Social Security Office (Thailand)

Since 1985, the international healthcare community has recommended the ideal rate of caesarean section (CS) to be 10%-15% at the national level. The literature has reported that overused CS without necessary medical indications can be harmful to both maternal and child health. To generate evidence to support policy on CS, this study evaluated the trend over time of CS in Thailand during January 2016 to October 2021 (which included the COVID-19 pandemic period) and explored predictors of CS use. This study was a retrospective secondary data analysis of de-identified hospitalisation data under the Universal Coverage Scheme (UCS) from the National Health Security Office's e-Claims database. Descriptive analyses were conducted to explore the number and rate of CS over time and across different characteristics (ie, age, hospital type, COVID-19 status and delivery day) including a multivariable logistic analysis to explore predictors of CS. Interrupted time series analysis was adopted to investigate the effect of the COVID-19 pandemic on CS rate. 569 321 CS cases under UCS from 2016 to 2021. The results showed an increasing trend of CS rate, from 30% in January 2016 to 35% in October 2021. Both clinical (eg, medical indication and age) and non-clinical (eg, region and day of delivery) factors were significantly associated with CS. Furthermore, the COVID-19 pandemic had no significant effect on CS rate (level: -0.0016, 95% CI -0.0085 to 0.0053, p=0.66). This study highlighted an increasing trend of CS in Thailand and could present supportive evidence that Thailand might have been facing an overuse of CS. More awareness and actions are warranted to ensure the movement towards reduction of unnecessary CS in Thailand.

Urban traffic safety measures are a strategic approach to reducing accidents, injuries, and fatalities on roads within urban areas. In line with the global Vision Zero initiative, this study explores the effectiveness of targeted safety interventions in enhancing traffic safety at an urban roundabout in Klang District, Selangor, Malaysia. A mixed-method approach was adopted, utilizing qualitative data obtained through interviews and surveys with road users, alongside quantitative data collected through traffic volume studies, speed spot analyses, and accident records. Preliminary findings suggest innovative solutions that align with the three Es of road safety: engineering, education, and enforcement. The findings affirm that Vision Zero strategies, when combined with engineering redesigns, significantly enhance road safety outcomes, particularly by improving traffic flow and fostering a culture of safety among stakeholders.

The integration of Fast Healthcare Interoperability Resources (FHIR) with generative artificial intelligence (GenAI) systems is accelerating across the healthcare landscape, particularly within pharmacy ecosystems responsible for medication dispensing, formulary management, prior authorization, and real-time benefit determination. While FHIR provides a standardized framework for interoperable data exchange, GenAI introduces new risks such as prompt injection, hallucinated clinical assertions, privacy violations, model inversion, and inadvertent leakage of protected health information (PHI). These risks become more pronounced when GenAI models are connected to high-sensitivity medication APIs used by payers, pharmacies, and clinical systems. This paper presents a comprehensive security architecture for FHIR-GenAI integration within pharmacy workflows. It proposes a multilayer strategy incorporating Zero Trust, privacy-preserving computation, API governance, model guardrails, and secure machine-learning pipelines. Code examples are provided to illustrate key enforcement mechanisms. The analysis demonstrates that secure implementation of GenAI in pharmacy systems must harmonize conventional enterprise security controls with new GenAI-specific risks while honoring regulatory requirements such as HIPAA, HITECH, and HITRUST CSF.

The global expansion of artificial intelligence (AI) and its increasing availability in educational settings present both unprecedented opportunities and major pedagogical challenges. The performance and learning outcomes enabled by AI raise fundamental questions about its meaningful, ethically responsible, and pedagogically justified integration into student learning processes. This article explores the possibilities and limitations of effectively incorporating AI into the educational environment from didactic, psychological, and ethical perspectives. It emphasizes how the use of AI tools can transform the dynamics of teaching and learning, redefining the roles of teacher and student in an increasingly technologized classroom.The theoretical foundations are rooted in personalized and adaptive learning theories, constructivist approaches to knowledge acquisition, and cognitive psychology focused on information processing and metacognition. The article also draws from current research on human-machine interaction and self-regulated learning, examining how AI-driven platforms can support differentiated instruction and formative assessment. Furthermore, it discusses potential risks such as overreliance on algorithms, loss of critical thinking, and ethical dilemmas arising from data privacy, authorship, and transparency of automated decisions.From a practical standpoint, the analysis reveals that while AI has the potential to strengthen inclusivity, enhance learner motivation, and optimize instructional efficiency, its educational effectiveness depends on the teacher’s pedagogical autonomy and digital competence. The authors propose a balanced approach that integrates AI as a supportive – not substitutive – partner in education, preserving the humanistic dimension of learning and the social- emotional interaction between teacher and student.The article concludes with theoretically and empirically informed recommendations for school practice, addressing the conditions necessary for responsible AI implementation. These include teacher training, curriculum adaptation, ethical policies for AI use, and strategies for maintaining equal access to technology. The paper is aimed at the professional community of educators, psychologists, and policymakers seeking evidence-based guidelines for making artificial intelligence a truly pedagogically meaningful element of contemporary education.

3D printing enhances denture fabrication, but the bond between printed teeth and bases is often weaker than traditional methods. This study investigates the effect of tooth-adhesive combinations on bond strength to enhance clinical reliability in digital dentistry. Forty-eight cylindrical 3D-printed denture bases were bonded with either 3D-printed (PT) or milled (MT) teeth using three bonding materials: NextDent (ND), Super-Bond (SUP), and Unifast Trad (UNI)(n=8/group). The PT-ND group served as the control. Specimens were subjected to shear bond strength testing using a universal testing machine at 0.5 mm/min, with a 4 mm shear pin, and failure modes were analyzed under a stereomicroscope. Tooth type, bonding material, and their interaction significantly influenced bond strength (P<0.05). MT-UNI and MT-SUP demonstrated the highest values (92.33 ± 4.90 N; 87.34 ± 2.41 N), while MT-ND had the lowest (11.72 ± 1.94 N). Among PT groups, PT-SUP performed best (45.59 ± 3.47 N), followed by PT-ND (34.12 ± 3.38 N) and PT-UNI (23.68 ± 4.14 N). High-strength groups exhibited predominantly mixed failure (MT-SUP, MT-UNI, PT-SUP), while lower-strength groups showed adhesive failure. (MT-ND, PT-UNI). Bond strength is influenced by both tooth material and bonding agent. From the results, Unifast Trad is optimal for milled teeth; Superbond is best suited for printed teeth. Material selection is critical for improving durability and chairside efficiency in digital prosthodontics.

This study reports the content validity findings of the Malay-translated version of the Parenting Scale (PS). The objective is to identify relevant items from the translated version. The content validity was evaluated using a relevance score by two groups of parents: 10 parents without disabilities and 10 parents with physical disabilities. The study is a cross-sectional design to assess the Content Validity Index (CVI), including I-CVI, S-CVI/Ave, and modified kappa statistics. Findings indicated that several items required elimination, revision, or retention, ensuring cultural and contextual appropriateness of the PS for Malaysian parents, including those with physical disabilities.

Introduction: As the largest group of healthcare professionals, nurses have crucial role for delivering evidence based practice for positive maternity outcomes along with cost effective quality care. The personal and organizational context influences its implementation. Objective: To find out the factor affecting evidence based maternity care practice among nurses in a Tertiary Maternity hospital. Method: Descriptive cross sectional study was done with sample of 84 nurses. Data were collected by using self-administered questionnaires which include attitude scale as well as barrier and facilitator scales. SPSS was used for data analysis. Result: Almost all nurses (97.6%) provided their opinion that evidence based practice is beneficial for the positive patient outcomes and professional development. Majority nurses (78.6%) believed that the care they delivered was evidence based. The nurses demonstrated a positive attitude toward evidence-based practice, with mean score of 2.45 + 0.41. However, they reported experiencing barriers to implementing evidence based practice in their daily clinical practice. Overall barrier scale had a mean score of 2.38 + 0.47, with the organizational subscale identified as the most significant barrier, scoring 2.14 + 0.55. Most important facilitating factor felt by the respondents were ‘Emphasized evidence based practice in nursing curriculum of all level’ (82%); ‘Reward and motivation for evidence based practice’ (79.8%) and ‘Adequate staffing and team work culture’ (79.7%). Conclusion: Emphasizing evidence based practice among nurses, the supporting factors should be enhanced and overcome identified barriers. As a result, the professional development of the nurses is also achieved along with positive health outcomes

Antimicrobial drugs used for pharyngitis are prone to irrational use owing to ease of access to various sources and other risk factors. A mirror-assisted screening device (MASD) was developed to promote rational antimicrobial use, but it was not fully evaluated. This study aimed to assess the effectiveness of MASD in aiding the pharyngitis diagnosis and rational antimicrobial use of patients with pharyngitis and to elicit the perceptions of patients and healthcare providers about the use of MASD. A single-blinded, quasi-intervention study was conducted among Thai patients with pharyngitis attending primary care centers, called sub-district health promoting hospitals, in 10 provinces of three regions, i.e. the Eastern, Northern and North-eastern regions, during the 2019-2021 period. Eligible samples were conveniently allocated to an intervention group obtaining normal care plus MASD use or a control group receiving solely normal care. Patients in both groups completed a questionnaire pre- and post-interventions. All data were analyzed using descriptive statistics and a Chi-square test. The results showed that patients in the intervention and control groups (n = 2,031 and n = 235, respectively) were mostly female adults working in agricultural sectors in the North-eastern region. The rates of antimicrobial use in both groups were statistically different (17.0% vs. 24.7%, p = 0.004; RR 0.69, 95%CI [0.54, 0.88]); the relative risk reduction was 31.2%. Both groups had anticipated and intended needs for an antimicrobial and also requested it. They were mostly satisfied with MASD and willing to check their throat infections and antimicrobial use. The providers were also satisfied with and confident in using MASD to facilitate the diagnosis. Overall, MASD was effective as a pharyngitis diagnostic aid that helped patients raise their awareness of antimicrobial consumption. Further studies are required to evaluate the use of MASD in other primary care settings.