location: , 'Thailand year: 2002 source: HSRI

title: Development of rehabilitation services for stroke patients at Maharat Nakhon Ratchasima Hospital

abstract: The study aimed to develop a new rehabilitation service system for stroke patients at Maharaj Hospital, Nakorn Ratchasima Province. The situation analysis showed some pitfalls of the existing system. For instances: there were underserved for occupational therapy services; the routine services and information given were not responsive to clients’ needs, in terms of supporting their self-concept; inadequate system to follow up discharged patients; and the increasing need for home rehabilitation service because of the inconvenience of client transportation. Participatory action research (PAR) was applied to work out among other related service providers or stakeholders to identify an alternative system. Those were physicians, physiotherapists and community nurses. Duration of the study was during The modified service was described as follows; The rehabilitation services would cover physical therapy and occupational therapy for every consulted case, even though it was not mentioned by physician. The essential rehabilitation guidelines had been set up to fit with Isan context. The follow up system was set up, and had to correspond with physician appointment date. Making linkages with community nurses to provide rehabilitation home care. Setting up the record and report systems for continuity of care between hospital and home care. Recommendations from this study were that this system should be applied for patients with other chronic conditions, such as paralysis or cerebral palsies, to whom rehabilitation services were needed. However, implementation of the recommended system should take personnel existing workloads for granted.


location: , 'Thailand year: 2007 source: HSRI

title: Difference in Socio-economic Status, Service Utilization, and Pregnancy Outcomes between Teenage and Adult Mothers

abstract: The objective of this study was to determine the differences in socio-economic status,
service utilization, and pregnancy outcomes between teenage and adult mothers aged
20-25 years old. Data were collected by interviewing and reviewing the medical records
of all mothers 13-25 years old who gave birth in Samroiyod Hospital, Prachuap Khiri
Khan Province, during the period September 1, 2006 to August 31, 2007. The study consisted
of 150 teenage mothers whose age was 13-19 years old and 255 mothers whose age
was 20-25 years old. Descriptive statistics including proportion, mean, and standard deviation
were used to present the analysis. The chi-square test or the Fisher’s exact test
was used to compare between the proportions of the two groups. Among the pregnant
women giving birth in the hospital during the study period, 29.0 percent were teenage
mothers. About 54.0 percent of the teenage mothers were 18-19 years old and 9.3 percent
were between 13 and 15 years of age. Their mean age was about 17.5 years old. The
teenage mothers had significantly higher educational levels than the adult cases. Insufficient
earnings, no home of their own, and being separated were significantly more common
in the teenage mothers than the adults. The proportions of teenage mothers completing
the antenatal care of four visits and taking iron supplement tablets regularly were
significantly lower than those of the adults. The teenage mothers were significantly more
likely to be in their first and unplanned pregnancies and have a history of abortion than
the adults. Stress was significantly more common in the teenage mothers than the adults.
The teenage mothers significantly had a higher incidence of antenatal complications, including
anemia and low weight gain during pregnancy, and low birth weight infants
than the adult mothers. Good antenatal care should intensively be provided to these
risky pregnancies. A reduction of the numbers of teenage pregnancies in the community
is essential.


location: , 'Thailand year: 2008 source: HSRI

title: Result of Phototherapy for Neonatal Jaundice Compared with the Use with and without Blue Light Lamps in Thabo Crown Prince Hospital, Nongkhai Province

abstract: Neonatal jaundice is a common and, in most cases, benign problem in neonates. The
treatment of neonatal jaundice is indicated in pathologic jaundice and the goal of therapy
is to prevent the concentration of unconjugated bilirubin in the blood from reaching levels
at which neurotoxicity may occur. For more than three decades, phototherapy has been the standard of care for the initial treatment of neonatal jaundice. A retrospective
study about the result of treatment for neonatal jaundice compared between phototherapy
with and without blue light lamps was done in Thabo Crown Prince Hospital from October
1, 2004 to September 30, 2007. The purpose of this study was to identify which type of
lamp used in phototherapy was more effective in decreasing the blood bilirubin level.
This study showed that the highest blood bilirubin level during treatment with phototherapy
without blue light lamps was significantly higher and also the length of stays for
treatment was significantly longer than in the group that used phototherapy with blue
light lamps. Although many factors affect the efficacy of phototherapy in decreasing the
blood bilirubin level, one of the important factors is the type of lamps used. This study
suggests that, for the treatment of neonatal jaundice to be effective, phototherapy with
blue light lamps is recommended.


location: , 'Thailand year: 2023 source: HSRI

title: End TB-Lanna: An Operational Research to Engage Private Clinics and Rrug Stores to Screen and Refer Persons with Tuberculosis Symptoms

abstract: Background: The previous study, entitled “The Development of Multi-Sectoral Approaches to End TB in Municipality and Central District (year 1)" was conducted in Chiangrai province in 2019 and 2020 revealed private pharmacies and clinics contributed to 25% tuberculosis (TB) detection rate (6 of 24 referred cases). Subsequently, this project was extended and implemented in 8 provinces of the Health Region 1 amid the Covid-19 pandemic. The project was coordinated by 8 operational researchers (OR) who are government health staff in provinces. The study aimed to develop a model involving pharmacies/clinics to screen and refer persons with TB risks and to investigate factors contributing to the implementation outcomes among 8 provinces. Methods: Developing two digital innovations, i.e. TB-Refer, a web-application for TB screening and referral and a TB online training course. The data were collected for 9 months and analyzed database of TB-Refer. The qualitative methods included in-depth interviews with OR, provincial TB administrators (Mr.TB), hospital staff and the pharmacies/clinics with and without referral cases. Results: The participation rate of pharmacies in 8 provinces is 50.4% (143/284) with a range of 12.7%-100% participation. Participation from clinics is only 4.6% (11/240) with no-participation in 2 provinces. Of the 143 pharmacies, 19 (13.3%) pharmacies screen and referred 37 persons with TB risk to the hospitals, while 2 out of 11 clinics screen and referred 2 cases made up to a total of 39 referred cases (38 symptomatic cases and 1 asymptomatic contact case). Only 19 referred persons arrived the hospitals and received TB screening and one pulmonary TB with sputum positive (AFB 3+) was detected. Fifty-seven pharmacists and five clinics doctors/staff enrolled and completed this training. The median scores of drug stores were increased from 16 (IQR = 4) to 23 (IQR = 2) (p < 0.001) while the mean scores of clinics were increased from 17.8 (SD 4.5) to 21.8 (SD 2.3) (p = 0.034). Drug stores and clinics completing the course had higher proportion of TB screening and referral cases to the hospitals than those without training (22.6% vs 7.6%, p=0.008). Among 8 provinces, only one province demonstrated regular referral and continuity of communications between OR and pharmacies/clinics. The OR of this province is a staff of disease control department who received excellent support from the department of consumer protection and public health pharmacies (CPHP), including supports from Mr.TB of the hospital and the provincial health office, particularly establishing a hospital’s fast track for referred patients. Conclusion and recommendations: It is feasible to involve drug stores and private clinic to screen and refer persons with TB risks to the hospital. The best model is the project’s coordinator should be a staff of disease control with good support of CPHP and provincial health authorities. Personals of drug stores and clinic should attend the TB online training course.


location: , 'Thailand year: 2010 source: HSRI

title: Evaluation of HSRI Users’ Satisfaction

abstract: This research had three major objectives that were: 1)to explore HSRI research users’ satisfaction both from the research contents and from accessibility to the research information, 2)to explore the problems and needs of the users and 3)to study the opinions on HSRI operation from the relevant parties who took part in formulating the policy of HSRI. The sample consisted of two groups; one from the executives or the parties relevant to policy formulation and the other from the researchers and academics who used the HSRI research. The data were gathered by mailing the questionnaires to the researchers and academics and interviewing the executives. The researchers and academics were randomly selected from 6,621 members of HSRI digital library during the years between 2007 to the mid 2008. The response rate was 48.4 percent calculating from 727 returned questionnaires. There were 9 executives who were interviewed.
The results were as follows:
1. The most important purposes of HSRI research usage were to develop themselves by increasing their research knowledge and to conduct their own research respectively. The least important purpose was to use the research for running their business.
2. For the satisfaction with HSRI research usage, the researchers and academics were most satisfied with publishing full text research papers in .pdf files and the contributions of research to develop health system respectively. The least score was the satisfaction with the research coverage of all areas of health system but the score was still at the high level of satisfaction.
  For the satisfaction with academic work of HSRI, the satisfaction of the researchers and academics was at the high level. However, the executives rated their satisfaction at moderate level by giving reasons that the role of HSRI had been diminishing and its research contributions leading to health policy adaption were less than its former research work.
3. Regarding HSRI research usage communication channels, the researchers and academics used research via Journal of Health System Research most. The least usage of communication level was radio broadcasting.
4. New threats such as natural disasters and terrorism were the most needed research topics that the researchers and academics required HSRI to develop more. The second highest needed topic was mechanisms and tools for solving health problems occurring from environment.
5. The research on health system was the most needed information that the researchers and academics required HSRI to gather and store in HSRI database. For the improvement of website, the most needed contents were research analysis column and health policy analysis column respectively.


location: , 'Thailand year: 2023 source: HSRI

title: Development of Thermal-Based Technique for Pharmaceutical and Medical Application – Phase 2 Development of a Prototype for Pharmaceutical Process Control

abstract: This research is an international collaboration among three organizations: the National Science and Technology Development Agency, the Pharmaceutical Organization, and the University of Oxford. Its purpose is to study the potential use of temperature sensor technology in pharmaceutical and medical applications. Temperature sensor technology can measure Thermal Product (TP), a heat property that is specific to each type of substance, and varies with the substance's density, specific heat capacity, and thermal conductivity. The University of Oxford has developed this technology for commercial use in the aerospace industry, specifically for detecting metal contamination in engine oil. We performed a feasibility study for commercial applications in various aspects in this project. The technology is tested in three areas: quality control of pharmaceuticals and raw materials, detection of counterfeit drugs or substandard drugs, and production processes related to medical cannabis. Collaborative research has been conducted to improve the sensor system for more appropriate use. From preliminary experiments, it was concluded that the current sensor system works well with liquid substances and has high sensitivity to detect changes in substance proportions. Therefore, it is suitable for use in quality control processes that require accurate measurement of substance proportions. The system is feasible both technically and commercially for use in quality control processes for drug production and pharmaceutical raw materials. It can help increase efficiency in production by adding real-time quality inspection and control processes during production stages, as the current quality control mainly relies on final product testing. The research team has proposed to install and test the system in the production process of Deferasirox, a pharmaceutical raw material product developed by the Governmental Pharmaceutical Organization (GPO), which is entering the commercial production stage in the middle of 2024. This will be the practical application of research results for commercial use which can also be expanded in the future.


location: , 'Thailand year: 2002 source: HSRI

title: An integral study and the effects of medical ethics toward the project of baht 30 all medical treatment

abstract: An Integral Study and the Effects of Medical Ethics Toward the Project of Baht 30 All Medical Treatment	This study was conducted by the sub-committee of the Medical Council of Thailand in December 2002.  It was undertaken to focus the impression towards medical treatment after which could result and affect the morality of medical practitioner in the project of Baht 30 for all treatment throughout Thailand.	The subcommittee has distributed pre-test questionnaires to physicians in both the government and   private sectors working in the central region and regional areas.  Four hundred fifty questionnaires were administered and 125 sets (27.8%) responded.  	The answered questionnaires were analyzed for the content validity and test the reliability.  The reliability of the questionnaires was 27.8% (more than 15%)   which is considered to be reliable and valid according to statistical analysis.  The subcommittee therefore distributed the questionnaires by using consensus.  All questionnaires were delivered to all physicians as shown in the name-list  of  the Medilcal Council, a total of 25,885 sets. Ninety - four sets of questionnaires were returned for the reason of no recevier or respondents were not at home. Forty-one questionnaires were returned after the data have been analyzed. It was believed that 5,506 of the questionnaires reached the respondents with a total of 25,791 (21.4%) sets which is equally close to the pre-test study.Section 1 : General Information	Only 21% of total male physicians (17,095)  returned questionnaires and 8,834 (19%) were female physicians.  Both of which is proportional. Comparing to the data, the highest number of physician who returned the questionnaires were between the age qroup of 50-59 years (28.3%), 40-49 years (28.1%), 30-39 years(20.4%), more than 60 years(19.5%) and less than 30 years (least returned) or (12.5%)	Information obtained from the Medical Council was as follows : general physician (13,976), surgeons including (extended) sub specialty (3,759), internal medicine including extended specialty (3,541), pediatricians (2,188) and  obstetricians and gynecologists (1,730).  It was noted that general physicians returned most of the questionnaires (29.4%), pediatricians (10.7%) obstetricians and gynecologists (9.7%) internal medicine (8.7%) and surgeons (8.2%) Among 5,465 physicians, who responded the questionnaires, 90% still provide medical treatment of which was considered to be the target group of this survey study.	Regarding the places, which provided medical treatment, 39.7% are in the government sectors, only 21.1% worked in private hospitals. Respondents from the central region (22.7%) and in Bangkok (22.7%) answered most of the questionnaires followed by the northeast region (14.0%), northern region (13.2%), the south (8.5%) and eastern region (6.3%) respectively. Part 2 : Sharing Views Among 5,464 physicians who responded agreed in principal and policy of the Baht 30 project all medical treatment.  Those agreed most (23.2%), moderately agreed (36.2%), and few agreed (38.4%), Respondents mostly agreed (3.9%) with the present structure, 18.5% moderately agreed and very few agreed of 75.2% respectively.	To conclude, 23.2% of respondents mostly  agreed in the campaign of Baht 30 all medical treatment but 75.2% did not agreed with its structure. From the Medical Council's point of view, only 2.3% agreed that the Medical Council should stay stagnant while others reflected that the gathered opinions should be forwarded to the government and the Ministry of Public Health. Approximately, 74.6% proposed to forward through the media, 61.6% to members of the Partiament and the Senate and 58.69% to the Economic Council and 53.6% proposed to arrange a seminar for all physicians over the country. Part 3 : Administration of the  Baht  30 Project	Respondents of 59.6% have received the policy from the management team to reduce the medicine costs and suppiles and 52.9% performed according to the policy given by the administrator. A percentage of 47.8 of physicians did not change the method of treatment towards the patiens and 39.0% admitted their changes of medical treatment does not bring good results to the patient.  Only 5.4% agreed the changes were good. For further search for this administration, 50.9% responded the study did not yield good results for further investigation, 31% responded no change and only 6% reponded improved.  	Regarding the freedom to choose the method of treatment according to medical standards, 54.4%  responded lessened, 39.9%  answered the same and inquired about the result of the medical treatment, 67.3% responded it was lessened, 13.2% the same and only 6.7% improved.


location: , 'Thailand year: 2021 source: HSRI

title: Development of a community-based model of promoting the living will acceptance among Thai elderly

abstract: This research and development project aims to develop a community-based model of promoting an uptake of a living will among the elderly. It was implemented in Prapplachai Sub-district located in Uthong District in Suphanburi province. The project has 2 major phases. The first phase involved a survey of 880 samples including 360 senior population (60+), 360 family members of senior people, 120 healthcare providers, 20 village health volunteers and 20 community leaders. Besides the survey, the research team compiled qualitative data utilizing 20 in-depth interviews with senior people and focus group discussions with 26 participants consisting of the community leaders and village health volunteers. Compiled data include attitudes towards patients in a palliative care stage, knowledge and attitudes about the living will. An analysis of the quantitative data relies on descriptive statistics (mean and percentage), whereas a content analysis is applied to the compiled qualitative data. Both qualitative and quantitative data supported one another. Biases towards living wills were palpable. All groups of the sample had a limited knowledge about the meaning and benefits of living wills. They also have inadequate understanding and ability to write and to utilize the living wills. The survey results show 94 % of the samples comprising the elderly, their family members, healthcare providers, community leaders and village health volunteers have never written their living will. Almost half of the elderly (47.5%) had a thought about writing their living will. Supporting reasons persuading them to write the living will included recommending from healthcare personnel (40%), their increased age (30%), and their desire to tell their needs to the family members (30%). Nevertheless, the survey has revealed that more than a half of the ageing people (62%) expressed their need about having the doctors to choose proper medical treatments for them instead of choosing by themselves. Also, 62 % of them preferred choosing medical treatments together with their doctors. The project assessed the samples’ knowledge about living wills using 10 questions, and each question has 1 score. A comparison of knowledge scores shows that the mean scores among the elderly, family members, community leaders, healthcare staff, and village health volunteers were 7.4, 7.5, 7.6, 7.4 and 3.9 respectively. The qualitative data has unveiled that a certain number of samples confused or misunderstood that the living will is similar to a consent to treatment, a body and organ donation, and a last will. Despite having some knowledge, the studied samples barely understood a comprehensive meaning of the living will. Especially, the village health volunteers had a lowest mean score of the knowledge Items that showed their lack of knowledge were describing one’s needs, choosing a person who will make a decision for oneself, identifying a person who can make a decision in case that you cannot make it by yourself due to health conditions, do not know when the living should be used, do not know that the living will can help doctors and caregivers to communicate an issue about choices of medical treatments for patients, do not know that the living will can be revised or annulled by the owners at any time. Likewise, a majority of aging, their family members and health volunteers were unsure or did not know about a right time to compose their living will. The Community leaders as well as health volunteers did not understand that patients and their family members might refuse medical treatments recommended by the doctors if they did not want to. Also, the study illustrates that healthcare personnel has limited knowledge about the living will in some issues such as they did not know that the living will can be used to reaffirm the patient’s needs regarding the alternative treatments in case the patients could not communicate with other people, that the living will could be cancelled or be revised by the owners at any time, and that the patients have the right to refuse medical treatments. The percentages of healthcare providers who were short of knowledge mentioned above are 47%, 29% and 20 % respectively. The second phase tied up with a model development aiming at increasing an uptake of living wills among the elderly. The research team organized workshops to share research results with the community members and to facilitate drafting a plan for promoting and increasing an uptake of the living wills, especially among the elderly. The elderly peer leaders, family representatives, community leaders, health volunteers and healthcare stuff from the community hospital as well as from the sub-district health promotion hospitals were invited to participate in the workshops. The model comprises 3 key components as the followings. 1) Empowering of all stakeholders: the activities included using a participatory approach to establish a committee mechanism which is responsible for promoting the living will uptake, Providing the training of the trainers (TOT) workshop to equip participants with knowledge and skill in writing the living wills. Participants were the elderly leaders, community leaders, healthcare personnel, and health volunteers. 2) Participatory strategic planning: The committees determined strategic activities to promote an acceptance of living wills. Planned activities were identifying platforms to dissimilate knowledge and information. For example, the village health volunteers proposed setting up a group line to provide Q&A about living wills to community members, distributing information and a living will form on the sub-district official website, disseminating information via village broadcasting station as well as via the community radio program, holding training workshops to help the elderly and their family members to write living wills, and presenting cases that have had an experience writing and using the living wills. 3) Strengthening the hospital system: To work with the community hospital’s director and healthcare stuff in order to integrate tasks about living wills into the services. Moreover, to develop a guideline or instruction for patients and caregivers to ease the writing and utilizing of the living wills. The project recommends the government, local hospitals, and local administrative organizations to 1) promote comprehensive knowledge, understanding, and positive attitudes towards living wills at the community level; 2) create a clear manual and form to help people to become capable of writing their living wills, and disseminating them in a variety of available platforms, such as in hospitals, public service offices, and new social media; 3) train local change agents, such as elderly leaders, family leaders, community leaders, village health volunteers, and local healthcare personnel to have adequate knowledge and ability to transform people’s bias and misapprehension towards living wills, as well as to coach people how to write living wills; 4) developing and strengthening the healthcare staff’s skills about palliative care, care for patients with chronic diseases, advance care plan, and how to write and utilize a living will; 5) integrate promoting living wills among patients and caregivers to be a KPI (key performance index) of hospitals at all level; 6) demand that local administrative organizations build the database of people who have their living wills and share the database with hospitals; 7) encourage community leaders, health volunteers and healthcare providers work together to support a unified service with respect to the utilization of living wills.


location: , 'Thailand year: 2008 source: HSRI

title: Migration and Distribution of Pharmacists in Thailand: Past and Present

abstract: The objective of this study was to describe the migration and the distribution pattern of pharmacists
in Thailand. A self-administered questionnaire survey was employed. Stratifried sampling by timing of
the compulsory pharmacist project of the Ministry of Public Health was used in the survey. The total
sample included 1,500 registered pharmacists in three sub-units: those who graduated with a bachalor’s
degree before, between, and after the compulsory pharmacist project, i.e. those who graduated between
1975 and 1988, 1989 and 2004, 2005 and 2006, respectively. The response rate was 43.27 percent. The
results showed that 59.78 percent of the samples had moved 1.8 times on average. The mobility patterns
from their first to current workplaces were different among the three sub-groups. According to the distribution, the results indicated that the number of pharmacists was increasingly distributed into regional
areas. Most of them had worked for the government sector, especially in government hospitals. It was
concluded that the compulsory pharmacist project may effect imbalances in the distribution of pharmacists in the public and private sectors. This problem could distort the professional development of pharmacists, particularly in the pharmaceutical industry and drugstores. Therefore, it is necessary to consider
the balance in the distribution of pharmacists between the public and private sectors in Thailand.


location: , 'Thailand year: 2017 source: HSRI

title: Graduation Rates of the Doctor of Medicine Program of Khon Kaen University

abstract: The purpose of this study is to identify graduation rates of Doctor of Medicine (M.D.) program of
Khon Kaen University during the academic year 1973-2012, with total number of 5,598 students from 40
admission classes. There were 3,966 alumni from 34 graduated classes. The information was collected
from the Registrar Office, Student Development Unit, and School Alumni Database, using percentage for
data analysis. The M.D. program responded to the policy of the Human Resources for Health Committee,
the admissions of students (classes# 1-40) were under two core projects: 1) Normal Project (including the
extra quota admissions), and 2) Mega Project for producing medical practitioners (the Collaborative Project to Increase Production of Rural Doctor or CPIRD and the One District One Doctor or ODOD), at 81% (or
4,545 persons), and 19% (or 1,053 persons), respectively. The graduation rate of MD program from 34
classes, was 95.71% (3,796 persons). The on-time graduation rate was 84.06% (3,191 persons); while delayed
graduation rate was 15.75% (598 persons). Under the Normal Project, the graduation rate was 95.81%
(or 3,434 persons), of which on-time graduation was 83.49% (or 2,867 persons). Under the Mega Project
(CPIRD and ODOD), the graduation was 94.76% (362 persons), of which on-time graduation was 89.50%
(324 persons). The graduation rate under the Direct Admission group was 96.09% (or 2039 persons). Additionally,
the graduation rate of Central Admission group was 95.74% (1,348 persons), the CPIRD 1 with a
maximum rate of 96.55% (196 persons), the CPIRD 2 93.25% (152 persons), and the ODOD 87.5% (14
persons). When studied on graduation rate in every 10 years, Phase 1: Year 1st - 10th (1973-1982), the
Normal Project admitted 584 students with graduation rate of 93.87% (or 551 persons), and on-time graduation
rate of 82.94% (or 457 persons). Phase 2: Year 11th - 20th, the Normal Project and CPIRD 1 admitted
1,284 students with graduation rate of 95.87% (or 1,231 persons), and on-time graduation rate of 78.15%
(or 962 persons). Phase 3: Year 21rd - 32nd, the Normal Project and CPIRD 1, admitted 1,571 students with
graduation rate of 96.69% (or 1,519 persons), and on-time graduation rate of 87.29% (or 1,326 persons).
Phase 4: Year 33rd - 40th, only 2 classes, i.e. Class# 33 - 34 (538 students) wer e graduated at a rate of 94.42%
(or 508 persons), and on-time graduation rate of 90.75% (or 461 persons). The academic achievements of
Direct Admission and Central Admission, under Normal Project, were relatively similar and the CPIRD 1
reached maximum academic achievement.


location: , 'Thailand year: 2021 source: HSRI

title: Development of industrial production of SuperMosqTM bioproduct

abstract: This study has the overall goal to develop and improve mass-rearing of the SuperMosqTM bio-products or sterile male mosquitoes produced either by Sterile Insect Technique (SIT) through low-dose irradiation or by Wolbachia-induced Incompatible Insect Technique (IIT). The specific objectives are as follows: 1) develop a high-quality, low-cost, industrial scale, Aedes aegypti larval diet, 2) develop a local sex separator device for separating Ae. aegypti male and female pupae, 3) test yeast proteins for blood meal replacement of female mosquitoes, and 4) assess quality control of mass-reared immatures and sterile mosquitoes. For the development of Ae. aegypti larval diets, it was found that an alternative larval diet had very little effect on the growth and development of both male and female pupae and adults when compared to those that were reared with the standard larval diet. Moreover, when the cost of the diet was taken into consideration, it was found that the cost of an alternative larval diet was 60% lower than that of the standard diet. Therefore, it was concluded that an alternative larval diet could be applied for mass production of mosquitoes at the industrial scale as it reduces the cost of production but still yield good quality of mosquitoes. For the development of local pupal sex separator device, It was found that there was no significant different in the efficacy between the local pupal sex separator and the imported one. When the speed of sex separation and the percentage of female contamination, together with other factors such as cost, transportation, maintenance, etc. was considered, it was found that there were no significant differences in the speed of sex separation and the percentage of female contamination while the cost of the locally assembled device was 70% lower. For the development of yeast protein Ae. aegypti females, it was found that the yeast protein diet was not able to replace the general blood meal as females could not lay eggs when they were fed with the yeast protein diet. Besides, Ae. aegypti females were less attractive to the yeast protein diet when compared to the pig blood. In addition, females that were fed on the yeast protein diet were unable to produce eggs. Therefore, it is necessary to study and find other raw materials in order to improve and develop recipes that could be used to replace blood in the future. For quality control of sterile male mosquitoes using flight ability test, it was found that there was no significant difference in the escape rate of the sterile mosquitoes produced from both low-dose irradiation and Wolbachia-induced incompatibility, or the SuperMosqTM bio-products, when compared to the control ones. Therefore, it could be concluded that the low-dose irradiation and the presence of Wolbachia bacteria did not affect the flight ability of the SuperMosqTM bio-products. For quality control of sterile male mosquitoes using sterility test, it was found that sterile mosquitoes, whether they were sterile by either low-dose irradiation or by Wolbchia-induced incompatibility, could make fertile Ae. aegypti females sterile; as the latter lay unhatched eggs or even could not produce eggs at all. In other words, it could be concluded that the SuperMosqTM bio-products, sterilized by either low-dose irradiation or Wolbachia-induced incompatibility, can cause sterility in the fertile Ae. aegypti females when they were mated and that the females could not produce any offspring. For quality control of sterile male mosquitoes by assessing male mating competitiveness, it was found that both radio-sterilized and Wolbachia-induced incompatible males had nearly similar ability to compete with wild males in order to mate with Ae. aegypti females. Therefore, when the SuperMosqTM bio-products were applied for vector control, they should be released in a ratio equal to 10 times of the number of wild males in the case radio-sterilized males and only one time of the number of wild males in the case of Wolbachia-induced incompatible males, in order to effectively compete with wild Ae. aegypti male mosquitoes. For quality control of sterile male mosquitoes by assessing survival rate and life expectancy, it was found that low-dose irradiation had no effect on average survival rate and life expectancy of sterile males when compared to the control ones, while those that were sterilized by Wolbachia-induced incompatibility reduced average survival rates and shortened the life expectancy of sterile males when compared to the control ones. For quality control of sterile male mosquitoes by detection of Wolbachia bacteria, it was found that Wolbachia bacteria was 100% present in the sterile males that were randomly selected for detection in every lots of productions. Therefore, it could be concluded that Wolbachia bacteria was stably established in the SuperMosqTM bio-products.


location: , 'Thailand year: 2010 source: HSRI

title: Indicators and Surveillance of the Health of People Living Near the Mae-Moh Power Plant

abstract: Mae-Moh Power Plant and Mae-Moh Lignite Mine may cause adverse environmental and health
effects. However, currently, there is no surveillance system to monitor the effects on the health of people
living near the power plant. This study is aimed at identifying indicators and studying the health impacts
in order to monitor the health status of people living near the power plant. The mining and power plant
processes were reviewed, together with their related pollutants and the possible health impacts of each
substance. A study on the health effects of people living near the power plant was reviewed. Practical
health indicators and a research methodology were suggested and reviewed by an expert and stakeholder.
It was found that these Mae-Moh facilities might produce several health hazards, including air pollutants,
water pollution, noise, accidents and other nuisances. The health indicators that should be monitored are:
(1) emergency room visits, (2) hospital visits and the services requested, (3) mortality monitoring, (4)
pulmonary function of school children, (5) lung function of adults with respiratory problems, (6) chronic
obstructive pulmonary disease cases, (7) pneumoconiosis among mine worker, and (8) stress and annoyance
due to the environmental problems.


location: , 'Thailand year: 2021 source: HSRI

title: Model Development for Integrated Health Information Technology and Digital Transformation of Diabetes and Hypertension Services in Primary Health Care System in Thailand

abstract: A series of research projects to develop a model of the information technology system to provide a service of diabetes and hypertension in the primary healthcare system in Thailand has an operational plan for 3 years. In this first year, the study is divided into 2 parts. The first is studying the situation and the need for health information to provide a service for diabetes and hypertension patients/risk groups. Another is developing a model of the information technology system by using standard health information and connecting such information between primary care units and community hospitals in a specific area where there is good data management. The team studied the need for the information on diabetes and hypertension from different groups namely family physicians, patients/risk groups, policy makers and technical officers, and found that they all required the same kind of information including medical records, a display in the form of a time series to reflect and analyze the patients’ behaviors, as well as an effective data transmission system between primary care units and community hospitals which is essential to long-term care and treatment. The team also developed the information technology system model to provide a health service in Kamphaeng Phet Hospital and its primary care units using HL7 FHIR. The program was used to set a standard of data for the users to be able to exchange and access the patients’ information while the patients can also reach their own health records from different places.


location: , 'Thailand year: 2020 source: HSRI

title: Application of System Dynamics Modelling for Health Workforce Planning for the Next 10 Years: A Pilot Project in the Regional Health 2

abstract: The reform of human resources for health (HRH) is an essential component of healthcare reform in having adequate number of HRH to achieve good health of population. Hence, effective HRH planning is one of key elements to have proper number of competent HRH at the right time according to demand in complex and dynamic healthcare shaping from internal factor, such as educational system and labour market dynamic, and external factors, such as technology advancement and vigorous economy. This study employs “system dynamic” approach to demonstrate future healthcare services by extensive participation of related stakeholders, called “group model building” approach then future demand of HRH is developed. 47 health facilities including regional, general and district hospitals in Health region 2 are study sites. This study employs information from primary and secondary data for quantitation part and focus group discussion and in-depth interview for qualitative part. Stella Software is used to demonstrate future model of services. This study emphasizes 5 areas of services, namely eye services, kidney services, general surgery services, services for non-communicable disease and cancer services. For Opthalmological services in the next 10 years, OPD patients will increase to 270,000 visits. Patients with cataract will slightly decrease to 135,000 patients while patients with glaucoma will increase to 108,000 patients. For kidney service, patients with hemodialysis will increase to 4,400 patients while ones with peritoneal dialysis will reach 1,700 patients. Furthermore, chronic kidney disease level 4-5 will increase to 47,000 patients which exceed service capacity in health region 2. For patients with non-communicable disease, patients with hypertension in health region 2 will approach 2 million in the next 10 year while ones with DM will reach 500,000 at the same periods. For general surgery services, non-elective cases will over 40,000 patients whereas elective cases will reach 47,000 patients. Patients with liver cancer will increase. However, mortality rate will decline stemming from early detection and more effective treatment. This study demonstrates that an imbalance of supply of resources to deal with an increase service demand still exists. In summary, to tackle with an increase demand of health services in the future need proper management of health resources. This study demonstrates some effective management, for example an increase staff’s capacity, expands utilization of medical equipment and infrastructures such as operating room and pool-resource including strengthening HR development and training.


location: , 'Thailand year: 2022 source: HSRI

title: Study of Germline Genome Data in Thai Cancer Patients: A Pilot Study for Genomics Thailand

abstract: Cancer is the first-leading cause of death in Thailand. Cancer is caused by gene mutations that control the cell functions in cell growth and division. The genetic mutation causing cancer can be divided into two broad categories based on the tissues of origins: somatic mutation and germline mutation. The germline mutation passes directly from parent to offspring which can be detected in every cell within the body. Cancers associated with germline mutations are called hereditary cancers. Most hereditary cancer patients have similar clinical symptoms and signs to sporadic cancer, it is difficult to distinguish the hereditary cancers for the benefit of preventing, treating and screening cancer in at-risk family members. In addition, hereditary cancers account for up to 12 percent of all cancer diagnoses. Thus, genomic medicine has the potential to make the diagnosis more accurate. This project aims to utilize genome sequencing technology to identify germline mutations and diagnose hereditary cancer syndromes among Thai cancer patients, this would also create an opportunity to build large genome database for future study of the cancer susceptibility genes and polygenic risk of cancer for Thai population. Moreover, this project has created collaborative network among medical schools, large university-affiliated hospitals and cancer centers to support and share experience, exchange knowledge, and facilitate the integration of genomic medicine in cancer care. Study by next-generation sequencing (NGS) found that approximately 16% of cancer patients participated in this study harbored germline pathogenic or likely pathogenic variants in various cancer susceptibility genes. This information was useful for further expanding to identify at-risk family members with appropriate cancer screening, early detection and prevention in the future. Genetic diagnosis, genome-guided screening and prevention of cancer were also cost-effective and would be a model of the implementation of genomic medicine in national healthcare system.


location: , 'Thailand year: 2013 source: HSRI

title: The effects and caregiving burdens of older persons in long-term care based on Thai culture.

abstract: This study was a qualitative research aiming to study the experience of long-term care,
its associated burden and impact as well as the role of organizations involved in long - term
care for the elderly in Thailand. Data were collected, from June of 2012 to May of 2013,
through indepth interview, focus group discussion, and direct observation of 179 elderly
persons and 187 caregivers, at 13 districts of nine provinces and five regions of Thailand. The
data were analyzed using content analysis, thematic analysis, and frequency and percentage.
The experiences of long-term dependency of the elderly with stroke, dementia, co -
morbidity, and aged 80 years and above, were documented. The care givers who provided
long-term care for the elderly in Thailand showed that the majority of them feel relative
powerless; most of them (85%) were female; one-third had a chronic health problem; and
one-third were elderly caregivers. Three-quarters of caregivers also work, about one in nine
people need to provide long-term care for more than one person, and the majority had
never experienced any long term care. In addition, it was found that the pattern of family
caregivers for long-term elderly care in Thai social that the caring was subject of gratitude.
Regarding the burden and effect of care, nearly four in five caregivers who care for the
elderly with stroke and co-morbidity experienced the economic burden, due to costs of care,
financial debt, and a lack of opportunities for career development. More than two in three of
caregivers experienced emotional burden including anxiety, depression, and severe stress, and
conflicts within relatives. More than two-thirds of caregivers experienced physical burden of
elderly care, including fatigue, body pain, increased health problems. And, the majority of
long-term care for the elderly was only activities daily living care. It found the elderly 45 %
who did not receive rehabilitation.
Also, the psychological burden and emotional problems were the most common,
about four in five, among those who provided care to elderly people with dementia. More
than three in four of these caregivers experienced physical, social and economic burdens.
Moreover, 11% of paid care workers quit their job. And,it found the restrictions of diagnosis
and knowledge of the elderly with dementia that the elderly lack of opportunity in the
treatment of 72%. In addition, there is a lack of continuity of care for the elderly in the longterm
health care system, a lack of assurance for the quality of home care, and the lack of
integration of missions of the organizations involved in the care of the elderly in a
community. In conclusion, the long-term care for the elderly in Thailand results in tremendous
burden on caregivers and families amidst the unavailability of family and community support
systems. Therefore, support system development and system design for long-term elderly
care options for caregivers and families in the community include; development of primary
care services, promote the role of local government in the long term care system for the
elderly, development potential family caregivers, and standardization and quality control
long-term elderly care nationality.Thus, leading to the development of a sustainable aged
care that is in accord with the culture of Thailand.


location: , 'Thailand year: 2007 source: HSRI

title: Community Participation in Promoting Health Development among Children in Chiang-Klang District, Nan Province

abstract: Malnutrition and dental problems in children have been identified as important
problems in Thailand.  Several studies and research activities have been undertaken in
order to identify solutions, but the problems still exist.  The Chiang-Klang Hospital Health
Team conducted a study by involving the community to become concerned about their
problems and become a part of the committee to solve problems themselves.  Namkha
village in Phayakaew sub-district of Chiang-Klang was selected to be a community model.
A quality measurement study was conducted as PAR (Participatory Action Research).
The study was conducted between June 2002 and December 2003.  Seven malnourished
children (15.22% of the total) were identifinal at the start (June 2002).  No children (0%)
were seen with malnutrition after six months.  The study team followed up the result for
one year and found that there were no cases of malnutrition.  Dental health was significantly improved in both the nursery center and primary school. This study has shown
that the communityûs health problems had been completely solved because of the cooperation of the community itself, which had been involved in all the relevent steps: problem investigation, finding a solution and following up on the health-care procedures
adopted by the team.


location: , 'Thailand year: 2021 source: HSRI

title: Factor Affecting Length of Stay More Than 6 Hours in Emergency Department

abstract: Background & Rationale: Extended length of stay (LOS) in the emergency department (ED) affects LOS in hospital, increased mortality and increased hospital resource uses. Knowing factors affecting extended ED LOS should lead to improved patient’s quality of care. Methodology: The study design was a retrospective analytical study in ED at Maharaj Nakorn Chiang Mai Hospital between January 2018 to June 2019 by collecting data from the electronic medical records. Data collection included factors expected to extend ED LOS 6 hours and longer by using multivariable logistics regression. Result: A total of 330 patients of whom 165 with ED LOS ≥ 6 hours were eligible. The risk factor for staying 6 hours and longer in the ED was having urine investigation (adjusted odds ratio [aOR] 3.43, 95% CI 2.05-5.73, p < 0.01). Moreover, patients in the evening and night shifts observed a shorter ED LOS compared to the day shift (aOR 0.26, 95% CI 0.15-0.47, p < 0.01 and aOR 0.40, 95% CI 0.21-0.77, p < 0.01, respectively). For patient presentation to ED, the refer-in patients had a shorter ED LOS compared to the walk-in patients (aOR 0.33, 95% CI 0.15-0.70, p < 0.01). Conclusion: The factors extending ED LOS ≥ 6 hours included urine investigation process and the day shift. Refer-in patients were likely to have a shortened ED LOS.


location: , 'Thailand year: 2019 source: HSRI

title: Development of Multidisciplinary Care Model for Outpatients with Chronic Heart Failure

abstract: Heart failure (HF) is a major health problem globally. Multidisciplinary team care increases standard medication treatment, decreases risk of hospitalization with heart failure and all-causes mortality, also improve quality of life in patient with heart failure. However, with the increasing of number of patients and lacking the clinical practice guidelines in the HF clinic, are affecting the problems of data management, redundancy of documentation. These are obstacles for data management in patient care, quality assurance and initiating of academic work. This is a participatory action research among staffs inside the HF clinics and outside the HF clinic, also patients or care givers. The objectives of this study including the development of multidisciplinary care model and the clinical practice guidelines for HF patients in the clinic, the development of data management system and other tools, and the comparisons of outcomes between before-after receiving care from the HF clinic The results from problem survey found that problem related to data management was the most important including data collection, documentation and report, redundancy of data documentation and communication within the clinic. The patient’s data-base system was developed, as well as the clinical practice guidelines and other tools for supporting patients’ care. A total of 100 patients, 58.00 percent were male, the mean age of 6 1 . 9 2 + 1 5 . 7 5 years old. Patients received treatment in the HF clinic for at least 6 months. The mean of ejection fraction (EF) was 30.80 + 8.48 %. The common cause of cardiomyopathy (CMP) was ischemic CMP (70.00%). The evaluation of all process outcomes found improved significantly including patient’s knowledge for self-care score, the mean guideline adherence indicator (GAI) increased from 64.35 + 38.25 % to 88.50 + 21.76 (p=0.009), the New York heart association functional class was improved, and also the 6-minute walk test. All drug related problems (DRPs) found were 134 problems. The common DRPs were dosage too low (47.00%), non-compliance (37.00%), and adverse drug reactions (21.00%). The DRPs were solved mostly by physicians adjusted the medication combined with pharmacist provided counseling to patients (61.94%). The majority of DRPs were solved completely (70.00%) with 29.00 percent were pending for following-up. The outcomes after development of patient’s care model resulted in the numbers of hospitalization with heart failure decreased significantly (33.0 and 8.0%, p<0.001) and saved the total of hospitalization cost 8,839.72 baht per patient, the quality of life score increased significantly, and the mean patient satisfaction score was in the level of good-best after received the developed patient’s care system.


location: , 'Thailand year: 2008 source: HSRI

title: Visual Function and Quality of Life in Cataract Patients after Phacoemulsification

abstract: Cataract is a significant cause of blindness in the global population. The objective of
this descriptive study was to study visual function (VF) and the quality of life (QOL) in 32
cataract patients treated by phacoemulsification at Bangnamprieo Hospital from January
to April 2007. Information was obtained before and one month after the intervention.
The patients were 12 men and 20 women, aged 50-82 years, with 62 years being the average.
Half of them had no occupation; average family income was 57,769 baht per year.
They suffered low vision for 23 months on average. The VF and QOL scores after one
month of treatment were higher than before, and the VF scores positively correlated to
the QOL scores (r =.567, p <.01). In conclusion, the present study shows higher visual
function and better quality of life scores after the intervention by phacoemulsification
together with the standard of care. The authors recommend this particular measure for
tackling cataract disease in community hospitals without full-time ophthalmologists, in
order to increase the health of the Thai population and improve the quality of life of the
people.


location: , 'Thailand year: 2001 source: HSRI

title: The Guidelines and Level Measures Relating to the Older Person's Welfare in Thailand

abstract: The guidelines and legal measures relating to the older persons welfare in Thailand  	This research aims to study the legal measures of older persons and found that : the right of older persons has been recommended by the International Law on Human rights as a fundamental right enacted in the Universal Declaration on Human rights by which every state has to follow. The United Nations International Action Plan on the Older Persons has been set up to improve their life and begin clearer when the United Nations declare the International Year of Older Persons in 1999 and recognize the right and policy to respect older persons equally.


location: , 'Thailand year: 2017 source: HSRI

title: Healthcare Healing Environment Design (2nd year)

abstract: The second year of Healthcare Healing Environment Design project (HHED) focus on the implementation of the HHED’s Assessment tool on the 17 project member hospitals along with the environmental improvement according to the assessment tool and selecting an area or a building to improve to be a model of HHED and also develop a related research topic according to HHED concept, finally, evaluating users experience from the improvement of the physical environment in order to create academics reference and development of Thai healthcare system.  The reflection from the users on the visiting of 17 member hospitals on healthcare healing environment problem, we found problems in 2 dimensions, firstly, for the infrastructure, it is lack of functional using area, secondly is the poor environmental quality that impact work performance and user’s well-being such as heat, poor air quality, bad ventilation which cause staffs’ infection as well as the exceeded standard of carbon dioxide quantity, too many sources of noise that reduce the efficacy of staffs’ productivities, lighting with both not enough light cause the medical errors and the reflection of glare light.  From research team’s perspectives, besides those 2 dimensions of problems, we found that there are too many poor-quality media installed on the visual field that increase stress for the user such as direction signposts, room name/ department name those are too diversity and not in a unity format. Sometimes it cause confusion or even straying. While producing various media to communicate to the users, for example, the service instructions, Patients’ terms of service, etc. These badges do not work in practical, the staff still have to answer the same questions which appearing on those badges there is also a large amount of health education media board that is not designed to be interesting. On the contrary, the user refuses to consume the medical education information provided by the hospital because there is too much details that users cannot remember and apply in daily life.  From such problems, there is a key issue in selection areas/ department/ buildings as the hospital selected pilot areas for the development of environmental quality that will be caped as healing environment. It is still in the process of collecting evidence of the problem to improve physical environment and the central research team will assist on designing the area according to the context. After the improvements, the research team will collecting data to evaluate user experience according to the improvements that is in the research processes of the third-year of the research project based on user experiences from 5 aspects from the HHED assessment tools which are: 1) Function and safety, 2) Sensing and comfort, 3) Interaction and support, 4) Empowerment and informed choice, and 5) Value and spirituality.


location: , 'Thailand year: 2005 source: HSRI

title: Co-payment in universal coverage scheme : A policy analysis

abstract: Universal Coverage Scheme was nation-wide launched by the government in October 2001. The scheme was financed by general tax revenue with literally free access to contractor primary care unit (PCU) and registered hospitals. A nominal fee (co pay), 30 Baht per visit or per admission, was introduced for UC Pay member (UCP).  UC exempted (UCE) members who were the ex-members of Low Income Scheme, the elderly, children under 12 years, monks, war veterans, and village health volunteers were exempted from the co pay. Current policy debates focused on the appropriateness of co pay level to deter any unnecessary demand for care as well as capacity to generate some revenue to finance the scheme. 	This study examined and classified income quintiles of UCE and UCP members, service utilization rate of UCP, and total revenue generate from co pay.  The study also proposed several scenarios for reform in both directions (termination and increase of co pay). The 2003 Health and Welfare Survey (HWS) conducted by the National Statistical Office (NSO) was the dataset used for the analysis. 	There was a substantial portion of the poorest (29%) and the poor (25%) quintiles among UCP members, and a small portion of the rich (9%) and the richest (4%) quintiles among UCE members. Estimate revenue from co pay was probably negligible. This was 1,073 million Baht in FY2003 or 1.9% of total capitation budget financed by the government.  Co pay was advocated to deter unnecessary demand among users, but this study proposed that it might not be necessary for IP as admissions were clinically indicated under global budget plus DRG payment system. However, co pay might be necessary for ambulatory services as contractors were in weaker positions to contain demand. 	We would recommend that any reform of co pay should over-haul the issuance of UCE and UCP to better targeting as a pre-requisite.  Co pay was not a significant resource generation tool to finance UC scheme compared to capitation.  Co pay for IP should be terminated to abolish barrier to health services and prevent patients’ welfare loss, there was literally no moral hazard as providers have no incentive to unnecessary admit patients. Finally, co pay should be terminated at HC level in order to advocate use of primary care. In the meantime, research to provide evidence if there was a moral hazard among UC members as well as quantifying the magnitude of moral hazard is needed, prior to major revision of this policy.


location: , 'Thailand year: 2012 source: HSRI

title: Scoping Review and Research Synthesis on the Financial Management of Oral Health Promotion System for the Disabled in Thailand

abstract: Empirical evidence of oral health care and dental service delivery systems for people with disabilities
in Thailand is needed. An important question for the national health policy-makers is how to improve
oral health promotion for disabled patients in healthcare priority-setting. The objective of this paper was
synthesis of common wisdom regarding financial management of the oral health promotion system for
the disabled people in Thailand. This study systematically reviewed the literature in PubMed and MEDLINE
databases and the unpublished-literature that reported data in Thailand, Japan, the United States of America,
Canada, and the Commonwealth of Australia. The relevance of 82 retrieved articles was reviewed for each
country based on its current oral-health insurance systems, cost-benefits, and healthcare financial management.
Thirty-seven stakeholders commented on these findings and made suggestions by group panel.
This evidence supports the need to develop oral-healthcare policies to support dental care service, especially
oral health promotion and prevention, and improvement of equity and quality of the disabled access
to dental primary, secondary, and tertiary healthcare delivery systems in Thailand.


location: , 'Thailand year: 2023 source: HSRI

title: Development Project of Personal Health Record Connect to the COVID-19 Vaccine Management Program in the Area of Health Region 9

abstract: This study is a developmented research with the objectives as analysis purposes. synthesis and development electronic Personal Health Record (PHRs) systems that are desirable to the health system
of Thai people by connecting the database of the COVID-19 Vaccine Information Management Program. Health Region 9 was selected as the target area. and establishing a framework for the development of a prototype central platform and an information network for the exchange of PHR systems between people and healthcare unit. Development system for connecting and retrieving data for display on smart phone. And central cloud development for interoperability between the different databases. Including designing user interface on the Mohpromt application. The results showed that The electronic personal health record should be Hybrid or Interconnected that can display the healthcare treatment and able to record health data by themselves. Developing program on Mohpromt platform which supports collaboration from multiple departments. Standards data and level of information to be displayed on the application in 3 levels: 1.) General information is the basic that shown immediately after registering Mohpromt application. 2.) Health information for individual That must go through a verification process and verify their identity before accessing and 3.) Treatment information for Healthcare Provider to view history treatment from others and must be obtained permission from the data’s owner before accessing. Personal health data is connected and retrieved between the COVID-19Vaccine management program and various hospital information systems via API to display on the Mohpromt application with more than 1,000 healthcare units. covering both the target group in region 9 and others. Established data governance regarding to the collection and use of personal data in limited According to the Personal Data Protection Act. Application evaluation divided into two aspects: satisfaction on technical quality and application content. Evaluation results from 100 users in region 9 in terms of technical quality and application content. Application development results in terms of technical quality and application content overall, it was a high level (x = 4.14) and users were satisfied with the PHR on the application overall, it was at a very good level (x = 4.89). The overall rating for the application, from 1 to 5 points, users gave an average score of 4.22 and satisfaction with the PHR menu on the application very favorably. 95 percent of users want to use PHR menu and will recommend the others. and suggested that other health behavior data should be recorded manually.


location: , 'Thailand year: 2009 source: HSRI

title: 1,3-Butadiene

abstract: The chemical 1, 3-butadiene is used primarily in the production of synthetic rubber and polymers. It
is a carcinogen, although the International Agency for Research on Cancer has not determined the affected
organ(s). This article reviews the production, exposure, exposure assessment, biomarker of exposure
and biomarker of effect of butadiene.


location: , 'Thailand year: 2008 source: HSRI

title: Remodeling health behavior among high-risk civil servants in Prayuen district, Khon Kaen province

abstract: The objective of the study was to evaluate the effectiveness of the remodeling of
health behavior programme. Participants included 118 civil servants of Prayuen district,
Khon Kaen Province. The programme consisted of lectures and behavioral remodeling
activities lasting two days and one night. Data collection was performed before and six
months after programme implementation. Six areas of health behavior according to the
Ministry of Public Health policy were measured by conducting interviews. Measurement
of blood pressure, body mass index, and blood sugar level were also performed. It revealed
that, at six months after programme implementation, the participants consumed less sugar, took more fish and decreased the amount of food consumed at dinner time,
at significantly different levels than before they began participating in the programme
(p-value = 0.03, 0.02 and 0.01, respectively). They also spent more time in performing
routine physical exercises, taking care of the sanitary environment and recycling garbage
(p-value = 0.01, 0.03 and 0.01, respectively). Significant improvement in physical examination
results were shown in terms of blood pressure (p-value = 0.02) and pulse rate
(p-value = 0.03). However, no significant differences were found in the following variables:
taking raw meat, participating in a health club, controlling emotions, eradicating
disease carriers, treating waste water, practicing protective measures against diseases,
practicing harmful behaviors that would lead to ruin and changes in body mass index.
More studies are needed to understand these unhealthy behaviors and to find appropriate
resolution.


location: , 'Thailand year: 2017 source: HSRI

title: New approaches in early detection of pre-cancerous lesions, early cervical cancer and human papillomavirus related diseases

abstract: Overexpression of human papillomavirus (HPV) 16 oncogenic protein E6 and hypermethylation of HPV16 L1 gene are of interest as biomarkers for cervical cancer progression. Immunochromatography (IC) and enzyme-linked immunosorbent assay (ELISA) are widely used to detect target biomolecules in human. In this study, we developed IC and ELISA assays to detect viral oncoprotein E6 and L1 gene methylation of HPV16 in cervical cells, respectively. The conjugated gold coated with protein G and mouse monoclonal anti-HPV16E6+HPV18E6 was optimized and can detect as low as 312.5 nanogram of HPV16 E6 purified protein using 0.5 microgram of antibody to E6 coated on strip in phosphate Buffer/0.05% Tween 20/1% BSA, pH 7.4 as running buffer. Positive band can also be detected in protein extraction from cervical cell lines containing HPV16 at least 1x105 cells. Nonspecific band was not detected when other types of HPV positive cell line and HPV negative cell line as well as bacterial cell lysate were used in the assay. The remaining cervical cells samples obtained from routine laboratory were used to evaluate the performance of the developed assay. HPV negative samples or other high-risk HPV types other than HPV16 and 18 showed negative results. HPV16 positive samples showed 40%, 22.22%, 50%, 28.6% and 18.18% positive results by IC in squamous cell carcinoma, CIN3, CIN2, CIN1 and inflammation/ASCUS groups, respectively. HPV16 L1 gene methylation status was first detected using bisulfite treated DNA and pyrosequencing assay was used for quantification of methylation. Hypermethylation was detected in cervical cancer but was low in normal/CIN1 lesions. CpG sites 5600 and 5609 are highly methylated compared to other CpGs. Indirect and sandwich ELISA were developed to detect HPV16 L1 gene methylation status using specific oligonucleotide probe for HPV16, however, it was not successful in developing sandwich ELISA assay. Indirect ELISA showed high background when oligonucleotide probe was present with other reagents in the absent of HPV16 positive DNA. Other system without oligonucleotide probe in the present of all reagents revealed low background. Optimization of blocking reagents, oligonucleotide probe concentration, streptavidin concentration, anti-5-methylcytosine dilution and incubation time were not successfully reduced the background. The ELISA assay was not yet developed successfully, however, troubleshooting will be further performed to reduce the background and can be further tested for specificity and sensitivity and will be applied in clinical samples


location: , 'Thailand year: 2017 source: HSRI

title: Research and Development of data visualization system for the national health examination survey data on the internet: phase 2

abstract: Development of data visualization system for the National Health Examination Survey data on the internet is a data presentation platform in addition to traditinal survey report. Users of the system can access via the internet and can select data and related variables for comparision as well as compare data over time between survey rounds. The National Health Examination Survey data used in this system consists of 3 rounds including the 3rd round in 2004, the 4th round in 2009 and the 5th round in 2014. This data visualization system presents 17 groups and 63 lists of outcome data. There are 3 types of outcome data consisting of proportion, multinomial proportion and mean. Data analysis for preparing data to be used in data visualization system is pre-calculated data from individual survey data for each survey round. It is a semi-automated process using ready-to-use command scripts that create summary tables to be further imported into the data visualization system. The design and development of data visualization system focuses on the flexibility of data selection and variables selection for disaggregation that can be 1 variable or 2 variables for presenting one particular round of survey data or one variable for presenting overtime comparison across 2 or 3 survey rounds. The variables for disagregation consist of sex, age group, region and administrative type of area. The data presentation is in form of bar chart for proportion and mean while stack bar chart is used for multinomial proportion. Graphs created by the system can be exported into image file, document file and spreadsheet file (Excel) for futher use in other platform. The system also provides the number of samples for each data disaggregated by selected variables for further use and reference. The aspect and use of data can be various such as indicating target population and area for each health problem, indicating distribution of severity of selected health problem and indicating trend of health problems over time. The access and use of the system covers general users as well as specific technical users related to specific health topics or health systems. Data presented in the system can be extended to further health movement and relevant policy recommendation. For system maintenance and updating of survey data in the future, the system allows modification and addition of new data by adjusting reference table and variables. The command script for preparing and analyzing data is semi-automated process creating new summary data for importing into data visualization system on the internet without need for development of new system.


location: , 'Thailand year: 2018 source: HSRI

title: Foreigners Employed as Hospital Workforce in Thailand

abstract: The aims of the present descriptive study of foreigners being employed as hospital workforce in Thailand were to explore the characteristics of foreign hospital employees, factors influencing decision making of foreigners seeking employment in Thailand, the process of being employed as foreign hospital employees, and problems or obstacles encountered while working in Thailand. One hundred foreign hospital employees in both government and private hospitals in Thailand were recruited using snowball sampling. A questionnaire was used for data collection. The data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. The results revealed that most participants were females with the mean age of 31.23 years. One-third of foreign hospital employees were the Filipinos. Success factors of being employed in Thailand included level of education (68%), competencies/special skills in needed fields (64%), and ability to communicate in Thai (55%). Factors influencing foreigners making decision to work in Thailand covered both push factors (such as low wages, limited career progression, unfair benefits, and high living expenses) and pull factors (including gaining new experience, job opportunities, and opportunity to improve career). The processes for being employed as foreign hospital employees included 1) preparation phase: foreigners prepared on language, working knowledge and employment laws, and health check-ups 2) application phase: most foreigners applied for a job themselves after receiving information. A tourist visa was initially granted at first arrival in Thailand and then changed to a non-immigrant visa “B”. The expenses of application phase included a visa, passport, work permit, and travel. Most participants (93%) were working as medical service assistants, such as interpreters and 7% were qualified to work as health care providers as described under the mutual recognition arrangement (MRA). Communication in Thai, adjusting to social and cultural differences, unfair wage, visa and work permit renewal were indicated as problems or obstacles encountered while working in Thailand. The recommendations from the present research were as follows: 1) stakeholders should revise the process of work permit renewal, and MRA; 2) the organization or employer should provide a basic training program in healthcare competencies, and improve workplace culture, including setting up appropriate remuneration system as international standard and equity basis.


location: , 'Thailand year: 2018 source: HSRI

title: The use of [F-18]Florbetapir ([F-18]-AV-45) PET to assess brain amyloid deposition in Alzheimer’s disease, mild cognitive impairment and normal aging

abstract: Objectives To evaluate the use of [F-18]Florbrtapir PET scan in assessing brain amyloid deposition in Alzheimer’s disease, mild cognitive impairment and normal aging and the correlation between brain amyloid deposition in PET scan and results from neuropsychological test, MRI brain and [F-18]FDG PET scan. We also aimed to evaluate the correlation between [F-18]Florbetapir PET scan results and changes in neuropsychological test, MRI brain and [F-18]FDG PET scan results. Conclusion Our results found a significant, high correlation between all imaging techniques using [F-18]Florbetapir and clinical diagnosis and neuropsychological test results, which the highest correlation was detected with [F-18]FDG PET followed by [F-18]Florbetapir PET and MRI, respectively. There were also significant and high correlation amongst imaging techniques. However, correlation between baseline and changes of these imaging results with changes in clinical symptoms as well as neuropsychological performances are still needed to be followed.


location: , 'Thailand year: 2008 source: HSRI

title: Treatment of HIV-infected and AIDs patients at Ladbualuang hospital, Phra Naknon Sri Ayutthaya province

abstract: The research objective was to study the effectiveness of antiretroviral (ARV) drugs
and the effective technique in taking care of HIV-infected and AIDS patients. The research
sample comprised 50 HIV-infected and AIDS patients taking ARV drugs. The
scope of the study included their sex, age, occupation, and time period before starting to
take ARV, history of ARV drug usage, CD4 levels before and after treatment, drug side
effects, prevalence of opportunistic infections, causes of changing drug formula, and
mortality rate; all data were analyzed by descriptive statistics. The result of the research
showed no difference among male and female subjects, whose age ranged from 30 to 39
years. Previous occupations were employees and industrial workers. The CD4 response
study disclosed that the group of subjects who had CD4 levels of 0-100 cells/mm3 had changed little from previous levels after the patients had taken drugs until the end of 24
months, with the highest CD4 level average being 68 cells/mm3. The second group had
CD4 levels of 101-200 cells/mm3; the CD4 level average increased until the patients had
taken drugs at the end of 24 months with the average being 173 cells/mm3. The third
group had CD4 levels of >200 cells/mm3; the CD4 level continued to increase when the
patients had taken drugs at the end of 24 months, with the highest average being 447.55
cells/mm3. The study about their weight found that it clearly changed and that about
opportunistic infections found that the most frequent were cryptococcosis (8%) and PCP
(6%). The change in drug formula was because of drug side effects. The study about
adverse drug reaction found that the most frequent were rash (8%) and hepatitis (6%).


location: , 'Thailand year: 2013 source: HSRI

title: Impact of Elective Surgery in Private Hospitals under the Civil Servant Medical Benefit Scheme (CSMBS) on the Health System

abstract: Since May 2011, CSMBS patients have been allowed to get certain elective surgeries in accredited
private hospitals. The scheme pays private hospitals by case-based payment, Diagnosis Related Group
(DRG), and the hospitals can charge extra for bed and board and doctor fee. This study aims to assess
utilization trend of CSMBS patients for certain elective surgeries in both public and private hospitals prior
to and after policy implementation, and its impacts on service utilization of UCS members, efficiency of
service provision, and burden of expenditure on patients and the scheme. Claim administrative databases
of the CSMBS and UCS were employed in the analysis.
Results reveal that Intraocular Lens (IOL) Replacement for cataract was major procedure used in
private hospitals, 80%, followed by childbirth (5%) and knee replacement (3%). the number of patients
receiving IOL has been prominently increased following the policy. This was due to relatively high payment
rate for IOL, active screening for patients with cataract in communities together with no co-payment
policy and free transportation provided by one private hospital chain who was major provider under this
policy (74% of cases). Shifting of CSMBS patients to private hospitals let public hospitals having more
available beds and doctor’s time for UCS patients. The numbers of childbirth and knee replacement in
private hospitals under the policy were low due to lack of active marketing, relatively high copayment
especially for knee replacement. Negative impact on public hospitals located in provinces where many
patients got care from private hospitals was not found. Under prospective payment system, private hospitals
were more efficient in managing resources. Private hospitals selected better paid procedures in the
provision; moreover, there was huge variation in the level of copayments for same procedure of different
private hospitals. The policy increased expenditure on private inpatient care; however, it did not affect
overall expenditure of the scheme.
In conclusion, the policy increased access to IOL replacement for cataract patients among CSMBS
members; however, monitoring and evaluation system should be strengthened before scaling up the program.


location: , 'Thailand year: 2015 source: HSRI

title: Infection control nurses networking for knowledge sharing Associated/in Nosocomial Infection Control Chiang Mai Province

abstract: Background : Quality of infection control in primary care center is very important for community health. The study aimed to develop the primary health center networks of infection control in Chiang Mai province.
Methods : An intervention study was conducted. Two hundred and sixty nine primary health centers were included the study. The interventions were a quality infection control network in Chiang Mai, group discussion for knowledge sharing and infection control guideline manual for primary health centers. Quantitative and qualitative data were collected and analyzed in order to describe impact of the intervention and factors associated successful of the network.
Result : The primary health center networks of infection control in Chiang Mai province were developed. During 17th Apr – 15th Dec 2014, The intervention was implemented to 150 of 269 primary care centers (55.78%). The intervention strengthened the network and improved infection control knowledge of study population.
Conclusion : Infection control nurses networking for knowledge sharing associated/in nosocomial infection control Chiang Mai province was developed by a quality infection control network in Chiang Mai. The effectiveness of the intervention and factors associated successful of the network are studying.


location: , 'Thailand year: 2023 source: HSRI

title: Efficacy of Pharmacotherapy and Non-Pharmacotherapy of Alzheimer Dementia: A Systematic Review and Network Meta-Analysis

abstract: Background: Alzheimer’s disease (AD) is the most common cause of dementia worldwide. Despite the publication of numerous systematic reviews and meta-analyses that have summarized the evidence associated with pharmacotherapies (PTs) and non-pharmacotherapies (NPTs) for the wide range of interventions available for AD treatment, the implementation of PTs and NPTs in the real-world practice is limited. Due to PTs have frequent adverse reactions causing poor drug adherence and NPTs have various approaches which result in difficult to get accessed by the AD patients. Additionally, their comparative safety and efficacy remains insufficiently defined. Methods: The systematic reviews of randomized controlled trials (RCTs) and meta-analysis (MA) is identified through PubMed and Scopus from March 2021 to December 2022. The RCTs are selected according to the following criteria: conducted in elderly patients aged 60 years or older with AD living in community or institutionalized settings, applied pairwise meta-analysis (PMA) or network meta-analysis (NMA) approaches providing pooled relative treatment effects for at least one pair of PTs or NPTs, and providing at least one of the following outcomes for patients/caregivers: cognitive, functional status, behavior, quality of life and caregiver stress or burden. We used Revised Cochrane Risk-of-bias tool for Randomized Trials (RoB2) to assess quality and risk of bias in all articles by two dependent reviewers. The two stage NMA is performed and relative treatment effects e.g. standardized mean differences (SMD), unstandardized mean differences (UMD), odd ratios (OR) or relative risks (RR) and variance will be estimated for individual RCTs and pooled across RCTs using STATA 17 Results: Of 2,060 citations of systematic review and MA screened, 282 studies (37,399 people with AD) were included. In the NMA of PTs, PTs+NPTs (122 studies; 26,977 people with AD) found that donepezil+cognitive training (CT) Mini-mental state Examination (MMSE): mean differences (MD) = 5.56 [95% confidence interval (CI) = 4.05, 7.06], Huperzine-A (4.00, 95% CI =1.48, 6.52), Memantine+huperzine (2.58, 95%CI = 1.24, 3.92) improved cognition more than placebo. NMA also found rivastigmine+cognitive stimulation (CS) Neuropsychiatric inventory: MD = -11.54 (95%CI = -18.70, -4.37), Gingo biloba extract (Egb761) (-7.36, 95%CI = -10.64, -4.08), donepezil+memantine (-4.86, 95%CI = -9.42, -0.29) improved behavior more than placebo. The combination of PTs and NPTs; Rivastigmine+CS (MD = 0.92, 95%CI 0.39, 1.44) were also significant interventions that improve functional status (ADL) more than placebo. Regarding to the NMA of NPTs (160 studies; 10,422 people with AD) found that non-invasive brain stimulation (MMSE: MD= 2.45, 95%CI = 1.04, 3.86), CT (1.89, 95%CI = 1.00, 2.78), exercise (1.77, 95%CI = 0.44, 3.10) improved cognition more than usual care. In addition, exercise was associated with functional outcome improvement (0.93, 95%CI = 0.18, 1.68), reducing behavioral problems (-4.52, 95%CI = -8.37, 0.67), and caregiver stress (SMD = -0.69, 95% = -1.28, -0.09) comparing to usual care. NMA of NPTs also discovered that occupational therapy (OT) is the most efficacious to reduce behavior problems (MD = -11.04, 95%CI = -18.82, -3.25) and improve the quality of life (QOL) in AD patients (SMD = 1.00, 95%CI = 0.41, 1.59). Conclusion: In this systematic review and NMA, pharmacotherapies combined with non-pharmacotherapies were found to be most efficacious for improving cognition, functional status and reducing behavior problems in people with AD. The policy makers can support AD patients, caregivers and clinicians in developing health services that enable implementation of NPTs such as exercise, occupational therapy, cognitive training, and cognitive stimulation.


location: , 'Thailand year: 2015 source: HSRI

title: Epidemiological Study of Chronic Kidney Disease Progression:  A large-Scale Population-Based Cohort Study

abstract: Aims/hypothesis: The prognostic information about CKD progression, particularly for GFR categories 1 and 2, is still limited. This cohort was therefore conducted to determine the CKD progression using a competing risk approach.
Methods: We conducted an ambi-directional cohort study linking community health screening with hospitals and death registry data in a province of Thailand, from 1997-2011. A competing risk model was applied by treating death as a competing risk factor to estimate 2-, 5-, and 10-yearprobability of kidney failure and median time for CKD progression from lower to higher GFR category.
Results: There were 17,074 non-diabetic and 15,032 diabetic CKD subjects. Diabetic subjects progressed more rapidly through GFR categories with the median times for CKD progression from GFR categories G1 to G2, G2 to G3a, G3a to G3b, G3b to G4, and G4 to G5 of 4.4, 6.1, 4.9, 6.3, and 9.0 years, respectively. Non-diabetic subjects took longer to progress with the corresponding median time of 9.4, 14.0, 11.0, 13.8, and >14.3 years. After adjusting for confounders, diabetic subjects were 49% (cause-specific hazard ratio (csHR=1.49, 95% CI: 1.37, 1.62) more likely to develop kidney failure than non-diabetic subjects. Albuminuria categories A3 and A2 were respectively 3.40 (95% CI: 3.07, 3.76) and 1.71 (95% CI: 1.53, 1.92) higher risk of kidney failure when compared to A1. For each albumin category, death rate increased as albuminuria increased particularly in diabetic subjects, which was approximately two times higher in A3 compared to A1.
Before 2008 (when the “PD first” project was launched), an access rate to renal replacement therapy for kidney failure patients belonging to the universal coverage scheme, civil servant medical benefit scheme, and social security scheme were 1%, 14%, and 18% respectively. The corresponding access rates rose to 25%, 43%, and 56% after 2008. Subjects with kidney failure who were members of the universal coverage scheme had increased risk of death when compared to the other 2 schemes.
Conclusions: Diabetic subjects progress through GFR and albuminuria categories and reach kidney failure about twice as rapidly as non-diabetic subjects.Although an access rate to renal replacement therapy among 3 health insurance schemes has consistentlyincreased since 2008, members of the universal coverage scheme still had substantially lower access rate when compared to the other 2 schemes. Further study assessing factors contributing to such low access rate and comparing CAPD and hemodialysis should be conducted.


location: , 'Thailand year: 2018 source: HSRI

title: Factors Related to Blood Sugar Control among Diabetes Mellitus Type 2 Patients

abstract: This study was a cross-sectional survey research that aimed to study the factors related to blood sugar level among diabetes mellitus type 2 patients. The sample consisted of 400 patients who visited outpatient department at hospitals in Satun province during March until May 2017. The instruments for data collection comprised 5 parts: (1) personal information, (2) information on treatment patterns, (3) results of the treatment, (4) knowledge on diabetes, and (5) self-care behaviors of 58 items. Data were analyzed by using binary logistic regression. The results showed that 25.0 per cent of diabetes mellitus type 2 patients were able to control blood sugar levels (HbA1c <7). The occupation and self-care behaviors were significant factors correlated with blood sugar control at the 0.05 level. Diabetes mellitus type 2 patients who did not have occupation were 2.71 times more likely to control blood sugar (HbA1c <7) than those who had occupation (ORadj = 2.71, 95% CI = 1.19-6.17). Likewise, diabetes mellitus type 2 patients who had low level of health care behaviors were 0.54 times less likely to control blood sugar (HbA1c <7) than those who had high level of health care behaviors (ORadj = 0.54, 95% CI = 0.29-0.99). Therefore, public health personnel must emphasize and develop a pattern of caring for type 2 diabetes mellitus patients, especially in those with no occupation and low level of health care behaviors to better control blood sugar level.


location: , 'Thailand year: 2022 source: HSRI

title: Preparedness and Responsiveness toward Covid-19 Epidemic at the Religious Institutions, Nakhon Si Thammarat Province

abstract: Religious places are sacred places where people come to perform important religious activities according to their respect and faith. However, this gathering could increase the risk for the transmission of COVID-19 through the respiratory route. In this study, the participatory action research was done in 9 religious places, including Buddhism, Christianity, and Islam, in Mueang and Tha Sala Districts, Nakhon Si Thammarat Province. A total sample of 202 people (from 9 studied places and other extended religious places) was recruited. The results found that religious places changed the form of the prevention of the COVID-19 in different ways during the pandemic. However, measures that all religious places must implement and comply with are the VUCA (Vaccine, Universal Prevention, COVID Free Setting and ATK), DMHTTA (Distancing, Mask Wearing, Hand Washing, Temperature, Testing and Application Thaichana), and environmental health measures. Moreover, when considered in the context of each religion, the developed guideline will include practical recommendations for people in charge of religious places, priests, people, and important religious activities.


location: , 'Thailand year: 2023 source: HSRI

title: A Health Promotion Program for Improving Weights, Body Mass Indexes, and Body Compositions among Individuals with Non-communicable Diseases in Thailand: RE-AIM Model and Financial Feasibility Study

abstract: Background: Non-communicable diseases (NCDs) are serious health issues in many countries. This paper aimed to evaluate a wellness center or health promotion program using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework and to investigate financial feasibility of NCDs prevention and promotion program in Thailand. Methodology: A retrospective plus interview study was used in this paper. Data were obtained from two wellness centers in public hospitals, Thailand. RE-AIM model was used to evaluate the program. Financial feasibility was performed with the home exercise and fitness center models based on financial and service assumptions. Results: A total of 217 participants were included in this study. After attending the prevention and promotion program for more than two months, the participants’ body weights and body mass indexes reduced significantly. Regarding the RE-AIM framework, the wellness centers reached target groups and continued providing services in the public hospitals. In terms of a financial feasibility study, the model could break-even in the first year (0.36 year for home exercise, while a fitness center model was 5.44 years with a fee of 4,500 THB per person). For the internal rate of return (IRR), both models showed positive investment. Discussion: RE-AIM model indicated that the wellness centers successfully reached its target groups. The findings provided a positive outcome and positive investment by financial feasibility study despite small sample size. Further studies are recommended to involve more hospitals to improve the generalizability of our findings.