Objectives: The study aimed to analyze the core capacities to implement World Health Organization International Health Regulations (IHR) in 6 countries: Indonesia, Cambodia, Vietnam, the Dominican Republic, Ghana, and the Republic of Korea. Methods: Secondary data from relevant databases and reports, including the electronic State Party Self-Assessment Annual Reporting mechanism and global health security index, were used to assess health security in these countries. Descriptive statistics summarized the basic features of the scores, and a strengths, weaknesses, opportunities, and threats (SWOT) analysis wassubsequently performed to identify factors affecting health security scores while highlighting key similarities and differences between countries. Results: Early warning and event management emerged as the primary strength in most countries.Common opportunities included international commitments and immunization programs.In contrast, many countries shared weaknesses related to the policy, legal, and normative frameworks for IHR implementation, as well as challenges in human resources, chemical event management, and radiation emergency preparedness. Recurring threats involved issues such as biosafety, biosecurity, dual-use research and the culture of responsible science, infection control practices, coordination between public health and security authorities, laboratory supply chain vulnerabilities, and communication with healthcare workers during public health emergencies. Conclusion In order to counter future global health threats, countries should prioritize enhancing surveillance capacity (early warning and event management) as well as the immunization indicator (vaccination rates for human and animal diseases, including the national vaccine delivery system).

Objectives: The study aimed to analyze the core capacities to implement World Health Organization International Health Regulations (IHR) in 6 countries: Indonesia, Cambodia, Vietnam, the Dominican Republic, Ghana, and the Republic of Korea. Methods: Secondary data from relevant databases and reports, including the electronic State Party Self-Assessment Annual Reporting mechanism and global health security index, were used to assess health security in these countries. Descriptive statistics summarized the basic features of the scores, and a strengths, weaknesses, opportunities, and threats (SWOT) analysis wassubsequently performed to identify factors affecting health security scores while highlighting key similarities and differences between countries. Results: Early warning and event management emerged as the primary strength in most countries.Common opportunities included international commitments and immunization programs.In contrast, many countries shared weaknesses related to the policy, legal, and normative frameworks for IHR implementation, as well as challenges in human resources, chemical event management, and radiation emergency preparedness. Recurring threats involved issues such as biosafety, biosecurity, dual-use research and the culture of responsible science, infection control practices, coordination between public health and security authorities, laboratory supply chain vulnerabilities, and communication with healthcare workers during public health emergencies. Conclusion In order to counter future global health threats, countries should prioritize enhancing surveillance capacity (early warning and event management) as well as the immunization indicator (vaccination rates for human and animal diseases, including the national vaccine delivery system).

Objectives: The study aimed to analyze the core capacities to implement World Health Organization International Health Regulations (IHR) in 6 countries: Indonesia, Cambodia, Vietnam, the Dominican Republic, Ghana, and the Republic of Korea. Methods: Secondary data from relevant databases and reports, including the electronic State Party Self-Assessment Annual Reporting mechanism and global health security index, were used to assess health security in these countries. Descriptive statistics summarized the basic features of the scores, and a strengths, weaknesses, opportunities, and threats (SWOT) analysis wassubsequently performed to identify factors affecting health security scores while highlighting key similarities and differences between countries. Results: Early warning and event management emerged as the primary strength in most countries.Common opportunities included international commitments and immunization programs.In contrast, many countries shared weaknesses related to the policy, legal, and normative frameworks for IHR implementation, as well as challenges in human resources, chemical event management, and radiation emergency preparedness. Recurring threats involved issues such as biosafety, biosecurity, dual-use research and the culture of responsible science, infection control practices, coordination between public health and security authorities, laboratory supply chain vulnerabilities, and communication with healthcare workers during public health emergencies. Conclusion In order to counter future global health threats, countries should prioritize enhancing surveillance capacity (early warning and event management) as well as the immunization indicator (vaccination rates for human and animal diseases, including the national vaccine delivery system).

Objectives: The study aimed to analyze the core capacities to implement World Health Organization International Health Regulations (IHR) in 6 countries: Indonesia, Cambodia, Vietnam, the Dominican Republic, Ghana, and the Republic of Korea. Methods: Secondary data from relevant databases and reports, including the electronic State Party Self-Assessment Annual Reporting mechanism and global health security index, were used to assess health security in these countries. Descriptive statistics summarized the basic features of the scores, and a strengths, weaknesses, opportunities, and threats (SWOT) analysis wassubsequently performed to identify factors affecting health security scores while highlighting key similarities and differences between countries. Results: Early warning and event management emerged as the primary strength in most countries.Common opportunities included international commitments and immunization programs.In contrast, many countries shared weaknesses related to the policy, legal, and normative frameworks for IHR implementation, as well as challenges in human resources, chemical event management, and radiation emergency preparedness. Recurring threats involved issues such as biosafety, biosecurity, dual-use research and the culture of responsible science, infection control practices, coordination between public health and security authorities, laboratory supply chain vulnerabilities, and communication with healthcare workers during public health emergencies. Conclusion In order to counter future global health threats, countries should prioritize enhancing surveillance capacity (early warning and event management) as well as the immunization indicator (vaccination rates for human and animal diseases, including the national vaccine delivery system).

Objectives: The study aimed to analyze the core capacities to implement World Health Organization International Health Regulations (IHR) in 6 countries: Indonesia, Cambodia, Vietnam, the Dominican Republic, Ghana, and the Republic of Korea. Methods: Secondary data from relevant databases and reports, including the electronic State Party Self-Assessment Annual Reporting mechanism and global health security index, were used to assess health security in these countries. Descriptive statistics summarized the basic features of the scores, and a strengths, weaknesses, opportunities, and threats (SWOT) analysis wassubsequently performed to identify factors affecting health security scores while highlighting key similarities and differences between countries. Results: Early warning and event management emerged as the primary strength in most countries.Common opportunities included international commitments and immunization programs.In contrast, many countries shared weaknesses related to the policy, legal, and normative frameworks for IHR implementation, as well as challenges in human resources, chemical event management, and radiation emergency preparedness. Recurring threats involved issues such as biosafety, biosecurity, dual-use research and the culture of responsible science, infection control practices, coordination between public health and security authorities, laboratory supply chain vulnerabilities, and communication with healthcare workers during public health emergencies. Conclusion In order to counter future global health threats, countries should prioritize enhancing surveillance capacity (early warning and event management) as well as the immunization indicator (vaccination rates for human and animal diseases, including the national vaccine delivery system).

OBJECTIVE

To determine whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the first three days of dengue illness are independent predictors of dengue severity among pediatric patients.

A cross-sectional analytical retrospective study was conducted among pediatric dengue patients admitted to The Medical City, Pasig from September 2021 to August 2024. Data collection was done through electronic chart review. Baseline characteristics were analyzed using the Kruskal-Wallis test, Chi-Square test, and Fisher’s exact test. Receiver Operating Characteristic (ROC) and Area Under the Curve (AUC) analyses, along with diagnostic performance metrics, were used to evaluate daily ratio cut-offs differentiating dengue classifications. Multivariable logistic regression was performed to assess NLR and PLR as independent predictors of warning signs or severe dengue development.

Among the 316 subjects included in the analysis, 40.5% had dengue fever without warning signs, 57.3% had dengue fever with warning signs, and 2.2% had severe dengue. Differentiating patients without warning signs from those with warning signs, the NLR cut-offs were 4.73, 2.07, and 2.5 on days 1-3, respectively, whereas from those with severe dengue, the cut-offs were 1.27, 0.68, and 0.47 on the same days. For this pairwise analysis, PLR cut-offs were 170, 233.92, and 208.79 for the first comparison; and 209.24, 244.12, and 187.5 for the second, respectively. Statistical analysis showed poor discrimination and diagnostic performance for all cut-offs. Likewise, multivariable linear regression revealed no significant correlation between either ratio and dengue severity.

NLR and PLR within the first three days of dengue illness revealed poor performance in predicting the development of warning signs or progression to severe dengue among pediatric patients.

INTRODUCTION

While a 600 mg loading dose (LD) of clopidogrel has demonstrated superior inhibition of platelet function compared to 300 mg LD, the clinical evidence supporting this superiority is limited. The debate centers on whether higher clopidogrel LD regimen in percutaneous coronary intervention (PCI) outperforms the standard 300 mg LD, with potential benefits being more pronounced in higher-risk patients. Balancing enhanced platelet inhibition to reduce ischemic events against the associated risk of increased bleeding remains a critical consideration in determining the optimal loading dose of clopidogrel for patients with ischemic heart disease.

A systematic literature search for randomized clinical trials (RCTs) was performed comparing 600 mg with 300 mg LD of clopidogrel using PubMed, MEDLINE, Embase, Cochrane, Clinicaltrials.gov and HerdinPH. Studies included those between 2010 and 2023 involving human subjects. The primary efficacy endpoint was a 1-month rate of major adverse cardiac event (MACE) and the primary safety outcome was bleeding adverse effects.

Nine RCTs involving 29,827 patients were included in the efficacy analysis. Mean duration of follow-up was 30 days. Only eight studies were eligible for safety analysis. Compared with standard LD clopidogrel, high LD significantly reduced the incidence of overall MACE (OR: 0.82, 95% CI: 0.74-0.91, p = 0.0002), nonfatal myocardial infarction (OR: 0.56; 95% CI: 0.32-0.99, p = 0.15) and target vessel revascularization (OR: 0.63; 95% CI: 0.41-0.95, p = 0.03), without significant difference in terms of cardiac death (OR: 0.89; 95% CI: 0.76-1.04, p = 0.15) and stroke (OR: 0.92; 95% CI: 0.67-1.26, p = 0.61). However, major bleeding risk was higher in the 600 mg LD (1.9%; 261/13288) compared with 300 mg LD (2.4%; 328/13242) [OR: 1.27; 95% CI: 1.08-1.49, p = 0.005] without significant difference in minor bleeding (OR: 1.05; 95% CI: 0.94-1.17, p = 0.35).

The administration of 600 mg clopidogrel LD reduces the overall risk of MACE with associated increased risk of major bleeding.

BACKGROUND

Diabetes mellitus (DM) is a significant and growing global health concern. Worldwide, 537 million adults have diabetes and 206 million of them are from the Western Pacific Region1. Local prevalence continues to remain high at 7.5%, with 4,303,899 adult Filipinos suffering from diabetes in 2021. DM significantly contributes to the growing burden of chronic kidney disease (CKD) worldwide with about 50% of end-stage renal disease (ESRD) being due to diabetic nephropathy alone. Likewise, 60% of Filipinos on maintenance dialysis have ESRD due to DM and hypertension. The primary care setting is the initial point of contact between healthcare providers and patients with type 2 diabetes, hence, the development of clinical practice guidelines that will provide guidance in caring for patients with stable complications of diabetes. The guideline is the first of 3 that are being developed by the Philippine Academy of Family Physicians for the diagnosis and management of adult patients with type 2 diabetes and stable microvascular complications – nephropathy, retinopathy and neuropathy.

This guideline aims to provide evidence-based recommendations on the diagnosis and management of adults with type 2 diabetes mellitus (T2DM) and early stage CKD and is divided into 5 main sections – Clinical Assessment, Diagnostic Tests, Pharmacologic Treatment, Non-pharmacologic Treatment and Patient Outcomes.

The method of guideline development followed the ADAPTE process. The Technical Working Group identified 19 key questions after consultation with colleagues and patients. Recommendations were adopted from high-quality clinical practice guidelines whenever applicable for most of the key clinical questions. On the other hand, the De Novo method of evidence review was used to answer key clinical questions for which recommendations from reviewed guidelines were not available. A modified GRADEPro was used in assessing the quality of evidence – high, moderate, low or very low. Following external review by a nephrologist, the draft recommendations were sent to the members of the consensus panel. Voting on whether to include or not by the consensus panel was facilitated to determine the strength of each recommendation – strong, moderate or weak.

After reviewing 3 high-quality clinical practice guidelines and the current evidence, the technical working group was able to develop 40 recommendations for the 19 key clinical questions.

BACKGROUND

The crop of novice nurses who are currently employed is a product of flexible learning who had limited contact hours with actual patients, which is contrary to those who graduated from traditional learning modalities. Hence, it is essential to evaluate how the impact of flexible learning modality has affected the practice preparedness levels of novice nurses in the hospital setting.

This study aimed to determine the level of practice preparedness and its associated factors among novice nurses who work in private hospitals.

The study utilized a cross-sectional survey design. Data was gathered from a total enumeration of ninety-four novice staff nurses who graduated from the flexible learning curriculum and are currently employed in private hospitals in Baguio City and La Trinidad. The tool used was a questionnaire in two parts. Part 1 consisted of questions related to demographic information and factors related to practice preparedness, and part 2 included the Nursing Practice Readiness Scale, with validity and reliability scores of >0.924 and 0.90, respectively. The data was analyzed using the SPSS V27 trial version. The protocol was approved by the Saint Louis University Research Ethics Committee.

Findings reveal that more novice nurses in private hospitals perceived themselves as well-prepared across all domains of practice preparedness: “Collaborative Interpersonal Relationship” (n=94, 100%); “Patient Centeredness” (n=92, 97.90%); “Self-regulation” (n=90, 95.70%); “Clinical Judgment and Nursing Performance” (n=78, 83.00%); and “Professional Attitudes” (n=76, 80.90%). There is a significant association between practice preparedness and the following factors: “Attended more than one Training/Seminars per year” (p=0.02), “Graduated from Private Schools” (p=0.03), and “Assigned in Regular Wards” (p=0.05). On the other hand, no significant association was found between practice preparedness and the following factors: “Sex” (p=0.61) and “Membership in Professional Organizations” (p=0.73).

In agreement with existing studies, practice preparedness is multifactorial. However, what this study contributes are new factors that are favorable in making novice nurses more confident in performing their roles and responsibilities. These include being a graduate of private schools, being assigned to regular wards, and attending professional training/seminars more than once annually. Advantageously, these factors that promote practice preparedness are modifiable.

Background: The crop of novice nurses who are currently employed is a product of flexible learning who had limited contact hours with actual patients, which is contrary to those who graduated from traditional learning modalities. Hence, it is essential to evaluate how the impact of flexible learning modality has affected the practice preparedness levels of novice nurses in the hospital setting. Objective: This study aimed to determine the level of practice preparedness and its associated factors among novice nurses who work in private hospitals. Methods: The study utilized a cross-sectional survey design. Data was gathered from a total enumeration of ninetyfour novice staff nurses who graduated from the flexible learning curriculum and are currently employed in private hospitals in Baguio City and La Trinidad. The tool used was a questionnaire in two parts. Part 1 consisted of questions related to demographic information and factors related to practice preparedness, and part 2 included the Nursing Practice Readiness Scale, with validity and reliability scores of >0.924 and 0.90, respectively. The data was analyzed using the SPSS V27 trial version. The protocol was approved by the Saint Louis University Research Ethics Committee. Results: Findings reveal that more novice nurses in private hospitals perceived themselves as well-prepared across all domains of practice preparedness: “Collaborative Interpersonal Relationship” (n = 94, 100%); “Patient Centeredness” (n = 92, 97.90%); “Self-regulation” (n = 90, 95.70%); “Clinical Judgment and Nursing Performance” (n = 78, 83.00%); and “Professional Attitudes” (n = 76, 80.90%). There is a significant association between practice preparedness and the following factors: “Attended more than one Training/Seminars per year” (p = 0.02), “Graduated from Private Schools” (p = 0.03), and “Assigned in Regular Wards” (p = 0.05).On the other hand, no significant association was found between practice preparedness and the following factors: “Sex” (p = 0.61) and “Membership in Professional Organizations” (p = 0.73). Conclusion In agreement with existing studies, practice preparedness is multifactorial. However, what this study contributes are new factors that are favorable in making novice nurses more confident in performing their roles and responsibilities. These include being a graduate of private schools, being assigned to regular wards, and attending professional training/seminars more than once annually. Advantageously, these factors that promote practice preparedness are modifiable.
nurses ; nursing staff, hospital ; hospitals, private