Economic burden of acute myeloid leukemia on patients in a resource-limited tertiary hospital in the Philippines

ABSTRACT Introduction: The remission induction treatment for acute myeloid leukemia (AML) has remained unchanged in the resource-limited setting in the Philippines. AML treatment consists of induction chemotherapy followed by high dose consolidation chemotherapy or allogeneic hematopoietic stem cell transplantation. In the Philippines, the Filipino household bears the burden of health care cost of hospitalization expenditure. Insights into the treatment costs becomes an essential requirement as these guides the allocation of resources to scheme health programs. Method: This study involved a retrospective cohort analysis of AML patients who underwent treatment for AML. Review of the statements of account per admission per patient during treatment for remission induction, consolidation, relapsed and refractory disease and best supportive care from 2017 to 2019. Of the 251 eligible patients, 190 patients were included. Result: The mean healthcare expenditure for remission induction chemotherapy (Phase 1) was US $2, 504.78 (Php 125,239.29). While 3 to 4 cycles of consolidation chemotherapy cost an average of US $3,222.72 (Php 162,103.20). For patients who had relapsed and refractory disease, an additional mean cost of US $3,163.32 (Php 159,115.28) and US $2, 914.72 (Php 146,610.55) were incurred, respectively. The average cost of palliative care was US $1,687.00 (Php 84,856.59). Conclusion: The cost of chemotherapy and other therapeutics bear most of the weight of the direct healthcare cost. The cost of AML treatment represents a significant economic burden for patients and the institution. The cost increases as patients proceed through subsequent lines of treatment for induction failure. Existing subsidy for health insurance benefits could still be improved for appropriate source allocation of resources.

The effect of the COVID-19 pandemic on procedures performed by fellows of the Vitreo-Retina Training Program at the Philippine General Hospital

BACKGROUND@#The COVID-19 pandemic has affected ophthalmology training. The Vitreo-Retina Training Program extended the training periods of its trainees in anticipation of a drop in surgical cases during the pandemic to make up for the expected drop.@*OBJECTIVE@#This study aimed to determine the effect of the COVID-19 pandemic on the Vitreo-Retinal Fellowship Program at the Philippine General Hospital (PGH), specifically the number of procedures performed by the Vitreo-Retina Fellows before and during the pandemic and their compliance with the Vitreo-Retina Society of the Philippines (VRSP) standards.@*METHODOLOGY@#This is a document review of vitreo-retinal procedures done at the Department of Ophthalmology and Visual Sciences of the PGH from January 1, 2017, to December 31, 2021.@*RESULT@#During the COVID-19 pandemic in 2020, there was a drop in the number of procedures performed by both the first year and second year vitreo-retina fellows. Despite the drop in numbers, the first year vitreo- retina fellows were still in compliance with the VRSP-recommended number of procedures. The second year vitreo-retina fellows, on the other hand, were not able to comply with the recommended numbers by the VRSP. The extension year allowed the second year fellows to do more procedures and comply with the recommended numbers of pars plana vitrectomy only.@*CONCLUSION@#There was a drop in the vitreo-retinal procedures during the COVID-19 pandemic. The second- year fellows were the most affected with the decrease in the number of surgical cases.

Comparison of faculty and student evaluations of the hybrid teaching of orthopedics during the COVID-19 pandemic

Background@#In the face of the COVID-19 pandemic and a country-wide lockdown, the University of the Philippines College of Medicine halted face-to-face teaching in exchange for online learning for its students. For the Learning Unit VI students, clinical rotations shifted to hybrid activities to continue learning activities while minimizing exposure risk. The Philippine General Hospital Department of Orthopedics introduced the following hybrid activities in its curriculum for Learning Unit VI students: 1) Online Lectures, 2) Online Departmental Conference, 3) Online Division Rounds, 4) Online SGDs, 5) Written Case, 6) Online Exams, 7) Preceptorship, Demo, Return Demo, and 8) Online OSCE. The department used a variety of platforms including synchronous sessions, asynchronous pre-recorded lectures, and face-to-face teaching, as appropriate. @*Objectives@#The study compared the faculty and student course evaluations of activities in the hybrid ORTHO 251 course. @*Methodology@#Faculty and students were asked to evaluate each activity according to the Course Evaluation By Students (CEBS), the standard questionnaire used by the college, to determine the overall rating of each activity as well as any differences between the two groups. @*Results@#The hybrid activities conducted in the ORTHO 251 course were rated as good or excellent by the faculty and students, with differences in a few activities. Consultants rated online exams as being less effectively integrated and that there was inadequate time allotment for online SGDs, written cases, and online exams. Meanwhile, students rated all activities higher in terms of stimulating self-directed learning. @*Conclusion@#With good to excellent outcomes, this study found that it has at least satisfactorily matched the learning platform to the learning component. While knowledge may be taught via asynchronous recorded lectures or reading materials, attitude and thinking processes are better formed through synchronous discussion. Skills in medical education, including Orthopedics, are still best taught via face-to-face demoreturn demo. With this information, the department can investigate the causes of these differences and improve on the identified weaknesses.

Midwives are crucial human resources for health to achieve universal health care

@#Midwives are primarily considered as professionals with expertise in assisting women before, during, and after childbirth. Thus, the competencies for midwifery as defined by the International Confederation of Midwives revolve principally around assessment and provision of care to women and the fetus/newborn/infant during the pre-pregnancy and antenatal periods, labor and birth, postnatal/postpartum periods.1 The availability of skilled midwives in communities has allowed women, especially those who belong to lower income groups, to access professional services around childbirth, as reflected in responses from the National Demographic and Household Survey.2 For instance, while 50% of all women surveyed received antenatal care from a midwife, it is notable that 70% of those who belonged to the lowest wealth quintile were seen by a midwife during the antenatal period. Furthermore, midwives assisted 30% of deliveries reported by respondents, while roughly a little over a third of deliveries for each of the three lowest quintiles were attended by a midwife. Furthermore, in the Philippine setting, midwives are recognized as the first professional point of contact for most members of a community, especially in rural and remote places, as midwives are the ones deployed to manage Barangay Health Stations. Elaborating the scope of the practice of midwifery in relation to the provision of “primary health care services in the community” as stipulated in Republic Act No. 73923, the Board of Midwifery of the Professional Regulation Commission, in a primer for the profession, stated that midwives are expected to, among others, (a) implement government health programs in accordance with policies and guidelines of the Department of Health; (b) supervise barangay health workers; and (c) manage a Barangay Health Station.4 Stated differently, midwives, given the scope of work that they do and the areas where they are deployed, serve as the face and touchpoint of the health sector in our communities. They are the embodiment of the different health policies and programs enacted at the national and local levels through which Filipinos experience, individually and collectively, the drive for better health (or lack thereof ) advanced by different agencies, personalities, and stakeholders. However, as pointed out by Felipe-Dimog et al.5 in this issue of Acta Medica Philippina, midwives, especially those working in the public health sector, may take on roles beyond that contemplated by law. For instance, in the course of my professional practice during which I was deployed briefly in a rural health unit, and worked with an urban health department, I have encountered midwives who were tasked to work as program coordinators (or assistant coordinators), sanitation inspectors, field epidemiologists, and supply managers, among others, because of scarcity in the overall staff complement of health departments. Given their close ties with their areas of assignments, midwives are also expected to be community coordinators, if not organizers. The extent to which midwives are assigned these additional tasks depend on their professional relationship with their immediate supervisor; the level of trust and confidence reposed on them by their superiors; in some instances, their attendance to specific training workshops; as well as the availability of more qualified personnel (or lack thereof ) in the locality. Yet despite all these – placement in remote, if not hardship posts; additional assignments beyond their job description – midwives receive salaries that may not be commensurate after consideration of the job context. Staff midwife positions (i.e., Midwife I to III) in government institutions are remunerated at Salary Grades 9 to 13 (i.e., approximate gross pay of PHP 21,000 to PHP 31,000, based on the fourth tranche of the Salary Standardization Law, but may be lower depending on the income classification of the local government unit6). Additional compensation and benefits under special laws may not always be provided as this will depend on the paying capacity of the employing agency. Furthermore, midwives – especially those who completed the two-year program under the previous policy – also must contend with issues concerning their professional status. I have personally encountered community members who do not consider midwives as professionals in the same league as nurses or physicians, or who view midwives as “assistants” or “subordinates” of nurses and physicians, forgetting that a certain degree of independent practice is allowed each professional licensed by the Republic of the Philippines. Midwives play a crucial role in caring for Filipinos not only around childbirth – this is their primary professional duty – but throughout the lifespan – especially for midwives working in local health departments. Stakeholders must not forget to give due recognition to the value and worth contributed by midwives in shaping the health and well-being of each generation of Filipinos.

Food and nutrition security in the Philippines during the COVID-19 pandemic / Journal of Rural Medicine

Objective: The COVID-19 pandemic placed the Philippines’ food and nutrition issues front and center. In this paper, we discuss the response of its government in addressing food and nutrition security at the beginning of the COVID-19 pandemic and describe its implications on nutritional status. We also cite initiatives that address food accessibility and availability in the communities. Lastly, we explore the importance of nutrition security dimension in food security.Methods: We analyze food and nutrition security issues in the Philippines during the COVID-19 pandemic through online reports and news articles.Results: The distribution of food and financial assistance in the country was extensive, albeit insufficient, considering the prolonged lockdown restrictions. Constantly changing community quarantine guidelines have affected the movement of food supply, delivery of health services, and household economic security. Nutrition programs, such as vitamin A supplementation, feeding for children, and micronutrient supplementation for pregnant women, had lower coverage rates, and by the latter half of 2020, the country had reached its highest recorded hunger rate. Cases of both undernutrition and overnutrition are predicted to rise because of dietary imbalances and a variety of factors. Conversely, community members and some local government units took it upon themselves to improve the food situation in their areas. The provision of food packs containing fresh fruits and vegetables was lauded, as it exemplified a conscious effort to deal with nutrition security.Conclusion: Efforts to address food security have always focused on increasing accessibility, availability, and affordability, often neglecting the nutritional components of foods. Strategies that incorporate nutrition security into food security are much needed in the country, especially during emergencies like the COVID-19 pandemic.

Cross-cultural validation of the Cebuano version of a screening questionnaire for Parkinson's disease / Validação transcultural da versão Cebuano de um questionário de triagem para a doença de Parkinson

Abstract Background In the Philippines, the exact prevalence of Parkinson's disease (PD) has not yet been determined. Although cases can be extrapolated from medical registries, this method may undermine actual case rates. A reliable screening tool for PD is essential for a timely diagnosis and community-based epidemiological studies. The most widely used screening questionnaire for PD diagnosis was developed by Tanner et al., which consists of nine questions about the motor symptoms of PD. Although this questionnaire has been translated to several languages, the translated version must be validated for use in our local setting. Objective To determine the validity of the Cebuano version of a PD screening questionnaire. Method The questionnaire was translated from English to Cebuano by a hired language specialist. Each item was supplied with ayes, no, ordon't know answer. A total of 73 patients with PD and 244 control subjects completed the study. Results The overall Cronbach alpha for internal consistency of the questionnaire was 0.9410. The item ontremor had the highest sensitivity (97.26%), while the item onproblems with buttoning had the highest specificity (100.00%). A cut-off score ≥ 3 obtained the best Youden index (99.18%), with a sensitivity of 100.00% and a specificity of 99.18%. The questionnaire had an almost perfect predictive ability to diagnose PD (AUC of 0.9994). Conclusion The translated version of the Tanner questionnaire is a validated instrument to identify PD in a literate Cebuano population.

Resumo Antedecentes Nas Filipinas, a prevalência exata da doença de Parkinson (DP) ainda não foi determinada. Embora os casos possam ser extrapolados dos registros médicos, esse método pode prejudicar as taxas reais de casos. Uma ferramenta de triagem confiável para DP é essencial para um diagnóstico oportuno e estudos epidemiológicos baseados na comunidade. O questionário de triagem mais utilizado para o diagnóstico da DP foi desenvolvido por Tanner et al., que consiste em nove questões sobre os sintomas motores da DP. Embora este questionário tenha sido traduzido para vários idiomas, a versão traduzida deve ser validada para uso em nosso meio. Objetivo Determinar a validade da versão Cebuano de um questionário de triagem de DP. Métodos O questionário foi traduzido do inglês para o cebuano por um especialista em idiomas contratado. Cada item foi fornecido com uma resposta "sim", "não" ou "não sei". Um total de 73 pacientes com DP e 244 controles completaram o estudo. Resultados Em geral o alfa de Cronbach para consistência interna do questionário foi de 0,9410. O item "tremor" teve a maior sensibilidade (97,26%), enquanto o item "problemas com abotoamento" teve a maior especificidade (100,00%). Um escore de corte > 3 obteve o melhor índice de Youden (99,18%), com sensibilidade de 100,00% e especificidade de 99,18%. O questionário teve uma capacidade preditiva quase perfeita para diagnosticar DP (AUC de 0,9994). Conclusão A versão traduzida do questionário de Tanner é um instrumento validado para identificar a DP em uma população cebuana alfabetizada.

Association of household food security and dietary diversity of mother-child pairs in the Philippines

@#Introduction: The majority of Filipino households experience food insecurity. Mothers and children are among the population groups suffering from poor diet quality. This study aimed to determine the extent of the association of household food security (HFS) to mothers’ and children’s dietary diversity score (DDS), and to identify the significant factors associated with meeting the DDS of these vulnerable groups. Methods: The study was a cross-sectional, population-based study utilising secondary data from the 2015 Updating Survey. From a total of 6,692 mother-child pairs, the association between HFS and meeting the DDS of mothers and children, as well as the potential predictors for meeting the DDS were tested using descriptive and logistic regression analyses. Results: The findings showed that HFS was significantly associated with meeting the DDS of mothers and children aged 6-36 months (p<0.001). The proportion of meeting the DDS among mothers and children was significantly higher in food-secure than in food-insecure households (20.7% vs. 14.4%). Furthermore, meeting the DDS decreased with increasing levels of food insecurity. Household food security status, education background, employment, child’s age, and wealth status were significantly associated with meeting the DDS. Conclusion: This study showed the extent of how food security was associated with meeting the DDS of mothers, children, and mother-child pairs, and the factors associated with meeting the DDS. Results can be used to strengthen the formulation of appropriate, evidence-based policies to address household food insecurity and low DDS among mothers and young children.

Discoursing terminology standards and interoperability in relation to the Philippine eHealth Strategy

Background@#eHealth is the use of information and communication technologies (ICT) for health. It helps in improving the flow of information, through electronic means, in support of the delivery of health services, and the management of health systems. eHealth is used as the strategic context and tool in achieving population health, improved health system status, and socio-economic development goals. @*Objectives@#This study is aimed at looking at the Philippine National eHealth Strategy, particularly the components of Terminology Standards and Interoperability concerning the eHealth strategy in the Philippines, and to assess the barriers and gaps in the integration of these two components. @*Methods@#This study used secondary literature, internet search, Philippine laws, administrative orders, memorandum circulars, and grey literature to discourse terminology standards and interoperability in the Philippine eHealth system, and issues and gaps related to these components that may impede the delivery of Universal Health Coverage in the country. @*Results@#The current Philippine National eHealth strategy includes the following sector governance, legislation, policy and compliance, eHealth solution (i.e., services and applications), strategy and investment, infrastructure (government), human resources, and standards and interoperability. Philippine Health Information Exchange (PHIE) is a software platform in the country that aims to connect many isolated electronic health systems. The proposed interoperability layer across health systems and services in the Philippines includes Patient’s Primary Healthcare Consultation at the Rural Health Unit, health research, legal information, patient healthcare at tertiary hospital, and health insurance claims. The study results showed that issues and gaps related to the interoperability of eHealth in the Philippines include technical issues such as lack of common semantics, lack of an institutional mechanism to regulate EMR, lack of incentives among eHealth providers and stakeholders to adopt standards for interoperability.@*Conclusion@#The effort of the Philippines to achieve interoperability and standards in eHealth goals can be characterized as a work in progress. The government, private sector, physician, patient, and other stakeholders are deemed to continuously develop a shared vision and interoperate under a standardized guide as eHealth is a complex endeavor that covers many aspects.

Is occupational therapy an ableist health profession? A critical reflection on ableism and occupational therapy / Terapia ocupacional é uma profissão da saúde capacitista? Uma reflexão crítica sobre capacitismo e terapia ocupacional

Abstract Introduction There is a need to engage in critical reflection and reflexivity to deconstruct ableist conceptualisations and practices in occupational therapy. Objectives: 1) to discuss ableism as a social construction within a practice system, 2) to deconstruct ableist mechanisms employed within occupational therapy practice, and 3) to propose inclusive and justice-oriented practices that can improve patterns of practices within the occupational therapy profession. Method Online discussions and reflective writing, producing critical reflections, were done to curate our experiences and insights based on our personal and professional experiences, thoughts, and observations as Filipino occupational therapy practitioners. Critical reflexivity was seen both as process and output to address the research objectives. Findings Despite the efforts of scholars, educators, and practitioners in employing inclusive and justice-oriented occupational therapy practices, ableism continues to proliferate through overt and covert mechanisms within professional practices. Conclusion As the occupational therapy profession continues to evolve, practitioners are expected to be critically reflective and reflexive to mitigate discriminatory practices and promote inclusive and participatory practices today and beyond. This article hopes to serve as an eye-opener for occupational therapy practitioners and reconsider their doings, knowings, and sayings in their present and future practice.

Resumo Introdução Há uma necessidade de se engajar em uma reflexão crítica e em reflexividade para desconstruir conceituações e práticas capacitistas em terapia ocupacional. Objetivos 1) discutir o capacitismo como uma construção social dentro de um sistema de prática, 2) desconstruir mecanismos capacitistas empregados na prática em terapia ocupacional e 3) propor práticas inclusivas e orientadas para a justiça que possam melhorar os padrões de práticas dentro da profissão de terapia ocupacional. Método Foram feitas discussões online e escrita reflexiva, produzindo reflexões críticas, para selecionar nossas experiências e insights, pensamentos e observações pessoais e profissionais como praticantes de terapia ocupacional nas Filipinas. A reflexividade crítica foi vista tanto como processo quanto como saída para abordar os objetivos da pesquisa. Resultados Apesar dos esforços de acadêmicos, educadores e profissionais em empregar práticas de terapia ocupacional inclusivas e orientadas para a justiça, o capacitismo continua a proliferar por meio de mecanismos abertos e encobertos nas práticas profissionais. Conclusão À medida que a profissão de terapia ocupacional continua a evoluir, espera-se que os profissionais sejam criticamente reflexivos para mitigar práticas discriminatórias e promover práticas inclusivas e participativas hoje e além. Este artigo espera contribuir como um alerta para terapeutas ocupacionais reconsiderarem seus fazeres, saberes e dizeres em sua prática presente e futura.

Risk factors of stunting during the complementary feeding period 6-23 months in the Philippines

@#Introduction: Stunting persists as a public health problem in the Philippines, affecting 30% of under-five children. This study aimed to identify the drivers of stunting in young Filipino children aged 6-23 months. Methods: Data were extracted from the cross-sectional Updating Survey conducted in 2015 by the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST). Potential predictors of stunting, which were categorised into childrelated characteristics, feeding practices, maternal socio-demographic status and health practices, and household economic and food security status, were examined using descriptive and regression analyses. Results: Of the 2,275 children aged 6-23 months, 18.7% were stunted and 8.3% were severely stunted. The risk of stunting increased significantly among older children aged 12-23 months (relative risk ratio, RRR 3.04), males within 6-23 months of age (RRR 1.99), and low-birth-weight infants (RRR 2.19). Children born from teenage mothers (RRR 1.90), mothers with short stature (RRR 2.33), and mothers with low education (RRR 1.59) posed higher risks of becoming stunted relative to their counterparts. Mothers with >4 children (RRR 2.44), coming from the poorest households (RRR 4.27), having untimely introduction of complementary foods (RRR 4.44), and not meeting the minimum meal frequency (RRR 2.30) increased the risks of severe stunting. Conclusion: The study illustrated the multi-factorial nature of stunting among Filipino children aged 6-23 months old. Therefore, a multi-sectoral approach is needed to address the underlying factors of stunting among young Filipino children to help achieve the country’s nutrition targets by 2025.

Comparison of faculty and student evaluations of the hybrid teaching of orthopedics during the COVID-19 pandemic

Background@#In the face of the COVID-19 pandemic and a country-wide lockdown, the University of the Philippines College of Medicine halted face-to-face teaching in exchange for online learning for its students. For the Learning Unit VI students, clinical rotations shifted to hybrid activities to continue learning activities while minimizing exposure risk. The Philippine General Hospital Department of Orthopedics introduced the following hybrid activities in its curriculum for Learning Unit VI students: 1) Online Lectures, 2) Online Departmental Conference, 3) Online Division Rounds, 4) Online SGDs, 5) Written Case, 6) Online Exams, 7) Preceptorship, Demo, Return Demo, and 8) Online OSCE. The department used a variety of platforms including synchronous sessions, asynchronous pre-recorded lectures, and face-to-face teaching, as appropriate. @*Objectives@#The study compared the faculty and student course evaluations of activities in the hybrid ORTHO 251 course. @*Methodology@#Faculty and students were asked to evaluate each activity according to the Course Evaluation By Students (CEBS), the standard questionnaire used by the college, to determine the overall rating of each activity as well as any differences between the two groups. @*Results@#The hybrid activities conducted in the ORTHO 251 course were rated as good or excellent by the faculty and students, with differences in a few activities. Consultants rated online exams as being less effectively integrated and that there was inadequate time allotment for online SGDs, written cases, and online exams. Meanwhile, students rated all activities higher in terms of stimulating self-directed learning. @*Conclusion@#With good to excellent outcomes, this study found that it has at least satisfactorily matched the learning platform to the learning component. While knowledge may be taught via asynchronous recorded lectures or reading materials, attitude and thinking processes are better formed through synchronous discussion. Skills in medical education, including Orthopedics, are still best taught via face-to-face demoreturn demo. With this information, the department can investigate the causes of these differences and improve on the identified weaknesses.

Study of Knowledge, Attitudes and Practices among Sanitary Workers Regarding Medical Waste Management in Khartoum Locality Teaching Hospitals, 2019

Health care waste is considered as a risk or dangerous to public health and the environment. The exposure of patients, staff, waste handlers, visitors and the community to medical waste is due to bad management practices in hospitals and health care centers. This cross sectional descriptive study was carried out in in Khartoum Locality Teaching Hospitals with the aim to assess knowledge, attitudes and practices among the health sanitary workers towards medical waste management. Total 210 respondents were participated in the study; the study uses questionnaires, interviews and observations as tools for data collection. The collected data were analyzed by Software Package for Social Sciences (SPSS) and the result was presented in text, figures and tables. The study revealed that 42.4% of the respondents have excellent knowledge about hazardous waste. Nearly half, 45.2% of the respondents have excellent and very good knowledge concerning waste transmitting diseases. 95.2%, 82.9%, 66.2%, 22.8% and 53.8% have favorable attitudes towards wearing gloves, wearing an apron, wearing masks, wearing boots, wearing gloves during the work respectively. 83.3% wash their hands after the work, but only 33.3% use soap. This study showed that females were significantly more knowledgeable, having favorable attitude, and better practices towards medical waste than males. The Study recommended that the Occupational Health Department in State Ministry of Health should apply programs to encourage the health workers to use the personal protective equipment..

Stakeholders’ Quality Framework of Nursing Education: A Brief Report

Objective: Stakeholders play an important role in generating criteria that will identify variables in evaluating nursing education. This brief report focuses on stakeholder’s involvement in perceiving and formulation of quality framework s in nursing education which is conducted in one of the state universities in the Philippines that offers a nursing program. Methods: Survey questionnaires, Focus Group Discussion (FGD) working papers, rubrics of responsiveness were used among 410 involved participants to identify the contributing factors towards stakeholder’s quality framework in nursing education. Content analysis was utilized for its qualitative results and simple frequencies and averages were applied for its quantitative descriptions. Results: Results showed that stakeholders defined quality education utilizing resources, practices, and outcomes with 7 elements namely: 1) Administration, 2) Curriculum and instructions, 3) Faculty, 4) facilities, 5) Student services, 6) Research and 7) Community extension. For the perspectives, meanings, and values of stakeholders’ revealed difference when it comes to limitations in achieving goals but participants believed that nursing education is the production of a system for its input-process-output model. It also showed that provision of quality education and services pertaining to community development matters in terms of attaining institutional goals. Conclusion: These findings likewise contribute to the definition of stakeholder’s quality framework that affects the delivery of nursing education which contains bearing when it comes to attaining its institutional goals, vision, and mission.

Immediate psychological responses and coping styles of tertiary school employees during the COVID-19 pandemic

Background@#The COVID-19 outbreak broadly affected not only the physical but also the psychological wellbeing of the people. However, few studies have been conducted concerning its psychological impact specifically on employees from the academe.@*Objectives@#To determine the psychological responses and coping styles of employees of the School of Health Sciences at the University of the Philippines - Manila during the COVID-19 pandemic. Specifically, this study sought to determine the association between participants' socio-demographic characteristics and their psychological responses, and between participants' psychological responses and their coping styles used. @*Methodology@#We employed a cross-sectional design and self-selection or volunteer sampling to recruit 46 academics and support staff employed during the COVID-19 pandemic. The data were collected in April 2020. Psychological responses were determined with the 10-item Kessler's Psychological Distress Scale. Coping styles were assessed with the short-form Cognitive Emotion Regulation Questionnaire. Likelihood ratio chisquare tests and Spearman rho tests were conducted to test the hypotheses. Statistical significance was determined at p < .05.@*Results@#The majority of participants reported low levels of psychological distress in the early stage of the pandemic (n=44; 95.65%). We found a statistically significant relationship between psychological responses and coping styles characterized by rumination (rs = 0.454; P = 0.002) and catastrophizing (rs = 0.408; P = 0.005).@*Conclusions@#Our study confirmed the significance of psychological responses during the COVID-19 pandemic and demonstrated a specific association with coping styles characterized by rumination and catastrophizing but are unsuitably less adaptive. Hence, the application of less adaptive techniques when psychologically distressed from the pandemic need to be corrected or modified.

Effect of education on the risk of gender-based violence in the Philippines

Background@#Gender-based violence originates when societal gender-based expectations and the reality are not consistent. One such example is: there has been a recent rise in women's education in the Philippines, yet the prevalence of traditional female role expectations in the context of the heavily Catholic Filipino society remains unchanged. @*Objectives@#In this paper, the relationship between women's education and their risk of gender-based violence (GBV) is examined and compared with the relationship between the education of their partners and the women's risk of experiencing GBV. @*Methodology@#Our sample included women living in the Philippines surveyed by the Demographic Health Survey in 2017. We used multivariate logistic regression on the respondents' and the partner's education level, with respondent's risk of experiencing GBV. @*Results@#We found that there was a slight but statistically significant decreased risk of GBV experience with increased years of education of both the female respondents and their male partners. For all female respondents, there was a 3.7% decrease in the risk of GBV per additional year of their own education. For those with partners, there was a 2.3% decrease in the risk of GBV per additional year of their partner's education. @*Conclusion@#We found that the education of male partners is as much of a factor as the women's own education in her likelihood of experiencing violence. From this, we established that partner selection based on their education levels may act as a protective factor for an individual's likelihood of experiencing GBV. Policy initiatives should address increasing male awareness of safe behavior and violence against women, especially while traditional gender roles are still predominant in the Filipino society.

Immediate psychological responses and coping styles of tertiary school employees during the COVID-19 pandemic

@#BACKGROUND: The COVID-19 outbreak broadly affected not only the physical but also the psychological wellbeing of the people. However, few studies have been conducted concerning its psychological impact specifically on employees from the academe. OBJECTIVES: To determine the psychological responses and coping styles of employees of the School of Health Sciences at the University of the Philippines - Manila during the COVID-19 pandemic. Specifically, this study sought to determine the association between participants’ socio-demographic characteristics and their psychological responses, and between participants’ psychological responses and their coping styles used. METHODS: We employed a cross-sectional design and self-selection or volunteer sampling to recruit 46 academics and support staff employed during the COVID-19 pandemic. The data were collected in April 2020. Psychological responses were determined with the 10-item Kessler’s Psychological Distress Scale. Coping styles were assessed with the short-form Cognitive Emotion Regulation Questionnaire. Likelihood ratio chi-square tests and Spearman rho tests were conducted to test the hypotheses. Statistical significance was determined at p < .05. RESULTS: The majority of participants reported low levels of psychological distress in the early stage of the pandemic (n=44; 95.65%). We found a statistically significant relationship between psychological responses and coping styles characterized by rumination (rs = 0.454; P = 0.002) and catastrophizing (rs = 0.408; P = 0.005). CONCLUSIONS: Our study confirmed the significance of psychological responses during the COVID-19 pandemic and demonstrated a specific association with coping styles characterized by rumination and catastrophizing but are unsuitably less adaptive. Hence, the application of less adaptive techniques when psychologically distressed from the pandemic need to be corrected or modified.

Reduction in inequalities in health insurance coverage and healthcare utilization among older adults in the Philippines after mandatory national health insurance coverage: trend analysis for 2003-2017

BACKGROUND@#Health policies in the Philippines have evolved in response to increasing health demands of older adults. However, there is a lack of research on equity among the ageing population in low-middle income countries. The objective of this study was to identify the trends in National Health Insurance Program (NHIP) coverage and healthcare utilization among older adults in the Philippines for the period from 2003 to 2017, during which NHIP expansion policies were implemented, focusing on reductions in socio-economic inequalities.@*METHODS@#A literature search of policies for older adults and an analysis of four Philippine National Demographic and Health Surveys (2003, 2008, 2013, and 2017) with data from 25,217 older adults who were 60 years or older were performed. The major outcome variables were NHIP coverage, self-reported illness, outpatient healthcare utilization, and inpatient healthcare utilization. Inequalities in NHIP coverage and healthcare utilization according to wealth were evaluated by calculating the concentration index for individual years, followed by a regression-based decomposition analysis.@*RESULTS@#NHIP coverage among older adults increased from 9.4 (2003) to 87.6% (2017). Although inequalities according to wealth quintile were observed in all four surveys (all P < 0.001), the concentration index declined from 0.3000 (2003) to 0.0247 (2017), showing reduced inequalities in NHIP coverage over time as observed for self-reported illness and healthcare utilization. NHIP coverage expansion for older adults in 2014 enabled equal opportunity for access to healthcare.@*CONCLUSION@#The passage of mandatory NHIP coverage for older Filipino adults in 2014 was followed by a reduction in inequality in NHIP coverage and healthcare utilization according to wealth.

Human Papillomavirus Serologic Profiles of Selected Filipinos with Head and Neck Squamous Cell Carcinoma

BACKGROUND: The low prevalence of human papillomavirus (HPV) DNA and mRNA in biopsy samples of Filipinos with head and neck squamous cell carcinoma (HNSCC) has been reported previously. Here, the HPV serologic profiles of HNSCC cases were analyzed and associated with lifestyle and sexual practices. METHODS: Serum samples were collected between May 2012 and September 2013 from HNSCC patients (n = 22) in the northwest region of the Philippines, and age- and sex-matched clinically healthy controls. Antibodies to capsid and early oncoproteins of HPV16, 18, 31, 33, 45, 52, 58, 6, and 11 were analyzed using multiplex serology. RESULTS: Most of the cases were males with tumors of the oral cavity or larynx. Two of the cases tested positive for at least one of the early oncoproteins (E6, E7, E1, and/or E2) of HPV16, and 11 did not display reactivity to any HPV early or late oncoproteins. Of the controls, four tested positive for at least one of the HPV16 early oncoproteins, and 10 were non-reactive to all HPV types. Titers to HPV16 E6 or E7 of the seropositive cases and controls were considerably lower than those typically observed in economically developed countries. CONCLUSIONS: The low HPV titers seen here are consistent with the results of molecular analyses for this population. Hence, the seropositivity of some of the HNSCC cases is likely an indication of prior exposure to the virus and not the presence of HPV-driven tumors.

Tuberculosis care: enhancing directly observed therapy in a peri-urban, low socioeconomic status neighbourhood

Tuberculosis (TB) is a major health issue in the Philippines. TB-Care was introduced in 2011 to tackle pulmonary TB among the urban poor in Payatas, Quezon City, Philippines. We evaluated the efficacy of TB-Care in increasing treatment success and compliance rates. This retrospective case series reviewed 44 patients with pulmonary TB enrolled in TB-Care from 2013 to 2014. Diagnosis and treatment of pulmonary TB was made in accordance with World Health Organization guidelines. Treatment outcomes included cure, completed treatment, successfully treated, failed treatment and transferred to another facility. 14 (73.7%) out of 19 patients tested were bacteriologically cured. The average 100% compliance rate was 90.8% over six months. The programme successfully treated 39 (88.6%) patients. This was comparable to the overall national treatment success rate of 90% for Philippines and 79% for Singapore, with higher compliance rates than were previously reported in this community.

The Emergence of Theranostics in the Philippines: Overcoming Challenges and Bringing Hope / 대한핵의학회잡지

Medical managements are becoming personalized while diseases are being understood at the molecular level. Nuclear medicine is one of the fields actively contributing to this development. In particular, theranostics, a combinatorial term for therapy and diagnostics, enables accurate imaging and subsequent targeted radionuclide treatment. Due to its high impact in healthcare, many countries have begun to offer Ga-68 PET/CTscans and Lu-177 therapies. The Philippines has followed suit through the initiative of this author and able support of the administration and staff of St. Luke's Medical Center. The Ga-68 DOTATATE and PSMA PET/CT scans became officially available in January 2018 while the first peptide receptor radionuclide therapy for neuroendocrine tumor and first PSMA radioligand therapy for prostate cancer occurred in May and June 2018, respectively. Amidst past, present, and future challenges, theranostics has emerged in the Philippines, offering hope to cancer patients in the country.