Background and Objectives: Tuberculosis (TB) remains a public health problem in the Philippines despite trends indicating a decline in the burden of disease. Persons who use drugs who are confined in government-retained drug abuse treatment and rehabilitation centers (DATRCs) face an increased risk for TB because of the congestion in the facility coupled with the absence of guidelines on TB management specific to DATRCs. Thus, this study was conducted to document the current case finding and case holding practices as well as TB treatment pathway in six (6) Luzon-based, government-retained DATRCs.

Methods: Key informant interviews were conducted with DATRC personnel involved in TB diagnosis and management in six selected DATRCs in Luzon, Philippines. Interviews were transcribed and coded for thematic analysis. We compared the DATRC practices with the provisions of the 2014 National TB Control Program (NTP) Manual of Procedures. Results were validated through a workshop with (a) a group of physicians and rehabilitation practitioners assigned in other DATRCs; and (b) a group of experts who have experience in managing or overseeing DATRCs in the country.

Results: Two physicians and four nurses participated in the interviews. Variations in case finding and case holding practices in six DATRCs have been found. National guidelines exist for congregate settings but are more specific to jails/prisons, which are administratively and operationally different from DATRCs.

Conclusion: Development of special guidelines for TB case finding and case holding in DATRCs as well as staff training on the latest NTP Manual of Procedures are recommended. However, gaps and inequities posed by the current set-up underscore the need to address health system-wide factors affecting the practice and performance of these facilities.

Key Words: tuberculosis, case finding, case holding, drug abuse treatment and rehabilitation centers, Philippines

Background and Objectives: Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015. Methods: All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence. Results: A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases. Conclusion The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.
Substance Abuse Treatment Centers ; Prevalence ; Philippines ; Tuberculosis ; Psychiatric Rehabilitation ; Behavior Therapy

OBJECTIVE: To investigate the effect of decreased Skeletal Muscle Index (SMI) and hand grip strength on functional recovery in subacute ambulatory stroke patients. METHODS: Subacute stroke patients who were referred to the rehabilitation center were recruited. Decreased SMI and hand grip strength were diagnosed according to the Asian Working Group on Sarcopenia. Diagnostic criteria were decreased SMI and decreased unaffected hand grip strength. SMI was measured by bioelectrical impedance analysis. Unaffected hand grip strength was measured with a hand dynamometer. Patients were divided into two groups, decreased group (DG) and not-decreased group (NDG), according to the presence of decreased SMI and hand grip strength. Both groups received conventional stroke rehabilitation for 3 weeks. All patients were evaluated at the baseline and at 3 weeks after treatment. Functional status was evaluated with 4-meter walk test (4MWT), 6-minute walk test (6MWT), Timed Up and Go test (TUG), and Modified Barthel Index (MBI). RESULTS: Both groups showed improvement in 4MWT, TUG, and MBI. NDG showed improvement in 6MWT. Comparing improvements between the two groups, NDG showed more improvement in 6MWT and TUG than DG. CONCLUSION: The presence of decreased SMI and hand grip strength had negative effects on functional recovery in subacute ambulatory stroke patients.
Asian Continental Ancestry Group ; Electric Impedance ; Hand Strength ; Hand ; Humans ; Muscle, Skeletal ; Rehabilitation ; Rehabilitation Centers ; Sarcopenia ; Stroke

The goal of the present study was to test the reliability and validity of the Japanese version of the Quality of Life after Brain Injury (QOLIBRI) scale. Correlations between the QOLIBRI and Glasgow Coma Scale scores, anxiety, depression, general quality of life (QOL), and demographic characteristics were examined to assess scale validity. The structure of the QOLIBRI was investigated with exploratory and confirmatory factor analyses, as well as the Partial Credit Model. Test–retest reliability was assessed over a 2-week interval. Participants were 129 patients with traumatic brain injury (TBI) recruited from rehabilitation centers in Japan. The QOLIBRI showed good-to-excellent internal consistency (Cronbach's α: 0.82–0.96), test–retest reliability, and validity (r = 0.77–0.90). Factor analyses revealed a 6-factor structure. Compared to an international sample (IS), Japanese patients had lower QOLIBRI scores and lower satisfaction in several domains. There were positive correlations between the QOLIBRI scales and the Short Form 36 Health Survey (r = 0.22–0.41). The Japanese version of the QOLIBRI showed good-to-excellent psychometric properties. Differences between JS and IS may reflect sampling bias and cultural norms regarding self-evaluation. The QOLIBRI could be a useful tool for assessing health-related QOL in individuals with TBI.
Anxiety ; Asian Continental Ancestry Group ; Brain Injuries ; Brain ; Depression ; Diagnostic Self Evaluation ; Glasgow Coma Scale ; Health Surveys ; Humans ; Japan ; Psychometrics ; Quality of Life ; Rehabilitation Centers ; Reproducibility of Results ; Selection Bias ; Weights and Measures

To investigate vitamin D status according to the diseases in patients admitted to the department of rehabilitation medicine. In total, 282 patients admitted to the department of rehabilitation medicine in our hospital were included. Patients were classified into 4 groups according to ailment: stroke, traumatic brain injury, spinal cord injury, and fracture. All patients were also classified as ambulatory or non-ambulatory. Serum 25-hydroxyvitamin D (25[OH]D) levels were estimated at admission and at discharge. Bone mineral density (BMD) and ionized calcium levels were also measured. All subjects completed the Desmond Fall Risk Questionnaire for fall risk assessment. In total, 92 patients (59 males and 33 females; mean age, 69.09 ± 9.4 years) was enrolled. Low serum 25(OH)D levels (6–28 ng/mL) were observed in all patients in this study, and these were lower in the group of fractures resulting from falls than in the group of strokes (p < 0.05). Significant correlations were found between BMD and ionized calcium levels, Desmond Fall Risk Questionnaire scores and BMD, and questionnaire scores and serum 25(OH)D (p < 0.05). Serum 25(OH)D levels were lower in the department of rehabilitation medicine inpatients in our study than in the general population. The ambulatory patients had higher serum 25(OH)D levels at discharge than the non-ambulatory patients'. The hospitalized rehabilitation patients had lower serum 25(OH)D compared with the community. There were lower serum 25(OH)D levels in patients with fractures and non-ambulatory groups. We should pay attention to serum vitamin D levels of rehabilitation center inpatients.
Accidental Falls ; Bone Density ; Brain Injuries ; Calcium ; Female ; Humans ; Inpatients ; Male ; Rehabilitation Centers ; Rehabilitation ; Risk Assessment ; Spinal Cord Injuries ; Stroke ; Vitamin D ; Vitamins

PURPOSE: This study examined the residential environment and accessibility of rehabilitation for cerebral palsy (CP) to identify the problems with residential laws pertaining to the disabled and provide basic data on the health legislation for the rights of the disabled. MATERIALS AND METHODS: The literature was searched using three keywords: residence, rehabilitation, and accessibility. Two items were selected: residential environment and rehabilitation accessibility. The questionnaire included 51 items; 24 were scored using a Likert scale and 27 were in the form of multiple-choice questions. RESULTS: This study included 100 subjects, of which 93 lived at home and seven lived in a facility. Of these 93 subjects, 65% were living in apartments, usually two or more floors above ground, and 40% of them were living without elevators. According to the Gross Motor Function Classification System, subjects with I to III belonged to the ambulatory group and IV, V were in the non-ambulatory group. Subjects from both groups who lived at home found it most difficult to visit the rehabilitation center by themselves. In contrast, among those who lived at the facility, the ambulatory group found it most difficult to leave the facility alone, while the non-ambulatory group found it most difficult to use the toilet alone. Moreover, 83% of respondents thought that rehabilitation was necessary for CP. On the other hand, 33% are receiving rehabilitation services. Rehabilitation was performed for an average of 3.6 sessions per week, 39 minutes per session. CONCLUSION: There is no law that ensures secure and convenient access of CP to higher levels. Laws on access routes to enter rooms are insufficient. The disabled people's law and the disabled person's health law will be implemented in December 2017. It is necessary to enact laws that actually reflect the difficulties of people with disabilities. Based on the results of this study, an investigation of the housing and rehabilitation of patients with CP through a large-scale questionnaire will necessary.
Cerebral Palsy ; Classification ; Disabled Persons ; Elevators and Escalators ; Hand ; Housing ; Humans ; Jurisprudence ; Legislation as Topic ; Rehabilitation Centers ; Rehabilitation ; Surveys and Questionnaires

PURPOSE: This study assessed the current working conditions and job satisfaction on aquatic therapy performed by physical therapists in South Korea. METHODS: A total of 139 (managers: 53, staff: 86) physical therapists participated in this survey (90 questionnaires) and the data were analyzed using the SPSS 21.0 Windows. RESULTS: The retention conditions of aquatic therapy facilitation was high in the rehabilitation centers (or disabled living facilities) and rehabilitation hospitals. On the other hand, there were regional variations. The physical therapists in this field were likely to have limitations or restrictions of professional aquatic therapy education. The subjects showed a tendency for a career interruption during their fifth working year. The overall job satisfaction on aquatic therapy of physical therapists was high (managers: 94.3%, staff: 95.3%, p=0.276), but the work intensity was higher than the other parts of physical therapy and the relative reward was comparatively low (managers: 60.3%, staff: 66.3%, p=0.865). CONCLUSION: Based on this study, the current working conditions regarding aquatic therapy by physical therapists were assessed. These results will help enhance aquatic therapy and/or in aquatic therapy facilitation.
Education ; Hand ; Humans ; Job Satisfaction ; Korea ; Physical Therapists ; Rehabilitation ; Rehabilitation Centers ; Reward

BACKGROUND: Elderly people's life is affected by multiple factors including social support, which is of the utmost importance. This study aimed to explore the association between social support and happiness as well as the impact of types of social support on happiness among elders. METHODS: This descriptive and analytical study was carried out on 411 elderly men and women referred to the retirement, cultural, and rehabilitation centers in Hamadan, west of Iran. Participants were selected by a multi-stage random sampling method. The research instrument included a questionnaire consisting of three parts: demographic information, the Oxford Argyle Happiness Inventory, and a Questionnaire derived from Social Support Theory. The questionnaire was completed through a self-report study. The collected data were analyzed using Pearson correlation coefficients, multiple linear regression, independent t-tests, and one-way analysis of variance in IBM SPSS Software ver. 22.0 (IBM Corp., Armonk, NY, USA). RESULTS: The mean for happiness was reported as 41.17±15.2. The values given for social support were 29.40±11.95 and for its dimensions were 7.53±3.89 and 13.70±4.90 for informational support and emotional support, respectively. Moreover, the mean value for appraisal support was 3.48±2.37 and was 4.70±2.56 for instrumental support. Multiple linear regression analysis revealed that social support and demographic variables could account for approximately 25% (R2=0.25) of changes in the variable of happiness. CONCLUSION: High social support could increase happiness among elders. The quality and quantity of social support can be taken into account as proper determinants and predictors of happiness among elders.
Aged* ; Female ; Happiness* ; Humans ; Iran* ; Linear Models ; Male ; Methods ; Rehabilitation Centers ; Retirement

BACKGROUND: Musculoskeletal disorders (MSDs) in the health industry are quite common, however, there have only been a few studies regarding physiotherapists, while in Greece, there is an apparent lack of research and data. The aim of this study is to investigate MSDs experienced by physiotherapists in Greece, their causes and specific measures, and good practices followed. Additional emerging risk factors will be examined. METHODS: A questionnaire of MSDs followed by individual and workplace characteristics was completed by 252 physiotherapists. It covered the major workplace categories such as public hospitals, private rehabilitation centers, and private practices. RESULTS: Analysis indicated that 89% of the respondents had experienced a work-related MSD; 32.2% of those injuries occurred within the first 5 years of working. The most lumbered physiotherapists were those working as private practitioners and almost half of the injured respondents chose to work while injured. The most common measure taken to tackle work related MSDs was found to be physical therapy sessions. Job satisfaction and psychosocial issues were also identified as side-effects of the economic slowdown. CONCLUSION: Physiotherapists in Greece were found to suffer from MSDs; workplace musculoskeletal injuries were quite common but under-reported. The body parts most affected were the lower back, the upper back, the shoulders, and the neck. There was a strong correlation between the workplace setting and the number of MSDs. A well-defined occupational safety and health management system and strict administration steering were found to reduce MSDs. The economic slowdown experienced in Greece during the execution of this study placed additional pressure on physiotherapists.
Greece ; Hospitals, Public ; Human Body ; Humans ; Job Satisfaction ; Neck ; Occupational Health ; Physical Therapists* ; Private Practice ; Rehabilitation Centers ; Risk Factors* ; Shoulder ; Surveys and Questionnaires

PURPOSE: Severe sepsis is associated with functional disability among patients surviving an acute phase of infection. Efforts to improve functional impairment are important. We assessed the effects of early exercise rehabilitation on functional outcomes in patients with severe sepsis. MATERIALS AND METHODS: A prospective, single-center, case-control study was conducted between January 2013 and May 2014 at a tertiary care center in Korea. Patients with severe sepsis and septic shock were enrolled and randomized to receive standard sepsis treatment or intervention. Intervention involved early targeted physical rehabilitation with sepsis treatment during hospitalization. Participants were assessed at enrollment, hospital discharge, and 6 months after enrollment. Functional recovery was measured using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living (IADL). RESULTS: Forty participants (21 intervention patients) were included in an intention-to-treat analysis. There were no significant differences in baseline MBI, FIM, and IADL between groups. Intervention yielded greater improvement of MBI, FIM, and IADL in the intervention group at hospital discharge, but not significantly. Subgroup analysis of patients with APACHE II scores ≥10 showed significantly greater improvement of physical function at hospital discharge (MBI and FIM) in the intervention group, compared to the control group (55.13 vs. 31.75, p=0.048; 52.40 vs. 31.25, p=0.045). Intervention was significantly associated with improvement of MBI in multiple linear regression analysis (standardized coefficient 0.358, p=0.048). CONCLUSION: Early physical rehabilitation may improve functional recovery at hospital discharge, especially in patients with high initial severity scores.
Activities of Daily Living ; APACHE ; Case-Control Studies ; Hospitalization ; Humans ; Korea ; Linear Models ; Prospective Studies ; Rehabilitation* ; Sepsis* ; Shock, Septic ; Tertiary Care Centers