BACKGROUND AND OBJECTIVES

Telerehabilitation is the remote delivery of rehabilitation services using telecommunication technologies. Its local adoption was catalyzed by the COVID-19 pandemic, prompting the need to assess user acceptance. This study aimed to determine the acceptance of stroke telerehabilitation among patients, carers, and rehabilitation providers in the Department of Physical Medicine and Rehabilitation at St. Luke’s Medical Center – Global City and Quezon City.

METHODS

This descriptive cross-sectional study used purposive sampling to recruit 73 rehabilitation providers and 10 consumers. Data were collected using a self-administered survey based on the Technology Acceptance Model, covering perceived ease of use, usefulness, and behavioral intent. Descriptive and inferential statistics were used for analysis.

RESULTS

Most providers (94.4%) were familiar with telerehabilitation, while only half of the consumers were aware of it. Acceptance was moderate among providers (mean score: 35.75 ± 8.67) and high among consumers (mean score: 31.6 ± 7.52). Female providers were less likely to accept telerehabilitation (p=0.049). Consumers identified financial constraints and lack of a companion as key barriers, while providers cited internet issues and technology use. Both groups viewed telerehabilitation positively for teleconsultation, teletherapy, and telemonitoring. Smartphones were the preferred device; Viber and Facebook Messenger were the most commonly chosen platforms.

CONCLUSION

Stroke telerehabilitation was moderately to highly accepted by rehabilitation stakeholders in two tertiary private hospitals in Manila. Findings may guide institutional planning for telerehabilitation services. Training, infrastructure support, and awareness campaigns can help address implementation barriers.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Remote Consultation ; Physical And Rehabilitation Medicine ; Tertiary Care Centers ; Telecommunications ; Telerehabilitation ; Cross-sectional Studies ; Technology ; Stroke ; Covid-19

OBJECTIVES

Clinical pathways (CPs) ensure adherence to heart failure (HF) management guidelines. To optimize quality care in a low resource setting, an evidence-based care pathway for the management of acute HF was implemented at the emergency department (ED) of the Philippine General Hospital (PGH), the designated national tertiary hospital and referral center. This study aimed to describe the characteristics of adults with acute HF admitted at the ED and evaluate the quality of care they received, measured using physician adherence to the hospital’s acute heart failure CP.

METHODS

This was a retrospective, descriptive cohort study. We reviewed the inpatient charts of all adult patients with acute HF admitted to the ED of the PGH and referred to the Division of Cardiovascular Medicine between December 1, 2022 and May 31, 2023. Quality of care was assessed based on adherence to quality indicators adapted from routine and conditional order sets detailed in the pathway. Descriptive statistics was utilized to describe patient characteristics, quality of care, and outcomes.

RESULTS

Two hundred thirty-six (236) patients were included, with a mean age of 51.8 years. Majority were male (53.4%); hypertension (61.4%) and ischemic heart disease (53.8%) were the most common comorbidities, and infection the most common precipitant of decompensation (60.6%). There were optimal adherence rates to routine orders, which included referrals to Internal Medicine and Cardiology, baseline vital signs monitoring, fluid intake and output monitoring, chest radiograph, complete blood count, blood urea nitrogen, sodium, potassium, prothrombin time, partial thromboplastin time, arterial blood gas, urinalysis, and N-terminal pro b-type natriuretic peptide. Conditional orders, such as oxygen support, focused echocardiography, thyroid - stimulating hormone, and the use of vasopressors, diuretics, and venous thromboembolism prophylactic agents, were optimally performed when warranted. However, we noted suboptimal adherence to certain resource-intensive conditional orders, such as hourly monitoring of urine output (61.4%), hooking to cardiac monitor (53.8%), and performance of 12-lead ECG within 10 minutes (56.8%). Further, only 43.9% of patients were referred to the intensive care unit. Troponin I, calcium, magnesium, and albumin were ordered in excess.

CONCLUSION

Overall adherence rate of physicians to the hospital’s Acute Heart Failure Pathway was satisfactory. Work is needed to improve adherence to hourly urine output monitoring, consistent hooking to cardiac monitor, and timely performance of 12-lead ECG – an effort that begins with expanding in-hospital diagnostic equipment and human resource supply. We recommend continuous pathway implementation with periodic evaluation and stakeholder feedback to further improve quality of care.

Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Adult ; Albumins ; Blood ; Blood Urea Nitrogen ; Calcium ; Cardiology ; Chart ; Charts ; Cohort Studies ; Critical Care ; Critical Pathways ; Diagnostic Equipment ; Disease ; Diuretics ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Equipment And Supplies ; Evaluation Studies As Topic ; Feedback ; Heart ; Heart Diseases ; Heart Failure ; Hormones ; Hospitals ; Hospitals, General ; Humans ; Hypertension ; Indicators And Reagents ; Infection ; Infections ; Inpatients ; Intensive Care Units ; Internal Medicine ; Lead ; Magnesium ; Male ; Medicine ; Myocardial Ischemia ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Nitrogen ; Overall ; Oxygen ; Partial Thromboplastin Time ; Patients ; Peptides ; Philippines ; Physicians ; Potassium ; Prothrombin ; Prothrombin Time ; Quality Of Health Care ; Referral And Consultation ; Sodium ; Statistics ; Tertiary Care Centers ; Thorax ; Thromboembolism ; Thromboplastin ; Thyroid Gland ; Time ; Troponin ; Troponin I ; Universities ; Urea ; Urinalysis ; Urine ; Venous Thromboembolism ; Vital Signs ; Work ; Workforce

BACKGROUND AND OBJECTIVE

Evidence base on employment-related medical examinations is highly variable. The aim of this study is to build expert agreement on the appropriate medical and laboratory tests in major industries in Quezon City.

METHODS

An initial scoping review of local, national, and international policies on employment-related diagnostic testing was done. The determination of industries at the selected study site (Quezon City) was accomplished through Pareto analysis. Interviews of key informants and representatives, and a consensus-building process through an expert panel were carried out by the Philippine College of Occupational Medicine (PCOM) Quezon City Chapter. Data gathered was used in the study and analyzed. An initial list of medical tests and diagnostics was drafted and the Modified RAND appropriateness method was used as the choice of mixed methods consensus-building process by an expert panel.

RESULTS

Regulations often vary significantly within settings and implementers, particularly the scope, content, and procedures for medical examinations of workers. History taking (including occupational history) and physical examination are the cornerstones of the screening process. CBC and chest x-ray were deemed appropriate screening laboratory tests for asymptomatic preemployment examination, while only chest x-rays were used during periodic examinations. Additional tests for medical surveillance should be based on job demands and specific exposure. For specific chemical exposure, standard references for medical requirements, like from Occupational Safety and Health Administration (OSHA), can be referred to.

CONCLUSION

A shift in how occupational health and safety measures are implemented is needed, particularly in the pre-employment and periodic examination practices, for more relevant screening while preventing unnecessary and low-yield testing and reducing costs for the employer and the employee. An occupational screening checklist/questionnaire based on the results of the study that includes appropriate clinical history-taking, review of systems (ROS), physical examination, and laboratories must be devised, which is to be followed by training in the proper conduction of these medical assessments.

Occupational Medicine ; Occupational Health ; Public Health ; Preventive Medicine

BACKGROUND

Burn injuries remain a significant global public health problem, causing substantial morbidity, mortality, and economic burden, particularly in low- and middle-income countries where nearly 90% of cases occur. Despite the importance of timely and appropriate first aid in reducing complications, community responses to burn injuries in many settings continue to rely on traditional or non-evidence-based practices.

OBJECTIVES

This qualitative phenomenological study explored community-based knowledge and responses related to the causes and first aid of burn injuries.

METHODS

The study involved ten (10) purposively selected informants residing in South Mangga Dua Urban Village, Central Jakarta, Indonesia. Data collection methods included semi-structured interviews, direct observations, and focus group discussions (FGDs). Thematic analysis was used.

RESULTS

Three (3) core domains were identified: (1) community perceptions of burn causes and classifications, (2) indigenous first aid practices used in domestic settings, and (3) sources of knowledge and information pathways related to burn first aid. Participants commonly attributed burns to incidents involving fire, hot liquids, and electrical faults. Their understanding of burn severity was limited to superficial assessments, with little awareness of clinical classifications. First aid responses were largely based on traditional practices such as the application of toothpaste, honey, or aloe vera, while evidencebased practices like using running water were rarely mentioned. Notably, most participants relied on familial teachings and informal community experiences as their primary sources of knowledge, with limited exposure to health professionals or verified media content.

CONCLUSION

Community knowledge is culturally rooted but misaligned with medical standards, potentially leading to unsafe practices. Culturally sensitive health education integrating traditional beliefs and accurate information is essential to improve outcomes in burn injury management.

Wounds And Injuries ; Residence Characteristics ; Public Health ; Mortality ; Insemination, Artificial, Heterologous ; Income ; Financial Stress ; Burns ; Health Education ; Attitude ; First Aid ; Medicine ; Health Communication ; Urban Population

BACKGROUND

Continuing Medical Education (CME) serves as a cornerstone for maintaining clinical competence and improving patient care. In the Philippines, CME has become increasingly digital, with the UP Med Webinars emerging as a leading platform for physician education over the past decade. Despite this growth, there has been limited evaluation of how well these webinars align with national health priorities, particularly those reflected in PhilHealth hospital admissions and claims data, which provide insights into the country's disease burden and healthcare utilization patterns.

OBJECTIVES

This study aimed to determine the extent to which the topics and reach of UP Med Webinars correspond with the Philippine health system’s most pressing clinical demands. Specifically, it aimed to analyze the trend in number of webinars by year; analyze the distribution of webinar topics by medical field; assess physician attendance as a proxy for clinical interest and engagement; evaluate the alignment between UP Med Webinar content and national health priorities based on PhilHealth’s top conditions, procedures, and reimbursed claims.

METHODS

The study used a qualitative content analysis of all Continuing Professional Development (CPD)-accredited UP Med Webinars from 2015 to 2024, supported by descriptive statistics. Webinar titles were coded thematically and categorized by topic and medical field. Attendance figures were analyzed to identify high-demand topics. These results were compared with PhilHealth Claims Reports (2020–2024), focusing on the top reimbursed medical diagnoses and procedures, to assess alignment with disease burden and health service delivery trends. These findings can help inform strategic planning for CME programs to ensure they remain responsive to the country's evolving public health needs.

RESULTS

From 2015 to 2024, a total of 686 CPDaccredited UP Med Webinars were conducted, attended by 685,994 participants. The annual number of webinars and attendees steadily increased, peaking during the COVID-19 pandemic (2020–2022) with heightened demand for virtual CME and pandemic-related topics. Internal Medicine consistently emerged as the most frequently covered field, accounting for 54.1% of webinars and 48.8% of total attendance, followed by Obstetrics and Gynecology (14.4% of webinars; 19.6% of attendance) and Pharmacotherapeutics (6.0% of webinars; 6.9% of attendance). Certain fields, including COVID-19 and Psychiatry, attracted disproportionately high attendance despite fewer sessions, indicating strong interest during periods of public health urgency. The top 10 webinar topics included Diabetes, Pregnancy, Cancer, Hypertension, Reproductive Health, COVID-19, Heart Disease, Antimicrobial Treatment, Vertigo, and Vaccination, reflecting a mix of chronic disease management, maternal health, infectious diseases, and emergent health concerns.

Comparison with PhilHealth claims data (2020– 2024) revealed a high disease burden in Internal Medicine, Obstetrics, and Pediatrics, with top medical conditions including Pneumonia, Dengue, Hypertensive emergencies, and Stroke. These findings indicate a strong alignment between the most covered webinar topics and national healthcare utilization trends, particularly in high-burden clinical areas.

CONCLUSION

Findings suggest that the UP Med Webinars have generally aligned with national health priorities, as indicated by PhilHealth claims data, particularly in highburden fields such as Internal Medicine and Obstetrics. However, gaps in coverage for certain high-priority conditions and procedures point to opportunities for more inclusive and data-driven CME planning. Aligning CME content with evolving health system needs can enhance its relevance, support clinical practice improvements, and ultimately contribute to better population health outcomes in the Philippines.

Education, Medical, Continuing ; Medicine ; Health Priorities

BACKGROUND AND OBJECTIVE

Identifying the factors and reasons behind medical students’ choice of medical specialty will provide an understanding to the health sectors and may serve as data for interventions necessary to address issues such as manpower allocation. This study aimed determine the factors that affect career interest in emergency medicine among postgraduate interns (PGI) of the University of the Philippines-Philippine General Hospital (UP-PGH).

METHODS

A cross-sectional study was conducted among UP-PGH PGI from August 2022 to June 2023. A website link for the validated questionnaire utilized previously by a similar study among medical students in Saudi Arabia was sent to the respondents which instructed them to choose the top 3 medical specialties that they were interested to pursue. Their top choices were evaluated through a 5-point Likert scale that ranged from 1-no influence to 5-major influence which included factors such as medical lifestyle, social orientation, prestige, hospital orientation, role model and varied wide scope of practice that were further divided into 30 variables. Data analysis was done using one-way ANOVA to compare the factors among specialty groups.

RESULTS

A total enumeration was conducted, involving 161 respondents. Respondents chose the following in order of preference as top choice: primary care (PC) (54.7%), controllable lifestyle (CL) (27.3%), surgical specialties (SS) (16.8%), and emergency medicine (EM) (5.6%). In the EM group, medical lifestyle was ranked the highest influential categorized factor and prestige as the least. The most important individualized factors that influence career interest in EM are acceptable hours of practice, able to spend appropriate time with family and focus on urgent care.

CONCLUSION

EM specialty was the least chosen top specialty among PGI. Medical lifestyle was considered to be the most influential factor among the EM group and prestige as the least. The low number of respondents who expressed interest in EM necessitates active promotion of the specialty to prevent the shortage of emergency physicians in the future.

Human ; Emergency Medicine

Professor LI Zhidao puts forward the application of "group acupoints" in his clinical practice by imitating the mutual reinforcement and mutual assistance of Chinese herbal medicine. It is based on the theory as "where is the acupoint located, what are the indications of this acupoint"; and consists with the specific actions of ancient needling techniques at acupoints. The distribution of "group acupoints" is in line with the "located by the region division of the head and trunk, and by the meridians on the four extremities", which is recorded in Zhenjiu Jiayi Jing (the Systematic Classic of Acupuncture and Moxibustion). It shows "the importance of the relationship between acupoints and zangfu", and "the emphasis on the distribution of nerves and muscles" respectively. In clinical practice, controlling needling sensation is the essence of this technique at "group acupoints", the integration of acupoints and needling technique is the basic requirement, and the step-by-step needling manipulation is critical for obtaining the therapeutic effect. "Group acupoints" combined with specific needling technique advance the application efficiency and the effect of acupoints.
Acupuncture Points ; Acupuncture Therapy/methods* ; Humans ; China ; History, 20th Century ; Meridians ; Medicine in Literature ; Acupuncture/history*

The paper introduces Professor ZHUANG Lixing's academic thought on Daoqi Tongjing (directing qi to preserve essence) needling technique and the clinical experience. Based on Huangdi Neijing (the Yellow Emperor's Inner Classic), Dongyuan needling technique and Professor JIN Rui 's Daoqi Tongjing needling method, and by inheriting the valuable experience from the ancient masters and associating with his own clinical practices, Professor ZHUANG Lixing fully displayes the characteristics of principles, methods, formulas, acupoints and techniques of acupuncture in diagnosis and treatment of diseases. He integrates the thought of regulating the mind with Daoqi Tongjing needling. This needling method focuses on directing qi through mind regulation and needle manipulation, in which, the operation steps are refined. Besides, this needling method involves both the reinforcing and reducing techniques. The satisfactory effect of this needling has been obtained in clinical treatment for many disorders such as qi reversion and disharmony of yin and yang.
Acupuncture Therapy/instrumentation* ; Humans ; Acupuncture Points ; China ; Qi ; History, Ancient ; Medicine in Literature

By analyzing the understandings of water points (acupoints connected with the kidney) and its association with water (kidney), zangfu organs and meridian-collateral recorded in Suwen: Shuire Xue Lun (Discussion on Water and Heat Diseases in Plain Question), it is found that the recognition on the water points is different from that on water diseases in Huangdi Neijing (the Yellow Emperor 's Inner Classic). The recognition on the water points focuses on the core theory, "rooted at the kidney", to explain the water diseases. Besides, in association with the study on the connotation of "luo" in Huangdi Neijing, it is discovered that "yinluo" discussed in water points is actually the misunderstanding of "zang zhi yinluo" that means "the connection by the kidney". It is shown that the discussion of water points refer to the elaboration of zangfu organs and 57 acupoints connected with water (the kidney), rather than the theory of collaterals. The characteristics of these 57 acupoints involved and the related needling techniques provide a new approach to the treatment of zangfu diseases.
Acupuncture Points ; Humans ; Meridians ; China ; History, Ancient ; Medicine in Literature ; Medicine, Chinese Traditional/history* ; Acupuncture Therapy/history*

The paper reviews the evolution of the theory related to meridians and zangfu organs during the Warring States, Qin and Han dynasties, so as to reveal the rules and value of its development. By analyzing historical documents, especially Zubi Shiyimai Jiujing (Moxibustion Classics of Eleven Meridians of Legs and Arms), Yinyang Shiyimai Jiujing (Moxibustion Classic on Eleven Yin and Yang Meridians), Laoguanshan bamboo medical slips of Han Dynasty and lacquer figure of meridian points, the evolutionary stages, i.e. the germination, development, and maturity of meridian-zangfu theory, are explored. In the time of the Warring States, Qin and Han dynasties, the meridian-zangfu related theory was developed from the germination to the maturity. In the classics of the early time, Zubi Shiyimai Jiujing and Yinyang Shiyimai Jiujing demonstrated the preliminary relationship between meridians and zangfu organs, focusing on the physiological connection and pathogenesis of three yin meridians of foot and zangfu organs. In the literature of Laoguanshan bamboo medical slips of Han Dynasty and lacquer figure of meridian points, the physiological connection between the yin meridians of hand and foot, and five zang organs, as well as the related diseases were further clarified; additionally, the meridian-zangfu theory had been developed in the field of diagnosis and treatment. In the era of Chapter of Meridians in Lingshu (Miraculous Pivot), there were up to 31 descriptions relevant with the connection of meridian distribution and zangfu physiological functions. It marks the construction of the "circular" flow of meridians and the interior-exterior communication of zang and fu organs; and enriches the knowledge in diseases, diagnosis and treatment with meridians and zangfu organs involved. The review on the evolution of the meridian-zangfu theory is conductive to supplementing and improving the development history of this theory of early time, and further recognizing its development rules and value. The maturity of this theoretical system not only links the meridians with the five zang and six fu organs, but also provides an important theoretical basis for the diagnosis and treatment of traditional Chinese medicine.
Meridians ; Humans ; History, Ancient ; China ; History, Medieval ; History, 19th Century ; History, 20th Century ; History, 18th Century ; History, 17th Century ; History, 16th Century ; Medicine, Chinese Traditional/history*