BACKGROUND

Type 2 diabetes is the most common type of diabetes in the Philippines. Diabetic foot complications represent a prevalent and significant chronic concern for individuals with type 2 diabetes. This poses an immediate community health concern, as diabetic complications may threaten an individual's well-being.

This study intends to cross-culturally adapt the Diabetic Foot Knowledge Subscale (DFKS) and Foot Self-Care Behavior Scale (FSCBS) questionnaires into the Filipino language as an assessment tool among Filipinos with diabetes.

The study employed a psychometric research design, where it entailed Phase A and Phase B. Phase A involved the forward translation of the DFKS and FSCBS questionnaires, followed by the synthesis of the translations and backward translation. Subsequently, an expert committee reviewed the translations and concluded the final version. The final translated versions of the questionnaires ensured that it can be understood by an individual who has a Grade 6 level of reading proficiency. Phase B entailed the validity testing with the evaluation of the expert committee, and reliability testing of the said questionnaires with a sample size of 30 participants. A wash-out period of 24 hours was given for the test-retest reliability, followed by data analysis. The validity and reliability of the questionnaires were measured using the item and scale content validity indices and the internal consistency and test-retest reliability, respectively, to ensure their accuracy and appropriateness. The content validity of the questionnaires was evaluated individually by the experts using a Likert scale from 1-4, with 4 being the highest meaning the item was very relevant and succinct. Scores per item were between 3 and 4, which indicate that the translated version of the items were relevant and succinct or were relevant but needed minor revisions.

The validity scores for the translated DFKS and FSCBS questionnaires were obtained using the Scale Content Validity Index (S-CVI) with a score of 0.96 and 0.92, respectively. Moreover, all items in the questionnaires obtained an Item Content Validity Index (I-CVI) of 0.88-1.00. The DFKS also has an acceptable internal consistency with a Cronbach’s alpha of 0.72, while the FSCBS has a good internal consistency with a Cronbach’s alpha of 0.85. The test-retest reliability shows an acceptable Spearman’s correlation at 0.76 for the DFKS and a strong positive Pearson correlation coefficient at 0.73 for the FSCBS.

The validity of the two questionnaires was acceptable and the test-retest reliability showed a strong positive correlation among the items thereby making the cross-cultural adaptation of the questionnaires successful. The Filipino versions of the DFKS and FSCBS questionnaires accurately measure the knowledge and behavior of individuals with type 2 diabetes, respectively.

BACKGROUND

Public health nurses (PHNs) are a significant cadre of the primary healthcare workforce working toward achieving universal health care (UHC). Exploring their work activities is integral to understanding how UHC is implemented better.

To describe and explore the work activities, roles, and functions of the PHNs in rendering primary care services in the context of UHC.

Key informant interviews were conducted with 12 PHNs in Tarlac Province who were working with permanent status in their respective rural health units (RHUs) for at least 1 year. They were selected through selection criteria. Data were recorded, transcribed, and subjected to thematic analysis.

Data analysis led to the emergence of 4 themes and 11 subthemes. The four themes were: (a) evolving scope and nature of work, (b) work challenges and barriers toward UHC implementation, (c) UHC outcomes, impact, and insights, and (d) communication and health promotion.

The study underscores the importance of exploring the PHNs’ roles and functions, as it offers a window on how they fulfill their duties toward achieving the goals of UHC. From the viewpoint of the interviewed PHNs, several elements and issues need to be addressed. Consequently, some positive impact on their work activities and functions emerged. Their nature of work brought them professional development and fulfillment as they render primary care and value-driven services despite the challenges and struggles they encountered in public health.

BACKGROUND

Groundwater is an essential resource for domestic use, agricultural needs, and economic activities, yet it is increasingly threatened by contamination and overextraction. To evaluate groundwater quality and identify associated health risks, the Philippine Groundwater Health Index (PGHI) project conducted a comprehensive assessment of selected sites across various regions in the country.

The study analyzed groundwater samples from multiple locations to determine compliance with the Philippine National Standards for Drinking Water. Parameters assessed included organochlorines, heavy metals, microbial indicators, and physical and nonmetal characteristics such as phosphate and ammonia levels. Results were compiled to evaluate overall groundwater safety and identify areas of concern.

No organochlorines were detected in any of the samples, and all heavy metals complied with national drinking water standards. However, significant noncompliance was observed in other parameters. Microbial contamination was widespread, with 79.25% of samples failing to meet microbial standards due to the presence of fecal coliforms and Escherichia coli. Elevated levels of physical and nonmetal parameters were also noted, with 21 of 27 sites exceeding phosphate limits and 8 sites exceeding ammonia levels. These findings indicate substantial health risks associated with fecal contamination and nutrient pollution.

The PGHI project underscores the urgent need for enhanced groundwater treatment processes, regular monitoring, and strengthened policy-making to ensure safe drinking water. While the study provides critical insights, limitations such as lack of seasonal data, absence of emerging contaminant analysis, and limited spatial coverage highlight the necessity for continued improvements in groundwater management. Addressing these gaps is essential to protect public health, preserve environmental quality, and ensure the sustainable availability of safe groundwater for future generations.

INTRODUCTION

Heart failure (HF) remains a significant global health issue, affecting approximately 64 million individuals worldwide. In the Philippines, the prevalence aligns with global estimates, disproportionately affecting older populations.

The Philippine National Heart Failure Network (PNHFN) conducted a cross-sectional survey from November 2021 to March 2022 to assess the landscape of HF management among medical professionals across the country.

A total of 1,649 physicians responded, primarily cardiologists (64%), internal medicine specialists (27%), and general practitioners (12%). While diagnostic tools such as electrocardiography (92%) and 2D echocardiography (85%) were widely available, advanced imaging modalities and specialized cardiac procedures, including cardiac catheterization and heart failure implantable devices, were less accessible outside metropolitan areas. Essential HF medications, including renin-angiotensin system blockers (84%), beta-blockers, and diuretics, were commonly prescribed; however, newer pharmacologic options such as sodium-glucose co-transporter 2 inhibitors remained underutilized.

Cardiac rehabilitation was accessible to less than half of respondents (48%), with unavailability cited as a major barrier. Despite these challenges, 97% of participants supported the establishment of HF programs to improve patient care and provider support. The findings highlight the need for improved access to advanced diagnostic and therapeutic modalities, enhanced education on guideline-directed HF management, and expanded infrastructure to bridge gaps in care delivery. Strengthening national HF initiatives and fostering collaboration among stakeholders are crucial in optimizing HF management and patient outcomes in the Philippines.

BACKGROUND: Lung cancer is one of the malignant cancers with the highest incidence rate, and it is important to identify the factors contributing to lung cancer carcinogenesis for prevention. Lifestyle and genetic factors play important roles in cancer development, however the impact of dietary factors, such as soy product intake, on lung cancer risk remains inadequately understood. This study aims to explore the associations between soy product intake, genetic risk, and lung cancer incidence, and validate the consistent effects of soy product intake in European populations, thereby providing new insights for lung cancer prevention. METHODS: Utilizing the Shanghai Suburban Adult Cohort and Biobank (SSACB) (n=66,311), Cox proportional hazards model was adopted to assess the association between soy product intake and lung cancer incidents, followed by subgroup analyses stratified by gender, smoking status, and pathological types of lung cancer. The UK Biobank (UKB) was used for validation of the effect of soy product intake on lung cancer. To investigate the association between genetic factors and lung cancer, in addition to previously reported loci, we incorporated newly identified loci from two independent studies in Southeast China: a nested case-control population from the SSACB cohort (433 cases/650 controls) and a case-control study from the Shanghai Cancer Center-Taizhou cohort (1359 cases/1359 controls). Meta-analysis and Linkage disequilibrium clumping (LD clumping) of the association results identified 23 loci for polygenic risk score (PRS) construction. Subsequently, conditional Logistic regression model was used to assess the association between genetic risk and lung cancer. RESULTS: In SSACB cohort, after adjusting for age, gender, smoking, chronic bronchitis, body mass index (BMI), vegetable intake and red meat intake, sufficient soy product intake was significantly associated with a reduced risk of lung cancer [hazard ratio (HR)=0.60, 95%CI: 0.47-0.77, Padj=6.69E-05], an effect that was consistent in males and females, smokers and non-smokers. In UKB, although the association did not reach statistical significance, a protective trend against lung cancer was also observed (HR=0.76, 95%CI: 0.55-1.06, Padj=0.10). In the nested case-control population within SSACB, a PRS score generated in the Chinese population was significantly correlated with lung cancer risk. After adjustment of age, gender, smoking, chronic bronchitis, and soy product intake, the high-PRS group had a 1.88 times higher risk of lung cancer compared to the low-PRS group (Padj=1.84E-03). CONCLUSIONS The prospective cohort study found that adequate intake of soy products was significantly associated with a reduced risk of lung cancer, while a high PRS is a risk factor for lung cancer development. Integrating soy product intake and PRS into traditional epidemiological risk factor prediction will guide personalized lung cancer prevention and high-risk population stratification.
Humans ; Lung Neoplasms/etiology* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Adult ; Aged ; Prospective Studies ; Biological Specimen Banks ; Risk Factors ; Case-Control Studies ; Cohort Studies

BACKGROUND: Lung cancer ranks as the foremost cause of cancer-related deaths in China, significantly undermining population health and longevity. By analyzing the trends of death and years of life lost caused by lung cancer in Handan from 2017 to 2023, data support is provided for the formulation of prevention and treatment strategies. METHODS: Lung cancer death data in Handan during 2017-2023 were collected. Excel 2010, SPSS 26.0 and Joinpoint 4.9.0.0 were used to analyze the mortality rate of lung cancer, average annual percentage change (AAPC), cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs), Fulfillment index, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), and standardized potential years of life lost rate (SPYLLR). RESULTS: The standardized mortality rate of lung cancer in Handan from 2017 to 2023 showed a decreasing trend (AAPC=-7.10%, P<0.01). The CELE of lung cancer increased by 2.49 years (AAPC=0.48%, P<0.05). The life loss rate decreased by 21.43% (AAPC=-4.61%, P<0.05). The Fulfillment index by lung cancer increased with the growth of age from 2017 to 2023. The PYLL, PYLLR, standardized potential years of life lost (SPYLL) and SPYLLR of lung cancer during 2017 to 2023 were 134,219.75 person years, 2.03‰, 98,735.63 person years, and 1.49‰, respectively. The annual PYLLR and SPYLLR showed a decreasing trend (AAPC=-6.34%, -9.34%, respectively, P<0.01). CONCLUSIONS The standardized mortality rate of lung cancer in Handan from 2017 to 2023 showed a decreasing trend, and the impact of lung cancer on life expectancy decreased. The mortality rates of lung cancer showed significant differences among different ages and genders. It is necessary to take good measures to prevent and control lung cancer in males and higher age groups.
Lung Neoplasms/mortality* ; Humans ; Male ; Life Expectancy/trends* ; Female ; China/epidemiology* ; Aged ; Middle Aged ; Aged, 80 and over ; Adult ; Young Adult

BACKGROUND: The incidence and mortality rates of lung cancer remain on the rise, creating an urgent need for screening among high-risk populations and early prevention. This study aims to explore the association and interaction between multidimensional lifestyle, socioeconomic status, and the incidence of lung cancer, and to provide scientific evidence for screening high-risk populations and preventing lung cancer. METHODS: Healthy lifestyle score was constructed using information on smoking, alcohol consumption, exercise, diet and sleep obtained through a questionnaire survey. Socioeconomic status was evaluated based on information on education, employment, and family income, and genetic testing data were used to assess the risk of genetic variation. A proportional hazards assumption test was conducted, and the Cox proportional hazards model was applied to analyze the associations between healthy lifestyle scores, socioeconomic status, and lung cancer, as well as the interactions among various factors, after adjusting for the risk of genetic variation, age, gender, diabetes, hypertension and the living environment score. RESULTS: A total of 245,538 samples that entered the cohort from March, 2006 to October, 2010 were included and followed up until December 31, 2022. The participants were divided into the case group (n=1472) and the control group (n=244,066). The analysis results showed that after adjusting for covariates, there was still an association between the healthy lifestyle score, socioeconomic status, and the incidence of lung cancer: compared with participants with a high healthy lifestyle score, the risk of lung cancer in participants with medium and low healthy lifestyle scores was significantly increased, with hazard ratios (HR) of 2.12 (95%CI: 1.86-2.41) and 3.36 (95%CI: 2.82-3.99) respectively; compared with participants with high socioeconomic status, the risk of lung cancer in participants with medium and low socioeconomic status was significantly increased, with HR of 1.29 (95%CI: 1.13-1.48) and 1.67 (95%CI: 1.46-1.90) respectively. Moreover, there were interactions between smoking status and socioeconomic status (Pfor interaction=0.05), as well as the other four lifestyle factors (Pfor interaction=0.02). CONCLUSIONS This study identified the association between multidimensional lifestyle factors and socioeconomic status with the incidence of lung cancer, as well as interactions between smoking and socioeconomic status and four other lifestyle factors, providing a scientific basis for screening and prevention in high-risk populations for lung cancer.
Humans ; Lung Neoplasms/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Life Style ; Social Class ; Aged ; Adult ; Risk Factors

OBJECTIVE: The relationship between benign prostatic hyperplasia (BPH) and the oxidative balance score (OBS) will be discussed in this study. METHODS: The clinical data on 16 dimensions of diet and 4 dimensions of lifestyle from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2008 were used to calculate OBS. We considered BPH as the outcome and investigated the linear and nonlinear relationships between the two. Additionally, subgroup analyses and interaction tests were conducted as well. Furthermore, the methods of machine learning including XGBoost, support vector machine (SVM) and naive Bayes (NB) were used to establish a predictive model for BPH. RESULTS: Higher OBS was consistently associated with an increased prevalence of BPH, with Restricted Cubic Splines highlighting a significant positive nonlinear association (P=0.015). Subgroup analyses revealed differences and interactive relationships based on alcohol consumption. Among the seven machine learning models that we included the OBS score in, the XGBoost model emerged as the best, with an AUC value of 0.769. CONCLUSION There is a significant association between OBS and the prevalence of BPH in the American population, which provides a valuable insight for further diagnosis and research of the disease.
Humans ; Male ; Prostatic Hyperplasia/epidemiology* ; Machine Learning ; Bayes Theorem ; Nutrition Surveys ; Support Vector Machine ; Life Style ; Oxidative Stress ; Aged ; Diet ; Prevalence

OBJECTIVE: To analyze the effect of Y chromosome AZFc microdeletion on pregnancy outcome of intracytoplasmic sperm injection (ICSI). METHODS: From 2016 to 2023, 6 765 cases of oligozoospermia in our hospital were selected as the research objects. The results of Y chromosome microdeletion test were retrospectively analyzed. According to the inclusion exclusion criteria and the principle of propensity distribution 1∶2, 180 patients were included in the study. Sixty patients with Y chromosome AZFc microdeletion and ICSI assisted pregnancy were enrolled into the experimental group. The other 120 patients without Y chromosome microdeletion and ICSI assisted pregnancy were included in the control group. Baseline characteristics, five male sex hormones, laboratory embryo culture and pregnancy outcomes were compared between the two groups. RESULTS: There was no significant difference in male age, female age, infertility years, gravidity and parity between the two groups (P>0.05). There was no significant difference in the five sex hormones of men (P>0.05). Except for transplantable embryos (P<0.05), there was no significant difference in other indicators in the process of embryo culture. There was no difference in pregnancy outcome indicators between the two groups except for the preterm birth rate (P<0.05). CONCLUSION ICSI assisted pregnancy with Y chromosome AZFc microdeletion has no significant effect on pregnancy outcome. And close follow-up of offspring is required.
Humans ; Sperm Injections, Intracytoplasmic ; Pregnancy ; Female ; Chromosomes, Human, Y ; Male ; Chromosome Deletion ; Pregnancy Outcome ; Retrospective Studies ; Sex Chromosome Disorders of Sex Development ; Sex Chromosome Aberrations ; Adult ; Infertility, Male/genetics* ; Oligospermia/genetics* ; Pregnancy Rate

BACKGROUND: As research progresses, there is a growing body of evidence indicating that urinary metallothionein (MT) levels may be elevated in individuals exposed to cadmium (Cd). This study aimed to investigate the potential association between urinary MT levels and causes of mortality among residents of the Kakehashi River Basin who have been exposed to Cd. METHOD: The study involved a total of 1,398 men and 1,731 women were conducted between 1981 and 1982, with follow-up until November 2016. The study employed the Cox proportional-hazards model to examine the association between higher urinary MT concentrations and the risk of all-cause or cause-specific mortality within the population. Furthermore, the Fine and Gray competing risks regression model was used to evaluate the links between specific causes of death. RESULTS: The findings revealed that elevated urinary MT concentrations were linked to increased all-cause mortality and higher mortality rates from renal and urinary tract diseases across all participants. Specifically, in men, higher urinary MT levels were associated with elevated all-cause mortality, while in women, increased concentrations were linked to higher mortality from endocrine, nutritional, and metabolic diseases, as well as cardiovascular diseases. Even after adjusting for competing risks, higher urinary MT concentrations were associated with tumor-related mortality in men and continued to be associated with cardiovascular disease mortality in women. CONCLUSIONS In conclusion, the results suggest that women may face a greater risk of adverse health effects due to prolonged exposure to Cd. Urinary MT levels could potentially serve as a biomarker for mortality from these diseases in populations chronically exposed to Cd.
Humans ; Male ; Female ; Cadmium/urine* ; Japan/epidemiology* ; Metallothionein/metabolism* ; Middle Aged ; Cause of Death ; Adult ; Follow-Up Studies ; Aged ; Environmental Exposure/analysis* ; Proportional Hazards Models