Disasters complicate the management of noncommunicable diseases (NCDs) by disrupting access to and delivery of health care, including medicines. Following Typhoon Haiyan in the Philippines in November 2013, much of the health infrastructure was destroyed and health service delivery was severely affected. This left many people with NCDs vulnerable as medicines were destroyed or washed away, food was scarce, and access to medicines and drugs and quality health care was difficult.

INTRODUCTIONThe near terminal patient with skeletal metastasis may suitably be palliated with an intramedullary nail whereas another patient with good survival potential may benefit from a more extensive resection and reconstructive procedure. In a previous study by the senior author (Nathan et al, 2005), life expectancy in patients operated on for bone metastases correlated with clinical and haematological parameters in a normogram. We performed a cross-cultural comparison to validate this normogram.

MATERIALS AND METHODSWe randomly selected 73 patients who had undergone surgery for metastatic bone disease between 28 December 2000 and 11 March 2009. The time to deaths was recorded from hospital records and telephone interviews. Multiple parameters including clinical, radiological and haematological were evaluated for significant prognostic value using Kaplan-Meier survivorship analysis. Statistically significant parameters were entered into a Cox regression model for statistically independent significance. A multi-tier prediction of survival was performed by workers from various levels of seniority.

RESULTSAt the time of analysis, there were 40 deaths (55%). Median survival was 15.8 (95% CI, 7.9 to 23.7) months. Kaplan-Meier analysis showed that low haemoglobin (P = 0.0000005), presence of lymph node metastases (P = 0.00008), multiple bone metastases (P = 0.003), presence of visceral metastases, (P = 0.007), low lymphocyte count (P = 0.02) and low serum albumin (P = 0.02) were significantly associated with poor survival. By Cox regression analysis, presence of visceral metastases (P = 0.002), presence of lymph node metastases (P = 0.0002) and low haemoglobin (P = 0.01) were shown to be independent factors in the prediction of survival. Survivorship readings were superimposed onto the previous normogram and found to be similar. Independent blinded use of the normogram allowed good prediction of survival. There was a tendency to underestimate survival when patients survived beyond 1 year of skeletal metastasis.

CONCLUSIONOur findings are similar to that of the previous study in showing a relationship between the above-mentioned parameters and survival. This is despite differences in patient demographic characteristics and management protocols. Use of the tools may allow better siting of most appropriate surgery in metastatic bony disease.

Bone Neoplasms ; mortality ; surgery ; Decision Support Systems, Clinical ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Analysis ; Terminal Care

Authors suggest efforts are needed to further explore the usefulness and utilization of psychoeducation at the community and professional levels as applied to various settings and populations. In addition, if developed and implemented carefully, psychoeducational interventions have promising application on other life challenges across levels of the public health, social, and educational systems. This quasiexperimental three group pre-test post-test study aims to investigate the effect of psychoeducation on the self-esteem and self-efficacy of college students. A total of 105 college students (35 subjects per group) who were enrolled at Saint Louis University, Baguio City, Philippines were included as sample. Sampling technique was purposive. The Rosenberg's Self-esteem Scale and Schwarzer's General Selfefficacy Scale were used as data gathering tools. A self-made psychoeducational module that was validated by experts in mental health and psychiatric nursing was utilized as intervention. SPSS version 20 was used for the statistical analysis. The results on the post-test scores of both treatment arms (informational and comprehensive model) were significantly higher compared to control group after eight sessions of psychoeducation. The researchers therefore conclude that both psychoeducation models (informational and comprehensive) showed evidence of effectiveness in increasing the self-esteem and self-efficacy levels of college students. 

Human ; Male ; Female ; Adolescent ; Self Efficacy ; Universities ; Mental Health ; Psychiatric Nursing ; Public Health ; Saints ; Self Concept ; Students ; Life

The use of child restraints such as car seats or booster seats inevitability increases with the implementation of laws mandating its use in the general public. This is of great importance to child health and injury prevention as child restraint use has been shown to reduce the risk of serious injury by 71% to 82% for children less than 1-year-old, and 45% for children aged 4 to 8 years old.2,3 In terms of averting death, child restraints were associated with 28% reduction in risk for death.4 It has been found that using ageand size-appropriate child restraints is the best way to save lives and reduce injuries in a crash.5 It is reasonable, therefore, that one study that investigated the association between child restraint law implementation and traffic injury rate among 4 to 6 years old children in New York State found that these children experienced an 18% reduction in traffic injury rate. (See full-text for continuation).
Human ; Child Preschool (a Child Between The Ages Of 2 And 5) ; Pediatrics

Authors suggest efforts are needed to further explore the usefulness and utilization of psychoeducation at the community and professional levels as applied to various settings and populations. In addition, if developed and implemented carefully, psychoeducational interventions have promising application on other life challenges across levels of the public health, social, and educational systems. This quasiexperimental three group pre-test post-test study aims to investigate the effect of psychoeducation on the self-esteem and self-efficacy of college students. A total of 105 college students (35 subjects per group) who were enrolled at Saint Louis University, Baguio City, Philippines were included as sample. Sampling technique was purposive. The Rosenberg's Self-esteem Scale and Schwarzer's General Selfefficacy Scale were used as data gathering tools. A self-made psychoeducational module that was validated by experts in mental health and psychiatric nursing was utilized as intervention. SPSS version 20 was used for the statistical analysis. The results on the post-test scores of both treatment arms (informational and comprehensive model) were significantly higher compared to control group after eight sessions of psychoeducation. The researchers therefore conclude that both psychoeducation models (informational and comprehensive) showed evidence of effectiveness in increasing the self-esteem and self-efficacy levels of college students. 

Human ; Male ; Female ; Self Efficacy ; Universities ; Mental Health ; Psychiatric Nursing ; Public Health ; Saints ; Self Concept ; Students ; Life ; Nursing ; Students