Overall health knowledge in the Philippines, multilevel confirmatory factor analysis of the Philippine National Demography Health Survey 2022 data.

A secondary data analysis of the 2022 Philippine National Demographic and Health Survey (PNDHS) was conducted to explore the underlying structure of knowledge regarding communicable and noncommunicable diseases using multilevel confirmatory factor analysis (CFA). The PNDHS data consist of two levels: level-1 represents within-household data (household questionnaire), and level-2 represents between-household data (primary sampling unit (PSU)). Therefore, a two-level CFA and two-level variance CFA were performed. Furthermore, a multigroup analysis assessed the structural differences between males/females and urban/rural groups. In the PNDHS survey, 30,372 household interviews were completed. Knowledge levels for cancer, heart disease, diabetes, dengue fever, TB, and COVID-19 were 96.7%, 94.9%, 97.8%, 98.4%, 96.7%, and 92.8%, respectively. The two-level CFA indicated that the coefficient loadings of each item for both levels were statistically significant (Z-test, P < 0.001). Regarding two-level variance CFA, the variance at level-1 was higher than that at level-2 (13 and 6.7, respectively). The multigroup analysis revealed that the model was non-invariant (not equal) across gender and residence (likelihood ratio test; P < 0.001, P < 0.001, respectively). In conclusion, level-1 has greater effect than does level-2 because the variance in level-1 is greater than that in level-2, the knowledge of COVID-19 has the lowest loading compared to other items, and rural/urban areas and females/males exhibit different levels of health knowledge.

Puppies as the primary causal animal for human rabies cases: three-year prospective study of human rabies in the Philippines.

Introduction: While rabies remains a global concern, detailed studies on human rabies, particularly regarding causal animals and the reasons for not receiving postexposure prophylaxis (PEP), are lacking. Methods: We conducted a 3-year prospective study (October 2019-September 2022) at the Philippines' largest rabies referral center. We interviewed patients with suspected rabies and their families. We used LN34 qRT-PCR and rapid fluorescent focus inhibition test on saliva samples. We also compared our findings with two retrospective studies at the same hospital. Results: We enrolled 151 patients, including 131 with potential rabies exposure. Similar to retrospective studies, the participants were predominantly males (75.5%), adults (76.8%), low-income individuals (91.4%), and rural dwellers (62.3%). The causal animals were mainly dogs (97.0%), with similar incubation periods, clinical symptoms, and a high proportion not receiving vaccines or immunoglobulins (93.2%). Most causal animals were owned by either the patients' households or their neighbors (60.2%), with a significant proportion being puppies (58.8%). Most patients had knowledge of rabies; however, reasons for not seeking PEP included misconceptions about minor bites not causing rabies (51.3%), beliefs in traditional healers (33.9%), and economic constraints (22.6%). Despite completing the WHO regimen, two PEP failures were observed. LN34 qRT-PCR detected 98 positive cases (sensitivity, 64.9%; 95% CI 56.7-72.5). These strains belong to the Southeast Asia 4 subclade. Discussion: In conclusion, this study highlights the role of puppies as primary causal animals and the presence of misconceptions that preclude patients from acquiring PEP.

Google trends as an early indicator of African swine fever outbreaks in Southeast Asia.

African Swine Fever (ASF) is a reportable disease of swine that causes far-reaching losses to affected countries and regions. Early detection is critically important to contain and mitigate the impact of ASF outbreaks, for which timely available data is essential. This research examines the potential use of Google Trends data as an early indicator of ASF outbreaks in Southeast Asia, focusing on the three largest swine producing countries, namely, Vietnam, the Philippines, and Thailand. Cross-correlation and Kullback-Leibler (KL) divergence indicators were used to evaluate the association between Google search trends and the number of ASF outbreaks reported. Our analysis indicate strong and moderate correlations between Google search trends and number of ASF outbreaks reported in Vietnam and the Philippines, respectively. In contrast, Thailand, the country of this group in which outbreaks were reported last, exhibits the weakest correlation (KL = 2.64), highlighting variations in public awareness and disease dynamics. These findings suggest that Google search trends are valuable for early detection of ASF. As the disease becomes endemic, integrating trends with other epidemiological data may support the design and implementation of surveillance strategies for transboundary animal diseases in Southeast Asia.

Effectiveness of smoking cessation intervention based on the ABC Approach in patients with TB.

SETTING: Urban setting in the Philippines. OBJECTIVE: To assess the effectiveness of the ABC Approach developed by The Union as a tobacco-smoking cessation intervention for TB patients at a primary healthcare level in an urban setting in the Philippines. DESIGN: We set up an intervention group whose patients with TB received the ABC approach and a control group of patients with TB receiving only routine health education in Manila, The Philippines. We collected smoking status and the domestic secondhand-smoking (SHS) status data from patients with TB at months 0, 2, 4, 6, 8, and 12. TB treatment outcome data were also collected. RESULTS: Patients with TB (n = 2,174) were enrolled upon TB registration. Smoking rates were consistently low in the intervention group (3.9% vs. 8.7% at Month 6). The odds ratios of both tobacco-smoking status and domestic SHS status in the intervention group were significantly lower than those in the control group (tobacco-smoking status: P < 0.001, domestic SHS status: P < 0.01). TB treatment success rates were similar between the groups (85.0% vs. 87.3%; P = 0.201). CONCLUSION: The ABC approach successfully reduced tobacco-smoking rates, maintained low domestic SHS rates and TB treatment success rates in the Philippines.

CADRE: Cadre urbain aux Philippines. OBJECTIF: Évaluer l'efficacité de l'approche ABC développée par L'Union en tant qu'intervention de sevrage tabagique pour les patients atteints de TB au niveau des soins de santé primaires en milieu urbain aux Philippines. MÉTHODE: Nous avons mis en place un groupe d'intervention dont les patients atteints de TB ont reçu l'approche ABC et un groupe témoin de patients atteints de TB ne recevant qu'une éducation sanitaire de routine à Manille, aux Philippines. Nous avons recueilli des données sur le statut tabagique et le statut de tabagisme passif (SHS, pour l'anglais « secondhand-smoking ¼) domestique des patients atteints de TB aux mois 0, 2, 4, 6, 8 et 12. Des données sur les résultats du traitement de la TB ont également été recueillies. RÉSULTATS: Les patients atteints de TB (n = 2 174) ont été recrutés lors de l'enregistrement de la TB. Les taux de tabagisme étaient constamment faibles dans le groupe d'intervention (3,9% contre 8,7% au 6e mois). Les rapports de cotes du tabagisme et du statut SHS canadien dans le groupe d'intervention étaient significativement inférieurs à ceux du groupe témoin (tabagisme : P < 0,001, statut SHS national : P < 0,01). Les taux de réussite du traitement de la TB étaient similaires entre les groupes (85,0% contre 87,3% ; P = 0,201). CONCLUSION: L'approche ABC a permis de réduire les taux de tabagisme, de maintenir de faibles taux nationaux de SHS et de taux de réussite du traitement de la TB aux Philippines.

Factors Influencing Cervical Cancer Screening Uptake among Reproductive-Aged Filipino Women: Findings from the 2022 Philippines National Demographic and Health Survey.

Background: Cervical cancer (CC) is the fourth leading cause of death among cancer cases and women intimate partner violence (IPV) survivors are more likely to experience CC-related mortality. This study aims to evaluate the factors influencing CC screening uptake among reproductive-aged women, especially among IPV survivors in the Philippines. Method: We used the 2022 Philippines' National Demographic and Health Survey. The outcome variable was undergoing CC screening. The independent variables were different types of IPV, sociodemographic characteristics (age groups, place of residency, education level, wealth quintile, marital status, religion, employment), and other important variables (number of sexual partners, number of children, and access to health care). Descriptive statistics and multivariable logistic regression analyses were performed to examine influencing factors of CC screening. Method: The results revealed that approximately 10% (n = 1,648) of the women who participated in the survey had screened for CC. The results showed that women who experienced at least one type of IPV (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.08-1.62), aged 45-49 years (aOR = 6.42, 95% CI = 2.60-15.54), higher education (aOR = 14.26, 95% CI = 3.28-61.99), wealthier (aOR = 3.46, 95% CI = 2.54-4.72), having current employment (aOR = 1.30, 95% CI = 1.08-1.57), and having more than five lifetime sexual partners (aOR = 3.16, 95% CI =1.00-9.97), were more likely to undergo CC screening than their counterparts. Conclusion: Future CC screening initiatives should prioritize women with lower educational and socioeconomic backgrounds to effectively bridge the gaps in health disparities.

Pregnancy and 'the Other': Nausea and Accommodation in Manila.

Pregnancy is a processual dialectic that involves continual acts of tactical, responsive, and creative accommodation by pregnant women. This article is a phenomenological investigation of pregnancy experience of working-class women in Manila. In it, I provide an outline of "accommodation:" acts which vary according to the political ecology of procreation in which they are enmeshed, and which are particularly evident in unexpected or unplanned pregnancies. Accommodation constitutes the core act in which the mother-to-be is engaged as the protagonist of procreation, transforming the character of unexpected pregnancy from uncertain and troubled to stable and even joyous as acts of accommodation restore bodily integrity.

What variables predict stigmatizing attitudes toward people with mental disorders and their treatment in Filipinos and Americans?

In the United States, Asian Americans express greater stigma toward those with mental disorders and report lower rates of seeking mental health treatment than do White Americans. However, research on these topics in Filipino cultural groups, especially Filipinos living in the Philippines (i.e., Filipino nationals), is sparse. To support the design of interventions to decrease stigma and improve rates of seeking treatment, we assessed attitudes toward mental disorders and help-seeking in Filipinos. U.S. national (i.e., American) and Filipino national participants completed an online survey containing the Mental Illness Stigma Scale, a Theory of Planned Behavior questionnaire measuring attitudes toward seeking treatment, and queries regarding demographic and psychosocial factors. Filipinos expressed significantly more stigma regarding relationship disruption, interpersonal anxiety, and poor hygiene, alongside increased perceived subjective norms opposing seeking treatment and decreased perceived behavioral control over getting treatment if necessary. We ran a linear mixed effects regression on each nationality separately to identify relationships between stigma and psychosocial factors. For Filipinos, increased parental education predicted decreased perceived relationship disruption and interpersonal anxiety; urbanization was associated with greater trust in mental health professionals, and having a close relative with a disorder led to decreased belief in patient recoverability. For Americans, increased participant education predicted decreased interpersonal anxiety, increased perceived recoverability, and improved perceived behavioral control over getting treatment if necessary, and having a close relative with a disorder predicted improved perceived treatability. The results guide programs for decreasing stigma and increasing treatment-seeking behavior. Limitations, future research directions, and possible interventions are discussed.

Regulatory landscape and public perception for gene-edited bananas in the Southeast Asian region.

Banana is a premier fruit crop in many parts of the world especially Southeast Asia. The demand for banana has contributed to significant national income to primary banana producers in the SEA region such as the Philippines, Indonesia, Thailand, Vietnam, and Malaysia. However, the widely traded banana industry is plagued by numerous threats including pests and diseases, post-harvest issues and extreme climate vulnerability. To address these challenges, new breeding techniques such as gene editing have been explored for breeding programs to develop improved banana varieties. The first gene-edited non-browning banana has been deregulated in the Philippines recently, and more regulatory applications are expected to submit for approvals soon. Hence, it is timely to review the policy options for gene editing that have been adopted and discussed in the Southeast Asian countries and highlight the implications of differing regulatory approaches to gene editing for trading activities. Positive stakeholders' perceptions and public acceptance are key factors in allowing the benefits of gene editing and thus appropriate outreach strategies are important to gain acceptance and avoid the "GMO stigma" that may be associated with gene-edited products.

Evaluation of cytokine profiles related to Mycobacterium tuberculosis latent antigens using a whole-blood assay in the Philippines.

Introduction: There is no useful method to discriminate between latent tuberculosis infection (LTBI) and active pulmonary tuberculosis (PTB). This study aimed to investigate the potential of cytokine profiles to discriminate between LTBI and active PTB using whole-blood stimulation with Mycobacterium tuberculosis (MTB) antigens, including latency-associated antigens. Materials and methods: Patients with active PTB, household contacts of active PTB patients and community exposure subjects were recruited in Manila, the Philippines. Peripheral blood was collected from the participants and used for whole-blood stimulation (WBS) with either the early secretory antigenic target and the 10-kDa culture filtrate protein (ESAT-6/CFP-10), Rv3879c or latency-associated MTB antigens, including mycobacterial DNA-binding protein 1 (MDP-1), α-crystallin (Acr) and heparin-binding hemagglutinin (HBHA). Multiple cytokine concentrations were analyzed using the Bio-Plex™ multiplex cytokine assay. Results: A total of 78 participants consisting of 15 active PTB patients, 48 household contacts and 15 community exposure subjects were eligible. The MDP-1-specific IFN-γ level in the active PTB group was significantly lower than that in the household contact group (p < 0.001) and the community exposure group (p < 0.001). The Acr-specific TNF-α and IL-10 levels in the active PTB group were significantly higher than those in the household contact (TNF-α; p = 0.001, IL-10; p = 0.001) and community exposure (TNF-α; p < 0.001, IL-10; p = 0.01) groups. However, there was no significant difference in the ESAT-6/CFP-10-specific IFN-γ levels among the groups. Conclusion: The patterns of cytokine profiles induced by latency-associated MTB antigens using WBS have the potential to discriminate between LTBI and active PTB. In particular, combinations of IFN-γ and MDP-1, TNF-α and Acr, and IL-10 and Acr are promising. This study provides the first demonstration of the utility of MDP-1-specific cytokine responses in WBS.

Falls among community-dwelling older adults in the Philippines and Viet Nam: Results from nationally representative samples.

Falls are a significant public health issue globally. However, studies with nationally representative samples have yet to be done to understand falls among older adults in the Philippines and Viet Nam. Using a biopsychosocial perspective, this study investigated the prevalence of falls and their associated factors among community-dwelling older adults in these countries. Cross-sectional data were drawn from the baseline survey of the Longitudinal Study of Ageing and Health in the Philippines (2018, N = 4,606) and the Longitudinal Study of Ageing and Health in Viet Nam (2018, N = 4,378). The outcome variables were any falls in the past year. Independent variables included sociodemographic factors (age, sex, education, living in urban areas, living alone, social network size), biophysical factors (vision, chronic conditions, functional impairments, pain locations, insomnia symptoms, sleep medications, grip strength, walking speed, postural control), and psychological factors (depressive symptoms). Descriptive analysis and logistic regression analysis were used to analyze the data. The results showed that 17.7 % and 7.3 % of older Filipino and Vietnamese adults fell in the year before the study. Significant factors associated with the odds of any falls among Filipino older adults were having a higher level of education, living in urban areas, living with others, experiencing more functional impairments, reporting one or more pain locations, and having poor grip strength. In Viet Nam, having more chronic conditions, experiencing more functional impairments, and reporting two or more pain locations were found to be associated with higher odds of any falls. The population in the Philippines and Viet Nam is aging rapidly. Findings from this study are timely in identifying at-risk individuals and preparing for effective fall prevention strategies.

Costs of Digital Adherence Technologies for Tuberculosis Treatment Support, 2018-2021.

Digital adherence technologies are increasingly used to support tuberculosis (TB) treatment adherence. Using microcosting, we estimated healthcare system costs (in 2022 US dollars) of 2 digital adherence technologies, 99DOTS medication sleeves and video-observed therapy (VOT), implemented in demonstration projects during 2018-2021. We also obtained cost estimates for standard directly observed therapy (DOT). Estimated per-person costs of 99DOTS for drug-sensitive TB were $98 in Bangladesh (n = 719), $119 in the Philippines (n = 396), and $174 in Tanzania (n = 976). Estimated per-person costs of VOT were $1,154 in Haiti (87 drug-sensitive), $304 in Moldova (173 drug-sensitive), $452 in Moldova (135 drug-resistant), and $661 in the Philippines (110 drug-resistant). 99DOTS costs may be similar to or less expensive than standard DOT. VOT is more expensive, although in some settings, labor cost offsets or economies of scale may yield savings. 99DOTS and VOT may yield savings to local programs if donors cover infrastructure costs.

Feasibility and acceptability of COVID-19 self-testing in the Philippines.

Self-testing for COVID-19 using antigen-detecting rapid diagnostic tests (Ag-RDTs) shows high promise in the Philippines. Self-testing has the potential to provide broader access to testing, empowering individuals by bringing healthcare services closer to them. We conducted 15 semi-structured interviews with health officers and decision-makers in the Philippines. These interviews explored the experiences and perspectives on the acceptability and feasibility of self-test use and implementation. We found that self-testing is easy-to-use, provides rapid results and can facilitate early detection. However, -regulatory policies, linkages to care and effective health -education plans must be in place for successful implementation.

Evaluation of lateral flow devices for postmortem rabies diagnosis in animals in the Philippines: a multicenter study.

Expansion of the use of lateral flow devices (LFD) for animal rabies diagnosis can help mitigate the widespread underreporting of rabies. However, this has been hindered by the limited number and small sample size of previous studies. To overcome this limitation, we conducted a multicenter study with a larger sample size to assess the diagnostic accuracy of the ADTEC LFD for postmortem rabies diagnosis in animals. Thirteen governmental animal diagnostic laboratories in the Philippines were involved in this study, and 791 animals suspected of having rabies were tested using both the direct fluorescence antibody test (DFAT) and ADTEC LFD between August 2021 and October 2022. The LFD demonstrated a sensitivity of 96.3% [95% confidence interval (CI): 94.1%-97.9%] and a specificity of 99.7% (95% CI: 98.4%-100%). Notably, false-negative results were more likely to occur in laboratories with lower annual processing volumes of rabies samples in the previous years (adjusted odds ratio 4.97, 95% CI: 1.49-16.53). In this multicenter study, the high sensitivity and specificity of the LFD for the diagnosis of animal rabies, compared to that of the DFAT, was demonstrated, yet concerns regarding false-negative results remain. In areas with limited experience in processing rabies samples, it is essential to provide comprehensive training and careful attention during implementation.

Plasmodium knowlesi Infection in Traveler Returning to Canada from the Philippines, 2023.

A 55-year-old man sought treatment for an uncomplicated febrile illness after returning to Canada from the Philippines. A suspected diagnosis of Plasmodium knowlesi infection was confirmed by PCR, and treatment with atovaquone/proguanil brought successful recovery. We review the evolving epidemiology of P. knowlesi malaria in the Philippines, specifically within Palawan Island.

Factors Affecting the Spread, Diagnosis, and Control of African Swine Fever in the Philippines.

African Swine Fever (ASF) is a highly contagious disease that threatens the swine industry globally. Since its introduction into the Philippines in 2019, ASF has spread extensively in both commercial and backyard farms. Here, using a mix of qualitative and quantitative methods, including conjoint and SWOT analyses, world café discussions, and multivariable regression models, the most important factors that influence the spread, diagnosis, and control of ASF in the Philippines were identified. Research findings suggest that swill or contaminated feed, inadequate biosecurity protocols, and movement of personnel were the top risk factors favoring ASF spread among farms in general. For commercial farms, contaminated vehicles and personnel were also important, whereas for backyard farms, the introduction of new pigs, environmental contamination, and poor feeding quality were relevant risk factors. Notable clinical signs of ASF in pigs include reduced feed intake, huddled behavior, and reluctance to stand. This study highlights the need for timely reporting, trust-building initiatives, and enhanced biosecurity measures to effectively manage ASF outbreaks in the country. Results here contribute to the knowledge of factors affecting ASF spread in the Philippines and can help design prevention and control measures in ASF-infected countries while enhancing preparedness in countries free from the disease.

Scoring tools to identify TB patients facing catastrophic costs in the Philippines.

BACKGROUND: This study was to meet a practical need to design a simple tool to identify TB patients who may potentially be facing catastrophic costs while seeking TB care in the public sector. Such a tool may help prevent and address catastrophic costs among individual patients. METHODS: We used data from the national TB patient cost survey in the Philippines. We randomly allocated TB patients to either the derivation or validation sample. Using adjusted odds ratios (ORs) and ß coefficients of logistic regression, we developed four scoring systems to identify TB patients who may be facing catastrophic costs from the derivation sample. We validated each scoring system in the validation sample. RESULTS: We identified a total of 12 factors as predictive indicators associated with catastrophic costs. Using all 12 factors, the ß coefficients-based scoring system (area under the curve [AUC] 0.783, 95% CI 0.754-0.812) had a high validity. Even with seven selected factors with OR > 2.0, the validity remained in the acceptable range (ß coefficients-based: AUC 0.767, 95% CI 0.737-0.798). CONCLUSION: The ß coefficients-based scoring systems in this analysis can be used to identify those at high risk of facing catastrophic costs due to TB in the Philippines. Operational feasibility needs to be investigated further to implement this in routine TB surveillance.

CONTEXTE: Cette étude visait à répondre à un besoin pratique de concevoir un outil simple pour identifier les patients atteints de TB qui pourraient potentiellement être confrontés à des coûts catastrophiques lorsqu'ils recherchent des soins de TB dans le secteur public. Un tel outil pourrait aider à prévenir et à traiter les coûts catastrophiques chez les patients individuels. MÉTHODES: Nous avons utilisé des données de l'enquête nationale sur les coûts des patients atteints de TB aux Philippines. Nous avons réparti aléatoirement les patients atteints de TB dans l'échantillon de dérivation ou de validation. À l'aide des odds ratio (OR) ajustés et des coefficients ß de la régression logistique, nous avons développé quatre systèmes de notation pour identifier les patients atteints de TB qui pourraient être confrontés à des coûts catastrophiques à partir de l'échantillon de dérivation. Nous avons validé chaque système de notation dans l'échantillon de validation. RÉSULTATS: Nous avons identifié un total de 12 facteurs en tant qu'indicateurs prédictifs associés à des coûts catastrophiques. En utilisant les 12 facteurs, le système de notation basé sur les coefficients ß (aire sous la courbe [AUC] 0,783 ; IC 95% 0,754­0,812) avait une validité élevée. Même avec sept facteurs sélectionnés avec OR > 2,0, la validité est restée dans la plage acceptable (basée sur les coefficients ß : AUC 0,767 ; IC 95% 0,737­0,798). CONCLUSION: Les systèmes de notation basés sur les coefficients ß dans cette analyse peuvent être utilisés pour identifier les personnes à haut risque de faire face à des coûts catastrophiques liés à la TB aux Philippines. La faisabilité opérationnelle doit être étudiée plus avant pour mettre en œuvre cela dans la surveillance de routine de la TB.

'Kontra-partido': untangling oppositional local politics and healthcare devolution in the Philippines.

A long-recognized problem of healthcare devolution in many developing countries is its inextricability from the influences of local politics. This has been particularly self-evident in the Philippines, where, since the adoption of the Local Government Code of 1991, the devolution of health governance, planning, administration and service delivery has placed the health system largely under the control of individual provinces, cities, municipalities and villages or barangays. In this article, we utilize the notion of 'kontra-partido' (the Filipino term connoting 'oppositional politics') to concretize local, oppositional politics as a lived experience of health workers, government officials and ordinary citizens in the country. Through multi-sited qualitative fieldwork, we demonstrate how 'kontra-partido' politics ultimately worsens health outcomes in any locality. We show how such politics figures in the relational dynamics of health governance, often resulting in petty infighting and strained relationships among local health authorities; how it leads to the politicization of appointments and prevents the local workforce, especially those at the grassroots, from doing their jobs efficiently amid environments rife with hostile patronage; and how it impedes service delivery as politicians prioritize 'visible' projects (over sustainable ones) and selectively deliver health care to their known supporters. In turn, health workers and ordinary citizens alike have been actively negotiating their roles within this political milieu, either by joining the so-called political frontlines or by engaging in the transactional relationships that develop between politicians and their constituents during perennial election seasons. We conclude with a reflection on the vulnerability of health to politicization and the visceral consequences of 'kontra-partido' politics to health workers, as well as an identification of possible areas of intervention for future policy reform, given the deepening political polarization in the country and the upcoming implementation of the recently passed Universal Health Care Law.

Now is no longer the time for poets.

A reflection piece-on rethinking the return of a Martial Law dictator in the form of his namesake, the newly elected president of the Philippines; the gamut of conversations on (un)covered facts, post-truth, appearances, interpolations, populism, revisionism and transformations, as well as the power of (trans)national media and images entangled with participatory publics; and how might a younger generation and/or transgender poet, such as myself, who did not experience first-hand the atrocities of military rule and learned them only through dominant narratives, might create and/or open capacious spaces for empathic opacity, new understandings, and possible coalitions and resistances within a historical moment concurrent with a present and/or imagined dystopia-expressed as a suit of three poems: To write another eye; Now is no longer the time for poets; Requisite condemnation.

Solved at last: The Philippine endemic Psychotriaphilippensis is a synonym of Scyphiphorahydrophylacea (Rubiaceae, Scyphiphoreae).

Psychotriaphilippensis (Rubiaceae) was described by Chamisso and Schlechtendal in 1829, was the first Psychotria name published for the Philippines and is currently considered a Philippine endemic. The name remained in a taxonomic limbo for almost two centuries as it was variously accepted, synonymized or considered obscure, probably because the type specimen in the Berlin herbarium was destroyed and no original material has survived or is currently known. A combined analysis of the information on morphology, type locality and ecology contained in the protologue and a review of relevant literature on the study of the name by various authors over the last two centuries finally clarified the identity of P.philippensis. The name is confirmed here as a synonym of the rubiaceous mangrove Scyphiphorahydrophylacea, as first proposed by Schumann, one of the authorities of the family in the late 19th century, and the application of P.philippensis is fixed by neotypification. This reduces the number of Philippine species of Psychotria by one, but fortunately, this is not happening through extinction, as has been the case with too many species of the highly endangered Philippine flora. In addition, the history of the discovery and study of S.hydrophylacea and its synonyms are described in detail, and one lectotype and one neotype are designated.

"They'd Better Really Treat Her Nice": Gendered Dynamics of Care and Control in Filipina Migrant-Broker Relations in Chile.

Critical scholarship on migrant brokers and brokerage have problematized the popular dichotomy of brokers as either altruistic or exploitative. Current research seeks instead to understand the diverse relationships and power dynamics between such migration intermediaries and migrants, and the strategies that both parties employ to reduce the risks inherent in long-distance international migration journeys. Drawing from a broader ethnographic project on Southeast Asian migration to Chile, this article presents the narratives of two Filipina women who facilitated the migration of Filipina domestic workers to Chile. Analysis of their experiences contributes to problematizing the category of "broker" and to understanding the complex and gendered dynamics of care and control that some intermediaries establish with migrants. I emphasize how these brokers' gendered migrant subjectivities shape their processes and strategies of mediation. In the specific context of Southeast Asian migration, focusing on these intermediaries sheds light on more individualized forms of migrant brokerage, in contrast to the predominant research on migration policies and commercial migrant recruitment and placement agencies. Attending to the complexity of who "brokers" are and their roles is important in apprehending migration and border policies that depend on defining their roles in the migration process.