Similar to bile duct cancer or cholangiocarcinoma (CCA) in the western world, opisthorchiasis-associated CCA in Southeast Asia is an aggressive cancer with high mortality rates. It is known to cause a significant health burden in the opisthorchiasis region in Thailand and possibly throughout mainland Southeast. To reduce this health burden, a comprehensive prevention and control program for opisthorchiasis, as well as CCA, is required. In this review, our aim is to provide a brief update of the current situation regarding the natural history of opisthorchiasis and health burden of CCA in Southeast Asia. A comprehensive approach to tackling these issues being implemented in Thailand under the “Cholangiocarcinoma Screening and Care Program” is described. This comprehensive program consists of a three stage prevention and patient care program. The primary prevention component involves opisthorchiasis screening using a new and sensitive urine assay. The secondary prevention component involves screening for CCA and periductal fibrosis, with suspected CCA patients following the protocol for confirmation and appropriate treatment. Due to the eco-epidemiology of opisthorchiasis-induced CCA, the anticipated impacts and outcomes of the program include short-, medium-, and the long-term goals for the reduction of CCA incidence. To achieve long-term sustainable impacts, concerted efforts to raise social awareness and participating action by general public, non-government organizations, and government agencies are necessary. The strategic plans developed for this program can be expanded for use in other endemic areas as well as being a model for use in other chronic diseases.

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This work aims to investigate the reflective thinking instructional model for enhancing empowerment of pre-service and in-service educational students in Roi-Et Rajabhat University, Thailand. In this research, qualitative methods, observation, interview, short note, and group discussion were used to indicate students' desirable learning outcomes, teaching and learning targets, social system relationships, indirect and direct specifications, performances, and specifications. Students' reflections are related to the social system and conceptualizations affecting students' activities. Persuasive thinking and experience reinforce the experimental exchanged report and reflections scales. Students' behaviours and recalling thinking of their experimentation toward their learning outcomes were found. Specification problems with their decision and belief positions on empirical data were satisfied. Students were able to select and presume the positions of the management existing evidence that solved their problems and developments. Students' skills and strategies of their reflective thinking involve increasing desirable outcomes purposeful and solving problems, formulating inferences, calculating likelihoods, and making decisions thoughtful and effectively in a particular context.

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