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.

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.

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.

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.

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.

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.

Demographic and clinical profiles of adult Filipino patients with psoriasis in Davao City: A cross sectional study

Background@#The Psoriasis Registry (PsorReg) was created by the Psoriasis Foundation of the Philippines with the goal of assessing the true magnitude of psoriasis in Davao City.@*Objectives@#To determine the demographic and clinical profiles of Filipino patients enrolled in PsorReg.@*Methods@#Cross-sectional study among adult patients enrolled in PsorReg.@*Results@#A total of 131 patients were included in the study. Mean age was 43.89 ± 15.8 years old. Chronic plaque psoriasis (96.2%) was the most common clinical pattern. 63.4% had nail involvement, while 35.1% had psoriatic arthritis. BMI was normal in 51.1% of patients. Common co-morbidities were hypertension (19.1%), diabetes (10.7%), and dyslipidemia (9.2%). Most common treatment were topical medications, while biologics were the least common. 42.7%, 49.6% and 37.4% had moderate psoriasis using BSA, PASI, and PGA, respectively. Majority (47.3%) reported a large effect of psoriasis on their quality of life.@*Conclusion@#This study determined the demographic and clinical profiles of adult Filipino patients registered in PsorReg in Davao City.

Genotype analysis of Acanthamoeba isolated from human nasal swabs in the Philippines

OBJECTIVE@#To analyze the genotypes of Acanthamoeba species isolated from human nasal swabs in the Philippines.@*METHODS@#Human nasal swabs were collected from two groups: a low exposure group composed of students of the University of the Philippines-Diliman and a high exposure group composed of laborers frequently exposed to garbage, soil and dust. After isolation using non-nutrient agar plate lawned with Escherichia coli and DNA extraction using Chelex-100 resin, the ASA.S1 region of the gene (Rns) coding for nuclear, small subunit ribosomal RNA of Acanthamoeba was amplified through polymerase chain reaction. Purified polymerase chain reaction products were then sequenced. Neighbor-joining, maximum parsimony, and maximum likelihood phylogenetic trees were then constructed.@*RESULTS@#In the low exposure group, 1 out of 70 (1.43%) students and 7 out of 110 (6.36%) in the high exposure group were culture-positive. Four soil samples were also obtained for comparison, all of which were tested culture-positive. Of the 12 Acanthamoeba isolates, only 9 were successfully sequenced. The basic local alignment search tool of the US National Center for Biotechnology Information was used to identify most similar sequences. Five isolates were identified as genotype T5, and 3 isolateds were genotype T4. Genotype T11 was also isolated from soil, the first to be reported in the Philippines.@*CONCLUSIONS@#Genotype T11 is a possible pathogenic strain and both T4 and T5 can be pathogenic to human, hence, healthy provisions, especially for high exposure groups, should be given more attention and reevaluated.

Genotype analysis of Acanthamoeba isolated from human nasal swabs in the Philippines

Objective: To analyze the genotypes of Acanthamoeba species isolated from human nasal swabs in the Philippines. Methods: Human nasal swabs were collected from two groups: a low exposure group composed of students of the University of the Philippines-Diliman and a high exposure group composed of laborers frequently exposed to garbage, soil and dust. After isolation using non-nutrient agar plate lawned with Escherichia coli and DNA extraction using Chelex-100 resin, the ASA.S1 region of the gene (Rns) coding for nuclear, small subunit ribosomal RNA of Acanthamoeba was amplified through polymerase chain reaction. Purified polymerase chain reaction products were then sequenced. Neighbor-joining, maximum parsimony, and maximum likelihood phylogenetic trees were then constructed. Results: In the low exposure group, 1 out of 70 (1.43%) students and 7 out of 110 (6.36%) in the high exposure group were culture-positive. Four soil samples were also obtained for comparison, all of which were tested culture-positive. Of the 12 Acanthamoeba isolates, only 9 were successfully sequenced. The basic local alignment search tool of the US National Center for Biotechnology Information was used to identify most similar sequences. Five isolates were identified as genotype T5, and 3 isolateds were genotype T4. Genotype T11 was also isolated from soil, the first to be reported in the Philippines. Conclusions: Genotype T11 is a possible pathogenic strain and both T4 and T5 can be pathogenic to human, hence, healthy provisions, especially for high exposure groups, should be given more attention and reevaluated.

Fiscal competition in health spending among local governments in the Philippines.

The Philippines is one of several Asian countries that has decentralized the provision of health care to its local governments in recent decades. In the context of decentralization, a few studies have previously examined the issue of fiscal competition among local governments in the developing world. This report presents a summary of a published study that examined the existence of interjurisdictional competition in health-care spending in the Philippines. The results indicate the presence of positive fiscal “spillovers” in health spending, consistent with municipalities/cities competing to outspend their neighbours. Several potential explanations for this finding are discussed. * This article is based on the article “Do Local Government Units (LGUS) Interact Fiscally While Providing Public Health Services In The Philippines?” published in the World Medical & Health Policy: Vol. 4: Issue. 2.

Food Preferences and Dietary Intakes of Filipino Adolescents in Metro Manila, The Philippines

Introduction: This study examined differences in food preferences and dietary intake among male and female Filipino adolescents of different nutritional status as measured by body mass index (BMI). Methods: One hundred and twenty 13- 17-year olds from various schools and communities in Metro Manila, The Philippines were selected through quota sampling with BMI, sex and age as criteria. Data on mean dietary intake and food preference were collected using pretested instruments - a 3-day food record and a food preference questionnaire, respectively. Resulting values were analysed using one-way ANOVA, Bonferroni test and Pearson’s product-moment and Spearman’s correlation using SAS Enterprise Guide version 2. Results: Preference for cereals prepared with added sugar or fat (ρ=0.21, p= .0240), and low fat meat (ρ=0.18, p=0.420) were found to be positively correlated with BMI, while preference for fruits that are high in vitamin A (ρ= -0.18, p=0.430) was negatively correlated with the said variable. Overweight respondents gave lower and significantly different preference scores to donut (p=.02780), banana cue (p=.0489) and mayonnaise (p=.0291). Respondents of different nutritional status also had statistically different intakes of fibre, calcium and phosphorus, corresponding with the positive correlation of fibre (ρ=0.25231, p=0.0054), calcium (ρ=0.2529, p=0.0134) and phosphorus (ρ=0.25887, p=0.0043) intake with BMI. With respect to sex, male respondents gave statistically higher preference for French fries (p=.0370), tofu (p=.0005), garlic (p=.0190) and mussels (p=.0023). Also, males have significantly higher intakes of energy and carbohydrate than female respondents. Conclusion: Results suggest that food preferences should be considered in the nutritional care management of malnourished adolescents.

Our 3-year community immersion in Barangay Tinajero, Bacolor, Pampanga: Hope in the land of survivors

Barangay Tinajero is one of the most depressed barangays (barrios) among the 21 barangays of Bacolor, Pampanga. Two UPCM (University of the Philippines, College of Medicine) Class 2012 Regionalization Program (RP) students conducted their three consecutive summer immersions (2008-2010) in Barangay Tinajero, Bacolor, the student's activities and their reflection on their experiences in the barangay.

KILUSAN LIGTAS MALARIA: Advancing Social Mobilization towards Sustainable Malaria Control in the Province of Palawan, the Philippines

As malaria continues to be a public health problem in the Philippines, its control is now the responsibility of the Local Government Unit (LGU). In this set-up, social mobilization is believed to be the key strategy in effective and sustainable implementation of malaria prevention and control activities. Palawan has always been the most malarious province in the country. Despite untiring malaria control efforts and huge funds spent to curb this malady for which Palawan has become known, this province remains the largest contributor of malaria cases and deaths. Thus, Kilusan Ligtas Malaria (KLM: meaning Movement Against Malaria) has focused on social mobilization in the implementation of malaria prevention and control. Microscopic confirmation of malaria is done by trained village microscopists, while health education-promotion activities, advocacy and linkage building are carried out by trained village community organizers. The noticeable outcomes are the increase in malaria case finding as reflected in the total number of malaria smears done, the increase in microscopic confirmation of malaria, and the decline in clinical diagnoses. Other outcomes include policy development and implementation in the form of executive orders and community ordinances to support the village microscopists and community organizers. Now, the biggest challenge of KLM is maintaining the momentum and sustaining gains.

A Study on Factors Influencing the Health Promoting Lifestyles of Koreans in the Philippines / 기본간호학회지

The purpose of this study was to determine the predictors of health promoting lifestyles(Health Promoting Lifestyle Profile: HPLP) of Koreans in the Philippines. The sample consisted of 100 Koreans who have lived in Manila, Philippines. Data were collected for two months from Feb. 1 to March 30, 1998. Analysis of the data was done by use of percentage, t-test, ANOVA, Pearson's Correlation Coefficients, and Stepwise Multiple Regression. The results of this study were summarized as follows : 1. The range of total HPLP score was from 73 to 175 and the mean score of that was 117.23. In comparison of mean scores depending on each item of six dimensions, self-actualization dimension tended to show the hightest score(2.98) and responsibility for health dimension, the lowest score(1.83). 2. The HPLP score showed a positive correlation with age(r=0.19), social support (r=0.39), self-efficacy(r=0.52) and perceived health status(r=0.27), but a inverse correlation with perceived health care service utilization barriers(r=-0.20). 3. By using stepwise multiple regression analysis it was determined that the main influencing factors on the HPLP score were self-efficacy(27.2%), social support(5.3%), age(5.3%) and perceived health status(2.9%). These variables made it possible to explain 40.7% of variance in HPLP score.