Academic literature on the topic 'Physicians Vocational guidance Thailand'

Abstract Background The professional demands on the expertise in pediatric intensive care have continuously increased in recent years. Due to a lack of applicants, the staffing of a continuous shift service with qualified medical staff poses major challenges to the hospitals. Methods A web-based questionnaire with 27 predominantly matrix questions on working conditions and motivation for working in this area was sent to pediatric hospitals throughout Germany. Results 165 doctors responded to the survey. The average age of the participants was 35.2 years. The average weekend work load reported by 79% of the respondents was 2 weekends per month, 70% of the study participants performed five to seven night shifts per month. 92% of the respondents stated that they basically enjoyed working in the intensive care unit (ICU). When asked to prioritize the working conditions, an appreciative working atmosphere in the team was named as priority 1 by 57%, followed by good guidance in the independent performance of interventions (25%) and good working conditions (19%). Discussion The survey result shows that neither aspects of work–life balance nor payments are the key issues selecting the interesting, but physically and emotionally demanding job in pediatric ICU. Conclusion When evaluating vocational training in pediatric intensive care medicine, the immediate working atmosphere in the team with mutual respect and understanding and the guidance in training are more important than the general conditions.

This article argues for law reform in Thailand concerning the protection of health data, particularly laws involving the data’s disclosure to third parties. It has been found that several pieces of Thai legislation governing this area are conflicting, causing confusion and disquiet to Thai physicians. Recently, Parliament has enacted the Personal Data Protection Act 2019. The said GDPR-style Act should have clarified all already-existing confusion regarding the inconsistency of legislation, but it has further complicated the matter instead. Doctors cannot disclose patients’ health data to third parties, even to protect others or public interests. Court cases from other jurisdictions show that courts are willing to impose on physicians the duty to disclose patients’ health data to third parties under certain circumstances, which makes the issue more significant to the Thai legal and medical communities. The article provides proposals to rectify the issue by amending relevant statutes and calling for professional guidance on this area which should be addressed by pertinent legislation. The relevant professional guidelines alongside the amended legislation will serve the interests of medical professionals, patients, and society at large.

Community-based mental health services are important for the treatment and recovery of patients with mental health disorders. The Chinese government has made the establishment of a highly efficient community-based health service an enduring priority. Since the 1960s, community-based mental health services have been developed in many Chinese cities and provinces. National policies, including mental health regulations and five-year national mental health working plans, have been issued to support the development of quality of mental health services. The accessibility and efficiency of community-based mental health services are now highly promoted to community residents. According to the National Standards for Primary Public Health Services, community-based mental health services are one of the most important components of primary public health services. They are mainly provided via Community Health Service Centres (CHCs), by a combination of general practitioners, public health physicians, nurses and social workers. Patients receive individualized and continuous health services according to their rehabilitation status. These services include regular physical examination, health education, rehabilitation guidance, social function rehabilitation training, vocational training and referral services; family members also receive care and psychological support. Future work will focus on expanding mental health service coverage and usage, increasing awareness of mental health and decreasing stigma, and strengthening service capability to establish an integrated model to enhance the overall efficiency of mental health services.

Abstract In Italy prior to 2006 central venous catheters were inserted only by anaesthesiologists. Nurses were excluded based on professional profile. In 2005 the nursing staff of the Pain Therapy and Palliative Care Unit (PTPCU) at Santa Chiara Hospital in Pisa, proposed that nurses be permitted to insert Peripherally Inserted Central Catheters (PICCs). The recommendation was submitted to the Italian National Board of Nurses with a request to implement a training program. The Board approved the proposal in January 2006. Initially the PTPCU nursing staff had PICC training programs through the St. Chiara Hospital Vocational Training Office. The program was initially implemented by a nurse volunteer who had critical care training, intravenous therapy experience and who demonstrated competence with PICC placement based on training by PTPCU interventional anaesthesiologists. To date, nearly 250 successful PICC placements have been performed using the Modified Seldinger Technique (MST) in conjunction with ultrasound guidance. Physicians and nurses identified potential candidates and the patients were assessed by the PICC nurse. The combination of PICC/MST was found to facilitate placement in patients with impalpable vessels and above the antecubital fossa as well as improve freedom of movement and reduce the likelihood of patients accidentally dislodging the device. The primary reasons for PICC placement included antibiotic or antiviral therapy (26%), total parenteral nutrition administration (35%) and chemotherapy (39%). There were 211 catheters used exclusively for inpatients and 39 catheters exclusively for outpatients. The PICC program resulted in an excellent safety profile, a high success rate, and few post-procedural complications. It was a less costly option compared to centrally inserted, tunnelled, or implanted central vascular access devices; it improved the quality of nursing care and decreased patients' waiting time for vascular access placement.

Abstract Introduction Antimicrobial intravenous-to-oral switch (IVOS) is an antimicrobial stewardship (AMS) strategy with patient safety and cost-effectiveness benefits. Studies show that IVOS decisions had no negative impact on patient outcomes,1 and pharmacist involvement brought about more appropriate antibiotic prescribing and 34% reduction in medication costs.2 Healthcare settings have developed individualised local IVOS checklists. Aim To collate IVOS criteria from local checklists, complete a rapid literature review to evaluate IVOS criteria and undertake a 3-step Delphi consensus-gathering process to agree evidence-based, UK-wide IVOS criteria for hospitalised adults. Methods Local IVOS checklists from the UK nations were sought through stratified sampling. The rapid review followed PRISMA guidance and is registered on PROSPERO [CRD42022320343]. Criteria with highest, or over 50%, appearance in checklists and literature were combined for Step 1 of the 3-step Delphi process. Step 1: Pilot/1st round questionnaire: An expert panel appraised each criterion via a 5-point Likert scale for relevance to safe and effective IVOS and ease of assessment in the clinical setting. Step 2: Virtual meeting: Step 1 respondents discussed questionnaire results and attained criteria consensus for Step 3. Step 3: 2nd round questionnaire: Healthcare professionals UK-wide stated level of agreement via a 5-point Likert scale regarding the need of each criterion for safe and effective IVOS. Results Forty-five local IVOS checklists were selected: 42 from English Acute Trusts, two from Scottish Health Boards and the All-Wales checklist. Sixteen of 477 papers were included in the rapid review. Criteria were synthesised into a 5-section framework: 1-Timing of IV antimicrobial review; 2-Clinical signs and symptoms; 3-Infection markers; 4-Enteral route; 5-Infection exclusions. Combination of IVOS criteria resulted in 41 criteria for Step 1. Step 1 had 24 respondents, 15 of those participated in Step 2. Thirty-five criteria went into Step 3, which had 242 respondents (England n=195, Northern Ireland n=18, Scotland n=18, Wales n=11). The majority were female (n=154; n=7 preferred not to say) and based in NHS Acute Teaching Trusts (n=121). Antimicrobial or infection specialist pharmacists were the highest respondents (n=65) followed by general physicians (n=55). Sixty-seven per cent of respondents (n=161) considered IVOS to have a positive impact on outcomes of clinically stable patients. Consensus was achieved for 27 IVOS criteria (66% of initial criteria). Examples of agreed criteria were: ‘IVOS should be considered within 48 hours of first dose of IV antimicrobial being administered’ and ‘Temperature between 36-38°C for past 24 hours’. Discussion/Conclusion Evidence-based consensus was achieved for IVOS criteria from a UK-wide multidisciplinary group and will be used to develop an IVOS tool for hospitalised adults. A study strength was use of the Delphi process to capture consensus; a limitation was no checklist from Northern Ireland was identified at time of the study, however Steps 1-3 had participation from Northern Ireland. Early IVOS initiatives led by ward pharmacists have previously been shown to reduce use of hospital intravenous broad-spectrum antibiotics: co-amoxiclav (-27.9%) and cefuroxime (-46.5%).3 Further research is needed to operationalise the nationally agreed criteria in UK hospitals, expand AMS roles of pharmacy and nursing teams and assess impact. References 1. Wongkamhla T, Khan-Asa B, Tongsai S, Angkasekwinai N. Infectious Disease Team Review Using Antibiotic Switch and Discharge Criteria Shortens the Duration of Intravenous Antibiotic: A Single-Center Cluster-Randomized Controlled Trial in Thailand. Open Forum Infect Dis. 2020;7(12):ofaa539. 2. Polidori P, Leonardi Vinci D, Adami S, Bianchi S, Faggiano ME, Provenzani A. Role of the hospital pharmacist in an Italian antimicrobial stewardship programme. Eur J Hosp Pharm. 2021;29:95-100. 3. Sze WT, Kong MC. Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals. Pharm Pract. 2018;16(2):855.

Although manpower and educational planning have been used in some developing countries for a considerable time to ensure an adequate supply of qualified manpower for the economy, the problem of manpower shortages still persists. An analysis of the reasons underlying the presumed failure of planning processes to ensure adequate supplies of qualified manpower for individual sectors of the economy forms the basis of this study. The issue was examined through an examination of the case of one specific sector of Thailand's economy: the tourism industry. In particular, the study sought to ascertain whether the shortages are the result of problems with the national manpower and educational planning models or whether they reflect issues intrinsic to individual economic sectors. The study draws on the literature in three areas: manpower planning, the relationship between manpower and educational planning, and employment and manpower development planning in the tourism industry. To explore possible explanations for the persistence of manpower shortages in the Thai tourism industry, two kinds of data were used: documentary and interview data. The interviews were conducted with three groups of key informants: employers in the tourist business, providers of tourism education and training, and senior government officials who are involved in manpower and educational planning. A total of 85 people in four tourist centres in Thailand were interviewed. The analysis of the data confirms that there is a mismatch between manpower demand and supply in the Thai tourism industry with demand significantly surpassing supply. The study concluded that there are limitations in the manpower and educational planning models, and that there is a lack of some of the conditions required for their optimal functioning, but that the mismatch between supply and demand in the Thai tourism industry is more fully explained by features intrinsic to the industry itself. A Abstract balance between manpower demand and supply in any sectors would be improved by having manpower planning at the macro level well meshed with educational planning, and by developing linkages between two levels of planning: the national and industry level. More importantly, however, within the industry itself, those involved have to take a planning stance by diagnosing the way their own sector operates and collaborating to rectify the problems they find. This study has implications for policy and improved practice of the planning, production and development of manpower required by the Thai tourism industry. It also has lessons for other sectors of the Thai economy as well as other developing countries.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Homoeopathy, Durban University of Technology, 2011.
Recent homoeopathic graduate studies (Babaletakis, 2006 and Sweidan, 2007) indicate that the majority of qualified Homoeopaths are currently practicing yet are experiencing many difficulties along the way. These setbacks are largely related to financial stresses and the difficulties experienced with regards to maintaining a practice. However, a minority of successful homoeopaths that have managed to overcome these difficulties have been identified. AIM This study aimed to identify a minimum of nine successful homoeopaths, and, through an in-depth interview discover their views on success and how they have managed to build up viable practices. The study aimed to identify the factors contributing to the success of these Homoeopathic practices and establish relationships that may have existed between these factors. METHODOLOGY This research was conducted in a qualitative manner, following an ethnographic approach, which also guided the method of data analysis. It was thus a descriptive, case study research design. Interviewees/subjects were selected through snowball sampling. Semi-structured in-depth interviews were conducted with each subject, in which the researcher followed an interview guideline. These interviews were recorded and analysed conceptually. All the transcribed interviews were then further organised by using the software programme NVivo 8.0. which allowed for the process of coding. iv RESULTS Common themes as related to success emerged from the data that was collected. Further analysis revealed links between certain factors that had been identified within the themes. The results reflected that honesty and the ability to listen and understand people, together with perseverance and determination, were qualities that enabled these homoeopaths to achieve success. It was evident that valuing oneself as a practitioner and thus charging accordingly, as well as minimising overheads where possible, all contributed to the viability of the practice. The use of modalities impacted on financial gain and was found to enhance patient numbers. Availability, success of healing and an interactive practitioner - patient relationship was also found to have an effect on patient base stability and size. Burnout was identified as being related to the balance in a practitioner’s lifestyle. A high self-esteem coupled with a good support structure, were factors that minimised burnout. Continued professional development was important to these practitioners as evidently one’s knowledge was seen to have an impact on confidence, patient numbers and thus overall success as a healer. CONCLUSION Success has been attributed to many factors in this study, many of which are interlinked. These findings have provided valuable insight into a successful homoeopathic career.

About 5 per cent of the overall UK cancer burden can be attributed to occupational exposures. However, occupational physicians in clinical practice are most likely to be called upon to support and advise employed patients with non-occupational cancers. Support services in the UK are being reconfigured to help the growing population of cancer survivors to live full and active lives for extended periods. Returning to the workplace is a part of this goal, and occupational physicians are likely to see increasing numbers of adults seeking still to work after treatment for conditions that in the past would have led to ill health-related retirement. Set against these improvements in clinical outcome, and the increasing emphasis on support for patients who achieve long-term survival, is evidence that many working-age adults treated for the common cancers subsequently encounter financial and occupational difficulties. People with cancer often experience a loss in income as a result of their condition. Thus, although most working adults diagnosed with primary cancer return to work, a significant minority do not. Cancer is increasingly seen as an illness that can be effectively treated, but functional outcomes vary considerably. Cancer survivorship is considered to encompass people who are undergoing primary treatment, in remission following treatment, show no symptoms of the disease following treatment, or are living with active or advanced cancer. Occupational physicians may be requested to assess work capability and provide advice on workplace support for cancer survivors in any of the survivorship states. In the UK, 98 per cent of public sector and 30 per cent of private sector employers have access to occupational health services. Employers will normally seek guidance from these services on how to manage employees who have developed a serious illness such as cancer. This means that occupational physicians can be in a key position to coordinate the vocational rehabilitation of cancer survivors. This chapter offers an overview of the evidence on work capability, rehabilitation, and occupational risk assessment that may apply to adults diagnosed with a range of cancers.