A singular medical incident can alert health officials to an emerging, if not widespread, but possibly undetected publichealth concern.

Our issue contains a remarkable case of a ruptured hepatic abscess in a 3-year-old, which turned out to be MethicillinresistantStaphylococcus aureus (MRSA) by authors Torrico and Tarnate.The concern is that the infection is communityacquired,and the patient was immunocompetent. This sounds the alarm for the occurrence of antimicrobial resistance (AMR)in the communities and calls for a response from health authorities to investigate, analyze, and propose solutions for sucha sentinel event.

We need to support these efforts and, in this issue, we publish such work from our investigators. Antimicrobial resistanceis an urgent global health concern.The impact is magnified in low to middle-income countries where health risks are high,and health infrastructure is weak. Thus, it is imperative that determinants of AMR are scrutinized to allow crafting offocused strategies to combat the problem.

The article by Dela Cruz and Hernandez on the prevalence and practices of antibiotic misuse among adult residents ofRodriguez, Rizal, contributes to this analysis.The paper reveals a disturbing prevalence of self-medication and identifiesbarriers to accessing proper health education and care. This is a global problem, and the paper from Brazil relates the observationof community pharmacists of antibiotic misuse to the rise of antimicrobial resistance.

Dela Cruz and Hernandez recommend stricter antibiotic regulation, and this falls squarely into the scope of concernof another article in this issue, the “Research Needs in Philippine Pharmaceutical Sciences: A Qualitative Perspective fromRegulatory and Clinical Research Sectors of the Pharmaceutical Industry” by Pena and co-authors.Interestingly, whiledrug registration and clinical trials were the focus of the paper, it may be a desired expansion of the regulatory reach of theindustry to temper the use of antibiotics as it is being dispensed to end users.Antimicrobial stewardship involves ethicalpromotion of use and equitable access to appropriate treatment, and these concerns require the responsible participation of thepharmaceutical industry.

Health challenges are complex. The analysis of these challenges requires surveillance of literature for sentinel events, useof community-based research to investigate phenomena, and system mapping to identify relevant sectors to improve strategyand to involve relevant stakeholders.

We support this type of scholarship, which seeks to expand the focus from isolated clinical interventions towards placinga spotlight on relevant work that will lead to impactful reform of broad health ecosystems.

Introduction: The increasing prevalence of diabetes represents a significant global health challenge. Modifiable risk factors, including physical inactivity, unhealthy dietary habits, and obesity contribute substantially to this rising burden. In conjunction with the 2025 World Diabetes Day (WDD) campaign focusing on “diabetes and the workplace,” we assessed diabetes risk among healthcare workers in our hospital using the Modified Asian Finnish Diabetes Risk Score (ModAsian FINDRISC). Methodology: Healthcare workers from various departments were invited to participate in the hospital WDD celebration. A total of 286 attendees underwent anthropometric measurements and completed the ModAsian FINDSRIC questionnaire. Descriptive statistics were used to summarize the prevalence of risk factors and overall diabetes risk. Results: The participants included doctors, nurses, allied healthcare professionals, as well as hospital support and administrative staff. The majority of participants (74.8%) were aged below 45 years. 39.2% were overweight while 30.8% were obese. One-third (37.4%) had increased waist circumference (WC) (≥90 cm for men, ≥80 cm for women). Additionally, 20% of respondents reported being on antihypertensive medication, and 23.8% had previously recorded high blood glucose. A family history of diabetes mellitus (DM) was reported by 62.6% of respondents. Additionally, about onethird were sedentary with less than 30 minutes of daily exercise or physical activity, another one-third did not consume fruits or vegetables on a daily basis. The median ModAsian FINDRISC score was 8, with approximately 30% of them classified as having moderate to very high risk of developing DM (moderate: 17.5%; high: 10.8%; very high: 2.8%). Conclusion These results revealed high metabolic risk in healthcare workers and highlight the need for targeted workplace health promotion strategies to reduce the risk of developing diabetes.
Tertiary Care Centers ; Health Personnel ; Diabetes Mellitus

BACKGROUND AND OBJECTIVES

Ensuring the total well-being of healthcare workers (HCWs), including their mental health and psychological well-being, is an essential aspect in the delivery of patient care and the preservation of the health workforce. This study aimed to determine the level of mental well-being and emotional state of HCWs in terms of depression, anxiety, and stress using the DASS-21 scale in a tertiary government hospital during the COVID-19 pandemic in the Philippines and to identify the job-related factors that may be associated with these outcomes.

This is an analytical, cross-sectional study among HCWs involved in direct patient care in a tertiary government hospital in the Philippines during the COVID-19 pandemic. Data collection was conducted from February to March 2022 through an online self-administered questionnaire, which included the Demand-Control-Support Questionnaire (DCSQ), and the 21-item Depression Anxiety Stress Scale (DASS-21). This was sent to doctors, nurses, and allied medical workers actively working in the clinical areas. All responses were collected and analyzed.

Three hundred sixty-four healthcare workers were included in the study. Majority were single (62.62%), living with immediate family (50.82%), and working in a COVID-designated area (62.09%). High prevalence of depression (49.18%), anxiety (61.54%), and stress (30.22%) was found among the HCWs. Work in high infection/COVID-designated areas was significantly associated with anxiety and stress, and high-job demand was significantly associated with all three mental health states compared to low job-demand.

Focus should be placed on modifying the condition of high job demand among healthcare workers working in hospitals. This includes ensuring optimum staffing levels and patient to HCW ratio which avoids HCWs from being subjected to high workloads and time pressures that subsequently increase risk for stress, anxiety, and depression.

OBJECTIVES

While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients.

Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes.

We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days.

We found that being an HCW is not associated with worse neurologic and clinical outcomes among patients hospitalized for COVID-19.

OBJECTIVES: Obtaining informed consent from research participants is an ethical and legal obligation for medical researchers in clinical studies. Electronic informed consent (eIC) is increasingly being adopted in clinical research worldwide. However, there is limited data on Chinese medical researchers' knowledge and attitudes toward eIC. This study aims to investigate their knowledge, attitudes, and influencing factors regarding eIC use in clinical research. METHODS: This cross-sectional study was conducted using stratified random sampling. From June to August 2022, medical researchers from 8 tertiary hospitals were surveyed via an online platform (Wenjuanxing). A self-developed eIC knowledge questionnaire and attitude scale were used to assess participants' understanding and perceptions of eIC. Univariate analysis was employed to explore factors influencing attitude scores and the correlation between knowledge and attitudes. A generalized linear model was used to analyze associations between demographic characteristics and attitude scores, including the frequency of difficulties in using smartphones or computers, preferred device for using eIC, and their interaction effects. Stratified analysis was further performed for significant interactions. RESULTS: A total of 399 valid questionnaires were collected. The mean accuracy rate on the eIC knowledge questionnaire was (94.88±15.50)%. Of the respondents, 74.9% had heard of eIC, and 84.5% preferred using mobile devices over computers to access eIC. The median attitude score was 3.41 (3.18, 3.76), indicating generally positive attitudes. Specifically, 81.7% found eIC more convenient than paper-based consent, 79.7% considered it more efficient, and 51.1% believed it could fully replace paper forms. However, 60.7% expressed concerns about data security and privacy, and 89.7% believed that relevant laws and regulations need improvement. Spearman correlation analysis showed a weak positive correlation between knowledge and attitude scores (r=0.171, P=0.001). Univariate analysis indicated that the frequency of difficulty using devices and preferred device for eIC were significantly associated with attitude scores (P<0.05). After adjusting for confounding factors, the generalized linear model demonstrated that participants who occasionally experienced had difficulty using devices had significantly lower attitude scores compared to those who never had difficulty (β=-0.040, 95% CI -0.071 to -0.009, P=0.012). Those who preferred using PCs had significantly lower attitude scores than those who preferred mobile devices (β=-0.066, 95% CI -0.108 to -0.023, P=0.002). Interaction analysis showed a significant interaction analysis showed a significant interaction between age and preferred device (P=0.011), particularly among participants aged ≥45-year (P<0.001). No other interactions were found to be significant (all P>0.05). CONCLUSIONS Medical researchers in China generally have a high level of knowledge and positive attitudes toward eIC, though concerns remain regarding data security and privacy. Future promotion of eIC in Chinese clinical research should be grounded in ethical considerations and address the specific needs of older users and mobile device users, while also enhancing researchers' competencies in using digital tools and eIC systems.
Humans ; Cross-Sectional Studies ; Informed Consent ; Surveys and Questionnaires ; Female ; Male ; Health Knowledge, Attitudes, Practice ; Adult ; Biomedical Research ; Research Personnel/psychology* ; Middle Aged ; China

Objective To understand the willingness of general practitioner(GP) to enhance working competence in community healthcare centers in Shanghai and provide a basis for the competence training of GPs in community healthcare centers. Methods In August 2023,GPs were selected from some community healthcare centers in Shanghai and their willingness to enhance working competence were studied by a questionnaire survey.The survey included 39 secondary indicators in three dimensions:general practice theory,skills,and humanity. Results A total of 1 192 GPs completed the questionnaire,with an effective rate of 100%.The total score of GPs' willingness to enhance their working competence was 258.45±80.93,and the mean score of the three dimensions was 6.63±2.08.The score for the general practice theory was the highest (6.92±1.95),while that for general practice humanity was the lowest (6.44±2.34) among the three dimensions.The score of willingness to enhance working efficiency differed across different age ranges (P<0.001),professional titles (P<0.001),years of work (P<0.001),and educational backgrounds of GPs (P=0.039).Those with the age younger than 30 years old,junior professional titles,less than 5 years of work experience,and a college degree or below had the highest willingness score to enhance their working competence.Among the top three secondary indicators of willingness score in each dimension,the top three methods of working competence enhancement were community general practice and specialized healthcare services combined with outpatient learning,flexible further training,and continuing education courses.Conclusions There is an urgent need for young GPs in community healthcare centers in Shanghai to enhance their working competence.Targeted enhancement plans can be provided to different groups of GPs with different characteristics through community general practice and specialized healthcare services combined with outpatient learning,flexible further training,and continuing education courses,which can further enhance the ability and quality of the GP team.
Humans ; China ; General Practitioners/psychology* ; Surveys and Questionnaires ; Community Health Centers ; Clinical Competence ; Female ; Adult ; Male ; Attitude of Health Personnel ; Middle Aged

Objective To investigate the key factors influencing the implementation of long-acting injection-promoting policies and propose effective improving paths.Methods Qualitative interviews were carried out for stakeholders involved in the promotion of long-acting injections,based on the consolidated framework for implementation research.Additionally,countermeasures for identified barriers were proposed based on expert recommendations for implementation changes.Results A total of 46 health administrators,healthcare workers,and patients in Beijing were interviewed.The study identified several barriers in the strength and quality of evidence,adaptability,relative advantage,complexity and cost,patient needs and resources,external collaboration,external policies and incentives,organizational structural characteristics,and self-efficacy.Conclusions From the perspectives and experiences of stakeholders,the promotion of long-acting injections has shown initial success but still faces multiple obstacles.It is recommended that efforts should be made to coordinate and adapt policies,improve and incentivize relative organizations,and continuously strengthen the advocacy and education for individuals.
Humans ; Beijing ; Delayed-Action Preparations ; Health Personnel ; Health Policy ; Injections

INTRODUCTION

This cross-sectional study investigated the relationship between work stress and dysglycemia among healthcare workers engaged in shift work at a level 1 government hospital in Antipolo City, Philippines.

Work stress was assessed using the Effort-Reward Imbalance (ERI) Questionnaire, and dysglycemia was measured through a 75g oral glucose tolerance test (OGTT).

A total of 126 healthcare workers aged 20–55 years participated Results showed that 65.1% of participants experienced work stress, with nurses reporting the highest prevalence (43.9%). Dysglycemia was present in 33.3% of participants, predominantly in the form of impaired glucose tolerance. Despite the high prevalence of both work stress and obesity (61.9%), no statistically significant associations were found between work stress and dysglycemia (p = .51), gender and work stress (p = .59), occupation and work stress (p = .059), or obesity and dysglycemia (p = .70).

The findings suggest that while work stress is common among healthcare workers, especially nurses, it may not directly predict dysglycemia in relatively young and active populations. However, the long-term metabolic risks associated with chronic occupational stress should not be overlooked. Future longitudinal studies with larger samples are recommended to better assess causality and guide workplace wellness programs.

BACKGROUND

This study explored the indigenous knowledge practiced by the traditional Panday in the care of pregnant Meranaw mothers during intrapartum care and how it is perceived by the midwives and the mothers. In analyzing their perspectives, qualitative method of research known as descriptive exploratory research design was utilized. The study gathered insights from 51 individuals.

Data collection methods included interview and observations through thematic content analysis. Four themes emerged: traditional Panday, practices in intrapartum care, midwives' perceptions of traditional Panday, reasons for home births among mothers, and suggested policies and programs for traditional Panday, and mothers.

Data revealed that most traditional Panday, exhibit satisfactory intrapartum care practices, which closely resemble those used in hospitals, indicating their capability to conduct safe home births. Some traditional Panday, demonstrate remarkable skills, such as identifying fetal position and even turning breech babies into the cephalic position during critical labor stages. The integration of herbal methods and Islamic practices, such as the recitation of Azan to the baby's ear, further distinguishes their approach. Regarding midwives' perspectives, opinions varied, with some viewing traditional Panday, as dependable partners, while others perceive them as threats to maternal safety. However, most midwives advocate for finding solutions and improving access to care rather than viewing traditional Panday, as obstacles.

Mothers' preference for home births is attributed to factors such as comfort, privacy, and financial considerations. Traditional Panday, are valued for their modest fees and cultural sensitivity, as they prioritize the well-being and modesty of women in their care.

Contraceptive Agents ; Health Personnel ; Primary Health Care ; Philippines