Health information sources and health-seeking behaviours of Filipinos living in medically underserved communities: Empirical quantitative research.

AIMS: To describe sources of health information and health-seeking behaviours of adults (aged ≥18) living in medically underserved communities in the Philippines. DESIGN: This is a secondary, quantitative analysis from a cross-sectional parent study. Participants completed a 10-item, self-report survey on their sources of health information, healthcare providers sought for health and wellness and health-seeking behaviours when ill. Responses were evaluated across two age groups (<60 vs. ≥60 years) and genders using generalized linear mixed models. RESULTS: Surveys were completed by 1202 participants in rural settings (64.6% female, mean age 49.5 ± 17.6). Friends and/or family were their key source of health information (59.6%), followed by traditional media (37%) and healthcare professionals (12.2%). For health promotion, participants went to healthcare professionals (60.9%), informal healthcare providers (17.2%) or others (7.2%). When ill, they visited a healthcare professional 69.1% of the time, self-medicated (43.9%), prayed (39.5%) or sought treatment from a rural health clinic (31.5%). We also found differences in health-seeking behaviours based on age and gender. CONCLUSIONS: Our findings highlight the need to organize programs that explicitly deliver accurate health information and adequate care for wellness and illness. Study findings emphasize the importance of integrating family, friends, media and healthcare professionals, including public health nurses, to deliver evidence-based health information, health promotion and sufficient treatment to medically underserved Filipinos. IMPLICATIONS: New knowledge provides valuable information to healthcare providers, including public health nurses, in addressing health disparities among medically underserved Filipinos. IMPACT: This study addresses the current knowledge gap in a medically vulnerable population. Healthcare professionals are not the primary sources of health information. Approximately one-third of participants do not seek them for health promotion or treatment even when ill, exacerbating health inequities. More work is necessary to support initiatives in low- and middle-income countries such as the Philippines to reduce health disparities. REPORTING METHOD: We adhered to the reporting guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution as our study design and methodology do not make this necessary.

Disparities in Colorectal Cancer Incidence among Asian and Pacific Islander Populations in Guam, Hawai'i, and the United States.

Colorectal cancer (CRC) ranks among the three most common cancers in Guam (GU), Hawai'i (HI), and the mainland United States (US). CRC prevalence in these areas is high among Filipinos, and indigenous CHamorus and Native Hawaiians; however, data on these populations are frequently aggregated in epidemiological studies, which can mask true CRC disparities. We examined CRC cumulative incidence rates (CIRs) among CHamorus in GU, Filipinos in GU, HI, and the US, and Native Hawaiians in HI and the US. CRC CIRs were calculated for two age groups (20-49 years; early onset, and 50-79 years; senior) and four time periods (2000-2004, 2005-2009, 2010-2014, and 2015-2019), stratified by ethnicity, sex, and location. Data analyzed included all invasive CRC cases reported to the Surveillance, Epidemiology, and End Results 9-Registry (n = 166,666), the Hawai'i Tumor Registry (n = 10,760), and the Guam Cancer Registry (n = 698) between 2000 and 2019. Senior CIRs were highest in HI and lowest in GU throughout all time periods, with a downward trend observed for senior CIRs in the US and HI, but not GU. This downward trend held true for all ethnic groups, except for CHamorus in GU, females in GU, and females of CHamoru ethnicity in GU. In contrast, early onset CIRs increased across all locations, sexes, and ethnic groups, except for Filipinos in HI and males of Filipino ethnicity in HI. Our findings provide crucial insights for future research and policy development aimed at reducing the burden of CRC among indigenous populations.

Prevalence, Awareness, Treatment, and Control of Hypertension Among Older Adults in the Philippines.

BACKGROUND: Little is known about the current prevalence and management of hypertension among older Filipinos. To address this gap, we examined the prevalence, awareness, treatment, and control of hypertension, as well as their correlates, among older Filipinos. METHODS: We analyzed a nationally representative survey of Filipinos aged 60 years and older (N = 5 985) in the Philippines. Blood pressure (BP) measurements were taken using a digital BP apparatus. People with hypertension included those with a systolic BP ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg, or those who reported current use of antihypertensive medication. People with undiagnosed hypertension were those who had measured hypertension but had not been diagnosed by a doctor as having hypertension, while people with untreated hypertension were those who had measured hypertension but not taking medication. Among those who were taking antihypertensive medication, respondents with measured hypertension were considered to have uncontrolled BP. RESULTS: Results showed that 69.1% of older Filipinos had hypertension, but only 61.6% of people with hypertension were aware of their hypertension and 51.5% were untreated. Sociodemographic factors, such as age, sex, education, and living arrangements, were significantly associated with hypertension prevalence, hypertension awareness, lack of treatment for hypertension, and/or suboptimal BP control. CONCLUSION: We observed a high prevalence of hypertension among older Filipinos and a relatively low level of awareness and treatment of hypertension among them. While there are government efforts to address the growing prevalence of hypertension in the country, more efforts should be made to bring these government programs to older Filipinos.

The differential prognostic implications of PD-L1 expression in the outcomes of Filipinos with EGFR-mutant NSCLC treated with tyrosine kinase inhibitors.

Background: The tumor immune microenvironment influences tumor evolution in non-small cell lung cancer (NSCLC). Yet, the prognostic value of programmed death-ligand 1 (PD-L1) in epidermal growth factor receptor (EGFR)-mutant NSCLC remains controversial. Additionally, prognostic studies in Filipinos with EGFR-mutant NSCLC remain unexplored to this day. Methods: We prospectively studied the outcomes of EGFR-mutant NSCLC in Filipino cohort, and retrospectively verified the survival trend using The Cancer Genome Atlas (TCGA) cohort. Kaplan-Meier method and generalized linear regression were used to assess survival. Expression and DNA methylation of cluster of differentiation 274 (CD274, gene that codes for PD-L1) were examined from TCGA tumor profiles. Pearson's correlation was used to correlate PD-L1 expression with outcomes associated with occurrence of EGFR mutations, tyrosine kinase inhibitor (TKI) types, and programmed cell death protein 1 (PD-1) expression. Proteome network analysis was used to examine the correlation between drug resistance and PD-L1. Results: PD-L1 positivity was associated with significantly longer progression-free survival (PFS; P=0.0096) but had a significantly contrasting influence in the overall survival (OS; P=0.0011). PD-L1 positivity (in both protein and RNA) was associated with longer median OS (mOS) in exon21 L858R, whereas, negativity was associated with longer mOS in exon19 deletion (exon19del). Stratification (high, low, negative) of PD-L1 expression lacked significant prognostic value (all P>0.05). PD-L1/CD274 expression (P<0.05) and DNA methylation (P<0.001) vary significantly among NSCLC subtypes and in different disease stages. Erlotinib treatment produced the longest median progression-free survival (mPFS; 874 days) relative to other EGFR-TKIs (137-311 days). PD-L1 lacked a significant correlation with EGFR-TKIs. Consistent with the immune-regulation activities of PD-1, higher expression leads to relatively shorter mOS. PD-1 correlated positively with PD-L1 expression and occurrence of exon21 L858R. Conclusions: PD-L1 differentially influenced the outcomes of Filipinos with EGFR-mutant NSCLC. NSCLC subtypes, disease stage, and PD-1 expression may impact the collective outcomes associated with PD-L1 and EGFR-sensitizing mutations.

Achieving health equity in cancer care in the Philippines.

Notwithstanding the progress made across the cancer care continuum, a major problem that many patients with cancer experience is the difficulty of access to global standards of care. Awareness of this problem has been increasing most especially when the economic context of a country forces health systems to deliver quality care despite the rising costs of diagnostic and therapeutic innovations amidst limited resources. Ultimately, inappropriate delivery of care to patients with cancer contributes to inadequate and unequal access to high-value therapy increasing financial toxicity among patients. This paper aims to highlight (1) the economic burden of cancer in the Philippines, (2) the saliency of identifying low-value interventions which come in two forms: the persistent over usage of proven ineffective modalities, and the underusage of potentially effective ones, and (3) the adverse effects of a decentralized health care system. The paper will also provide suggestions to address the challenges of achieving health equity in cancer care.

The frequency of major ABCG2, SLCO1B1 and CYP2C9 variants in Asian, Native Hawaiian and Pacific Islander women subgroups: implications for personalized statins dosing.

Aim: The frequencies of SLCO1B1*5 and CYP2C9*2 and *3 in specific Asian, Native Hawaiian and Pacific Islander (NHPI) subgroups are unknown. Patients & methods: Repository DNA samples from 1064 women self-identifying as Filipino, Korean, Japanese, Native Hawaiian, Marshallese or Samoan and aged 18 years or older were used for targeted sequencing of three genetic variants (rs4149056, rs1799853 and rs1057910). Results: SLCO1B1*5 was significantly less frequent in NHPI women (0.5-6%) than in Europeans (16%). Except for Koreans, CYP2C9*2 (0-1.4%) and *3 (0.5-3%) were significantly less frequent in all subgroups than in Europeans (8 and 12.7%, respectively). Prior reports showed that Asian and NHPI individuals have significantly higher ABCG2 Q141K allele frequency (13-46%) than Europeans (9.4%). Combined phenotype rates for rosuvastatin and fluvastatin revealed that Filipinos and Koreans had the highest frequencies of statin-associated myopathy symptoms risk alleles. Conclusion: Differences in ABCG2, SLCO1B1 and CYP2C9 allele frequencies among different racial and ethnic subgroups highlight the need for increased diversity in pharmacogenetic research. Risk alleles for statin-associated myopathy symptoms are more prevalent in Filipinos, underscoring the importance of genotype-based statin dosing.

Statins are medications used to lower low-density lipoprotein ('bad') cholesterol. Variation in genes for proteins which transport drugs (SLCO1B1 and ABCG2) or metabolize drugs (CYP2C9) may significantly influence how much statin someone is exposed to. Genetic variants within SLCO1B1 can affect exposure to all statins, while variants within ABCG2 and CYP2C9 can affect exposure to rosuvastatin and fluvastatin, respectively. The prevalence of the decreased or no-function genetic variants is unknown among Filipino and Native Hawaiian and Pacific Islander (NHPI) subgroups. The major racial categorization of 'Asians and NHPI' (ANHPI) can miss potential genetic and ancestral differences among population subgroups. Our study used biobank data from 1064 women of ANHPI descent to estimate the frequencies of four important variants within SLCO1B1, ABCG2 and CYP2C9. Those of ANHPI ancestry were less likely to have variations in SLCO1B1 and CYP2C9 but significantly more likely to have nonfunctional ABCG2 than Europeans. Our findings provide insight into SLCO1B1 and CYP2C9 genetic variations among under-represented subgroups. Specifically, Filipinos and Koreans have the highest rates of higher risk genetic variants linked to high rosuvastatin and fluvastatin exposure and muscle-related side effects. Estimating the frequency of genetic variations in under-represented subgroups is pivotal in reducing health disparities in treatment outcomes, diversifying pharmacogenetic research and advancing personalized medicine.

The frequency of rs2231142 in ABCG2 among Asian subgroups: implications for personalized rosuvastatin dosing.

Statins are widely used medications for the primary and secondary prevention of cardiovascular diseases. Statin-induced musculoskeletal symptoms are the primary adverse drug events contributing to poor adherence to lipid-lowering therapy. Rosuvastatin is characterized by interindividual differences in systemic exposure among different patient population subgroups. The missense variant Q141K within ABCG2, highly prevalent in some Asian subgroups, results in decreased transporter efflux function and increased exposure to rosuvastatin. We aim to highlight the implications of ABCG2 genotype in prescribing rosuvastatin and the ramifications of interpopulation differences in Q141K frequencies in the starting dose of rosuvastatin in major Asian subgroups, using the most recent genetic-based guidelines. The high frequency of Q141K in Filipinos could warrant a lower starting rosuvastatin dose versus non-Filipinos. The Q141K genotype frequencies in Asian subgroups suggest significant interpopulation differences, reinforcing the need to move beyond race-based to genotype-based rosuvastatin dosing.

Rosuvastatin, a commonly prescribed cholesterol-lowering drug, has differences in response between different population subgroups. Rosuvastatin may also cause muscle pains, contributing to low adherence to the medication. Asians have a significantly high frequency of genetic variation (Q141K) within ABCG2, a critical rosuvastatin-efflux pump, leading to less functional transporter and higher drug levels. This special report highlights the role of ABCG2 genotyping in prescribing rosuvastatin. Also, it describes the consequences of between-population differences in the Q141K frequency in deciding the starting dose in individuals of Asian background, using the most recent genetic-based guidelines. Among different Asian subgroups, Filipinos have the highest Q141K polymorphism frequency and are more likely to require a lower starting dose of rosuvastatin than other Asians. Knowledge of the Q141K frequency in different Asian subgroups could drive individualized rosuvastatin dosing and reduce racial disparities in drug safety and efficacy.

Phenomenological Probe on Senior High School Teachers’ Experiences in Teaching Sports Track During the Transition Years of Philippine K To 12 / Sondeo fenomenológico sobre las experiencias de los maestros de secundaria superior en la enseñanza de deportes de atletismo durante los años de transición de Filipinas K a 12

The Philippine education system is currently under transition due to the implementation of Republic Act 10533, also known as the Enhanced Basic Education Act. Since its enactment in 2013, physical education researchers have been examining the initial impact of this transition. Yet, investigations to determine teachers' challenges in the sports Track Program of the senior high school curriculum were barely sufficient. Hence, this research was conducted to probe the challenges of these teachers using a qualitative phenomenology research design. Research participants from selected schools in the Cotabato Province in the Philippines were involved in focus group discussions, in-depth interviews, and extensive field observation. Six significant concerns from the research participants transpired; these are difficulties with online learning, mismatched of students’ interests; unrealistic curriculum; inadequate facilities; overloaded teaching loads; and struggles of non-physical education graduates. The findings then served as crucial elements in drawing conclusions and recommendations to better implement the sports track program in the Philippine senior high school curriculum. (AU)

El sistema educativo filipino se encuentra actualmente en transición debido a la implementación de la Ley de la República 10533, también conocida como Ley de Educación Básica Mejorada. Desde su promulgación en 2013, los investigadores de educación física han estado examinando el impacto inicial de esta transición. Sin embargo, las investigaciones para determinar los desafíos de los profesores en el Programa de Pista deportiva del plan de estudios de la escuela secundaria superior fueron escasamente suficientes. Por lo tanto, esta investigación se llevó a cabo para sondear los desafíos de estos profesores utilizando un diseño de investigación de fenomenología cualitativa. Los participantes de la investigación de escuelas seleccionadas en la provincia de Cotabato en Filipinas participaron en discusiones de grupos focales, entrevistas en profundidad y una extensa observación de campo. Transcurrieron seis preocupaciones significativas de los participantes de la investigación; estos son: dificultades con el aprendizaje en línea; desajuste de los intereses de los estudiantes; plan de estudios poco realista; instalaciones inadecuadas; cargas de enseñanza sobrecargadas; y luchas de los no graduados en educación física. Luego, los hallazgos sirvieron como elementos cruciales para sacar conclusiones y recomendaciones para implementar mejor el programa de atletismo deportivo en el plan de estudios de la escuela secundaria superior de Filipinas. (AU)

An investigation into the relationship between climate change anxiety and mental health among Gen Z Filipinos.

Climate change and mental health concerns are both defining issues of the generation of today. It has been established that the worsening climate causes many environmental disasters and physical health problems. However, its psychological impacts are still not well understood. Climate change has brought about an emerging psychological phenomenon termed 'climate anxiety' or 'eco-anxiety,' which has been described as a "chronic fear of environmental doom" (Clayton et al., 2017, p. 68) due to the impact of climate change. This predictive cross-sectional study investigated the link between climate change anxiety and mental health among 433 Filipinos. A total of 145 males and 288 females aged 18 to 26 completed the Climate Change Anxiety Scale and the Mental Health Inventory (MHI-38). Results show a significant relationship between climate change anxiety and mental health, with climate change anxiety predicting 13.5% of the overall Mental Health Index variance. Significantly, climate change anxiety was associated with the MHI-38's global scale of Psychological Distress but not with the global scale of Psychological Well-being. The findings are discussed concerning the broader context of research on the mental health impacts of climate change.

A national online survey of Filipinos' knowledge, attitude, and awareness of antibiotic use and resistance: A cross-sectional study.

BACKGROUND: Antibiotic resistance is one of the 21st century's most challenging clinical and public health issues. However, this health issue remains underreported in the Philippines. AIM: This study examined Filipinos' knowledge, attitude, and awareness regarding antibiotic use and resistance and the associated predictive variables of antibiotic resistance. METHODS: A cross-sectional design and Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used in this study. Convenience sampling of 3767 participants completed the Eurobarometer survey on antibiotic resistance from October 2021 to February 2022. χ2 and regression analysis were used to analyze the data. RESULTS: Most participants were familiar with the popular types of available antibiotics. Males and healthcare workers had a higher percentage of correct responses on antibiotic resistance knowledge. Participants had moderate to high knowledge levels of antibiotic resistance. Age, educational attainment, profession, antibiotic use in the previous year, and household members taking antibiotics were significant predictors of the level of knowledge of antibiotic resistance. There was a significant difference in participants' sex, age, and educational attainment in their attitudes toward acquisition, hygienic practices, and the role of health professionals in antibiotic resistance. CONCLUSION: Government agencies and policymakers should consider the identified predictors when establishing policies on antibiotic resistance. This will ensure that antibiotic use is safe and effective.

Intersectionality and the invisibility of transgender health in the Philippines.

Transgender (trans) Filipinos are disproportionately vulnerable to health problems because of the inaccessibility of essential healthcare services resulting from the invisibility and exclusion of trans health in Philippine health and related social institutions. Because of the institutional prejudice and discrimination against trans Filipinos in Philippine society, an intersectional approach presents an opportunity to analyze the invisibility and potentially elucidate the unique health needs of trans Filipinos. This article elucidates how the invisibility of trans Filipinos in health is a product of co-existing and interacting prejudiced and discriminatory institutions, such as the law, education, and medicine, where the historical experiences of colonization, the hegemony of cisgenderism, and the impact of capitalism remain salient. By elucidating these co-existing and interacting structures and forces, this article highlights the gaps in the Philippine healthcare system, such as the lack of affirming and protective policies for trans health and the limited cultural competence of healthcare providers. In light of these, future research and policy work must work towards integrating gender-specific and gender-inclusive approaches, centering the voices of trans Filipinos in health discourses, and decolonizing and expanding the local understanding of trans health among Filipinos.

Young adult preference analysis on the attributes of COVID-19 vaccine in the Philippines: A conjoint analysis approach.

Objective: Vaccines are utilized to prevent the severity of illnesses like the COVID-19 virus. Currently, there are a lot of COVID-19 vaccines available in the market like Pfizer, Moderna, AstraZeneca, Johnson and Johnson, and Sinovac. This research aimed to analyze the preference on the existing vaccine attributes of COVID-19. Study design: Specifically, this study considered 7 attributes such as cost, brand, recommendations, efficacy, side effects, vaccine type, and dose. Methods: A conjoint analysis with orthogonal design was utilized and 865 respondents were participated. Results: The result showed that consumers considered brand as the highest attribute, specifically Pfizer and Moderna among other brands. Moreover, the efficacy of 90% and higher were the preferred vaccine with 1 in 100 patient side effects reported. It was seen that safety and effectiveness is the priority in choosing a COVID-19 vaccine. Interestingly, the knowledge and understanding of the COVID-19 vaccine was found to drive consumer's preference for the vaccines available. Conclusions: The findings of this study could be utilized by the government to increase the willingness to be vaccinated. Lastly, the result of this study would pave a way to promote herd immunity to help fight the COVID-19 pandemic worldwide.

Cardiometabolic genomics and pharmacogenomics investigations in Filipino Americans: Steps towards precision health and reducing health disparities.

Background: Filipino Americans (FAs) are the third-largest Asian American subgroup in the United States (US). Some studies showed that FAs experience more cardiometabolic diseases (CMDs) than other Asian subgroups and non-Hispanic Whites. The increased prevalence of CMD observed in FAs could be due to genetics and social/dietary lifestyles. While FAs are ascribed as an Asian group, they have higher burdens of CMD, and adverse social determinants of health compared to other Asian subgroups. Therefore, studies to elucidate how FAs might develop CMD and respond to medications used to manage CMD are warranted. The ultimate goals of this study are to identify potential mechanisms for reducing CMD burden in FAs and to optimize therapeutic drug selection. Collectively, these investigations could reduce the cardiovascular health disparities among FAs. Rationale and design: This is a cross-sectional epidemiological design to enroll 300 self-identified Filipino age 18 yrs. or older without a history of cancer and/or organ transplant from Virginia, Washington DC, and Maryland. Once consented, a health questionnaire and disease checklist are administered to participants, and anthropometric data and other vital signs are collected. When accessible, we collect blood samples to measure basic blood biochemistry, lipids, kidney, and liver functions. We also extract DNA from the blood or saliva for genetic and pharmacogenetic analyses. CMD prevalence in FAs will be compared to the US population. Finally, we will conduct multivariate analyses to ascertain the role of genetic and non-genetic factors in developing CMD in FAs. Virginia Commonwealth University IRB approved all study materials (Protocol HM20018500). Summary: This is the first community-based study to involve FAs in genomics research. The study is actively recruiting participants. Participant enrollment is ongoing. At the time of this publication, the study has enrolled 97 participants. This ongoing study is expected to inform future research to reduce cardiovascular health disparities among FAs.

Is there compression or expansion of morbidity in the Philippines?

AIMS: This study contributes to previous initiatives examining healthy and active aging in the Philippines. METHODS: We employed the Sullivan method to calculate healthy life expectancy (HLE) and active life expectancy (ALE) using the 2007 Philippine Survey on Aging and the 2018 Longitudinal Study of Ageing and Health. We compared the estimates at two time points, providing evidence of change over time. RESULTS: There was no statistically significant change in the relative proportion of HLE over time for both sexes, suggesting dynamic equilibrium. For men, the increase in life expectancy was mainly an increase in unhealthy state (UHLE). The slight increases in HLE for all ages were not statistically significant. The differences in relative increase in HLE were not statistically significant. HLE for women increased over time, with statistically significant increases at ages 60 and 70 years. ALE declined in all age groups for both sexes, but the decline was statistically significant only among women in their 60s and 70s. There was also a statistically significant decline in the proportion of remaining life in an active state for all ages among both men and women, suggesting an expansion of morbidity. CONCLUSIONS: Findings suggest no evidence of compression of morbidity in the Philippines from 2007 to 2018. The HLE results suggest a dynamic equilibrium, while ALE results indicate an expansion of morbidity. The findings emphasize the need for the government to promote life course interventions that foster healthy choices and conduct further research to understand the factors influencing longevity and active aging in the Philippines. Geriatr Gerontol Int 2022; 22: 511-515.

Mix-and-Match or Mismatch? Exploring the Perspectives of Older Adults About Zumba Dance and Its Potential Utilization for Dual-Task Training.

Despite the popularity of Zumba dancing, research is scarce about its impact on older adults. Meanwhile, the integration of cognitive tasks with physical exercises, also known as dual tasking, is an evolving strategy to facilitate activities for older adults. This study investigated the perceptions of persons aged ≥55 years on Zumba and its potential to be incorporated into a dual-task program. We conducted a descriptive-qualitative study involving 44 Filipino older adults. Using content analysis, four themes were identified: moving toward match or mismatch, balancing benefits with burdens, dual tasking as innovative yet potentially challenging, and overcoming barriers with enablers. Although Zumba was perceived as an inclusive and beneficial activity, individual and contextual limitations could hinder its suitability. Moreover, dual tasking in Zumba was considered an innovative approach, although challenges should be addressed to promote its feasibility. Several strategies could enable the design and implementation of age-appropriate Zumba and dual-tasking programs for older adults.

Socio-ecological determinants of distress in Filipino adults during COVID-19 crisis.

The present study examined the socio-ecological factors that influenced psychological distress (combined index of depression and anxiety symptoms) among Filipino adults during the COVID-19 crisis. The study involved 401 adult participants currently residing in the Philippines. Data were collected using a self-reported online questionnaire administered to the participants. Findings revealed that one individual level factor, such as individual resilience, and two family level factors, such as safety at home and being a parent, negatively influenced psychological distress. On the other hand, a family level factor, family's financial difficulties, positively predicted psychological distress. Societal level factor such as national resilience, but not the community level factor, community resilience, positively predicted psychological distress in Filipino adults. Findings identified individual resilience, national resilience, and financial difficulties as the strongest predictors of psychological distress among Filipino adults during the COVID-19 crisis. Implications, limitations, and future directions are discussed.

Is Loneliness Associated With Celebrity Attraction in LGBT+ Persons?

The present study is a conceptual replication of the functional alternative hypothesis, which states that when it is difficult for some persons to form satisfactory interpersonal relationships they turn to parasocial relationships as a functional alternative. In this study, the Celebrity Attitude Scale (CAS), a one-item measure of interest in celebrities in general, the Five-item Adaptation of the Revised UCLA Loneliness Scale (FALS), and the Receiving Emotional Support Subscale (RESS) were administered to 222 self-identified LGBT+ and 436 self-identified heterosexual persons from the Philippines aged 18 to 77 years old. We hypothesized that sexual orientation would moderate the relationship between loneliness and celebrity worship, such that the association between loneliness and celebrity worship would be stronger among LGBT+ individuals than among heterosexual individuals. This hypothesis was confirmed when the target person was one's favorite celebrity. Second, we hypothesized that lower levels of perceived social support among LGBT+ Filipinos would be associated with a stronger correlation between loneliness and celebrity worship as compared to LGBT+ Filipinos with a higher level of social support. Third, we hypothesized that younger LGBT+ persons would have a stronger association between loneliness and celebrity worship as compared to older LGBT+ persons. Results failed to confirm the social support and age hypotheses. The findings and limitations were discussed, and suggestions for further research were noted.

Health Disparities of Cardiometabolic Disorders Among Filipino Americans: Implications for Health Equity and Community-Based Genetic Research.

Health disparities are well-documented among different racial and ethnic minority groups in the United States. Filipino Americans (FAs) are the third-largest Asian-American group in the USA and are commonly grouped under the Asian categorization. FAs have a higher prevalence of cardiometabolic disorders than non-Hispanic Whites and other Asian subgroups with rates comparable to African Americans. Although no major epidemiological studies have ascertained the prevalence of cardiometabolic diseases in FAs, limited reports suggest that FAs have a higher prevalence of dyslipidemia, hypertension, diabetes, metabolic syndrome, hyperuricemia, and gout than non-FAs. A recent genetic study has shown that FAs could have the highest prevalence of a genetic polymorphism strongly associated with the development of gout and gout-related comorbidities. While developing cardiometabolic disorders is a heterogeneous and multifaceted process, the overall prevalence of certain cardiometabolic disorders parallel the prevalence of population-level risk factors, including genetics, dietary lifestyles, health beliefs, and social determinants of health. Therefore, assessment of the Filipino cuisine, health behaviors among Filipinos, socio-cultural factors, and acculturation to living in the USA are equally critical. Ascertaining the contribution of the biological causes to disease onset and the different psychosocial factors that could modulate disease risk or disease management are needed. Ultimately, a multilevel research approach is critical to assess the role of biological and non-biological risk factors of cardiometabolic disorders in FAs to inform culturally appropriate health promotion, disease prevention strategies, and a personalized approach to health.

Characterization of mortality and high-risk characteristics of thyroid cancer in Filipinos using the California Cancer Registry.

Introduction: Filipinos are the third largest Asian American subgroup and have the highest incidence of thyroid cancer among all races. To better understand this racial/ethnic disparity in thyroid cancer affecting Filipinos we analyzed the California Cancer Registry (CCR) data in Filipino thyroid cancer cases from 1988 to 2018. Methods: 97,948 thyroid cancer cases in California from 1988 to 2018 (until 2015 for Asian subgroups) were evaluated. We examined the case distribution by sex, age at diagnosis, race/ethnicity including Asian ethnic subgroups, histology, TNM stage, tumor size, lymph node involvement, lymphovascular invasion, and multifocality. We also looked at treatment data including surgery and radiation including radioactive iodine therapy. We calculated age-adjusted mortality rates (AAMR) for each major racial group and each Asian ethnic subgroup. Binary logistic regression was used to determine the likelihood of high-risk characteristics and treatment when comparing Filipinos to other racial/ethnic groups. Kaplan-Meier Estimate was performed to evaluate thyroid cancer survival across all race/ethnicities. Multivariate Cox proportion hazards regression was performed to evaluate mortality risk from all causes of death by race. Results: There were 5,243 (5.35%) Filipino thyroid cancer cases in California from 1988 to 2018. Filipinos had the highest AAMR (1.22 deaths per 100,000) in 2015. Filipinos had a higher likelihood of Stage IV thyroid cancer compared with Non-Hispanic Whites, Non-Hispanic Blacks, Hispanics and nearly all Asian subgroups. Filipinos had a worse 5-year and 10-year overall survival (OS) than the combination of all other Asian/Pacific Islanders. Filipinos compared to Non-Hispanic Whites had significant mortality risk in overall and papillary thyroid cancer cases (Overall HR: 1.10, 95% CI 1.07-1.13, p < 0.0001, Papillary HR: 1.11, 95% CI 1.07-1.14, p < 0.0001) when adjusted for race/ethnicity, age, gender, socioeconomic status, and stage. When stratified by Charlson comorbidity score, Filipinos compared to Non-Hispanic Whites still had significant mortality risk (Charlson 0 HR: 1.07, 95% CI 1.02-1.11, p = 0.0017, Charlson 1+ HR: 1.07 95% CI 1.002-1.14, p = 0.0434). Conclusions: Filipino thyroid cancer patients have higher incidences of high-risk pathological features and greater AAMR and mortality risk. These findings warrant further investigation into better understanding the connection between the greater incidence of high-risk characteristics and increased mortality in Filipinos.