OBJECTIVE: To provide an overview on the impact of healthcare disruption by the COVID-19 pandemic to urology training programs in the Philippines. METHODS: A survey questionnaire was used in collaboration with the study done by Rosen, et al. last May 2020. Telephone survey of the study population was done determining the status of resident staffing, workload, health/wellness, and didactics. Numerical and categorical data were analyzed and descriptive statistics are provided. RESULTS: All the observations on resident time in the workplace, including assignment to teams (81%), redeployment responses (55-97%), and remote clinical work (65%) were significant. Fifty one percent of residents have decreased research load. Eighty one percent have didactics in small groups. Fifty-five percent have 1 to 2 Video-based learning/conferences per week (p=0.007) followed by those with 3-4 with 98% (p=0.120) and those with >5 with only 6% (p=0.729). For Resident health and wellness, 87% of the residents were exposed to COVID-positive patients, but only 8% of residents were COVID positive (p=0.591). Lastly, 59% of the participants do not have access to wellness programs. CONCLUSION Data from respondents revealed significant changes in the different aspects of the present study. Urology residents spent more time away from their specialties, and have been re-deployed to COVID-19 floors. Ambulatory services, conferences, educational lectures have mostly shifted to virtual platforms. Resident concerns for COVID-19 exposure have been addressed properly; however, wellness programs have not been widely available for residents. As a first national survey, the present study may give significant insights on program changes and may be used as preliminary data for future studies.
Philippines

INTRODUCTION: Psoriasis affects 0.1-3% of the world's population. It is a chronic multifactorial disease with a genetic basis and various triggering factors. In the Philippines, extrapolated data from 2004 reveals a 2% prevalence. Thus it is important to develop a database with psoriasis patients' demographics, disease characteristics, treatment and quality of life. Most institutions still rely on paper-based methods of recording patient data. This is prone to error and destruction. Further consolidation and analysis of this unsystematic data is problematic, making it difficult to assess real-time setbacks and develop programs. OBJECTIVE: To develop and assess the validity of a Psoriasis Questionnaire in the local setting, which will be further utilized towards developing a Psoriasis Registry. The data from this can in turn be used to generate a Psoriasis Guideline. METHODS: This is a multicenter study. The Questionnaire was developed from Psoriasis literature and worldwide registries, as well as local patient encounters. It was answered by Dermatologists and their patients. Cronbach's alpha (CA) was used to check for validity and internal consistency of the questionnaire. RESULTS AND CONCLUSION 124 questionnaires were accomplished. Each part of the questionnaire was assessed with CA. Some sections showed CA <0.70, indicating variability in the test response. To improve this, some modifications in the Questionnaire were recommended. The overall CA score however was 0.8, indicating that in totem the questionnaire is consistent and valid.
Philippines

BACKGROUND: Melasma is an acquired hyperpigmentary disorder occurring in the sun-exposed areas of the face and neck. There is little information on its prevalence, epidemiology and clinical characteristics in the Philippines. OBJECTIVE: To determine the prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients METHODS: This was a multicenter, cross-sectional study conducted from July to December 2013. The investigators determined the prevalence of melasma in 12,068 dermatology patients from 6 government hospitals and private centers in Metro Manila, Philippines. The melasma patients, aged 18 years and above were examined and given self-administered questionnaires to determine the epidemiological and clinical characteristics of their melasma. RESULTS: Of the 12,068 dermatology patients who were seen at the selected hospitals and private centers, 153 (1.26%) were clinically diagnosed with melasma. Majority of the melasma patients were Filipinos (73.20%), aged 41-50 years old (37.91%), with an average age of 42.40 + 9.68 years, and Fitzpatrick skin types III and IV (29.41% and 57.52%, respectively). Melasma was more prevalent in females (81.70%), wherein majority had a prior history of pregnancy (76.8% of the females). Oral contraceptive use was also reported in 37.6% of the female patients and 63.83% of those who have used OCP, have used it for only 1 year or less. Majority had no thyroid disease (75.16%) and daily sun exposure was limited to 1 hr or less for most patients (43.14%). Their melasma was mostly malar in distribution (60.13%), epidermal (61.44%), and mild (51.63%) to moderate (27.45%) in severity. The average mMASI score was 4.63 + 3.32. CONCLUSION Prevalence of melasma was low among the Philippine dermatology patients sampled. Majority of the melasma patients were Filipinos, aged 41-50 years old, with Fitzpatrick skin type IV, limited sun exposure and no thyroid disease. They were mostly females, with a prior history of pregnancy. Their melasma was mostly malar, epidermal, and mild in severity. These descriptive data can serve as baseline information for further studies on melasma in the Philippines.
Philippines

BACKGROUND: Medical malpractice is an act or omission by a health care provider that deviates from accepted standards of professional practice leading to injury to the patient. Tort actions of negligence prevail when a plaintiff establishes in court that: (1} the physician had a duty to the patient referred to as patient-physician relationship; (2} a dereliction or breach of that duty occurred (3} the dereliction of duty resulted in damage to the patient, and (4} the patient was, in fact, damaged (Brown, 1976). METHODS: The study was conducted to describe the patterns of the resolved medical malpractice cases in the Philippines. Transcripts of records of resolved medical malpractice cases were retrieved, analyzed and evaluated by 2 lawyers and the researcher. RESULTS: Negligence was established as the main cause of litigation among the 6 resolved medical malpractice cases. Eight physicians were found liable while 4 were acquitted. The litigation process was protracted, lasting 13-24 years. CONCLUSION The results of the study serve to provide an overview of medical malpractice cases in the Philippines. It is hoped to increase the awareness of health care providers regarding medical malpractice.
Philippines

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 ;

OBJECTIVE: This paper describes the process utilized in developing a training program on data use for decision- making tailored for real-time monitoring of maternal and child health indicators through Community Health Information Tracking System (rCHITS) end-users in selected areas in the Philippines. METHODS: Guided by the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model and the training cycle, existing records and reports lodged with the National Telehealth Center (NTHC) pertaining to rCHITS were reviewed, supplemented by interviews with the technical staff of the NTHC and discussion with healthcare workers. Training design was developed, training modules and materials were prepared, critiqued, revised and finalized. The training was implemented and evaluated using an evaluation tool designed for this specific capability-building endeavors. RESULTS: A tailored training program on data use for decision-making was designed for rCHITS end-users in select areas in the Philippines. The process of developing the training program was guided by the ADDIE Model and the Training Cycle. Training was delivered to a total of 128 public health workers. Majority of the participants gave high evaluation on the clarity and relevance of objectives, discussion of topics, methods of delivery, and time devoted in addressing issues (range 3.5-3.8 out of highest possible score of 4) CONCLUSION This paper demonstrates the utility of the ADDIE Model and the Training Cycle in developing a training program aimed at enhancing the capability of the field personnel in utilizing the data generated from rCHITS in decision-making. Training participants must also be monitored and evaluated in their workplace setting in order to determine if the concepts and principles covered during the training program are put into practice.
Philippines

Background Organizational life is a drama in which all are actors playing different roles, hence it is made relevant by its contextually-embedded focus on role enactment.
Philippines

The Philippine Government has implemented community quarantine throughout the country to respond to the COVID-19 pandemic that has since profoundly affected the lives, health, and well-being of individuals, families, and communities. This has also created an impact on the practice of occupational therapy in the country as the pandemic presents occupational disruptions in the new normal. This paper summarizes the current conditions of the practice of occupational therapy in times of the unprecedented disaster highlighted by the COVID-19 crisis and the situation of practitioners and recipients of service across the regions of the country. Findings conclude that there are: (1) emerging delivery service patterns, (2) consequences of COVID-19 to therapists, and (3) insights moving forward.
Philippines

An alternative and augmentative communication (AAC) device replaces or supplements a person’s natural speech. Speech-Language Pathologists (SLPs) collaborate with a team of healthcare professionals in the process of identification and use of the right AAC device for a person with complex communication needs (CCN). In the Philippines, occupational therapists (OTs) and SLPs are more likely to collaborate in the treatment of their clients due to their interprofessional education (IPE) experience. However, most Filipino SLPs do not engage in interprofessional collaboration (IPC) when rendering AAC services. Thus, there is a need to identify existing literature that tackles collaborative practices to raise the quality of service and care. Hence, this study aimed to identify and discuss existing literature that documented IPE and IPC strategies between OTs and SLPs in the field of AAC. The structure of this literature review was guided and adapted from the topics outlined in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Literature archived in two databases (Pubmed and Scopus) were reviewed. Two articles out of five studies were included in this review. Strategies found were “case based learning approach” for post-graduate students and the “Beyond Access model” in supporting practitioners. In conclusion, there is a dearth of literature on IPC practices among OTs and SLPs in the field of AAC. There is a need to report IPE and IPC efforts in the Philippines to provide applicable strategies to the local healthcare landscape.
Philippines

This is a case of a 66-year-old, Filipina, who presented with persistent proteinuria diagnosed with renal amyloidosis. In the presented case, the equivocal cardiac and incidental extracardiac findings in the Tc-99m pyrophosphate (Tc-99m PYP) scan aided in the diagnosis of primary systemic light chain amyloidosis (AL amyloidosis). Tc-99m PYP scan with single photon emission computed tomography (SPECT) is currently used as a non-invasive imaging modality to diagnose Transthyretin amyloidosis (ATTR amyloidosis) however its role in diagnosing AL amyloidosis is not well documented. The case highlights its role in detecting extracardiac amyloid burden and suggests possible biopsy sites. The researchers recommend an additional whole-body planar scan with possible SPECT/CT on the 3rd hour delay to survey other areas with possible amyloid protein deposit.
Philippines