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: The Philippine Department of Health (DOH) is mandated by law to, among others, develop capacities and accredit physicians and rehabilitation practitioners across the country on the assessment and management of drug dependence. This paper describes the design and presents the outputs of an advanced course on screening and assessment of drug dependence developed by DOH in partnership with the College of Public Health of the University of the Philippines Manila, Philippine College of Addiction Medicine, and the Group for Addiction Psychiatry of the Philippines.

Methodology: Review, abstraction and synthesis of data from training-related documents and records for the training activities implemented in 2014.

Results: The Level 2a course is a five-day program that focuses on enhancing the skills of physicians and rehabilitation practitioners on the screening and assessment of drug dependence using team-based and practical learning approaches, and builds on learnings from the basic accreditation course. A total of 36 participants from ten Drug Abuse Treatment and Rehabilitation Centers (DATRCs) in nine regions completed the pilot implementation of the course in 2014. In general, the overall participant feedback on the training was mainly favorable based on data from 47% of participants who agreed or strongly agreed to statements on the relevance and attainment of the course aims (mean rating of 1.10±0.31, 1 = Strongly agree, 5 = Strongly disagree), and the appropriateness of its content (1.24±0.43) and design (1.18±0.39). A paired-samples t-test comparing scores for 44% of participants showed that there was a highly statistically significant difference in the pre-test (54%±13%) and post-test scores (69%±10%); t(16)=6.4240, p <0.0001.

Conclusion: Development and design of capability-building initiatives in the field of drug rehabilitation will necessitate alignment with practice standards, grounding in the real-world setting in which professionals work, and orientation towards practical learning.

Background: 'Inter-organizational collaboration' and 'partnership' have been emphasized in drug treatment and rehabilitation over the decades. Nevertheless, the synthesis of knowledge of related arrangements has been limited in scope. This study fills a gap by systematically reviewing the features, outcomes, facilitators, and barriers of inter-organizational collaborations in drug rehabilitation to propose insights to improve policy and practice. Methodology: This review is based on searches of MEDLINE, CINAHL Complete, Embase, and PsychINFO databases. All retrieved papers were independently screened and underwent quality assessment based on the protocol proposed by Peters et al. (2017). Data charting from the included sources was performed using NVivo. Results: A total of 5,631 unique records were retrieved, of which 54 were included in the analysis. Most of the papers were published between 2011 and 2019, and primarily described, or tested, a collaborative activity from a case study or survey research. Treatment services were often partnered with public health, primary care, or social service organizations. The outcomes of initiatives were commonly about the increase in service utilization or the enhancement of service provision. Facilitators and barriers to collaboration were reported by two-thirds of the papers, which primarily pertained to contextual or organizational dimensions. Conclusion This piece of evidence provides good descriptive content on what, how, and how well the interorganizational collaborations have been conducted in drug treatment and rehabilitation. Implications for promoting good practices that range from University education, staff exchange, and incentives to support by governments are discussed.
Intersectoral Collaboration ; Substance-Related Disorders ; Substance Abuse Treatment Centers

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

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

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

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

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

Adult ; China ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Substance Abuse Treatment Centers ; statistics & numerical data ; Substance-Related Disorders ; therapy ; Surveys and Questionnaires ; Violence ; statistics & numerical data