Royal Thai Air Force Medical Gazette

The Role of Artificial Intelligence in Advancing the Dental Public Health for the General Population and Immigrants under the U.S. Healthcare System

2026-02-25T11:20:48+07:00

The Affordable Care Act (ACA) has played a vital role in promoting health coverage and reducing financial and service disparities within the U.S. healthcare system. Although it has greatly improved access to medical care, disparities in public dental health still exist, especially among low-income adults, older adults, and immigrant populations. Immigrants encounter linguistic, cultural, and structural barriers that prevent them from receiving preventive and restorative oral healthcare. Artificial Intelligence (AI) has the potential to address these inequities by improving diagnostic accuracy, supporting clinical decision-making, and enabling culturally responsive telemedicine models in dentistry.

This article examines the ACA’s impact on healthcare inclusion and explores how AI technologies are being integrated into dental pulblic health systems, especially for immigrant and underserved populations. Reviews indicate that AI-driven solutions, when guided by ethical, transparent, and community-centered frameworks, can enhance oral health surveillance, improve wervice delivery, and support workforce training.

However, technological issues such ans algorithmic bias, data privacy, and digital literacy disparities must be addressed to promothe equitable adoption. Lessons from the U.S. public dental health sector offer insights for creating an inclusive “Thai Dental AI Model” that prioritizes accessibility, trust, and sustainability in dental public health innovation.

Artificial Intelligence and Nursing Education: Challenges of Nursing Instructors

2025-11-03T09:52:48+07:00

Artificial Intelligence (AI) is a rapidly advancing technological innovation that is being increasingly applied across various fields, including nursing education. Artificial Intelligence technologies such as Personalized Learning, Simulation Based Learning (SBL), Virtual Reality (VR), Augmented Reality (AR) and Mixed Reality (MR) are being utilized to enhance nursing practice skills, support learning processes, and improve decision-making skill. The integration of AI into nursing education represents a significant shift that enhances the quality of education and strengthens students’ learning outcomes. However, it also presents challenges for nursing instructors, who must have artificial intelligence literacy and adapt quickly to technological changes. Nursing instructors are now required to develop digital competencies and harness the benefits of AI to design and implement effective learning and teaching process. Importantly, this integration must be guided by ethical principles and the professional code of conduct in nursing to ensure the production of high-quality nursing graduates who meet the standards of the profession.

The Effect of Problem-Solving Therapy with Family Participation Program on Depressive Symptoms of Adult Persons with Major Depressive Disorder

2025-12-04T11:29:38+07:00

This quasi-experimental study aimed to evaluate the effectiveness of the problem-solving therapy with family participation program in reducing depressive symptoms among adults with major depressive disorder. A total of 64 patients aged 20–59 years receiving psychiatric care at a tertiary hospital in Bangkok were randomly assigned to an experimental group (n = 32), which received the intervention, or a control group (n=32), which received standard nursing care. Research instruments included 1) Data collecting tools composed of problem-solving therapy with family participation program and the BDI-II and 2) Intervention monitoring tools, problem-solving inventory and shared care assessment, with strong content

validity (CVI = 1.00 and 1.00) and reliability (Cronbach’s alpha = 0.89 and 0.79), data were analyzed using descriptive statistics, the Wilcoxon Signed-Ranks Test, and the Mann-Whitney U Test.

The results indicated a statistically significant reduction in depressive symptoms within the experimental group after the intervention (p < 0.05), and in comparison to the control group (p < 0.05). These findings suggest that the problem-solving therapy with family participation program is effective in alleviating depression in adult patients.

Incidence of Full Stomach in Patients Who Underwent Non-emergency Surgery at Patong Hospital

2026-01-22T11:29:52+07:00

Background: Pulmonary aspiration is a common respiratory complication during anesthesia and may result in severe morbidity when a large volume is aspirated, which is related to the amount of residual gastric contents. A full stomach is still encountered in patients undergoing elective surgery, due to misunderstanding of fasting guideline as well as other risk factors. Gastric ultrasonography is an accurate method for assessing the volume and characteristics of gastric contents.

Objectives: To determine the incidence of a full stomach in patients undergoing non-emergency surgery at Patong Hospital and to identify risk factors associated with a full stomach.

Methods: This prospective descriptive study included patients aged 18–70 years undergoing non-emergency surgery who gave history of completed the fasting regimen. Exclusion criteria were pregnancy >20 weeks, presence of a large intra-abdominal or pelvic mass above the umbilicus, BMI >35 kg/m2, and inability to lie in the right lateral decubitus position. Qualitative and quantitative assessments of the gastric antrum were performed using ultrasonography.

Results: A full stomach was identified in 19 of 79 patients (24.1 %). Among these, four patients had solid contents and fifteen had clear fluid greater than 1.5 mL/kg or >100 ml. Factors associated with a full stomach were obesity (BMI >30 kg/m2): adjusted OR 8.4 (95% CI 1.40–50.08; p=0.020) and ASA physical status 3: adjusted OR 10.9 (95% CI 2.10–56.86; p=0.005).

Conclusions: The incidence of a full stomach among non-emergency surgical patients at Patong Hospital was 24.1 %. Obesity and ASA physical status 3 were significant risk factors for a full stomach.

Organizational Engagement of Registered Nurses Across Generations

2025-12-08T15:14:37+07:00

This descriptive research aimed to investigate the organizational engagement of registered nurses across different generations at Bhumibol Adulyadej Hospital, Directorate of Medical Services, Royal Thai Air Force. The study employed the Delphi technique, gathering insights from four groups of experts totaling 51 participants: 1) 9 senior and middle-level nurse administrators (Baby Boomers), 2) 9 first-line nurse managers (generation X), 3) 14 staff nurses (generation Y), and 4) 19 newly graduated nurses (generation Z).

The study was conducted in three rounds: Round 1 involved interviewing experts regarding organizational commitment to develop a questionnaire; Round 2 required experts to rate the importance of each item; and Round 3 involved re-evaluating the responses to calculate the median and interquartile range (IQR).

Each generation prioritizes different aspects: Baby Boomers emphasize job security, organizational culture, loyalty, and a sense of ownership; generation X focuses on career advancement, organizational pride, and workplace relationships; generation Y values happiness at work, professional worth, development opportunities, and work-life balance; generation Z prioritizes work relationships, teamwork, mentorship systems, and role clarity. These findings serve as a strategic framework for nursing administrators to design customized human resource management policies that address the specific needs of a multi-generational workforce, thereby enhancing long-term organizational engagement and reducing turnover rates.

The research results revealed that organizational commitment among registered nurses across all generations comprises five key dimensions: 1) job characteristics, 2) work experience, 3) job satisfaction, 4) organizational culture, and 5) work relationships (median=4.13-4.60, IQR=0.69-1.07). These findings serve as a strategic guideline for human resource management to enhance organizational engagement among registered nurses.

Factors Influencing the Intention to Use Artificial Intelligence in Pharmaceutical Care

2026-02-08T23:02:36+07:00

This study aims to investigate the factors influencing pharmacists’ intention to use artificial intelligence (AI) in pharmaceutical care and to develop guidelines for promoting the adoption of AI to support pharmacists’ professional practice. The study analyzes the relationships among factors related to technology usage intention, drawing on the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT). The findings reveal that factors with a statistically significant positive influence on the intention to use AI include performance expectancy (b=0.489, p<0.001), which exerts the strongest effect, followed by social influence (b=0.312, p<0.001) and attitude toward use

(b=0.174, p=0.044). However, effort expectancy, perceived ease of use, and facilitating conditions were not found to have a statistically significant effect on usage intention. These results suggest that pharmacists place greater emphasis on treatment effectiveness and work efficiency than on the ease of using technology. This study contributes to a deeper understanding of the role of factors influencing pharmacists’ intention to adopt artificial intelligence. The knowledge gained can be applied to policy formulation and strategic planning aimed at enhancing healthcare professionals’ attitudes and confidence in the use of technology.

Correlation Between Medial Margin-to-Midline Distance in Decompressive Craniectomy and Postoperative Hydrocephalus

2026-02-19T16:00:14+07:00

Purpose: To evaluate whether decompressive craniectomy with a distance to the midline (DTM) of 2.5 cm. is associated with post-craniectomy hydrocephalus in patients with traumatic brain injury and stroke, and to determine the optimal DTM cut-off value with the highest specificity for predicting post-craniectomy hydrocephalus.

Method: A retrospective analysis study was conducted on patients who were diagnosed with traumatic brain injury, ischemic infarction and hemorrhagic stroke who underwent decompressive craniectomy. A 3D reconstruction CT scan was used to determine the DTM and follow up post-operative hydrocephalus.

Results: In 109 patients, the mean DTM was significantly shorter in the post-craniectomy hydrocephalus group (2.07+0.89 cm) compared to the non-hydrocephalus group (2.48+1.12 mm; P=0.033). Univariate analysis showed that DTM <2.5 cm was associated with hydrocephalus (crude OR=2.39; 95% CI: 1.10–5.28; P=0.029). However, after adjusting for potential confounders (age, post-operative GCS, ICH, infection, evacuation, and IVH) using multiple logistic regression, DTM was not an independent predictor of hydrocephalus (adjusted OR=2.17; 95% CI: 0.85–5.68; P=0.107). Significant independent risk factors identified were age (P=0.013) and intraventricular hemorrhage (P=0.044). We found the maximum specificity cut-point found that interval more or less than 1.64 centimeters, so that more incidence of hydrocephalus. However, adjusted for this by multiple logistic regression, found no significant difference between the interval of midline and margin of craniectomy and the occurrence of hydrocephalus.

Conclusion: While a medial margin-to-midline distance (DTM) of <2.5 cm showed an initial association with hydrocephalus in univariate analysis, it was not identified as an independent risk factor in the multivariable model. Advanced age and intraventricular hemorrhage (IVH) are the primary independent predictors of post-craniectomy hydrocephalus. Clinical risk assessment should prioritize these patient-related factors alongside surgical considerations.

The Effect of Using Application Media on the Knowledge of Adolescents Regarding Emergency Contraceptive Pill Use in Phayao Province

2026-02-19T16:19:48+07:00

Providing health education through online platforms for adolescents is essential in today’s era. This research is a quasi-experimental study using a one-group pretest-posttest design, aimed at comparing knowledge about the use of emergency contraceptive pills before and after viewing educational content on the TikTok application, as well as evaluating adolescents’ satisfaction with this educational media. The sample consisted of 156 college students from an educational institution in Phayao Province. The tool consisted of TikTok-based educational media on emergency contraceptive pills. Data was gathered using a questionnaire on knowledge regarding emergency contraceptive pills and a satisfaction questionnaire about the TikTok application via Google Forms. All research instruments used in this study were evaluated by a panel of experts. Data was analyzed using descriptive statistics and the Wilcoxon Matched Pairs Signed-Ranks Test. The research findings revealed that the average score for knowledge about the use of emergency contraceptive pills before using the application media was 12.54 out of a total of 20 points, which is 62.70 %. After using the application media, the average score increased to 19.22 out of 20 points, representing 96.10 %. The comparison of scores regarding knowledge about the use of emergency contraceptive pills before and after using the application media showed that the scores after using the application were significantly higher than those before its use (Z = -10.680, P-value <0.05). Furthermore, the adolescents expressed a high level of satisfaction with the application media concerning knowledge about the use of emergency contraceptive pills, with a mean score of 4.68 and a standard deviation of 0.49

Diagnostic Accuracy of Focused Assessment with Sonography for Trauma (FAST) in the Initial Evaluation of Abdominal Stab Wounds

2026-07-16T09:10:25+07:00

Objective: This study aimed to determine the accuracy of Focused Assessment with Sonography for Trauma (FAST) in screening patients with penetrating abdominal stab injuries who require emergency laparotomy.

Materials and Methods: A retrospective study was conducted on 269 patients admitted to the Trauma Center of Bhumibol Adulyadej Hospital with stab wounds to the anterior abdomen, thoracoabdomen, or flank. FAST was performed as an adjunct to the primary survey to assess abdominal injury. Patient data, including demographics, physical examination findings, FAST and CT results, surgical procedures, and treatment outcomes, were analyzed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FAST for predicting successful non-operative management were calculated and reported with 95 % confidence intervals. Outcomes of patients who underwent surgery were compared with those successfully managed non-operatively using chi-square and Fisher’s exact tests.

Results: The FAST results included 59.7 % true positives (TP), 99.0 % true negatives (TN), 1.0 % false negatives (FN), and 40.3 % false positives (FP). The sensitivity of FAST was 95.24 % (95% CI: 83.84–99.42), specificity was 88.11 % (95% CI: 83.17–92.01), PPV was 59.70 % (95% CI: 50.81–67.99), NPV was 99.01 % (95% CI: 96.27–99.74), and overall accuracy was 89.22 % (95% CI: 84.89–92.66).

Conclusion: FAST is a rapid and accurate initial diagnostic modality for evaluating patients with abdominal

stab wounds. Its high sensitivity and specificity may help reduce unnecessary laparotomies.

Risk Factors Associated with Pneumonia in Pediatric COVID-19 Patients

2026-07-27T15:42:12+07:00

Background: While the COVID-19 pandemic has been extensively studied in adults, there is a lack of data on the clinical characteristics and outcomes of the disease in pediatric populations, particularly regarding the development of pneumonia.

Objective: To determine the risk factors for developing pneumonia in children under 15 years of age who were infected with COVID-19.

Materials and Methods: A retrospective case-control study was conducted at Bhumibol Adulyadej Hospital, Thailand, from April 1 to November 30, 2021. The study included children under 15 years old with RT-PCR-confirmed COVID-19 infection. The patients were divided into two groups: 145 cases with radiologically confirmed pneumonia and 145 controls without pneumonia. We analyzed and compared patient

demographics, clinical symptoms, comorbidities, and RT-PCR cycle threshold (Ct) values between the two groups. Multivariate logistic regression was performed to determine the independent risk factors for pneumonia.

Results: A total of 290 pediatric patients were included in the analysis. The findings showed that an age of less than 3 years (OR 3.5; 95% CI 2.07–5.92) and the presence of fever (OR 4.23; 95% CI 2.33–7.86) were significant independent risk factors for the development of pneumonia. Other symptoms, including

diarrhea and rash, were also associated with an increased risk of pneumonia.

Conclusion: Children under the age of three and those who present with a fever are at a significantly higher risk of developing pneumonia when infected with COVID-19. These findings highlight the need for close monitoring of these high-risk pediatric patients to facilitate early intervention and improve clinical outcomes.

The Effect of a Preparatory Instructional Video on Procedure Time and Confidence in Pediatric Patients Undergoing Spirometry

2025-11-02T14:59:30+07:00

Introduction: Spirometry is a standard tool for assessing respiratory function. However, the procedure is often time-consuming for pediatric patients due to the complexity of the instructions, which can lead to anxiety. Such anxiety often results in a lack of self-confidence in performing the test correctly, thereby affecting patient cooperation and data quality. This study aims to evaluate the effectiveness of a video-based preparatory intervention in enhancing children’s self-efficacy—a crucial factor in overcoming

psychological barriers and improving the overall efficiency of the spirometry procedure.

Objective: To compare the effectiveness of video-based preparation versus standard preparation on testing time and the level of procedural confidence among pediatric patients undergoing spirometry.

Methods: This quasi-experimental research involved 140 pediatric patients aged 7–15 years at Nakhon Pathom Hospital between January and June 2025. Participants were divided into an experimental group (video intervention, n=70) and a control group (standard care, n=70). Research instruments consisted of (1) the experimental tool (preparatory video) and (2) data collection tools, including a time-tracking log and a confidence level questionnaire (Cronbach’s alpha = 0.85). Data were analyzed using descriptive statistics and independent t-tests with a significance level of 0.05.

Results: The experimental group had a significantly shorter mean testing time compared to the control group (27.27+4.24 minutes vs. 41.74+16.90 minutes; t=7.16, p<0.001). Furthermore, the level of procedural confidence was significantly higher in the experimental group than in the control group (4.70+0.46 vs. 2.60+0.98; t=12.33, p<0.001). These findings demonstrate that video-based preparation effectively enhances procedural readiness and reduces variability in testing time for pediatric spirometry.

Conclusion: Video-based preparation is highly effective in reducing testing time and increasing confidence levels in pediatric patients. Therefore, video media should be integrated into clinical standards for pediatric spirometry preparation to optimize operational efficiency and improve patient cooperation during the procedure.