Background: Despite the persistent relevance of mental health in the lives of Filipinos and the long tradition of mental health care in the Philippines, scholarly works on the history of mental illnesses and mental health institutions, particularly during the colonial period, remain scarce. Objective: This paper aimed to explore the various policies implemented by the American colonial government in the Philippines to address issues regarding insanity from 1903 to 1928. Methodology: As a historical inquiry, the paper employed historical analysis in examining sources of data such as archival documents, official reports, bulletins, and statistics produced by the various offices of the American colonial government in the Philippines. Results: Three specific policies were identified – the establishment of the Insane Department at the San Lazaro Hospital in 1904 as a response to the overcrowding and inadequate treatment methods at the Hospicio de San Jose, the Insane Department's adherence to the principles of moral treatment, and enactment of different laws pertinent to insane persons, most notably the Insanity Law of 1912. Conclusion The historical narrative shows that these policies had been used by the American colonial government to showcase their alleged benevolence and preserve public order. It was also demonstrated that the colonizers ultimately failed to develop the Insane Department as a modern insane asylum, as indicated by persistent problems such as overcrowding, lack of proper facilities, and outdated treatment methods.
Mental Disorders

Introduction: Hockey is a team sport that involves running, sprinting, and making sudden changes in directions of movement to control a ball against the opposing team. Therefore, due to its nature of fast movement, hockey players may be at risk of various musculoskeletal injuries. This study aimed to identify the prevalence and pattern of musculoskeletal injuries sustained among Malaysian Hockey League players. Materials and Method: Data were collected from 84 field hockey players that participated in the Malaysian Hockey League competition from June 2016 until December 2016. All injuries were recorded by the participating medical team using a structured questionnaire. A descriptive statistical analysis and Chi-Square test were used to explore the prevalence of the injury. Result: More than half of the players were reported to have lower limb injuries (51.6%). Sprain and strain were the most prevalent injuries (63%) and mostly affected the ankle (29%). Male players sustained more injuries (50.8%) compared to female players (49.2%). Conclusion: This study suggests that a guideline is needed for injury prevention strategies that will benefit the hockey players in preventing injuries.

Objective: This study aims to describe a new extraoral technique for reducing bilateral temporomandibular joint (TMJ) dislocations. Methods: Design: Retrospective Preliminary Case Series Setting: Tertiary Government Training Hospital Participants: Ten (10) adults with bilateral TMJ dislocation Results: Ten patients, 7 males and 3 females with median age of 35.50 (IQR:21.25 [23.50, 44.75]) years old were included in our series. Seven had more than one previous episode of TMJ dislocation, and the dislocation spontaneously occurred while yawning or eating in six patients. Our new technique resulted in complete bilateral reduction in three patients who had first-episode TMJ dislocations but only in four out of seven with previous dislocation. The three others (two partial, unilateral failure of reduction and one complete failure of reduction) needed conventional extraoral reduction (Hippocratic technique). Conclusion This new extraoral technique may show promising preliminary results in the management of temporomandibular joint dislocation, but a larger trial in comparison with other techniques is needed.
Temporomandibular Joint ; Temporomandibular Joint Disorders ; Joint Dislocations ; Therapeutics

INTRODUCTION: Stigmatizing attitudes are barriers to treatment of mental health disorders. The burden of stigma has not been established locally. This study aimed to assess the stigma in the community by determining the knowledge, attitudes and behaviors of barangay residents towards mental health and persons with mental health illness. METHODS: A total of 422 participants were included using convenience sampling. Participants were given self-administered questionnaires that consisted of the Mental Health Knowledge Schedule (MAKS), Community Attitudes Towards the Mentally Ill (CAMI), and Reported and Intended Behavior Scale (RIBS) tools. The mean scores and percentages were computed and compared across the sociodemographic data of the respondents. RESULTS: Knowledge levels were relatively high with a mean score of 26.63. Depression, stress, bipolar disorder and drug addiction were recognized as mental illnesses by the majority of the participants. Scores in the stigmatizing ideologies authoritarianism (3.07) and social restrictiveness (2.58) were low, while the positive ideologies benevolence (3.76) and community health ideology (3.85) had higher scores. Participants were reluctant to work with mentally-ill people (3.18) but were willing to be friends with them (3.87). CONCLUSION This study concludes that the respondents were generally knowledgeable about mental health illness. There was a general acceptance and less stigmatizing attitude, and a willingness to interact with people with mental illness.
psychiatry ; Mental health ; Social Stigma

INTRODUCTION: This study determined the level of awareness of Grade 10 junior high school students in physical therapy education, scope of practice, their source of information, and aimed to identify factors resulting in non-familiarity of the students on physical therapy. METHODS: Grade 10 junior high school students were recruited from three private schools in the National Capital Region through non-probability sampling techniques. The students completed a self-administered survey questionnaire. Descriptive statistics focused on frequency distribution. RESULTS: Most of the 387 respondents were aware of the discipline (physical therapy), with 31% of them answering that their family was their primary source of information. Many thought Bachelor of Science in Physical Therapy was a four-year course, with human anatomy being one of the major subjects. The respondents also knew that a licensure examination was essential to practice physical therapy. They also expected physical therapists to offer different treatment modalities, such as exercises, massage therapy, hot and cold packs for various musculoskeletal disorders. Respondents also viewed the work of physical therapists to be hospital-based, with average monthly income ranging from Php 12,000.00 to Php 20,000.00. On the other hand, students who were unaware of physical therapy did not have relatives who were health professionals and appeared to be uninterested in pursuing any health or science-related degree program in college. CONCLUSION Even though most of the students were aware of physical therapy as a profession, majority of them lacked knowledge as to physical therapy education and scope of practice.

Objective: This pilot study investigated whether serum B-type Natriuretic Peptide (BNP), bioelectrical impedance analysis (BIA), and left ventricular end-diastolic diameter (LVEDD) can be used to predict fluid overload and clinical outcomes in pediatric sepsis. Methods: Pediatric sepsis patients were enrolled. BNP, BIA, and LVEDD were obtained on admission and on Day 3. Diagnostic performances of BNP, BIA, LVEDD and correlation with fluid status were obtained. Results: Twenty-two patients were enrolled. Day 3 BNP was higher in non-survivors (9241 vs. 682.2 pg/mL, p=0.04) and day 3 LVEDD Z-score was lower in non-survivors (-3.51 vs. -0.01, p=0.023). There was no difference in the fluid balance between survivors and non-survivors. Admission BNP >670.34pg/mL predicted vasopressor use with a sensitivity of 85.71% and specificity of 86.67% while ΔBNP>5388.13pg/mL predicted mortality with 100% sensitivity. Day 3 LVEDD <22mm predicted mortality with a sensitivity of 94.74%. Cumulative fluid balance was strongly correlated with BIA and LVEDD (r=0.65, p=0.001; r=0.74, p<0.001 respectively). The median length of stay in hospital days for non-survivors was not significantly different from survivors (4 [1-12] vs. 8 [6-12] days,p=0.21). Conclusion Rise in BNP levels appear to be independent of fluid status and is a good predictor of mortality, vasopressor, and mechanical ventilator use but not of length of hospital stay. LVEDD and BIA are good estimates of cumulative fluid balance but not as predictors of mortality, vasopressor, mechanical ventilator use, and length of hospital stay. Significance of the outcomes of the study was limited due to the small sample size.
Natriuretic Peptide, Brain ; Echocardiography

After two years of the Coronavirus Disease 2019 (COVID-19) pandemic, cases have generally begun to decline in the different regions of the world, and consequently a lot of people are gradually returning to face-to-face interactions, including health-related activities. Based on scarce local literatures published recently, telerehabilitation was envisioned to be a viable solution to bridge the perennial gaps in the delivery of rehabilitation services across the Philippine archipelago, such as the lack of manpower and resources, aggravated by the pandemic.
Delivery of Health Care ; Telemedicine ; Telerehabilitation ; COVID-19 ; Developing Countries

Background: The presence of COVID-19 has increasingly overwhelmed the Philippine healthcare system, which is affecting the mental and emotional health of healthcare workers in the country. Objective: The study aimed to assess the emotions, stressors, stress-reducing factors, coping mechanisms, and motivational factors of the emergency room (ER) doctors in selected high-risk private hospitals within the National Capital Region (Metro Manila) during the COVID-19 pandemic between March 14, 2020 to November 12, 2020. Methodology: A quantitative, cross-sectional descriptive study was conducted using electronic and/or physical surveys, given to 127 ER doctors in Cardinal Santos Medical Center in San Juan, Makati Medical Center in Makati, and Chinese General Hospital in Manila. Results: Results showed that ER doctors continuously work as it is their professional and ethical duty despite feeling nervous and scared to do so. However, the safety of their colleagues and family increases their stress levels, which were reduced when their family and friends were safe from COVID-19 and when the condition of their colleagues improved. Following strict protocols and chatting with friends and family helped them cope to alleviate stress, and the assurance of adequate personal protective equipment and family support motivated the ER doctors to continue working. Conclusion The COVID-19 pandemic has had an effect on ER doctors, and all involved parties can improve the experiences of ER doctors during any future outbreaks similar to COVID-19 by providing psychosocial interventions.

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.

Introduction: During the COVID-19 pandemic, medical schools shifted to blended learning. This study aimed to determine the demographic and level of confidence of a private medical school’s clinical clerks of School Year 2021-2022 on general competencies and skills. Methods: The study aimed to identify the skills that exhibited the highest and lowest levels of confidence among a group of 139 clinical clerks. Additionally, it sought to examine whether there were significant differences in confidence levels based on sex and prior clinical experience. An analytical cross-sectional study design was employed using a Google Form as the data collection tool. Results: The clerks were most confident in handwashing, and least in NGT insertion, performing digital rectal examination (DRE), and suturing. Females were more confident in history taking of obstetric and gynecologic, surgical, and medical patients, physical examination of pediatric patients, and preparing a discharge summary, while males were more confident in performing digital rectal examination. Clerks with prior medical experience were significantly more confident in foley catheter insertion, intravenous insertion, blood extraction, suturing, and performing essential intrapartum and newborn care (EINC) than those without. The results aligned with previous studies since clerks with prior experience were able to practice the skills in a psychomotor sense. Conclusion The study revealed significant differences in the confidence level on the competencies and skills for medical practice between sex and prior medical experience.
Clinical Competence