OBJECTIVES

This study determined the prevalence of BBD among toilet-trained children attending a tertiary hospital’s pediatric outpatient clinic, and to evaluate the effectiveness of standard urotherapy among affected children.

A prospective interventional study was conducted among 144 toilet-trained children aged 7 to 12 years seen at the University of Santo Tomas Hospital outpatient clinic from August 2025 to September 2025. Sociodemographic data were collected, and BBD was screened using the validated Filipino version of the Dysfunctional Voiding Symptom Scores (DVSS) questionnaire. Children with BBD underwent standard urotherapy, which included behavioral and lifestyle interventions such as timed voiding, adequate hydration, constipation management and proper voiding posture. DVSS assessments were repeated at two and four weeks.

The overall prevalence of BBD was 22.9% (33 of 144). BBD was significantly more prevalent among females (31.88%) than males (14.67%) (adjusted OR = 2.96, 95% CI: 1.28–6.86; p = 0.011). At baseline, children with BBD had significantly higher mean total DVSS scores (9.15 ± 3.64) compared to those without (2.01 ± 1.80, pCONCLUSION

Standard urotherapy proved effective in reducing symptom scores within two weeks and resulted in complete clinical resolution after four weeks among those who continued therapy. Routine screenings for BBD using DVSS and early initiation of standard urotherapy in pediatric outpatient settings are recommended to prevent complications and improve children’s urinary and bowel health.

BACKGROUND AND OBJECTIVE

Access to healthcare remains a challenge in most areas in the Philippines. Fifty-three percent (53%) of the Philippine population do not have access to a rural health unit (RHU) within a 30-minute travel t ime. As a response, the Department of Health (DOH) needs to construct an additional 2400 RHUs by 2025. This paper uses the Philippine Health Facility Development Plan 2020-2040 (PHFDP) as a reference to present a solution for locating sites for RHU placement in under-served areas using neural networks to meet the 30-minute travel time by maximizing population accessibility.

RHU accessibility was measured using geographic attributes as inputs to a back propagation neural network (BPNN) and a recurrent neural network (RNN): (1) land coverage and hazard data, representing geographical limitations; (2) population density and distribution, indicating demand for healthcare services; and (3) infrastructure-related features, such as road networks, points of interest, and the locations of existing RHUs, which influence healthcare accessibility. The models were trained to identify underserved areas and were implemented on a nationwide scale, excluding NCR, to locate candidate areas to increase population access to the new RHUs. The models were validated using a healthcare facility accessibility index (HCFAI) to assess RHU coverage improvement.

The BPNN showed stronger generalization across regions, achieving 79.1% average accuracy in distinguishing low from high accessible areas on Region 1 and identifying 1668 out of 3305 locations in the region as candidate sites. The RNN, better capturing unique regional characteristics, required separate training: 77.2% average accuracy on Region 1, identifying 1593 candidate sites. Our findings suggest expanding the use of land improves population access to healthcare facilities. Both models found more than the needed number of RHUs by 2040. The BPNN was more consistent than RNN to improve a region’s overall accessibility by increasing the HCFAI. The BPNN can increase population access to an RHU from 2.5-98.5% from its original population with access to an RHU.

The study demonstrates the usage of geographic attributes and neural networks to improve healthcare accessibility. The BPNN and RNN are adequate algorithms to find under-served areas and candidate sites for RHU construction to maximize population accessibility. The HCFAI metric validates the locations to highlight which neural network maximizes more of the region’s populat ion. The study contributes to ongoing efforts to improve healthcare infrastructure and accessibility, offering datadriven recommendations for RHU locations.

BACKGROUND: The efficacy of routine childhood immunization depends on timely vaccine uptake and facility use patterns. This study examined the association between pediatric vaccination facility use patterns and routine childhood immunization uptake among children up to age eight years. METHODS: As part of the Kochi Adjunct Study of the Japan Environment and Children's Study (JECS), we analyzed data from 1,644 participants whose Maternal and Child Health Handbook photographs were collected in the eighth year of the cohort study. Maternal and Child Health Handbook records determined immunization completion. Participants were categorized into four groups based on pediatric vaccination facility use patterns: single facility use throughout, multiple facility use during the first period, multiple facility use during the second period, and multiple facility use throughout both periods. Maternal and child characteristics were collected via paper-based questionnaires. Associations between facility use patterns, sociodemographic factors, and immunization completion were analyzed using chi-square tests and logistic regression. RESULTS: Overall, routine childhood immunization completion was observed in 1,259 (76.6%) participants. Chi-square tests indicated that marital status, educational level, lower parity, never smoking, not attending nursery, and breastfeeding practice for infants aged four months old were significantly associated with routine childhood immunization completion. Single facility use throughout the immunization period was observed in 1,011 (61.5%) participants. Multiple facility use (38.5%) was associated with higher odds of routine childhood immunization incompletion than single facility use. This association was the strongest for those who used multiple facilities throughout the vaccination period (adjusted odds ratio, 1.90; 95% confidence interval, 1.24-2.91). CONCLUSIONS Single pediatric facility use was associated with higher routine immunization uptake. Our findings suggest that encouraging the use of one medical institution for a child's vaccinations may be a useful approach to consider when addressing vaccination coverage challenges.
Humans ; Japan ; Female ; Male ; Infant ; Child, Preschool ; Health Facilities/statistics & numerical data* ; Child ; Vaccination/statistics & numerical data* ; Adult ; Immunization/statistics & numerical data* ; Cohort Studies ; Infant, Newborn

BACKGROUND AND OBJECTIVES

The adoption of electronic medical records (EMRs) in the Philippines has been initiated and adjusted since the last decade through the Philippine eHealth Agenda framework. EMRs are known to improve clinical management and have been widely adopted in advanced economies. However, empirical research on EMR implementation remains limited. This study aims to determine how public primary health care facilities in the country interacted with EMRs before and during the COVID-19 pandemic to understand EMR adoption.

More than 270,000 records generated from EMR usage logs in six rural primary health facilities in Western Visayas were analyzed. Average time of EMR use during work hours was estimated and compared before and during the pandemic. EMR adoption based on specific EMR features used was also determined.

In 2020, EMR use ranged from less than one hour to more than eight hours in selected rural health units (RHUs). There was a statistical increase and decrease in use of features during the pandemic. Some EMR users had efficient use indicated by complete adoption of EMR features although such features were not as frequently used as those pertaining to basic adoption.

This study demonstrates that for EMR use in rural settings, progressive use from basic to complete may vary among users. Public health emergencies such as a pandemic may also affect EMR use. Future research directions should explore other mechanisms which affect user behavior and encourage full adoption of technology such as use of games or non-monetary incentives.

Development of extramural health care for chronic wounds is still in its infancy in China, and thus it is urgent and vital to establish a correct concept and practicable principles. The authors reviewed recent domestic and international literature and summarized the following treatment procedures and principles for extramural health care of chronic wounds. (1) The patient needs to do self-assessment of the wound by using available simple methods; (2) The patient consults with professional physicians or nurses on wound care to define the severity and etiology of the non-healing wound; (3) Professionals evaluate the existing treatment strategies; (4) Etiological treatments are given by professionals; (5) Patients buy needed dressings via the more convenient ways from pharmacies, e-commerce platform or others; (6) Professionals provide a standardized and reasonable therapeutic plan based on the patient's wound conditions; (7) Both professionals and the patient pay attention to complications to prevent adverse outcomes; (8) Professionals strengthen the public education on wound care and integrated rehabilitation. This review expected to provide new perspectives on the therapeutic strategies for chronic wounds in an extramural setting.
Humans ; Wound Healing ; Health Facilities ; Delivery of Health Care ; China ; Wounds and Injuries/therapy*

Humans ; Genomics ; Health Facilities ; Delivery of Health Care

Addressing weight stigma is essential to obesity management as it causes inequalities in healthcare and impacts the outcomes of health. This narrative review summarises systematic review findings about the presence of weight bias in healthcare professionals, and interventions to reduce weight bias or stigma in these professionals. Two databases (PubMed and Cumulative Index to Nursing and Allied Health Literature [CINAHL]) were searched. Seven eligible reviews were identified from 872 search results. Four reviews identified the presence of weight bias, and three investigated trials to reduce weight bias or stigma in healthcare professionals. The findings may help further research and the treatment, health and well-being of individuals with overweight or obesity in Singapore. Weight bias was prevalent among qualified and student healthcare professionals globally, and there is a lack of clear guidance for effective interventions to reduce it, particularly in Asia. Future research is essential to identify the issues and inform initiatives to reduce weight bias and stigma among healthcare professionals in Singapore.
Humans ; Weight Prejudice ; Singapore ; Asia ; Databases, Factual ; Health Facilities

The problems and shortcomings revealed in our response to COVID-19 epidemic have suggested us to take measures to improve the disease control and prevention system of China. For the reform and development of China's disease control and prevention institution in the new era,we need to rethink the function orientation of the disease control and prevention institution, the key and difficult points in institutional mechanism reform and the building of core competence and essential capacity of disease control and prevention system.
COVID-19 ; China/epidemiology* ; Epidemics/prevention & control* ; Health Facilities ; Humans ; SARS-CoV-2

Humans ; Diagnostic Imaging ; Health Facilities

INTRODUCTION: Approximately 1000 children die each year due to preventable water and sanitation-related diarrheal diseases. Six in 10 people lacked access to safely managed sanitation facilities in 2015. Numerous community- and school-based approaches have been implemented to eradicate open defecation practices, promote latrine ownership, improve situation sanitation, and reduce waterborne disease. OBJECTIVE: Given that current evidence for sanitation interventions seem promising, the aim of this study was to systematically summarize existing research on the effectiveness of community- and school-based randomized controlled sanitation intervention in improving (1) free open defecation (safe feces disposal), (2) latrine usage, (3) latrine coverage or access, and (4) improved latrine coverage or access. METHODS: Eight electronic databases were searched: PubMed, Scopus, WHO Global Health Library (GHL), Virtual Health Library (VHL), POPLINE, Web of Science, Cochrane, and Google Scholar up to 26 April 2019. Original randomized clinical trials addressing community-based or school-based intervention that reported feces disposal and latrine coverage were deemed eligible. More than two researchers independently contributed to screening of papers, data extraction, and bias assessment. We conducted a meta-analysis by random-effects model. The risk of bias was assessed by the Cochrane risk of bias tool. RESULTS: Eighteen papers that matched all criteria and 16 studies were included in the final meta-analysis. Compared to the control, the sanitation intervention significantly increased safe feces disposal (OR 2.19, 95% CI 1.51-3.19, p < 0.05, I CONCLUSION Our study showed strong evidence for both community- and school-based sanitation interventions as effective for the safe disposal of human excreta. The finding suggests major implications for health policy and design of future intervention in developing countries.
Community Participation/statistics & numerical data* ; Randomized Controlled Trials as Topic ; Sanitation/instrumentation* ; School Health Services/statistics & numerical data* ; Toilet Facilities/statistics & numerical data*