Background: Wellness programs can be implemented in a university setting and may include varied elements such as physical activity, occupational balance, and vocal health. However, there is limited information that highlights and synthesizes why and how these programs work. Therefore, this study aimed to understand effective programs on physical activity, occupational balance, and vocal health for university constituents in relation to the implementation contexts, mechanisms, and outcomes (CMO). Methodology: Guided by the Health Belief Model in the context of a realist review design, the researchers conducted an iterative search among seven peer-reviewed electronic databases in the health and education fields using a predetermined set of eligibility criteria. Results: The search identified 6564 records, of which programs from 20 records contributed to data synthesis. Nine CMO statements were created, with physical activity programs accounting for most configurations. Key themes identified were tailored and individualized interventions, medium-term incentivization, lifestyle education programs utilizing information and communications technology, interdisciplinary multi-component programs, use of self-monitoring strategies, social support, and shared experiences among employees and students. Analysis of the mechanisms of these effective university programs revealed processes and structures that were consistent with elements of the Health Belief Model. Conclusion Effective university-based PA programs result from a health-supporting culture among staff and students, utilizing self-based, technological, and social approaches that target and address individual and organizational behaviors in physical activity, occupational balance, and vocal health. This realist review provides practical information that may guide the development of university-based programs and policies targeting these areas of wellness.
Exercise ; Work-Life Balance

Background: Speech sound disorders (SSD) refer to difficulties in perceiving, mentally representing, and/or articulating speech sounds. In 2018, the Tagalog Sentence Repetition Test (SRT) was developed due to the lack of a commercially available local assessment tool for children with suspected SSDs. The SRT had not been validated or piloted yet. Objectives: This study aimed to determine the SRT’s content validity (comprehensiveness, relevance, comprehensibility), ability to successfully elicit the target sounds, and logistical feasibility and flaws. Methodology: All procedures were conducted online. Three linguists evaluated the comprehensiveness of the sounds covered, while 31 Manila Tagalog-speaking children (7 to 21 years old) participated in pilot testing. Post-testing, the children answered a questionnaire to evaluate their familiarity with the sentences’ words (relevance) and the comprehensibility of the test instructions. Content validity was assessed by computing the Content Validity Index (CVI). To see how well the test elicits the target sounds, the number of participants who produced each sound were computed. Results: A CVI of 1.0 was obtained for all aspects of content validity. All targets were produced by almost all the participants, except for the final glottal stop (18/31, 58%). The test administration seemed feasible as participants from all age groups successfully executed the task. Conclusion Although the SRT exhibited good content validity, some sentences need to be revised to address sound production issues noted during the pilot. This new version should be re-piloted to 7 to 11-year-olds in-person and via teleconferencing. A manual should also be created to facilitate administration.
Speech Disorders ; Speech Production Measurement

Background: This research assesses the training needs of employees at the University of the Philippines Manila (UPM) to prepare a comprehensive plan and program intervention for the 2023 training calendar. Objectives: This study specifically examines the reaction of the employees to the training program (Level 1), changes in the level of learning (Level 2), and transfer of training in the workplace or behavioral changes (Level 3). This TNA survey is essential to identify skill gaps, set priorities, and tailor training programs suitable to the needs of UPM employees. Methodology: The study employed a quantitative survey method in assessing employees’ needs across different colleges, units, and offices using a training needs assessment (TNA) survey. A total of 382 employees were surveyed regarding their needs to enhance their core, technical, leadership, and job-specific competencies. Results: Results showed that based on the varying degree of necessity, all the training programs in the training needs assessment survey were considered needed by the employees. Twelve training programs were proposed in the 2023 training calendar as a result of this TNA including three programs for improving core competencies, four programs for technical competencies, two programs for leadership competencies, and three programs for job-specific competencies. Specifically, the training focus on Stress Management, Handling Complaints and Grievances, and Safety and Emergency for core competency; Written and Spoken Communication, Google Workspace/Microsoft Office Applications, Data/Records Management for technical competency; Succession Planning and Managing People for leadership competency; and Procurement, Research Skills, and Creative Design Training for job-specific competency. Conclusion The Training Needs Assessment conducted at the University of the Philippines Manila revealed crucial areas where tailored training programs can play a transformative role in boosting workforce competence and effectiveness. The findings highlight the importance of training in areas such as stress management, decision-making, safety protocols, ethical leadership, and conflict resolution.
Education

Background: Response surface methodology (RSM) is a cost-effective multivariate technique employed in optimization of pharmaceutical formulations. Central composite experiment design is one of the common designs under RSM used for determining optimum nanoparticle formulation parameters. Objectives: To optimize a formulation for meropenem-loaded chitosan alginate nanoparticles using central composite experimental design. Methodology: Meropenem loaded chitosan-alginate nanoparticles were fabricated using aqueous sodium alginate solution and ionotropic gelation with calcium chloride and chitosan, using an optimized formulation derived from a central composite design. The fabricated Mer-CS/Alg NPs were characterized for their particle size, zeta potential, encapsulation efficiency, and loading capacity. The central composite design has been used to adequately assess the influence of two factors namely meropenem concentration and Alg/CS mass ratio on the responses based on a limited number of 13 triplicate formulation runs. Results: This study successfully formulated meropenem-loaded chitosan/alginate nanoparticles. The optimal formulation of the Mer- CS/Alg NPs was 1.7 mg/mLcurcumin, and a Alg/CS mass ratio of 9.8:1. Based on the predicted values of the response variable, the optimal formulation would have a particle size of 490.64 nm, zeta potential of -28.59 mVand a loading capacity of 76.89%. Conclusion The central composite experimental design successfully optimized the nanoparticle formulation of meropenem and chitosan/alginate polymer solution. The optimum formulation produced nanoparticles with adequate size, high stability, and high drug load.
Meropenem ; Nanoparticles ; Research Design

Background: The effect of treatment delays on the quality of life of breast cancer patients undergoing radiotherapy remains to be seen, especially from quarantine measures implemented during the COVID-19 pandemic. Objective: The objective of this study is to assess the health-related quality of life (HR-QOL) of breast cancer patients referred for radiotherapy during the COVID-19 pandemic. Methodology: This cross-sectional analysis included histopathologically proven breast cancer patients referred for radiotherapy at the Philippine General Hospital from June to October 2020. The University of the Philippines-Department of Health Quality of Life Scale for Cancer Patients was used to assess the HR-QOL of the respondents across five domains. Results: A total of 60 respondents (median age of 52, range 33-71) were surveyed and eligible for analysis. College degree holders and good performers were associated with higher HR-QOL scores (p=0.008). The median interval from diagnosis to survey was 10.7 (SD±6.18) months and a longer illness duration was detrimental to HR-QOL. Overall, the global HR-QOL score was high (80.0% of respondents, HR-QOL score of 5.38±0.46). This was observed in all, except for the cognitive domain where HR-QOL was moderate among respondents (4.24±0.76). Conclusion This assessment was conducted within seven months into the pandemic, when an overall high HR-QOL score was observed among breast cancer patients. With further restrictions in treatment census encountered during the pandemic, strategies are recommended to address these indicators of health related QOL in this patient population through equitable and prompt access to needed care, such as radiotherapy.
Breast Neoplasms ; COVID-19 ; Quality of Life ; Radiotherapy

Background: The global impact of the COVID-19 pandemic has been significant, affecting individuals across all health spectrums. Many have adapted their lifestyles to navigate the challenges posed by the pandemic. Despite this, there remains a lack of understanding regarding the specific lifestyle changes made by Filipinos with comorbidities during this time. Objectives: We aimed to ascertain the lifestyle changes among Filipinos with comorbidities and examine how their condition and various sociodemographic factors influenced these changes during the pandemic. Methodology: We conducted a community-based cross-sectional study involving 402 Filipino adults with comorbidities residing in Metro Manila. Using descriptive statistics, we summarized sociodemographic profiles and considerations for lifestyle changes. We assessed lifestyle changes using principal component analysis. Multiple linear regression was used to identify factors associated with these changes. Results: Lifestyle modifications include positive changes in a healthy diet, nutrition, and social support, as well as negative changes in restorative sleep, mental and physical states, and unhealthy eating habits. Monthly household income was positively associated with lifestyle changes. Specifically, individuals belonging to the middle to upper-income categories tend to adopt these modifications compared to those in the lower-income brackets (B [unstandardized beta]=3.99; 95% CI [Confidence Interval)= 0.98, 6.99). The primary reason for embracing these changes was to delay or prevent the progression of diseases, followed by the desire to minimize health complications. Conclusions High-income Filipinos are more inclined to adopt lifestyle modifications compared to lower-income individuals. Prioritizing disease prevention and minimizing health complications are common considerations for these changes.
Chronic Disease ; Comorbidity ; COVID-19 ; Health

Purpose: The field of speech-language pathology (SLP) is a young profession in the Philippines compared and relative to the other health sciences in the country. The emergence of this profession is marked by the milestones laid by the development of the first speech pathology education and training program at the University of the Philippines (UP); the establishment of its national professional organization, the Philippine Association of Speech Pathologists (PASP); and the enactment of RA 11249 or the Speech Language Pathology Act, which created the Professional Regulatory Board for Speech-Language Pathology (PRB-SLP) under the Professional Regulation Commission (PRC). This article looks back at these early beginnings, focuses at the current status of the profession, and provides perspectives for its growth moving forward. Specifically, this article provides an overview of the education and training, professional organization, and local practice of Filipino SLPs. Some emerging issues about the local practice and research gaps are also discussed. Conclusions The SLP profession in the Philippines has come a long way in developing education and training programs, expanding its national professional organization, and obtaining regulation of the practice of this profession under the law. However, there is still much work to be done to ensure its growth and further its development as a health science. Among these, strengthening the body of research to respond to the evolving needs and distinct landscape of local practice could further the growth of SLP in the Philippines.
Speech-Language Pathology ; Philippines

Background: Dermatomyositis - a rare autoimmune myositis – is a disease affecting primarily the skin and muscles which has been correlated with an elevated risk of solid tumors - commonly affecting the ovaries, breast, colon and nasopharynx. However, there is a rare association between dermatomyositis and pulmonary large cell neuroendocrine carcinoma such that in a thorough literature review of published material, only two cases have been reported internationally and none locally. Large cell neuroendocrine carcinoma - in itself, is also a rare malignancy representing only 1-3% of all primary lung carcinomas. Case Presentation: This is a case of a 53-year-old Filipino female, hypertensive, diabetic, dyslipidemic, hypothyroid - nonsmoker – who presented with an eight-month history of facial erythema, swelling of bilateral metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, and erythema over extensor surfaces of the MCP and PIP joints. She had markedly elevated creatine kinase MM and positive anti-nuclear antibody for which she was prescribed prednisone, which she did not comply with. She lost weight and experienced severe abdominal pain. Abdominal imaging subsequently revealed multiple confluent abdominal and thoracic lymphadenopathy with histopathology of large cell neuroendocrine carcinoma (LCNEC). Peculiar to this case however is that despite being a lung carcinoma, the scan showed no pulmonary masses or nodules. Immunohistochemical stains of the lymph node were positive for neuroendocrine markers: pancytokeratin, synaptophysin, TTF-1 and negative for any mutation in the epidermal growth factor receptor. Her Ki-67, which is used as a prognostic factor and correlates with mitotic count - was 70% and PD-L1 tumor proportion score – a predictor of therapeutic effect - is 5-10%. She was subsequently diagnosed with dermatomyositis and pulmonary LCNEC. She has presently completed her 8th cycle of cisplatin and etoposide and has gained weight. Presently, her musculocutaneous lesions have resolved. However, a repeat PET scan was done still showing multiple confluent paraaortic, aortocaval, pericaval lymph nodes with no significant interval change from the first PET scan. Next generation sequencing had been requested showing DIS3 to be the gene altercation – however, as of this writing, no available therapeutic modalities are available to target this. Patient was nonetheless given Pembrolizumab for 3 cycles and subsequently expired due to complications of pneumonia. Conclusion Among published data, we herein present the third reported case of dermatomyositis associated with pulmonary large cell neuroendocrine carcinoma worldwide and the first reported case in the Philippines thereby contributing to the present medical literature. This case demonstrates two rare diseases associated with each other and exemplifies the need for an awareness of such disease entities. It demonstrates a rare case of LCNEC peculiarly without any pulmonary masses or nodules. It also illustrates the necessity in evaluating patients with dermatomyositis for their respective risk in terms of malignancy and other immunocompromised states. Lastly, it contributes to the knowledge on therapeutic options that may be given to patients presenting with both disease entities.
Dermatomyositis ; Lung Neoplasms

Background: The enactment of the Philippine Universal Health Care (UHC) Act mandates the formation of Integrated Health Care Provider Networks (IHCPN), linking hospitals and health facilities, which includes government and privately-owned primary care providers. While hospitals and some health facilities are already under government regulation, primary care providers have not been subjected to formal licensing requirements. In this changing service delivery model, the possible impact of three regulatory policy options being considered need to be assessed according to the goal of ensuring that health services remain affordable and are of high quality. Methodology: A multi-method approach to regulatory impact analysis (RIA) systematically assessed three regulatory options: 1) one Department of Health (DOH) license per hospital and health facility (status quo); 2) one DOH license for all public hospitals and health facilities within an IHCPN and another for individual private hospitals and health facilities; and 3) one DOH license per individual hospital and health facility, and one DOH certification issued to individual hospitals and health facilities as part of an IHCPN. Information from literature, documents, focus group discussions, and cost analyses were triangulated. Results: Regulators are faced with two main risks: there is no standard for networked health care delivery that could provide a foundation for regulation, and provider participation is voluntary, which could lower the interest of private providers to integrate. The three regulatory options considered these risks. Option 1 requires the least change in regulatory policy, but is expected to increase costs to regulators due to the expansion of licensing and enforcement work covering primary care providers. Option 2 requires the most change in regulatory policy, but may be the least expensive to enforce, especially if all facilities join a network. This can also be preferred in a setting with existing interlocal health zones, and participation in the network by private providers poses the most challenge. Option 3 is a tiered regulatory set up that projects the highest cost to regulators as a result of both establishing new certification standards and guidelines on top of a wider scope for enforcement. Conclusion This is the first RIA conducted for the Philippine health system, with challenges similar to those experienced in developing countries. Across the three pre-determined regulatory models, the least costly option may not be the easiest to mount and enforce. Implementability appears to be a stronger consideration which seems to be hinged to the option requiring incremental rather than large form of changes.
Philippines ;

Background: Alcoholic liver disease (ALD) is a major health problem referring to the collection of liver damage caused by excessive alcohol intake. The search for effective and safe alternatives for compounds from plants to protect the liver from extensive damages and delay the progress to a disease is still a big effort done in the scientific community. 2,3,5,6-Tetramethylpyrazine (TMP) is a compound found in a Chinese herbal medicinal plant, Ligusticum chuanxiong Hort and in some other plants. Objective: This study was done to assess the hepatoprotective effects of TMP against ALD using histopathological analysis of zebrafish livers subjected to different exposure groups. TMP has been mainly used for the treatment of cardio- and cerebrovascular diseases due to its antioxidant, anti-inflammatory, and antiapoptotic properties. Methodology: Adult male zebrafish were exposed to three TMP concentrations (40, 60, and 80 mg/L TMP) and to 1% v/v of ethanol. The dissected livers of the zebrafish were processed for fixing on glass slides using the H&E stains and were observed under the light compound microscopes for scoring. The safety of the TMP to the early life stages of the zebrafish was tested using the Zebrafish Embryotoxicity Test (ZFET). Results: Results showed that TMP was able to dose-dependently decrease mean scores for the four parameters diagnostic of ALD, i.e., steatosis, inflammation, cell death, and ballooning degeneration. These scores were comparable to those of the untreated group (no ethanol + no treatment) and positive control (ethanol + Hepasil DTXTM), with all groups' scores being statistically different from those of the negative control group (ethanol + no treatment) (p<0.05). Results for the ZFET showed that incidence of embryo mortality as well as teratogenic malformations of embryos exposed to TMP were significantly lower compared to the positive control group. Conclusion The hepatoprotective role of TMP was implied because anomalies such as cholestasis, vessel congestion, and hemorrhage were only observed in the ethanol-treated group and not in the other groups. In the analysis of the early development of the embryos using the Zebrafish Embryotoxicity Test (ZFET), TMP was found to be non-toxic and non-teratogenic at concentrations used for liver treatment. These initial findings on TMP provided justification for its plausibility as a hepatoprotective compound against alcoholic liver diseases (ALD).
Liver Diseases, Alcoholic