Determining the Implementation Status of Benefits Under Magna Carta of Public Health Workers (RA 7305) in the Philippines

@#Background. The Republic Act 7305 or the Magna Carta of Public Health Workers was enacted in 1992 to address health workers' welfare. However, the implementation of this act was reportedly inconsistent among local government units (LGUs). Objectives. This study was conducted to determine the implementation status of provisions under the law among LGUs. Methods. This is a descriptive case study employing mixed methods. The quantitative data were derived from LGU scorecards, and the qualitative data were obtained from focus group discussions and key informant interviews of mayors, municipal health officers, and budget officers. Results. A total of 1,557 LGU scorecards with 2017 data showed that more than half (52.0%) of LGUs do not provide the full benefits of hazard pay, subsistence allowance, and laundry allowance. Disaggregation by income class showed that the provision of benefits is higher among LGUs with higher income classes (56.10%) compared to LGUs of lower-income classes (38.73%), and this translates to a correlation of income class with the provision of benefits (χ2=59.0, p<0.001). Factors influencing the provision of benefits include the political will of the mayor, the active role of municipal health staff to lobby for their rights, the limited resources of the LGU, the personnel services budget ceiling, the lack of enforcement of the law, and the limiting specifications of the law. Conclusion. This study demonstrated that the Magna Carta benefits for public health workers in municipalities and cities are inadequately implemented. Local governments must enforce public health workers' rights and benefits, but the national government should aid and ensure its unvarying implementation.

The association of chronic hepatitis B infectivity with fetomaternal outcome: A retrospective cohurt study in a tertiary hospital / Philippine Journal of Obstetrics and Gynecology

Background@#Hepatitis B infection on pregnancy has been linked to preterm labor, risk of prematurity, low birth weight, and the occurrence of gestational diabetes mellitus.@*Objective@#To determine the association between Chronic Hepatitis B infectivity and fetomaternal outcome such as preterm birth, low birth weight, gestational diabetes and preeclampsia among pregnant patients admitted in a Tertiary Hospital.@* Methodology@#A retrospective cohort study was done among pregnant women diagnosed with chronic hepatitis B infection admitted in a tertiary hospital from January 1, 2014 to December 31, 2018. The association of Hepatitis B infectivity and fetomaternal outcomes namely preterm birth, gestational diabetes, preeclampsia and low birth weight was determined.@*Results@#Chronic Hepatitis B infection had 1.43% prevalence among the study group. 149 patients were able to able to fulfill the inclusion criteria. Pregnant women with high infectivity Hepatitis B infection tend to be younger, have lower BMI, have lesser gravidity and parity than patients who are nonreactive to Hepatitis B e-antigen. AST and ALT were also higher among those with high infectivity Hepatitis B. However, there was no significant difference among the two groups in terms of elevated ALT. There was no significant association between Hepatitis B infectivity and fetomaternal outcomes such as preeclampsia, gestational diabetes mellitus, preterm birth and low birth weight. There is no increased risk for patients with high infectivity for preeclampsia, gestational diabetes mellitus, and low birth weight. There appears to be an excess risk in the likelihood of preterm birth/labor among those women who have a high infectivity Hepatitis B infection during pregnancy.@*Conclusion@#The prevalence of chronic hepatitis B infection among Filipino pregnant women admitted in a tertiary hospital was 1.43% from 2014 to 2018. There was no association between chronic hepatitis B infectivity and preeclampsia, Gestational diabetes mellitus. There seems to be an increased risk for HBeAg positive patients for preterm birth preterm labor, and occurrence of low birth weight, but was not statistically significant in the study population.

Stress and coping strategies among nursing students: an international study.

BACKGROUND: Mounting literature on stress and coping in nursing students are available; however, most of the findings are confined to a single cultural group. AIMS: This study was conducted to determine the level of stress, its sources and coping strategies among nursing students from three countries: Greece, the Philippines and Nigeria. METHODS: Using a descriptive, comparative research design, 547 nursing students (161 Greek nursing students, 153 Filipino nursing students, 233 Nigerian nursing students) participated in the study from August 2015 to April 2016. Two standardized instruments were used, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI). RESULTS: Findings revealed that the degree of stress and the type of stressors and coping styles utilized by nursing students differ according to the country of origin. The year of study predicted overall stress (ß = -0.149, p < 0.001) while advanced age predicted overall coping (ß = 0.008, p = 0.037) in the nursing students. CONCLUSIONS: Strengthening nursing students' positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches maybe useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students.

Multi-parent advanced generation inter-cross (MAGIC) populations in rice: progress and potential for genetics research and breeding.

BACKGROUND: This article describes the development of Multi-parent Advanced Generation Inter-Cross populations (MAGIC) in rice and discusses potential applications for mapping quantitative trait loci (QTLs) and for rice varietal development. We have developed 4 multi-parent populations: indica MAGIC (8 indica parents); MAGIC plus (8 indica parents with two additional rounds of 8-way F1 inter-crossing); japonica MAGIC (8 japonica parents); and Global MAGIC (16 parents - 8 indica and 8 japonica). The parents used in creating these populations are improved varieties with desirable traits for biotic and abiotic stress tolerance, yield, and grain quality. The purpose is to fine map QTLs for multiple traits and to directly and indirectly use the highly recombined lines in breeding programs. These MAGIC populations provide a useful germplasm resource with diverse allelic combinations to be exploited by the rice community. RESULTS: The indica MAGIC population is the most advanced of the MAGIC populations developed thus far and comprises 1328 lines produced by single seed descent (SSD). At the S4 stage of SSD a subset (200 lines) of this population was genotyped using a genotyping-by-sequencing (GBS) approach and was phenotyped for multiple traits, including: blast and bacterial blight resistance, salinity and submergence tolerance, and grain quality. Genome-wide association mapping identified several known major genes and QTLs including Sub1 associated with submergence tolerance and Xa4 and xa5 associated with resistance to bacterial blight. Moreover, the genome-wide association study (GWAS) results also identified potentially novel loci associated with essential traits for rice improvement. CONCLUSION: The MAGIC populations serve a dual purpose: permanent mapping populations for precise QTL mapping and for direct and indirect use in variety development. Unlike a set of naturally diverse germplasm, this population is tailor-made for breeders with a combination of useful traits derived from multiple elite breeding lines. The MAGIC populations also present opportunities for studying the interactions of genome introgressions and chromosomal recombination.

Overexpression of the RNA polymerase alpha subunit reduces transcription of Bvg-activated virulence genes in Bordetella pertussis.

Overexpression of the RNA polymerase alpha subunit in Bordetella pertussis reduces expression of the virulence factor pertussis toxin. Here we show that this reduction is at the level of transcription, is reversed by overexpression of the transcriptional activator BvgA, and is dependent on the C-terminal domain of alpha.

Intracellular delivery of a cytolytic T-lymphocyte epitope peptide by pertussis toxin to major histocompatibility complex class I without involvement of the cytosolic class I antigen processing pathway.

A CD8(+) cytolytic T-lymphocyte (CTL) response to antigen-presenting cells generally requires intracellular delivery or synthesis of antigens in order to access the major histocompatibility complex (MHC) class I processing and presentation pathway. To test the ability of pertussis toxin (PT) to deliver peptides to the class I pathway for CTL recognition, we constructed fusions of CTL epitope peptides with a genetically detoxified derivative of PT (PT9K/129G). Two sites on the A (S1) subunit of PT9K/129G tolerated the insertion of peptides, allowing efficient assembly and secretion of the holotoxin fusion by Bordetella pertussis. Target cells incubated with these fusion proteins were specifically lysed by CTLs in vitro, and this activity was shown to be MHC class I restricted. The activity was inhibited by brefeldin A, suggesting a dependence on intracellular trafficking events, but was not inhibited by the proteasome inhibitors lactacystin and N-acetyl-L-leucyl-L-leucyl-L-norleucinal (LLnL). Furthermore, the activity was present in mutant antigen-presenting cells lacking the transporter associated with antigen processing, which transports peptides from the cytosol to the endoplasmic reticulum for association with MHC class I molecules. PT may therefore bypass the proteasome-dependent cytosolic pathway for antigen presentation and deliver epitopes to class I molecules via an alternative route.

Effect of mutations causing overexpression of RNA polymerase alpha subunit on regulation of virulence factors in Bordetella pertussis.

In Bordetella pertussis, expression of virulence factors is controlled by the Bvg proteins, which comprise a sensor-regulator two-component signal transduction system. Previously, we described a mutant strain of B. pertussis that had reduced transcription of pertussis toxin and adenylate cyclase toxin genes, while other virulence factors were relatively unaffected. We obtained a B. pertussis clone that repaired the defect in both this strain and an independent mutant strain with a similar phenotype when introduced onto the chromosome by allelic exchange. Further analysis revealed that the mutations were just upstream of the translational start site of the rpoA gene encoding the alpha subunit of RNA polymerase. We confirmed that these mutations were responsible for the mutant phenotype by site-directed mutagenesis. Our hypothesis that these mutations cause an overexpression of rpoA was confirmed by Western immunoblotting and translational fusion analysis. Corroboration of this effect was obtained by overexpressing rpoA on a plasmid in wild-type B. pertussis, which caused the same phenotype as the mutants showed. Conclusions in regard to the identity of the transcription activator of the toxin genes are discussed.

Optimization of a recombinant von Willebrand factor fragment as an antagonist of the platelet glycoprotein Ib receptor.

The binding of von Willebrand factor (vWF) to platelet glycoprotein (GP) Ib receptor is one of the initial events in thrombus formation. Previous studies have shown that RG12986, a reduced and alkylated recombinant fragment of vWF (Ser445-Val733), can inhibit binding of native vWF to GP Ib and offers potential as an anti-thrombotic agent. We have now evaluated a series of deletion mutants of RG12986 and found that reduced and alkylated rvWF508-704 is close to the minimal sequence with optimal RG12986-like activity (IC50 for inhibition of GP Ib-dependent platelet aggregation in the absence of modulators: 0.022 microM +/- 0.01, n = 3) and that it too binds directly to GP Ib. Under in vitro conditions, with no exogenous modulators present and in the absence of shear stress, oxidized rvWF508-704 (containing a disulfide bond between Cys508 and Cys659) is approximately 5-fold less active than reduced and alkylated rvWF508-704; the two fragments, however, display comparable activity in the presence of the modulator botrocetin. The smaller rvWF508-704 fragment offers distinct advantages over RG 12986. In particular, removal of non-active NH2 and COOH terminal sequences may reduce the risk of antigenicity and may contribute to rendering the molecule mostly monomeric in solution, as opposed to the monomer-dimer equilibrium previously described for RG12986.

Measuring medical and nursing students' attitudes toward AIDS.

Investigated attitudes toward AIDS patients among medical and nursing students. Two separate cohorts of students (total N = 550) were surveyed to examine and then validate with confirmatory factor analysis the latent factor structure of such attitudes. Results indicate that a three-factor structure representing fear of contagion, negative emotions, and professional resistance provides a good fit to the data (goodness-of-fit index [GFI] = .92, parsimonious GFI = .67). We offer the resulting 15-item AIDS Attitudes Scale (AAS) as a reliable and valid measure for assessing health care students' attitudes toward working with AIDS patients. Our results suggest the presence of multiple predictors of such attitudes.

Predictors of medical and nursing students' levels of HIV-AIDS knowledge and their resistance to working with AIDS patients.

Among health professionals, knowledge about the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is often limited, inaccurate, or both. Many health professionals also resist working with AIDS patients. This 1988 survey examined exaggerated risk estimates for HIV contagion in relationship to HIV-AIDS knowledge and resistance to working with AIDS patients among medical and nursing students at a large Northwestern teaching hospital. The results indicate that among the respondents, exaggerated risk estimates were associated both with a lack of HIV-AIDS knowledge and with greater resistance to working with AIDS patients. Results from multiple regression analyses revealed that (1) a lack of clinical experience with AIDS patients and (2) antihomosexual attitudes were significantly associated with the students' lack of HIV-AIDS knowledge, even after controlling for the effects of exaggerated risk estimates. The first two variables also were shown to be significantly predictive of the students' resistance to working with AIDS patients, as was an intolerance of drug use and drug users, beyond the influence of exaggerated risk estimates. Specific approaches of developing effective HIV-AIDS educational programs for health professionals are proposed.