An evaluation of the Medical Pool Placement and Utilization Program (MedPool PUP) of the Philippine Department of Health

OBJECTIVE: This study evaluates the effectiveness of the Medical Pool Placement and Utilization Program (MedPool PUP) of the Philippine Department of Health whose purpose is to augment the medical resource requirements of public hospitals.  METHOD: Mix method was used to gather data through a questionnaire survey sent by fax, email or postal mail. Beneficiary hospitals were selected and key informant interviews done to both the executive officers and the deployed medical pool physicians to further gain insights on the results of the survey.  RESULTS: A total of 75 public hospitals were beneficiaries of the MedPool PUP covering all hospital categories- Level 1, Level 2, Level 3 and Level 4 hospitals. Fifty-one hospitals responded to the survey. Justifications for requesting deployment include: a) need for additional physicians (43%), b) need for a medical specialist of a given clinical specialty (23%), c) need for accredited specialists to maintain a residency training accreditation (23%), d) need for substitute doctors while their regular doctors undergo training (8%) and e) need for a trainer of a specific medical specialty (2%). Almost all deployed doctors have finished a residency training program belonging to a medical specialty. Although the work descriptions covering the deployment of the MedPool doctors are focused on providing medical care to the patients, the contributions to the achievements of the hospitals s by the MedPool doctors go beyond these. They are also involved in medical training of other doctors, many are also given additional assignments in clinical administration and researches. Some also get involved in outreach services. Many exceptional contributions to the hospitals were given by the deployed doctors. In 12 out of 16 (75%) hospitals visited, the doctors deployed were able to introduce new clinical services such as heart surgery, ophthalmology, renal transplant, hepato-biliary surgery, automation of clinical laboratory procedures, among others. This is the primary basis for this study to conclude that the MedPool PUP is effective. CONCLUSION: The effectiveness of the MedPool PUP has been shown to go beyond augmenting the medical staffs of public hospitals in providing services. The doctors it deployed have contributed significantly in improving the clinical services by introducing new specialty services and enhancing existing ones. It is recommended that MedPool PUP be continued and strengthened to fill the needs of public hospitals based on a system of priorities. 

Health human resource needs of government hospitals in the Philippines

OBJECTIVE: To describe the health human resource needs of government hospitals in the Philippines.METHODS: All 733 licensed government hospitals were included in a survey except 75 of them which the Department of Health have been deploying medical specialists and medical officers to augment the needs of these 75 hospitals.RESULTS: A total of 96 government hospitals responded to the self-administered survey questionnaire sent to them. Analysis showed 20% to 29% among the level 2, level 3 and level 4 hospital responders have their Chief of Hospitals still without a master's education degree as required by the Department of Health. Fifty-nine percent (59%) of all hospitals do not have nearby medical educational institutions while 28% of them do not have nearby nursing educational institutions.The greatest need, however, is in the adequacy of the number of doctors and nurses. The minimum required number of doctors and nurses has not been met based on the staffing pattern standards set by the Department of Health for the different hospital categories and by the required 40 work hours per week set for civil servants.CONCLUSION: The decline in the adequate number of health human resources noted to start when local public hospitals were devolved from the national government to the local government units in 1991. With this inadequacy, one cannot expect these public hospitals to provide even fair quality of hospital care; thus, the need for the national government to intervene.

Partnership for health development through the field practice

This article describes the partnership between the College of Public Health, University of the Philippines Manila and the province of Laguna in the context of implementation of the field practice course. This partnership paved the way for the development and implementation of projects in seven field practice sites. Projects concentrated mainly on improving quality of data and health information system, development of educational materials, and addressing health problems such as tuberculosis, hypertension and rabies. After the implementation of the various activities, there is a need for both parties (the College of Public Health and the Provincial Health Office of Laguna) to monitor and evaluate if projects have been sustained. Moreover, successful projects must also be fully documented which can serve as models for other areas in the province of Laguna.

Caries patterns in the primary dentition: cluster analysis of a sample of 5169 Arizona children 5-59 months of age / 国际口腔科学杂志·英文版

<p><b>AIM</b>Cluster analysis was conducted on data from 5,169 United States (U.S.) Arizona children, age's 5-59-months with the goal of delineating patterns of caries in the primary dentition of pre-school children without a priori pattern definitions.</p><p><b>METHODOLOGY</b>Cluster analyses were conducted using all data for children ages 0-4 years in aggregate: (1) for all subjects, and (2) for subjects without crowned restored teeth. Each of these two sets of analyses consisted of 8 differently specified cluster analyses as a validation procedure.</p><p><b>RESULTS</b>The caries patterns identified from the clustering analysis are: (1) smooth surfaces (other than the maxillary incisor), (2) maxillary incisor, (3) occlusal surfaces of first molars, and (4) pit and fissure surfaces of second molars.</p><p><b>CONCLUSION</b>The cluster analysis findings were consistent with results produced by multidimensional scaling. These cross-validated patterns may represent resulting disease conditions from different risks or the timing of various risk factor exposures. As such, the patterns may be useful case definitions for caries risk factor investigations in children under 60 months of age.</p>

The toxicity of ammonia, nitrite and nitrate to the fish, Catla catla (Hamilton).

The acute toxicity of unionized ammonia; nitrite and nitrate to the Indian major carp Catla catla (Hamilton) was determined using static and continuous flow through systems for 24 hours. The median lethal concentration (LC50) values for 24 h of ammonia (NH3-N), nitrite (NO2-N) and nitrate (NO3-N) were 0.045 mg/l, 120.84 mg/l and 1565.43 mg/l in static test respectively and were 0.036 mg/l, 117.43 mg/l and 1484.08 mg/l in continuous flow through test respectively.

Toxicity and residue studies of fenvalerate to some selected freshwater fishes.

The toxicity test of fenvalerate were conducted to fresh water fishes Labeo rohita (Hamilton), Catla catla (Hamilton), Cirrhinus mrigala (Hamilton), Aplocheilus punchex (Hamilton) and Ctenopharygodon idellus (Valenciennes). The static and continuous flow through tests were employed to determine the lethal concentration (LC50) for 24h, 48h and 96h to the test fish. It was observed that Cirrhinus mrigala is more sensitive to this pesticide followed by Applochielus punchex, Lebeo rohita, Catla catla and Ctenopharyngodon idellus. The residue analysis for qualitative confirmation was done by thin layer chromatography (TLC) to assess the deposition of pesticide in different tissues of fishes. The quantitative study of accumulation in the whole body tissue was done by Gas liquid chromatography (GLC). The quantitative residues confirm the toxic action.

Antiinflammatory and antipyretic activity of Michelia champaca Linn., (white variety), Ixora brachiata Roxb. and Rhynchosia cana (Willd.) D.C. flower extract.

Methanolic extracts of the flowers of M. champaca, I. Brachiata and R. cana were found to possess antiinflammatory activity against cotton pellet granuloma in rats at a dose level of 100 mg/kg body weight, sc. The latter two drugs showed higher activity (AIA) as compared to that of M. champaca. They reduced the protein content, acid phosphatase, glutamate pyruvate transaminase and glutamate oxalo-acetate transaminase activities in liver and serum. A significant reduction in the ascorbic acid content in adrenals was also observed in drug-treated animals. R. cana was recorded to possess significant antipyretic activity from the first hour of administration. These pharmacological properties may be traced to the presence of flavonoids in the flowers of these plants.

Antiinflammatory and antipyretic activity of vicolides of Vicoa indica DC.

Vicolides A,B, C and D, the sesquiterpene lactones isolated from V. indica exhibited antiinflammatory activity against cotton pellet granuloma in rats at dose level of 10 mg/kg body weight, sc. Highly significant activity was observed with vicolides C and D. They reduced the protein content, acid and alkaline phosphatase, glutamate-pyruvate transaminase and glutamate oxaloacetate transaminase activities in liver and serum. Significant reduction in ascorbic acid content in adrenals was also observed in treated animals. The highly significant antiinflammatory activity of vicolides C and D can be attributed to their chemical structures. Vicolide D has an epoxy angeloyl group while vicolide C has 3,4 epoxy group and an ester moiety in the molecule. Vicolide D possesses antipyretic activity at 250 mg/kg body weight, po dose. It may be due to the presence of epoxy angeloyl group in the molecule.