Elderly’s Health Survey in Nam Phon : A Case Study

An  objective  of  a  descriptive  study  was  to  investigate  health  status  of  elderly  who  resided  in  Nam  Phong,  rural  area.  Study  population  were  all  of  elderly  aged  60  and  over   who  living  in 3  Villages,  Nam  Phong  district,  Khon  Kaen  Province.  Research  instruments  for  data  collection  were  weighing  of  body  weight  and  height  measurement  in order  to  obtain  body  mass  index  (BMI),  stool  examination  for  detecting  parasites  ova,  included  interviewing  with  questionnaire.  A total  subject  was  90 elderly. Result  of  this  study  revealed  that  49.4%  had  BMI  lower  than  normal  which  found  higher  in  males  than  females.  Based  on  BMI  criteria,  there  were chronic  energy  deficiency  23.5%,  obesity  12.3%.  Stool  examination  showed  30.5%  of  elderly  found  parasites.  One  third  (33.3%)  of  elderly  reported  use  of  analgesic  drugs  and  cocktail  drug  (a  set  of  variety  drug  called  “Ya-Chud”).  Approximately  half  of  this  figure  were  drug  abuse.  The  elderly  were  still  at  risk  to  chemical  use  in  agricultural  activities  and  19%  were  smoking  at  work. An  establishing  group  of  elderly  in rural  area  is  recommended  by  the  authors  in order  to  promote  recreation,  helping  and  teaching  each  other,  which  will  be  effective  not  only  physical  health  but  also  mental  health  of  elderly  as  well.

Achievement in Personality and Ethics Development 1st year medical student, 1994 Academic year.

Objective1. To establish and develop personality in order to promote good leadership and member the essential merit and ethics that correlate to the social needs of students.2. To build up and create appropriate values in Thai society among the students themselves especially in terms of unity, affection and a sense of belonging to each other and to the Academic Institute.3. To develop the students in terms of Social, Emotional \& Moral behaviour so that they can adapt to the new society.4. Build up the sensitivity and responsibility of students society and to the country after graduation.Methods – Assigning the students to attend the 2 night camp,s activities.  There was an Analysis lecture of the present situation, social problems and human behaviour.  There was a video show about the Developemtn trends or the ‘new life’ Community Development.  Example of development experiences, leadership and human relations were raised.  There was a planning group meeting, arranging a project, self and family development activities,  The proposal of group and other activities from evaluation by collective observations, interviews and questionaires.  It has been found that to accomplish the target object.  The students program needed to be supplemented \& develop in order to get better personality, leadership and member, good merit \& ethics in society.  Appropriate values had to be emphasized such as unity, affection, relationships with one another, a price in the institute, adaptation to colleaques and the environment.  These values also include the feeling of responsibility for society that effect the entire country in the future. The recommendation from students and lecturers who attended this program is that it should have there activities for the 2 nd year and the 3 rd year students and there should be a chane of locations for demonstration.  The suggested place should be within a walking distance to the campus and provide proper accommodation and a conference room.  Interesting \& effective media should be used.  There main meals should be arranged and the light meal or snack could be reduced.  Public relations procedure should be advertised throughroughly and lecturers should participate in the activities, The evaluation should be done regularly so as to adjust and improve the weak points and consequently become the faculty policy Further more.  The academic program should include the merit and ethical teaching and the supplementary activities should be continuously administered until graduation.

The uses of physical exercise and mental practice for physical healing.

 The uses of physical exercise associated with mental practice for physical healing were conducted through the mobile health service. The objective of the physical healing project were : (1) to study the behavior of villagers concerning their responsiveness to exercise and practice without drug treatment, (2) to practice the techniques which assist patients to reach tranquility, and (3) to promote and motivate patients to use physical exercise and mental practice for stress, strain and exhaustion conditions. The results revealed that the exercise and practice were accepted by the villagers. Such exercise and practice do not go against Thai culture and the faith of  Buddism. Patients who suffered from muscular, nervous, digestive and respiratory system problem found relief from such sicknesses after the exercise and practice were performed.

Health Behavior of Elderly in Khon Kaen Province

 Studies  concerning  socioeconomic  and medical  problems  of  the  elderlies  in  Khon  Kaen  Province,  Northeast  Thailand,  were  conducted  in  1989 – 1990.  The  objectives  of  these  stuidies  were  to  out  nutritional  status,  eating  habit  and  parasitic  infection.   A  tobal  of  464  elderly  persons  from  a  semi – urban  area  and  a  rural  area   of  Khon  kean  Province  were  sampled  by  the  30  cluster  sampling  technique  in  each  area,   The  method  was  composed  of  an  interview  by  structured  questionnaire,  an  in – depth  interview,  a  24 – hour  recall  interview,  stool  examination  and  anthropometry  by  height  and  weight   measurement.  The  results  revealed  theat  most  of  elderly  lived  with  their  relatives  and  or  children  and  had  been  taken  care  by  their  elotives.   Half  of  the  tobal  elderlies  were  widwed  and  primary  school  educated ;  and  22.4  per  cent  were  working ;  66.3  percent  were  smokers  and  most  of  them  were  males ;  37.1  per  cent  were  drinkers.  Seventy – six  per  cent  of  the  total  elderly  group  habitually  chewed  areca   nuts  and   betel  leaves  smeared  with  lime  ;  36.4  per  cent  consumed  improperly   cooked  food. IIIness  prevalence  of  elderly  during  the  previous  2  weeks,  was   fond  that  the  number  of  sick  elderly  in  the  semi – urban  area  was  slightly  higher  than  those  in  the  rural  area.   Curative  behavior  or  health  seeking  behavior  when  getting  ill  of the  elderly  was  found  as  following  :  42.2  percent  went  to  see  a  doctor  at  the  health  station  or  clinic  and 39  percent  had  self  medication. Nutritional  status  of  the  elderly,  using  body  mass  index  (BMI)  calculated  from  weight  and  height  revealed   that  rural  elderlies  were  lean  significantly  much  more  than those in  semiurban  aaea. (BMI

Elderly’s Food Consumption Behaviour In A Rural Area In Northeast Thailand : Study In Non-Com District

 The study was udndrtaken to obtain informaiton about food consumption, food habit and nutritional status of the food eaten by the elderly, The subjects of the study were 82 elderly people (38 men, 44 women) in Sern-Nae village and Pha-Gua village, both in Non-com District , KhonKaen Province, Northeast Thailand. All the villagers aged sixty and over were interviewed. The nutritional status of the elderly was assessed by body mass index (BMI). Semi quantitative of food comsuption in 24 hours was studied in 30 percent of the elderly group (randomly selected). The elderly were asked about foods eaten in the previous 24 hours and also interviewed about food habits. The average age of the subjects was 71 years. They generally lived with Their  famillies and had meals with other members .Foods were cooked by daughters or daughters-inlaw. 43.9 percent of the subjects had a chronic illness. It is traditionally believed that the elderly should not eat raw food. Half of the group had chewing problems that the elderly should not eat raw food. Half of the group had chewing problems. 71 percent were found to have low nutritional status (the average body mass index of this percentage was 19.5 kg/m2 for men and 17.2 kg/m2 for women). Therefore , the elderly had a tendency to be unhealthy and malnurished. Although their food had a low fat content they got enough calories, rotein and iron. Larger amounts of vitamin B1 Vitamin B2 niacin and Vitamin C , which were rather low , should be recommended. Furthermore, to improve the healh of the elderly , the midwives would be a valuable group to use in compaigning and educating the public, Those who prepare food should be educated so that they can prepare appropriate foods for the elderly.

Study groups of mother or relatives whose level of education are higher

 It was believed that more highly educated mothers could take care of their children better than less educated mothers.  Other factors involved the growth development of children during infant and preschool years.  Two villages in Khon Kaen provinces were studied and compared.  The target groups were children below five years and their mothers.  Only mothers in a studied village were given health education.  The result showed that children in a studied village were slightly more developed and healthier than children in a controlled village.  However, when the mothers education levels were compared, data showed that mothers with lower education could look after their children better than those in a higher education group.  This happened in both villages.  It might be that lower educated mothers had more time for their children and tended to follow the local health worker’s teaching.  In contrast the mothers in the higher educated group had more chance to work outside and left children with their cousins.  There fore, this might effect children’s growth development and health.

Development of Appropriate Personality and Ethics in Medical Students.

Background:  The objective of this research was to evaluate the progressive behavior development of fourth and fifth year medical students based on their first to third year attendance at the seminars, “How to develop good personality qualities and ethics.”  The research focused on: 1. Behavioral differences between trained versus previous groups of students who had not been trained. 2. Whether and how the training actually affected student behavior. 3. Development of recommendations for future course.Method:   This was prospective cohort behavioral study.  The data were elicited from fourth and fifth year medical students using questionnaires, direct observations, and informal interviews.  They were compared with the collective subjective judgement of faculty members regarding former students who did not undergo the same training.Results:  Students who passed all of the training sessions had good relationships with teachers, colleagues patients, and family.  The tone of their conversation was positive.  Their behavior (manners and responsiveness to patients) and ethics (capacity to use appropriate medical techniques) were judged to be better than those students who had not been trained. We concluded that since the first three years of training are formative (with eagerness and newness), training in behavior and ethics at this time is well-received; allowing students to prepare themselves for the following more interactive clinical phase of medical education. Notwithstanding, the wholly subjective nature of the comparison of trained versus untrained students, all (100%) of the department heads and head nurses agreed that medical students should attend training in ethics and personal behavior development.  Similarly, 92% of the fourth and fifth year students were of the opinion that behavior and ethics training, both in class and at camp, should continue because they learned about economizing, psychology, manners, appropriate attire, public conduct, and respectfulness toward teachers, colleagues, seniors and juniorsKey words: Medical Students, Personality, Ethics

Health Service Utilization of the Patients under the Social Security Scheme, Newly Registered in 2004 at Srinagarind Hospital

Background:  In 2004, most medical-school hospitals in Thailand stopped taking new registrations for the social security scheme   because the scheme was predominantly used by persons with severe or chronic diseases.  Srinagarind Hospital itself initiated a private clinic network in order to increase admissions eligible for funding under the  social security scheme, but also found expenditure is increasing.Objective: To determine  the proportion   of  the utilization of health services   of  the group that  was new for Srinagarind Hospital, but previously registered at other hospitals(nfs group), compare to all new registrants .Design:  Descriptive studySetting:   Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, ThailandSubjects:  Between May 1 and July 31 2004, 113 persons came for treatment at Srinagarind Hospital.Results:  We found that the nfs group  accounted for 57.4% (95% CI : 48.3,  66.5 )of  the number of health visits   of all new registrants but 84.2% (95% CI : 77.5,  90.9 ) of  the total expenditures.  By contrast, the new and  never registered anywhere else’ group (nn group)  accounted for 43% of the number of health visits  of all new registrants but only 16% of the expenditures.  Age and sex were not statistically significant factors when comparing the two groups.  The nfs/nn ratio was 3.92 (i.e. 6,921.4 vs. 1,763.5 Baht) for the treatment cost per patient  and 5.11 (i.e. 21.5 and 4.2%) for the inpatient admission rate.Conclusion:  The study confirms an existing of the selection bias by patients with expensive and chronic diseases for healthcare provided by the social security scheme.  Further study is needed to get the appropriate risk adjustment figures to make the scheme more efficient.

Prevalence of Bamboo-meal syndrome in the Northeast Thais

Background:  Many patients in clinical practice of one of the authors had various symptoms after eating bamboo shoots e.g. headaches, back/waist/leg pains and/or dyspepsia. This study could establish a part of baseline data to solve the other related problems. Objective:  The aim of this study was to determine the frequency of bamboo shoot consumption and prevalence of various symptoms particularly those with a hereditary link.Method:   A descriptive study.  Data were collected using a structured questionnaire completed through an in-depth interview.Setting:   Bandong subdistrict, Ubonrat district, Khon Kaen province and Phosrisumran subdistrict, Nonesaard district, Udornthani province, Thailand.    Population:  married women, of at least 20 years of age.Results:  Two hundred and five married women were interviewed. Most of them (77%) were 31 to 50 years of age.  The majority (75% of the 153 cases) ate bamboo shoots often.  Among those who urinated in a bowl at night, 61% observed a turbid white precipitate. Ninety cases (44%) had other  symptoms after eating bamboo shoots, such as, stomach pain and dyspepsia, leg/arm pains, back pain, joint pain, fatigue and headaches. Half (53%) of respondents remembered their predecessors  having similar symptoms after eating bamboo shoots, however, there was no statistically significant association of the symptoms between the respondents and their known forebears. Suggestions:  Further research should be conducted into the dietary habits of rural Northeast Thais including cooking techniques for detoxifying bamboo shoots as techniques may help prevent the gall stones endemic among them.Key words:   symptom prevalence, bamboo shoots, bamboo-meal syndrome.