Factors Influencing Patient Health Behaviors for Delaying the Progress in Stage 3 - 4 Chronic Kidney Disease Patients at Khlongkhlung Hospital, Khampangphet Province

Objective: To determine level of health behaviors for delaying chronic kidney disease (CKD), functional health literacy, self-efficacy perception and social support acquisition, and factors that influenced the health behaviors for delaying CKD progression in patients with CKD stage 3 and 4. Method: This predictive correlation research included a sample of 240 stage 3 and 4 CKD patients, who were treated at CKD Clinic, Khlongkhlung Hospital, Khampangphet province. The study instrument was self-administered questionnaire. The obtained data were analyzed by descriptive statistics and step-wise multiple regression analysis. Results: The study population possessed functional health literacy, self-efficacy perception, social support acquisition and health behaviors for delaying CKD progression at the highest level. Results from the step-wise multiple regression analysis revealed that factors of self-efficacy perception, social support acquisition, mean monthly income and functional health literacy together could predict 27.00% (R2 = 0.270) of the health behaviors for delaying CKD progression with statistical significance (P-value < 0.001). The best factor that could predict health behaviors for delaying CKD progression was perceived self-efficacy (b = 0.321, P-value < 0.001), social support acquisition (b = 0.177, P-value = 0.006), mean monthly income (b = -0.158, P-value = 0.006) and functional health literacy (b = 0.143, P-value = 0.023). Conclusion: Public health professionals should promote the increase in the level of perceived self-efficacy and health literacy in CKD patients, as well as encourage families to be part of patient care, to better health behavior change for delaying CKD progression. Keywords: health behavior, chronic kidney disease, health literacy, self-efficacy, social supportบทคัดย่อ วัตถุประสงค์: เพื่อศึกษาระดับพฤติกรรมสุขภาพเพื่อชะลอไตเสื่อม ความแตกฉานด้านสุขภาพขั้นพื้นฐาน การรับรู้สมรรถนะแห่งตน การได้รับแรงสนับสนุนทางสังคม และปัจจัยที่มีผลต่อพฤติกรรมสุขภาพเพื่อชะลอไตเสื่อมของผู้ป่วยโรคไตเรื้อรังระยะที่ 3 - 4 วิธีการศึกษา: การวิจัยหาความสัมพันธ์เชิงทำนาย (Predictive correlation research) มีกลุ่มตัวอย่างคือ ผู้ป่วยโรคไตเรื้อรังระยะที่ 3 - 4 ที่มารับบริการที่คลินิกโรคไตเรื้อรัง โรงพยาบาลคลองขลุง จังหวัดกำแพงเพชร จำนวน 240 ราย เครื่องมือวิจัยเป็นแบบสอบถามที่ตอบด้วยตนเอง วิเคราะห์ข้อมูลโดยใช้สถิติเชิงพรรณนา และการวิเคราะห์ถดถอยพหุคูณแบบขั้นตอน (Step-wise multiple regression analysis) ผลการศึกษา: กลุ่มตัวอย่างมีระดับความแตกฉานด้านสุขภาพขั้นพื้นฐาน การรับรู้สมรรถนะแห่งตน การได้รับแรงสนับสนุนทางสังคม และพฤติกรรมสุขภาพเพื่อชะลอไตเสื่อมโดยรวมอยู่ในระดับสูงมากที่สุด ผลการวิเคราะห์ถดถอยพหุคูณแบบขั้นตอน พบว่าการรับรู้สมรรถนะแห่งตน การได้รับแรงสนับสนุนทางสังคม รายได้เฉลี่ยต่อเดือน และความแตกฉานด้านสุขภาพขั้นพื้นฐานสามารถร่วมกันทำนายพฤติกรรมสุขภาพเพื่อชะลอไตเสื่อมได้ร้อยละ 27.00 (R2 = 0.270) อย่างมีนัยสำคัญทางสถิติ (P-value < 0.001) โดยการรับรู้สมรรถนะแห่งตนสามารถทำนายพฤติกรรมสุขภาพเพื่อชะลอไตเสื่อมได้ดีที่สุด (b = 0.321, P-value < 0.001) รองลงมา ได้แก่ การได้รับแรงสนับสนุนทางสังคม (b = 0.177, P-value = 0.006) รายได้เฉลี่ยต่อเดือน (b = -0.158, P-value = 0.006) และความแตกฉานด้านสุขภาพขั้นพื้นฐาน (b = 0.143, P-value = 0.023) ตามลำดับ สรุป: การส่งเสริมพฤติกรรมสุขภาพเพื่อชะลอไตเสื่อมของผู้ป่วยโรคไตเรื้อรังระยะที่ 3 - 4 สามารถทำได้โดยเพิ่มการรับรู้สมรรถนะแห่งตนในผู้ป่วย ส่งเสริมให้ครอบครัวมีส่วนร่วมในการดูแลผู้ป่วย และสร้างความแตกฉานด้านสุขภาพในกลุ่มผู้ป่วยโรคไตเรื้อรังเพื่อให้มีการปรับเปลี่ยนพฤติกรรมสุขภาพอันจะนำไปสู่การชะลอไตเสื่อมต่อไป คำสำคัญ: พฤติกรรมสุขภาพ, โรคไตเรื้อรัง, ความแตกฉานด้านสุขภาพ, สมรรถนะแห่งตน, แรงสนับสนุนทางสังค

To Switch or Not to Switch Payment Scheme? Determinants and Effects in a Bargaining Game

The incentive scheme selected in a laboratory experiment might trigger different type of behavior in participants. This paper is an attempt to screen the strategies adopted by agents in a bargaining game when buyer and seller have partly conflicting interests and are asymmetrically informed. We allow participants to choose the incentive scheme through which they will be paid at the end of the experiment controlling for past experience and individual characteristics. It is well known that payment method is highly correlated to the risk preferences shown by individuals, but little research is devoted to the analysis of the behavior induced by Random Lottery Incentive scheme (RLI for short) and Cumulative Scheme payment (CS for short) both on individual and social results. This paper aims to fill the gap

CHEMICAL COMPOSITIONS AND BIOLOGICAL PROPERTIES OF ESSENTIAL OILS FROM ZANTHOXYLUM RHETSA (ROXB.) DC AND ZANTHOXYLUM LIMONELLA ALSTON

Background: Zanthoxylum rhetsa (Roxb.) DC and Zanthoxylum limonella Alston are spices for flavouring in indigenous Thai food. They are traditionally used as an aromatic, astringent, antimicrobial, antiseptic and antidiabetic agent. The purpose of this study is to examine their chemical compositions and evaluate antibacterial, antioxidant and anticancer properties of the essential oils. Materials and Methods: The essential oils of Z. rhetsa and Z. limonella were analysed for phytochemical constituents by Gas chromatography–mass spectrometry (GC-MS). The antibacterial activity was determined against several bacteria using the microdilution method. Antioxidant capacity was determined by free radical scavenger 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and 2, 2-azinobis-3-ethyl-benzothiazoline-6-sulfonic acid (ABTS) methods. The anticancer activity was determined with two breast cancer cell lines (MCF-7 and MDA-MB-231) and the normal African green monkey kidney epithelial (Vero) cell line and using MTT assay. Results: Sabinene (22.51%) and terpinene-4-ol (32.33%) were found to be major components of Z. rhetsa essential oil while limonene (57.94%) and alpha-phelladrene (15.54%) were the major components of Z. limonella essential oil. Essential oil from Z. limonella exhibited broad spectrum antibacterial activity. Z. rhetsa and Z. limonella essential oils exhibited moderate antioxidant activity. The essential oil from Z. rhetsa possessed the ability to inhibit breast cancer cell (MCF-7 and MDA-MB-231) proliferation and cell viability. Conclusion: This study suggest that the essential oils from Z. limonella and Z. rhetsa could be applied as safe antibacterial and antioxidant agents for food and have the potential for further development of new anticancer agents

A novel synthetic bandage for corneal wound repair

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A cost-effectiveness study of intravenous immunoglobulin in childhood idiopathic thrombocytopenia purpura patients with life-threatening bleeding

Background: Although the international guideline recommends intravenous immunoglobulin (IVIG) as the first-line treatment for childhood idiopathic thrombocytopenia purpura (ITP) with life-threatening bleeding, ITP patients may not be able to access IVIG because of the limitation in health benefit packages especially in developing countries. There remains an important policy question as to whether IVIG used as a first-line treatment is worth the money spent. Thus, the objective of this study was to perform a cost-effectiveness analysis of adding IVIG to the standard treatment of platelet transfusion and corticosteroids, for the treatment of childhood ITP with life-threatening bleeding in the context of Thailand. Methods: A cost-effectiveness analysis using a hybrid model consisting of a decision tree and Markov models was conducted with a societal perspective. The effectiveness and utility parameters were determined by systematic reviews, while costs and mortality parameters were determined using a retrospective electronic hospital database analysis. All costs were presented in 2012 US$. The discount rate of 3$3,172 per quality-adjusted life-year gained ($/QALY) for the addition of IVIG versus standard treatment alone. The probability of response to corticosteroids was the most influential parameter on ICER. According to the willingness-to-pay of Thailand, of approximately$3,861/QALY, the probability of IVIG being cost effective was 33 %. Conclusions: The addition of IVIG to standard treatment in the treatment of childhood ITP with life-threatening bleeding is possibly a cost-effective intervention in Thailand. However, our findings were highly sensitive. Policy makers may consider our findings as part of the information for their decision making

Quality of reporting of randomised controlled trials of herbal interventions in ASEAN plus six countries: a systematic review

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Additional items assessed for the quality of reporting of randomised controlled trials of herbal interventions in ASEAN Plus Six Countries.

<p>95% CI: 95% Confidence Intervals ∧Unable to compute (the value(s) of the variable was zero).</p><p>Additional items assessed for the quality of reporting of randomised controlled trials of herbal interventions in ASEAN Plus Six Countries.</p

Flow chart of the identified articles, the screening and inclusion process.

<p>Flow chart of the identified articles, the screening and inclusion process.</p

Characteristics of databases.

<p><b><i>Note</i>: AED</b>, Adverse Effects Database; <b>BMI</b>, Body Mass Index; <b>BN</b>, Bureau of Nutrition Department of Health; <b>BNCD</b>, Bureau of Non-Communicable Disease; <b>BP</b>, Blood Pressure; <b>BPS</b>, Bureau of Planning and Strategy; <b>BRFSS</b>, Behavioral Risk Factors Surveillance System; <b>CA,</b> Cancer; <b>CBC</b>, Complete Blood count; <b>CGRN</b>, ConvergenceCT Global Research Network; <b>COPD</b>, Chronic Obstructive Pulmonary Disease; <b>CR</b>, Cancer Registry; <b>DM</b>, Diabetes Mellitus; <b>DMH</b>, Department of Mental Health; <b>EBMP</b>, Medical Data Vision EBM Provider^®;<b>EKG,</b> Electrocardiography; <b>ESRD</b>, End-Stage Renal Disease; <b>FBS</b>, Fasting Blood Sugar; <b>FSR</b>, The Fukuoka Stroke Registry; <b>HAT</b>, The Heart Association of Thailand under the Royal Patronage; <b>Hb</b>, Hemoglobin;<b>HbA1c</b>, Hemoglobin A1c;<b>Hct</b>, Hematocrit; <b>HDL</b>, High-density Lipoprotein; <b>HFCT</b>, Heart Failure Council of Thailand; <b>HIV/AIDS</b>, Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; <b>HPVC</b>, Health Product vigilance Center Thai FDA;<b>HSRI</b>, Health System Research Institute; <b>HTN</b>, Hypertension; <b>HWS</b>, Health and Welfare Survey; <b>IHD</b>, Ischemic Heart Disease; <b>IMS NPA</b>, IMS NPA data; <b>JARM DB</b>, Rehabilitation Patients Database; <b>JARM</b>, the Japanese Association of Rehabilitation Medicine; <b>JDPC</b>, The Japanese Diagnosis Procedure Combination database; <b>JMDC</b>, Japan Medical Data Center Claims Database; <b>JMIRI</b>, JMIRI Pharmacy Claims DB; <b>JPIC</b>, Japan Pharmaceutical Information Center; <b>JSTAR</b>, Japanese Study of Aging and Retirement; <b>LDL</b>, Low-density Lipoprotein; <b>Mdevice</b>, Database of Medical Device; <b>MEDIS-DC</b>, Medical Information System Development Center; <b>MHLW</b>, List of Statistical Surveys conducted by MHLW;<b>MHLW</b>, Ministry of Health, Labor and Welfare; <b>MICS</b>, Multiple Indicator Cluster Survey; <b>NCI</b>, National Cancer Institute; <b>NCPCDB</b>, NIHON CHOUZAI Pharmacy Claims DB; <b>NDS</b>, National Disability Survey; <b>NESMH</b>, National Epidemiology Survey on Mental Health; <b>NHES</b>, National Health Examination Survey; <b>NHSO</b>, National Health Security Office; <b>NHWS</b>, National Health and Wellness Survey; <b>NNS</b>, National Nutrition Survey; <b>NSO</b>, National Statistical Office; <b>NST</b>, Nephrology Society of Thailand; <b>OU</b>, Osaka University; <b>PCI</b>, Percutaneous Coronary Intervention; <b>PCU</b>, Primary care unit; <b>PHC</b>, Population and Housing Census; <b>PMDA</b>, Pharmaceutical and Medical Devices Agency; <b>QOL</b>, Quality of Life; <b>RAD-AR</b>, Risk/benefit Assessment of Drug-Analysis & Response; <b>RCPT</b>, The Royal College of Physiatrists of Thailand; <b>RHS</b>, Reproductive Health Survey; <b>RIETI</b>, The Research Institute of Economy, Trade and Industry; <b>SES</b>, Socio-Economic Survey; <b>TC</b>, Total Cholesterol; <b>TDR</b>, Thai Diabetes Registry; <b>TES</b>, Thailand Endocrinology Society; <b>TG</b>, Triglyceride; <b>Thai ADHERE</b>, Thai Acute Decompensated Heart Failure Registry; <b>TPCIR</b>, Thai National Percutaneous Coronary Intervention Registry; <b>TPDR</b>, Thai Parkinson’s Disease Registry; <b>TRC</b>, Thai Red Cross Society; <b>TRRTR</b>, Thailand Renal Replacement Therapy Registry; <b>TSRR</b>, Thai Stroke Rehabilitation Registry</p><p>Characteristics of databases.</p

Economic evaluation of intravenous immunoglobulin plus corticosteroids for the treatment of steroid-resistant chronic inflammatory demyelinating polyradiculoneuropathy in Thailand

Background and Objective: Intravenous immunoglobulin (IVIG) has been recommended for steroid-resistant chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The treatment, however, is very costly to healthcare system, and there remains no evidence of its economic justifiability. This study aimed to conduct an economic evaluation (EE) of IVIG plus corticosteroids in steroid-resistant CIDP in Thailand. Methods: A Markov model was constructed to estimate the lifetime costs and outcomes for IVIG plus corticosteroids in comparison with immunosuppressants plus corticosteroids in steroid-resistant CIDP patients from a societal perspective. Efficacy and utility data were obtained from clinical literature, meta-analyses, medical record reviews, and patient interviews. Cost data were obtained from list prices, an electronic hospital database, published source, and patient interviews. All costs [in 2015 US dollars (US)] and outcomes were discounted at 3\ua0% annually. One-way and probabilistic sensitivity analyses were conducted. Results: In the base-case, the incremental costs and quality-adjusted life years (QALYs) of IVIG plus corticosteroids versus immunosuppressants plus corticosteroids were US2112.02 and 1.263 QALYs, respectively, resulting in an incremental cost-effectiveness ratio (ICER) of US$1672.71 per QALY gained. Sensitivity analyses revealed that the utility value of disabled patients was the greatest influence on ICER. At a societal willingness-to-pay threshold in Thailand of US$4672 per QALY gained, IVIG plus corticosteroids had a 92.1\ua0% probability of being cost effective. Conclusions: At a threshold of US$4672 per QALY gained, IVIG plus corticosteroids is considered a cost-effective treatment for steroid-resistant CIDP patients in Thailand