACT) in locally advanced stage cervical cancer after concurrent chemoradiation (CCRT) comparing to CCRT alone in terms of response rate, progression-free survival (PFS), and overall survival (OS).  Methods: Patients with FIGO stage IIB to IVA, aged between 18-70 years, had ECOG performance score 0-2, had histopathology of squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma, and had no para-aortic lymph node enlargement were randomized to CCRT (arm A) or CCRT and ACT (arm B). The patients in both arms had concurrent cisplatin weekly along with pelvic radiation. After a 4-week period after CCRT, the patients in arm B had paclitaxel plus carboplatin every 4 weeks for 3 cycles.  Results: Data analysis of 259 patients showed no significant difference of complete responses: 94.1% in arm A vs 87.0% in arm B (p=0.154). With the median follow-up of 27.4 months (range 3.2 – 49.0 months), 15.5% of patients in arm A and 10.8% in arm B experienced recurrences: (p=0.123). There were no significant differences regarding the loco-regional failure but the patients in arm B had significantly lower systemic recurrences, 10.1% vs 5.4% (p=0.029). The 3-year PFS and 3-year OS of the patients in arm A were not significantly different from those of arm B: 66.6% (95% CI, 57.4-75.8%) vs 63.4% (95% CI, 54.6-72.2%) for PFS and 80.1% (95% CI, 71.9-88.3%) vs 69.5% (95% CI, 59.3-79.7%) for OS. The hazard ratio of PFS and OS arm B compared to arm A were 1.26 (95% CI 0.82-1.96) and 1.42 (95% CI 0.81-2.49) respectively.  Conclusions: Adjuvant chemotherapy with 3 cycles of paclitaxel plus carboplatin after CCRT did not improve response rates and survivals compared to CCRT alone. There were no differences of loco-regional failure but a significant decrease of systemic recurrences by adjuvant chemotherapy.


location: , 'Thailand year: 2023 source: HSRI

title: The Study of Implementation of Public-Private Partnership in Oral Health Services Program for 3-6 Years Old Children in Bangpoo Municipality and Phraek Sa Municipality, Samut Prakan Province

abstract: The objective of this research project is to experiment with a public-private partnership model for dental services. Local government organizations coordinate with the area-level health promotion fund to purchase preventive dental care services from private dental clinics to increase access to dental services for children aged 3-6 years in the education area. This is to expand the coverage of dental services provided by the Ministry of Public Health agencies. Prior to the research project, according to the education area data, primary care units in the area were able to provide dental services such as dental check-ups and fluoride varnish to approximately 50% of the population of children aged 0-5 years. This indicates the limitations of the capacity of state agencies in areas with limited resources and the need to care for all age groups, in addition to the COVID-19 pandemic situation in 2021 which halted the provision of dental services from primary care dental units in the area and resulted in a significant decrease in access to dental services for children before school age. Data from a survey showed that during the COVID-19 pandemic, there were children before school age who needed oral health care but did not receive it. The results of the project show opportunities to use dental health resources in the area more efficiently to better care for the dental health of the population. The public-private partnership model can be a way to increase access to dental services for children. The cooperation of various organizations, including local government organizations and private dental clinics, is an important factor in the success of the project. The results of this study have interesting and beneficial issues for the development of policies to improve access to dental services for children in urban areas. There are four main issues: (1) The involvement of local government organizations in providing dental services using budget from the local health promotion fund. (2) Increasing the dental care access for children in urban area via PPP model (3) Using digital information systems for managing oral health services (4) Management of oral health systems at the regional level. Policy notes: To increase access to dental services for the public, especially children in urban areas, developing new service models by coordinating cooperation from local government organizations and utilizing budgets from new sources is an opportunity and challenge for Thailand, particularly in the context of decentralization and the increasing number of private dentists in a situation where the Ministry of Public Health limits funding for dental services. Coordination of dental services by the public health sector, local government organizations, and private dental service providers is a potential model for developing the dental service system in areas that should be supported. This support should involve various relevant sectors as follows: Ministry of Interior/ Ministry of Finance, supporting local government organizations to expand their role in healthcare in the area, amending regulations to facilitate health-related projects. National Health Security Office, providing consultation on the process of using the health fund and supporting the connection of health data. Provincial Health Office, developing the role in policy direction, service performance indicators, coordination, and system management, and supporting academic activities. Dental Council, supporting academic activities, setting standards for preventive dentistry, supporting policy promotion and implementation. The Department of Dental Public Health/General Dentists, supporting raise awareness and knowledge among the public about oral health to develop the behavior of taking care of their oral health.


location: , 'Thailand year: 2003 source: HSRI

title: Review of Current Knowledge on the history of medicine and public health in Thailand

abstract: Historical dimension has been a missing aspect in studies on medicine and health development in Thailand. This was partly because the interrelation between health and its socio-political contests was not adequately appreciated. History of medicine and public health in Thai society was understood merely as a chronology of medical technological advancement and the growth of state medical service.	This study explores works in the field of Thai medical and public health history both in Thai and English languages. It aims at assessing the state of knowledge and suggesting directions for further studies in medical and public health history in Thailand. The study found that although there were a number of studies in medical and public health history done by physicians, pubic health export, and social scientists, most of the works only compiled and listed the chronologies of events. They didn’t adequately provide historical explanation or interpretation of the events. Such studies failed to create new understanding on the medical history in Thailand. Not only new historical knowledge has been absent, but there was a lacking of the development of relevant methodology in medical historical study.	Historical writings in the early period were mostly done by medical or public health professionals in an  attempt to “construct their own discourses.” The changing of Thai political landscape after October 14, 1973, has led to the new area of historical knowledge. Medical and public health history was no exception. New interpretation of health and medical history was created within the contests of pro-democratic movement. Although various new sociological and historical methodologies were gradually developed and used, it was only in the past decade that greater interest in historical methodology and historiography has gained currency resulting in a building up of new knowledge of the Thai medical past.	The current state of knowledge in Thai medical history focused on two main issues. The first concerned with the evolution and domination of modern medicine. The second issue was in the changes and discontinuity of traditional Thai medicine. The repetitive theme was mainly on the decline of traditional medicine and the success of modern medicine which has become mainstream and increasingly dominant in Thai society. There was a lack of critical scrutiny of medical institutions and historical figures. This was partly because of the adherence to writing history with the framework of the Great Man and the royal nationalism theory. There was a need to put more emphasis on understanding medical history as related to social, cultural, and political circumstances.


location: , 'Thailand year: 1999 source: HSRI

title: The Price Comparison of US Drugs imported to Thailand

abstract: The price comparison of US drugs inported to ThailandThe price differential of drugs, calculated by item, group and purchasing power parity (PPP), was conducted to compare drug price between Thailand and the U.S. The 209    samples accounted for 34.9 percent of the total import, or 12.9 percent of the total import and manufactured. The comparison by item showed that 17 drugs in Thailand were more  expensive than in the U.S. The total import of the 17 items was 17,491,517 US dollars. Of these drugs, four of them were AIDS/virus drugs and five were antibiotics. The comparison analysis by therapeutic group showed that AIDS/virus group were priced 6percent higher in Thailand than in the U.S. where ones of antihypertensive drugs, phychotropic drugs, anticancer agents, miscellaneous group, cardiac drugs, antibiotics, vasodilating agents and antiinflammatory agents were(percent) 18.7,  24.3, 28.1,  45.0,  49.2,  47.5,  73.1 and  73.6  differences respectively.   Comparison by registration type demonstrated higher price of the new drugs over the old drugs category with percentage of differences at(percent) 20.0 and 44.4 lower in Thailand than in the U.S.  Comparison by dosage for did not show significant differences among groups of injection, tablet and capsule; and other form which were 38.0,  37.4 and  34.4  lower in Thailand than in the U.S. respectively. Comparison by using the 1995 PPP (Thai PPP=28 and U.S. PPP=100) indicated that most imported drug were charged more in Thailand than in the U.S. expect antiinflammatory drugs and vasodilating agents.


location: , 'Thailand year: 2007 source: HSRI

title: Describes and analyses the Thai alcohol policy process in the period 1997- 2006

abstract: The Report describes and analyses the Thai alcohol policy process in the period 1997- 2006, in order to investigate the characteristics and areas for potential improvement of the Thai alcohol policy process. The analysis used several extant public policy models. The models covered three aspects of the process at the macro level: stages of development, the characteristics and behaviors of major policy players, and the policy context. At the micro level, the analysis employs concepts of agenda setting, policy formulation, policy implementation, monitoring and evaluation, stakeholder relationships and policy context. Information on Thai alcohol policy was collected from two sources: secondary data included official documents, literature, technical publications and mass media; primary data was collected through stakeholder interviews.
Thai alcohol policy, during this period became more comprehensive and more oriented to public health. Problem-reduction values gained momentum while economic values remained significant. Thai policy stakeholders focused on the formulation process, while implementation, monitoring and evaluation were neglected. Limited resources, human capacity and ineffective management exacerbated this situation. Incrementalism characterized Thai alcohol policy formulation; existing policy or the policy precursor was very important to the decisions made. Limitations in the availability, accuracy and utilization of knowledge about alcohol consumption, related problems and alcohol policy also affected the process.
The Thai alcohol policy process became a more open public policy sphere for stakeholders. Many new players made major contributions to the process. The mechanisms stakeholders use to influence policy have become more complex and included:  technical knowledge, the use of mass media and civil movements, and coordination among stakeholders. A centralized bureaucratic administration and personal and institutional interests are critical features for official stakeholders, while connection to high-ranking officials and representation in the process are significant for interest groups. The Thai cultural context had a crucial impact on the alcohol policy process; cultural features that are not explicitly covered in the Western policy models utilized include cronyism, relationships, representation, commitment, negligence, and compromise. These characteristics make the Thai alcohol policy process difficult to fully explain in terms of the available public policy theories.


location: , 'Thailand year: 2023 source: HSRI

title: Strengthening Quality of Life of Village Health Volunteers in the 8th Public Health Region for Supporting Primary Health Services During the COVID-19 Pandemic

abstract: The study of strengthening the quality of life of village health volunteers in the 8th Public Health Region for supporting primary health services during the COVID-19 pandemic was conducted by a mixed-method study using a survey and group interview procedure. The sample for this study was 800 individuals of village health volunteers from 7 provinces under the 8th Public Health Region, which are Udon Thani, Sakon Nakhon, Nakhon Phanom, Loei, Nong Khai, Nong Bua Lamphu, and Bueng Kan. Descriptive statistics utilized percentage, mean, distribution, and standard deviation for data analysis. Most of the village health volunteers were females aged between 51-60 years old 43.5%, married 77.3% with secondary education65.9%. Most of them were farmers 62.2% with an average income of under 6,000 baht per month56.3%. The duration of being a village health volunteer was between 10 and 19 years39.0%. The longest duration was 41 years, and the shortest was one year. The village health volunteers were responsible for looking after 10-15 households. The majority used a smartphone 97.7% and paid a phone bill of over 300 baht per month. Half of them had received the award or glorification50.3%. Most of them do not have congenital diseases 70.9% and are members of the funeral assistance 72.7%. The village health volunteers know the practice of disease prevention and control during the COVID-19 pandemic at the highest level (x̄ = 4.38, SD = 0.64). The aspect of strengthening the quality of life of village health volunteers found that they have strengthened the quality of life in seven aspects. The aspects that have been strengthened at the “highest” level are mental, value, and pride (x̄ = 4.37, SD = 0.66). The aspects that have been strengthened at the "high" level are societal and social support (x̄ = 4.19, SD = 0.34), working environment (x̄ = 3.92, SD = 0.59), physical (x̄ = 3.85, SD = 0.55), advancement (x̄ = 3.77, SD = 0.88), compensation, and welfare (x̄ = 3.62, SD = 0.77), and working balance (x̄ = 3.06, SD = 0.46 ). The aspect that has been strengthened at the "moderate" level is having enough money to spend as they wish (x̄ = 3.19, SD = 0.88). The suggestion from this study is that at the policy, working via the smartphone should be promoted and support the phone bill that they have used for their work. Review and increase the welfare, compensation, and glorification of the village health volunteer to encourage morale in working. Enhance the quality of life of the health aspect in various ways for the village health volunteers to be healthy and be role models for health.


location: , 'Thailand year: 2018 source: HSRI

title: Development of Health Service System for Delaying Dialysis in Patients with Chronic Kidney Disease

abstract: This collaborative action research aimed to develop a health service system for delaying dialysis in patients with chronic kidney disease (CKD). The research was conducted from January to December, 2017 at the outpatient department of Chumphae Hospital, Khon Kaen. Participants consisted of two groups: (1) the patients who had a diagnosis of chronic kidney disease (not more than stage 3b), had the underlying diseases of diabetes and hypertension, and received treatments at the study setting; and (2) The multidisciplinary team including physicians, registered nurses, and pharmacists. The process of conducting the research consisted of situation analysis, development of health service system model, and outcome evaluation. Data were analyzed through quantitative and qualitative methods. The results revealed that from the situation analysis and based on the chronic care model (CCM), the Chumphae model for delaying dialysis in CKD patients (Chumphae DDCKD model) was developed which has four components, including delivery system design, self-management support, clinical information system, and decision support. After the model was implemented at the 3rd and 6th month, the patients in a treatment group performed self-management behaviors better than before and better than those in a control group. Also, their eGFR declined only 27.1%, comparing to the control group 75% or 7.89 times of the treatment group (95% CI 4.79-12.77). Patient satisfactions of health service system in the treatment group were higher than the control group, comparing between mean 23.8 (SD 0.05) and mean 16.3 (SD 1.7). In conclusion, the Chumphae DDCKD model can help to improve self-management behaviors and effectively delay dialysis at the 3rd and 6th month in patients with CKD.


location: , 'Thailand year: 2012 source: HSRI

title: Cold Weather Death Surveillance in Thailand,October 2010 - February 2011

abstract: Cold weather is one of causes that can be effected to higher morbidity and mortality in Thai citizens.
Hypothermia condition can lead to a dangerous of the brain and heart. A cross-sectional study aimed to
monitor trend, described characteristics of the deaths, identified risky behaviors and risk factors of coldrelated
to death for future planning in assistance to the victims. The guidance, definition of cold-related
deaths and reporting form have been developed for the surveillance system. The results showed that total
number of 30 deaths and suspected cases related to the cold weather had been reported from 21 provinces.
Out of these, 2 from Lei and Chiangrai province were confirmed for cold-related deaths. Most of them
were male (86.7%), mean age was 49 years, 30.1% were elderly (> 60 years). 40.0% were indoor deaths
whilst the others were outdoor deaths. The major risk factors were exposure to cold weather combined
with alcohol drinking, having underlying diseases and wearing clothing that could not prevent cold weather
(60.0%, 53.3% and 83.3% respectively). The above results can be beneficial to the health care guidance,
providing appropriate assistance to the risk group such as children, elderly or people with underlying
diseases including health service, referral system and provide warm clothing in order to decrease coldrelated
mortality.


location: , 'Thailand year: 2007 source: HSRI

title: Health and Environmental Surveillance in the Northern Region Industrial Estate,

abstract: This cross-sectional descriptive study was aimed at studying the situation of occupational health and environmental surveillance in the Northern Region Industrial Estate, Lamphun Province.  There were seven small, eight medium-sized and four large factories, that were chosen by purposive sampling.  A total of 503 workers were chosen as
subjects by simple random sampling of workers in the 19 factories plus 19 administrative
staff.  The instruments used in this study were an interview form and questionnaire.
Content validity was reviewed by five experts.  Data were analyzed by using descriptive
statistics (the SPSS software program for Windows) The duration of the study was from
January to September 1999.
The findings from this study showed that all sizes of factory posed similar health
and environmental risks.  The data collection and analysis were not efficient.  In addition,
the Action Plan of Occupational Diseases was not applicable, and the data coordination
system was not appropriate for the participating organizations, although all administrative staff were ready to develop a more effective workers’ health and environmental      surveillance system.
The following are recommendations from this study:  Factories should design occupational health and environmental surveillance in line with the occupational risks and in
accordance with the factories and the participating organizations.  They should also implement continuous tracking and evaluation as well as develop an effective data-coordinating system.


location: , 'Thailand year: 2016 source: HSRI

title: Active surveillance of novel human betacoronavirus in bats

abstract: Bats are natural reservoirs of Coronaviruses (CoV), which includes the genera
Alphacoronavirus (alphaCoV) and Betacoronavirus (betaCoV). Bat CoVs are also closely
related to human pathogens such as severe acute respiratory syndrome (SARS) and
the Middle East respiratory syndrome (MERS). Thailand has previously detected viruses
in the same lineage as SARS-CoV, in the Hipposiderous larvatus, and MERS-CoV from
unidentified bat guano. Thailand houses 139 different bat species, including
Tylonycteris spp., Pipistrellus spp. and Taphozous spp. These species have been
reported to carry MERS-CoV in other countries. It is thus important to conduct a study
to monitor these bat species and identify the viruses they harbor. Specimens from 645
bats, 33 species, were collected between 2011 and 2015, from 10 provinces (13
locations). Rectal swabs from these bats were analyzed using PCR, specifically for the
RNA-dependent RNA polymerase gene. Fifty seven (8.8%) of the samples were positive
for CoV; alphaCoV (19/57) and betaCoV (36/57). Two bats were found to be coinfected
with viruses of 2 different genera. Eight samples were positive for MERS-CoV
lineage, which is classified under betaCoV lineage C. Two of these samples were from
Tylonycteris robustula, the same bat species previously reported to harbor the virus in
China. Six samples were found in the Chaerephon plicata, which has never been
known to harbor CoV. Two samples from Rhinolophus malayanus were also positive
for SARS-CoV lineage, also previously reported in China from the same bat genus.
Detection of viruses in the same lineage of MERS-CoV and SARS-CoV in Thai bats
indicates the need for vigilant zoonotic disease surveillance to monitor virus jump
species to new hosts that may cause severe disease in humans or other animals, in
addition to the measures in place to contain disease outbreak. Thailand’s
preparedness and prompt diagnosis of the two imported (from Oman) MERS cases,
whose genetic analyses from whole genome sequencing revealed to be the same
strain as the outbreak in South Korea, prevented an outbreak in Thailand. Early
detection for cause of disease in patient and pre-identification of new pathogens from
natural reservoirs that can potentially case disease in humans can reduce the scale
and severity of next outbreak.


location: , 'Thailand year: 2006 source: HSRI

title: A study of meaning and value of life of people with disabilities in Buddhism: A case study of Buddhist monks’ understanding in Khonkaen province

abstract: This is a qualitative research using quantitative data collected by a survey research and having the objective to study the meaning and value of life of People with Disabilities in Buddhism so as to comprehend Buddhist monks’ understanding about the meaning and value of life of People with Disabilities in Khonkaen province and to know about the problems, obstacles and suggestions of practice following the teachings of Buddhism regarding meaning and value of life of People with Disabilities.
	The results of the study indicate that according to Buddhist principles of People with Disabilities are able to train themselves by special method from other normal people depending on the level of their physical disability. Self-training not only means to train in right livelihood which is value of life at the mundane level but also means dhamma practice in order to develop the mind that leads to value in super mundane level.
	Life of People with Disabilities has the following values-(1) They are born with moral rights that have intrinsic values, (2) Their life is the moral matrix or they are creator of virtues that appear clearly in this world same as normal people, (3) They have the potentiality of self-training following the Buddhist teaching.
Whether it’s congenital disability or disability that arises later on , Buddhist perspective holds that-(1) disability can tell us about the past so as to understand the reality of life and action and its effect, thereby making one acknowledge the value of life that is lived in a heedless way- (2) Physical disability can also indicate the future that is based on physical difference from normal people. (3) Physical disability is also social narrative tool indicating that society should learn from the life of People with Disabilities in the same way as one’s own life so that the “otherness” of People with Disabilities will disappear from society. When society understands People with Disabilities in a real sense it would be possible to create the necessary and appropriate things for them which lay the foundation of a friendly society. There are Buddhist teachings that are supportive of a society that is kind to People with Disabilities and there are Buddhist principles that can be used in practice to support and assert value of life for them. These principles are-frendliness (Kalyanamitta), Divine Abidign (Brahma Vihara), Principles of service (Sangahavatthu), states of conciliation or virtues for fraternal living (Saraniyadhamma), and enlightenment factors (Bojjhanga).
	Regarding the Buddhist monks’ understanding of the meaning and value of life of People with Disabilities in Khonkaen, the study found that they have good understanding of intrinsic value at a moderately level. Regarding the problem of meeting the religious needs of People with Disabilities it has been found that at times Buddhist monks lack the religious information about them and most temples/monasteries do not have the aids and place that can be used for the practice of religious activities of People with Disabilities
	The present research has the following policy-related suggestions- (1) increase the imparting of knowledge about the meaning and value of life of People with Disabilities in Buddhism to both monks and laypeople; (2) give opportunity and support to People with Disabilities to receive education, knowledge, participation in religious activities that are appropriate to them at the individual level.
	For future research it can be suggested that more research is needed to be undertaken regarding the religious practice of People with Disabilities of different types including both ordained and laypeople and also about the bioethics of these people.


location: , 'Thailand year: 2022 source: HSRI

title: Understanding Perceived Needs for Tooth Replacement in Older Adults: A Case Study of Dan Kwian

abstract: Tooth loss holds a complex relationship with oral health-related quality of life. A recent national survey reported only half of Thai elderly population with fewer than 20 remaining teeth had their
dentures made, despite a policy promoting denture fabrication free of charge. The aim of this study was to explore the perspectives of older adults’ perceived needs for tooth replacement. We purposefully selected older adults living in Dan Kwian subdistrict who were identified with a denture needed by a dental nurse but not currently wearing the prosthesis, for a face-to-face in-depth semi-structure interview. Data saturation was reached with 29 older adults. Inductive content analysis of the interview transcripts yielded two main themes. First, the factors influencing the needs for denture were: 1.1) “the word of mouth from neighbors & the village health volunteer as the main influencer” inducing the needs; 1.2) the socialization stimulated the needs; and 1.3) indirect cost despite free denture hindering the needs. Second, the dynamic of conflicting priorities: 2.1) from attach to detach once getting old or being ill; 2.2) changing perceived needs over time in response to changes in life circumstance. In sum, insights from this study may help reduce the discrepancies between professionally defined needs and the patient perceived needs.


location: , 'Thailand year: 2018 source: HSRI

title: Regulations for Control the Beverages Containing Not More Than 0.5% Alcohol by Volume in Thailand and Foreign Countries

abstract: The definition of alcohol from the Excise Tax Act, B.E. 2560 requires that alcoholic beverages not more than 0.5% alcohol by volume are not considered alcoholic. So, the beverages containing not more than 0.5% alcohol by volume are not controlled by labelling, advertising, and other measures under the Alcohol Control Act, B.E. 2551 and other relevant laws. The objective of this study was to review the beverages containing not more than 0.5% alcohol by volume regulations in Thailand and foreign countries. Searches were conducted through government database from websites, MEDLINE (PubMed), and Google for ten years (from 2008-2017). Purposive sampling was used to select 6 countries; the United States, Singapore, Australia, South Africa, Norway and Thailand. All regulations were analyzed using a content analysis approach. The study of labelling found that the US, Singapore, Australia and South Africa laws stated that the beverages containing not more than 0.5% alcohol by volume must be labelled as non-alcoholic products and the beverages containing not more than 0.05% and 0.0% alcohol by volume must be labelled “alcohol-free”. For advertising control, the US, Australia and South Africa laws stated that the non-alcoholic and alcohol-free beverages were not allowed to be advertised as alcoholic product. Besides, the US and South Africa laws indicated that the beverage advertising had to show the content and intensity of alcohol on the label. Additionally, the US has a law to ban deceptive advertising techniques and strongly control brand name and brand advertising.


location: , 'Thailand year: 2005 source: HSRI

title: Pilot Study Potential Benefit of AZT Preventive Therapy in Perinatal HIV Transmission and Its Cost-effectiveness Analysis : A Case Study of BMA Medical College and Vajira Hospital

abstract: This is a descriptive cross-sectional study. The aim of this study is to find the cost-effectiveness of giving AZT to prevent the transmission of HIV from mother to child and to compare the result of this study to previous studies in the aspect of provider and consumer perspective. The information summarized from this study would be a policy implication for Bangkok Metropolitan Office for properly administration of AZT to HIV-infected pregnant women to prevent the transmission of HIV.	Overall, 80 percent of mother received AZT before delivery. Normal delivery was accounted for 63.5% and 130 mothers (24.6%) were appointed for cesarean section and/or having cesarean section. In mother with normal delivery, average cost on procedures, medicines and medical consumables was 2,900 TBH, average cost on labor cost and all cost was 3,250 and 6,150 TBH respectively. In mother with cesarean section, average cost on procedures, medicines and medical consumables was 6,000-11,050 TBH, average cost on labor and all cost was 3,550-4,500 and 9,550-14,400 TBH respectively.	Overall, 7 of 103 (6.8%) children were HIV positive. The administration of AZT in overall was not related to cost on procedures, medicines and medical consumables but was accounted for the increasing of labor and all cost by 420 TBH. The difference of having AZT once and twice before delivery was accounted for the increasing of all cost by 1,900 TBH, whilst there was no difference of all cost between giving AZT for one time and no AZT. So, it is suggested that the budget of giving AZT is not only for the cost of drug but also for the administration of drug such as PCR testing.


location: , 'Thailand year: 2008 source: HSRI

title: Factors Relating Self-care Behavior to the Control of Cervical Cancer in a Target Group of Women in Tambol Nong Ya Sai, Nong Ya Sai District, Suphan Buri Province

abstract: This survey research study was aimed at to examining the self-health-care behavior
of women in preventing cervical cancer among a target group of women in Tambol Nong Ya Sai, Amphur Nong Ya Sai, Suphan Buri. Applying the Health Belief Model Theory as
a guideline, the research had been performed during June and July 2007 using purposive
sampling on 251 target women aged 35, 40, 45, 50, 55 and 60 in the area under the responsibility
of Nong Ya Sai Hospital. The research workflow consisted of interviewing, data
collection and analyzing processes, using frequency distribution, percentage, means, standard
deviation, chi-square test and Pearson’s correlation coefficient.
The results indicated that 46.6 percent of the target group of women had an intermediate
level of knowledge about cervical cancer, 97.2 percent had an intermediate level
of acknowledging risk opportunities in having cervical cancer, 68.1 percent had an intermediate
level of acknowledging cervical cancer, 72.9 percent had a high level of acknowledging
the benefit of having a Pap smear test, 60.6 percent had a high level of self-care
behavior in preventing cervical cancer, 53.0 percent had a Pap smear test, while 10.7 percent
did not undergo that test. The research also informs that marriage status and knowledge
about cervical cancer have a significant relationship with self-care behavior in preventing
cervical cancer (p value ≤ 0.05).
Recommendation: Public health officials should provide knowledge about cervical
cancer to increase the number of target group women who have undergone a Pap smear
test, which will lead to good health.


location: , 'Thailand year: 2000 source: HSRI

title: Community participation in government hospital administration

abstract: Community Participation in Government Hospital Administration	The primary purpose of this study is to explore the current situation of community participation in government hospitals in Thailand. This concerns community participation in the context of hospital development and management, as well as its underlying factors. The methods of data collection include both quantitative and qualitative.A nation-wide mailed questionnaire survey was carried out to determine the extent of participation in government hospitals with at least 60 patient-beds. The questionnaires were mailed to the total number of 212 eligible hospitals and 209 completed questionnaire were returned, or the response rate was 98.8 percent. The qualitative data collection aims at in-depth investigation of the process and underlying factors of community participation in hospital development and management.                        		The survey result indicated that community participation in any specific health program organized by the hospitals has been developed at a certain level, but not in the hospital administration except Ban Peaw community hospital in the central part of the country.  The most popular form of participation reported by hospitals is community leaders participating as hospital consultative committee members.  The main activity of the committee is to help fund raising and mobilize local resources for hospital development. On the part of hospitals, the reported significant reasons underlying community participation development was to strengthen hospital accessibility by the community they served (89.8 percent).  The other important reasons reported included inadequacy of the government budget (47.4 percent) and communities’ interest (43.0 percent).  The majority of hospitals (95.9 percent) appeared to recognize the importance and benefits of community participation. About one-third reported no problems in hospital development as a result of community participation, and about one-fourth had plans to reform the administration to become autonomous hospitals.		Four hospitals experienced with community participation in development and management including 3 government community hospitals and one private-non profit foundation hospital were purposively selected as case studies for qualitative data analysis.  The hospital administrators and key staff members as well as community leaders were given in-depth interviews.  The major findings are that the communities have competence in hospital development and management in the direction they need. The four major existing forms of community participation include 1) community participation in the decision making process of hospital development plans and policy formulation for the health service system, 2) community participation in hospital management of infrastructure and non-medical activities, 3) community involvement in health care service implementation, and 4) community involvement as coordinators to bridge gaps between hospitals and communities. The factors facilitating community participation are threefold: 1) hospital related factors, 2) community related factors and 3) quality of relationship between hospitals and communities they served.  The crucial hospital related factors are the policy of community involvement expressed by the hospital administrators, the competence and leadership of hospital administrators, the inadequacy of the government budget for hospital development, the hospital administrators’ expression of his or her sincere welcoming of community members to participate in hospital development/ administrative/consultative committees, as well as strategies for mobilizing local resources through the integration of religious beliefs held by the community. On the part of community, the critical factors are community health needs, community competence, community faith and trust in hospital administrator, sense of belonging to hospital, and community satisfaction with the services provided. Lastly, but very important, is the good relationship between hospital administrators/staff and community members.   		To sustain effective community participation, the government sector, including government hospitals should construct communities’ social and economic conditions to facilitate community participation in government hospital administration. The concepts of civil society, good governance based upon democratic ideology, equity and patient’s rights, and sense of belonging to government hospitals are recommended as strategies to be promoted in the communities.  In addition, the health promotion hospital policy of providing out-reach health promotion services should be strengthened. To empower community members with sufficient potentiality to actively participate in hospital administration, the government sector and government hospitals should promote  comprehensive development projects, both health-based and community-based economy, based in the communities they serve.  This should be coordinated with the existing community organizations, both government and non-government, including community temples.To facilitate community power in decision making in hospital administration, the present hospital administrative structure needs to be reformed.  All, or at least more than half of the total number of the administrative committee members should be selected from among the representatives of community members. Practical rules and regulations for community participation, for instance, the composition of the hospital administrative committee members, the characteristics of eligible representatives of the community members and selective procedures, should be developed and considered through the process by which the community has equity participation in decision making.


location: , 'Thailand year: 2004 source: HSRI

title: Healthy public policy and health impact assessment (HPP-HIA)

abstract: In 2001, the Health System Research Institute (HSRI) launched a research programme “Healthy Public Policy and Health Impact Assessment (HPP-HIA)” with an aim to develop an important component of the new health system in the future.   Recognizing that HPP-HIA was a new experience for the Thai society, the HSRI perceived the first three years of the programme (2001-2003) as a research and social experiment to test the relevance and acceptance of HPP-HIA in the Thai society, and as a first step toward capacity and institutional building.  The programme experience will help determine an appropriate approach in developing a HPP-HIA programme in Thailand.    The main purpose of the programme evaluation in 2004 was to facilitate the review of the experience, success, and constraints of the programme, and to consider future options.   The evaluation team’s mission was to conduct and facilitate “empowerment evaluation” to help the management and staff of the HPP-HIA programme reflect on past performance – and consider future options.  This participatory exercise was designed to maximize the opportunities for exchanges among all parties concerned, to plan for better programme performance, and to discuss development alternatives.	In advancing HPP-HIA, the programme has 4 strategies: (1) analytical framework, (2) institutional framework, (3) critical mass, and (4) enabling environment, which are expected to (1) facilitate social learning especially among civil society and community actors., (2) influence policy changes at national and local levels toward a healthy public policy, and (3) support the health reform movement.   	The four strategies were implemented through a system of networking.  The thematic (policy) networks consist of industry and energy policy network, water management network, agricultural and rural development network, urban and transportation network, natural resources and international agreements network.   The regional networks consist of the Northern network, the Northeastern network, and the Southern network.    The programme core team was responsible for overall management.  The programme also included the HPP knowledge development center and the HPP-HIA thesis programme at Chiang Mai University, both of which aimed to create and expand a HPP-HIA “critical mass”.	Findings from the evaluation indicate that:   The HPP-HIA programme’s strength lied in its role in pioneering the development and dissemination of HPP-HIA knowledge and practice in Thailand.   The programme management, staff and networks were highly dedicated individuals who were committed to work as a team.   As a result, the programme, within a span of 3-4 years, produced a large volume of works in various forms, namely research, policy papers, manual, training, workshop, newsletter, etc that covered a wide range of issues and geographical areas. The programme was successful in raising the awareness and the interest concerning HPP-HIA among academics, health personnel, and civil society groups.   HPP-HIA was perceived to have a good potential to drive policy and social changes.  But the programme had some limitations in networking with the public sector especially at the national policy level, and had less success in influencing policy changes at the national level.Although the programme outlined a set of strategies, it expanded at a very fast rate to the extent that it had spread itself too thin, and lacked a strategic focus.   This complicated the coordination within the programme and with other groups.In recent years, the programme encountered a number of problems due to personnel and budget constraints.   The situation called for a medium-term and long-term organization/business strategic plan.The followings were significant “new situations” that emerged during 2003-2004.HSRI scaled down the planned programme budget.  Other “HPP-HIA” programmes were set up, partly as a result of the programme’s success in promoting HPP-HIA.    This represented an opportunity for collaboration, but also called for a serious review of the programme’s positioning, mission, and core competencies, to maximize synergy and minimize overlapping with other programmes.  	The performance review and the situation analysis provided the background and context for the consultations and meetings between the evaluation team and the programme management and staff that took place throughout the evaluation period (January-August 2004).    The followings are results or ideas that play a role in shaping the future of the programme. The programme’s first mission will be HPP-HIA knowledge development and knowledge dissemination; secondary mission will be influencing and shaping HPP, which will be implemented mainly by providing policy advocate groups with the programme’s knowledge and practical experience about HPP-HIA.The programe will develop a medium-term and long-term organization/business strategic plan that includes resource mobilization.  HPP-HIA research and training will be more responsive to the needs of potential clients and the programme will explore the use of social marketing to support its overall operation.The programme will adopt a leaner and flexible structure.   It is possible that the programme will have only 2 work components, namely the regional networks, and the center which features the policy group, the knowledge management group, with administrative support.The programme will outline key strategic results and restructure the programme and work process as well as develop core competencies of various parts of the programme accordingly.The new work process calls for a common strategic focus and synergy among various work groups/network, while allowing adequate room for each group/network to tailor its work in response to local situations.   In the next three years, the regional networks should have the ability to drive the implementation all four strategies at the local level, with support from the center.   The center will focus on strengthening the programme by leveraging on existing outputs and driving the programme’s key strategic results.In medium-term, the programme aims to be an independent institute under the HSRI.


location: , 'Thailand year: 2023 source: HSRI

title: Addressing Neurodegenerative Diseases: Molecular Biomarkers Initiatives

abstract: Objective Thailand is experiencing demographic ageing. Consequently, the socioeconomic burden of neurodegenerative diseases (NDDs) is expected to escalate drastically posing a challenge for the middle-income country. Much can be done to mitigate the consequences NDDs including imposing preventive interventions, planning an integrated care chain, accelerating biomedical research etc. Using neuropathology-specific biomarkers is indispensable for successful implementation of such measures because they can detect NDDs in the long presymptomatic stages at which disability can be prevented. Nevertheless, their use is limited by cost and accessibility, perceived invasiveness and lack of validation in non-white population. The aim of this project is to develop biomarkers for NDDs including Real-time Quaking-induced Conversion (RT-QuIC) for diagnosing prion diseases and synucleinopathies, plasma phosphorylated tau (p-tau) for diagnosing Alzheimer's disease, and multimodal biomarker evaluation scheme for evaluating idiopathic normal pressure hydrocephalus (iNPH), that is affordable, accessible, non-invasive and accurate with regards to Thai people along with an effective guidance for their use. Materials and methods In-house recombinant truncated hamster prion protein (recPrP) purified using a pre-packed column and simultaneous refolding and dialysis (siphon method) served as the substrate for RT-QuIC, which was performed on two sets of cerebrospinal fluid (CSF) specimens. The first comprised of 30 CSF specimens of patients from various hospitals suspected of having sporadic Creutzfeldt-Jakob disease (sCJD). An identical set of aliquots was transferred to an established RT-QuIC facility to determine the inter-laboratory agreement. The second set comprised of CSF from 39 patients presenting at King Chulalongkorn Memorial Hospital suspected of having sCJD. Complete clinical data are available in this group enabling the evaluation of the diagnostic performance. In-house recombinant human α-synuclein (rec-humα-syn) purified using a single Q-Sepharose column served as the substrate for RT-QuIC, which was performed on 11 control CSF specimens as a pilot experiment. P-tau181 quantification using single-molecule array (SIMOA) were performed on plasma specimens from participants with dementia who had previously undergone 18F-Florbetaben positron emission tomography (PET) to determine the optimal cutoff for diagnosing Alzheimer’s disease (AD). Participants with amnestic mild cognitive impairment (MCI) were consecutively enrolled in another cohort whose plasma samples were collected and full neurocognitive assessment were done. The participants subsequently underwent 18F- fluorodeoxyglucose- PET 18F-Florbetaben PET and 18F- PI2620 PET to determined AD biomarker status and prospectively evaluated the diagnostic performance of plasma p-tau181. Participants who were suspected of having iNPH were and evaluated with the proposed multimodal biomarker evaluation scheme. NDD biobank was established for future research use of biological specimen. Results RT-QuIC using in-house recPrP conferred 90% (95% confidence interval (CI) 74.4% – 96.5%) agreement with the results from an established RT-QuIC facility whereas the Cohen’s kappa is 0.876 (95%CI 0.871 - 0.882). The sensitivity and specificity when tested on 39 CSF specimens from possible sCJD patients were 0.92 (95%CI 0.67-0.99) and 1.00 (95%CI 0.87-1.00) respectively. RT-QuIC using in-house rec-humα-syn was positive in 1 out of 6 positive controls and negative in all 5 negative control specimens. The optimal plasma p-tau181 cutoff for diagnosing AD (2.46 pg/mL) were derived from 29 individuals with known AD status. Using this cutoff, the sensitivity, specificity and accuracy of plasma p-tau181 were 0.80 (95%CI 0.64-0.90), 0.75 (95%CI 0.51-0.90) and 0.78 (95%CI 0.65-0.88), respectively, when tested prospectively on 51 amnestic MCI participants. The study had enrolled 6 iNPH participants to undergo the multimodal biomarker evaluation scheme. The NDD biobank is currently fully functional with 902 plasma specimens and 251 other types of specimens from 838 individuals and are operating according to consensus biobanking standard. Conclusion This research project focuses on developing accurate and assessable fluid biomarkers for ND including prion diseases, synucleinopathies, AD etc. Its second year had completed with substantial success. RT-QuIC for prion disease achieved near-perfect agreement with establish laboratory and equal diagnostic performance. Plasma p-tau SIMOA were completely evaluated in real-life settings and is considerably accurate. The results of other tests and biomarkers are underway.


location: , 'Thailand year: 2018 source: HSRI

title: Development of a test kits (ELISA and lateral flow rapid format) for detection of antifilarial IgG4 using   recombinant antigen

abstract: Lymphatic filariasis (LF), commonly known as elephantiasis is caused by Filaria parasite i.e. Wuchereria bancrofti, Brugia malayi, B. timori and transmitted by mosquitoes. There are about 40 million people in tropical and subtropical areas suffer from severe disfigurement and disability caused by the disease. It is estimated that more than million Myanmar migrant workers have settled in Thailand and some of them also carry Wuchereria bancrofti. Moreover, Thailand was certified by WHO for successful elimination of lymphatic filariasis and now is in surveillance phase to prevent reemergeing of the disease. Since microfilariae detection by thick blood smear staining technique need night blood collection. Thus, convenience and effective diagnositic tool is needed for the management of filarial infection both at the level of the individual treatment and disease control in populations in regions endemic for filariasis. In the present study, two recombinant proteins iPGM and SXP were produced. Then prototype two test kits, an enzyme-linkedimmunosorbentassay (ELISA) based test kit (FilariaDIAG test kit) and a chromatographic rapid test kit (FilariaDIAGRAPID), were developed, using iPGM recombinant protein and SXP recombinant protein as antigen. Efficacy of the developed test kits were validated in both laboratory condition and in field. Sensitivity of the rapid test kit using recombinant protein SXP antigen shows 97.9% sensitivity, 98.9% specificity, 95.8% positive predictive value and 99.4% negative predictive value when using microfilaria detection by thick blood smear staining as gold standard. The rapid test kit using recombinant protein iPGM antigen reveals sensitivity, specificity, positive predictive value and negative predictive value of 72.3%, 68.8%, 51.6% and 90.5% respectively. For the ELISA based test kit (FilariaDIAG test kit) showed sensitivity, specificity, positive predictive value and negative predictive value of 98.1%, 98.9%, 96.3% and 99.4% accordingly. For field validation, the prevalence of bancroftian filariasis in 509 Myanmar live in Thai-Myanmar boarder in Masod and Phoppha district, Tak province was 1.2% (6/509) while the prevalence of bancroftian filariasis in 363 Myanmar live in Thai-Myanmar boarder in SopMye district, Mahongsorn province was 1.9% (7/363). For prevalence of brugian filariasis in Thai people live in Tak Bai, Sugnai-Padee and Sugai-kolok Narathiwat province (endemic areas of B. malayi) was 0.57% (3/525). Using the ELISA based test kit (FilariaDIAG), antifilarial IgG4 was detected in 1.2% (6/509) of sera collected from Myanmar live in Thai-Myanmar boarder in Masod and Phoppha district, Tak province and in 1.9% (7/363) of sera collected from Myanmar live in Thai-Myanmar boarder in SopMye district, Mahongsorn province. In conclusion, the 2 prototype test kits are useful as tools for screening and surveillances of lymphatic filariasis in B. malayi-endemic areas as well as in Myanmar workers.


location: , 'Thailand year: 1996 source: HSRI

title: The impact of paying health personnel by fee-for-service and non-private-practice allowances

abstract: The impact of paying health pesonnel by fee-for-serviceand non-private-practice allowanceThis research is to evaluate the impact of these  implementations among regional/general/community hospitals. Four research methods were applied to answer different research objectives. Analysis of reported data to the Provincial  Hospital and the Rural Health Divisions was to see the impact on hospital financial liquidity. Postal, self-administered questionnaire survey was carried out in 17 provinces to study  attitude towards non-private-practice allowance including fee-for-service pay. Qualitative research techniques, ie focus group discussions and indepth interviews were carried out in 4 provinces to focus mainly on fee-for-service pay but also included other payment schemes. A before and after case-review was carried out to compare quality of care provided to 3 tracer conditions in 5 hospitals. The overall result suggest that financial liquidity of the hospitals was not affected by the implementation of the payment schemes, although the hospitals had to pay a higher percentage of their revenue for their personnel. In 1991, they paid 7-11 percent of the hospital revenue for their personnel and in 1995, up to 20-30 percent of the revenue. Fee-for-service pay got the highest share (more than 60 percent) of the total payment categories and increased productivity especially the number of extra-office-hour surgcical operations. Non-private-practice allowance increased job satisfaction amongst those who did not work in private sector but caused the feelings of unfair treatment among those who were ineligible. Moral hazard of providers occurred in both schemes but was more frequently observed in the fee-for-service scheme. Management system played a minimal role in safeguarding medical ethics.


location: , 'Thailand year: 2001 source: HSRI

title: A community survey of musculoskeletal pain and manangement in Namphong district, Khon Kaen province

abstract: A Community Survey of Musculoskeletal Pain and  Management In Namphong District, Khon Kaen ProvinceObjective: Studying of incidence and cause of muscleskeletal pain and epidermiologic of Ya-chud in Namphong district, Khon Kaen Province.Study design: Descriptive survey studyLocation of study: Rural community in Namphong district, Khon Kaen Province.Sample Population:Distributor of Ya-chud  in 12 villages  of  Namphong  district  which  simple random sampling amount 86 distributors.Population  in Namphong  district,who age over 15 years-old,lived in the villages amount 685 persons which clustur random sampling.Methadology:Surrogate  survey and open survey on distributors in the villages. Analyted component of  Ya-chud and compared  between two-way.Interviewed sample population in musculoskeletal pain and self-care,then examination in sample who had musculoskeletal pain recently on 7 days before interviews to diagnosis caused of musculoskeletal pain by American Rheumatism Association.Result: Groseries in rural villages had Ya-chud and surrogate survey had directed sale Ya-chud amount 18. Total Ya-chud which surveyed have 51 types. Analytical component in each type,10% had corticosteroid only,16%  had NSAIDs only,71% have corticosteroid plus NSAIDs. Corticosteroid  had dexamethasone since 1 to 3  tablets in each set. Almost NSAIDs had indomethacine and/or phenylbutazone. 74% of population used to musculoskeletal pain; 43% had pain recently 7 days before interviewed. Cause  of musculoskeletal pain refered from work.Examination in patient who had pain recently amount 264;54% is LBP, 25%  is soft- tissue rheumatism,17% is myofacial pain syndrome,17% is peripheral osteotitis,prolong  treatment is 9%. Caused of LBP from back  muscle  strian and L-spondylosisInterviewed on population who had musculoskeletal pain 508 and 58%  used to use Ya-chud for pain  when they had pain syndrome; 12.5%  used to use Ya-chud and ¼ used every day. 95% of population had known side effect from health worker and advertising ,68% used to treatment when they had pain syndrome and 33% choose to used Ya-chud because of convenient and low price. Impact of decision to treated from experience and household.Excepted Ya-chud  they had massage and hot compress.Health facility has popular too; 6.7% choose to go to health center because nearly house.Conclusion and dissicustion :Ya-chud had dangerous component and community problem ;they had distributed in general of rural community of Thailand. Population bought freedom from groserlies, although they  known side effect from Ya-chud. Musculoskeletal had refered from work and short-course therapy. Chronic rheumatism disease which prolong treatement had few in community. When they had pain symtom,they choose to low cost treatment, comfortable and related daily life. Solved of Ya-chud is present convenience treatment , low price ad effectiveness, such as massage, compress  and develop health worker of health center to treat simple musculoskeletal diseases in community.


location: , 'Thailand year: 2007 source: HSRI

title: Health-promoting Behavior and Quality of Life of the Elderly in Khowrai Primary Care Units, Na Chueak District, Maha Sarakham Province

abstract: The study involved descriptive research using the survey method to study the healthpromoting
behavior, quality of life and relationship between health-promoting behavior
and quality of life of the elderly in Khowrai subdistrict. It was conducted in the period
February-May 2007. Data were collected by interviewing the sample population using
modified questionnaires of Kwanjai Tantiwattasatien, Pechara Intarapanich and
Daowrueng Khommuang puk, which utilized alpha coefficient for accuracy. Samples
included the elderly over 60 years old. Both men and women subjects lived in Khowrai
subdistrict; 248 persons were selected by cluster sampling from 18 villages. Data were
analyzed by descriptive statistics, mean, percentage, standard diviation and Pearson’s
coefficient for assessing the relationship between health-promoting behavior and quality
of life.
The findings were as follows: health-promoting behavior regarding nutrition, exercise,
daily hygiene, sociability, stress management, and health responsibility were medium
grade; quality of life was high grade by if considered in detail the quality of life in
terms of residence and social interaction were low level, but the quality of life in health,
recreation and self-assessment were high. Health-promoting behavior relates significantly
to quality of life. The results can be used for policy and strategic planning for health
promoting innovation for the elderly by cooperating with health personnel and subdistrict
organizations to solve social, economic and health problem in the elderly.


location: , 'Thailand year: 2008 source: HSRI

title: The development of health communication community via internet

abstract: The purposes of this action research were three folds: 1) to develop a Health Community via Internet (HCI); 2) to analyze the key success of the HCI; and 3) to propose strategies to develop the HCI  The setting selected in this study was located in Nakonpathom province.  The study samples were 28 health-work volunteers. The research method consisted of 4 steps as follows: 1) exploring a study setting context regarding health problems and health communication, 2) developing the HCI 3) implementing the HCI for 3 months  and 4)  analyze key success for developing the HCI.  Data collections were used by questionnaires, interview and focus group discussion.
The study findings were as follows:
1. The context of study setting, Nakonpathom is located in central part of Thailand and divided into 7 districts (Amphoe) 106 locally districts (Tambol) and 930 communities  (MooBarn). The total population are 828,846.  The average income are126,510 baht/year. Most (32.09%) are agriculturist. According to health care delivery, there are sixteen public hospital and 5 private hospitals. There are 195 physicians, 1,259 nurses and 7,462 health care volunteers. A proportion of a physician and population is 1: 4,138 and a proportion of a nurse and population is 1:641.
2. Indicators deciding the project success were as follows:  (1) Input and Output indicators, researchers recorded the numbers of membership who accessed to Nakonpathom's web and of health files uploaded to the web. We found that there were 28 members participating in the web and 650 data files disseminated on the web.   (2) Process indicators, in the study, a community participation was used by inviting members to analyze SWOT of  Nakonpathom's health web, strategies and indicators for measuring product/outcome of the project.  After three months of a project implementation, we found that members reported that they were highly satisfied (mean = 4.43, S.D. = .59) with knowledge of health communication via Internet.  For the moderate satisfaction (mean = 3.29, S.D. = 1.10)) were the community participation via Internet.
Based on data conducted by using focus group discussion and interviews, we found that factors relating to develop a health community via Internet were 1) Peopleware, health personnel lack knowledge of developing health databases and  Internet access time while health care volunteers lack technological skills and computer knowledge; and 2) Hardware, there were lacks of computers and Internet connection in a selected community.  According to a problem of peopleware, community members were trained computer uses and Internet skills.  After training, the community members practiced computer and Internet use under supervision of researchers.  Finally, the members could disseminate and train others to access health information via Internet.
  3.  The proposed strategies of developing the HCI
                   Based on a focus group discussion of 12 key persons, They agreed that the HCI concept as a way of health communication. However, the good components of members were important to maintain the HCI activities.   According to a sustainability of the HCI, experts suggested that it should build a network with consultants from a public health sector and university located in Nakonpathom.  In addition, It should be an autonomous organization managed by a community and get financial support from private and public organization.


location: , 'Thailand year: 2008 source: HSRI

title: Situation of an Outbreak of Acute Diarrheal Disease in Tapanhin District, Phichit Province

abstract: This study was aimed at investigating an outbreak of acute diarrhea during the
period February 20 to March 23, 2006 in Tapanhin district, Phichit Province. It is a descriptive
epidemiological study that was undertaken to identify the problems and the interventions needed to control the disease, using an interview with individual case surveillance,
as designed by the Bureau of Epidemiology, and specimen collection. The study
population comprised 554 cases, including all cases who visited health-care facilities and
those in communities in Tapanhin district. An additional study was based on an observation
of the environmental factors and the disease-control measures. Quantitative data
analysis was presented in percentage, ratio, minimum and maximum, using a computer.
These data analyses were based on triangulation in order to make links, between the
factors and effective implementation.
The study found 554 cases in total (526.67 per 100,000 population). The epidemic
began in the municipal area and spread rapidly to surrounding sub-districts. The highest
prevalence was among children 1-4 years old (3,485 cases per 100,000) and 5-9 years (1,413
cases per 100,000), respectively. Leading symptoms included watery stool (85.35%), and
stomach ache (58.81%). Non-pathogenic bacteria were detected in 94.52% of the cases
based on rectal swab culture, whereas rota virus was detected in 3 of 9 stool cultures. A
centralized operation unit was set up in order to conduct active case surveillance and
control the disease. The interventions were conducted through both sanitation (cleaning
animal slaughter units, markets, and public restrooms) and education of street food-vendors.
As a result, the epidemic was brought under control within four weeks.
The achievement of diarrhea prevention and control requires rapid disease investigation
and community intervention from the district health system. To determine the
root cause of an epidemic, objective data, based on active case surveillance and comprehensive
laboratory examination are helpful.


location: , 'Thailand year: 2011 source: HSRI

title: Analysis of the Cost-effectiveness of Community-based DOTS versus In-hospital Care in the Treatment of Tuberculosis

abstract: This study was aimed at comparing the cost-effectiveness of tuberculosis treatment strategies between
community-based DOTS (Directly Observed Therapy, Short Course) and hospital care at Maesai
Hospital, Chiang Rai Province. Data on costs were collected in terms of provider and patient perspectives.
Cost-effectiveness was calculated as the cost per patient successfully treated. The nine-month historical
cohort study from November 1, 2009 to July 31, 2010 was designed to measure outcomes of tuberculosis treatment. By matching new pulmonary tuberculosis patients aged 15 to 60 years, the study included
54 patients from community-based DOTS programs and 52 patients receiving hospital care. The
hospital cases were divided into three groups, i.e. days since admission: 1 to 7; 8 to 14; and more than 14,
totalling 38, 8 and 6 patients, respectively. The provider cost data were collected from medical records
while the patient cost data were collected in face-to-face interviews.
Results showed that the average tuberculosis treatment costs under community-based DOTS Programs
and hospital care were 9,436.84 baht and 13,540.32 baht per patient, respectively. Communitybased
DOTS reduced costs by 30.31 per cent in comparison with hospital care. Sub-group cost analysis of
hospital care of 1 to 7, 8 to 14 and more than 14 days since admission showed costs of 10,051.97, 19,168.63
and 27,969.72 baht per patient, respectively. The clinical success rates of community-based DOTS and
hospital care were 90.74 per cent and 94.23 per cent respectively. The incremental costs of a case successfully
treated in hospital were 1,175.78 baht higher than that of a community-based DOTS program.
The study suggested that community-based DOTS is a more economically attractive option than
hospital care. This is particularly important in settings where a TB clinic is implemented under the
limited resources available to Maesai Hospital.


location: , 'Thailand year: 2015 source: HSRI

title: Performance Assessment of District Health System at Tak Province

abstract: Performance Assessment of District Health System in Tak Province.The aims of this study were to assess of the provincial and district committee level,in 9 district of Tak province. ), which will assess the compliance of the project in the context ,input, process, output and outcome .Using the model CIPP Model of Stoughton Waffle Beam. (Stufflebeam's CIPP Model ) Data were collected and analyzed by quantitative method with descriptive statistics.
	The results showed that the context of each area with the integration of technical development in areas already include self-assessment. The district health system Using a model planned community with quality development, including the development of quality guidelines HA PCA standard and are used for process-driven application development, network management services, process know-how. The knowledge from  routine  to research. The input policy, budget, personnel, equipment showed that. Commented that there is a consistent level. The process Issue Rating Is the process of implementation Tracking supervision and evaluation The samples of the opinion that there is consistency in the level of output of the sample is of the opinion that there is a consistent level of results, the sample is of the opinion that there is a consistent level. The development of district health network. The collaboration at the district level were moderate consensus. Providing essential care The samples of the opinion that there is a consistent level. The sharing and development groups. Commented that there is a consistent level. The involvement of community groups. Commented that there is a consistent level. And the value of work Sample Commented that there is a consistent level.


location: , 'Thailand year: 2018 source: HSRI

title: The simulation model to study the behavior of malaria outbreak

abstract: Malaria is one of the major mosquito-borne diseases especially in tropical and sub-tropical countries, including Thailand. The weather in this area is suitable for living and producing offspring for mosquito, so it causes illness and died in people, who live in that area. Although it has few cases in Thailand yearly, Malaria is difficult to get rid of from Thailand. To make more understanding of behavior and environment of the disease, computational can be utilized to study disease. This research aims to make the reputation of mosquito-borne illness, so-called mABMs-MAR, which is a hybrid of combination for computational and mathematical methods. In term of computational, Agent-Based Modeling plays as the major method of simulation with the corporation with another model, such as the Global Stochastic Contact Model (GSCM). To make the relationships between hosts, humans and mosquitos. For a mathetical method, it will be used to shorten the processing time for small objects, which is the mosquito.


location: , 'Thailand year: 2010 source: HSRI

title: An Application of Decision Tree Algorithms for Diagnosis of the Respiratory System: A Case Study of Pranakorn Sri Ayudthaya Hospital

abstract: The objectives of this study involved (a) the application of methods of knowledge discovery from
database using decision tree algorithms for respiratory system diagnosis to classify patients of the Pranakorn
Sri Ayudthaya Hospital into three groups: acute upper respiratory tract infection, acute sinusitis, and
pneumonia, and (b) the comparison of performance of the three decision tree algorithms, i.e., ID3, C4.5,
and CART, for the classification or screening of the patients with the three diseases. The data used in this
study came from the medical records of 7,327 out-patients with respiratory diseases who attended Pranakorn
Sri Ayudthaya Hospital in the period from 2003 to 2006. The variables considered were age, body temperature,
residential area, occupation, and certain symptoms, e.g., rhinorrhea, fever, nasal congestion,
periorbital pain, headache, wheezing and coughing. The study methods were knowledge discovery with
the employment of ID3, C4.5, and CART decision tree algorithms from the hospital’s medical records and
determination of the effectiveness of the three algorithms. The validity of the decision tree algorithms was
studied by dividing the data into two sets: training and testing data sets, which were based on the crossvalidation
and the percentage split methods.
The results of the knowledge discovery method found that, for the patients with acute URI with only
seven selected variables and a ratio 70:30 of the training data set and the testing data set, the C4.5 algorithm
was the most effective, with a classification accuracy of 92.31 per cent. For the classification of the
patients with acute sinusitis with only eight selected variables and ratio 70:30 of the training data set and
the testing data set, the C4.5 algorithm was the most effective, with a classification accuracy of 94.70 per
cent. For the classification of the patients with pneumonia with only seven selected variables and ratio
50:50 of the training data set and the testing data set, the CART algorithm was the most effective, with a
classification accuracy of 94.69 per cent. The results obtained could be used to support the diagnosis of
patients with respiratory diseases.


location: , 'Thailand year: 2012 source: HSRI

title: Good Governance Mechanisms for Medical Profession Regulations in the United Kingdom, New Zealand and South Africa

abstract: Medical council is the core component of health system governance and the regulatory body of
medical profession in many countries. In the case study of the medical councils in the United Kingdom,
New Zealand and South Africa, they have development and changes from time to time so as to protect,
promote and maintain the health and safety of the public and to keep the public trust and confidence. The
study is a qualitative and documentary research and aims to study the philosophy, conceptual framework
and the role of these medical councils as an organization regulating the medical profession, and to propose
the good governance to be applied to the Medical Council of Thailand as appropriate.
The results showed that Medical Councils of these countries have good governance mechanisms, especially,
the General Medical Council (GMC) in the UK which is the model of the Medical Council of Thailand.
The reform or changes of the these medical council have been developed with its aims of effective,
accountable with greater patient and public involvement and with faster, fairer and more transparent
procedures in making decisions on fitness to practice of alleged physicians.