Service time, waiting time, good practices and areas for improvement in the UP Health Service during the 2020 COVID-19 pandemic: A five-day cross-sectional study

Background@#The COVID-19 pandemic has emphasized the critical task of the UP Health Service in recognizing and addressing the primary care needs of health care workers and support staff of the Philippine General Hospital. This helps in effective staff management and engendering trust in the hospital that performs critical functions in the pandemic response.@*Objectives@#To determine the service and waiting time in the facilities of the UPHS and describe good practices and areas for improvement for better service delivery at the UPHS during the COVID-19 pandemic@*Methods@#A cross-sectional study using patient flow analysis of processes in the non-COVID, COVID, and swabbing areas of the UPHS was conducted from June 1 to 5, 2020. All clinic visits by PGH employees and health care workers, including consultations and procedure for swabbing, were included in the study. Average service and waiting time in three areas of the UPHS were measured and analyzed from recorded time points using Microsoft Excel. Daily observations recorded on field notes were transcribed and analyzed using MaxQDA Analytics Pro 2020.@*Results@#A total of 604 PGH employee visits in the three main service areas of the UPHS were recorded during the 5-day study period. The average total service time was 25 (SD±17) minutes in the non-COVID clinic and 12 (SD±5) minutes in the COVID clinic. The mean swabbing time was 2 (SD±3) minutes. The average waiting time was longest in the COVID clinic at 46 (SD±39) minutes, followed by the swabbing area at 33 (SD± 32) minutes, and was shortest in the non-COVID clinic at 10 (SD±17) minutes. Good practices were observed in the areas of communication and coordination among the UPHS team, staff complementation, and application of telehealth solutions. Meanwhile, improvements may be made in identifying a practical and robust queuing system, enforcing firmer infection prevention and control measures and providing clearer patient instructions and cues especially during patient surge.@*Conclusion@#The average service time in the non-COVID, COVID and swabbing areas of the UPHS, were 25, 12 and 2 minutes, respectively. The average waiting time was longest in the COVID clinic, followed by the swabbing and non-COVID areas. Good practices were observed in terms of leadership, communication, staff complementation and feedback process while infection control and prevention measures, queuing system for crowd control and patient instructions can be further improved.

Antibody monitoring six months post-COVID-19 vaccination in four healthcare workers: A case series

@#This case series described four healthcare workers with exposure to patients and co-workers, who were potential or confirmed cases of COVID-19. They had negative nasopharyngeal swab reverse transcriptase polymerase chain reaction (RT-PCR) tests at different time points and had zero IgG antibodies on VITROS Anti-SARS-CoV-2 IgG Antibody test prior to CoronaVac inoculation on March 1, 2021. The levels of antibody titers, which showed increasing then declining trends of immunoglobulins, were measured at different time points. Although the antibody levels are not proof of immunity against SARS-CoV-2 and the protective quantity is yet to be determined, the titers are evidence that vaccines do elicit an immune response and may have a role in the fight against infection

Perception and satisfaction survey of foster families hosting students of the University of the Philippines in the community rotation

Background@#Immersion programs under the Community Health and Development Program (CHDP) of the University of the Philippines involved students living in a foster home. The experiences of foster families are valuable in improving the community immersion program.@*Objective@#To determine the perceptions and satisfaction of foster families in hosting students of the University of the Philippines rotating in the five select municipalities of Cavite@*Methods@#This was a cross sectional study utilized a semi-structured questionnaire. Data collection was done by a research assistant who was not involved with the students rotation@*Results@#A total of 90 foster parents who hosted 430 students in three consecutive years were included. In general, there was favorable perception towards hosting students with a mean score of 8.47 (SD± 1.37). The lowest scores were reported by 13 families (14%) at a score of 6/10. The weekly monetary contributions, free consultations, monitoring of health conditions, acquiring additional knowledge about health prevention and if needed, an easy referral to Philippine General Hospital were some of the reported benefits. On the other hand, poor socialization, negative attitudes, non-performance of household chores and lack of privacy were the disadvantages expressed by families@*Conclusion@#Foster families were generally happy and satisfied however there were mixed positive and negative perceptions in hosting UP students rotating in the community

Effects of active video games on the physical and psychological well-being of children, adolescents, and young adults: A meta-analysis

Background@#Game developers incorporated the enjoyment of playing video games into the promotion of positive health outcomes. It led to the development of video games that are considered to be a form of exercise and are now popularly called exergames.@*Objective@#To determine the effect of active video-gaming on the physical and psychological well-being of children, adolescents, and young adults@*Methods@#Literature was searched using databases such as PubMed, ProQuest, Scopus, ScienceDirect, CINAHL, and PsychInfo. Bibliographical articles from included studies were also examined. The review included studies involving children and adolescents (4-17 years old) and young adults (18-24 years old) who are of normal weight, overweight, or obese. The included articles were assessed for any risk of bias using RoB tool in Review Manager (RevMan) [Computer program] Version 5.3, Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration (2014).@*Results@#A total of 7 studies were included in the quantitative assessment of physical activity (PA), Body Mass Index (BMI), body fat, and heart rate (HR). A total of 8 studies were included in the systematic review on perceived exertion, enjoyment, motivation, and perceived competence. Study results showed that exergames increase moderate-to-vigorous physical activity by 5.93 minutes 95% CI [4.81, 7.05]. However, there was no benefit found on body mass index, body fat, and heart rate. The review of articles showed mixed results on the benefits of exergames on RPE, enjoyment, motivation, and perceived exertion@*Conclusion@#Active video gaming increases moderate-to-vigorous physical activity in children, adolescents, and young adults. However, exergames neither decrease nor increase BMI, heart rate, and body fat. There were mixed results on the benefits of exergames on rating of perceived exertion, enjoyment, motivation, and perceived competence

Cost of Medications, Preference and Willingness-to-Pay for Pain Relief among Adult Patients Diagnosed with Acute and Chronic Musculoskeletal Pain Conditions

Objective@#To determine the current cost, medication preferences, willingness to pay for symptom relief and reduced adverse events of adult patients with acute and chronic musculoskeletal pain. @*Methods@#This was a cross-sectional study among adult Filipinos consulted for musculoskeletal conditions at Family Medicine Clinic. Data were collected through a questionnaire and a systematic sampling of respondents. @*Results@#The study had a total of 342 participants with degenerative osteoarthritis as the most common primary diagnosis. Twenty percent (N=69/342) were acutely symptomatic while 273/342 (80%) have chronic musculoskeletal pain. Most would prefer medicines at a lower price point, effectively reduces pain, fast onset of action, longer therapeutic effects and less adverse effects. Willingness-to-pay was at an average price of Php 86.11 (SD±15.47) per pill for complete symptom relief. @*Conclusion@#Adult Filipinos with musculoskeletal pain symptoms prefer pain medicines with good symptom control, less adverse event and were willing to pay for complete symptom relief at an average of eighty-six pesos per pill.

Summary recommendations on the use of protective equipment for health care personnel involved in triage and ambulatory consult of patients in COVID-19 pandemic

Background@#In a low resource setting, strategies to optimize Personal Protective Equipment (PPE) supplies are being observed. Alternative protective measures were identified to protect health care personnel during delivery of care@*Objective@#To provide list of recommendations on alternative protective equipment during this Coronavirus Disease 2019 (COVID-19) pandemic@*Methodology@#Articles available on the various research databases were reviewed, appraised and evaluated for its quality and relevance. Discrepancies were rechecked and consensus was achieved by discussion.@*Recommendations@#The use of engineering control such as barriers in the reception areas minimize the risk of healthcare personnel. Personal protective equipment needed are face shields or googles, N95 respirators, impermeable gown and gloves. If supplies are limited, the use of N95 respirators are prioritized in performing aerosol-generating procedures, otherwise, surgical masks are acceptable alternative. Cloth masks do not give adequate protection, but can be considered if it is used with face shield. Fluid-resistance, impermeable gown and non-sterile disposable gloves are recommended when attending to patients suspected or confirmed COVID-19. Used, soiled or damaged PPE should be carefully removed and properly discarded. Extended use of PPE can be considered, while re-use is only an option if supplies run low. Reusable equipment should be cleaned and disinfected every after use@*Conclusion@#In supplies shortage, personal protective equipment was optimized by extended use and reuse following observance of standard respiratory infection control procedures such as avoid touching the face and handwashing. The addition of physical barriers in ambulatory and triage areas add another layer of protection

Summary recommendations on the various disinfection strategies in the community

Background@#Local government units conduct community – based responses to control spread of COVID-19 infection. Initiatives include city-wide disinfecting operations on streets and establishments, and mist spraying outside houses, vehicles, and even directly on persons.@*Objective@#To provide a list of recommendations on the different disinfection strategies applicable for use in the community@*Methodology@#Articles and guidelines about community disinfection were searched in various research databases. All evidencebased recommendations were reviewed, appraised, evaluated and summarized@*Recommendations@#General disinfection in households and community recommends use of diluted bleach solution of 75ml Sodium hypochlorite in 3.8L or 1 gallon of water (1000ppm). It is recommended to clean and disinfect frequently touched surfaces such as tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and electronics. In disinfecting local quarantine facilities, all surfaces must be regularly cleaned using damp cleaning cloth and mops. Ethyl alcohol (70%) is used for small surfaces and well-ventilated spaces while diluted household bleach is used for surface disinfection. Spraying or fogging with ethyl alcohol or bleach disinfectant may be hazardous and has no proven benefit on disease prevention and control@*Conclusion@#The use of properly diluted household disinfectant solution for direct surface cleaning is an effective infection control measure in the community setting. Available evidence, however, recommends against the use of spraying, misting or fogging

Practice profile of Filipino family physicians nationwide: A web-based survey

Background@#The practice of Family Medicine is important in the provision of primary health care. Family physicians (FPs) provide health services both in the public and private settings@*Objective@#To describe the practice profiles and geographic aggregation of Filipino family physicians@*Methods@#This study was a web-based cross-sectional design involving family physicians who are registered in the Philippine Academy of Family Physicians membership database. The questionnaire was semi-structured with 3 consecutive sections: consent form, basic demographics, practice profile of family physicians.@*Results@#Overall, 95% (N=1357) of family physicians reported seeing patients in a health facility at least once a week. Thirty percent of physicians are from Luzon (N=426), 28% from the National Capital Region (N=395), 20% from the Visayas region (N=288) and 18% from Mindanao (N=261). There were more FPs who reported mixed-type clinical practice (51%) than those who were exclusively engaged in practice (49%). Involvement in the private sector was common among physicians who are in the clinics (59%), while employment in the public sector was commonly reported among those in mixed-type of practice (42%). Family physicians provide a wide range of clinical services including counselling, vaccinations, simple surgical excision, and palliative services. The average reported outpatient consultation fees of FPs was Php 321 (SD+120) per patient.@*Conclusion@#The practice profile of family physicians includes active clinical practice, employment in either the public or private sector, with a small fraction in solo clinic practice. The range of primary care services offered include management of chronic conditions, counselling, home visits, preventive care such as prenatal care, vaccinations and screening tests like pap smear