Background: Gender-based violence originates when societal gender-based expectations and the reality are not consistent. One such example is: there has been a recent rise in women's education in the Philippines, yet the prevalence of traditional female role expectations in the context of the heavily Catholic Filipino society remains unchanged. Objectives: In this paper, the relationship between women's education and their risk of gender-based violence (GBV) is examined and compared with the relationship between the education of their partners and the women's risk of experiencing GBV. Methodology: Our sample included women living in the Philippines surveyed by the Demographic Health Survey in 2017. We used multivariate logistic regression on the respondents' and the partner's education level, with respondent's risk of experiencing GBV. Results: We found that there was a slight but statistically significant decreased risk of GBV experience with increased years of education of both the female respondents and their male partners. For all female respondents, there was a 3.7% decrease in the risk of GBV per additional year of their own education. For those with partners, there was a 2.3% decrease in the risk of GBV per additional year of their partner's education. Conclusion We found that the education of male partners is as much of a factor as the women's own education in her likelihood of experiencing violence. From this, we established that partner selection based on their education levels may act as a protective factor for an individual's likelihood of experiencing GBV. Policy initiatives should address increasing male awareness of safe behavior and violence against women, especially while traditional gender roles are still predominant in the Filipino society.
Female ; Philippines ; Gender-Based ; Violence ; Marriage Violence ; Surveys and Questionnaires

Background and Objective: Anthocyanins are associated with aging and longevity. However, the mechanism involving the pure anthocyanin compounds in aging remains elusive. To investigate the possible mechanism of action of the different anthocyanin compounds towards aging-associated enzymes, the lead-likeness, binding affinity, and binding interactions were evaluated. Methodology: The different anthocyanin compounds such as cyanidin, delphinidin, malvidin, pelargonidin, peonidin, and petunidin were assessed for lead-likeness following the criteria of Lipinski's rule of five (Ro5). These same compounds were virtually docked to different aging-related enzymes involved in MAPK, AMPK, and insulin signaling pathways. The top binding anthocyanins for each enzyme were visualized and compared to the enzyme inhibitors. Results: The different anthocyanin compounds abide with Ro5 denoting its potential as a lead compound. For each enzyme, there were different top-binding anthocyanins. The crystal structures of the docked anthocyanins reveal that there were different substructures involved during the non-covalent interaction. Some substructures, particularly the hydroxy groups, have different roles during the H-bond formation. These findings suggest that the various anthocyanin compounds may have a distinct mechanism of action towards a specific enzyme. Conclusion Taken together, these results suggest that the anthocyanin compounds may have varying effects in aging enzymes, which may be due to the differences in their substructures. Nonetheless, further investigations are needed to understand these findings using cells and animal models.
Insulin ; AMP-Activated Protein Kinases ; Anthocyanins ; Insulin, Regular, Human ; Computer Simulation

Background and Objective: Manila Bay plays an important role both in economics and ecology because it serves as the major economic center of the Philippines and as it harbors different habitats and biodiversity. Unfortunately, it is threatened by various pollutions including the unregulated discharge of wastewater from industrial, agricultural, and household sectors and improper disposal of trash such as macroplastics among others. All these contributes to the current state of Manila Bay. This study identified bacteria isolated from water, seafood and floating macroplastic samples from Baseco Beach, Manila Bay and determined their antibiogram profiles. Methodology: Bacterial isolates were obtained from water, seafoods and macroplastic samples from Baseco Beach, Manila Bay using conventional culture techniques. Identification of the isolates was done using Vitek-2 Automated System and antibiogram profiling was done using Kirby-Bauer Disk Diffusion Susceptibility Test. Results and Conclusions A total of 30 bacterial isolates were obtained from different samples from water, seafood and macroplastic samples from Baseco Beach, Manila Bay. These isolates were identified and found to belong to 13 different bacterial species with Bacillus spp. comprising 33.33% of the isolates (10 out of 30), and Vibrio alginolyticus comprising 23.33% of the isolates (7 out of 30) and the other species comprise the remaining 43.34% (Pseudomonas spp., Vibrio fluvialis, Klebsiella pneumoniae, Shewanella alga, Sphingomonas paucimobilis, Staphylococcus haemolyticus, Chryseobacterium indologenes, Myroides sp. and Aeromonas salmonicida). Of these, six out of 30 isolates (20%) showed susceptibility to all six representative antibiotics used (Cefazolin 30μg, Gentamicin 10 μg, Chloramphenicol 30 μg, ampicillin 10 μg, Cefuroxime 30 μg, Ceftazidime 30 μg) while 7 isolates (23.33%) were resistant to only one class of antibiotic. Moreover, 17 out of 30 isolates (56.66%) were resistant to two or more classes of antibiotic while only one isolate (3.33%) was found to be resistant to gentamicin. All 30 isolates (100%) were susceptible to chloramphenicol. Interestingly, three antibiotic resistant (AMR) bacteria were isolated from macroplastics namely Pseudomonas oleovorans (S2), Vibrio alginolyticus (S5), and Pseudomonas alcaligenes (S29) which were all resistant to ampicillin and cefazolin. This is the first study in the Philippines to isolate AMR bacteria from macroplastics from Manila Bay. The presence of AMR bacteria in macroplastics shows that these materials can be a reservoir for its dynamics and distribution. Lastly, with the emergence of antimicrobial resistant bacteria, the elucidation of the antibiogram profile of bacteria is necessary to determine its implication sand threats to public health. This study served as a baseline study of presence of AMR bacteria in macroplastic samples from Manila Bay.
ays ; Microbial Sensitivity Tests ; Disk Diffusion Antimicrobial Tests

Background and Objectives: Periodontitis and Diabetes Mellitus are both inflammatory conditions that trigger the host response in a similar manner. The effect of uncontrolled diabetes on the progression of periodontitis, as well as the effect of periodontal health on the glycemic control of a patient, have been well documented. The need to include oral health in the management of a diabetic patient is deemed necessary. The objective of this study is to determine the awareness of the interrelationship between diabetes and periodontal disease among Endocrinologists in the Philippines and to determine whether management of a diabetic patient includes measures on maintaining periodontal health. Methodology: A 20-item self-administered survey questionnaire was distributed to endocrinologists registered in the Philippine Society of Endocrinology, Diabetes and Metabolism (PSEDM) Seminar and General Assembly held on September 5-6, 2015 at Sofitel Manila, Pasay City. The questionnaire was comprised of eight multiple choice and 12 yes-no questions, which combined queries on demographics, associations between diabetes and periodontitis as well as patient management. Results: Most of the endocrinologists answered that tooth brushing and flossing should be performed at a minimum of twice a day (96.6%) and that frequency of dental visits should be at least every six months (71.3%). Although most endocrinologists claimed to be aware of the manifestations of gingivitis and periodontitis, only 3.6% accurately identified the symptoms of gingivitis and 3% accurately identified the symptoms of periodontitis. Majority (79.2%) were aware that periodontal disease affects Diabetes Mellitus (DM) and that DM is a risk factor for Periodontitis (95.9%). However, only 38.6% noted periodontitis as one of the complications of diabetes. More than half of the respondents refer their patients to dentists but less than half educate their patients on oral health. Conclusion More than 90% of the Endocrinologists are aware of the bidirectional relationship of Periodontal disease and diabetes mellitus but do not clearly know the difference between gingivitis and periodontitis. In addition, the awareness is not translated to the management of diabetic patients.
Endocrinologists ; Periodontal Diseases

Objective: This study aimed to compare the cost of hospitalization for open and laparoscopic cholecystectomy (OC and LC) among adult patients with cholelithiasis in the Philippine General Hospital. Methodology: The billing records of all patients admitted for elective cholecystectomy from February to July 2017, were reviewed. An item by item costing for room and board, laboratories, radiologic exams, surgical and anesthesia needs for each patient meeting the inclusion criteria was done. Results: From February to July 2017, a total of 391 cholecystectomies were performed; 156 cases (78 OC and 78 LC) were included in the analysis. There is no significant difference between the mean total cost for the laparoscopic group which was 20,549 +/- 4,972 pesos and 18,465 +/- 7,908 pesos (p < 0.05) for the open group. Conclusion Total cost of LC is comparable to OC. However, when the total expenses were divided into categories, the OC group incurred significantly bigger charges than the LC group in room and board, laboratories, radiology, pharmacy, and surgery needs. On the other hand, the LC group had significantly higher mean charges for the surgery needs inclusive of the laparoscopic machine and disposable instruments.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Laparoscopy

Background: Undergraduate researches in universities are potential sources of useful data in medicinal plant research. In higher education institutions, many of these manuscripts remain untapped and inaccessible to researchers and scientists. If widely utilized, these can contribute in the growth of knowledge on medicinal plants. Objectives: This article aimed to catalogue the medicinal plant researches of the Bicol University – Department of Biology from 1991 to 2019, highlight significant developments, trends, and responsiveness of the research, and recommend policies to improve medicinal plant research in the next decade. Methodology: A complete list of undergraduate research titles was obtained and analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) process. Categorization of researches included the medicinal plants studied, year of study, and the biological assays conducted. The final list included two things: researches that utilized medicinal plants and those researches which tested the biological and medicinal properties of plants. Results were presented in percentages. Results: To date, 18.72% of the 865 thesis titles archived in the department are medicinal plant researches and majority of which focused on antimicrobial and toxicity studies. There were 52 plant families, 99 genera, and 114 plant species investigated. Leguminosae and Asteraceae were the most studied plant families. The years 2011-2019 were the most fruitful in terms of research completed. Conclusion Undergraduate researches can provide vital information on medicinal plants studies, especially on an institutional and regional level. It is recommended that medicinal plants research be included as a thematic area among higher education institutions, and that policies be implemented to support publication of researches.
Burseraceae ; Anti-Bacterial Agents ; Asteraceae ; Animal Care Committees ; Anti-Infective Agents ; Biological Assay ; Licensure

Background and Objectives: Reforms in health professions education in the past decade entails the development of effective curricula that impact and improve health outcomes. Along with health professionals, barangay health workers (BHW) are not spared from experiencing curricular mishaps when they undergo trainings for community health work. This article described the process of a participatory approach in curriculum development for BHWs in a local community in the Ilocos Region. Methodology: An exploratory sequential mixed method design was used for this pilot study. The method was framed from six (out of ten) steps in the Research and Development Cycle; these steps were categorized in three phases: 1) needs assessment, 2) participatory curriculum development, and 3) implementation of the curriculum and evaluation. Results: Our findings yielded both qualitative (Phases 1 and 2) and quantitative (Phase 3) data which were analyzed separately and sequentially. Phase 1 revealed findings based on the strengths, weaknesses, opportunities, and threats found in the community's health care context which were used to determine the four potential training topics to develop a curriculum. Phase 2 generated a curriculum on hilot wellness through the participation of the local government and curriculum experts. Phase 3 produced evaluative data on the reaction, learning, and behavior of BHWs towards the implemented curriculum on hilot wellness. Conclusion The participatory curriculum development process entailed the generation and analysis of data from the community that produces a curriculum for the community. This curriculum does not only offer sustainable and longitudinal health care services but is sensitive to the values and culture of the community while considering the notion that learning it not linear. This article demonstrated that a participatory approach in curriculum development within health professions education can be pursued to address the everchanging healthcare needs of local communities.
Health Workforce ; Public Health ; Workforce ; Health Personnel ; Curriculum ; Occupational Health ; Community Health Services

Background: Summative assessment of student performance should provide information on achievement of program outcomes to support evaluation decisions. Alternative approaches to the traditional assessment systems like the written licensure examinations in Physical Therapy (PT) should be explored to ensure valid measurement of achievement of these terminal outcomes. Objective: The study aimed at establishing equivalence of two summative assessments new to PT in measuring achievement of the PT outcomes: work-based assessment using Entrustable Professional Activities (EPA) and knowledge-based assessment using Context-Dependent Item Sets (CDIS). Methodology: Thirty-two newly graduated PT's underwent a one-week EPA assessment and took a 102-item CDIS test (based on 14 clinical vignettes). Qualitative data from blueprint review, group face-to-face interviews with participants and assessors, and field notes from observations, and quantitative data from EPA entrustment decisions and CDIS scores were utilized to ascertain their comparability in terms of Purpose, Administration, Quality and Decisions. This was used to determine the extent of equivalence of the two assessments. Results: Review of both blueprints show alignment with PT outcomes, with integrative content motivating participants towards professional development. Administration were equally acceptable to users, though EPA had more practice opportunities with a longer assessment time. Entrustment decisions in EPA had a high inter-rater reliability, while CDIS had low reliability, with most items having poor discriminative power. Decisions of “pass” or “fail” had good concordance when high prevalence indices were considered. Conclusion There is high extent of equivalence in purpose of EPA and CDIS but are not equivalent in terms of administration. There is moderate equivalence in quality and decisions, with potential for increased concordance if improved quality of CDIS is attained.
Humans

Background and Objective: Peer-assisted learning (PAL) is an established concept in which students obtain mutual benefits by teaching and learning from each other. In the clinical environment, this often occurs intentionally or unintentionally in various formats such as same level or cross level peer tutoring, peer mentoring, cooperative learning and the like. This study determined the effectiveness of Peer Assisted Learning in achieving identified program outcomes in the curriculum for clerks and postgraduate interns rotating in Otorhinolaryngology specialty. Methodology: Study has 2 parts. Part 1 was a one-group pre-test and post-test design that involved teaching training of 16 PGI to be peer tutors in Otorhinolaryngology Physical Examination (ORL PE) to clerks. Video recorded pre-training baseline and post-training actual skills demonstrations of the PGI were rated. Scores were compared using Wilcoxon Signed Ranks test with p value at 5% level of significance. Part 2 was a randomized controlled single-blind trial of Peer-Led vs. Expert Faculty-Led ORL PE training of 55 clerks. Tutees performed a post training video-recorded skills demonstration assessed by a faculty rater who was blinded as to who among the clerks underwent the PAL-Led or Expert Faculty-Led training. Scores of the tutees in the 2 models of instruction were compared using the Mann-Whitney U-test at 5% level of significance. Results: Part 1 results showed significant improvement in the post-training scores of the 16 PGI in the identified micro skills and ORL PE skills. For Part 2, 33 and 22 clerks underwent PAL-Led and Expert Faculty-Led instruction respectively. Comparison of performance scores of the clerks in the 2 models of instruction showed no significant difference. Conclusion Teaching training for PGI improved their knowledge, skills and attitude in teaching ORL PE skills to clerks. There was no significant difference in the performance outcomes between clerks that underwent PALLed and Expert Faculty-Led model of instruction.
Teacher Training ; Peer Group

Background: Professionalism is a core competency of physicians, identified as one of the learning outcomes for the Doctor of Medicine program. In all the efforts geared towards supporting students develop high standards of professionalism through the 4-year course of medical education, perhaps the greatest gap is in assessment. Objectives: The study aimed to determine how attitudes towards professionalism among medical students change during clinical clerkship, which attitudes change, and if these changes are associated with certain demographic factors and specific clinical rotations. Methodology: This is a cohort study with a baseline and three consecutive measurements of attitudes towards professionalism among students in a medical school as they rotated in the different clinical departments for the first semester of AY 2018-2019. A 36-item questionnaire based on a validated instrument was used. Frequency counts, means, percentages, paired t-tests, analysis of variance, and chi-square were used to analyze the data. Results: Overall, the attitudes towards professionalism among medical students were positive at baseline and did not significantly change through three consecutive clinical rotations. The scores were highest and most stable for altruism, accountability, and excellence. No association was found between any change in attitudes and certain demographic factors including age, gender, and pre-medical course, and specific clinical rotation. Conclusion No significant change in attitudes towards professionalism was found among fourth year medical students as they rotated through three consecutive clinical rotations. While many factors should be considered, this finding should prompt a comprehensive look at how clinical clerkship experiences actually educate for professionalism.
Professionalism ; Clinical Clerkship ; Attitude